In order to clean the endoscopic tube more effectively, a new double-headed endoscopic cleaning brush was used in this study. A total of 130 colonoscopies were selected from the Digestive Endoscopy Center of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from June 2019 to August 2020. The colonoscopy cleaning sequence was marked with odd and even number. Colonoscopies marked with the odd number were assigned to the conventional group ( n=65) which received back and forth cleaning with the single-headed endoscope cleaning brush. Colonoscopies marked with the even number were assigned to the experimental group ( n=65) which received one-way cleaning with a nylon brush at the head and a dense non-woven brush at the tail. The cleaning methods for endoscopes were in accordance with Flexible Endoscopic Cleaning and Disinfection Technical Specification WS507—2016. ATP bioluminescence tests and bacterial quantitative cultures were applied to evaluate the cleaning effects of the two methods. The results showed that ATP relative light unit (RLU) decreased in both the experimental group and the conventional group [530.63 RLU (26-3 559 RLU) VS 270.87 RLU (20-1 415 RLU)] before and after cleaning the endoscope tube, showing significant difference between the two groups ( Z=-2.894, P<0.05). After scrubbing, the positive rate of bacterial culture on the brush head was 86.2% (56/65) for the double-headed non-woven brush head, 46.2% (30/65) for the double-headed nylon brush head and 32.3% (21/65) for the single-headed nylon brush head with significant differences among the three groups ( χ 2=41.046, P<0.05). The cleaning effect of the new double-headed endoscopic cleaning brush is better than that of the conventional single-headed endoscopic cleaning brush for soft endoscope cleaning. Non-woven brush is better than nylon brush in eliminating bacteria.

目的 自行设计密闭式胆汁回输装置并评估其临床应用效果.方法 自行设计密闭式胆汁回输装置,选择2015年9月—2017年10月本院急诊重症监护室胆源性重症急性胰腺炎患者21例,采用自行设计的密闭式胆汁回输装置联合肠内营养同步收集回输,并进行效果评价.结果 胆汁回输后患者实验室营养指标改善,发生营养管阻塞1例.无误吸、导管滑脱及移位等不良事件发生.医护人员未发生职业暴露.结论 新型胆汁回输装置安全实用,提高疾病治疗效果,提升工作效率,值得推广应用.

Objective To investigate the application of intravenous transfusion instruments used in the emergency department of a Class Ⅲ GradeⅠhospital in Shanghai and to analyze relevant factors.Methods Totally 153 patients received intravenous treatment in the emergency department were selected and surveyed with self-designed ques-tionnaires on April 2015.Results The usage rate of clinical venous indwelling needle are widely used in clinical set-tingshas been higher,but there are still non-standard performances in terms of controlling its indication,inappro-priate use and incorrect selection of puncture site were existed.Lacking of the standard maintenance of venous in-dwelling needle and,the usageusing of infusion connector connection.and the disinfection of the connector,and the awareness of earlier phlebitis need to be improved for the emergency department nurses.Conclusion The imple-mentation standard of the intravenous therapy of is not strictly implemented by the clinical nurses is not good,and standardized effective training on intravenous therapy for nurses in the intravenous treatment is suggested to guar -antee and promote the its safety of intravenous therapy.

目的:汇总分析2010年上海世博会期间急救医疗转运的实际成效及出现的相关问题,以期提高今后大型公共活动急救医疗转运保障能力.方法:采集了上海市医疗急救中心记录的全部8 533份世博急救转运随车病案,对运力、转运病患特点、转运时效性、随车救援措施、救援车辆能耗等情况进行了回顾和相应的分析.结果:世博期间,急救转运月平均出车(1238.86±194.23)车次,转运患者(1 192±188.90)人次,有效转运率为90.92％,常规配备的救护车可基本满足日常急救转运需求.转运患者中以创伤患者(37.55％)最为常见,其中又以女性患者居多(62.51％).园区内转运半径及转运时效性优于全市平均水平,但救援车辆油耗量高于相关要求,且随车急救措施、救护能力及信息记录系统有待进一步完善.另外随车救援实施率仅为34.98％.结论:创伤是上海世博会期间最常见的需转运的疾病类型,世博会期间的医疗运力和时效性基本满足实际需要,但仍可通过改善布局、完善法规、促进民众意识、优化流程、改良设施配备来进一步的提高转运效率,以符合此类大型活动的需求.