The decrease in blood glucose in perinatal dairy cows affects the energy supply and im-mune function of peripheral blood neutrophils(PMN).Fibroblast growth factor 21(FGF21)is an important regulator of glucose metabolism,and serum FGF21 levels in some perinatal cows are significantly elevated after farrowing.In order to explore the effect of FGF21 on PMN glucose ho-meostasis in perinatal dairy cows,the cows were divided into high FGF21 group(high FGF21,n=8,FGF21＞800 ng/L)and low FGF21 group(low FGF21,n=8,FGF21＜200 ng/L)within 3 weeks postpartum.The results showed that compared with the low FGF21 group,the glucose up-take of PMN and the mRNA expression of glucose transporters SLC2A1 and SLC2A3 were signifi-cantly increased in the high FGF21 group.The activities of phosphofructokinase 1(PFK1)and glu-cose-6-phosphate dehydrogenase(G6PDH)were significantly increased,and the activity of glyco-gen synthase(GCS)was significantly decreased in PMN in the high FGF21 group.The lactate con-tent and ATP content of PMN were significantly increased,and the mRNA and protein expressions of hexokinase(HK2)and PFK1 were significantly increased in the high FGF21 group.These re-sults indicated that the uptake and utilization of glucose by PMN in perinatal peripheral blood FGF21 increased to ensure the ATP supply of PMN,which provided a theoretical basis for the pro-posal of a new strategy to alleviate immunosuppression in perinatal dairy cows.

Objective:To explore the chain mediating effect of empowerment and activation between chronic disease resources and self-management in elderly patients with chronic obstructive pulmonary disease (COPD) .Methods:A convenience sampling method was used to select 306 elderly COPD patients who were treated at the Affiliated Hospital of Shaoxing University from December 2022 to May 2024. General information questionnaires, COPD Self-Management Scale (COPD-SMS), Chronic Illness Resources Survey-Chinese version (CIRS-C), COPD Empowerment Evaluation Scale, and the Patient Activation Measure (PAM 13) were used for the survey. AMOS 22.0 software was employed to construct a structural equation model to analyze the pathways influencing self-management in COPD patients.Results:A total of 306 questionnaires were distributed, with 291 valid ones returned, resulting in an effective response rate of 95.10%. Empowerment and activation played a mediating role between chronic disease resources and self-management in elderly COPD patients. A total of three pathways were identified: chronic disease resources→activation→self-management (effect size=0.099, accounting for 18.07% of the total effect), chronic disease resources→empowerment→self-management (effect size=0.084, accounting for 15.33% of the total effect), and chronic disease resources→empowerment →activation→self-management (effect size=0.039, accounting for 7.11% of the total effect). Chronic disease resources also had a direct effect on self-management (effect size=0.326, accounting for 59.49% of the total effect) .Conclusions:The self-management level of elderly COPD patients urgently needs improvement. Nursing staff should focus on optimizing the allocation of chronic disease resources for elderly COPD patients, empowering them to stimulate activation and promote the improvement of their self-management abilities.

Alzheimer′s disease (AD) is one of the most common neurodegenerative diseases, and its diagnosis heavily relies on imaging biomarkers. This paper integrates core pathological markers, such as amyloid β (Aβ)-positron emission tomography (PET), tau-PET, structural magnetic resonance imaging, and fluorodeoxyglucose-PET, with the latest advancements in novel imaging biomarkers, including inflammation, synaptic imaging, and cerebrovascular injury-related markers, based on the Aβ proteinopathy, tau proteinopathy, neurodegeneration, inflammation, α-synuclein and vascular brain injury biomarkers (AT 1T 2NISV) framework proposed by the 2024 Alzheimer′s Association diagnostic guidelines. With the development of machine learning and artificial intelligence technologies, future research should focus on enhancing the specificity of imaging biomarkers and developing precise diagnostic models for comorbidities to better address the heterogeneity and complex pathological features of AD.

Objective This study aims to summarize the situation,development experiences,and existing problems in the development of Hospital S,and provide relevant suggestions as a reference for the high-quality development path of public hospitals.Methods Thirteen managers of Hospital S(including hospital leaders,functional departments,and clinical depart-ment heads)and eight experts in the field of hospital management were selected as research subjects.The phenomenological re-search method of qualitative research was used,and semi-structured interviews were conducted to collect relevant data.The Co-laizzi phenomenological data analysis method was used to analyze the interview data.Results Through the analysis of the inter-view data,four themes related to high-quality development were identified:medical care,scientific research and teaching,tal-ents,and disciplines.Each theme has specific areas that need priority and focused attention.Under the theme of medical care,there are four sub-themes:medical quality,medical safety,medical technology,and medical services.Scientific research and teaching,as a strategic support for promoting the hospital's sustained high-quality development,includes four sub-themes:re-search innovation,achievement transformation,teaching system,and mentor team.Talents,as the core competitiveness of the hospital,include three sub-themes:top-level design,high-level talents,and training system.The discipline theme includes four sub-themes:development ideas,development opportunities,development directions,and discipline leaders.Conclusion Public hospitals are facing new situations in high-quality development,and accelerating the improvement of medical service capabilities is a direct manifestation of high-quality development.It is necessary to promote key work such as research innovation,teaching management,talent team building,and discipline construction in a coordinated manner to achieve synchronous improvement in quality and efficiency.

Objective:To examine the relationships between perceived organizational support in job resources, self-efficacy in personal resources, and teaching commitment based on the job requirement-resource model, and to explore the path of influencing clinical teachers' teaching commitment.Methods:Using the convenience sampling method, 463 clinical teachers from 16 university-affilicated hospitals in Shandong Province, China were selected as the study subjects. Surveys were conducted using the Perceived Organizational Support Scale, Self-efficacy Scale, and Teaching Commitment Scale. A statistical analysis was performed using SPSS 26.0. A structural equation model was constructed using AMOS 26.0 to test the mediation effect.Results:①The level of teaching commitment of clinical teachers was relatively high, with a total score of (45.25±9.21) points. The total score of perceived organizational support was (38.22±9.75) points, and the total score of self-efficacy was (112.27±17.30) points. ②Perceived organizational support and self-efficacy were positively correlated with teaching commitment ( r=0.59, r=0.65, both P<0.01). ③ Perceived organizational support had significant and direct positive effects on teaching commitment and self-efficacy ( β=0.36, β=0.51, both P<0.01). Self-efficacy significantly and positively affected teaching commitment ( β=0.47, P<0.01). Self-efficacy played a significant and partial mediating role in the effect of perceived organizational support on teaching commitment (standardized mediating effect value of 0.239, P<0.01), and the mediating effect percentage was 39.83%. Conclusions:Perceived organizational support not only directly predicts clinical teachers' teaching commitment, but also indirectly affects teaching commitment through self-efficacy. University-affiliated hospital administrators should pay attention to clinical teachers' perceived organizational support to improve their self-efficacy and teaching commitment, thereby ensuring teaching quality.

The decrease in blood glucose in perinatal dairy cows affects the energy supply and im-mune function of peripheral blood neutrophils(PMN).Fibroblast growth factor 21(FGF21)is an important regulator of glucose metabolism,and serum FGF21 levels in some perinatal cows are significantly elevated after farrowing.In order to explore the effect of FGF21 on PMN glucose ho-meostasis in perinatal dairy cows,the cows were divided into high FGF21 group(high FGF21,n=8,FGF21＞800 ng/L)and low FGF21 group(low FGF21,n=8,FGF21＜200 ng/L)within 3 weeks postpartum.The results showed that compared with the low FGF21 group,the glucose up-take of PMN and the mRNA expression of glucose transporters SLC2A1 and SLC2A3 were signifi-cantly increased in the high FGF21 group.The activities of phosphofructokinase 1(PFK1)and glu-cose-6-phosphate dehydrogenase(G6PDH)were significantly increased,and the activity of glyco-gen synthase(GCS)was significantly decreased in PMN in the high FGF21 group.The lactate con-tent and ATP content of PMN were significantly increased,and the mRNA and protein expressions of hexokinase(HK2)and PFK1 were significantly increased in the high FGF21 group.These re-sults indicated that the uptake and utilization of glucose by PMN in perinatal peripheral blood FGF21 increased to ensure the ATP supply of PMN,which provided a theoretical basis for the pro-posal of a new strategy to alleviate immunosuppression in perinatal dairy cows.

Objective:To examine the relationships between perceived organizational support in job resources, self-efficacy in personal resources, and teaching commitment based on the job requirement-resource model, and to explore the path of influencing clinical teachers' teaching commitment.Methods:Using the convenience sampling method, 463 clinical teachers from 16 university-affilicated hospitals in Shandong Province, China were selected as the study subjects. Surveys were conducted using the Perceived Organizational Support Scale, Self-efficacy Scale, and Teaching Commitment Scale. A statistical analysis was performed using SPSS 26.0. A structural equation model was constructed using AMOS 26.0 to test the mediation effect.Results:①The level of teaching commitment of clinical teachers was relatively high, with a total score of (45.25±9.21) points. The total score of perceived organizational support was (38.22±9.75) points, and the total score of self-efficacy was (112.27±17.30) points. ②Perceived organizational support and self-efficacy were positively correlated with teaching commitment ( r=0.59, r=0.65, both P<0.01). ③ Perceived organizational support had significant and direct positive effects on teaching commitment and self-efficacy ( β=0.36, β=0.51, both P<0.01). Self-efficacy significantly and positively affected teaching commitment ( β=0.47, P<0.01). Self-efficacy played a significant and partial mediating role in the effect of perceived organizational support on teaching commitment (standardized mediating effect value of 0.239, P<0.01), and the mediating effect percentage was 39.83%. Conclusions:Perceived organizational support not only directly predicts clinical teachers' teaching commitment, but also indirectly affects teaching commitment through self-efficacy. University-affiliated hospital administrators should pay attention to clinical teachers' perceived organizational support to improve their self-efficacy and teaching commitment, thereby ensuring teaching quality.

Objective This study aims to summarize the situation,development experiences,and existing problems in the development of Hospital S,and provide relevant suggestions as a reference for the high-quality development path of public hospitals.Methods Thirteen managers of Hospital S(including hospital leaders,functional departments,and clinical depart-ment heads)and eight experts in the field of hospital management were selected as research subjects.The phenomenological re-search method of qualitative research was used,and semi-structured interviews were conducted to collect relevant data.The Co-laizzi phenomenological data analysis method was used to analyze the interview data.Results Through the analysis of the inter-view data,four themes related to high-quality development were identified:medical care,scientific research and teaching,tal-ents,and disciplines.Each theme has specific areas that need priority and focused attention.Under the theme of medical care,there are four sub-themes:medical quality,medical safety,medical technology,and medical services.Scientific research and teaching,as a strategic support for promoting the hospital's sustained high-quality development,includes four sub-themes:re-search innovation,achievement transformation,teaching system,and mentor team.Talents,as the core competitiveness of the hospital,include three sub-themes:top-level design,high-level talents,and training system.The discipline theme includes four sub-themes:development ideas,development opportunities,development directions,and discipline leaders.Conclusion Public hospitals are facing new situations in high-quality development,and accelerating the improvement of medical service capabilities is a direct manifestation of high-quality development.It is necessary to promote key work such as research innovation,teaching management,talent team building,and discipline construction in a coordinated manner to achieve synchronous improvement in quality and efficiency.

Objective:To explore the chain mediating effect of empowerment and activation between chronic disease resources and self-management in elderly patients with chronic obstructive pulmonary disease (COPD) .Methods:A convenience sampling method was used to select 306 elderly COPD patients who were treated at the Affiliated Hospital of Shaoxing University from December 2022 to May 2024. General information questionnaires, COPD Self-Management Scale (COPD-SMS), Chronic Illness Resources Survey-Chinese version (CIRS-C), COPD Empowerment Evaluation Scale, and the Patient Activation Measure (PAM 13) were used for the survey. AMOS 22.0 software was employed to construct a structural equation model to analyze the pathways influencing self-management in COPD patients.Results:A total of 306 questionnaires were distributed, with 291 valid ones returned, resulting in an effective response rate of 95.10%. Empowerment and activation played a mediating role between chronic disease resources and self-management in elderly COPD patients. A total of three pathways were identified: chronic disease resources→activation→self-management (effect size=0.099, accounting for 18.07% of the total effect), chronic disease resources→empowerment→self-management (effect size=0.084, accounting for 15.33% of the total effect), and chronic disease resources→empowerment →activation→self-management (effect size=0.039, accounting for 7.11% of the total effect). Chronic disease resources also had a direct effect on self-management (effect size=0.326, accounting for 59.49% of the total effect) .Conclusions:The self-management level of elderly COPD patients urgently needs improvement. Nursing staff should focus on optimizing the allocation of chronic disease resources for elderly COPD patients, empowering them to stimulate activation and promote the improvement of their self-management abilities.

Alzheimer′s disease (AD) is one of the most common neurodegenerative diseases, and its diagnosis heavily relies on imaging biomarkers. This paper integrates core pathological markers, such as amyloid β (Aβ)-positron emission tomography (PET), tau-PET, structural magnetic resonance imaging, and fluorodeoxyglucose-PET, with the latest advancements in novel imaging biomarkers, including inflammation, synaptic imaging, and cerebrovascular injury-related markers, based on the Aβ proteinopathy, tau proteinopathy, neurodegeneration, inflammation, α-synuclein and vascular brain injury biomarkers (AT 1T 2NISV) framework proposed by the 2024 Alzheimer′s Association diagnostic guidelines. With the development of machine learning and artificial intelligence technologies, future research should focus on enhancing the specificity of imaging biomarkers and developing precise diagnostic models for comorbidities to better address the heterogeneity and complex pathological features of AD.