Objective:to detect the effect of working qulity in operating room before and after apply ISO9000 series standard.Methods:the questionnaire of the satisfaction comes from the patients to the nurses of the operating room,the examine score chart to the instrumental nurses in the operating room,the examine score chart to the circulating nurse of operating room as the 3 measuring scale to be investigated as the comparation about the effect of the application of the ISO9000 standard.Results:①The degree of the patients satisfation is improved to such an extent after the ISO9000 standards applied.②The checking result of the instrumental nurses and the circulating nurses is also of the obvious difference;what is more,once the nursing matron published the specific checking standards and the checking result,it is liable to the nurses to realize their own faults.③Through this period of the investigation and the research,the application of the ISO9000 quality managing architecture better formalize the nurses work than before,everything is equipped with foundation and standard,thus the working quality is improved.

Objective: To explore age-based clinical and immune parameters in Henoch-Schönlein purpura (HSP) to determine clinically useful markers reflecting disease characteristic. Methods: A cohort of 502 patients with HSP were enrolled into this retrospective study to evaluate their clinical and immune data. Results: Majority HSP cases occurred at age ≤14 years and showed significant immune imbalances of ESR, CD3⁺ cells, CD4⁺ cells, CD3^-CD16⁺CD56⁺ cells, CD4⁺/CD8⁺ cells, IgG, IgA, IgM, IgE, complements C3/C4 and ASO in the acute phase. Compared to patients aged >14 years, symptoms of joint were more frequent at disease onset in patients aged ≤14 years (20.8% vs 7.6%, χ²=13.547, P<0.001) , and involvement of digestive tract and joint were also more frequent (57.4% vs 33.8%, χ²=24.106, P<0.001; 55.9% vs 32.5%, χ²=23.768, P<0.001, respectively) , but not for involvement of kidney (21.4% vs 51.3%, χ²=42.440, P<0.001) . The patients aged ≤14 years had distinct immune state, reductions of CD3⁺ cells, CD4⁺ cells and IgG were more frequent than patients aged >14 years, also increase of ASO (33.1% vs 20.0%, χ²=6.656, P=0.010) , but not increase of IgA (2.6% vs 39.4%, χ²=15.582, P<0.001) . In addition, reduction of IgG and increase of IgE were positively associated with digestive tract involvement (P<0.001, P=0.001, respectively) , reduction of CD3⁺CD4⁺ cells and normal IgM were positively associated with joint involvement (P=0.004, P=0.003, respectively) , increase of CD3⁺CD8⁺ cells and normal CD3⁺ cells were positively associated with kidney involvement (P=0.032, P=0.014, respectively) . Conclusion HSP showed significant immune imbalance in the acute phase, patients between aged ≤14 and >14 years had distinct clinical and immune characteristic, and abnormal immune parameters were significantly associated with organ involvements.