Five years have passed since the Japan Nursing Association started the Diagnostic Service for Improving Labor and Nursing Quality (DiNQL). We have participated in DiNQL data input support analysis activities since 2013, and the DiNQL Promotion Committee was launched in 2015. Here, we report on the activities of the DiNQL Promotion Committee and evaluate the results of these activities. The DiNQL Promotion Committee's four main activities involve being in charge of the floor at meetings, clarifying the input method aimed at shortening data collection time, supporting analysis of the DiNQL data input, and holding workshops for analysis and utilization. A self-administered questionnaire was administered to 43 ward nursing managers (including section chiefs and managers) to evaluate these committee activities. Both section chiefs and clerical staff responded that DiNQL data input time was shortened by more than 90%. Section chiefs comprised 64% and managers 79% of those who responded that DiNQL data could be utilized for determining annual departmental goals. In total, 71% of managers and 50% of section chiefs responded that DiNQL data is useful for nursing management. Based on these results, we confirmed that setting up the DiNQL Promotion Committee and its activities has led to nursing management support.

In order to further s tandardize the clinical application of proton pump inhibitors and provide reference for prescription suitability review ，under the guidance of Guiding Principles for Clinical Use of Proton Pump Inhibitor which was promulgated by the General Office of National Health Commission of the People ’s Republic of China ，Pharmaceutical Admini- stration Committee of Chongqing Hospital Association initiates “the formulation Project on Prescription Review Rules for Proton Pump Inhibitors ”. The First Affiliated Hospital of the Army Medical University takes the lead and cooperates with clinical experts ， pharmaceutical experts and evidence-based experts from many domestic medical institutions to discuss the indications ，usage and dosage，medication for special groups and drug interactions of proton pump inhibitors ，and finally forms this consensus. The main contents of the consensus include the basic prescription review rules of omeprazole ，esmeprazole，pantoprazole，rabeprazole， lansoprazole and iprazole （including injection and oral preparations ，calculated by common name ），and 12 prescription review recommendations for some clinical applications not covered on the basic prescription review rules ，in order to provide reference for medical institutions at all levels.

‍The concept of day-case surgery was first proposed by British surgeon Nicoll， referring to the surgery or procedure in which a patient completes admission and discharge within one day （24 h）. In recent years， China has gradually implemented the day-case mode of laparoscopic cholecystectomy. Day-case laparoscopic cholecystectomy could significantly shorten hospital stay， reduce hospital infections， accelerate patient recovery， improve the efficiency of medical resource utilization， and reduce medical costs. In order to provide reference for exploring and developing standardized day-case laparoscopic cholecystectomy and promote the standardized application and promotion of day-case laparoscopic cholecystectomy， the Minimally Invasive Surgery Committee of the Chinese Research Hospital Association organized experts from surgery， anesthesia， and nursing to develop this expert consensus.

Informed consent is one of the key elements to protect the rights and welfare of the patients or research subjects. With the development of electronic information technology, the diversity and convenience brought by the electronization makes the electronic informed consent (E-Consent) come into being. European and American countries have begun to apply E-Consent in the field of clinical trials, established a relatively perfect E-Consent platform and software system, and initially formed the guiding principles and recommendations of E-Consent. However, the implementation of E-Consent is still less in China, and there is no targeted legal basis and guidelines for ethical review. Therefore, this paper explored the implementation potential of E-Consent domestically by analyzing the application scenarios, advantages and disadvantages, and feasibility of E-Consent, and tried to establish the practical ethic review points of E-Consent based on the basic principles of ethical principles, to ensure that clinical trials have an appropriate E-Consent process.

Extended clinical trials are medical treatment activity based on the humanitarianism to provide new medical products during the clinical trials for specific patients who have no other effective medical means to prolong life or alleviate pain. Extensive clinical trials have both medical and scientific attributes, which are significantly different from registered clinical trials and require special ethical attention. At present, the extended clinical trials in China are still in the initial stage, laws, regulations and supporting management methods are not perfect, and there is a lack of experience in ethical governance of such special clinical trials. This paper took the expanded clinical trial of medical devices as an example, referred to the current laws and regulations at home and abroad, analyzed their characteristics, and put forward some suggestions on the ethical governance of the whole process of the expanded clinical trials of medical devices in China,including special concerns in the application and acceptance, the first review approval strategy and the key points in continuing review.

Computer-assisted combined indocyanine green (ICG) molecular fluorescence imaging technology can be used for preoperative planning and intraoperative detection from three-dimensional (3D) morphological anatomy and level of cellular function to guide the anatomical, functional and radical hepatectomy of liver tumor. This technology has received wide acceptance and has shown important diagnostic and therapeutic value. This guideline is intended to standardize the application of computer-assisted combined ICG molecular fluorescence imaging for accurate diagnosis and treatment of liver tumors in the following aspects: (1) the workflow of 3D visualization technology; (2) the mechanism and application flow of ICG molecular fluorescence imaging; (3) clinical application of 3D visualization technology and virtual reality technology; and (4) clinical application of ICG molecular fluorescence imaging. ICG molecular fluorescence imaging can help to define tumor boundary, determine hepatic segment and hepatic lobectomy tangent at the molecular and cellular level, and detect small lesions or metastases. According to the fluorescence signal characteristics of liver tumors and combined with rapid frozen pathological examination during operation, the differentiation degree of liver space-occupying lesions (such as primary liver cancer) can be preliminarily determined, and residual tumors and biliary leakage on the hepatic section can be detected after hepatectomy. Computer-assisted ICG molecular fluorescence imaging in the diagnosis and surgical navigation of liver tumors provides a new approach to digital diagnosis and treatment of liver tumors. With its development in clinical practice and the technological innovation, this technology will be further improved to allow more accurate diagnosis and treatment of liver tumors.

It is the responsibility of a clinical research institution to protect the rights and interests of research subjects. For the full process supervision of clinical research projects, the construction of a Human Research Protection Program (HRPP) which is suitable to the hospital’s situation can gradually improve the ethical review quality, and provide comprehensive protection measures for participants and potential participants throughout the entire clinical research process. Combined with the characteristics of clinical research and ethical review of Traditional Chinese Medicine(TCM), this paper introduced the construction of an HRPP system that highlights TCM characteristics. At the same time, this paper systematically analyzed the division of responsibilities, communication and cooperation of different committees and departments within the HRPP system to ensure the effective operation of the entire HRPP system, improve the quality of TCM clinical research and the protection level of the HRPP system, in order to achieve the goal of promote the healthy, orderly and scientific development of clinical research.

In the case of extremely shortage of donor kidney sources, the number of Expanded Criteria Donors (ECD) with relatively poor kidney quality and transplantation effect is increasing. In order to alleviate the contradiction between supply and demand by using transplantable kidneys as much as possible and avoid the failure or poor effect of transplantation caused by poor quality kidneys, the quality assessment and evaluation criteria of ECD kidney have become a research hotspot in the field of kidney transplantation. This paper analyzed the possible ethical defects in the research process, and put forward some suggestions for the transplantation team to strictly follow the ethical principles of "no harm", "beneficial" and "informed consent", and the organ transplantation ethics committee to pay attention to the ethical review of the quality evaluation process of ECD donor kidney.

In the training process of medical students in clinical stage,it is very important to strengthen the medical students’ scientific research integrity and ethical awareness and pay attention to the promotion of their scientific research ethics literacy. The traditional training mode is generally through giving lectures in the classroom. In the current COVID-19 prevention and control normalization period,online training mode through network courses,video training,and learning materials sharing has been used to carry out training on scientific research ethics. This online training mode can effectively use students’ scattered time,which makes the training more convenient and students’ participation is higher. Through the questionnaire survey of 350 clinical medical students,this study analyzed the training courses related to scientific ethics that they hope to offer through online training,as well as specific training materials,application software and other issues,in order to enrich the content of online training,update information in a timely manner,and improve the effectiveness of scientific research ethics training.

Therapeutic misconception refers to the misunderstanding of the essence， purpose， and potential benefits of clinical research among patients， who fail to recognize that participating in clinical research does not involve individualized treatment， but rather aims to obtain generalizable scientific knowledge. This paper explored the definition， causes， and impact of clinical research of “therapeutic misconception”， and proposed strategies to address them. By gaining a deeper understanding of “therapeutic misconception”， the quality of informed consent of research participants can be improved， their rights can be protected， and the quality of research can be enhanced.