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Objective To investigate the current situation of medical instrument cleaning in Central Sterile Supply Departments(CSSD),in order to identify problems and provide references for further improvements of equipment cleaning.Methods Questionnaire survey was adopted,data of 127 CSSDs in five coastal provinces or cities in China in 2017 were collected,and status of each link of medical instrument cleaning was analyzed.Results The allocation rate of ultrasonic cleaner and spray cleaner were 96.6％ and 78.7％,respectively;62.2％ of hospitals used tap water to pre-rinse,and 10.2％ used normal saline or sterile water to pre-rinse,11.0％ used tap water for finial rinsing;78.7％ of hospitals did not perform continuous humidification in transit,and 18.1％ of hospitals did not perform continuous humidification and their time of transit was more than 2 hours;66.9％ of CSSDs only used multi-enzyme detergent.More than half of the hospitals did not record time for manual rinsing/manual final rinsing.Conclusion The configuration of medical instrument cleaning equipment of 127 CSSDs is good.However,it is necessary to pay more attention to cleaning details.Specifications for instrument cleaning water should be established;continuous humidification during transportation of medical instruments should be promoted;cleaning methods and cleaning detergents should be selected reasonably;standardized rinsing should be enhanced to ensure quality of medical instrument cleaning.
ABSTRACT
<p><b>BACKGROUND</b>Endometriosis affects natural fertility through various approaches, and in vitro fertilization (IVF) is a good treatment. But the IVF result of endometriosis patients is still under debate. We investigated the effect of endometriosis on IVF by analyzing the data from a single reproductive center.</p><p><b>METHODS</b>A retrospective, database-searched cohort study was performed. Relevant information was collected from the electronic records of women who underwent IVF/intracytoplasmic sperm injection between January 2006 and December 2010 in the Assisted Reproductive Unit of Sir Run Run Shaw Hospital. Patients with endometriosis were enrolled the study group. The rest of the women formed the control group. The main outcome was the clinical pregnancy rate. Secondary outcomes were oocytes retrieved number, fertilization rate, high-quality embryo rate, number of high-quality embryo for embryo transplantation, and implantation embryo/high-quality embryo ratio (IE/HQE ratio). Comparisons were performed by the c(2)-test and independent t-test.</p><p><b>RESULTS</b>The endometriosis group (n = 177) had a markedly lower oocytes retrieved number, fertilization rate, implantation rate, and clinical pregnancy rate (7.6 ± 5.1, 63.6%, 27.7%, and 45.2%, respectively) compared with the non-endometriosis group (n = 4267; 11.8 ± 7.3, 68.4%, 36.2%, and 55.2%, respectively). Stratified analysis showed that this difference was found in the subgroup younger than 35-years old, while only fertilization rate and implantation rate were different in the elder subgroup. The ratio of high-quality embryos transferred is lower in endometriosis group (53.7% vs. 71.8%, P < 0.05), but there is no difference in IE/HQE ratio between two groups. There is no significant difference in fertilization rate, implantation rate, and clinical pregnancy rate between mild and severe endometriosis patients.</p><p><b>CONCLUSIONS</b>Endometriosis patients suffer a decreasing IVF pregnancy rates mainly caused by reducing oocytes number and fertilization rate, regardless of the severity of the disease. Appropriate intracytoplasmic sperm injection manipulation might improve the outcomes of IVF.</p>
Subject(s)
Female , Humans , Pregnancy , Endometriosis , Fertilization in Vitro , Infertility, Female , Therapeutics , Pregnancy Rate , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of mouse preimplantation embryos on the expressions of DNA methyltransferase 1(Dnmt1) of mouse oviduct epithelial cells.</p><p><b>METHODS</b>The histological location of Dnmt1 protein was detected by immunohistochemical staining and the expression levels of Dnmt1 mRNA and protein in mouse oviduct were assayed by real-time reverse transcription-PCR(RT-PCR) and Western blotting in both pregnant and pseudopregnant mice at the 2-cell, 4-cell and 8-cell stages.</p><p><b>RESULTS</b>The expressions of Dnmt1 protein were mainly located in the epithelial cells of mouse oviduct. It was found that during all three stages, the expression levels of Dnmt1 mRNA in the epithelial cells of the pregnant mice were significantly lower than those in the pseudopregnant mice (P< 0.05), and the level of Dnmt1 protein expression in the pregnant mice was significantly decreased as compared with that in pseudopregnant mice at the 4-cell stage.</p><p><b>CONCLUSION</b>Expressions of both Dnmt1 mRNA and protein in the epithelial cells of mouse oviduct could be regulated by mouse preimplantation embryos, which might play an important role in the expression changes of some genes in oviduct epithelial cells during the preimplantation period.</p>