皮肤消毒液的种类及特点

皮肤消毒液是临床工作中不可缺少的杀菌药品。因为皮肤表面、毛囊及汗腺含有多种细菌，常见的细菌包括金黄色葡萄球菌、大肠埃希菌以及假单胞菌属、链球菌属、梭菌属和变形菌属等，这其中包括许多对抗生素耐药的菌株。皮肤消毒液杀菌效果的好坏直接影响着临床工作的质量。在临床工作中常用的皮肤消毒液有氧化剂类、表面活性剂类及醇类3大类。     

应用碘伏冲洗治疗脓胸的临床观察与护理

脓胸是呼吸内科及胸外科常见而难治的呼吸系统疾病，一般胸穿引流很难彻底治愈．抗生素难以进入包裹的脓胸，故往往病程长而治疗效果差。碘伏是近年广泛应用于临床的广谱杀菌剂，具有毒性低、杀菌力强的特点。对金黄色葡萄球菌、淋病奈瑟菌、铜绿假单胞菌等都有较强的杀灭作用，对皮肤黏膜无刺激．可直接作用于创面。2006年3月至2007年10月，本院对9例急性及慢性脓胸患者采用了胸腔镜手术下脓胸清除术和术后0．5％碘伏冲洗的综合治疗方法，取得了较好的疗效。现将护理措施报道如下。     

多学科综合诊疗模式在肺移植受者多重耐药菌感染防控的应用

目的 探讨多学科综合诊疗（MDT）模式在肺移植受者术后多重耐药菌（MDRO）感染防控中的实践效果。方法 选择2019年至2022年的肺移植受者,从2020年1月开始成立MDT专家组,开展一系列防控措施,分析2020年至2022年MDRO防控措施落实率、环境物表MDRO检出率以及2019年至2022年肺移植受者MDRO检出率。结果 医护人员总体MDRO防控措施落实率由2020年的64.9%上升至2022年的91.6%,呈逐年升高趋势（P<0.05）。监测环境物表MDRO检出率从2020年的28%下降到2022年的9%,呈逐年下降趋势（P<0.05）。肺移植受者MDRO检出率从2019年的66.7%降低至2022年的44.3%,呈逐年降低趋势（P<0.001）。结论 通过MDT模式管理,提高了医务人员MDRO防控措施的执行力,有效降低了肺移植受者术后MDRO感染率和环境物表MDRO检出率,值得推广利用。     

蒲公英酸奶的研制及其抑菌效果的研究

以鲜牛乳和蒲公英汁为主要原料,添加蔗糖,经杀菌、接种保加利亚乳杆菌和嗜热链球菌为发酵剂.采用5因素4水平L16(45)正交试验,获得了制作蒲公英酸奶的最佳工艺参数:在鲜牛乳中添加8 g/dL的蔗糖,121 ℃杀茵15 min,加入体积分数9%的蒲公英汁,接种体积分数3.5%的发酵剂,发酵温度为42 ℃、时间为4 h.用该奶制品作纸片法抑菌试验,结果表明:其抑菌作用的大小依次为:蜡样芽孢杆菌＞金黄色葡萄球菌＞溶血性链球菌＞志贺氏菌＞沙门氏菌＞致泻大肠埃希氏菌;而且当蒲公英酸奶中蒲公英汁体积分数≤9%时,其抑菌作用随蒲公英汁含量的增加而增强;而当蒲公英汁体积分数＞9%后,其抑菌强度增加极缓,并非成正比增强,其原理有待进一步研究.     

院内痰培养中常见病原菌的耐药性分析

有报道显示,大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌和铜绿假单胞菌是临床常见的革兰阴性杆菌。为及时了解本院痰培养中常见病原菌的耐药性,以指导临床经验治疗呼吸道感染,本研究对2013年1月至2013年12月本院痰培养标本中检出率居前4位的病原菌进行耐药性分析,现报道如下。     

Iodine intoxication after subcutaneous irrigations of povidone iodine

Irrigation of povidone iodine considered as a safe and effective procedure, is frequently used for deep infections. We report a case of intoxication by iodine in a man of 68-year-old after subcutaneous irrigations of Betadine at a concentration of 20% for a subcutaneous infection of the thigh. Abnormalities of cardiac conduction, lactic acidosis, acute renal failure, hypocalcaemia and thyroid dysfunction were the manifestations of the intoxication confirmed by a very high level of total blood iodine and urine iodine.     

利福平和几丁糖对慢性骨髓炎的影响

目的 报告利福平（ＲＦＰ）和几丁糖治疗慢性骨髓炎的临床疗效。方法 根据患者年龄、肝脏功能、症状体征以及Ｘ线片改变来确定ＲＦＰ与几丁糖的日服量和治疗总量。结果 本组病例随访时间平均２７月,临床愈合２３例,有效２例,无效３例。结论 ＲＦＰ与几丁糖联合应用能增强抗菌效力,减少ＲＦＰ对肝脏和强化肝脏机能以及提高机体免疫力。     

碘伏油纱伤口换药疗效观察

将 12 0例伤口换药病人随机分为观察组和对照组各 6 0例。观察组采用碘伏油纱 ,对照组采用庆大霉素纱布条换药。结果两种不同方法换药疗效比较 ,观察组疗效明显优于对照组 (P <0 .0 1)。提示碘伏油纱与新生肉芽组织不粘连 ,能减轻病人痛苦 ,缩短换药时间。     

复方氯已定甲硝唑栓治疗肛窦炎的临床观察

为观察复方氯已定甲硝唑栓治疗肛窦炎的疗效,我们将120例肛窦炎患者随机分为治疗组和对照组,各60例。治疗组应用复方氯已定甲硝唑栓,对照组应用肤痔清软膏。结果显示,治疗组总有效率为95．0％,明显优于对照组78．3％（P〈0．01）。结果表明,复方氯已定甲硝唑栓治疗肛窦炎疗效好,起效快。     

Chlorhexidine versus povidone iodine in preventing colonization of continuous epidural catheters in children: a randomized, controlled trial

BACKGROUND: Chlorhexidine is better than povidone iodine for skin preparation before intravascular device insertion or blood culture collection, but it is not known whether chlorhexidine is superior in reducing colonization of continuous epidural catheters. METHODS: Children requiring an epidural catheter for postoperative analgesia longer than 24 h were randomly assigned to receive skin preparation with an alcoholic solution of 0.5% chlorhexidine or an aqueous solution of 10% povidone iodine before catheter insertion. Using surgical aseptic techniques, catheters were inserted into either the lumbar or the thoracic epidural space based on the preferences of the anesthesia team, on clinical indication, or both. Immediately before epidural catheter removal, their insertion site and hub were qualitatively cultures. After their removal, the catheter tips were quantitatively cultured. Catheters were classified as colonized when their tips yielded 1,000 or more colony-forming units/ml in cultures. RESULTS: Of 100 randomly assigned patients, 96 were evaluable. The clinical characteristics of the patients and the risk factors for infection were similar in the two groups. Catheters were kept in place for a median (range) duration of 50 (range, 21-100) h. Catheters inserted after skin preparation with chlorhexidine were one sixth as likely and less quickly to be colonized as catheters inserted after skin preparation with povidone iodine (1 of 52 catheters [0.9 per 100 catheter days] vs. 5 of 44 catheters [5.6 per 100 catheter days]; relative risk, 0.2 [95% confidence interval, 0.1-1.0]; P = 0.02). Coagulase-negative staphylococci were the only colonizing microorganisms recovered, and the skin surrounding the catheter insertion site was the origin of all the colonizing microorganisms. CONCLUSIONS: Compared with aqueous povidone iodine, the use of alcoholic chlorhexidine for cutaneous antisepsis before epidural catheter insertion reduces the risk of catheter colonization in children.     

The effect of methimazole, iodine and splenocytes on thyroid transplants in BB/Wor rats.

BACKGROUND: BB/Wor rats develop spontaneous autoimmune insulin-requiring diabetes mellitus and lymphocytic thyroiditis (LT). Our investigations examined the effect of the thyroid-specific agents, iodine and methimazole (MMI) on thyroid graft survival in BB/Wor rats, compared the intrathyroidal cytokine mRNA expression of endogenous and engrafted thyroids, and ascertained whether unfractionated splenocytes could protect thyroid grafts from lymphocytic infiltration. METHODS: In study 1, 0.025% iodine water-treated LT-prone NB line BB/Wor rats were randomized to receive one of the following treatments: (1) 1.0 x 10(8) splenocytes, IV from LT-resistant WA line BB/Wor rats, (2) WA rat thyroid transplants, (3) both, or (4) neither (controls). In study 2, after thyroid transplantation, LT-prone BB/Wor rats were randomized to receive (1) WA splenocytes, (2) 0.025% iodine water, (3) 0.05% MMI water or, (4) tap water (controls). The incidence of LT was determined by microscopic inspection after hematoxylin and eosin staining. Lymphocytic infiltrates were characterized by immunohistochemistry. Cytokine mRNA was detected by RT-PCR. RESULTS: Grafts from MMI-treated rats had a significantly lower incidence of lymphocytic infiltration (MMI: 2/5; Tap: 5/5; I 5/5, P<0.05, chi2). IL-10 mRNA was expressed in 77% (7/9) endogenous thyroids and 20% (1/5) of the transplanted WA thyroids (P<0.05, chi2) from iodine-treated rats with LT. There was no difference in IL-12 mRNA expression. Lymphocytic infiltration occurred in 100% of the splenocyte-treated graft recipients. Both endogenous and engrafted thyroids contained CD4 and C8 T cells with scattered IgG staining. CONCLUSION: Target organ-specific interventions that suppress antigen presentation may have an adjunctive role in transplantation tolerance. The differential expression of IL-10 may indicate preferential Th2 lymphocyte activation in the endogenous tissues.     

摄入不同剂量碘对雄性大鼠生殖系统的影响

目的研究碘过量对雄性大鼠生殖功能的潜在影响。方法离乳雄性大鼠喂饲添加高碘0．5、1、2．5、5倍饲料为实验组,以喂饲正常饲料（碘含量200μg／kg）为对照组,连续130～136d,观察生殖器官组织和精子质量的变化。结果实验组动物睾丸重量降低且具有剂量效应关系,高碘1倍以上3组降低明显（P〈0．05～0．01）;精子活动性指标未见明显影响（P〉O．05）;精子浓度和总数均呈下降趋势,分别降低6．59％、22．53%、17．36％、18．06％,但仅在高碘1倍组降低明显（P〈0．05）;高碘各组正常精子形态明显降低（P〈0．05）;高碘5倍组睾丸组织细胞形态可见轻度改变。结论碘过量对大鼠可能具有潜在的雄性生殖毒害作用。     

The effect of organism environment on bacteriostatic and mechanical properties of Palacos R cement mixed with antibiotic]

The results of bacteriological tests of Palacos R cement with antibiotic directly after its obtaining and 3 and 6 months after implantation in rabbit organism have been presented in this work. The results of tests of mechanical characteristics of cement with and without antibiotic samples after being kept in physiological saline for 3 to 6 weeks have also been presented. Bacteriological tests prove that antibiotic (III generation cephalosporin) added to surgical cement retain its bacteriostatic properties. When tested on rabbits cement plus antibiotic retains its bacteriostatic properties only in the initial period. Kep of the Palacos R cement with and without III generation cephalosporin in physiological saline insignificantly decreased the strength properties as compared to respective values of dry cement strength and did not lead to any loss of its visco-elasticity.