沟通在无菌物品全程优质供应服务中的应用

目的 以沟通的方式发挥消毒供应科与各临床科室的协同作用,达到无菌物品管理工作全程质量监控良好运行.方法 2004年1月-2006年9月将灭菌专业知识编排、打印成彩页逐期下发科室,将无菌物品全程质量监控、管理工作、安全使用注意事项等纳入日常沟通工作中.结果 经过沟通起到了与科室间无菌物品供应及需求的和谐,畅通了无菌物品的下送全程优质保供服务管理工作.结论 消毒供应科与各临床科室在无菌物品全程质量管理中的沟通十分重要.     

Characterization of two Mst1‐deficient mouse models

Mammalian sterile 20‐like kinase 1 (Mst1) is a ubiquitously expressed serine/threonine kinase belonging to the family of Sterile 20‐like kinases. MST1 has been inferred to play important roles in apoptosis and in the inhibition of proliferation in mammalian cells. Here, we describe the genetic characterization of Mst1‐deficient mice produced by two distinct gene‐trap insertions. Animals generated from clone RRT293 exhibit transmission ratio distortion favoring the mutated allele which is amplified with each generation. Inexplicably, while the mutated allele is favored for transmission, its homozygosity is embryonic lethal. By contrast, animals generated from the second Mst1 gene‐trap clone, AJ0315, do not show any gross abnormalities. We find that the discrepancy in phenotype is most likely attributable to a second insertion in the RRT293 clone. Thus, a mutation in Mst1 alone does not affect survival. Our results set the stage for identification of the lethal second‐site mutation that is paradoxically favored for transmission. Developmental Dynamics 237:3424–3434, 2008. © 2008 Wiley‐Liss, Inc.     

碘伏纱条覆盖手术切口的临床观察

目的 观察应用碘伏纱条覆盖手术切口预防切口感染的临床效果。方法 手术患者随机分为两组,实验组采用碘伏纱条覆盖手术切口,对照组用普通无菌纱布覆盖,均于术后第3天、第5天观察切口,是否有感染、渗血、水肿。结果 采用碘伏纱条覆盖的手术切口,术后感染率明显降低,较之对照组有显著差异(P<0.05)。结论 应用碘伏纱条覆盖手术切口,可有效预防术后切口感染。     

Aquacel Ag with Vaseline gauze in the management of toxic epidermal necrolysis (TEN)

Toxic epidermal necrolysis (TEN) is a rare condition with potentially high mortality and involves severe exfoliative disease of the skin and mucous membranes induced by drugs. The reported fatality of TEN varies widely from 20% to 60%. The technique for TEN wound coverage described in this article involves the use of various dressings.     

Antibiofilm activity of nanosized magnesium fluoride

The ability of bacteria to develop antibiotic resistance and colonize abiotic surfaces by forming biofilms is a major cause of medical implant-associated infections and results in prolonged hospitalization periods and patient mortality. This raises the urgent need to develop compounds that can inhibit bacterial colonization of surfaces. In this study, we present an unreported microwave-based synthesis of MgF₂ nanoparticles (Nps) using ionic liquid. We demonstrate the antimicrobial activity of these fluoride nanomaterials and their ability to restrict biofilm formation of common bacterial pathogens. Scanning and transmission electron microscopic techniques indicated that the MgF₂·Nps attach and penetrate into the cells. Flow cytometry analysis revealed that the Nps caused a disruption in the membrane potential. The MgF₂·Nps also induced membrane lipid peroxidation and once internalized can interact with chromosomal DNA. Based on these findings we further explored the possibility of using the MgF₂·Nps to coat surfaces and inhibit biofilm formation. A microwave synthesis and coating procedure was utilized to coat glass coupons. The MgF₂ coated surfaces effectively restricted biofilm formation of the tested bacteria. Taken together these results highlight the potential for developing MgF₂ nanoparticles in order to inhibit bacterial infections.     

Sterilisation of skin allograft with gamma irradiation

The primary surgical requirement of skin allografts within the UK is for cryopreserved viable allografts as these engraft to the wound bed and gain a vascular supply, thus providing true wound closure and a superior clinical performance. Consequently the only disinfection treatment the skin receives is exposure to an antibiotic cocktail. However, antibiotic treatment does not reliably decontaminate skin allografts and 22% of cryopreserved skin fails microbial acceptance criteria and cannot be used clinically. We describe here a study which was carried out to determine a means of saving and using the microbiologically failed skin. Four different treatment regimens were investigated; treatment with 20%, 50% and 85% glycerol followed by 25 kGy irradiation at -80 degrees C, and treatment with 85% glycerol at ambient (30-40 degrees C) temperature and irradiation. Following treatment, the grafts were evaluated for their histological structure, in vitro cytotoxicity and handling properties. The radioprotective effects of the different glycerol concentrations and temperatures on microorganisms were also determined. The data indicate that 25 kGy irradiation of deep-frozen skin in 20% glycerol sterilised the tissue without any histological, cytotoxicological or physical alterations compared to normal cryopreserved skin. In contrast, irradiation of all other glycerol concentrations elicited some cytotoxicity and/or histological effect. These non-viable grafts can be made available for surgical use when cryopreserved viable grafts are not available or required.     

Ischémie reperfusion en transplantation rénale

Ischemia-reperfusion injury is an inescapable phenomenon in kidney transplantation. It combines lesional processes of biochemical origin associated with oxydative stress and of immunological origin in connection with the recruitment and activation of innate immunity cells. Histological lesions associate acute tubular necrosis and interstitial œdema, which can progress to interstitial fibrosis. The extent of these lesions depends on donor characteristics (age, expanded criteria donor, etc.) and cold ischemia time. In the short term, ischemia-reperfusion results in delayed recovery of graft function. Cold ischemia time also impacts long-term graft survival. Preclinical models, such as murine and porcine models, have furthered understanding of the pathophysiological mechanisms of ischemia-reperfusion injury. Due to its renal anatomical proximity to humans, the porcine model is relevant to assessment of the molecules administered to a donor or recipient, and also of additives to preservation solutions. Different donor resuscitation and graft perfusion strategies can be studied. In humans, prevention of ischemia-reperfusion injury is a research subject as concerns donor conditioning, additive molecules in preservation solutions, graft reperfusion modalities and choice of the molecules administered to the recipient. Pending significant advances in research, the goal is to achieve the shortest possible cold ischemia time.     

抽吸速度对一次性使用无菌注射器溶血率的影响分析

用不同容量的注射器在低、中、高不同抽吸血液的速度下进行溶血试验，以研究分析不同溶血结果的干扰原因实质。通过试验发现：抽吸小管的不同管径、管壁质量，内腔不同管径是机械性溶血干扰的直接原因。在分析了干扰和抽吸速度的灵敏关系后，认为抽吸速度的干扰具有随机性。因此，提出了萃取液试验方法以避开直接抽吸血液的机械性溶血干扰，并通过各种萃取时间试验证明了萃取液试验方法的可操作性、重复性、稳健性和准确性。     

ε-聚赖氨酸与灭菌注射用水湿化效果二阶段交叉试验分析

目的采用二阶段交叉试验分析ε-聚赖氨酸与灭菌注射用水的湿化效果。方法选择我院神经内科94例长期氧疗患者行分组研究。按患者入院顺序将其编号,再按随机数字表法将其分为A组(n=47)及B组(n=47)。A组第一阶段湿化液为灭菌注射用水,第二阶段湿化液为ε-聚赖氨酸;B组第一阶段湿化液为ε-聚赖氨酸,第二阶段湿化液为灭菌注射用水。对比两组采样菌落数、合格率及氧疗舒适度。结果通过二阶段交叉试验发现:A组及B组在应用ε-聚赖氨酸作为湿化液期间菌落数更少(P0.01)。湿化液灭菌注射用水的合格率为82.98%,明显低于ε-聚赖氨酸的合格率100.00%(P0.01)。与灭菌注射用水相比,应用ε-聚赖氨酸作为湿化液具有更温暖、更湿润、舒适度更高、异味及噪声更少等优点(P0.01)。结论应用ε-聚赖氨酸作为氧疗湿化液可有效减少湿化液污染,增进患者氧疗舒适度,值得临床推广应用。