消化内镜清洗消毒闭环管理系统构建与应用

结合消化内镜图文系统,根据消化内镜中心工作实际,构建并应用消化内镜清洗消毒闭环管理系统。实施后,清洗消毒错误事件从2017年2 973例下降至663例,工作效率从2017年30条/天提升至40条/天,差异均具有统计学意义（P<0.05)。消化内镜清洗消毒闭环管理系统提高了清洗消毒质量,提高了人力资源使用效率,提升了消化内镜中心质量管理水平。     

我院保洁工作的调查与评价

目的通过对我院保洁工作的调查与评价,探索如何提高医院保洁质量. 方法对我院84名保洁员就员工基本情况、使用的保洁方法、消毒液浓度、自身防护等方面进行无记名问卷调查,并对医院病房内门把手、灯开关、床桌、氧气台、窗台、水池、便器周围、保洁用地巾、抹布等在保洁后15 min采样培养,细菌计数. 结果掌握了员工的年龄、文化程度、从事保洁工作的时间、是否喜爱所从事的工作、是否参加公司的培训等基本情况;微生物学检查除水池以外,抽样合格率均＞85%. 结论系统、经常性地培训和严格管理是保证保洁工作质量的关键.     

碱性和中性多酶清洗剂清洗复用骨穿针效果比较

目的：比较碱性和中性多酶清洗剂清洗复用骨穿针的效果。方法：将2014年1-2月本院消毒供应中心回收的污染复用骨穿针按清洗日期分为实验组和对照组,每组150件。实验组用1：270的碱性多酶清洗剂清洗,对照组用1：270中性多酶清洗剂清洗,比较两组器械的清洗效果。结果：实验组和对照组的器械表面清洗合格率分别为98.67%、97.33%,比较差异无统计学意义（P〉0.05）,而实验组针腔内壁清洗合格率为96.00%、杰力试纸检测合格率为95.33%,分别高于对照组的90.00%、88.67%,差异均有统计学意义（P〈0.05）。结论：碱性多酶清洗剂清洗复用骨穿针的效果优于中性多酶清洗剂,值得推广使用。     

Attentional Bias in specific symmetry and cleaning dimensions of obsessive-compulsive disorder

Attentional bias (AB) refers to increased allocation of attention on threat stimuli when compared to neutral stimuli. It is not clear if AB occurs in subjects with obsessive-compulsive disorder (OCD). We tested AB for symmetry and cleaning symptoms of OCD. Sixty-two patients with OCD and 40 healthy controls matched by gender, age and IQ, completed a computerized dot-probe task where two pictures (with symmetry or cleaning related content) were shown. The probe appeared in the location previously occupied by one of the pictures. Within-subjects linear mixed-effect models were used to investigate the effects of the factors: group (patients vs controls), OCD dimension (cleaning vs symmetry), task condition (neutral, congruent and incongruent), and the interaction among them. We also correlated AB scores with the clinical and demographic variables. No positive interaction resulted among the factors, but positive results were observed in group and condition, separately. Patients were significantly slower than controls (p-value = 0.014) (an effect that was accounted for by depression and anxiety symptoms and comorbidity) and the neutral condition was significantly faster when compared the other two conditions (congruent and incongruent, p-value = 0.013). No association was found between AB scores and clinical symptoms. There was no AB toward specific, content-related, stimuli in this sample of OCD patients.     

复用器械使用后保存方式与时间对清洗效果的影响

目的探讨复用医疗器械使用后安全有效的保存和清洗方法,保证复用医疗器械清洗灭菌质量,降低由这一途径引起的医院感染。方法采用人工污染方法,将新鲜血液污染后的复用医疗器械随机分为A1、A2、B1、B2、C1、C2、D1、D2、E1、E2共10组,每组污染器械又分为6个小组,分别放置1h、2 h、3 h、4 h、12 h、16 h后再采用不同清洗方法对污染的医疗器械进行清洗,对清洗后的医疗器械进行潜血阳性检查,以检验清洗效果.该实验重复3次,合计4500件实验器械。结果对不同保存方法,不同的放置时间段,不同的清洗方法清洗后的复用医疗器械,潜血阳性率差异有统计学意义（P〈0.01）,其中放置16 h,不加任何处理开放保存的器械采用多酶机清洗[1]潜血阳性率最高,为66.67%。5种保存方法在1 h内2种清洗方法清洗,潜血阳性率差异无统计学意义（P〉0.01）。浸清水或多酶洗液浸泡组的器械在16 h内2种清洗方法清洗,其潜血阳性率在各自组内比较,差异无统计学意义（P〉O.01）。开放保存组、干密闭组和喷酶保存组2种清洗方法清洗,潜血阳性率在各自组内比较,差异有极显著的统计学意义（P〈0.01）。结论污染的医疗器因存放方式、存放时间及清洗方法的不同,清洗效果有明显差异。     

不锈钢麻花牵引圈的制作及在管腔器械清洗质量检查中的应用

目的 制作不锈钢麻花牵引圈并探讨其在管腔器械清洗质量检查中的应用效果。方法 将制作的不锈钢麻花牵引圈用于管腔器械清洗质量的检查,通过与目测+光源放大镜法、探条纱布法、ATP生物荧光法做比较,评价其在管腔器械清洗质量检查中的效果。结果 A类空腔器械清洗质量检查中,麻花牵引圈法、目测+放大镜法和ATP生物荧光法的清洗质量检查合格率差别有统计学意义（P<0.010）,两两比较,目测+放大镜法合格率最高,与其他2组的检查合格率差异具有统计学意义（P<0.017）,麻花牵引圈法与ATP生物荧光法的检查合格率差异无统计学意义（P>0.017）。B类空腔器械清洗质量检查中,4种清洗质量检查方法合格率差异具有统计学意义（P<0.010）,两两比较,目测+放大镜法合格率最高,与其他3组的检查合格率差异具有统计学意义（P<0.008）。麻花牵引圈法、探条纱布法和ATP生物荧光法的检查合格率差异无统计学意义（P>0.008）。结论 不锈钢麻花牵引圈在管腔器械清洗质量检查中,能发现目测+放大镜法无法检出的不合格器械,其检测效果与探条纱布法、ATP生物荧光法相当,比ATP生物荧光法节省费用,但操作较金属探条法便捷,适用范围更广。     

不同清洗口腔器械方法的效率与质量比较

目的 比较手工、手工联合超声清洗口腔器械的效率与质量。方法 将安徽医科大学附属口腔医院2019年1~6月口腔器械按随机数字表法分为A组（手工清洗）与B组（手工联合超声清洗）,每组200件。比较两组器械清洗耗时及合格率。结果 A组器械一次清洗耗时（1.02±0.29）h,B组（1.33±0.19）h,两组差异有统计学意义（t=-12.500,P<0.001）;A组器械二次清洗耗时（0.68±0.32）h,B组（0.32±0.20）h,两组差异有统计学意义（t=4.318,P<0.001）;A组器械完全合格清洗耗时（1.12±0.44）h,B组（1.34±0.21）h,两组差异有统计学意义（t=-6.367,P<0.001）。A组器械一次清洗合格率为85.50%,B组为94.50%,两组差异有统计学意义（χ²=9.000,P=0.003）。A组器械二次清洗合格率为89.66%,B组为100.00%,两组差异无统计学意义（P>0.05）。结论 手工联合超声清洗口腔器械,效率、清洗质量更高。     

Efficacy of various cleaning solutions on saliva-contaminated zirconia for improved resin bonding

PURPOSE

This study aimed to investigate the efficacy of cleaning solutions on saliva-contaminated zirconia in comparison to air-abrasion in terms of resin bonding.

MATERIALS AND METHODS

For saliva-contaminated airabraded zirconia, seven cleaning methods)-no contamination (NC), water-spray rinsing (WS), additional airabrasion (AA), and cleaning with four solutions (Ivoclean [IC]; 1.0 wt% sodium dodecyl sulfate [SDS], 1.0 wt% hydrogen peroxide [HP], and 1.0 wt% sodium hypochlorite [SHC])-were tested. The zirconia surfaces for each group were characterized using various analytical techniques. Three bonded resin (Panavia F 2.0) cylinders (bonding area: 4.5 mm²) were made on one zirconia disk specimen using the Ultradent jig method [four disks (12 cylinders)/group; a total of 28 disks]. After 5,000 thermocycling, all specimens were subjected to a shear bond strength test with a crosshead speed of 1.0 mm/minute. The fractured surfaces were observed using an optical and scanning electron microscope (SEM).

RESULTS

Contact angle measurements showed that groups NC, AA, IC, and SHC had hydrophilic surfaces. The X-ray photoelectron spectroscopy (XPS) analysis showed similar elemental distributions between group AA and groups IC and SHC. Groups IC and SHC showed statistically similar bond strengths to groups NC and AA (P>.05), but not groups SDS and HP (P<.05). For groups WS, SDS, and HP, blister-like bubble formations were observed on the surfaces under SEM.

CONCLUSION

Within the limitations of this in vitro study, some of the cleaning solutions (IC or SHC) were effective in removing saliva contamination and enhancing the resin bond strength.