Objective To develop the Expert Consensus on Sensitive Indicators for Assessment of the Quality of Nursing in Operating Theatre and provide a scientific and practical guidance for improving the quality of nursing in operating theatre.Methods The writing team established by the Operating Room Nursing Professional Committee of Guangdong Nursing Association conducted systematic literature retrieval and screening,and used the updated clinical Guidelines for Research and Evaluation Ⅱ in UK 2017.AGREE Ⅱ and the evidence evaluation system of the Australian JBI(Joanna Briggs Institute,JBI)Evidence-Based Health Care Center evidence level system(2016 Edition)comprehensively analyzed the evidence related to the sensitive indicators for evaluating the quality of operating room nursing and the suggestions of the writing group members.The first draft was formed based on the three-dimensional quality evaluation theoretical framework of"structure-process-result".Through the Delphi method,after two rounds of expert consultations and members'votes,the first draft was deeply revised and improved.Results Based on the three-dimensional quality evaluation theoretical framework of"structure-process-outcome"proposed by American scholar Donabedian,the expert consensus finally included five primary indicators:basic nursing quality,quality indicators of patient safety,quality indicators of hospital infection control,quality indicators of medication and safety management,and quality indicators of specialised nursing in operating theatre.The secondary indicators consisted of one structural indicator(management of commonly used instrument and equipment in operating theatre)and 17 process indicators(e.g.,infusion and blood transfusion management,body temperature management,etc.).The tertiary indicators included 26 process indicators and 11 outcome indicators(e.g.,incidence of adverse reactions of infusion during surgery,incidence of intra-operative hypothermia,etc.).Conclusion The evidence-and guideline-based Expert Consensus on Sensitive Indicators for Assessment of the Quality of Nursing in Operating Theatre based on eviclence and guidelines was established through rigorous evidence-based methods.It is operational and practical,and offers theoretical support and practical guidance for the managers of operating theatre to improve the quality of nursing.

Objective To develop the Expert Consensus on Sensitive Indicators for Assessment of the Quality of Nursing in Operating Theatre and provide a scientific and practical guidance for improving the quality of nursing in operating theatre.Methods The writing team established by the Operating Room Nursing Professional Committee of Guangdong Nursing Association conducted systematic literature retrieval and screening,and used the updated clinical Guidelines for Research and Evaluation Ⅱ in UK 2017.AGREE Ⅱ and the evidence evaluation system of the Australian JBI(Joanna Briggs Institute,JBI)Evidence-Based Health Care Center evidence level system(2016 Edition)comprehensively analyzed the evidence related to the sensitive indicators for evaluating the quality of operating room nursing and the suggestions of the writing group members.The first draft was formed based on the three-dimensional quality evaluation theoretical framework of"structure-process-result".Through the Delphi method,after two rounds of expert consultations and members'votes,the first draft was deeply revised and improved.Results Based on the three-dimensional quality evaluation theoretical framework of"structure-process-outcome"proposed by American scholar Donabedian,the expert consensus finally included five primary indicators:basic nursing quality,quality indicators of patient safety,quality indicators of hospital infection control,quality indicators of medication and safety management,and quality indicators of specialised nursing in operating theatre.The secondary indicators consisted of one structural indicator(management of commonly used instrument and equipment in operating theatre)and 17 process indicators(e.g.,infusion and blood transfusion management,body temperature management,etc.).The tertiary indicators included 26 process indicators and 11 outcome indicators(e.g.,incidence of adverse reactions of infusion during surgery,incidence of intra-operative hypothermia,etc.).Conclusion The evidence-and guideline-based Expert Consensus on Sensitive Indicators for Assessment of the Quality of Nursing in Operating Theatre based on eviclence and guidelines was established through rigorous evidence-based methods.It is operational and practical,and offers theoretical support and practical guidance for the managers of operating theatre to improve the quality of nursing.

OBJECTIVE To investigate the current situation of pharmaceutical management in compact medical consortium of Guangdong province， and to provide decision-making basis for promoting the high-quality construction and sustainable development of the provincial medical consortium. METHODS A self-designed questionnaire was used to select 50 compact medical consortiums in Guangdong province. The survey was answered by the heads of the pharmacy department of the general hospitals. The survey covered the basic scale of the consortium， the appointment of chief pharmacists， the implementation of pharmaceutical management and pharmaceutical care homogenization within the consortium， the difficulties in promoting the homogenization， and the expected provincial support. Descriptive statistical analysis was performed on the survey results. RESULTS A total of 50 questionnaires were collected， and the effective recovery rate was 100%. There were 16 chief pharmacists （32.00%） in charge of the pharmacy department of the general hospital in the medical consortium. Thirty-seven medical consortiums （74.00%） had established a drug supply support system within the consortium， 35 medical consortiums （70.00%） had carried out pharmaceutical management and coordination work within the medical consortium， 23 medical consortiums （46.00%） had established a clinical medication guidance system， 25 medical consortiums chenwenying2016@163.com （50.00%） had established a bidirectional communication mechanism， and only 8 medical consortiums （16.00%） had developed new models of pharmaceutical care. At present， the difficulties in promoting the homogenization of pharmaceutical management and pharmaceutical care within the medical consortium were mainly found in three aspects： the wide gap in management level of each member unit， the lack and uneven level of pharmaceutical personnel， and insufficient policy support and implementation. Most medical consortiums hoped that relevant departments could promote the homogenization of pharmaceutical work by holding special training courses or special supervision. CONCLUSIONS At present， the compact medical consortium in Guangdong province has achieved initial results in the implementation of the chief pharmacist system， the homogenization of pharmaceutical management and pharmaceutical care. However， it is still necessary to improve the coverage of chief pharmacist appointments in the medical consortium， implement the homogenization of pharmaceutical management， and accelerate the homogenization process of pharmaceutical care.

Objective : To investigate the relationship between vitamin D receptor (VDR) gene polymorphisms and the clinical prognosis of acute pancreatitis (AP) , and to provide a genetic basis for early identification of critically ill patients. Methods : A total of fourteen single nucleotide polymorphisms (SNPs) on the VDR gene were detected in 508 AP patients by using improved ligase detection reaction (imLDR) technology. Unconditional Logistic regression analysis was used to explore the association of VDR gene polymorphisms with outcome ( sepsis/severe AP/death) of AP patients after adjusting for age , sex , body mass index(BMI) , smoking and drinking status and APACHE II score under different genetic models. Results : Rs12721375 GA/AA genotype had a lower risk of sepsis than GG (P = 0. 02) and the A allele had a lower risk of sepsis than G (P = 0. 009) . Rs2853559 GA and GA/AA had higher risks of sepsis than GG (P = 0. 022 and 0. 026 respectively) . Rs11168287 AA had a higher risk of severe AP than GG and GG/GA (P = 0. 030 and 0. 022 respectively) . Rs2853559 AA genotype had a higher risk of severe AP than GG and GG/GA ( P = 0. 022 and 0. 021 respectively) . The risk of death of rs11168283 CT/TT genotype was lower than that of CC (P = 0. 046) . Conclusion VDR gene polymorphisms are related to the clinical outcome of AP patients in Chinese Han population. VDR gene is involved in the progression of AP.

Objective To study the coagulation function of premature infants at birth and the associated risk factors.Method From January 2014 to January 2018,a prospective study was conducted on preterm infants born in obstetrics department of our hospital.According to the gestational age,these infants are assigned into early preterm group,moderate preterm group and late preterm group.The prothrombin time (PT),activated partial thromboplastin time (APTF),fibrinogen (FIB) and thrombin time (TT) were measured using automatic coagulation analyzer.The possible risk factors affecting the coagulation function in each group were analyzed.Result A total of 795 preterm infants were studied including 93 in the early preterm group,151 in the moderate preterm group and 551 in the late preterm group.In the early preterm group,infants with premature rupture of membranes (PROM) had increased FIB,shortened TT,and infants with severe asphyxia had prolonged PT,and the differences were statistically significant (P ＜ 0.05).In the moderate preterm group,infants with PROM had significantly prolonged APTT (P ＜ 0.05).In the late preterm group,PT and TT were prolonged and FIB was decreased in male infants.Infants with PROM have increased FIB;PT was prolonged among infants with severe asphyxia (P ＜ 0.05).Multivariate linear regression analysis showed that neonatal asphyxia,weight and gender were the main factors affecting PT (P ＜ 0.05),gestational age was the main risk factor affecting APTT (P ＜ 0.05),PROM,gestational age,weight and gender were the main factors affecting FIB (P ＜ 0.05),and neonatal asphyxia was the main factor affecting TT (P ＜ 0.05).Conclusion The coagulation function of premature infants is affected by many factors including gender,gestational age,weight,asphyxia,PROM,and maternal complications.Coagulation function should be monitored in preterm infants with severe asphyxia.

Objective:To evaluate the influence of minimally invasive corticotomy on the treatment time and molar anchorage of adult orthodontic extraction cases.Methods:60 adult cases of Angle Class Ⅰ crowding malocclusion were devided into 3 groups (n =20) and treated by orthodontic treatment wtih minimally invasive corticotomy(group A),orthodontic treatment with classic modified corticotomy(group B) and routine orthodontic treatment (group C) respectively.Time needed for leveling and alignment,space closure,delicate adjustment,total treatment time and mesial sagittal antedisplacement of first molar anchorage were compared among the 3 groups.Results:Time needed for leveling and alignment of orthodontic treatment of group A,B and C was (5.64 ± 2.57),(4.91 ± 3.31) and (8.87 ± 3.75) months respectively(C vs A or B,P ＜ 0.01).Time needed for space closure of group A,B and C was (6.84 ± 2.69),(6.64 ± 3.87) and (8.63 ± 3.29) months respectively(C vs A or B,P ＜0.01).Time needed for delicate adjustment showed no significant difference among the 3 groups(P ＞ 0.05).Total treatment time of group A,B and C was (16.07 ± 6.21),(15.77 ± 5.11)and (21.94 ± 5.74) months respectively (C vs A or B,P ＜ 0.01).There was on statistical difference of mesial sagittal antedisplacement of first molar anchorage among the 3 groups.Conclusion:Minimally invasive corticotomy can shorten the orthodontic treatment time,but can not decrease the retraction resistance of the anterior teeth.

OBJECTIVETo investigate the influence of class III forces in craniofacial morphology and sutural histology in Rhesus monkeys.

METHODSSix male Rhesus monkeys in mixed dentition were employed in this study, two as 90-day experimental group, two as 45-day experimental group and the other two as control respectively. The experimental monkeys were casted magnetic orthopedic appliance-III (MOA-III), the control monkeys received no treatment. Intraoral photographs, casts and cephalometric radiographs of each animal were obtained at the beginning and at the end of the experiment. Fluorescent and haematoxylin-eosin staining were used to observe the histological changes in craniofacial sutures. RESULTS; In experimental groups, the maxillomandibular relationship changed more significantly in 90-day experimental group than 45-day experimental animals. But changes were scarcely noted in the control. The bony depositions of the sutures were distinctly found during the experimental period, especially in zygomaticomaxillary, transverse palatine, pterygopalatine and zygomaticotemporal sutures.

CONCLUSIONThis study indicates that this kind of magnetic appliance could cause skeletal and dental changes of maxilla and mandible, and change the arrangement of connective tissues in craniofacial sutures, and lead to significant new bone deposition in craniofacial sutures.

Objective To establish effective method for large-scale purification of islet cells from pig pan-cress. Methods Pig pancreas tissue was digested with collagenase P followed by purification in a HCA-Fi-coil dis continuous gradient using Cobe2991 cell separator. After isolation, the islet cell yield and purity were evaluated with light microscope with DTZ staining, and the islet function assessed by insulin release as-say in vitro. Results The number of the islets coll ected from each pancreas averaged (275 000±20 895)islet equivalents (IEQ) before purification, and (230 350±26 679) IEQ after the purification with discon-tinuous gradient centrifugation. From each gram of the pancreatic tissue, (2710±229) IEQ were obtained with an average purity of (50.2±1.95) %. The purified islets responded well to high-concentration (16.7 mmol/L) glucose stimulation with a 4. 74-fold increase of insulin secretion over the basal level (3.3 mmol/L, P <0.001). Conclusion The established method can be applicable for large-scale purifi-cation of fully functional islet cells from pig pancreas.

Objective To evaluate the functional and aesthetic disturbance of patients treated with lingual orthodontic surgery and to investigate the key points of laboratory procedure and clinical treatment of lingual orthodontic deformity. Methods A total of 30 cases of Angle class Ⅰ with moder-ate crowding were selected. They were equally divided into two groups: one group was treated using lingual brackets, and the other using conventional labial brackets. Each patient completed a four-part survey right after the bracket placing and 7, 28, 56 days after the treatment. The differences of tongue-lip-cheek soreness, eating and speech difficulties and aesthetic problems were evaluated be-tween two groups. Lateral cephalograms were analyzed at the start of the treatment and the end of the overall treatment. Results Speech difficulties of lingual orthodontics were significantly greater (P<0.01) than that in the labial orthodontics group in the first week of the treatment. Eating difficulties were greater (P<0.01) in the lingual orthodontics group by 28 days, whereas aesthetic problems were greater in group using labial appliance than group lingual appliance. Conclusions In the first two months of the orthodontic treatment, eating and speech difficulties are the most severe problems for the lingual group. Lingual orthodontics offers important aesthetic advantages over labial orthodontics, and it will be one of the development directions of current orthodontics.

OBJECTIVEThe aim of this study was to analyse the stress distribution in the periodontium of the maxillary first molar and to search optimal loads pattern when distal movement to provide biomechanical basis for the clinical practice.

METHODSBy spiral CT scanning, a three-dimensional finite element model of the maxillary first molar was established, and then four different load patterns were added to the molar to obtain the optimal load partern for molar bodily distal movement.

RESULTSDifferent loads lead to different stress distributions when distal movement.

CONCLUSIONA distalizing force combined with a countertipping moment (Mt/F = 10) and a counterrotation moment(Mr/F = 6) can lead to a lower and uniform stress on the distal side of the periodontal ligament, it implys a tendency of translation of the maxillary first molar.