新型四腔水箱在腹外科腔镜电凝线清洗消毒中的应用研究

摘要〓目的〓研究四腔水箱在腹外科腔镜电凝线擦拭法清洗消毒中的应用效果。方法〓通过目测法和ATP生物荧光法,对本研究的四腔水箱用于腹外科腔镜电凝线的清洗效果进行评价。结果〓传统治疗碗清洗的206件腔镜电凝线清洗质量合格率为86.4%,四腔水箱清洗的206件腹腔镜电凝线清洗质量合格率为94.6%,差异有统计学意义（P＜0.01）。用四腔水箱清洗腔镜电凝线擦拭过程中的护理人员满意度较高。结论〓四腔水箱可提高腹外科腔镜电凝线清洗质量和护理人员满意度。     

An XPS and SEM evaluation of six chemical and physical techniques for cleaning of contaminated titanium implants

The purpose of the present study was to analyse clinically failed and retrieved implants prior to and after cleaning by means of scanning electron microscopy (SEM) and X-ray induced photoelectron spectroscopy (XPS) as compared to unused controls. Six different chemical and physical techniques for cleaning of contaminated titanium implants were evaluated: 1) rinsing in absolute ethanol for 10 min, 2) cleaning in ultrasonic baths containing trichloroethylene (TRI) and absolute ethanol, 10 min in each solution, 3) abrasive cleaning for 30 s, 4) cleaning in supersaturated citric acid for 30 s, 5) cleaning with continuous CO2-laser in dry conditions at 5 W for 10 s, 6) cleaning with continuous CO2-laser in wet conditions (saline) at 5 W for 10 s. SEM of failed implants showed the presence of contaminants of varying sizes and XPS showed almost no titanium but high carbon signals. XPS of unused titanium implants showed lower levels of titanium as previously reported, probably due to contamination of carbon which increased with time in room air. Cleaning of used implants in citric acid followed by rinsing with deionized water for 5 min followed by cleaning in ultrasonic baths with TRI and absolute ethanol gave the best results with regard to macroscopical appearance and surface composition. However, as compared to the unused implants the results from an element composition point of view were still unsatisfactory. It is concluded that further development and testing of techniques for cleaning of organically contaminated titanium is needed.     

Efficacy of an air-cleaning device equipped with a high efficiency particulate air filter in house dust mite respiratory allergy

The efficacy of an air-cleaning device equipped with a high efficiency particulate air (HEPA) filter (without further avoidance measures) was studied in patients allergic to house dust mite. The effects of the air-cleaner on indoor Dermatophagoides sp. levels, symptom score and bronchial hyperresponsiveness in nine mite-allergic patients were assessed using a cross-over controlled study. No significant effect was demonstrated on indoor Dermatophagoides sp. levels when comparing the period of air-cleaner activity (2 months) with the control period (2 months). The Dermatophagoides sp. levels in the houses studied were lower than the risk level for asthmatic attacks, making it difficult to assess any effect on asthma; however, neither bronchial hyperresponsiveness nor rhinitis symptom score were changed by air-cleaner activity. During the trial period, however the mean level of Dermatophagoides sp. allergen in the houses changed spontaneously from 4.4 micrograms/g (mean level in the first 2 trial months) to 1.75 micrograms/g of dust (second 2 months) (P less than 0.05). Owing to this change, the mean rhinitis symptom score also decreased (P less than 0.05), even if no significant correlation was demonstrated (r = 0.4 P = 0.089). HEPA filter air-cleaners appear insufficient as substitutes for standard avoidance measures in mite allergic patients.     

HQJ-500多功能净水装置装舰试用评价

目的：改善舰船官兵的饮用水水质，提高舰员的生活质量。方法：将研制的HQJ-500多功能净水装置装舰试用，征求试用意见并进行水质分析。结果：经实船试用证实，该多功能净水器能经受住各种海况下颠簸，摇晃的考验。运行正常。处理后的水质有明显改善。结论：该装置净化，消毒效果肯定，适合舰船使用，可推广应用。     

In vitro effectiveness of dental floss in plaque removal

This study was designed to determine whether there was any measurable difference in the effectiveness of bacterial plaque removal between 4 commercially available dental flosses. By means of a highly standardized and controlled in vitro experimental model technique utilizing 50 freshly extracted third molars, the possibility of intra- and inter-individual variability was eliminated. Each tooth was individually mounted in a formatray block and the surface was finished to either a "planed" or "unplaned" surface configuration. The "planed" root surface (dentin) was achieved by using 600 grit wet-sandpaper for tooth surface reduction while the "unplaned" root surface was achieved by using 600 gift wet-sandpaper. The teeth were then individually processed to effect the growth of bacterial plaque (S. mutans) on the prepared surfaces. Each tooth was subsequently disclosed, flossed and photographed without interruption. The flossing was carried out on a flossing machine utilizing a controlled force of 50 g. A controlled direction of the stroke perpendicular to the long axis of the tooth, and a controlled frequency of flossing (2 strokes per trial) was used. The results of the clinical trials were evaluated utilizing Ektachrome slides of the previously flossed and disclosed tooth surfaces. The photographs were projected, measured, and statistically analyzed (Student t-test and paired t-test) for the effectiveness of plaque removal of the 4 dental flosses and the effect of root surface roughness on the ability of the flosses to remove bacterial plaque. It was found that on smooth, "planed" root surfaces, there were no measurable difference among the 4 flosses.(ABSTRACT TRUNCATED AT 250 WORDS)     

ATP生物荧光检测在气管镜清洗消毒质量监测中的应用研究

目的探讨三磷酸腺苷(ATP)生物荧光检测对气管镜清洗消毒合格参考值范围和检测方法。方法选取360条患者使用后的气管镜随机分为A、B、C三组,每组120条。A组床旁预处理后分为A1、A2两组(每组60条气管镜),B组气管镜在人工清洗后分为B1、B2两组,C组气管镜在高水平消毒后分为C1、C2两组,A1、B1、C1组采用细菌采样,A2、B2、C2组进行ATP生物荧光采样。两种采样方法对气管镜表面采样为全部长度涂抹采样,管腔的采样方法均为冲刷法。同时选取临床使用后的60条气管镜经过人工清洗后,对管腔运用冲洗法,对冲洗液进行ATP生物荧光检测,比较冲洗法和冲刷法对管腔采样的有效性。结果气管镜在人工清洗后,对管腔采样的冲洗法和冲刷法,两组ATP总量的相对发光值(RLU)差异有统计学意义(P=0.040)。气管镜在A1、B1组的细菌采样中,管腔和表面菌落数差异均有统计学意义(P均<0.001),高水平消毒后表面和管腔菌落数均为0;气管镜在A2、B2、C2三组的ATP生物荧光检测采样中,表面ATP总量RLU值A2与B2组间比较差异有统计学意义(P<0.001),B2与C2组间比较差异有统计学意义(P=0.040);管腔ATP总量RLU值A2与B2组间比较差异有统计学意义(P<0.001),B2、C2两组差异无统计学意义(P=0.450)。结论 ATP生物荧光采样冲刷法对气管镜管腔采样更有效;人工清洗环节非常重要,人工清洗后气管镜表面和管腔ATP总量建议低于10 000和3 400。     

Infection prevention and surgery in the pandemic era

The COVID-19 pandemic has had a significant impact on surgical specialties. COVID-19 carries a significant risk to the surgical patient and the healthcare workers looking after them, with an increased incidence of pulmonary complications and mortality in patients who test positive perioperatively. Appropriate infection prevention and control measures are critical to ensure appropriate care is given and to reduce the risk of onward transmission. This article will discuss the measures that have been instigated and contributed to infection control in surgery, such as testing, patient isolation, personal protective equipment and ventilation. The COVID-19 pandemic has led to healthcare workers across many specialities working together to provide essential clinical care. This collaborative approach is critical to maintain excellent infection prevention and control practices required during this pandemic, which protect patients and preserve surgical services.     

薄层扫描法测定洁阴洗液中苦参碱的含量

目的：采用双波长薄层扫法测定洁阴洗液中苦参碱的含量。方法：用反射式锯齿扫描法测定,测定波长λｓ＝５２０ｎｍ,参比波长λＲ＝ｎｍ;展开剂为：氯仿－甲醇－氨水（３０：１：０．５）,显色剂为稀碘化铋钾试液。结果：点样量在０．６１３￣３．０６４μｇ范围内呈良好的线性关系,平均回收率为９９．５４％,ＲＳＤ为１．３５％（ｎ＝６）。结论：该法分离效果好,简便,快速,结果准确,适用于该制剂的质量控制。     

恒康正清在妇科手术前肠道准备中的应用

目的研究恒康正消口服灌肠剂在妇科手术前肠道准备中的应用，评价其耐受性及临床效果。方法我院妇科从2004年11月～2005年1月共有50例患者行妇科手术前接受恒康正清口服灌肠剂进行肠道准备。平均年龄51．2岁（29～75岁）。其中普通手术组16例，阴式手术组20例，恶性手术组14例。同期常规手术口服甘露醇行肠道准备10例为对照。术前1日给予恒康正清（甘露醇）口服，观察记录口服恒康正清过程中有无不适反应评价其耐受性。根据患者末次排便或灌肠排出物的性状及术中肠管胀气情况评判肠道准备的满意程度。术后观察患者有无腹胀，术后排气时间评价术后患者恢复情况。结果50例患者中，18例（36％）患者出现恶心、呕吐、腹痛、腹胀反应，但程度均较轻，患者可以耐受，未影响术前准备及手术。口服恒康正清普通手术组与对照组相比患者平均排便次数分别为6．0次和3．4次，两者比较差异有显著性，普通手术组满意率为81．3％，阴式手术满意率为95．0％。恶性手术组满意率为85．7％。普通手术组术后平均排气时间为40．5h，阴式手术组为铝．0h，恶性手术组为73．7h，前两组差异无显著性，但与恶性手术组相比差异有显著件。对照组平均排气时间为31．2h，与普通手术组相比差异无显著性。结论恒康正清口服肠道准备患者耐受性好．准备效果及术后患者恢复与甘露醇相比差异无显著性，适合妇科常用的手术前准备。     

前列地尔(凯时)对尿蛋白及肌酐清除率的影响

目的观察前列地尔(凯时注射液)静点对糖尿病肾病患者的尿蛋白排泄量及肌酐清除率的影响。方法对41例糖尿病肾病患者应用凯时治疗前后24小时尿蛋白及肌酐清除率对照。结果凯时对糖尿病肾病患者的尿蛋白及肌酐清除率均有改善(P<0.05)。结论凯时可以减少糖尿病肾病患者的尿蛋白及肌酐清除率。