An intemationlly recognized systematic and preventive approach to food safety, Hazard Analysis Critical Control Points(HACCP) is scientific, simple, convenient and practical. An effective way to improve managerial efficiency and the quality of nutritional meals and to enhance patient satisfaction is to use the principles of HACCP in the following aspects: conducting quality control of nutritional meals in hospitals and determining a scientific and rational process flow; analyzing marked hazards affecting the safety of nutritional meads; proposing preventive measures; estabhshing critical control points; and specifying how to establish a threshold of, monitor, set right, verify and record the critical control points.

Micro-syringe as a result of the high frequency of clinical use, direct contact with patients, the failure of its equipment will have a direct impact on the patient's disease status. Researchers in this paper, by simulating the test fluid, electrical safety testing and analysis of statistical methods such as maintenance records, consider six kinds of common injection pump, in terms of performance, safety and the failure rate of three performance. Compared the performance analysis, summarized the various types of injection pump characteristics, researchers make suggestions to clinical departments, equipment procurement and equipment management departments for usage and improvement.
Equipment Failure ; Equipment Safety ; Syringes

Objective To understand the clinical characteristics of primary small vessel vasculitis with involvement of lungs in children and analyze the causes of misdiagnosis.Methods Clinical data from 16 patients with primary small vessel vasculitis were collected and their pathological,antineutrophil cytoplasmic antibody(ANCA),pulmonary lesion manifestations,image and misdiagnosis were further analyzed.Results Among 16 cases,9 cases were microscopic polyarateritis(MPA) and 4 cases were Wegeners granulomatosis(WG) and 3 cases were Churg-Strause syndrome(CSS).The ages of onset were from 3 to 14 years old with average age of 7.5 years old.Seventy-five percent(12/16) were ANCA positive.The patients with lung involvement had cough,chest pain,dyspnea,hemoptasis and asthma.Findings on lung X-ray films were variable.Some showed multiple patch shadows,others showed single or multiple masses or nodular shadows with or without cavity formation.After the treatments with corticosteroid and cyclophosphamide,10 cases turned better;including 8 cases with normal on lung X-ray films.Three cases given up;3 cases died.Conclusion It is very difficult to make diagnosis of primary small vessel vasculitis with involvement of lungs and should be paid more attentions to this issue.

Objective To review the causes of 21 cases of exteric fistula after surgery,treatment and prognosis,and to explore the clinical treatment of exteric fistula after surgery.Methods To collection the Xinjiang Uygur Autonomous Region People's Hospital of Gastrointestinal Surgery from Aug 2013 to Aug.2016 admitted during the period of parenteral fistula patients after abdominal surgery,21 patients with intestinal fistula outside,12 cases were male,9 were female cases.According to the case records of descriptive statistics,the treatment methods was summarized and analyzed retrospectively.Results Au patients with intestinal fistula outside,12 cases were male,female 9 cases.Conservative treatment of 11 cases,healing in 2 cases,5 cases,4 cases died and the sigmoid colon perforation repair 1 case,postoperative ileus postoperative renal function failure in 1 case,gastric cancer by intraperitoneal hemorrhage after early postoperative restrictive ploration in 2 cases;Early surgical treatment of 10 cases,of which the deterministic operation in 1 case,late deterministic surgery in 9,were cured.Conclusions The early diagnosis of parenteral fistula and rapid processing,taken on the basis of the condition of the patients with timely complete drainage,infection control,reasonable nutrition support and correct homeostasis imbalance as the main content of a comprehensive individualized treatment,most patients can improve the self-healing,cannot heal patients to choose the appropriate surgical timing and proper operation method,can improve the cure rate and reduce the case fatality rate.

Objective : To systematically evaluate the adherence to antiretroviral therapy among HIV/AIDS patients in China, so as to provided evidence-based insights into improving the efficacy of antiretroviral therapy. Methods: Publications pertaining to the adherence to antiretroviral therapy among HIV/AIDS patients in China were retrieved in CNKI, Wanfang Data, VIP, PubMed, and Cochrane Library from 2012 to 2022. A meta-analysis was performed using the software Stata 16.0. Sensitivity analysis was performed with the leave-one-out method, and the publication bias was evaluated using funnel plot and Begg's test. Results: A total of 1 171 publications were screened, and 33 publications were included in the final analysis, which covered 11 218 subjects in 19 study areas and included 18 high-quality publications and 15 medium-quality publications. Meta-analysis showed that the pooled adherence to antiretroviral therapy was 86.57% (95%CI: 86.01%-87.12%, P<0.05) among HIV/AIDS patients, and subgroup analysis showed high adherence among HIV/AIDS patients in eastern China (92.13%, 95%CI: 91.45%-92.82%). Sensitivity analysis showed the robustness of the meta-analysis results, and no publication bias was detected as revealed by the funnel plot and Begg's test (P>0.05). Conclusions The adherence to antiretroviral therapy is 86.01% to 87.12% among HIV/AIDS patients in China. Intensified health education and follow-up management is required among HIV/AIDS patients in China.

Objective To observe the effect of Tanggankang on the expression of CREB in diabetic-fatty liver rats;To investigate the mechanism of Tanggankang. Methods STZ and feeding high fat forage induced diabetic rats were randomly divided into model group, Huganning group, Tanggankang high dose group, Tanggankang medium dose group, Tanggankang low dose group, 10 rats in each group, with 10 normal rats as control. After 12 weeks of drug intervention, rats were killed, the livers were removed, and the expression of CREB was detected by Western blot. Results Compared with normal group, the level of CREB of model group was significantly decreased (P<0.01). Compared with model group, Tanggankang low, medium and high dose group significantly decreased the level of CREB (P<0.01). Conclusion Tanggankang may play an active role in glucose and lipid metabolism by affecting the expression of CREB.

Objective To investigate the effect and molecular mechanism of cyclooxygenase-2 (COX-2) on the benign prostatic hyperplasia (BPH) in rat model. Methods Thirty-six SD rats were randomly divided into 3 groups:normal control (group A,n=12),BPH model (group B,n=12) and BPH+selective COX-2 inhibitor celecoxib (group C,n=12). At the 5th week after treatment, the weight of the prostates was measured, and the morphological changes were examined under light microscope.Detection of ki-67 and TUNEL in prostatic epithelial and stromal cells was undertaken to assess the proliferation and apoptosis status.The protein and mRNA expression of COX-2,epidermal growth factor (EGF),basic fibroblast growth factor (bFGF) and transforming growth factor-?1 (TGF-?1) were analyzed by means of immunohistochemisty and RT-PCR. Results The prostate index [prostate wet weight (mg)/rat body weight (g)] of group B was significantly higher compared with those in groups A and C (1.88?0.17 vs 1.70?0.09 and 1.74?0.16,P0.05). Conclusions The increased expression of COX-2 may play an important role in the pathogenesis of BPH by modulating the expression of growth factors and affecting the proliferation and apoptosis of prostate cells.

OBJECTIVE: To test cathepsin L as a biomarker of myocardial ischemia by examination of cathepsin L expression in plasma after myocardial ischemia and ischemia-reperfusion in rats. METHODS: The rat models were established and divided in acute myocardial ischemia model (myocardial ischemia 30 min, 1 h, 2 h groups), ischemia-reperfusion model (ischemia-reperfusion group), and isoflurane-pretreated ischemia-reperfusion model (isoflurane-pretreated group), respectively. Normal control group and sham-operated group were established as contrast. The contents of cathepsin L in plasma were examined by ELISA and myocardial infarction areas were measured after TTC staining. RESULTS: No statistical significant changes were found among the experimental groups compared with the normal control group and sham-operated group (P>0.05). The cathepsin L from the ischemia-reperfusion group increased to 2.37 times compared with the normal control group (P<0.05). The cathepsin L and myocardium infarction size of isoflurane-pretreated group decreased compared with the ischemia-reperfusion group (P<0.05). CONCLUSION The cathepsin L in plasma is not a promising biomarker of acute myocardial ischemia. Isoflurane preconditioning can reduce the cathepsin L in plasma caused by ischemia-reperfusion injury.
Animals ; Biomarkers/blood* ; Cathepsin L/analysis* ; Isoflurane ; Myocardial Infarction/metabolism* ; Myocardial Ischemia ; Myocardial Reperfusion Injury/metabolism* ; Myocardium ; Rats

Objective To compare the effect of intracoronary versus intravenous administration of tiroifban for acute coronary syndrome (ACS) patients during percutaneous coronary intervention (PCI). Methods A search was retrieved from Pubmed, EMbase, Chinese Biomedical Literature Database (CBM), Chinese Journal Full-text Database (CNKI), Chinese Science and Technology Periodical Database (VIP), Cochrane Library to systematically collect the randomized controlled trials of intracoronary versus intravenous administration of tirofiban for the patients with ACS undergoing PCI. The data was extracted from the included studies and analyzed by Cochrane Collaboration's RevMan5.2 software. Results Twenty-five studies involving 2516 patients met the inclusion criteria. The results of meta-analysis showed that thrombolysis in myocardial infarction (TIMI) grade 3 lfow (RR 1.15, 95%CI 1.07-1.23, P=0.0001) were signiifcantly more often achieved in the patients by intracoronary administration of tiroifban (IC group) than those by intravenous strategy (IV group). Left ventricular ejection fraction (LVEF) values in a week after PCI which were evaluated by Cardiac Ultrasound were statistically significant between the two groups (WMD 2.69, 95%CI 0.14-5.25, P=0.04). LVEF values in IC group were increased by an average of 2.69% compared with group IV. Intracoronary administration resulted in a reduced incidence of major adverse cardiovascular events (MACE) at 30-day follow-up (RR 0.51, 95%CI 0.38-0.69, P < 0.0001). However, the incidence of bleeding complications was not statistically signiifcant between the two groups (RR 0.95, 95% CI 0.76-1.19, P=0.64). Conclusions Compared with intravenous strategy, intracoronary administration of tiroifban can be more effective in increasing coronary blood lfow and microvascular perfusion, more signiifcantly in reducing the incidence of MACE at 30-day follow-up and improving the prognosis after PCI without increasing the risk of bleeding.

Objective To assess the virtual non-contrast liver CT from dual-energy CT for the clinical application. Methods In total, 51 patients were included in the study, and all patients underwent multi-phase liver CT on a dual-source CT. The True non-contrast liver CT (TNCT) was performed in a single-energy acquisition mode, but the arterial and portovenous liver CT (VNCT) were performed in a dual-energy mode of 110 kV and 140 kV respectively. The virtual non-contrast CT images were derived from the arterial data using liver virtual non-contrast software. Between the true non-contrast CT and the virtual non-contrast CT, the image quality, mean CT HU values in the liver and muscle, signal to noise (SNR), the radiation dose of volume CT dose index (CTDIvol) and dose length product (DLP) in a single phase and total examination were compared with t test. Results There was no significant difference in the detection of liver lesions between TNCT and VNCT. The CT Hu values of muscle on both TNCT and VNCT images were almost equal. The CT HU values of liver on VNCT images were higher than that on TNCT images and the difference was significant [61.32 ±6. 04 vs. (56. 85 ±4. 80) HU, t = -3. 927,P＜0.01]. There was also significant differenc of SNR between TNCT (11.28±2. 78) and VNCT (8.65 ± 1.56) images( t =-5.590,P＜0.01). The CTDIvol and DLP of single phase were (7.07 ±0.85) mGy and (155.11 ±respectively, but in TNCT the total CTDIvol and DLP reached (21.43 ± 2. 46 ) mGy and (469. 02 ±significance, but the total CTDIvol and DLP were significantly different (t = 16. 168 and 13. 132, P ＜0. 01). Conclusion With the consequent reduction in radiation dose, the VNCT can replace TNCT as an imaging protocol in multi-phase abdominal CT examination in clinic.