两种灭菌方法对新生儿脐带套安全性能的影响

目的 探讨新生儿脐带套的安全有效灭菌方式.方法 将由气门芯、索线制作成统一规格的脐带套800根均分为改良组和传统组,改良组采用预真空压力蒸汽灭菌器灭菌8 min,传统组煮沸15 min后置75%乙醇溶液浸泡备用,两组有效期均为2周.结果 有效期内传统组消毒灭菌合格率84.00%,改良组合格率100%,差异有统计学意义(P＜0.01);两组跨越实验合格率和拉力比较,差异无统计学意义(均P＞0.05).结论 采用预真空压力蒸汽灭菌法对脐带套灭菌效果可靠,不影响脐带套的拉力,可替代传统方法 .     

真空式压力蒸汽灭菌器工作性能及灭菌效果监测进展

总结目前真空式压力蒸汽灭菌器工作性能及灭菌效果监测进展情况，以便采用更先进、更科学的监测方法对真空式压力蒸汽灭菌嚣工作性能及灭菌效果进行监测，保障医疗安全。对目前真空式压力蒸汽灭菌器工作性能及灭菌效果监测情况进行总结综述。提出真空式压力蒸汽灭菌器工作性能和灭菌效果监测已由原来的不够严谨和复杂难做，发展到越来越科学完善和简便易行，为灭菌效果100％合格提供了可靠的保障。提示随着社会经济的发展和人们生活水平的提高，真空式压力蒸汽灭菌将会被更广泛地使用，其工作性能和灭菌效果监测手段也将会更加先进和科学。     

真空式压力蒸汽灭菌器工作性能及灭菌效果监测进展

总结目前真空式压力蒸汽灭菌器工作性能及灭菌效果监测进展情况,以便采用更先进、更科学的监测方法对真空式压力蒸汽灭菌器工作性能及灭菌效果进行监测,保障医疗安全.对目前真空式压力蒸汽灭菌器工作性能及灭菌效果监测情况进行总结综述.提出真空式压力蒸汽灭菌器工作性能和灭菌效果监测已由原来的不够严谨和复杂难做,发展到越来越科学完善和简便易行,为灭菌效果100%合格提供了可靠的保障.提示随着社会经济的发展和人们生活水平的提高,真空式压力蒸汽灭菌将会被更广泛地使用,其工作性能和灭菌效果监测手段也将会更加先进和科学.     

两种脐带护理方法的临床观察

目的:通过比较两种脐带护理方法的效果,探究怎样促进新生儿脐部早日愈合.方法:将1000名新生儿随机分为对照组450例和试验组550例,对照组新生儿脐部采用气门芯和脐带夹双重结扎法,脐带残端用0.5%碘伏消毒后包裹无菌敷料,24h后去掉敷料,试验组新生儿脐部同样采用双重结扎法,脐带残端用20%高锰酸钾溶液烧灼后暴露,两组新生儿每日沐浴后用75%酒精消毒,观察两组新生儿脐带愈合情况。结果:试验组新生儿在脐部红肿、脐部出血和脐周渗出物方面优于观察组,在脐带干燥和脱落时间上优于观察组,两组资料经统计学检验P<0.05具有显著意义。     

不同脐部护理方式对新生儿脐炎发生率与脐带脱落时间影响的网状Meta分析

目的 评价不同脐部护理方式对新生儿脐炎发生率与脐带脱落时间的影响,为选择合适的脐部护理方法提供参考.方法 计算机检索PubMed、Web of Science、Cochrane Library、EMbase、中国生物医学文献数据库、中国知网、万方数据库及维普数据库、中国/美国临床注册中心,检索时限为建库至2020年9月...     

两种消毒方法对静脉留置针贴膜固定效果的影响

目的比较两种不同的消毒方法对留置针贴膜固定效果的影响。方法将220例静脉留置针患者随机分为实验组(120例)和对照组(100例),实验组留置针穿刺前采用0.2%碘伏消毒后75%乙醇脱碘,对照组仅采用0.2%碘伏消毒。结果实验组留置针固定效果显著优于对照组(P0.01)。结论静脉留置针穿刺前采用0.2%碘伏消毒后75%乙醇脱碘的消毒方法能提高留置针贴膜固定效果,减少留置期间贴膜卷边和起泡现象。     

胎儿窘迫为指征的剖宫产两种椎管内麻醉方法对新生儿影响的比较

目的:观察腰-硬联合麻醉(CSEA)和硬膜外麻醉(EA)在胎儿窘迫为指征的剖宫产术中对新生儿评分及脐静脉血血气值的影响,比较这两种椎管内麻醉方法的优劣.方法:把我院2009年01月～2009年03月所行60例胎儿窘迫为指征的剖宫产随机分为两组:A组用CSEA,B组用EA.观察新生儿出生时、1、5、10min Apgar评分及娩出后脐静脉血血气值.结果:A组与B组在新生儿出生时1min Apgar评分及娩出后脐静脉血气值差异有统计学意义(P<0.05).结论:CSEA可快速解除胎儿宫内窘迫状况,减轻对新生儿的影响,优于EA,可视为胎儿窘迫为指征的剖宫产首选的麻醉方法.     

两种吸痰方法对气管插管早产儿SpO2及HR的影响

目的比较密闭式吸痰法(CSS)与开放式吸痰法(OSS)对早产儿SpO2及HR的影响。方法将34例气管插管早产儿采取掷硬币法随机分为OSS组18例和CSS组16例,分别采取OSS和CSS,比较两组吸痰前后SpO2、HR值变化。结果 CSS组吸痰过程中SpO2下降幅度显著小于OSS组,SpO2恢复时间显著短于OSS组(均P0.05),HR增快幅度及恢复时间亦小于和短于OSS组。结论对早产儿采用CSS有利于SpO及HR值的稳定。     

冻存对人脐血间充质干细胞生物学特性的影响

目的观察冻存复苏对人脐血（human umbili calcord blood）间充质干细胞（mesenchymal stem cells，MSCs）生物学特性的影响。方法体外分离、培养人脐血MSCs，传代后，将第3代的MSCs加入含10％二甲基亚砜（DMSO）和90％胎牛血清的细胞冻存液中，-196℃液氮保存4周，观察比较冻存前及冻存复苏后MSCs的形态、增殖及多向分化能力。结果冻存前及冻存复苏后，MSCs形态无明显差别，均呈典型的梭形，MSCs贴壁生长；MSCs生长曲线相似，冻存复苏后的细胞生长曲线略有下降，但差异无统计学意义（P〉0．05）；MSCs经脂肪诱导液诱导2周后，细胞浆中出现脂肪细胞所特有的脂肪滴，经0．5％油红0染色，脂肪滴染为红色，说明MSCs有向脂肪细胞分化的能力；Mscs经成骨诱导液诱导4周后，VonKossa染色可见黑色的矿化结节沉积，钙结节的形成为成骨细胞特有，说明Mscs有向成骨细胞分化的能力。提示冻存复苏后Mscs经诱导仍然可以向脂肪细胞和成骨细胞分化，与冻存前无明显差异。结论人脐血MSCs经冻存复苏后，其生物学特性可获良好保持。     

断脐时机对母婴结局影响的研究

目的研究断脐时机对母婴结局的影响。方法选取阴道试产的健康足月初产妇随机分为三组,早断脐组(n=108)断脐时机为胎儿娩出即刻至60s,晚断脐1组(n=92)断脐时机为胎儿娩出60~120s,晚断脐2组(n=68)断脐时机为胎儿娩出120s或至脐带停止搏动。追踪至婴儿6月龄。结果三组产妇胎盘剥离时间、产后2h出血量比较,差异无统计学意义(均P0.05)。三组新生儿出生后第4天血红蛋白含量存在统计学差异,晚断脐2组显著高于早断脐组、晚断脐1组(均P0.05)。三组婴儿6月龄血清铁蛋白含量比较,差异有统计学意义(P0.05),晚断脐2组显著高于早断脐组、晚断脐1组(均P0.05)。结论胎儿娩出2min后或脐带停止搏动时断脐不影响分娩进程及产后出血,可提高新生儿血红蛋白水平和6月龄血清铁蛋白含量。     

人脐带间充质干细胞移植治疗晚期外伤性癫痫

目的探讨人脐带间充质干细胞移植治疗晚期外伤性癫痫的临床价值。方法对31例晚期外伤性癫痫患者进行人脐带间充质干细胞移植,观察临床效果。结果癫痫发作完全消失或仅有先兆者21例,极少发作(≤3次/年)者5例,发作明显改善(减少≥75%)者4例,无明显改善(减少<75%)者1例,满意率83.87%。结论人脐带间充质干细胞移植对治疗外伤性癫痫具有较好的效果。     

人脐带间充质干细胞向血管内皮祖细胞诱导分化的实验研究

目的探讨人脐带间充质干细胞定向诱导分化为血管内皮祖细胞的可行性,为构建组织工程血管瓣膜内皮化提供新的细胞来源。方法无菌条件下取剖宫产新生儿脐带,复合胶原酶消化法获取脐带间充质干细胞进行培养,以流式细胞仪检测脐带间充质细胞的表面标志。取扩增3～6代的脐带间充质干细胞用VEGF和b-FGF诱导分化。用免疫荧光法鉴定内皮祖细胞的标志。结果脐带间充质干细胞可以诱导分化为血管内皮样细胞,表达CD34、CD133和vWF,且Dil-acLDL实验阳性。结论脐带间充质干细胞可以诱导分化为血管内皮祖细胞,可为构建组织工程血管瓣膜提供新的种子细胞来源。     

碘酊乙醇棉签擦拭瓶盖的数量及放置时间对消毒效果的影响

目的 探讨2％碘酊、75％乙醇棉签安全消毒瓶盖的数量及消毒后安全放置的时间。方法 将0.9%氯化钠注射液（500ml)180瓶扮为6组，每组30瓶，均用1根碘酊棉签消毒、1根乙醇棉签脱磺，连续消毒6个瓶盖，分别取样行细菌培养。另取同样液体150瓶，分为A、B、C、D、E5组，每组30瓶，1根碘酊、乙醇棉签消毒1个瓶盖，分别于消毒后放置0．5、1、2、4、6min取样行细菌培养。结果 1根碘酊、乙醇棉签连续消毒至第4个瓶盖时污染数明显增加（P＜0．05）。消毒后放置4min时污染数明显增加（P＜0．05）。结论 1根2％碘酊、75％乙醇棉签连续消毒3个瓶盖，消毒后放置2min最为安全。     

长期体外培养对人脐血间充质干细胞成骨分化潜能的影响

目的观察体外长期培养对人脐血间充质干细胞（Human umbilical cord blood derived mesenchymal stem cells,UCB-MSCs）成骨分化潜能的影响,探讨其作为组织工程骨种子细胞的可行性。方法流式细胞技术观察长期体外培养的UCB-MSCs细胞表面抗原表达的变化规律,并通过Alizarin Red染色及碱性磷酸酶活性、骨钙蛋白含量和钙离子含量的检测观察长期体外培养对UCB-MSCs成骨特性的影响。结果第10代之前的UCB-MSCs能够高表达间充质干细胞表面标志物,7代之前的细胞体外增殖能力不随传代次数而发生明显变化。Alizarin Red染色及碱性磷酸酶活性、骨钙蛋白含量和钙离子含量的检测显示8代之前的UCB-MSCs仍能保持较强的成骨分化能力。结论7代之前的UCB-MSCs能保持稳定的体外成骨分化特性,有望成为较理想的组织工程骨种子细胞。     

The Effect of Sterilization Methods of Endoscopic Instruments on the Body: A Study on Rat Model

Purpose: Laparoscopy is widely used in many surgical areas for diagnosis and treatment. The need for sterilization of reusable instruments is an important issue. Ensuring patient safety, preventing infection, and protecting the functionality of the instruments are the most important points to be considered. We aimed to investigate two sterilization methods and their effects generated by their distribution into intra-abdominal tissues during insufflation. Materials and Methods: 21 rats were used in the study. The Control Group (Group 1) received anesthesia for 1 hour; Group 2 (Glutaraldehyde (GA)-Pneumoperitoneum Group) received anesthesia for 1 hour; Group 3 (Ethylene Oxide (EO)-Pneumoperitoneum Group) received anesthesia for 1 hour. After 24 hours, the animals were sacrificed, and the kidneys and omentum of the animals were analyzed in a histopathological manner. Blood samples were analyzed at preoperative 24th hour and at postoperative 24th hour. Results: There was a statistically significant difference in omentum, endothelium, and glomerular scores between the groups (p < 0.001 for all groups). Endothelial and glomerular scores were different at a statistically significant level in the EO and GA groups compared to the Control Group. The total score was higher at a statistically significant level in the EO and GA groups compared to the Control Group (p < 0.001 for both groups). Conclusion: It was determined in our study that sterilization methods such as EO and GA cause damage in intra-abdominal tissues. In the light of these results, we consider that the most ideal laparoscopic surgery set is the single-use laparoscopy set. However, this does not seem possible especially in developing countries in practice.     

Effect of Oral Ciprofloxacin on Bacterial Flora of Perineum,Urethra, and Lower Urinary Tract in Men with Spinal Cord Injury

Abstract

A study was performed in 25 men with spinal cord injuries undergoing intermittent catheterization whose urine had > 1Cf’ bacterial colonies/ml to determine efficacy of ciprofloxacin in eradicating susceptible organisms from urine, urethra, and perineum. Cultures were obtained prior to, during, and 5 to 7 days after administration of 500 mg twice daily for 10 days. Organisms in urine were also present in the urethra and/or perineum in 20 cases. Susceptible bacteria disappeared from urine in all subjects; but at follow-up 12 had cultures positive for ciprofloxacin-resistant Gram-positive cocci, including 1 with methicillin-resistant Staphylococcus aureus (MRSA), and 2 with ciprofloxacin-resistant Acinetobacter sp. Treatment significantly reduced Gram-negative bacilli in perinea and urethras, but ciprofloxacin-susceptible organisms were replaced by resistant staphylococci, including MRSA, enterococci, and Acinetobacter sp. We support use of ciprofloxacin for treatment of urinary tract infections in persons with spinal cord injury, but in view of supercolonization with resistant organisms, the drug should be reserved for symptomatic persons not likely to respond to other oral agents.     

Fertility of Spinal Cord Injured Males: Effect of Genitourinary Infection and Bladder Management on Results of Electroejaculation

ABSTRACT

Thirty-eight men undergoing electroejaculation (EEJ) procedures for anejaculatory infertility were examined for the presence or absence of infection in urine and semen. In 29 spinal cord injury patients, a high incidence of infected urine and infected semen (41% and 56%, respectively) was seen, in contrast to patients with normal bladder function (0% and 11 %).

Urinary infection was associated with slightly lower sperm quality and lower pregnancy rates (10% vs 30% in the presence of sterile urine). Semen infection had no effect on sperm counts or pregnancy rates. If intermittent self-catheterization (ISC) was used to empty the neurogenic bladder, slightly better sperm quality was seen, the total failure rate was less, and much better pregnancy rates (44%) resulted than for patients using an alternative bladder management (7%).

Antibiotics did not reduce the incidence of urine or semen infection, but did improve sperm counts slightly. Continuous prophylaxis was associated with bacterial resistance to many oral antibiotics and had no advantage over a short course of antibiotics prior to the procedure.

Despite the above associations, the sperm quality in our patient population was never normal compared with that of men who ejaculate normally. We conclude that the low sperm quality seen in electroejaculation specimens from spinal cord injured males is not due entirely to infection or to the type of bladder management. Short courses of antibiotics, instead of continuous antibiotic prophylaxis, may be beneficial. Intermittent catheterization is superior to other methods of neurogenic bladder management in maintaining the fertility of spinal cord injured men.