Evaluation of the Impact of Refined Quality Control Management Model on the Qualified Rate of Disinfection and Sterilization of Surgical Instruments in the Sterilization Supply Center

Objective:To evaluate the application value of a refined quality control management model for a sterilization supply center.Methods:A retrospective analysis was conducted on the work situation of the sterilization supply center from January 2021 to January 2023.The work situation before January 31,2022,was classified as the control group;a routine quality control management model was implemented,and the work situation after January 31,2022,was classified as the observation group.The quality of medical device management and department satisfaction between the two groups were compared.Results:The timely recovery and supply rate,classification and cleaning pass rate,disinfection pass rate,packaging pass rate,sterilization pass rate,and department satisfaction score in the observation group were all higher than those of the control group(P<0.05).Conclusion:Implementing a refined quality control management model in the sterilization supply center can improve the quality management level of medical devices and department satisfaction and is worthy of promotion.

Escherichia coli inactivation by pressurized CO_2 treatment methods at room temperature: Critical issues

This study aims to increase the inactivation efficiency of CO_2 against Escherichia coli under mild conditions to facilitate the application of pressurized CO_2 technology in water disinfection. Based on an aerating-cycling apparatus, three different treatment methods（continuous aeration, continuous reflux, and simultaneous aeration and reflux） were compared for the same temperature, pressure（0.3–0.7 MPa）, initial concentration, and exposure time（25 min）. The simultaneous aeration and reflux treatment（combined method） was shown to be the best method under optimum conditions, which were determined to be 0.7 MPa, room temperature, and an exposure time of 10 min. This treatment achieved 5.1-log reduction after 25 min of treatment at the pressure of 0.3 MPa and 5.73-log reduction after 10 min at 0.7 MPa. Log reductions of 4.4 and 5.0 occurred at the end of continuous aeration and continuous reflux treatments at 0.7 MPa, respectively.Scanning electron microscopy（SEM） images suggested that cells were ruptured after the simultaneous aeration and reflux treatment and the continuous reflux treatment. The increase of the solubilization rate of CO_2 due to intense hydraulic conditions led to a rapid inactivation effect. It was found that the reduction of intracellular p H caused by CO_2 led to a more lethal bactericidal effect.

Gene expression changes in blood RNA after swimming in a chlorinated pool

Exposure to disinfection by-products（DBP） such as trihalomethanes（THM） in swimming pools has been linked to adverse health effects in humans, but their biological mechanisms are unclear. We evaluated short-term changes in blood gene expression of adult recreational swimmers after swimming in a chlorinated pool. Volunteers swam 40 min in an indoor chlorinated pool. Blood samples were drawn and four THM（chloroform,bromodichloromethane, dibromochloromethane and bromoform） were measured in exhaled breath before and after swimming. Intensity of physical activity was measured as metabolic equivalents（METs）. Gene expression in whole blood m RNA was evaluated using Illumina Human HT-12v3 Expression-Bead Chip. Linear mixed models were used to evaluate the relationship between gene expression changes and THM exposure. Thirty-seven before-after pairs were analyzed. The median increase from baseline to after swimming were： 0.7 to 2.3 for MET, and 1.4 to 7.1 μg/m^3 for exhaled total THM（sum of the four THM）.Exhaled THM increased on average 0.94 μg/m^3 per 1 MET. While 1643 probes were differentially expressed post-exposure. Of them, 189 were also associated with exhaled levels of individual/total THM or MET after False Discovery Rate. The observed associations with the exhaled THM were low to moderate（Log-fold change range：-0.17 to 0.15）. In conclusion, we identified short-term gene expression changes associated with swimming in a pool that were minor in magnitude and their biological meaning was unspecific. The high collinearity between exhaled THM levels and intensity of physical activity precluded mutually adjusted models with both covariates. These exploratory results should be validated in future studies.