酸性氧化电位水与戊二醛对消化内镜消毒效果的比较研究

目的研究酸性氧化电位水(简称酸化水)消毒内镜及其附件的应用价值. 方法将HBsAg阳性血清和真菌、大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌等常见致病菌稀释液注入胃镜活检孔道内使其污染,对消毒前、后标本进行各个时间段检测;随机抽取胃和结肠镜受检者20例,用酸化水和戊二醛分别进行消毒,并行菌落计数检测和致病菌培养. 结果酸化水30 s可杀灭乙肝病毒,戊二醛需10 min;酸化水1～3 min可杀灭细菌及真菌,戊二醛需3～15 min. 结论酸性氧化电位水消毒内镜高效、迅速、安全,值得推广.     

酸性氧化电位水在心胸外科的应用

目的研究并验证酸性氧化电位水(EOW)在心胸外科的应用及效果。方法参照卫生部《消毒技术规范》,对医务人员手、物体表面、诊疗用品及病房内空气采用EOW进行现场消毒试验,并与消毒前样本(阳性对照组)对比分析。结果对60人次医务人员手消毒作用1min,消毒前后平均杀灭对数值1.934;对物体表面消毒作用5min,消毒前后平均杀灭对数值2.638;对使用后诊疗用品常规清洗处理后流动浸泡5min,消毒前后平均杀灭对数值2.892;对病房内空气按照15ml/m3剂量进行喷雾消毒,消毒前后杀灭对数均值1.619;各试验组消毒前后杀灭对数值均1,判定为消毒合格。结论 EOW具有环保、安全的优点,适合于心胸外科的应用。     

酸性氧化电位水消毒医疗器械的效果观察

目的 了解酸性氧化电位水(EOW)对医疗器械的消毒效果.方法 采用稳定性试验,测量有效氯含量及pH值;将含氯消毒剂作为对照组,与酸性氧化电位水试验组进行对比,计算消毒后的细菌杀灭率.结果 浸泡器械前测量EOW的pH平均值和有效氯含量平均值,与浸泡器械后测量的两组平均值差异无统计学意义;实验室存放7、14 d,有效氯分别下降了32%、46%,但其pH值变化不明显;EOW消毒医疗器械5 min,细菌杀灭率为100.0%;含氯消毒液消毒医疗器械30 min,细菌杀灭率为100.0%,两者杀菌效果相同,但EOW的时间明显短于含氯消毒液.结论 酸性氧化电位水可用于医疗器械的消毒,其杀菌效果好、作用快速,节约资源优于含氯消毒液.     

氧化电位水对口腔器械消毒效果的探讨

目的 评价氧化电位水（EOW）对口腔器械污染菌的消毒效果。方法 以临床使用后的扩大针和高速手机为对象，扩大针分别用EOW和2％戊二醛消毒，手机分别用EOW消毒和高温高压灭菌，于消毒前、后采样，细菌培养，菌落计数。结果 对扩大针消毒10min，两种消毒剂的消毒合格率均达100％，对手机采用两种消毒方法均可全部杀灭其表面和冷却水管内污染菌，但EOW组不采用内部冲洗时，手机内部冷却水管内仍有大量细菌生长。结论 EOW消毒可达与2％戊二醛浸泡消毒、高温高压蒸汽灭菌同样可靠的消毒效果。     

2007～2008年大连市部分医院消化内镜污染状况调查

[目的]了解大连市医院使用的胃镜和肠镜消毒现状,进一步规范消毒操作方法,提高消毒质量。[方法]20072008年对大连市17所二级以上医疗机构的胃镜、肠镜进行消毒效果检测。[结果]20072008年合计检测胃、肠镜内腔64件,细菌总数合格率为68.75%,其中胃镜合格率为73.47%,肠镜合格率为53.33%（P〉0.05）。检测内镜活检口27件,细菌总数合格率为70.37%,其中胃镜活检口合格率为89.47%,肠镜活检口合格率为2/8（P=0.002）。检测使用中的内镜消毒剂戊二醛有效含量24件,合格率为87.50%;测定8件样品的消毒剂染菌量,全部达到标准。[结论]大连市部分医院胃镜和肠镜消毒效果不佳,消毒剂的使用存在问题。     

新型复方戊二醛杀菌效果观察

目的了解一种新型复方戊二醛消毒液实际应用的杀菌效果及其他相关性能。方法采用问卷方法调查山东利尔康消毒科技有限公司研发的新型低味低泡复方戊二醛的气味和泡沫;用胃镜、医疗器械的现场消毒试验及连续使用稳定性杀菌试验检测该消毒液杀灭微生物的效果。结果与普通戊二醛消毒液相比,该新型复方戊二醛低味、低泡;使用中戊二醛消毒浸泡器械3、7、14 d后,其戊二醛含量平均下降率分别为1.06%、2.28%、5.58%;胃镜在该戊二醛消毒液中浸泡1 h,经检测,细菌总数平均为9个,无致病菌;浸泡10 h后,细菌总数为0,无致病菌;医疗器械在该戊二醛消毒液中浸泡10 h,可达到灭菌效果;连续使用14 d后的该戊二醛消毒液浸泡医疗器械10 h,仍可达到灭菌效果。结论该新型复方戊二醛消毒液低味、低泡、性能稳定,对胃镜、医疗器械的消毒、灭菌效果良好,连续性使用灭菌效果亦好。     

120份戊二醛与酸性氧化电位水用于软式内镜消毒的对比研究

目的 对比研究戊二醛与酸性氧化电位水两种软式内镜消毒方式的效果.方法 对软式内镜进行现场消毒试验,戊二醛组60份(胃镜43份,肠镜17份);酸性氧化电位水组60份(胃镜37份,肠镜23份),采用现场采样监测法对其两组消毒后的内镜进行生物学监测,对比分析其消毒效果、时间、经济成本及腐蚀性.结果 两组共采样检测120份,未检出阳性标本;戊二醛组总消毒时间平均为23.5 min、酸性氧化电位水组总消毒时间为10 min;戊二醛组每月消耗戊二醛折合人民币约9180元,酸性氧化电位水组每月消耗上业盐折合人民币约108元;两组均未发现对内镜有明显腐蚀性.结论 戊二醛和酸性氧化电位水两组消毒方法均可达到消毒要求,而酸性氧化电位水消毒法相比于戊二醛消毒法更省时、成本更低廉和环保.     

聚维酮碘消毒液毒性与消毒效果观察

目的观察聚维酮碘消毒液的毒性与消毒效果。方法依据《消毒技术规范》对其进行毒理学、实验室定量杀菌及手现场消毒试验。结果该消毒液对小鼠急性经口毒性试验结果LD50〉5 000mg/kg.BW;微核试验阴性;多次皮肤刺激、急性眼刺激、1次阴道黏膜刺激试验结果均无刺激性。样品500mg/L有效碘溶液对金黄色葡萄球菌、大肠杆菌、铜绿假单胞菌作用0.5min杀灭对数值均〉5.00,对白色念珠菌作用0.5min杀灭对数值〉4.00;对30人次志愿受试者手皮肤表面自然菌消毒1min,平均杀灭对数值〉1.00,各项指标均达到消毒合格要求。结论聚维酮碘消毒剂为实际无毒级,杀菌效果良好,杀菌谱广,作用快,可用于人体体表皮肤和黏膜消毒。     

酸性氧化电位水现场消毒效果试验研究

目的验证酸性氧化电位水的现场消毒效果。方法参照国家卫生部有关消毒规范方法对医务人员手、一般物体表面、医疗器械、消化内镜分消毒组与阳性对照组进行现场消毒试验。结果对30人次手消毒作用1 min,自然菌平均杀灭对数值为2.72;对物体表面作用5 min,自然菌平均杀灭对数值>1.00;对使用后一般医疗器械常规清洗后浸泡消毒10 min,器械表面细菌的总平均杀灭对数值>1.00;对使用后胃镜、肠镜常规清洗和酶洗处理后消毒3 min,各内镜细菌总数范围为0~2 CFU/件,且均未检出致病菌;试验各组均消毒合格。结论酸性氧化电位水的现场消毒效果良好。     

聚维酮碘、戊二醛、氯氧三嗪泡腾片对金黄色葡萄球菌的杀灭作用

目的 了解聚维酮碘、戊二醛、氯氧三嗪(三氯异氰尿酸)泡腾片对医院感染金黄色葡萄球菌与标准菌株的杀灭效果是否存在差异,为实际消毒应用提供试验依据.方法 采用悬液定量杀菌试验.结果 聚维酮碘、戊二醛、氯氧三嗪泡腾片原液对金黄色葡萄球菌标准菌株100.0%的杀灭率的作用时间分别是1.5、3、1 min;聚维酮碘50 mg/L、戊二醛125 mg/L、氯氧三嗪泡腾片125 mg/L对金黄色葡萄球菌标准菌株作用10 min的杀灭率也可达100.0%;相同浓度的消毒剂对20株临床金黄色葡萄球菌作用10 min的杀灭率均达100.0%.结论 在临床应用中,若消毒剂浓度被稀释则适当的延长消毒剂的作用时间亦可达到杀灭病原菌的效果.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.