三重组合口腔护理在口腔颌面外科护理中的应用

目的：探讨三重组合口腔护理（冲洗器冲洗＋口腔含漱＋传统擦拭）在口腔颌面外科护理中的应用效果。方法选择2010年12月至2012年12月在我院行口腔颌面术的患者200例，随机分为观察组与对照组，每组100例，观察组采用冲洗器冲洗＋口腔含漱＋传统擦拭护理，对照组采用冲洗器冲洗＋传统擦拭的护理方法，比较两组患者口腔清洁度、口腔舒适度及舌苔的变化。结果观察组患者口腔清洁程度、口腔舒适度、舌苔情况均明显好于对照组患者，组间差异具有统计学意义（P＜0.05），两组患者均未发生不良反应。结论三重组合口腔护理能有效防治舌苔增厚，提高口腔清洁度与舒适度，提高患者生存质量，值得推广应用。     

Wipe and flexion withdrawal reflexes display different EMG patterns prior to movement onset in the spinalized frog

Summary We investigated the hypotheses (1) that the initial flexion part of the wipe reflex elicited in the spinalized frog has the same EMG pattern for wipes to different target locations (Berkinblit et al. 1986), thereby reducing the complexity of the control of this task, and (2) that this initial flexion is the same as occurs in the flexion withdrawal reflex (Easton 1972). The activities of seven muscles of the hindlimb of the spinal frog were recorded via intramuscular electromyograms (EMGs) during the wipe reflex to two target locations and during the flexion withdrawal reflex. The EMGs were analyzed during the interval between stimulus placement and movement onset for mean integrated EMG and duration from EMG onset to movement onset. This analysis revealed significant differences (p<0.0001) in the EMG patterns that preceded the initial flexion posture for all three movements. These findings suggest that the spinal circuitry coordinating the initial flexion part of the wipe reflex to different target locations and the flexion withdrawal reflex may not be uniformly shared.     

呼和浩特市2009年消灭脊萌灰质炎工作的评价与分析

目的通过对呼和浩特市2009年消灭脊髓灰质炎工作进行评价与分析，以探讨今后工作重点，达到及时完成各项工作。方法对基层上报有关资料利用有关软件进行统计分析。结果2009年报告AFP病例6例，发病高峰为6～8月，病例主要集中在〈3～5岁，AFP报告发病率1．43／10万，各项指标达到了国家卫生部和WHO的指标；流动儿童常规免疫在90％以上。结论我市应在6～8月份加强医院对AFP病例报告的督导工作，防止漏报发生：圆满完成针对流动儿童的TOPV常规免疫和强化免疫工作。通过对呼和浩特市2009年消灭脊髓灰质炎工作的调查与分析，可以比较全面了解2009年本市的脊髓灰质炎的预防控制情况，从而为今后的AFP防治策略和措施的指定提供依据。     

抹药罐治疗支气管哮喘急性发作期护理观察

目的观察抹药罐治疗支气管哮喘急性发作期(中医证属寒哮)的护理效果。方法将60例支气管哮喘急性发作期的患者随机分为治疗组和对照组,治疗组采用抹药罐联合布地奈德福莫特罗粉吸入剂吸入治疗,对照组采用布地奈德福莫特罗粉吸入剂吸入治疗,疗程均为10天。观察两组治疗前后FEV1%预计值、PEF、中医症候积分等变化。结果治疗组患者肺功能变化与对照组比较有显著性差异(P0.05)。结论抹药罐治疗支气管哮喘急性加重期有较好的疗效。     

血液透析机表面污染境况调查

目的调查现行感染控制管理制度下,血液透析机治疗前后表面污染情况及进行消毒擦拭前后的差别。方法在严格按照《北京市血液透析质量控制管理规范》实施感染控制管理的前提下,进行日常2个班次的透析治疗。依据《医院消毒卫生标准》GB15982-1995要求,对上、下午透析前后33台血液透析机的台面及面板取样进行细菌培养,并依据《医院消毒卫生标准》GB15982-1995标准评价其检测结果。结果所有样本总合格率96.2%,其中上、下午透析前合格率均为100%,上、下午透析后未擦拭前合格率分别为93.9%和90.9%。各班次透析前、后菌落计数对比差异有统计学意义(P<0.05);2班次之间进行消毒擦拭前后菌落计数对比差异无统计学意义(Z=-1.61,P>0.05),但是擦拭后的合格率达100%。结论《北京市血液透析质量控制管理规范》规定的透析治疗各班次之间擦拭消毒血液透析机是必要而且有效的。     

Occupational exposure to antineoplastic drugs in four Italian health care settings

Exposure assessment of health care workers to antineoplastic drugs (ADs) is still an open issue since new, critical, and emerging factors may put pharmacists who prepare hazardous drugs or nurses who administer anti cancer agents to an increased risk of developing adverse health effects. Overall, eight pharmacies and nine patient areas have been surveyed in this study. Wipe and pad samples were experienced during the surveillance program in four Italian health care settings. Urine samples were collected from workers handling ADs. Cyclophosphamide (CP), ifosfamide (IF), and gemcitabine (GEM) were detected in all the work environments by using a LC-MS/MS method-based capable of analysing all the three drugs simultaneously. In total, 54% of wipe samples were positive for at least one drug and 19% of pad samples were shown to be contaminated by cyclophosphamide. Pharmacies were generally more contaminated than patient areas with the exception of one site where a nurse had an acute exposure during the cleaning-up of an hazardous drug solution spill. In total, 22 urine samples collected from pharmacists and 78 urine samples from nurses had no detectable concentrations of any antineoplastic drugs. Despite the adherence to the recommended safety practices residue contamination on surfaces and floors has continued to be assessed in all the investigated sites.     

微酸性电解水对物体表面擦拭消毒的效果评价

摘要：目的 评价一种新型绿色消毒剂----微酸性电解水在医院物体表面擦拭消毒的效果。方法 分别应用微酸性电解水和500 mg/L有效氯溶液对2组床旁桌台面进行擦拭消毒,进行消毒前、消毒后5分钟、 4小时和8小时的微生物采样,比较2种消毒液的细菌杀灭率和消毒持久性。结果 微酸性电解水对物体表面擦拭消毒后5分钟的杀菌率为99.32%,优于500mg/L有效氯溶液的97.74%,差异有统计学意义（P＜0.01）。2组台面擦拭消毒后不同时段细菌培养的合格率均有下降,消毒后8小时微酸性电解水组和有效氯溶液组的合格率分别仅为62.9%和54.3%,差异无统计学意义（P＞0.05）,结论 微酸性电解水的即时杀菌效果优于含氯消毒剂,基于其更安全环保,推荐临床推广应用;但物表消毒后易再次污染,应加强消毒频率。     

不同擦拭方法对医院床头柜表面消毒效果的监测分析

目的寻找快速、简单、有效的医院床头柜擦拭方法。方法将使用中的床头柜随机编号,分别采用A、B、C,3种不同擦拭消毒方法,于床头柜擦拭前、后采样,并进行细菌计数及常见病原菌检测。结果 3种擦拭消毒方法均能达到消毒技术管理规范要求,且消毒效果比较无统计学意义P>0.01;所有床头柜消毒前细菌计数均超标。消毒后床头柜除2份检出金黄色葡萄球菌外,其他均未检出致病菌。结论所采用的3种擦拭消毒方法均能达到良好的消毒效果。     

Environmental and biological monitoring of antineoplastic drugs in four workplaces in a Swedish hospital

Objectives Exposure to antineoplastic drugs should be avoided due to the risk of getting adverse health effects. Antineoplastic drugs such as cyclophosphamide (CP) and ifosfamide (IF) are commonly used in medical attendance. In this study the variability of surface contamination of CP and IF was investigated by repeated wipe sampling over time in four workplaces in a university hospital. The surface contamination levels were also evaluated and health care workers were biologically monitored. Methods A hospital pharmacy, two oncology wards and one oncology outpatient department were selected. Between 10 and 13 different surface areas such as work areas, floors and handles were selected in each workplace and wiped between 7 and 8 times during 9 months. Pre- and post-shift urine samples were collected from the workers in the investigated workplaces. Analysis was performed by liquid chromatography combined with tandem mass spectrometry. Results Measurable amounts of CP and IF were detected on the majority of the sampled surfaces. The highest concentrations were found on the floors in the patient lavatories and utility rooms (up to 95 ng cm⁻²). In general, the surface contamination of CP and IF on floors did not vary much over time. Work areas and handles had larger variability. Neither CP nor IF were detected in any of the collected urine samples. Conclusions The variability in surface contamination of CP and IF was rather low especially on floors. Higher concentrations of CP and IF were found on the floors compared with the work areas. The highest surface loads were found on floors (in patient lavatories and utility rooms) that were related to patient activities such as handling of patients’ urine. Although high contaminations were found, the biological monitoring showed no uptake. Wipe sampling is a good method to improve the work practices.     

Wipe Test在HLA组织配型实验室污染监测及预防管理中的应用

目的建立人类白细胞抗原(HLA)组织配型实验室常规DNA污染监测试验体系,预防和消除可能会干扰检测准确性的PCR产物或基因组DNA的污染。方法设计含多种阴阳性对照和各关键监测点的完整反应链,针对HLA-Ⅰ类和Ⅱ类基因扩增区域内的非多态区进行引物特异性PCR,琼脂糖凝胶电泳测定扩增产物;对被污染监测点进行局部灭活处理后对相应监测点重新采样进行灭活验证;同时采取不定期抽查监测与定期全面监测相结合的方式确保实验过程零污染。结果灭活处理及整改后,所监测HLA基因分型实验过程中的核酸抽提区、PCR加样区、PCR扩增区、下游产物处理区4个区域的主要监测点污染监测结果均合格。结论该研究建立的以Wipe Test为核心的DNA防污染监测实验体系能够有效监测和灭活验证可能会干扰检测准确性的PCR产物或基因组DNA的污染,是HLA组织配型实验室质量控制管理程序的重要组成部分。