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.

Objective:To observe the effect of timosaponin AⅢon the proliferation of cultured melanoma B16 and A375 cells and nitrite produced from macrophage activation. Methods:MTT assay was adopted to detect the cell growth inhibition. The morphological changes of B16 and A375 cells were observed under an inverted microscope. Nitrite production of activated mouse macrophages induced by lipopolysaccharide ( LPS) plus IFN-γ was measured by Griess assay. Results: Timosaponin AⅢ could significantly inhibit the growth of B16 cells at the concentration of 16 μmol·L-1 after the 48- and 72-hour treatment, and significantly inhibit the growth of A375 cells at the concentration ranged from 4 to 16 μmol·L-1 after the 48-and 72-hour treatment. Shrinkage, vacuoles and necrosis of B16 and A375 cells were observed after the 48-and 72-hour treatment by 16μmol·L-1 timosaponin AⅢ,the other concentration of timosaponin AⅢ showed no notable effect on B16 cells and vacuoles of A375 cells appeared at the concentration from 4 to 16 μmol· L-1. Compared with RAW 264. 7 stimulated LPS plus IFN-γ,timosaponin AⅢ could significant inhibit nitrite production of macro-phage inflammatory cell model at the concentration of 10μmol·L-1(P<0. 01). Conclusion:Timosaponin AⅢcan inhibit the prolif-eration of melanoma B16 and A375 cells and macrophage inflammation,suggesting it has anti-tumor and anti-inflammatory effects . The anti-tumor effect of timosaponin AⅢ may be related to the inhibition of tumor inflammation.

Objective By investigating the departments of ECG and the staff in China,to study the current ECG status and thus provide references for training ECG workers,improving the work environment and stabilizing the ECG professional team.Methods One hundred and twenty four domestie grass-root hospitals were investigated through real-name questionnaire surveys.The data was collected and analyzed.Results Among the 124 investigated hospitals,the educational background description is:(1) The ECG workers in provincial or municipal hospitals had mainly been entitled with Bachelor's degree or above accounting for 72.7％ of whole ECG workers;the ECG workers in the county or township hospitals were entitled with college degree or below,accounting for 85.7％ of whole ECG workers.The difference between the two kind of workers was significant(P＜0.01).(2) The proportion of ECG workers owning senior professional titles in provincial or municipal hospitals and county or township hospitals were both low,which were 12.2％ and 3.6％,and the former one was significantly higher than the later(P＜0.01).(3) The proportion of hospitals which established dependent department of ECG was low;the percentage of provincial or municipal hospitals was 23.4％,which was significantly higher than that of county or township hospitals (3.3％,P＜0.05).(4) The provincial or municipal hospitals were well equipped and also conducted various of inspection projects in comparison to county or township hospitals.Conclusions The grass-root ECG staff in China has no satisfying education background and professional titles;ECG department belonging varies and the special inspection projects are insufficient and the economic benefit was low.So this study suggest that the competent departments take measures in improving ECG personnel enthusiasm,improving the working environment,and ensuring the healthy and orderly development of ECG profession.

Thirty-six cases of delayed tramatic intracranial hematomas are reported in this paper. Among them 9, 5, 10 and 12 cases were epidural, subdural, intracerebral and multiple hematomas, respectively. The initial CT scans showed normal or brain contusions accompanied by a Me hemorrhage in 23 patients, and delayed intracranial hematomas developed after the earlier neurosurgical operations for evacuations of another traumatic mass lessions for urgent decompressions in 13 patients. Delayed hematomas occurred mostly in the acute stage of head injuries and most patients were impacted occipitally. Deterioration of consciousness was the most important manifestation for diagnosis. The responsible mechanisms of delayed intracranial hematomas are investigated and the indications of repeat CT scans or surgery for its early diagnosis are Droposed.

This paper reports 17 cases of traumatic bilateral epidural hematomas. The incidence of these cases was 8.7% of all cases of epidural hematoma. The hematomas in 15 cases were across the midline, and in the other 2 cases were at different location on either side. The mechanism and clinical features of bilateral epidural hematomas were discussed. The indications for early diagnosis were stressed.

Objective To explore the effect of acupuncture at Yanglingquan (GB 34) on white matter structure of stroke patients. Methods 6 stroke patients with left hemiplegia in recovery stage were recruited. The sham acupoint was as control, the diffusion tensor imaging (DTI) data in a 1.5 T SIEMENS scanner before and after acupuncture at Yanglingquan point was collected. Differences between the two conditions were compared with the Tract-Based Spatial Statistics (TBSS), which is one of FSL tools. Results The brain areas included left precentral gyrus, postcentral gyrus, middle temporal gyrus, inferior temporal gyrus, supplementary motor area, inferior frontal gyrus, internal capsule, fornix and bilateral inferior parietal gyrus, in which the verum acupuncture had stronger effect on fractional anisotropy (FA) than the sham acupuncture. White matter tract such as pyramidal tract, arcuate fasciculus, corpus callosum and other inter-cortex association fibers passed these brain areas. The fiber tracts and brain areas were found to be involved with multiple brain networks of motor compensation, somatosensory, language and cognition. Conclusion Compared with the sham point, acupuncture at Yanglingquan point can change the microstructure of stroke patients' white matter, mainly in the inaffected side and related to multiple functional networks.

Objective To investigate the serum concentration of 25-hydroxyl vitamin D in the common autoimmune diseases and whether the differences of the 25-hydroxyl vitamin D level exist in different autoimmune diseases.Methods 137 cases of autoim-mune diseases,including 71 cases of rheumatoid arthritis(RA),36 cases of systemic lupus erythematosus(SLE),16 cases of Sjogren syndrome(SS)and 14 cases of ankylosing spondylitis(AS),in our hospital from January 2012 to April 2013 were selected as the re-spondents.The serum samples were collected for detecting the 25-hydroxyl vitamin D level by the electrochemiluminescence method and comparing the differences of the 25-hydroxyl vitamin D level among different autoimmune diseases.At the same time whether the differences in the proportion of the normal level,insufficiency and lack of 25-hydroxyl vitamin D exist among different kinds of disease.Results The serum 25-hydroxyl vitamin D concentration had statistically significant difference among the patients with dif-ferent autoimmune diseases(P =0.006),which in the RA group was significantly higher than that in the other groups;the propor-tion of 25-hydroxyl vitamin D insufficiency in RA,SLE,SS and AS were 29.6%,52.8%,62.5% and 57.1% respectively,which in the SLE,SS and AS groups was significantly higher than that in the RA group(P <0.05).Conclusion The 25-hydroxyl vitamin)D insufficiency is general in common autoimmune diseases,the vitamin D supplements needs to be strengthened.

Objective To evaluate the effect of cisplatin on analgesia with morphine in rats with incisional pain.Methods Forty-two adult male Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 6 groups (n =7 each) using a random number table:normal saline group (group C),normal saline + Pglycoprotein inhibitor LY335979 group (group CL),normal saline + morphine group (group CM),cisplatin group (group S),cisplatin + morphine group (group SM) and cisplatin + morphine + LY335979 group (group SML).Cisplatin 2 mg/kg was injected intraperitoneally once every two days for 5 times in S,SM and SML groups,while the equal volume of normal saline was injected intraperitoneally in C,CL and CM groups.At 2 days after the end of administration,the incisional pain models were established.At 10 min after establishing the model,normal saline 2 ml was injected subcutaneously in C and S groups; LY335979 20 mg/kg was injected via the caudal vein and normal saline 2 ml was injected subcutaneously in group CL; morphine 2 mg/kg was injected subcutaneously in CM and SM groups; LY335979 20 mg/kg was injected via the caudal vein and morphine 2 mg/kg was injected subcutaneously in group SML.Cumulative pain score was used to evaluate analgesia.Results Compared with group C,cumulative pain scores were significantly decreased in group CM,and no significant change was found in cumulative pain scores in CL and S groups.Compared with group CM,cumulative pain scores were significantly increased in group SM,and no significant change was found in cumulative pain scores in group SML.Cumulative pain scores were significantly lower in group SML than in group SM.Conclusion Cisplatin can weaken analgesia induced by morphine in rats with incisional pain through enhancing P-glycoprotein function in the blood-brain barrier.

Objective To investigate health literacy before and after the medical intervention and its influencing factors so as to provide evidence for public health promotion.Methods Stratified multi-stage random sampling method was applied for residents aged 15-69 years from 8 urban or rural communities of Taishun County of Lucheng District.The comprehensive health literacy promotion and intervention was carried out,and a unified citizen health literacy questionnaire was designed.Residents' health literacy,the three aspects of health literature and five categories of health literacy issues levels were compared before and after the intervention,and Chi-square test was used for data analysis.Results The overall rate of having health literacy was 11.8％ and 16.3％ in 2012 and 2013,respectively (x2=7.20,P＜ 0.01).The rate of basic health concept and knowledge,health lifestyles and behaviors,and medical skills were significantly raised from 18.5％,9.4％ and 23.5％ to 28.0％,14.6％ and 33.5％,respectively (x2 values were 21.60,11.07 and 20.85,respectively; all P＜0.01).As to the five issues of health literacy,the level of the scientific healthy literacy,the chronic disease literacy,the literacy of infectious disease,the safety and first aid literacy and the basic health literacy were significantly inclined (52.4％ vs.40.4％,39.3％ vs.31.8％,27.8％ vs.22.4％,74.0 ％ vs.58.2％ and 41.9％ vs.33.8％,respectively; x2 values were 27.79,34.95,8.10,43.07 and 13.61,respectively; all P＜0.01).Conclusion Health education was helpful in the promotion of healthy literacy.Healthy lifestyles and behavior literacy and chronic disease prevention literacy should be important for the rural,elderly,low-education level and low-income populations.