石家庄公共场所集中空调通风系统微生物污染监测与评价

目的分析石家庄市集中空调通风系统卫生状况,为加强集中空调通风系统的消毒管理提供技术支持。方法按照《公共场所集中空调通风系统卫生规范》,对公共场所集中空调通风系统的冷凝水、冷却水、积尘、空气分别进行采样、检测。结果通风管积尘:总合格率57.6%;送风口空气:总合格率74.8%;冷却水、冷凝水中嗜肺军团菌:总合格率79.5%。结论石家庄市的空调通风系统存在着一定的卫生问题,建议定期清洗消毒,加强监管。     

Use of oxygen in the resuscitation of preterm infants: Current opinion and practice in Australia and New Zealand

Aim:   The aim of this paper was to explore the opinions and practices of tertiary health-care professionals in Australia and New Zealand regarding air and oxygen blending (OB) for the resuscitation of preterm infants.
Methods:   Structured questionnaires were sent to the directors of 25 tertiary perinatal units, with instructions to distribute the questionnaires to 15 pertinent clinical staff.
Results:   Response rate was 72% ( n  = 271); medical-staff response was 25%. Sixteen (64%) perinatal units had OB resuscitation equipment. Among respondents, 114 (42%) had access to OB and 73 (27%) had OB for all resuscitations. Pulse oximetry was available to 160 (59%) of respondents. The majority (173, 64%) would initiate resuscitation with Fractional inspired oxygen (FiO₂) ranging from 0.3 to 0.9 (mean 0.5), with 15% and 21% preferring air and 100% oxygen, respectively. There were large variations in managing FiO₂ changes thereafter. Half of the respondents were either unsure (39%) or not convinced (15%) that 100% oxygen during resuscitation would cause harm. Conversely, 42% suggested that OB might improve outcome with bronchopulmonary dysplasia and retinopathy of prematurity being the most important considerations. Most (92%) would advocate for OB in the delivery suite. Set-up cost (50%) and lack of guided experience (38%) ranked highest as barriers to change.
Conclusions:   Two-thirds of the tertiary centres have at least some OB equipment in the delivery suite, but the ways and opinions in which OB is utilised differ widely. Most practitioners would advocate for a change. There is an urgent need for further research to achieve a consistent and meaningful clinical management for OB resuscitation of preterm infants.     

静电吸附式空气消毒机在呼吸道隔离区域中的净化效果观察

目的观察空气消毒机在呼吸道隔离区域中的净化消毒效果。方法用仪器采样和细菌培养方法,对两种类型空气消毒机在呼吸道隔离区域空气净化效果进行了观察。结果在室内无人工作状态下,柜式空气消毒机启动运行60 min,可使室内空气中自然菌总数从平均706 cfu/m3下降到200 cfu/m3以下;壁挂式空气消毒机启动运行60 min,可使室内空气中自然菌总数从平均597 cfu/m3下降到200 cfu/m3以下;两者符合Ⅱ类环境卫生要求。结论两种类型空气消毒机启动60 min对呼吸道隔离区室内空气净化效果能达到Ⅱ类环境卫生标准。     

输血科卫生消毒质量监测

目的了解输血科环境和设备卫生消毒质量,加强输血环境卫生管理。方法采取现场采样和细菌检验方法,对输血科储血设备和室内环境卫生消毒质量进行了监测。结果室内空气质量以储血室最好,从2007年以后均能控制符合Ⅱ类环境要求;其他室内空气质量均符合Ⅲ类环境的卫生标准。输血科物体表面卫生质量以储血冰箱内壁最好,每年度检测均符合I类环境标准,其他工作面卫生质量符合Ⅱ类环境要求。工作人员手经过抗菌洗液清洗之后,其卫生质量达到了Ⅲ类环境的卫生标准。结论本医院输血科环境卫生质量比较好,在消毒或清洁之后均符合相关卫生标准要求。     

术晨湿式清洁对洁净手术室空气质量的影响

目的探讨取消洁净手术室术晨物体表面湿式清洁对手术室空气质量的影响。方法2008年10-12月取3间10 000级洁净手术室,对照组在术晨常规实施物体表面的湿式清洁,研究组在术晨取消湿式清洁。两组均于手术结束后彻底清洁手术室,手术室停用时采用值班运行的低净化状态,日晨启动高净化状态,比较两组的物体表面细菌量、空气沉降菌落数、空气微粒数、外科伤口部位感染(infection surgical site,SSI)率等指标。结果两组在全天手术结束、手术室湿式清洁后30 min、次日高净化后30 min物体表面细菌培养均为阴性,空气细菌培养均为阴性;对照组术晨物体表面清洁前后≥0.5μm和≥5μm的尘粒数均在国家规定的范围内;两组SSI率均为0。结论手术结束后彻底清洁手术室,并在停用时采用值班运行的低净化状态,术晨可以取消物体表面湿式清洁;该做法不影响手术室物体表面和空气的质量,能节约人力资源。     

Predictors of house-dust-mite allergen concentrations in dry regions in Australia

BACKGROUND: House-dust-mite allergen content differs between houses and is thought to be a function of the housing characteristics and furnishing choices that affect indoor microclimate and mite proliferation. The importance of these features may differ with regional climates. METHODS: Concentrations of mite allergen were analysed as a function of housing features. Information on housing features was collected by questionnaire in 50 houses in two towns in a dry inland region of Australia. Mite allergen (Der p 1) was measured by ELISA in dust samples collected on five occasions over 2 years from beds and floors. RESULTS: Der p 1 was detected in all houses. Many housing features did not influence mite allergen concentrations. However, the presence of evaporative cooling increased mite allergen by 3.34-fold in beds (P=0.007) and 3.94-fold in floors (P=0.003). Mite allergen was threefold higher in mattresses >5 years old, and synthetic and feather duvets tended to have higher and lower levels of mite allergen, respectively. CONCLUSIONS: In houses in dry, inland regions of Australia, evaporative cooling and older mattresses are associated with higher concentrations of mite allergen. Alternative forms of air conditioning to evaporative cooling may be useful for control of mite allergen in dry regions.     

空气洁净器除菌效果及影响因素的试验观察

今是牌 Ｍ ＫＪ型空气洁净器由预过滤器、复合过滤器、活性碳膜、静电场及负离子发生器等组成。以气溶胶定量除菌试验,了解其消除空气细菌效果及影响因素。结果,在２０℃、相对湿度６０％的条件下,作用 ３０ ｍｉｎ,对空气中金黄色葡萄球菌和枯草杆菌黑色变种芽胞的消除率分别为 ９９．９９％与 ９９．９３％,作用 ６０ ｍｉｎ时均达 １００％。关闭静电或负离子发生器作用 ３０ ｍｉｎ,对金黄色葡萄球菌的消除率分别为９９．２５％与９９．９９％,作用６０ｍｉｎ者亦均达１００％。其除菌效果在相对湿度６０％时较好,随室温升高而增强。结果说明,静电有较明显加速除菌作用。     

紫外线空气消毒器对手术室空气动态消毒效果

天使牌空气消毒机为由低臭氧高强度紫外线灯和过滤系统组成的循环风紫外线空气消毒器。为了解其对室内空气消毒效果,对空气细菌总数进行了检测。结果,用该机（１３０ｍ３手术室的两端墙上各装１台）消毒３０ ｍｉｎ,空气细菌总数由３１１３ ｃｆｕ／ｍ３减至１６７ｃｆｕ／ｍ。在手术中用该机每隔１５ｍｉｎ消毒作用１５ｍｉｎ,可控制空气细菌总数≤１２５ｃｆｕ／ｍ３。该机对手术室空气动态消毒是有效的。     

急诊室二种不同空气消毒法的临床研究

目的探讨简便,高效,可行的空气消毒方法。方法在急诊治疗室应用MKJ除菌消毒空气洁净器和甲醛加锰酸钾熏蒸法对空气消毒效果进行比较。结果MKJ除菌消毒空气洁净器的空气消毒明显优于甲醛加高锰酸钾熏蒸法,大大缩短消毒时间,两组比较：P＜0．0001,差异有极显著意义。结论 MKJ除菌消毒空气洁净器高效,省时,简便,安全性高,尤其能在有人活动场合连续灭菌消毒,这一特性是空气消毒方法的新的突破点。     

细支气管肺泡癌的X线CT诊断

目的提高细支气管肺泡癌(BAC)的X线、CT诊断水平.材料与方法回顾性分析24例BAC的X线、CT表现,将其分为结节型、炎症型和弥漫型.结果结节型7例,均为单发结节.炎症型6例,两肺多发斑片状影4例,大叶实变2例.弥漫型11例,两肺呈细小结节影10例,网状结节影1例.单侧或双侧胸腔少量积液8例,心包大量积液5例,双侧肺门淋巴结增大3例.胸部及远处骨质破坏6例.结论BAC影像表现多种多样,炎症型需与肺结核、肺炎等鉴别.仔细观察、分析X线、CT征象并结合临床表现与治疗情况,可提高BAC的诊断正确率.