基层医院凡士林纱布高压灭菌失败原因分析

目的　观察凡士林纱布厚度、消毒灭菌次数及在锅中各位置的灭菌效果 ,对凡士林纱布的灭菌失败原因进行分析。方法　将嗜热脂肪杆菌芽胞 ATCC795 3布片 ,夹置于各种厚度凡士林纱布的中心放于铝储物盒中 ,经手提式压力蒸汽灭菌器灭菌后做细菌定性分析。结果　经 2次高压灭菌的 32层以内的凡士林纱布中的嗜热脂肪杆菌芽胞 (ATCC795 3)全部杀灭 ,杀灭指数为 5× 10 5～ 5× 10 6。结论　采用手提式压力蒸汽灭菌器灭菌方法可靠 ,灭菌失败原因与凡士林纱布厚度、消毒灭菌次数及在锅中各位置有关 ,应控制凡士林纱布的厚度 ,不易过厚(不超过 32层 ) ,并经 2次高压消毒灭菌 ,置于锅中上层为消毒效果最佳位置。     

干、湿热对凡士林消毒效果观察

目的：了解干、湿热对凡士林灭菌的效果。方法：将嗜热脂肪杆菌芽胞片和枯草杆菌芽胞片放置于凡士林纱布的中间（约10～20层）分别放入干热灭菌器内上、中、下三个人于160℃、170℃、180℃消毒1小时。或将含有嗜热脂肪杆菌芽胞片的几士林纱布放入高压锅内，上前、上后、中、下前、下后五个点于121℃、126℃、132℃、140℃灭菌6～30分钟。结果：当干热温度达到180℃小时能杀灭嗜热脂肪杆菌芽胞和枯草杆菌芽胞从而证实干热对凡士林灭菌效果较好，而压力蒸汽灭菌温度达140℃6分钟时也不能完全杀灭嗜热脂肪杆菌芽胞，说明压力蒸汽灭菌器不适宜凡士林纱布灭菌。结论：干热消毒凡士林比湿热消毒凡士林效果好。     

凡士林纱布灭菌方法的研究

灭菌凡士林纱布是外科常用的内敷料之一 ,在防治创口粘连、促进愈合及控制医院内感染方面起着重要的作用。凡士林纱布的灭菌 ,通常采用 16 0℃干烤 2ｈ。但该方法使凡士林纱布干燥、油润差、变黄、脆性增加 ,临床应用常使创面与凡士林纱布粘连 ,增加患者的痛苦。为解决油润性差、干燥和脆性增加的缺点 ,我们研究一种组合灭菌方法 ,解决了上述灭菌方法存在的缺陷 ,并能达到灭菌的效果 ,现报告如下。材料与方法1　材料1 1　灭菌器 :脉动真空压力蒸汽灭菌器、干烤箱。1 2　生物指示剂 :嗜热脂肪杆菌芽胞 (ＡＴＣＣ795 35 0× 10 5～ 5 0× 10…     

企业医院压力蒸汽灭菌监测结果分析

压力蒸汽灭菌是一种可靠的灭菌方法 ,它能杀死一切微生物。因此压力蒸汽对医疗器械、用品灭菌效果的好坏与院内感染的发生有直接或间接的联系。为了减少和防止院内感染的发生 ,控制疾病的传播和蔓延 ,保证医护质量 ,我们于 1998～ 1999年对鞍钢五所综合性医院共计 14个压力蒸汽灭菌器进行了10 3锅次的监测 ,结果如下。1　监测方法及标准1.1　方法　将北京四环卫生药械厂生产的菌片 (嗜热脂肪杆菌 ATCC795 3芽胞为指示菌 ,规格为 5× 10 5 ～ 5× 10 6 cfu/片 )装入试管 ,加塞放入有孔饭盒内 ,随同要进行消毒的医疗用品装入压力蒸汽灭菌器…     

生物检测法对压力蒸汽灭菌效果的监测

在进行压力蒸汽灭菌工作中 ,注重利用嗜热脂肪芽胞杆菌的活菌对灭菌的效能进行监测 ,能及时发现问题并解决问题 ,保证了灭菌工作的顺利进行。1　材料与方法　　生物指示菌片 :嗜热脂肪芽胞杆菌 ATCC- 795 3,菌量 5× 10 6 CFU/片 ,溴甲酚紫葡萄糖蛋白胨水培养基 ;5 6℃专用培养箱。将嗜热脂肪芽胞杆菌的片装入无菌小试管编号 ,放入待灭菌包裹的中央部位 ,每次监测按上中、中中、下中、前下、后下 5处布点。在灭菌器内 12 1℃、1.0 5 5 k Pa、灭菌 2 0min后取出嗜热脂肪芽胞杆菌的菌片 ,投入溴甲酚紫葡萄糖蛋白胨水培养基中 ,置 5 6℃专…     

福尔马林低温灭菌效果探讨

目的 探讨福尔马林低温蒸气灭菌器的灭菌效果。方法 采用进口福尔低温蒸汽灭菌器,选择灭菌温度80℃、灭菌时间10min、注入药量130ml/0．76m^3、负压控制在－4．2－50．5kPa条件下,将ATCC7953嗜热脂肪杆菌芽胞采用两种放置形式进行灭菌试验。结果 专用化学指示卡变色全部合格,ATCC7953嗜热脂肪杆菌芽胞杀灭率达100％。结论 采用福尔马林低温蒸气灭菌法时,在纸／塑包装条件下通过具有加湿、保温、抽真空、高密封性及有蒸气冲洗排放等功能的灭菌设备,能服务其穿透力弱及刺激性气味的缺点,可达到灭菌之目的。     

凡士林纱布条压力蒸汽灭菌效果监测

目的 探讨凡士林纱布条经压力蒸汽灭菌1次后的灭菌效果。方法 将干纱布条40层放在铝饭盒内，将1-3cm纱布长或嗜热脂肪芽胞村菌片或生物指示管，132℃灭菌化学指示管或132℃蒸汽灭菌包内卡，留点温度计，放在设定的监测层中交流电，然后在干纱布条上铺1块纱布块，将凡士林膏75g均匀，涂抹在纱布块上，盖好盒盖，常规压力蒸汽灭菌1次后做细菌培养或生物监测。结果 细菌培养无菌生长率98.1%。嗜热脂肪芽胞植炒菜率100%，总无菌生长率99.9%，指示卡和管达灭菌标准，盒平均温度129.8℃。结论 凡士林纱布条压力蒸汽灭菌1次，即可达到灭菌效果。     

惠州市三级医院压力蒸汽灭菌效果监测分析

目的了解某市三级医院压力蒸汽灭菌器的灭菌效果。方法采用生物指示剂嗜热脂肪杆菌芽胞菌片对压力蒸汽灭菌器的灭菌效果进行监测。结果2002年3～9月共监测424台压力蒸汽灭菌器，合格率为80．19％。卧式、立式、手提式压力蒸汽灭菌器的灭菌合格率分别为84．30％，75．79％，73．56％；市级、区(县)级、镇级(包括社区医疗机构)医院压力蒸汽灭菌器灭菌合格率分别为88、40％，79．17％，78．07％。结论加强对医院供应室消毒人员的培训，规范各项操作程序，才能提高压力蒸汽灭菌的合格率。     

下排气压力蒸汽灭菌器对凡士林纱布灭菌的试验观察

[目的]观察手提式压力蒸汽灭菌器对凡士林纱布的灭菌效果。[方法]采用载体定性杀菌试验方法进行灭菌试验。[结果]当灭菌器充分排除冷空气,温度控制在121～126℃时,用自动启闭式铝盒或用搓开盒盖的密闭盒盛装油纱,放入灭菌器内桶上层或中层,作用60min,盒内80层凡士林纱布可达灭菌要求;当盛装油纱的容器置于内桶底层时,灭菌效果则难以保证。对自动启闭式铝盒盛装的凡士林纱布121～126℃作用30min,间隔24h,再次重复灭菌,40层油纱处经培养仍有活菌生长。[结论]手提式下排气压力蒸汽灭菌器用于凡士林油纱灭菌是可行的,但要严格控制冷空气排除时间、灭菌温度与时间、盛装容器、油纱比例与层数,以及盛装容器在压力蒸汽灭菌器内桶放置位置,以保证灭菌效果。应用下排气压力蒸汽对凡士林油纱灭菌不适于采用隔日重复灭菌的方法。     

高压灭菌效果检测方法比较

为了解我县医疗保健机构压力蒸汽灭菌效果,并比较四种不同检测方法(嗜热脂肪杆菌芽胞菌片法、3M指示胶带法、sy-1型化学指示管法及散装硫磺粉法)对压力蒸汽灭菌的指示效果,本站于1997年5月份对全县各级医疗保健机构的灭菌器进     

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.     

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.     

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.     

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.     

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.     

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.