What is the HACCP (hazard analysis critical control point) approach and how can it be applied to enteral tube feeding?

The HACCP (hazard analysis critical control point) concept is now widely applied in the food industry and provides a structured and critical approach to the identification and control of hazards that may affect food safety. It has shifted the emphasis for control from retrospective end-product testing to the effective control of raw materials and key processing operations.
This paper discusses how the HACCP approach can be applied to enteral feeding. This involves each unit assembling a multidisciplinary team of personnel involved in enteral feeding. This team will then carry out a detailed analysis of the process from selection of ingredients and feeding systems through to consumption of the feed by the patient by constructing a flow chart that relates specifically to each unit. They can then identify and assess the hazards associated with the handling of the product at each stage in the process. This will enable them to identify the points where control over an identified hazard can be achieved (critical control points, CCP) such as quality of ingredients, design of administration systems, preparation and distribution of the feeds and the procedures involved in the assembly and manipulation of the systems. Control and monitoring procedures can then be specified and implemented at relevant stages in the process. The major strengths of the HACCP procedure are that it entails a team effort from key personnel involved in the full range of activities associated with the product and each detailed analysis is specific to each unit's practices and resources and can be continually reviewed and modified in response to changing circumstances.     

胃粘膜癌变初发点及其组织背景的病理学：癌变初发点的一般组织病理学

本文通过对228例各种类型胃粘膜上皮异型增生的病理切片的复查,发现并详细地描述了不同类型异型增生腺管和上皮细胞癌变的初发点(Start point)。其形态有的是从再生腺管的腺颈部或底部以“发芽”形式,向质内浸润并分枝生长;有的是从再生腺管基底膜向侧方的间质浸润。从再生的胃上皮型异型腺管所出现的癌变多为低分化型腺癌;从肠上皮型异型腺管所发生的癌变则为高分化型腺癌。强调了胃粘膜再生性异型增生有些具有癌前性质。     

东方人苯丙酮尿症的分子遗传学—苯丙氨酸羟化酶基因中一终止突变与单体型4的连锁不平衡性

应用聚合酶链反应(PCR)方法扩增苯丙氨酸羟化酶(PAH)基因的每个外显子及其侧翼的内含子,并克隆到M 13载体中进行序列分析。发现中国人苯丙酮尿症(Phenylketonuria,PKU)患者的PAH基因外显子3中有1个Arg~(111)→Ter~(111)的点突变,此突变与东方人最常见的突变单体型4呈连锁不平衡。此突变占中国人PAH等位基因的10％左右,但不存在于高加索人群中,表明在种族分化过程中PAH基因位点发生了互不相关的突变事件。     

Point mutation in the parkin gene on patients with Parkinson’s disease

Summary To investigate the distribution of possible novel mutations from parkin gene in variant subset of patients with Parkinson’s disease (PD) in China and explore whether parkin gene plays an important role in the pathogenesis of PD, 70 patients were divided into early-onset group and late-onset group; 70 healthy subjects were included as controls. Genomic DNA from 70 normal controls and from those of PD patients were extracted from peripheral blood leukocytes by using standard procedures. Mutations of parkin gene (exon 1–12) in all the subjects were screened by PCR-single strand conformation polymorphism (SSCP), and further sequencing was performed in the samples with abnormal SSCP results, in order to confirm the mutation and its location. A new missense mutation Gly284Arg in a patient and 3 abnormal bands in SSCP electrophoresis from samples of another 3 patients were found. All the DNA variants were sourced from the samples of the patients with early-onset PD. It was concluded that Parkin point mutation also partially contributes to the development of early-onset Parkinson’s disease in Chinese. WANG Tao, male, born in 1961, Associate Professor This work was supported by grants from the key program of the special scientific project of Scientific & Technologic Agency of Hubei Province (Serial No. 2001AA308B01) and the Hygienic Research Project of Hygienic Agency of Hubei province (Serial No. WJ 01529).     

醒脑开窍针刺法治疗恢复期中风临床及实验研究

采用醒脑开窍针刺法与传统针刺法治疗恢复期中风92例,按随机原则分成醒脑开窍针刺组50例,传统针法组42例。治疗结果表明,醒脑组与传统组基本治愈率分别为42％、16.67％,醒脑组显效及有效率亦明显优于传统组。实验结果表明,醒脑组在血液流变学、血脂、微循环和体外血栓形成等绝大多数指标上,均有明显改善,其程度和范围均明显优于传统针刺组。     

视觉近点测定修布和验布作业视疲劳的初步探讨

应用视觉近点测定评价纺织厂不同作业工人的视疲劳。检查了32名修布工人和38名验布工人。同一工厂的33名保育员作对照组。结果表明:视觉近点的测定指标比调查受试者主诉的眼视觉症状更为敏感。修布和验布组在工作后,作业者的视觉近点比上班前明显变远,但时照蛆工作前后无明显变化。三组视觉近点比较,发现修布和验布组视觉近点的变化。提示由修布和验布作业引起的视觉疲劳,可以通过测定视觉近点来进行评价。     

天然有机分子精细立体结构规律的初步研究Ⅱ．影响熔点的结构因素

应用Ｘ衍射方法测定雷公藤两个化合物的晶体结构，并对影响固体熔点的结构因素进行分析。晶型（或空间对称群）、结晶溶剂、分子间作用力及分子构象的精细变化均可导致晶态物质的熔点变化。     

Tension-free vaginal tape for the treatment of urodynamic stress incontinence with intrinsic sphincteric deficiency

The purpose of this study was to evaluate the outcome of tension-free vaginal tape (TVT) procedure in women with urodynamic stress incontinence diagnosed as having intrinsic sphincteric deficiency (ISD). The combination of a maximal urethral closure pressure <20 cm H₂O and a Valsalva leak point pressure <60 cm H₂O was considered as diagnostic of ISD. Subjects with detrusor overactivity on preoperative urodynamics were excluded. A total of 35 patients with both low closure pressure and leak point pressure were enrolled. Bladder perforation occurred in three (8.6%) cases. Postoperative urinary voiding difficulties occurred in nine (25.7%) women. Two patients underwent surgical detension of the tape, with complete resolution of urinary retention and no relapse of incontinence. Women with postoperative voiding dysfunction had a significantly lower detrusorial pressure at the peak flow on preoperative urodynamics compared to those who voided efficiently after TVT. The mean (range) follow-up time was 12.5 months (3–36). The objective cure rate for stress incontinence was 91.4%. Two of the three (66%) patients in whom the TVT procedure failed had a fixed urethra. De novo urge incontinence was found in five (14.3%) patients.     

瞄准前沿以人为本全面提升医院的综合竞争力

介绍了医院创新工作思路和瞄准国际前沿,高起点培训专业技术人才,全面提升医院综合竞争力的主要做法及取得的成效.     

人心肌肌钙蛋白I第2和第4个密码子同义突变对其在大肠埃希菌中表达的影响

目的 对人心肌肌钙蛋白I（cTnI）基因实行定点突变并进行原核表达，观察此突变对cTnI表达量的影响。方法 利用RT-PCR方法从人心肌细胞的总RNA中克隆出编码人心肌肌钙蛋白I的cDNA片段，设计引物将其第2和第4个密码子突变后插入原核表达载体形成重组体，并导人宿主菌BL21（DE3）中，经IPTG诱导表达，Ni-NTA树脂纯化后行Western blot鉴定，观察突变对cTnI表达的影响。结果 突变后的cTnI基因与对照组相比在大肠埃希菌中得到高效表达，经纯化可获得电泳单点纯的cTnI蛋白。结论 成功克隆了cTnI基因，所设计的同义突变可促进cTnI在大肠埃希菌中的高效表达。