1.Study on different test methods to evaluate the drying effect of flexible endoscope
Xianhuang LI ; Ziyi HUANG ; Liuji CHEN ; Jing ZHEN ; Haixia LIU ; Yanxia ZHANG ; Xun ZHANG ; Xi HUANG ; Jiuhong MA
China Journal of Endoscopy 2025;31(11):34-39
Objective To compare the effectiveness of cobalt chloride test papers and borescope in evaluating the drying of endoscopes,providing a reference for clinical selection of appropriate assessment tools.Methods 10 gastroscopes and 10 colonoscopes procedures were selected from November 2023 to March 2024 for circulation experiments.After endoscope reprocessing,they were randomly divided into five groups with different drying times(30 s,3 min,6 min,9 min,and 12 min)with 200 samples.Cobalt chloride test paper and borescope were used to evaluate the drying effectiveness.Results The qualified rate of gastrointestinal endoscope by borescope was significantly higher than that by cobalt chloride test paper,but cobalt chloride test paper was obviously better than that by borescope in convenience and cost-effectiveness.The borescope had the function of visualization,and the quantitative positioning observation of residual droplets showed that there were a large number of droplets left after gastrointestinal endoscope drying for 30 s,and the number of droplets was obviously reduced after drying for 3 min.Among them,the gastroscope was mainly light(1~5 drops/strip)and none(0 drops/strip),and the colonoscope was mainly moderate(6~10 drops/strip)and light droplets.Compared with different drying times,there was a significant statistical difference in the number of residual droplets in the endoscope(P<0.01),and the localized droplets mainly remained in the distal bending part and the proximal bifurcation part of the lumen.Conclusion Both cobalt chloride test papers and borescope are important methods for assessing endoscope drying efficacy,each with its own advantages and limitations.Clinicians can use both methods in combination to comprehensively evaluate the overall dryness of endoscopes,thereby ensuring the safety and effectiveness of the endoscope reprocessing process.
2.Monitoring of bacterial contamination of water specimens at different pre-discharge time of flexible endoscopic final rinse water before daily use:a multicenter study
Jing ZHEN ; Liuji CHEN ; Yangyang ZHANG ; Ziyi HUANG ; Haixia LIU ; Xianhuang LI ; Xi HUANG ; Jiuhong MA
Chinese Journal of Infection Control 2025;24(2):236-241
Objective To investigate the bacterial contamination of water specimens at different pre-discharge time of flexible endoscopic final rinse water before daily use,and provide reference basis for choosing the optimal pre-dis-charge time in clinical work.Methods From August to December 2023,the water produced by the purified water equipment of the digestive endoscopy centers of 4 tertiary first-class medical institutions in Jiangxi Province,as well as the final rinsing water at the terminal-point at different pre-discharge times(before pre-discharge,discharge of 1,3,5,and 10 minutes)were subjected to on-site sampling,the collected water specimens were performed microbio-logical cultures by pouring and filter membrane methods,unqualified water specimens were performed bacterial i-dentification.Results 48 specimens of water produced by purified water equipment were collected,with qualified rate of 100%.480 final water specimens were collected,with a qualified rate of 0 before pre-discharge.The quali-fied rates of pre-discharge at 1,3,5,and 10 minutes were 0,21.88%,55.21%,and 73.96%,respectively.Bac-terial colony counts in the final rinse water with different pre-discharge times in 4 medical institutions showed statis-tically significant differences(all P<0.001).As the pre-discharge time increased,bacterial colony counts in the fi-nal rinse water of all four medical institutions showed a decreasing trend.The pairwise comparison of the overall bacterial colony count of the final rinse water at different pre-discharge time showed that there was no statistically significant difference in the bacterial colony count of the final rinse water at 5 and 10 minutes of pre-discharge(P>0.05),while the pairwise comparison between other time points showed statistically significant differences(all P<0.001).Environmental contaminated bacteria such as Micrococcus luteus,Cupriavidus paucula,and Sphin-gononas paucimobilis were detected from the unqualified water specimens.Conclusion With the extension of pre-discharge time,the degree of bacterial contamination in the final rinse water significantly decreases.All levels of medical institutions need to pre-discharge the final rinse water daily,and the pre-discharge time should last for at least 5 minutes.
3.Establishment and application of standard operational procedure for cleaning and disinfection of biopsy valves of flexible endoscope:a multi-center study
Haixia LIU ; Xianhuang LI ; Jing ZHEN ; Liuji CHEN ; Jiuhong MA
Chinese Journal of Infection Control 2025;24(7):988-992
Objective To investigate the current status of cleaning and disinfection of endoscopic biopsy valves in three digestive endoscopy centers in Jiangxi Province,and evaluate the effectiveness of establishing a standard opera-tional procedure(SOP)of cleaning and disinfection for flexible endoscopic biopsy valves.Methods The cleaning and disinfection procedures of biopsy valves in three digestive endoscopy centers were recorded using on-site investi-gation method(the control group).Based on relevant literature and manufacturer manuals at home and abroad,SOP was established and cleaning and disinfection training for cleaning professional was provided(the trial group).Biop-sy valve specimens from two groups were taken.The disinfection qualified rate,microbial positivity rate before dis-infection,and microbial load after disinfection before and after procedure improvement were compared between two groups.Results A total of 180 biopsy valve specimens were taken from two groups(60 specimens from endoscopy centers A,B,and C each).On-site investigation showed that the cleaning and disinfection procedure for biopsy valves was inconsistent among the three endoscopy centers.The total qualified rate of disinfection in the trial group was higher than that in the control group(95.5%vs 83.3%),with statistically significant difference(P<0.05).The total microbe positive rate of biopsy valves from the trial group was lower than that from the control group(25.0% vs 57.2%),with statistically significant difference(P<0.05).The difference in microbial load after disin-fection between two groups of biopsy valves was statistically significant(Z=-6.47,P<0.05).Conclusion Al-though being a tiny accessory,the flexible endoscopic biopsy valve can be a potential source of infection if not tho-roughly cleaned and disinfected.Developing SOP can help improve the cleaning effectiveness of biopsy valves.At present,there is no unified standards for the cleaning and disinfection procedure of endoscopic biopsy valves.In the future,standardization of the SOP for biopsy valves should be continuously explored,so as to reduce the risk of cross infection.
4.Analysis of Alleviating Effect of Calcium Cyanamide on Replanting Problems of Rehmannia glutinosa
Lianghua LIN ; Hengrui ZHANG ; Haoxiang YU ; Fan YANG ; Yufei WANG ; Caixia XIE ; Tao GUO ; Zhongyi ZHANG ; Liuji ZHANG ; Bao ZHANG ; Suiqing CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(22):212-222
ObjectiveTo investigate the alleviating effect of calcium cyanamide (CaCN2) soil fumigation on replanting problems of Rehmannia glutinosa. MethodsNewly soil (NP) was used as the control group, while three treatment groups were established: replanted soil (RP), newly soil treated with CaCN2 (120 g·m², tillage depth 25 cm) (NPCC), and replanted soil treated with CaCN2 (RPCC). R. glutinosa was cultivated in all groups. At harvest, the tuber agronomic traits (number of enlarged roots, maximum root diameter, fresh weight, dry weight) were measured. The content of catalpol and rehmannioside D was quantified by ultra-high-performance liquid chromatography (UPLC) to evaluate medicinal quality. Rhizosphere soil available nutrients and enzyme activities were analyzed by assay kits. The community structure and composition of fungi and bacteria in rhizosphere soil were assessed via internal transcribed spacer 2 (ITS2) sequencing and 16S rDNA sequencing, respectively. ResultsCompared with NP, the RP group showed obviously reduced in tuber agronomic traits and quality indicators (P0.05). However, the RPCC group showed significant improvement in agronomic traits and a notable increase in rehmannioside D content compared to RP (P0.05). The contents of available phosphorus and potassium in RPCC and NP groups were obviously lower than those in RP (P0.05). The polyphenol oxidase soil (S-PPO) activity in RP was obviously lower than in NP (P0.05), while sucrose soil (S-SC), acid phosphatase soil (S-ACP), and S-PPO activities in RPCC were obviously higher than in RP (P0.05). Microbial richness and diversity in RP were obviously higher than in NP (P0.05), whereas no significant differences were observed between the RPCC and NP. The relative abundances of fungal genera Nectria, Myrothecium, Tomentella, and bacterial genus Skermanella were obviousl lower in RPCC and NP than in RP (P0.05). Correlation analysis that S-ACP activity was positively correlated with the content of rehmannioside D (P0.05). Fungal genera Engyodontium and Alternaria, and bacterial genera Pir4 lineage, Pirellula, Methyloversatilis, Brevundimonas, Ralstonia, and Acidibacter were obviously positively correlated with tuber dry weight (P0.05). Conversely, fungal genera Pseudaleuria, Nectria, Haematonectria, Ceratobasidium, and bacterial genera Streptomyces, Skermanella, RB41, Gemmatimonas, and Bacillus were obviously negatively correlated with dry weight (P0.05). The fungal genus Alternaria and bacterial genera Brevundimonas, Ralstonia, Acidibacter, and Dongia showed positive correlations with medicinal quality of R.glutinosa tuber, while fungal genera Pseudaleuria, Nectria, Stachybotrys, Fusarium, Gibberella, Ceratobasidium, and bacterial genera Sphingomonas, Skermanella, RB41, Gemmatimonas, and Bacillus were obviously negatively correlated (P0.05). ConclusionCaCN2 soil fumigation can significantly improve enzyme activities in replanted Rehmannia rhizosphere soil, enhance the utilization of available nutrients, reshape microbial community structure of replanted R.glutinosa at the family and genus level, and notably improve tuber agronomic traits and medicinal quality. This study provides a novel approach to alleviating replanting problems and offers insights for the integrated development of standardized cultivation techniques, including soil disinfection, nutrient-targeted regulation, and microbial inoculant application.
5.Application and management status of automated endoscope reprocessors in 292 medical institutions
Jin ZHEN ; Liuji CHEN ; Haixia LIU ; Jiuhong MA ; Xianhuang LI ; Xi HUANG
Chinese Journal of Infection Control 2025;24(9):1278-1285
Objective To understand the current status of application,management,and maintenance of automa-ted endoscope reprocessors(AERs)in China.Methods A questionnaire survey was conducted using convenience sampling method on the application,management,maintenance,and monitoring of AERs,as well as personnel training in digestive endoscopy centers of 292 medical institutions(MIs).Results A total of 316 questionnaires were distributed,and 292 were available,with an effective response rate of 92.41%.Among the 292 MIs,198(67.81%)were equipped with AERs,with equipment rates of 75.11%in tertiary MIs and 41.27%in secondary MIs.88.38%of MIs performed manual cleaning before placing endoscopes into AERs,while 2.02%of MIs still didn't perform this step,mainly in tertiary MIs.The most common problems in the application of AERs were the detachment or damage of connecting pipes(83.33%),followed by disinfectant leakage of AERs(43.94%),mal-function of control panel(43.94%),and failure or poor water flow of AER pipeline(42.93%).92.42%of MIs regularly disinfected AERs,72.73%of MIs regularly replaced AER air filters,and 80.30%of MIs regularly re-placed AER water filters.96.46%of MIs monitored the concentration of disinfectants before daily application of AERs,87.88%of MIs regularly monitored the final rinse water of AERs,and 96.97%of MIs provided professio-nal training for new employees to use AERs for the first time.Conclusion The equipping rate of AERs at all levels of MIs in China still needs to be improved.Most MIs are able to monitor and maintain AERs well,but there are still many problems in the application process.Due to the large volume of endoscopic diagnosis and treatment as well as insufficient execution rate of manual cleaning in tertiary MIs,it is necessary to optimize workflow and strengthen training.Secondary MIs face challenges such as equipment shortages and low monitoring execution rates,requiring increased funding and regulatory efforts.It is recommended that manufacturers continuously optimize AER design,MIs establish standardized AER application protocol,and relevant departments improve AER application and ma-nagement standards,in order to improve the quality of endoscopic cleaning and disinfection and ensure patient safety during diagnosis and treatment.
6.Application and management status of automated endoscope reprocessors in 292 medical institutions
Jin ZHEN ; Liuji CHEN ; Haixia LIU ; Jiuhong MA ; Xianhuang LI ; Xi HUANG
Chinese Journal of Infection Control 2025;24(9):1278-1285
Objective To understand the current status of application,management,and maintenance of automa-ted endoscope reprocessors(AERs)in China.Methods A questionnaire survey was conducted using convenience sampling method on the application,management,maintenance,and monitoring of AERs,as well as personnel training in digestive endoscopy centers of 292 medical institutions(MIs).Results A total of 316 questionnaires were distributed,and 292 were available,with an effective response rate of 92.41%.Among the 292 MIs,198(67.81%)were equipped with AERs,with equipment rates of 75.11%in tertiary MIs and 41.27%in secondary MIs.88.38%of MIs performed manual cleaning before placing endoscopes into AERs,while 2.02%of MIs still didn't perform this step,mainly in tertiary MIs.The most common problems in the application of AERs were the detachment or damage of connecting pipes(83.33%),followed by disinfectant leakage of AERs(43.94%),mal-function of control panel(43.94%),and failure or poor water flow of AER pipeline(42.93%).92.42%of MIs regularly disinfected AERs,72.73%of MIs regularly replaced AER air filters,and 80.30%of MIs regularly re-placed AER water filters.96.46%of MIs monitored the concentration of disinfectants before daily application of AERs,87.88%of MIs regularly monitored the final rinse water of AERs,and 96.97%of MIs provided professio-nal training for new employees to use AERs for the first time.Conclusion The equipping rate of AERs at all levels of MIs in China still needs to be improved.Most MIs are able to monitor and maintain AERs well,but there are still many problems in the application process.Due to the large volume of endoscopic diagnosis and treatment as well as insufficient execution rate of manual cleaning in tertiary MIs,it is necessary to optimize workflow and strengthen training.Secondary MIs face challenges such as equipment shortages and low monitoring execution rates,requiring increased funding and regulatory efforts.It is recommended that manufacturers continuously optimize AER design,MIs establish standardized AER application protocol,and relevant departments improve AER application and ma-nagement standards,in order to improve the quality of endoscopic cleaning and disinfection and ensure patient safety during diagnosis and treatment.
7.Establishment and application of standard operational procedure for cleaning and disinfection of biopsy valves of flexible endoscope:a multi-center study
Haixia LIU ; Xianhuang LI ; Jing ZHEN ; Liuji CHEN ; Jiuhong MA
Chinese Journal of Infection Control 2025;24(7):988-992
Objective To investigate the current status of cleaning and disinfection of endoscopic biopsy valves in three digestive endoscopy centers in Jiangxi Province,and evaluate the effectiveness of establishing a standard opera-tional procedure(SOP)of cleaning and disinfection for flexible endoscopic biopsy valves.Methods The cleaning and disinfection procedures of biopsy valves in three digestive endoscopy centers were recorded using on-site investi-gation method(the control group).Based on relevant literature and manufacturer manuals at home and abroad,SOP was established and cleaning and disinfection training for cleaning professional was provided(the trial group).Biop-sy valve specimens from two groups were taken.The disinfection qualified rate,microbial positivity rate before dis-infection,and microbial load after disinfection before and after procedure improvement were compared between two groups.Results A total of 180 biopsy valve specimens were taken from two groups(60 specimens from endoscopy centers A,B,and C each).On-site investigation showed that the cleaning and disinfection procedure for biopsy valves was inconsistent among the three endoscopy centers.The total qualified rate of disinfection in the trial group was higher than that in the control group(95.5%vs 83.3%),with statistically significant difference(P<0.05).The total microbe positive rate of biopsy valves from the trial group was lower than that from the control group(25.0% vs 57.2%),with statistically significant difference(P<0.05).The difference in microbial load after disin-fection between two groups of biopsy valves was statistically significant(Z=-6.47,P<0.05).Conclusion Al-though being a tiny accessory,the flexible endoscopic biopsy valve can be a potential source of infection if not tho-roughly cleaned and disinfected.Developing SOP can help improve the cleaning effectiveness of biopsy valves.At present,there is no unified standards for the cleaning and disinfection procedure of endoscopic biopsy valves.In the future,standardization of the SOP for biopsy valves should be continuously explored,so as to reduce the risk of cross infection.
8.Study on different test methods to evaluate the drying effect of flexible endoscope
Xianhuang LI ; Ziyi HUANG ; Liuji CHEN ; Jing ZHEN ; Haixia LIU ; Yanxia ZHANG ; Xun ZHANG ; Xi HUANG ; Jiuhong MA
China Journal of Endoscopy 2025;31(11):34-39
Objective To compare the effectiveness of cobalt chloride test papers and borescope in evaluating the drying of endoscopes,providing a reference for clinical selection of appropriate assessment tools.Methods 10 gastroscopes and 10 colonoscopes procedures were selected from November 2023 to March 2024 for circulation experiments.After endoscope reprocessing,they were randomly divided into five groups with different drying times(30 s,3 min,6 min,9 min,and 12 min)with 200 samples.Cobalt chloride test paper and borescope were used to evaluate the drying effectiveness.Results The qualified rate of gastrointestinal endoscope by borescope was significantly higher than that by cobalt chloride test paper,but cobalt chloride test paper was obviously better than that by borescope in convenience and cost-effectiveness.The borescope had the function of visualization,and the quantitative positioning observation of residual droplets showed that there were a large number of droplets left after gastrointestinal endoscope drying for 30 s,and the number of droplets was obviously reduced after drying for 3 min.Among them,the gastroscope was mainly light(1~5 drops/strip)and none(0 drops/strip),and the colonoscope was mainly moderate(6~10 drops/strip)and light droplets.Compared with different drying times,there was a significant statistical difference in the number of residual droplets in the endoscope(P<0.01),and the localized droplets mainly remained in the distal bending part and the proximal bifurcation part of the lumen.Conclusion Both cobalt chloride test papers and borescope are important methods for assessing endoscope drying efficacy,each with its own advantages and limitations.Clinicians can use both methods in combination to comprehensively evaluate the overall dryness of endoscopes,thereby ensuring the safety and effectiveness of the endoscope reprocessing process.
9.Monitoring of bacterial contamination of water specimens at different pre-discharge time of flexible endoscopic final rinse water before daily use:a multicenter study
Jing ZHEN ; Liuji CHEN ; Yangyang ZHANG ; Ziyi HUANG ; Haixia LIU ; Xianhuang LI ; Xi HUANG ; Jiuhong MA
Chinese Journal of Infection Control 2025;24(2):236-241
Objective To investigate the bacterial contamination of water specimens at different pre-discharge time of flexible endoscopic final rinse water before daily use,and provide reference basis for choosing the optimal pre-dis-charge time in clinical work.Methods From August to December 2023,the water produced by the purified water equipment of the digestive endoscopy centers of 4 tertiary first-class medical institutions in Jiangxi Province,as well as the final rinsing water at the terminal-point at different pre-discharge times(before pre-discharge,discharge of 1,3,5,and 10 minutes)were subjected to on-site sampling,the collected water specimens were performed microbio-logical cultures by pouring and filter membrane methods,unqualified water specimens were performed bacterial i-dentification.Results 48 specimens of water produced by purified water equipment were collected,with qualified rate of 100%.480 final water specimens were collected,with a qualified rate of 0 before pre-discharge.The quali-fied rates of pre-discharge at 1,3,5,and 10 minutes were 0,21.88%,55.21%,and 73.96%,respectively.Bac-terial colony counts in the final rinse water with different pre-discharge times in 4 medical institutions showed statis-tically significant differences(all P<0.001).As the pre-discharge time increased,bacterial colony counts in the fi-nal rinse water of all four medical institutions showed a decreasing trend.The pairwise comparison of the overall bacterial colony count of the final rinse water at different pre-discharge time showed that there was no statistically significant difference in the bacterial colony count of the final rinse water at 5 and 10 minutes of pre-discharge(P>0.05),while the pairwise comparison between other time points showed statistically significant differences(all P<0.001).Environmental contaminated bacteria such as Micrococcus luteus,Cupriavidus paucula,and Sphin-gononas paucimobilis were detected from the unqualified water specimens.Conclusion With the extension of pre-discharge time,the degree of bacterial contamination in the final rinse water significantly decreases.All levels of medical institutions need to pre-discharge the final rinse water daily,and the pre-discharge time should last for at least 5 minutes.
10.Antioxidant Kinetic Characteristics and Online Identification of Active Compounds in Chrysanthemi Flos Stems and Leaves
Wanqian TU ; Xin LU ; Liuji ZHANG ; Yifei LIU ; Jianxia WANG ; Xiangyang LI ; Jingjing CHEN
World Science and Technology-Modernization of Traditional Chinese Medicine 2024;26(7):1862-1869
Objective To study the antioxidant activity and free radical scavenging kinetics of Chrysanthemi flos stems and leaves,and online screen the active components related to free radical scavenging.Methods Using DPPH method and ABTS method the antioxidant activity of extracts from Chrysanthemi flos stems and leaves was observed,and the effects of different influencing factors,such as drug concentration,reaction temperature and reaction time on free radical scavenging rate were compared,the half scavenging rate(IC50)was determined.The flavonoids,such as luteolin glucuronic acid,luteolin,and caffeic acid,phenolic acids such as chlorogenic acid,neochlorogenic acid,cryptochlorogenic acid,isochlorogenic acid A,B,and C in the samples before and after the reaction were chosen as indexes,and their contents were determined by HPLC.Results The drug concentration,reaction temperature and reaction time could affect the scavenging rate of DPPH free radical and ABTS.The IC50 of DPPH and ABTS were 0.395 mg·mL-1 and 2.039 mg·mL-1 respectively.After reaction with DPPH and ABTS,the contents of the analytes above all decreased significantly,which suggested that,the components above might be the antioxidant components in Chrysanthemi flos stems and leaves.Conclusions Chrysanthemi flos Stems and leaves have good free radical scavenging activity.In this study,the kinetic characteristics of scavenging DPPH and ABTS free radicals in Chrysanthemi flos stems and leaves were preliminarily clarified,and the active components were found out.It provides an experimental basis for the future comprehensive development of Chrysanthemi flos stems and leaves.

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