Ototoxicity of povidone-iodine——A case report

Objective: The ototoxicity of povidone-iodine has been documented in animal studies. However, there is limited evidence of these ototoxic effects in humans. This is the first report to show the ototoxic effects of povidoneiodine in a human subject.Patient: A 36-year-old woman came to our hospital complaining of left unilateral persistent hearing loss. One month before presentation, her child had accidentally struck her on her left ear. She applied approximately three drops of povidone-iodine(10% weight/volume) into her left auditory canal. Immediately after application, she felt severe pain and vertigo. An audiogram revealed severe left unilateral sensorineural hearing loss. Magnetic resonance imaging showed mild enhancement of the left vestibule and basal turn of the left cochlea.Conclusions: Even a single application of povidone-iodine could cause significant hearing loss and disequilibrium. It should, therefore, be used with caution.

The Antiseptic Efficacy of Povidone-Iodine in Reducing Early Surgical Site Infections in Orthopaedic Implant Surgeries

Background: Surgical site infection (SSI) is a dreaded nightmare for the Orthopaedic surgeon. Preoperative skin cleaning with antiseptics has been shown to reduce the microbial burden of the skin and results in reduced incidence of SSI. However, the ideal skin cleaning agent remains to be established. Aim: To compare the efficacy of Povidone-Iodine/Povidone-Iodine (PI-PI) combination with that of Chlorhexidine-Gluconate/Alcohol (CG-A) combination in re-ducing SSI in Orthopaedic surgeries. Methods: This was a prospective, randomized, double-blinded, controlled study. Subjects that met the selection criteria and gave consent were randomized into PI-PI group (test group) and the CG-A group (control group). Both the patients and the assessors for SSI were blinded to the group a participant belongs. Blocking was done on the type of surgery to cancel the confounding effect of surgery type on SSI. Standard perioperative protocols were applied to both groups. Assessment for features of SSI was done on the 3rd day, 7th day, 14th day, 6th week and 12th-week postoperative period. The diagnosis of SSI was made based on the Centers for Disease and Control (CDC) guidelines. Results: We recruited 124 patients for this study, 62 males and 54 females. The mean age of the subjects was 37.5 years (SD = 14.7 years). Sixty-two subjects were randomized into each group. There was no significant difference in the distribution of the genders in the study arms. Other possible confounders such as duration of hospital stay, use of drains, the surgeon involved and age were evenly distributed in the two groups. Eight patients did not complete the study. The overall incidence of SSI in the study was 2.6%. Subjects in the control group had an SSI of 3.4% while those in the PI-PI group had a rate of 1.8%;however, this was not significant, p = 0.579. Conclusion: Both CG-A and PI-PI combinations are equally efficacious as preoperative skin antiseptic in Orthopaedic implant surgeries.

Effects of Povidone-Iodine or Ethanol Exposure on Bone Formation at the Osteotomy Site of the Proximal Tibia in Rats

Background: Povidone-iodine (PVI) irrigation is currently used to decrease the frequency of postoperative surgical site infections. Ethanol (EtOH) is sometimes applied to prevent local recurrence after curettage of benign bone tumors. However, the effects of PVI and EtOH on surrounding soft tissue and on bone union are unclear. The purpose of this study was to determine whether PVI or EtOH adversely affects the cancellous bone healing of the osteotomy site at the proximal tibia in rats. Methods: A cancellous bone osteotomy was performed at the right proximal tibia in 4-month-old, female, Sprague Dawley rats. Vehicle, 10% PVI, or 95% EtOH-soaked gauze was inserted into the osteotomy site and maintained for 6 minutes. The rats were euthanized 2 or 4 weeks after the osteotomy. Results: Two weeks after treatment, the bone union rate was significantly higher in the vehicle group than in the PVI group and the EtOH group (p < 0.001). However, the bone union rate was not significantly different between the PVI and EtOH groups. There was no significant difference among the three groups in the bone union rate 4 weeks after treatment. Conclusion: PVI or EtOH delayed bone union of the cancellous bone osteotomy site of the proximal tibia in the early phase (2 weeks), but not at 4 weeks, in rats.

Research on Bacteriostatic and Bactericidal Efficacy of Povidone Iodine on Aeromonas

[Objective] The aim of this study is to investigate the bacteriostatic and bactericidal efficacy of povidone iodine as one kind of disinfectants for aquaculture on Aeromonas.[Method] With the standard strain of Aeromonas ATCC7966 and the Aeromonas strains isolated from diseased fish or aquatic environment as the tested strains,the bacteriostatic and bactericidal efficacy of povidone iodine was studied by double broth dilution method.[Result] The povidone iodine could inhibit the growth of Aeromonas strains at lower concentration,and killed Aeromonas strains at higher concentration.The minimum bacteriostatic concentration（MIC） of povidone iodine on Aeromonas sp.T1,Aeromonas sp T2 and Aeromonas sp.T4 was 125.00 mg/L,and the minimum bactericidal concentration（MBC） was 4.00 g/L.Whereas,the minimum bacteriostatic concentration（MIC） of povidone iodine on ATCC7966,Aeromonas sp.T3,Aeromonas sp T5 and Aeromonas sp.T6 was 250.00 mg/L,and the minimum bactericidal concentration（MBC） was 8.00 g/L.[Conclusion] This study provides certain basis for reasonable application of povidone iodine.

Effect of diluted povidone iodine in adenoviral keratoconjunctivitis on the rate of subepithelial corneal infiltrates

AIM: To evaluate the clinical characteristics of adenoviral keratoconjunctivitis, the management modalities, as well as the incidence of subepithelial corneal infiltrates(SEI).METHODS: Patients with characteristic clinical symptoms and signs, who presented to our clinic within the first week of symptoms and received the diagnosis of adenoviral keratoconjunctivitis between January 2013 and April 2016, were included in the study. A total of 211 patients were included in the study. Patients were evaluated for the incidence of clinical signs, late complications, management preferences, and the effect of diluted povidone-iodine(d-PVP-I) 2%. RESULTS: Patients’ mean age was 33.03±14.76 y. We observed an increase in the number of cases according to the years. At presentation and/or early follow-up, the clinical signs were conjunctival hyperemia(100%), conjunctival follicules(79.1%), edema of the eyelids(39.3%), chemosis(16.1%), pseudomembrane formation(16.6%), and corneal epitheliopathy(29.9%). During late follow-up 13.3% patients developed conjunctival subepithelial fibrosis, and 39.8% developed SEI. A significant decrease in the incidence of SEI development was observed in patients who used d-PVP-I 2%(P=0.032;33.3% vs 45.9%, respectively in patients who received d-PVP-I 2% and who did not).CONCLUSION: Adenoviral keratoconjunctivitis has a tremendous effect on patient’s comfort and abilities in short-term. Additionally, almost half of the patients develop visual problems related to SEI. According to our clinical experience, using d-PVP-I 2% in the first days of adenoviral keratoconjunctivitis might be helpful in reducing the risk of SEI as a complication.

Effects of diquafosol sodium in povidone iodine-induced dry eye model

AIM:To investigate the effects of diquafosol sodium(DQS)for dry eye model induced with povidone-iodine(PI)solution.METHODS:Ten Sprague Dawley rats as the control group.Thirty Sprague Dawley rats were used to establish the dry eye model with stimulation of 10 g/L PI for 14d,then divided rats into three groups:dry eye group with no treatment(DED group,n=10);phosphate buffer saline treated group(PBS group,n=10);diquafosol treated group(DQS group,n=10).Clinical changes were observed by tear production test,fluorescein staining,tear breakup time(TBUT)test,corneal confocal microscope and ocular surface comprehensive analyzer.Eyeballs were collected on day 10 of treatment for hematoxylin-eosin(HE),periodic acid-Schiff(PAS),and alcian blue staining.TUNEL assay,polymorphonuclear(PMN)and mucin 1(MUC1)immunofluorescence were performed and corneal ultrastructural changes were detected by electron microscopy.RESULTS:Compared with DED and PBS groups,tear production(7.26±0.440 vs 4.07±0.474 mm;7.26±0.440 vs 3.74±0.280 mm;all P<0.01)and TBUT(7.37±0.383s vs 1.49±0.260s;7.37±0.383s vs 1.42±0.437s;all P<0.01)were significantly increased in DQS group.HE,PAS,and alcian blue staining and MUC1 immunofluorescence showed mucins and conjunctival goblet cells density(8.45±0.718 vs 5.21±0.813 cells/0.1 mm^(2);8.45±0.718 vs 5.36±0.615 cells/0.1 mm^(2);all P<0.01)increased in DQS group.Confocal microscopy,PMN immunofluorescence and TUNEL staining showed inflammatory infiltration and corneal epithelial cells apoptosis decreased in DQS group.The increased number of microvilli in corneal epithelial and the recovered cell junction were observed in DQS group.CONCLUSION:PI instillation can induce goblet cells and mucin loss,epithelial cell apoptosis and inflammation,which are consistent with the pathological manifestations of dry eye.Diquafosol can repair the ocular surface damage caused by PI,reduce corneal inflammation,inhibit corneal epithelial cell apoptosis,promote mucin secretion and maintain tear film stability.

Is the Prophylactic Administration of Povidone Iodine Intranasally Preoperatively in Elective Total Knee Replacement as Effective as MRSA Prophylactic Screening and Mupirocin Treatment?—A Retrospective Analysis

Surgical Site Infections (SSIs) remain a prevalent issue in healthcare. An average of 2% to 4% of all Total Knee Arthroplasties (TKA/TKR) result in a Prosthetic Joint Infection (PJI) (Ashraf et al. , 2018). These surgical site infections cause significant distress to the patient and require extended courses of antibiotic treatment and revision surgery of the infected joint. SSIs also reduce financial reimbursement to the surgery facility and affect the performing surgeon’s performance scores. To prevent surgical infection, healthcare facilities have implemented various screening or decolonization methods to prevent surgical infection to may cause infection. Various treatment methods exist for managing MRSA preoperatively which include Povidone Iodine (PI) application as a universal decolonization method and/or screening every patient pre-operatively for MRSA and treating MRSA-positive patients with Mupirocin ointment. Both interventions are well-established in the literature. At the author’s facility, the elective TKR populations were analyzed while each intervention was implemented. In 2019 TKR patients underwent MRSA swabbing and testing and in 2021 PI decolonization was the decolonization method of choice. The study revealed that MRSA testing and swabbing were better at reducing SSI related to MRSA than Povidone Iodine decolonization.

聚维酮碘对家兔创面组织浸泡冲洗的影响

背景:临床上人工关节置换所面临的最危险、最严重的并发症就是发生人工关节假体周围感染,找到一个能够预防人工关节置换假体周围感染的方法是迫切需要的。目的:观察聚维酮碘对家兔肌肉、血管、脂肪和骨质等组织进行浸泡冲洗后的影响。方法:选取40只10周龄雄性新西兰大白兔,每只兔子的左后腿作为实验组,右后腿作为对照组。兔后肢麻醉后切开,显露后肢的肌肉、血管、脂肪和骨质,对照组手术切口内用生理盐水浸泡和冲洗;实验组手术切口内用聚维酮碘原液及生理盐水浸泡和冲洗。40只兔分别在浸泡聚维酮碘0,1,3,5 min时随机处死10只切取创面组织标本,采用苏木精-伊红染色制片,对细胞数目及分布进行统计学分析和比较。结果与结论:①经聚维酮碘浸泡冲洗的肌肉、血管、脂肪和骨质与生理盐水对照组相比,镜下未见其细胞结构、形态及数目有明显的差异;②运用配对t检验探究对照组与实验组之间的差异性,配对数据均没有呈现出差异性(P>0.05);③提示聚维酮碘对家兔肌肉、血管、脂肪和骨质等组织进行浸泡冲洗后与生理盐水相比未见明显差异,反映了聚维酮碘溶液作为创口内消毒剂的安全有效性。

米诺环素联合聚维酮碘含漱液治疗中重度牙周炎患儿疗效及对龈沟液PGE2、IL-1β、IL-8水平的影响

目的探讨米诺环素联合聚维酮碘含漱液(PIG)治疗中重度牙周炎患儿疗效及对龈沟液前列腺素E2(PGE2)、白细胞介素(IL)-1β、IL-8水平的影响。方法选取2021年5月至2022年5月该院收治的中重度牙周炎患儿120例作为研究对象,按简单随机化法将其分为对照组(n=60,在牙周基础治疗基础上使用PIG治疗)和观察组(n=60,在对照组基础上使用米诺环素治疗)。对比两组患儿治疗效果;检测并对比两组治疗前后牙周相关指标[出血指数(BI)、牙龈指数(GI)和菌斑指数(PLI)]评分及牙周功能相关指标[牙周探诊深度(PD)和附着丧失(AL)]及龈沟液炎症因子(PGE2、IL-1β、IL-8)水平;记录并对比两组患儿不良反应发生情况。结果治疗后,观察组治疗总有效率为96.67%,明显高于对照组的85.00%(P<0.05)。治疗后,两组BI、GI、PLI评分和PD、AL及龈沟液PGE2、IL-1β、IL-8水平显著低于治疗前,且观察组治疗后BI、GI、PLI评分和PD、AL水平及龈沟液PGE2、IL-1β、IL-8水平显著低于对照组,差异均有统计学意义(P<0.05)。两组患儿不良反应总发生率比较,差异无统计学意义(P>0.05)。结论米诺环素联合PIG治疗中重度牙周炎患儿疗效显著,可有效改善患儿牙周指标、牙周功能,降低龈沟液炎症因子水平,安全、可靠,适合临床推广应用。

纳米硒联合聚维酮碘对手术感染杀菌的效果

【目的】负载多功能纳米硒聚维酮碘(PVP-I@Se)消毒剂对金黄色葡萄球菌(SA)、耐甲氧西林金黄色葡萄球菌(MRSA)的杀菌效果,为皮肤手术部位消毒提供实验依据。【方法】实验分为PVP-I组(对照组)与PVPI@Se组(实验组),两组的碘浓度梯度相同,分别为50、75、100、200和400μg/mL,实验组硒浓度2μg/mL,对照组不添加硒,比较两组不同的消毒液对SA、MRSA的消毒效果,检测指标包括最低抑菌浓度(MIC)和最低杀菌浓度(MBC);碘浓度50μg/mL时的最短杀菌时间;碘浓度200μg/mL、400μg/mL时的抑菌圈大小。【结果】对照组对SA、MRSA的MIC均为79.17μg/mL、实验组分别为54.17和70.83μg/mL。而对照组对SA、MRSA的MBC分别为129.17和150.00μg/mL,实验组分别为70.83和87.50μg/mL。碘浓度50μg/mL时,对照组对SA、MRSA的最短杀菌时间为130 s、140 s,实验组分别为65 s、75 s。碘浓度200μg/mL时,对照组对SA、MRSA的抑菌圈直径分别为7.67 mm、8.33 mm,实验组均为9.50 mm。碘浓度400μg/mL时,对照组对SA、MRSA的抑菌圈直径分别为9.00 mm、9.33 mm,实验组分别为11.67 mm、12.00 mm。【结论】在聚维酮碘浓度为50、75、100、200和400μg/mL时,分别加入浓度为2μg/mL的硒,可增强其对SA、MRSA的杀菌效果、缩短作用时间。硒(SeNPs)加入PVP-I对SA、MRSA的杀菌效果均有增效作用。但增敏效果SA较MRSA显著。MRSA的增效作用对碘浓度(400μg/mL)需求较高。为临床精准选用消毒剂的浓度和作用时间,降低临床皮肤手术部位感染提供理论依据。

4种水产常用药物对华鳈鱼苗的急性毒性试验

采用静态急性毒性试验法,开展了硫酸铜、敌百虫、甲苯咪唑、聚维酮碘等4种水产常用药物,对华鳈鱼苗的急性毒性试验。结果表明,硫酸铜对华鳈24,48和96 h的半致死浓度(LC_(50))分别为0.63,0.41和0.29 mg/L,安全浓度(SC)为0.05 mg/L;敌百虫对华鳈鱼苗24,48和96 h的LC_(50)分别为58.73,25.58和13.98 mg/L,SC为1.44 mg/L;甲苯咪唑对华鳈鱼苗24,48和96 h的LC_(50)分别为4.89,3.11和2.57 mg/L,SC为0.38 mg/L;聚维酮碘对华鳈24,48和96 h的LC_(50)分别为11.58,10.43和10.31 mg/L,SC为2.54 mg/L。指出,硫酸铜慎用于试验规格的华鳈鱼苗,敌百虫、甲苯咪唑、聚维酮碘可用于试验规格华鳈鱼苗的疾病防治。

在人工关节置换术中应用聚维酮碘溶液冲洗预防术后感染效果的Meta分析

目的:系统评价在人工关节置换术中应用聚维酮碘溶液冲洗预防术后感染的效果。方法:应用计算机检索中国知网、万方数据库、PubMed、Embase、Web of Science和Cochrane Library中关于在人工关节置换术中应用聚维酮碘溶液冲洗预防术后感染的对比研究文献,检索时限均为建库至2023年11月1日。试验组术中采用聚维酮碘溶液冲洗,对照组术中采用其他冲洗液冲洗。依据文献检索及筛选方案筛选出符合要求的文献后,由2名研究人员分别独立进行数据提取和质量评价。采用RevMan5.3软件进行Meta分析。结果:共检索到601篇文献,最终纳入14篇,共涉及61 471例患者,其中试验组20 110例、对照组41 361例。2组总感染发生率、假体周围感染发生率、切口延迟愈合或不愈合发生率、二次手术率的组间比较,差异均无统计学意义[OR=0.68,95%CI(0.43,1.07),P=0.090;OR=0.68,95%CI(0.38,1.23),P=0.210;OR=2.08,95%CI(0.73,5.96),P=0.170;OR=1.18,95%CI(0.92,1.51),P=0.200],试验组浅层感染发生率低于对照组[OR=0.52,95%CI(0.30,0.89),P=0.020]。结论:现有证据表明,与其他冲洗液相比,在人工关节置换术中应用聚维酮碘溶液冲洗并不能显著减少术后假体周围感染和切口延迟愈合或不愈合的发生,但能减少术后浅层感染的发生。

维生素D联合匹维溴铵治疗腹泻型肠易激综合征患者疗效及对肠道屏障功能指标的影响研究

目的探讨维生素D联合匹维溴铵治疗腹泻型肠易激综合征(IBS-D)疗效及对肠道屏障功能指标的影响。方法选取2022年1月至2024年1月在秦皇岛市第一医院接受治疗的108例IBS-D患者,根据入院时间先后顺序随机分为两组,其中对照组54例接受匹维溴铵治疗,观察组54例接受维生素D联合匹维溴铵治疗,均治疗4周。比较两组临床疗效、肠道菌群、肠道屏障功能指标、25羟基维生素D水平及IBS临床症状严重评分系统(IBS-SSS)评分。结果观察组临床总有效率94.44%高于对照组临床总有效率79.63%(χ^(2)=5.441,P<0.05)。治疗2周、4周后,观察组乳酸杆菌、双歧杆菌数量高于对照组,肠杆菌数量低于对照组(t=2.164、2.843、3.016、2.850、3.117、2963,P<0.05);观察组血清25羟基维生素D高于对照组,血清二胺氧化酶、D-乳酸、肠脂肪酸结合蛋白水平均低于对照组(t=3.152、4.274、3.975、4.628、3.728、3.415、4.416、3.521,P<0.05);观察组IBS-SSS各维度评分均低于对照组(t=5.729、5.823、4.962、4.683、5.382、5143、4.670、4.527、5.106、5.317,P<0.05)。结论维生素D联合匹维溴铵治疗IBS-D可有效缓解临床症状、调节肠道微生态、修复肠道屏障功能,从而提高疗效。

消毒剂聚维酮碘对养殖水体沉积物中氮循环微生物的影响

水产养殖中使用消毒剂杀死致病微生物的同时,也可能会对氮循环功能微生物产生毒害作用,进而影响水产养殖生态系统的氮循环。本文测定沉积物中氨氧化古菌(AOA)、氨氧化细菌(AOB)、亚硝酸盐氧化菌(NOB)以及反硝化细菌的丰度,结合水体氮素指标并利用16S rRNA基因高通量测序技术,研究聚维酮碘对养殖水体沉积物中氮循环微生物的影响。结果表明,聚维酮碘的添加影响了氮循环中NH4+向其他形式氮的转化,功能基因丰度层面聚维酮碘的使用抑制了AOA amoA、AOB amoA的增长;微生物群落结构层面聚维酮碘的添加使氨氧化菌属中Ellin6067属的基因丰度由增加73.40%变成了减少24.47%,说明聚维酮碘对Ellin6067属的基因丰度增长有较强的抑制作用。

聚维酮碘含漱液结合盐酸米诺环素软膏在慢性牙周炎治疗中的疗效及安全性评价

目的探讨聚维酮碘含漱液(PVP-I)结合盐酸米诺环素软膏在治疗慢性牙周炎方面的疗效及其安全性。方法选取自2019年8月—2022年3月在天津市儿童医院就诊的106例慢性牙周炎患者,根据随机数字表法将研究对象随机分为对照组和研究组。其中,对照组46例予以盐酸米诺环素软膏治疗,研究组60例另外加用PVP-I治疗。对比两组患者疗效及不良反应。结果研究组治疗后总有效率为95.0%,较对照组的78.3%高(χ^(2)=5.314,P=0.021);研究组治疗后口腔健康评分为(8.9±1.1)分,低于对照组的(16.8±2.0)分(t=25.928,P<0.001)。研究组治疗后牙周探诊深度(PD)、龈沟出血指数(SBI)、临床附着水平(CAL)、菌斑指数(PLI)分别为(2.1±0.2)mm、(1.1±0.1)、(2.6±0.2)mm、(1.8±0.2),均低于对照组的(3.8±0.4)mm、(2.4±0.2)、(3.2±0.3)mm、(2.8±0.3)(t=28.661,43.759,12.332,20.554,均P<0.001)。研究组治疗后不良反应发生率为3.4%,低于对照组为4.3%(χ^(2)=0.133,P=0.715)。结论使用PVP-I与盐酸米诺环素软膏的联合治疗方案在治疗慢性牙周炎方面展现出了突出的疗效,显著提升了患者的治疗效果和预后质量,且不增加用药风险,值得进一步大样本研究。

微量稀释联合平板计数法评价聚维酮碘抗菌活性及其影响因素

[目的]建立一种评价聚维酮碘抗菌效果的科学方法,并研究影响其抗菌能力的因素,为聚维酮碘防控水产细菌病提供参考。[方法]采用微量稀释联合平板计数法(包括标测法和模测法)测定了不同厂商和批次聚维酮碘的最小抑菌浓度和最小杀菌浓度,并评估了孵育温度、细菌浓度、培养基浓度、pH、货架期对聚维酮碘最小抑菌浓度的影响。[结果]标测法测得的聚维酮碘对4株渔源多重耐药菌的MIC(213~17g/m^(3))和MBC(216~19g/m^(3))是临床使用浓度的数万倍。模测法测得的聚维酮碘对MH可培养水生菌的MIC(27~11g/m^(3))和MBC(29~12g/m^(3))是临床使用浓度的数百到数千倍。试验体系的温度(5℃到35℃)越高、细菌浓度(103到108cfu/mL)越大、培养基浓度(0.082~21 g/L,MH)越大、pH(5.5到9.5)越高,聚维酮碘对细菌的MIC越大。聚维酮碘固态原粉货架期为18个月,而聚维酮碘溶液货架期约3个月。[结论]聚维酮碘对渔源致病菌和水生MH可培养菌的MIC远远高于临床使用浓度;水温、pH、培养基浓度、细菌浓度都影响抗菌活性;聚维酮碘固体稳定性远高于其水溶液。

不同稳定剂对槲皮素纳米晶稳定性的影响研究

目的制备槲皮素纳米晶提高其溶出速率,并考察不同稳定剂种类和比例对纳米晶稳定性的影响。方法采用溶剂超声法制备槲皮素纳米晶,分别比较3种不同稳定剂(聚维酮K30、泊洛沙姆F188、十二烷基硫酸钠),以粒径为筛选指标考察放置的稳定性,并结合扫描电镜、红外光谱和X射线衍射的方法,表征纳米晶的微观形态,以及探讨稳定剂与纳米晶的作用机制。结果通过试验筛选,结果显示聚维酮K30的稳定性能最好,纳米晶同样为棒状结晶形态,纳米晶的溶出速率较原料药有了明显的提高。结论稳定剂的种类和用量会影响纳米晶的稳定性。

聚合物辅料对无定形氯雷他定溶出行为和结晶形态的影响

目的考察聚合物辅料对无定形氯雷他定溶出和结晶的影响。方法用紫外分光光度法考察无定形氯雷他定在不同体积分数聚维酮K30(PVP-K30)、聚乙二醇4000(PEG 4000)和羟丙基甲基纤维素(hydroxypropyl methylcellulose,HPMC)3种聚合物溶液中的溶出情况;用偏光显微镜观察无定形氯雷他定在水及3种聚合物溶液中的结晶形态及结晶生长情况。结果不同种类的聚合物对无定形氯雷他定均有一定的增溶作用,聚合物体积分数越高,增溶作用越明显,其中PEG 4000的增溶作用最强。不同种类的聚合物对氯雷他定晶体的生长均有一定的抑制作用。结论聚合物辅料的种类和体积分数对无定形氯雷他定的溶出特性及晶体形态有一定的影响,为无定形药物稳定性研究及制剂研发提供理论指导。

3种消毒剂对超声洁牙机单元水路的消毒效果研究

目的评估3种临床常用消毒剂对超声洁牙机单元水路的消毒效果。方法将12台牙周超声洁牙机按消毒方案随机分为4组:A组蒸馏水、B组3%过氧化氢(H_(2)O_(2))、C组500 mg/L含氯消毒剂和D组5%聚维酮碘。每台洁牙机用于日常牙周治疗,每天有效工作6 h。分别在基线、消毒后即刻和消毒后1~7 d收集水样。对可培养细菌进行计数、分离和纯化,通过16S rRNA基因测序进行鉴定,基因扩增子序列按操作分类单元(OTUs)进行聚类。扫描电子显微镜(SEM)观察消毒7 d后水路内壁生物膜的形态和厚度。结果所有组别基线菌落总数均超过了100 CFU/mL。但在消毒后,各组菌落总数均显著降低(P<0.05)。3%H_(2)O_(2)消毒后3 d内、500 mg/L含氯消毒剂消毒后6 d内和5%聚维酮碘消毒后4 d内,菌落总数保持在100 CFU/mL以下(P<0.05)。在超声洁牙机单元水路中检测到了嗜麦芽窄食单胞菌(Stenotrophomonas maltophilia)等病原体。扫描电镜显示,与对照组相比,3%H_(2)O_(2)组和5%聚维酮碘组生物膜厚度更薄(P<0.05)。结论牙科超声洁牙机单元水路中存在致病菌污染,对患者和医务人员构成潜在的感染风险。在日益严峻的感控背景下应根据临床实际制定适宜的消毒方案。

0.01%次氯酸在白内障超声乳化术前应用的安全性和有效性

目的:评估0.01%次氯酸作为白内障超声乳化术前结膜囊消毒剂的效果和对眼表的影响。方法:随机对照临床试验。285例单眼拟行白内障超声乳化手术的患者随机分为次氯酸组和聚维酮碘组,在消毒前后取结膜囊拭子,使用血琼脂培养基和巧克力琼脂培养基分别进行细菌培养和菌落形成能力(CFUs)测试。所有患者在消毒后2 h,1 d和1 wk接受眼部症状评分、疼痛程度评分的评估,并行角膜荧光素染色、眼红指数、泪河高度和非接触式泪膜破裂时间(NIBUT)检查,记录术后眼内炎的发生率。结果:使用0.01%次氯酸进行结膜囊消毒可显著降低细菌培养阳性率和CFUs,与消毒前相比有差异(均P<0.01),次氯酸消毒能力与聚维酮碘相当(χ2=0.811,P=0.368)。次氯酸组患者眼部症状评分和疼痛程度评分显著低于聚维酮碘组(均P<0.01)。次氯酸组角膜荧光素染色评分、眼红指数均显著低于聚维酮碘组(均P<0.01)。两组患者均无眼内炎发生。结论:0.01%次氯酸作为结膜囊消毒剂安全有效,且患者的不适和对眼表的损伤较小。