An Environment‑Tolerant Ion‑Conducting Double‑Network Composite Hydrogel for High‑Performance Flexible Electronic Devices

High-performance ion-conducting hydrogels(ICHs)are vital for developing flexible electronic devices.However,the robustness and ion-conducting behavior of ICHs deteriorate at extreme tempera-tures,hampering their use in soft electronics.To resolve these issues,a method involving freeze–thawing and ionizing radiation technology is reported herein for synthesizing a novel double-network(DN)ICH based on a poly(ionic liquid)/MXene/poly(vinyl alcohol)(PMP DN ICH)system.The well-designed ICH exhibits outstanding ionic conductivity(63.89 mS cm^(-1) at 25℃),excellent temperature resistance(-60–80℃),prolonged stability(30 d at ambient temperature),high oxidation resist-ance,remarkable antibacterial activity,decent mechanical performance,and adhesion.Additionally,the ICH performs effectively in a flexible wireless strain sensor,thermal sensor,all-solid-state supercapacitor,and single-electrode triboelectric nanogenerator,thereby highlighting its viability in constructing soft electronic devices.The highly integrated gel structure endows these flexible electronic devices with stable,reliable signal output performance.In particular,the all-solid-state supercapacitor containing the PMP DN ICH electrolyte exhibits a high areal specific capacitance of 253.38 mF cm^(-2)(current density,1 mA cm^(-2))and excellent environmental adaptability.This study paves the way for the design and fabrication of high-performance mul-tifunctional/flexible ICHs for wearable sensing,energy-storage,and energy-harvesting applications.

Highly Flexible Graphene-Film-Based Rectenna for Wireless Energy Harvesting

Herein,we report the design,fabrication,and performance of two wireless energy harvesting devices based on highly flexible graphene macroscopic films(FGMFs).We first demonstrate that benefiting from the high conductivity of up to 1×10^(6)S m^(-1)and good resistive stability of FGMFs even under extensive bending,the FGMFs-based rectifying circuit(GRC)exhibits good flexibility and RF-to-DC efficiency of 53%at 2.1 GHz.Moreover,we further expand the application of FGMFs to a flexible wideband monopole rectenna and a 2.45 GHz wearable rectenna for harvesting wireless energy.The wideband rectenna at various bending conditions produces a maximum conversion efficiency of 52%,46%,and 44%at the 5th Generation(5G)2.1 GHz,Industrial Long-Term Evolution(LTE)2.3 GHz,and Scientific Medical(ISM)2.45 GHz,respectively.A 2.45 GHz GRC is optimized and integrated with an AMC-backed wearable antenna.The proposed 2.45 GHz wearable rectenna shows a maximum conversion efficiency of 55.7%.All the results indicate that the highly flexible graphene-film-based rectennas have great potential as a wireless power supplier for smart Internet of Things(loT)applications.

Manipulating the Macroscopic and Microscopic Morphology of Large-Area Gravure-Printed ZnO Films for High-Performance Flexible Organic Solar Cells

Gravure printing is a promising large-scale fabrication method for flexible organic solar cells(FOSCs)because it is compatible with two-dimension patternable roll-to-roll fabrication.However,the unsuitable rheological property of ZnO nanoinks resulted in unevenness and looseness of the gravure-printed ZnO interfacial layer.Here we propose a strategy to manipulate the macroscopic and microscopic of the gravure-printed ZnO films through using mixed solvent and poly(vinylpyrrolidone)(PVP)additive.The regulation of drying speed effectively manipulates the droplets fusion and leveling process and eliminates the printing ribbing structure in the macroscopic morphology.The additive of PVP effectively regulates the rheological property and improves the microscopic compactness of the films.Following this method,large-area ZnO∶PVP films(28×9 cm^(2))with excellent uniformity,compactness,conductivity,and bending durability were fabricated.The power conversion efficiencies of FOSCs with gravure-printed AgNWs and ZnO∶PVP films reached 14.34%and 17.07%for the 1 cm^(2)PM6:Y6 and PM6∶L8-BO flexible devices.The efficiency of 17.07%is the highest value to date for the 1 cm^(2)FOSCs.The use of mixed solvent and PVP addition also significantly enlarged the printing window of ZnO ink,ensuring high-quality printed thin films with thicknesses varying from 30 to 100 nm.

Malignant glaucoma treated by low-dose laser cycloplasty: a 1-year multicenter prospective noncomparative study

AIM:To report a one-year clinical outcomes of low-dose laser cycloplasty(LCP)among malignant glaucoma patients.METHODS:In this prospective,multicenter,noncomparative clinical study,participants with malignant glaucoma were recruited and underwent LCP at eight ophthalmic centers in China.Patients were followed up at 1wk,1,3,6,and 12mo.Intraocular pressure(IOP),number of glaucoma medications,anterior chamber depth(ACD),and complications were recorded.Anatomical success was defined as the reformation of the anterior chamber based on slit-lamp biomicroscopy.Recurrence was defined by the presence of a shallow orflat anterior chamber after initial recovery from treatment.RESULTS:A total of 34 eyes received LCP.Mean IOP and medications decreased from 36.1±11.5 mm Hg with 3.3±1.5 glaucoma medications pre-treatment to 20.9±9.8 mm Hg(P<0.001)with 2.9±1.6 medications(P=0.046)at 1d,and 17.4±6.7 mm Hg(P<0.001)with 1.3±1.7 medications(P<0.001)at 12mo.The ACD increased from 1.1±0.8 mm at baseline to 1.7±1.0 mm and to 2.0±0.5 mm at 1d and 12mo,respectively.A total of 32(94.1%)eyes achieved initial anatomical success.During follow-up,2(5.9%)eyes failed and 8(23.5%)eyes relapsed,yielding a 12-month anatomical success rate of 64.3%.Complications including anterior synechia(8.82%),choroidal/ciliary detachment(5.88%)and hypopyon(2.94%)were observed within 1wk.CONCLUSION:LCP is simple,safe,and effective in reforming the anterior chamber in malignant glaucoma.

Artificial Intelligence Meets Flexible Sensors:Emerging Smart Flexible Sensing Systems Driven by Machine Learning and Artificial Synapses

The recent wave of the artificial intelligence(AI)revolution has aroused unprecedented interest in the intelligentialize of human society.As an essential component that bridges the physical world and digital signals,flexible sensors are evolving from a single sensing element to a smarter system,which is capable of highly efficient acquisition,analysis,and even perception of vast,multifaceted data.While challenging from a manual perspective,the development of intelligent flexible sensing has been remarkably facilitated owing to the rapid advances of brain-inspired AI innovations from both the algorithm(machine learning)and the framework(artificial synapses)level.This review presents the recent progress of the emerging AI-driven,intelligent flexible sensing systems.The basic concept of machine learning and artificial synapses are introduced.The new enabling features induced by the fusion of AI and flexible sensing are comprehensively reviewed,which significantly advances the applications such as flexible sensory systems,soft/humanoid robotics,and human activity monitoring.As two of the most profound innovations in the twenty-first century,the deep incorporation of flexible sensing and AI technology holds tremendous potential for creating a smarter world for human beings.

Oxygen functionalization-assisted anionic exchange toward unique construction of flower-like transition metal chalcogenide embedded carbon fabric for ultra-long life flexible energy storage and conversion

The metal-organic framework(MOF)derived Ni–Co–C–N composite alloys(NiCCZ)were“embedded”inside the carbon cloth(CC)strands as opposed to the popular idea of growing them upward to realize ultrastable energy storage and conversion application.The NiCCZ was then oxygen functionalized,facilitating the next step of stoichiometric sulfur anion diffusion during hydrothermal sulfurization,generating a flower-like metal hydroxysulfide structure(NiCCZOS)with strong partial implantation inside CC.Thus obtained NiCCZOS shows an excellent capacity when tested as a supercapacitor electrode in a three-electrode configuration.Moreover,when paired with the biomass-derived nitrogen-rich activated carbon,the asymmetric supercapacitor device shows almost 100%capacity retention even after 45,000 charge–discharge cycles with remarkable energy density(59.4 Wh kg^(-1)/263.8μWh cm^(–2))owing to a uniquely designed cathode.Furthermore,the same electrode performed as an excellent bifunctional water-splitting electrocatalyst with an overpotential of 271 mV for oxygen evolution reaction(OER)and 168.4 mV for hydrogen evolution reaction(HER)at 10 mA cm−2 current density along with 30 h of unhinged chronopotentiometric stability performance for both HER and OER.Hence,a unique metal chalcogenide composite electrode/substrate configuration has been proposed as a highly stable electrode material for flexible energy storage and conversion applications.

Ionic Liquid-Enhanced Assembly of Nanomaterials for Highly Stable Flexible Transparent Electrodes

The controlled assembly of nanomaterials has demon-strated significant potential in advancing technological devices.However,achieving highly efficient and low-loss assembly technique for nanomate-rials,enabling the creation of hierarchical structures with distinctive func-tionalities,remains a formidable challenge.Here,we present a method for nanomaterial assembly enhanced by ionic liquids,which enables the fabrication of highly stable,flexible,and transparent electrodes featuring an organized layered structure.The utilization of hydrophobic and non-volatile ionic liquids facilitates the production of stable interfaces with water,effectively preventing the sedimentation of 1D/2D nanomaterials assembled at the interface.Furthermore,the interfacially assembled nanomaterial monolayer exhibits an alternate self-climbing behavior,enabling layer-by-layer transfer and the formation of a well-ordered MXene-wrapped silver nanowire network film.The resulting composite film not only demonstrates exceptional photoelectric performance with a sheet resistance of 9.4Ωsq^(-1) and 93%transmittance,but also showcases remarkable environmental stability and mechanical flexibility.Particularly noteworthy is its application in transparent electromagnetic interference shielding materials and triboelectric nanogenerator devices.This research introduces an innovative approach to manufacture and tailor functional devices based on ordered nanomaterials.

Mechanical reliable,NIR light-induced rapid self-healing hydrogel electrolyte towards flexible zinc-ion hybrid supercapacitors with low-temperature adaptability and long service life

Hydrogel electrolytes hold great potential in flexible zinc ion supercapacitors(ZICs)due to their high conductivity,good safety,and flexibility.However,freezing of electrolytes at low temperature(subzero)leads to drastic reduction in ionic conductivity and mechanical properties that deteriorates the performance of flexible ZICs.Besides,the mechanical fracture during arbitrary deformations significantly prunes out the lifespan of the flexible device.Herein,a Zn^(2+)and Li^(+)co-doped,polypyrrole-dopamine decorated Sb_(2)S_(3)incorporated,and polyvinyl alcohol/poly(N-(2-hydroxyethyl)acrylamide)double-network hydrogel electrolyte is constructed with favorable mechanical reliability,anti-freezing,and self-healing ability.In addition,it delivers ultra-high ionic conductivity of 8.6 and 3.7 S m^(-1)at 20 and−30°C,respectively,and displays excellent mechanical properties to withstand tensile stress of 1.85 MPa with tensile elongation of 760%,together with fracture energy of 5.14 MJ m^(-3).Notably,the fractured hydrogel electrolyte can recover itself after only 90 s of infrared illumination,while regaining 83%of its tensile strain and almost 100%of its ionic conductivity during−30–60°C.Moreover,ZICs coupled with this hydrogel electrolyte not only show a wide voltage window(up to 2 V),but also provide high energy density of 230 Wh kg^(-1)at power density of 500 W kg^(-1)with a capacity retention of 86.7%after 20,000 cycles under 20°C.Furthermore,the ZICs are able to retain excellent capacity even under various mechanical deformation at−30°C.This contribution will open up new insights into design of advanced wearable flexible electronics with environmental adaptability and long-life span.

Vibration Control of A Flexible Marine Riser System Subject to Input Dead Zone and Extraneous Disturbances

An observer-based adaptive backstepping boundary control is proposed for vibration control of flexible offshore riser systems with unknown nonlinear input dead zone and uncertain environmental disturbances.The control algorithm can update the control law online through real-time data to make the controller adapt to the environment and improve the control precision.Specifically,based on the adaptive backstepping framework,virtual control laws and Lyapunov functions are designed for each subsystem.Three direction interference observers are designed to track the timevarying boundary disturbance.On this basis,the inverse of the dead zone and linear state transformation are used to compensate for the original system and eliminate the adverse effects of the dead zone.In addition,the stability of the closed-loop system is proven by Lyapunov stability theory.All the system states are bounded,and the vibration offset of the riser converges to a small area of the initial position.Finally,four examples of flexible marine risers are simulated in MATLAB to verify the effectiveness of the proposed controller.

Hierarchically Structured Nb_(2)O_5 Microflowers with Enhanced Capacity and Fast-Charging Capability for Flexible Planar Sodium Ion Micro-Supercapacitors

Planar Na ion micro-supercapacitors(NIMSCs) that offer both high energy density and power density are deemed to a promising class of miniaturized power sources for wearable and portable microelectron-ics. Nevertheless, the development of NIMSCs are hugely impeded by the low capacity and sluggish Na ion kinetics in the negative electrode.Herein, we demonstrate a novel carbon-coated Nb_(2)O_5 microflower with a hierarchical structure composed of vertically intercrossed and porous nanosheets, boosting Na ion storage performance. The unique structural merits, including uniform carbon coating, ultrathin nanosheets and abun-dant pores, endow the Nb_(2)O_5 microflower with highly reversible Na ion storage capacity of 245 mAh g^(-1) at 0.25 C and excellent rate capability.Benefiting from high capacity and fast charging of Nb_(2)O_5 microflower, the planar NIMSCs consisted of Nb_(2)O_5 negative electrode and activated car-bon positive electrode deliver high areal energy density of 60.7 μWh cm^(-2),considerable voltage window of 3.5 V and extraordinary cyclability. Therefore, this work exploits a structural design strategy towards electrode materials for application in NIMSCs, holding great promise for flexible microelectronics.

Recent progress of self-supported air electrodes for flexible Zn-air batteries

Smart wearable devices are regarded to be the next prevailing technology product after smartphones and smart homes,and thus there has recently been rapid development in flexible electronic energy storage devices.Among them,flexible solid-state zinc-air batteries have received widespread attention because of their high energy density,good safety,and stability.Efficient bifunctional oxygen electrocatalysts are the primary consideration in the development of flexible solid-state zinc-air batteries,and self-supported air cathodes are strong candidates because of their advantages including simplified fabrication process,reduced interfacial resistance,accelerated electron transfer,and good flexibility.This review outlines the research progress in the design and construction of nanoarray bifunctional oxygen electrocatalysts.Starting from the configuration and basic principles of zinc-air batteries and the strategies for the design of bifunctional oxygen electrocatalysts,a detailed discussion of self-supported air cathodes on carbon and metal substrates and their uses in flexible zinc-air batteries will follow.Finally,the challenges and opportunities in the development of flexible zinc-air batteries will be discussed.

Control method based on DRFNN sliding mode for multifunctional flexible multistate switch

To address the low accuracy and stability when applying classical control theory in distribution networks with distributed generation,a control method involving flexible multistate switches(FMSs)is proposed in this study.This approach is based on an improved double-loop recursive fuzzy neural network(DRFNN)sliding mode,which is intended to stably achieve multiterminal power interaction and adaptive arc suppression for single-phase ground faults.First,an improved DRFNN sliding mode control(SMC)method is proposed to overcome the chattering and transient overshoot inherent in the classical SMC and reduce the reliance on a precise mathematical model of the control system.To improve the robustness of the system,an adaptive parameter-adjustment strategy for the DRFNN is designed,where its dynamic mapping capabilities are leveraged to improve the transient compensation control.Additionally,a quasi-continuous second-order sliding mode controller with a calculus-driven sliding mode surface is developed to improve the current monitoring accuracy and enhance the system stability.The stability of the proposed method and the convergence of the network parameters are verified using the Lyapunov theorem.A simulation model of the three-port FMS with its control system is constructed in MATLAB/Simulink.The simulation result confirms the feasibility and effectiveness of the proposed control strategy based on a comparative analysis.

ZnSb/Ti_(3)C_(2)T_(x)MXene van der Waals heterojunction for flexible near-infrared photodetector arrays

Two-dimension(2D)van der Waals heterojunction holds essential promise in achieving high-performance flexible near-infrared(NIR)photodetector.Here,we report the successful fabrication of ZnSb/Ti_(3)C_(2)T_(x)MXene based flexible NIR photodetector array via a facile photolithography technology.The single ZnSb/Ti_(3)C_(2)T_(x)photodetector exhibited a high light-to-dark current ratio of 4.98,fast response/recovery time(2.5/1.3 s)and excellent stability due to the tight connection between 2D ZnSb nanoplates and 2D Ti_(3)C_(2)T_(x)MXene nanoflakes,and the formed 2D van der Waals heterojunction.Thin polyethylene terephthalate(PET)substrate enables the ZnSb/Ti_(3)C_(2)T_(x)photodetector withstand bending such that stable photoelectrical properties with non-obvious change were maintained over 5000 bending cycles.Moreover,the ZnSb/Ti_(3)C_(2)T_(x)photodetectors were integrated into a 26×5 device array,realizing a NIR image sensing application.

Wearable flexible zinc-ion batteries based on electrospinning technology

Flexible wearable batteries are widely used in smartwatches, foldable phones, and fitness trackers due to their thinness and small size. Zinc-based batteries have the advantages of low cost, high safety, and ecofriendliness, which are considered to be the best alternative to flexible lithium-ion batteries(LIBs).Therefore, wearable flexible zinc-ion batteries(FZIBs) have attracted considerable interest as a promising energy storage device. Electrospun nanofibers(ESNFs) have great potential for application in wearable FZIBs due to their low density, high porosity, large specific surface area, and flexibility. Moreover, electrospinning technology can achieve the versatility of nanofibers through structural design and incorporation of other multifunctional materials. This paper reviews a wide range of applications of electrospinning in FZIBs, mainly in terms of cathode, anode, separator, polymer electrolyte, and all-inone flexible batteries. Firstly, the electrospinning device, principles, and influencing parameters are briefly described, showing its positive impact on FZIBs. Subsequently, the energy storage principles and electrode configurations of FZIBs are described, and some of the common problems of the batteries are illustrated, including zinc anode dendrite growth, corrosion, cathode structure collapse, and poor electrical conductivity. This is followed by a comprehensive overview of research progress on the individual components of FZIBs(cathode, anode, separator, and polymer electrolyte) from the perspective of electrostatically spun fiber materials and an in-depth study of all-in-one flexible batteries. Finally, the challenges and future development of FZIBs are individually concluded and look forward. We hope that this work will provide new ideas and avenues for the development of advanced energy technologies and smart wearable systems.

Viologen-based flexible electrochromic devices

Electrochromic technology has gained significant attention in various fields such as displays,smart windows,biomedical monitoring,military camouflage,human-machine interaction,and electronic skin due to its ability to provide reversible and fast color changes under applied voltage.With the rapid development and increasing demand for flexible electronics,flexible electrochromic devices(FECDs)that offer smarter and more controllable light modulation hold great promise for practical applications.The electrochromic material(ECM)undergoing color changes during the electrochemical reactions is one of the key components in electrochromic devices.Among the ECMs,viologens,a family of organic small molecules with 1,1'-disubstituted-4,4'-dipyridinium salts,have garnered extensive research interest,due to their well-reversible redox reactions,excellent electron acceptance ability,and the ability to produce multiple colors.Notably,viologen-based FECDs demonstrate color changes in the liquid or semisolid electrolyte layer,eliminating the need for two solid electrodes and thus simplifying the device structure.Consequently,viologens offer significant potential for the development of FECDs with high optical contrast,fast response speed,and excellent stability.This review aims to provide a comprehensive overview of the progress and perspectives of viologen-based FECDs.It begins by summarizing the typical structure and recent exciting developments in viologen-based FECDs,along with their advantages and disadvantages.Furthermore,the review discusses recent advancements in FECDs with additional functionalities such as sensing,photochromism,and energy storage.Finally,the remaining challenges and potential research directions for the future of viologen-based FECDs are addressed.

Efficacy and safety of low-dose cyclophosphamide combined with lenvatinib, pembrolizumab and TACE for unresectable hepatocellular carcinoma:A single-center, prospective,single-arm clinical trial

Objective: Unresectable hepatocellular carcinoma(uHCC) continues to pose effective treatment options. The objective of this study was to assess the efficacy and safety of combining low-dose cyclophosphamide with lenvatinib, pembrolizumab and transarterial chemoembolization(TACE) for the treatment of uHCC.Methods: From February 2022 to November 2023, a total of 40 patients diagnosed with uHCC were enrolled in this small-dose, single-center, single-arm, prospective study. They received a combined treatment of low-dose cyclophosphamide with lenvatinib, pembrolizumab, and TACE. Study endpoints included progression-free survival(PFS), objective response rate(ORR), and safety assessment. Tumor response was assessed using the modified Response Evaluation Criteria in Solid Tumors(mRECIST), while survival analysis was conducted through KaplanMeier curve analysis for overall survival(OS) and PFS. Adverse events(AEs) were evaluated according to the National Cancer Institute Common Terminology Criteria for Adverse Events(version 5.0).Results: A total of 34 patients were included in the study. The median follow-up duration was 11.2 [95% confidence interval(95% CI), 5.3-14.6] months, and the median PFS(mPFS) was 15.5(95% CI, 5.4-NA) months.Median OS(mOS) was not attained during the study period. The ORR was 55.9%, and the disease control rate(DCR) was 70.6%. AEs were reported in 27(79.4%) patients. The most frequently reported AEs(with an incidence rate >10%) included abnormal liver function(52.9%), abdominal pain(44.1%), abdominal distension and constipation(29.4%), hypertension(20.6%), leukopenia(17.6%), constipation(17.6%), ascites(14.7%), and insomnia(14.7%). Abnormal liver function(14.7%) had the most common grade 3 or higher AEs.Conclusions: A combination of low-dose cyclophosphamide with lenvatinib, pembrolizumab, and TACE is safe and effective for u HCC, showcasing a promising therapeutic strategy for managing uHCC.

Flexible perovskite light-emitting diodes for display applications and beyond

The flexible perovskite light-emitting diodes(FPeLEDs),which can be expediently integrated to portable and wearable devices,have shown great potential in various applications.The FPeLEDs inherit the unique optical properties of metal halide perovskites,such as tunable bandgap,narrow emission linewidth,high photoluminescence quantum yield,and particularly,the soft nature of lattice.At present,substantial efforts have been made for FPeLEDs with encouraging external quantum efficiency(EQE)of 24.5%.Herein,we summarize the recent progress in FPeLEDs,focusing on the strategy developed for perovskite emission layers and flexible electrodes to facilitate the optoelectrical and mechanical performance.In addition,we present relevant applications of FPeLEDs in displays and beyond.Finally,perspective toward the future development and applications of flexible PeLEDs are also discussed.

Flexible Graphene Field‑Effect Transistors and Their Application in Flexible Biomedical Sensing

Flexible electronics are transforming our lives by making daily activities more convenient.Central to this innovation are field-effect transistors(FETs),valued for their efficient signal processing,nanoscale fabrication,low-power consumption,fast response times,and versatility.Graphene,known for its exceptional mechanical properties,high electron mobility,and biocompatibility,is an ideal material for FET channels and sensors.The combination of graphene and FETs has given rise to flexible graphene field-effect transistors(FGFETs),driving significant advances in flexible electronics and sparked a strong interest in flexible biomedical sensors.Here,we first provide a brief overview of the basic structure,operating mechanism,and evaluation parameters of FGFETs,and delve into their material selection and patterning techniques.The ability of FGFETs to sense strains and biomolecular charges opens up diverse application possibilities.We specifically analyze the latest strategies for integrating FGFETs into wearable and implantable flexible biomedical sensors,focusing on the key aspects of constructing high-quality flexible biomedical sensors.Finally,we discuss the current challenges and prospects of FGFETs and their applications in biomedical sensors.This review will provide valuable insights and inspiration for ongoing research to improve the quality of FGFETs and broaden their application prospects in flexible biomedical sensing.

Preparation by Wet-spinning and Properties Polyaniline-Polyethersulfone Fibers for Flexible Supercapacitor Electrodes

Flexible PANI-Polyethersulfone (PES) fibers were fabricated using the wet-spinning technique.PANI particles were uniformly distributed within the matrix and micropores formed by the phase separation of PES,which prevented PANI particles aggregation and facilitated the formation of continuous ion transport channels.The experimental results reveals that the electrochemical performance of the fiber electrode material is optimal when the concentration of PES in the spinning solution is 15wt%.The assembled supercapacitor exhibits a commendable specific area capacitance of 162.75 mF·cm^(-2) at a current density of 0.5 mA·cm^(-2) and achieves an energy density of 14.47 mWh·cm^(-2) at a power density of 321.69 mW·cm^(-2).The capacitor retains 98.1% of its capacitance after 1 000 bending cycles.Therefore,the prepared fibers have good electrochemical properties and flexibility,and this simple and efficient preparation method is promising for the scalable production of flexible electrodes.

Efficacy of spray flushing in the reprocessing of flexible endoscopes:A randomized controlled trial

BACKGROUND Commonly used cleaning brushes in the reprocessing of flexible endoscopes often cause damage within the working channels.AIM To develop a spray flushing system to achieving effective cleaning of the working channels while minimizing damage.METHODS This prospective study included 60 used endoscopes and 60 Teflon tubes randomly divided into a control group(n=30)and an experimental group(n=30).The material of Teflon tubes was the same as that of the endoscope working channel.Endoscopes in the control group were manually cleaned using traditional cleaning brushes,while those in the experimental group were cleaned using the newly developed spray flushing system.ATP levels,cleanliness,and microbiological testing of the working channels were measured.Additionally,Teflon tubes in the control group underwent 500 passes with a cleaning brush,while those in the experimental group were subjected to the spray flushing system,and channel damage was evaluated.RESULTS The ATP levels(RLU)in the two groups were 32.5(13-66)and 26(16-40),respectively(P>0.05).Cleanliness scores were 1.5(1-2)and 1(1-2),respectively(P>0.05).Debris was found in 73.3%of the control group,which was significantly higher than 46.7%in the experimental group(P<0.05).Microbiological tests for both groups yielded negative results.Teflon tube damage in the control group was rated at 4(4-5.25),which was significantly higher than in the experimental group 4(3-4)(P<0.01).CONCLUSION The spray flushing system demonstrated superior efficacy in removing debris and resulted in less damage to the endoscope working channels compared with traditional cleaning brushes.