The potential of microscopic sterile sponge particles to induce foreign body reaction

The sterile sponges may lose a significant amount of lint during their routine use in surgery, which is usually neglected. We designed an experimental model to evaluate the potential of sterile sponges to lose lint and to induce foreign body reaction in surgically created wounds. In 15 Wistar rats, separate subcutaneous pockets were created. Left-sided pockets were temporarily packed with sterile sponges, while the right-sided pockets remained empty. All the pockets were then irrigated with sterile saline. The presence of microscopic sponge particles was evaluated in the irrigation materials. After 4 weeks, the presence of inflammation and foreign body reaction were evaluated histologically. Microscopic sponge remnants were present in 14 of 15 samples collected from the left sides. The presence of foreign body giant cells with ingested sponge particles and formation of well-defined foreign body granulomas were observed only in samples collected from the left sides. A statistically significant difference was observed between the two sides when the intensity of inflammation was graded (P= 0.012). Cotton sponges used in surgery are shown to have a potential of losing invisible microscopic particles that have a potential to induce foreign body reaction.     

0．45％氯化钠溶液与灭菌注射用水在机械通气患者气道湿化中的对照研究

目的观察两种不同湿化液在建立人工气道机械通气患者气道湿化中的作用。方法将我院2009年1-4月心脏外科接受心脏手术治疗后行机械通气的患者40例,利用随机数字表随机分为A组和B组各20例,A组给予0．45％氯化钠溶液100ml加沐舒坦15mg气道湿化液,B组给予灭菌注射用水100ml加沐舒坦15mg作为气道湿化液,观察2组患者吸出痰液的量、颜色、黏稠度、患者的体温、肺部的听诊以及x线胸片情况。结果机械通气后4、8、16、24h及l～2、3～5、6．7d2组患者痰液的量、颜色、黏稠度、患者的体温以及x线胸片情况比较无显著差异,2组患者机械通气后4、16、24h,1-2、3-5、6-7d患者的肺部听诊隋况无显著差异,机械通气后8h的肺部的听诊情况B组优于A组。结论没有足够的依据认为0．45％氯化钠溶液100ml加沐舒坦15mg和灭菌注射用水100ml加沐舒坦15mg作为气道湿化液在机械通气患者气道湿化中的作用效果不同。     

Optical Density Value and Ratio as Novel Indexes for Nanoemulsion Sterile Filtration Process Control or Characterization

Sterile filtration is an effective method to remove any microorganisms present during nanoemulsion preparation. However, it lacks effective control parameters. Here, we established a simple and rapid approach for the process control of nanoemulsion sterile filtration by utilizing optical density detection as a process control parameter. During sterile filtration, the optical density or optical density ratio of the filtrate were continuously monitored to explore the correlation between optical density and the emulsion content and the change in the optical density ratio before and after sterile filtration. In the emulsion stability test, the optical density ratio was determined. A good correlation was obtained between the optical density and the nanoemulsion content during sterile filtration, thereby reducing sterile filtration loss. The optical density ratio changed significantly after sterile filtration, indicating that it could be used as a process control parameter to monitor leakage during emulsion sterile filtration. The optical density ratio can be a characterization index for stability monitoring as it is more sensitive than particle size detection and more convenient than large particle detection. These parameters may be used for sterile filtration process control and as an index for nanoemulsion characterization. This approach overcomes the limitations of existing nanoemulsion characterization methods.     

Acetaminophen-induced Liver Injury: from Animal Models to Humans

Drug-induced liver injury is an important clinical problem and a challenge for drug development. Whereas progress in understanding rare and unpredictable (idiosyncratic) drug hepatotoxicity is severely hampered by the lack of relevant animal models, enormous insight has been gained in the area of predictable hepatotoxins, in particular acetaminophen-induced liver injury, from a broad range of experimental models. Importantly, mechanisms of toxicity obtained with certain experimental systems, such as in vivo mouse models, primary mouse hepatocytes, and metabolically competent cell lines, are being confirmed in translational studies in patients and in primary human hepatocytes. Despite this progress, suboptimal models are still being used and experimental data can be confusing, leading to controversial conclusions. Therefore, this review attempts to discuss mechanisms of drug hepatotoxicity using the most studied drug acetaminophen as an example. We compare the various experimental models that are used to investigate mechanisms of acetaminophen hepatotoxicity, discuss controversial topics in the mechanisms, and assess how these experimental findings can be translated to the clinic. The success with acetaminophen in demonstrating the clinical relevance of experimental findings could serve as an example for the study of other drug toxicities.     

A rare case report describing the relation between sweet syndrome and spontaneous recurrent peritonitis

IntroductionSweet syndrome (acute febrile neutrophilic dermatosis) is a subset of rare inflammatory disorders, first described by Dr. Robert Douglas Sweet in 1964 (Sweet, 1964). The co-existence of Sweet syndrome and spontaneous recurrent peritonitis has never been previously mentioned in the medical literature.Presentation of caseWe report a case of a 37-year old female patient with known idiopathic Sweet syndrome, diagnosed on skin biopsy, who presented with multiple episodes of spontaneous peritonitis. Investigation through abdominal laparoscopy showed large amounts of free pus in the abdomen without bacterial isolation.DiscussionDifferential diagnoses, investigations and management of suspected spontaneous peritonitis are discussed. It was suspected that her Sweet syndrome had caused a rare form of previously undescribed recurrent sterile peritonitis.ConclusionThis case illustrates the importance of careful evaluation of patients with known inflammatory disorders, such as Sweet syndrome. It also demonstrates the need to have a multidisciplinary approach, by collaboration between the disciplines of medicine, surgery, microbiology and radiology.     

Viruses vector control proposal: genus Aedes emphasis

The dengue fever is a major public health problem in the world. In Brazil, in 2015, there were 1,534,932 cases, being 20,320 cases of severe form, and 811 deaths related to this disease. The distribution of Aedes aegypti, the vector, is extensive. Recently, Zika and Chikungunya viruses had arisen, sharing the same vector as dengue and became a huge public health issue. Without specific treatment, it is urgently required as an effective vector control. This article is focused on reviewing vector control strategies, their effectiveness, viability and economical impact. Among all, the Sterile Insect Technique is highlighted as the best option to be adopted in Brazil, once it is largely effectively used in the USA and Mexico for plagues related to agribusiness.     

自制数字号码标识牌在手术室无菌物品管理中的应用

无菌物品管理是手术室的重要内容之一。我院供应室因存放无菌物品空间有限，无法贮存手术室各类灭菌包，灭菌后直接送回手术室。为了保证手术供应，各种无菌布类包总数多，在无菌物包管理上很棘手。以往我们采用在贮存柜上挂上移动式“先用”的标识牌，但贮存柜是多层的，挂标识的一层用完后，存在乱拿乱放的现象，消毒班护士需不定时到无菌物品间移动标识牌，甚至需将无菌包一包一包搬动，费时费力，为解决这一问题我们将“先用”的移动式标识牌进行改进，取得满意效果，现报告如下。     

不同温度生理盐水对采集乳腺肿瘤标本的影响

目的 探讨不同温度的无菌生理盐水对采集乳腺肿瘤组织标本的影响,建立更加规范的生物样本采集、保存的标准化流程（SOP）。方法 2012年10～12月由专人采集乳腺癌肿瘤组织标本60例,每例标本平均分成3份,分别用4～8℃的无菌生理盐水（C1）、22～26℃的无菌生理盐水（C2）、37～41℃的无菌生理盐水（C3）漂洗两次后放置于—80℃冰箱保存,24h内送至实验室由专职实验人员进行标本的总RNA提取鉴定。结果 三组标本RNA保存质量差异有显著意义（P〈0.01）,使用C1漂洗过的标本RNA保存质量最高。结论 在采集乳腺癌肿瘤组织标本的过程中,使用4～8℃的无菌生理盐水漂洗标本后对肿瘤标本的RNA保存质量影响最小,可增添至生物样本采集、保存的标准化流程中。     

无菌敷贴在开放性骨折伤口换药中的效果观察

目的：评价无菌敷贴在开放性骨折伤口换药中的疗效,探讨预防开放性骨折伤口感染的最佳换药护理方法。方法将136例150处伤口开放性骨折病人,在传统换药方法的基础上,用换药无菌敷贴保护伤口,以开放性骨折伤口为中心,顺序抚平敷贴,将敷帖四周压紧。结果伤口转归0级84例,1级53例,2级8例,3级5例,伤口甲级愈合率（0～1级）91．3％。结论精心护理下应用无菌敷贴换药,能够明显抑制细菌生长,减少开放性骨折的感染机会,而且病人对新的换药护理方法满意度高。     

508 例无菌手术抗菌药物使用问题分析简

目的 通过分析无菌手术抗菌药物的使用情况以提高医院合理使用抗菌药物的水平.方法 抽取2012年全院各科的508例无菌手术住院病历,以卫生部的《抗菌药物临床应用指导原则》手册无菌手术抗菌药物的使用原则为标准,从用药指征、给药方法、给药剂量、途径等方面,采用回顾分析法比较分析这508例无菌手术抗菌药物的合理使用情况.结果 508例无菌手术病历中,共有400病历份存在问题,主要包括：预防用药指征不合理占27.75％、用药记录不当25.50％、选药不合理22％、用药时间过长20.25％、联合用药不合理3.5％等6种抗菌药物不合理使用的方式.结论 抗菌药物的不合理应用既影响疗效,也会造成经济损失和浪费医疗资源,医生、临床药师双方共同努力,来规范、合理使用抗菌药物.