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 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.

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.

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 compare the dosimetric characteristics of helical tomotherapy(HT)and step-and-shoot intensity modulated radiotherapy(IMRT)for post-operative cervix cancer patients. Methods Ten patients with post-operative cervix cancer were enrolled in this study.HT and IMRT plans were developed for each patient.The dose distributions of the targets,organs at risk(OARs),CI and HI were analyzed and compared.The prescribed dose was 60 Gy/25 f for CTV1,50 Gy/25 f for CTV2.The iso-dose line of 50 Gy was used.Results The homogeneity indexes(HI)(0.94±0.03),conformity index(C1)(1.28±0.02)in HT group were better than in IMRT group(0.85±0.01 and 1.36±0.03),respectively(t=5.12,-6.34,P<0.001).The Dmean of PTV in HT group(51.77 Gy)was lower than that in IMRT group(54.53 Gy)(t=-8.01,P<0.05).The Dmax ,Dmean,V30,V40 and V50 of bladder、rectum and small bowel were lower in HT group than those in IM RT group.The Dmax,Dmean,V30 and V40 of right and left femoral head were lower in HT group than those in IMRT group.Conclusion Helical tomotherapy treatment plan has a better homogeneity,steeper dose gradient,and a better protection for organs at risk.

Objective To evaluate the feasibility of active breathing control (ABC) in conformal radiotherapy (CRT) for patients with non-small cell lung cancer (NSCLC). Methods From Feb 2005 to Mar 2008, 29 patients with inoperable NSCLC (stage Ⅱ-Ⅳ) were evaluated. For each patient, two series of CT scans were obtained with free breathing (FB) and ABC system during simulation, respectively. Then two confonnal radiotherapy (CRT) plans were finished based on the two sets of reconstructed images. The pattern of post-inspiratory breath-hold was triggered at 80% of the peak of inspiration curve. The margin of clinical target volume (CTV) to planning target volume (PTV) was 0. 6 cm for lesions of the superior lobe, and 1.0 cm for the lesions of middle and inferior lobes. Three to five coplanar fields were performed in conformal radiotherapy. The gross tumor volume (GTV), CTV, PTV, volume of the bilateral lungs (Volume_(lung)), V_(20) and mean lung dose (MLD) of two plans were evaluated by dose-volume histogram (DVH). The World Health Organization criteria and National Cancer Institute Common Toxicity Criteria 3.0 (NCI-CTC3.0) scale were used to assess the immediate response and acute side-effect, respectively. Results Significant differences of GTV, CTV, FIN, Volum_(lung), V_(20) and MDL were observed between the two plans (36. 35 cm~3 vs. 31.40 cm~3, t = 9. 70, P <0. 001 ;82. 33 cm~3 vs. 70. 83 cm~3, t = 8. 19, P < 0. 001 ; 230. 73 cm~3 vs. 197.59 cm~3 ,t=5.72,P <0. 001 ;21.66% vs. 18. 76% ,t = 11.16,P <0. 001 ;1329. 07 Gy vs. 1143. 14 Gy, t = 13. 24, P < 0. 001). With ABC, all patients completed their treatment successfully except one patient for financial problems. The median radiation dose to the GTV was 64 Gy (60 -64 Gy). The overall immediate response rate was 64% (18/28). According to the NCI-CTC 3.0, grade 1 and 2 acute radiation-related toxicities occurred in 68% (19/28) and 18% (5/28) of patients for esophagitis, 82% (23/28) and 7% (2/28) for pneumonitis, respectively. Grade 1, 2 and 3 bone marrow suppression occurred in 57% (16/28), 25% (7/28) and 14% (4/28) of patients, respectively. Grade 1 and 2 acute cardiac injuries occurred in 86% (24/28) and 14% (4/28) of patients. Conclusions During CRT for patients with NSCLC, the use of ABC can decrease the radiation dose and acute complications of normal tissues.

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