Objective: To investigate the accuracy of the mandibular curve of Spee and mandibular curve of Wilson curve, mandibular posterior crown inclination, maxillary and mandibular arch width, and mandibular incisor labial inclination changes in the invisible orthodontic treatment of extracted and non-extracted patients to provide a basis for the study of the therapeutic efficacy of the invisible aligner. Methods: This study was approved by the Unit Medical Ethics Committee. Adult bony Class I patients treated with invisible aligners between 2016 and 2023 were selected and categorized into 32 cases in a group with four first premolar extractions and 33 cases in a non-extraction group. The initial scanning model (T1), the orthodontic plan design model (T2), and the scanning model after alignment and leveling (T3) were collected, and the scanning data at different time points were exported to STL format files. They were then analyzed and measured using GOM Inspect 2019 software; the clinical effect (T1-T3) was defined as AC, and the expected result (T1-T2) was defined as CC. To explore the mandibular curve of Spee, the leveling accuracy of the mandibular Wilson curve (AC/CC×100%), the change in mandibular posterior crown inclination, the change in maxillary and mandibular arch width and the change in mandibular incisor labial inclination. The results were tallied using R4.3.2 software. Results: The leveling accuracy of the mandibular curve of Spee was 3.2% and 10.1% in the extraction and non-extraction groups, respectively; the leveling accuracy of the mandibular first molar in the extraction and non-extraction groups was 9.5% and 4.2%, respectively, and the leveling accuracy of the mandibular second premolar was 32.8% and 25%, respectively. The leveling accuracy of the mandibular curve of Wilson was 126% in the extraction group compared to 704% in the non-extraction group. The maximum values of AC for crown inclination of the mandibular posterior teeth were all found in the first molar and the minimum values in the second premolar (P< 0.05); CC was the greatest in the second premolar and the least in the first molar in the extraction group (P< 0.05), and in the second molar and the least in the second premolar in the non-extraction group (P< 0.05). There was no significant difference in the change of maxillary and mandibular arch widths in the extraction group (P> 0.05); the AC of the arch widths at the maxillary first molar and at the mandibular second premolar and first molar in the non-extraction group was significantly greater than the CC (P< 0.05). The AC of the mandibular second premolar crown inclination was significantly greater in the non-extraction group than in the extraction group (P < 0.05), showing a more pronounced buccal inclination of the crowns; in contrast, there was no significant difference between the mandibular molar crown inclination AC and CC in the two groups (P > 0.05). The CC of mandibular curve of Spee in the extraction group was significantly greater than that in the non-extraction group (P < 0.05), whereas there was no significant difference in AC between the two groups (P > 0.05). In addition, the AC of the labial inclination of the mandibular incisors in the extraction group and the non-extraction group was smaller than the CC, but both were positive, indicating an increase in the degree of labial inclination of the mandibular incisors. Conclusion The invisible aligner mandibular curve of Spee leveling was poorly expressed, and there was a tendency for overexpression of the mandibular curve of Wilson leveling. Increased labial inclination of the mandibular incisors was observed in patients. The extraction group was accurately predicted in arch width control, there was overexpansion in the non-extraction group.

Objective To measure and analyze through cone-beam computed tomography(CBCT)of the incidence of alveolar bone fenestration and dehiscence,as well as the thickness and height of the alveolar bone in the maxillary canine region of adult patients with different sagittal skeletal patterns.Methods A total of 174 adult patients meeting the criteria were selected.In the first step,the inci-dence rates of fenestration and dehiscence were measured and statistically analyzed after grouping according to ANB.In the second step,the patients with bone fenestration and bone dehiscence were excluded,and the thickness of the alveolar bone at the apical,mid-dle and cervical regions on the labial and palatal sides of the maxillary canine area and the height of the alveolar crest were measured in the remaining samples.Then,the three groups of patients were further divided into three groups according to the FMA for comparison and analysis.Results The incidence of bone fenestration and bone dehiscence in the maxillary canine area was higher in adult patients with skeletal Class Ⅱ.The thickness of the labial alveolar bone at the apical region in skeletal Class Ⅲ was greater than that in skeletal Class Ⅱ and skeletal Class Ⅰ.The thickness of the palatal alveolar bone at the middle root in skeletal Class Ⅱ:average angle＞low angle＞high angle.In skeletal Class Ⅲ,the thickness of the palatal alveolar bone at the cervical root:low angle＞average angle＞high angle.Conclusion The incidence of bone fenestration and bone dehiscence was the highest in adult patients with skeletal ClassⅡ.The thickness of the labial alveolar bone at the apical region was greater in skeletal Class Ⅲ than in skeletal Class Ⅱ and skeletal Class Ⅰ.The thickness of the palatal alveolar bone at the middle root in skeletal Class Ⅱ high angle patients was thinner than that in the average angle and low angle groups,and the thickness of the palatal alveolar bone at the cervical region in skeletal Class Ⅲ was thinner in the high angle group than in the average angle and low angle groups.

Objective To measure and analyze through cone-beam computed tomography(CBCT)of the incidence of alveolar bone fenestration and dehiscence,as well as the thickness and height of the alveolar bone in the maxillary canine region of adult patients with different sagittal skeletal patterns.Methods A total of 174 adult patients meeting the criteria were selected.In the first step,the inci-dence rates of fenestration and dehiscence were measured and statistically analyzed after grouping according to ANB.In the second step,the patients with bone fenestration and bone dehiscence were excluded,and the thickness of the alveolar bone at the apical,mid-dle and cervical regions on the labial and palatal sides of the maxillary canine area and the height of the alveolar crest were measured in the remaining samples.Then,the three groups of patients were further divided into three groups according to the FMA for comparison and analysis.Results The incidence of bone fenestration and bone dehiscence in the maxillary canine area was higher in adult patients with skeletal Class Ⅱ.The thickness of the labial alveolar bone at the apical region in skeletal Class Ⅲ was greater than that in skeletal Class Ⅱ and skeletal Class Ⅰ.The thickness of the palatal alveolar bone at the middle root in skeletal Class Ⅱ:average angle＞low angle＞high angle.In skeletal Class Ⅲ,the thickness of the palatal alveolar bone at the cervical root:low angle＞average angle＞high angle.Conclusion The incidence of bone fenestration and bone dehiscence was the highest in adult patients with skeletal ClassⅡ.The thickness of the labial alveolar bone at the apical region was greater in skeletal Class Ⅲ than in skeletal Class Ⅱ and skeletal Class Ⅰ.The thickness of the palatal alveolar bone at the middle root in skeletal Class Ⅱ high angle patients was thinner than that in the average angle and low angle groups,and the thickness of the palatal alveolar bone at the cervical region in skeletal Class Ⅲ was thinner in the high angle group than in the average angle and low angle groups.

Objective To learn the effects of family supportive supervisors on medical staff turnover intention. Methods The scales of family supportive supervisor behavior scales, work-family conflict scale and turnover intention scale were used in the study. The data were collected from a questionnaire survey of 214 army tertiary hospitals′ medical staff during October to December 2017. Hierarchical regression analysis was used to establish a model to understand the influence of family supportive supervisor behavior, two-way conflict between work and family, using the independent variables, on turnover intention of medical staff. Results The and family supportive supervisor behaviors had a negative explanation to medical staff turnover intention ( β = - 0. 211, P < 0. 01), work interference with family had a positive explanation to it (β = 0. 358, P < 0. 01), family interference with work had an obscure explanation to medical staff turnover intention (β = 0. 104, P > 0. 05). Work interference with family had a partially mediating effect which influenced family supportive supervisor behaviors on medical staff turnover intention. Conclusions Family supportive supervisor behavior, as an organizational support, can effectively alleviate the work interference on family for medical staff and thus minimize their turnover intention.

Objective To understand the current situation and requirements of laboratory quality control of blood diseases in Chongqing .Methods A self‐designed questionnaire was designed ,and the investigation was carried out in 60 hospitals of Chongqing district .The main contents of the investigation were related to the instruments of work environment ,the regulations ,the conditions of the personnel ,etc .Results A total of 60 questionnaires were distributed ,57 questionnaires were valid .In the study ,only 14 .04%laboratories were the blood disease specialist laboratory ,most hospitals could complete the basic inspection items .66 .67% hospitals had all the experimental procedures and SOP documents .Most of staffs were with intermediate professional titles and undergraduate education .A total of 35 .08% experimental equipments with the value of over 5 million RMB ,45 .61% equipments had a special in‐spection records .About 45 .61% test reports would refer to the clinical performance ,and had a strict signing guideline .Most of the research objects reflected the problems ,including the backward equipments and the lack of personnel ,and hoped to set up telemedi‐cine indemnity system and carry out further education .Conclusion The overall quality of the laboratory for blood diseases in Chongqing is better ,it is recommended to strengthen the full quality control ,to establish emergency system ,and to improve the quality and level of laboratory .

To explore the optimized dispatch of the rescue resources based on the mastered resources informa-tion. The objective function was set as the shortest rescue time, and 0-1 programming models were established and solved for the conditions that the number of medical rescue units was more or less than needed by the missions. In the two conditions, the model's calculated results were both optimal, and could be used to obtain the optimal dispatch solutions while the medical rescue time was the shortest. The 0-1 programming model can be effectively used to optimize dispatch strategy for medical rescue team.

Objective To establish core competence evaluation index system of orthopaedic specialized nurse .Methods Alto‐gether 35 experts from Class Ⅲ Grade Ⅰ hospital in Chongqing ,Beijing ,Jiangshu were consulted by a three‐round delphi survey ,and finally established the core competence evaluation index system of orthopaedic and the weight of each index .Results The core com‐petence evaluation indexes of orthopaedic specialized nurse included 4 first class indexes ,14 second class indexes and 72 third class indexes .The expert authority coefficient was 0 .833 ,the familiar coefficient was 0 .794 ,the determination coefficient was 0 .872 ,The coordination coefficient of primary and secondary and third indicators were 0 .390 ,0 .324 ,0 .308 ,respectively ,and there were statis‐tically significant differences (P< 0 .05) .Conclusion The expert opinions for the core competence evaluation indexes are consist‐ent ,the results are objective and scientific .It can provide quantitative standards for training ,examining and evaluation of orthopaedic specialized nurse .

Quality management covers every corner of hospital services,which upholds full-process quality management,continuous quality improvement and smooth management with patients at the center.By means of building a 3-tier quality management framework at the hospital,development of quality management criteria,appraisal indicators and documentation and use of quality management tools,quality management defects were identified from a third-party perspective.This effort has significantly improved quality of care at the hospital,and elevated the management execution and general service quality of the hospital.

Cerebral ischemia models of rabbits were induced by four-artery obstruction method. The changes of excitatory amino acid (EAA) transmitters,brain-tissue calcium (TCa) and intramitochondria calcium (MCa) of the cerebral cortex were measured and the effects of ketamine were observed. The results revealed that 20 minutes after ischemia,the amoumts of the EAA transmitters (Glu and Asp) in brain tissues were decreased, and decreased further after reperfusion. But after 20 minutes ischemia,the levels of TCa and MCa were elevated and higher than that of ischemia and contral groups significantly after the reperfusion. Ketamine could increase the Glu and Asp contents and decrease the TCa and MCa levels during ischemia and reperfusion.

The implementation of the Malpractice handling Regulations, which has set new and higher demands on medical institutions and medical workers, will have a certain impact on hospital administration and patient care. Medical institutions and medical workers must be highly aware of this. The entire staff of each hospital must study the Regulations carefully and try to obtain an objective understanding of it. Management of medical institutions must be strengthened, weak links identified, measures formulated and regulations perfected. Medical workers ought to strive for better professional skills, and supervision and management of medical records ought to be intensified.