Objective Weifang is a pilot of the health system reform, the research aims to investigate the present situation of turnover intention within the medical staff in Weifang's public hospitals, seeking main influencing factors, while exploratory research about how to bulid a three-stage early-warning system also included. Methods Chooseing 29 public hospitals with stratified random sampling method, questionare investigation for 933 qualified samples,and spss 16. 0 was also used as an analysis method. Results About 49% of the respondents have turnover intention, those working years less than 10 have the strongest turnover intention, individual work-emotional exhaustionsocial support from family members or friends, and restriction of personal development are three main causes from Logistic analysis. Conclusion According to the stage characteristic of turnover intention, building an early-warning system could play an important role in controlling brain-drain.

Objective:To summarize the clinical characteristics of high-risk neuroblastoma (HR-NB) in a single center, analyze the prognostic factors of HR-NB.Methods:The clinical data of children with HR-NB who were treated and followed up at the hematology-oncology center of Beijing Children′s Hospital from February 1, 2007 to June 30, 2018 were analyzed retrospectively. The clinical features were summarized. Kaplan-Meier method was used for survival analysis and Cox regression was used to analyze the prognostic factors. The last follow-up time was June 30, 2019.Results:A total of 458 children with HR-NB were enrolled in this study, including 265 males (57.9%) and 193 females (42.1%), the age at diagnosis was 40.0 months (4.5-148.0 months), the follow-up time was 22.0 months (0.2-138.0 months) and the time of tumor progression or recurrence was 15 months (1-72 months). The 5-year event-free survival (EFS) rate was (31.2±2.6)% and the 5-year overall survival (OS) rate was (43.9±3.2)%. The 5-year EFS rate and 5-year OS rate in 142 hematopoietic stem cell transplantation (HSCT) patients with bone marrow metastases were better than that in 196 non-transplantation cases with bone marrow metastases ((26.5±4.5)% vs. (25.1±3.6)%, χ2=13.773, P=0.001; (38.1±5.5)% vs. (35.7±4.7)%, χ2=9.235, P=0.002); 128 transplantation patients with bone metastases had higher 5-year EFS rate and 5-year OS rate than 188 non-transplantation cases with bone metastases ((28.5±5.0)% vs. (26.7±3.8)%, χ2=10.222, P=0.001; (37.1±6.0)% vs. (36.2±4.8)%, χ2=7.843, P=0.005). The 5-year EFS rate was higher in 37 HSCT patients with MYCN amplification than in 49 non-transplantation cases with MYCN amplification ((26.8±8.0) % vs. (20.5±6.4) %, χ2=5.732, P=0.017). No significant difference was found in 5-years OS rate between transplantation group with MYCN amplification and non-transplantation group with MYCN amplification ((31.4±8.6) % vs. (26.2±7.4) %, χ2=3.230, P=0.072). Univariate survival analysis showed that lactate dehydrogenase (LDH)≥1 500 U/L was associated with poor prognosis of patients with MYCN amplification (χ2=6.960, P=0.008). Multivariate Cox analysis showed bone marrow metastasis and LDH≥1 500 U/L were independent risk factors for poor prognosis of patients with non-MYCN amplification ( HR=2.427, 1.618;95 %CI：1.427-4.126, 1.275-2.054, P<0.05) for both comparisons. Conclusions:LDH≥1 500 U/L was the poor prognostic factor for patients with MYCN amplification. The bone marrow metastasis and LDH≥1 500 U/L were the poor prognostic factors for HR-NB patients with non-MYCN amplification. HSCT can improve the prognosis of patients with bone or bone marrow metastasis. It can also retard the time of progression or recurrence for patients with MYCN amplification.