A good talent cultivation model is inseparable from scientific talent classification and evaluation methods.This article depends on the actual needs of talent cultivation in public hospitals and leverages"Internet+"technology and other smart hospital management means.It builds a talent classification and evaluation framework system based on the smart hospital plat-form,achieving scientific,quantifiable,and visual management of health professionals and technicians.This approach is of great research significant value for stimulating the work enthusiasm and creativity of talents,promoting the construction of talent teams and disciplines,and reforming the hospital personnel allocation system.This framework also has great practical significance for further improving the comprehensive management level and competitiveness of hospitals.

Objective To investigate the risk factors and nursing strategies for clinical deterioration during intrahospital transport of critically ill patients in the emergency department. Methods A retrospective study was conducted in critically ill patients admitted to the emergency department from March to December 2023 who required intrahospital transport for diagnostic and therapeutic purposes. Data were collected including risk scores prior to transport, patients'clinical information, qualification of the transporting nurses, preparation time, final care time, and the National Early Warning Scoring (NEWS) score indicating clinical deterioration during transport. Multivariate Logistic regression analysis was performed to identify the risk factors influencing clinical deterioration during intrahospital transport of critically ill patients. Results Among 839 critically ill patients transported within the hospital, the clinical deterioration rate was 28.37%. Multivariate Logistic regression analysis revealed that transport duration ranging from 21 to 25 minutes were significantly associated with clinical deterioration (β=0.133, P=0.027). Patients'symptoms including body part injury, head injury, burns, poisoning (β=0.670, P=0.030), respiratory distress/spasm (β=0.919, P < 0.001), shock/arrhythmia/chest pain/hemorrhage (β=1.134, P < 0.001), coma/changes in mental status/fainting (β=1.343, P < 0.001), and cardiac arrest (β=2.251, P < 0.001) were highly correlated with clinical deterioration. Patients with unstable conditions (β=1.689, P < 0.001), those with pre-transport risk scores of 8 or higher (β=0.625, P < 0.001), and those transported by non-dedicated transport nurses (β=0.495, P < 0.008) were significantly related to increased risk of clinical deterioration. Conclusion The incidence of clinical deterioration during intrahospital transport of critically ill patients is relatively high. Diseases involving the circulatory, respiratory, and nervous systems, unstable clinical conditions, high pre-transport risk scores, transport duration of 21 to 25 minutes, and presence of transport by non-specialized nurses are all associated with higher rates of clinical deterioration.

Objective To investigate the changes of platelet reactivity and its influencing factors after aspirin treatment in patients with ischemic stroke complicated with diabetes. Methods From September 2016to December 2017, patients with acute ischemic stroke admitted to the Department of Neurology, Weihai Municipal Hospital within 24 h of onset were enrolled. All patients took aspirin (100 mg/d) within 24 h ofadmission, and after taking the drug (7 ±2 d), the PL-11 platelet function analyzer was used to determine the maximum platelet aggregation ratio (MAR) induced by arachidonic acid (AA). The baseline data of the patients were documented. The factors affecting high platelet reactivity (HPR) were analyzed. Results A total of 398 patients with ischemic stroke were enrolled, including 137 in the diabetes group and 261 in the non-diabetes group. MARAA (43. 45％ ± 14. 11％ vs. 31. 55％ ± 19. 39％; t = 6. 996, P < 0. 001) and the incidence of HPR (34. 3％ vs. 19. 9％; χ2 = 9. 946, P = 0. 002) in the diabetes group were significantly higher than in those in the non-diabetes group. Of the 137 patients with ischemic stroke complicated with diabetes, 47 had HPR. The proportions of patients with hyperlipidemia, previous history of stroke or transient ischemic attack and baseline NIHSS score, HOMA-IR (homeostatis model assessment-insulin resistance),high-sensitivity C-reactive protein, fasting blood glucose, and glycosylated hemoglobin in the HPR group were significantly higher than those in the non-HPR group (all P < 0. 05). Multivariate logistic regression analysis showed that HOMA-IR (odds ratio [OR] 1. 153, 95％ confidence interval [CI] 1. 027-1. 295; P =0. 016), high-sensitivity C-reactive protein (OR 9. 416, 95％ CI 2. 271-39. 049; P = 0. 002), fasting blood glucose (OR 1. 125, 95％ CI 1. 025-1. 235; P = 0. 013), and glycosylated hemoglobin (OR 1. 458, 95％ CI 1. 170-1. 816; P = 0. 001) were the independent risk factors for HPR. Conclusion The platelet reactivity during aspirin therapy in patients with ischemic stroke complicated with diabetes mellitus was high, and platelet activity was associated with multiple mechanisms, such as inflammation, insulin resistance, and hyperglycemia.

Objective To observe the changes of spleen volume in patients with acute cerebral infarction, and to explore the relationship between the spleen volume and platelet reactivity , inflammatory factors'lymphocyte subsets.Methods This is a case control study.Thirty patients with acute cerebral infarction from January 2017 to June 2017 in Department of Neurology , Weihai Municipal Hospital were included.The spleen volume, arachidonic acid-induced maximum platelet aggregation ratio ( AA-MAR), interferon gamma (IFN-γ) and lymphocyte subsets of patients were monitored in 24 hours of stroke, at 48 hours of stroke, at four days of stroke and at seven days of stroke.Twenty patients without acute cerebral infarction with the same baseline data were selected as the control group , to determine the baseline of spleen volume, AA-MAR, IFN-γand lymphocyte subsets.A t test was used to describe the changes of spleen volume, AA-MAR, IFN-γand lymphocyte subsets at different time points , and Pearson's correlation analysis was used to estimate the relationship between the spleen volume and these variables .Results Compared with the control group ((120.12 ±10.28) cm3), the patients with acute cerebral infarction in 24 hours of stroke ((117.48 ±7.93) cm3) and at 48 hours of stroke ((111.61 ±9.21) cm3) had smaller spleen volume (t＝-2.142, P＜0.05; t＝-2.790, P＜0.01), whereas at four days ((121.31 ±8.16) cm3) and seven days of stroke ((126.11 ±10.31) cm3) had bigger spleen volume (t＝2.242, P＜0.05;t＝2.762, P＜0.01), with the spleen volume decreased first and increased later.Compared with the control group, the patients with acute cerebral infarction had more AA-MAR (control group:20.97%±8.21%;24 h:31.86%±9.54%,t＝3.165,P＜0.01;48 h:41.38%±8.55%,t＝3.254,P＜0.01;4 d:35.34%± 8.15%, t＝3.203,P＜0.01;7 d:29.38% ±10.46%,t＝2.494,P＜0.05) and IFN-γ(pg/L, control group:15.21 ±5.21;24 h:29.75 ±4.57,t＝3.262,P＜0.01;48 h:43.37 ±12.15,t＝3.304,P＜0.01;4 d:40.44 ±9.86, t＝3.291,P＜0.01;7 d:20.93 ±5.51, t＝2.417,P＜0.05) at different time points, with the most AA-MAR at 48 hours of onset, and the most IFN-γat four days of stroke.Compared with the control group, the patients with acute cerebral infarction had more T 4, B lymphocytes and natural killer lymphocytes at the four time points , while the level of T8lymphocytes did not show statistically significant difference even though also increased at the four time points.The correlation analysis results showed that in patients with acute cerebral infarction , the level of AA-MAR (r＝-0.397, P＜0.05; r＝-0.515, P＜0.01; r＝-0.382, P＜0.05) and IFN-γ(r＝-0.408, P＜0.05; r＝-0.479, P＜0.01; r＝-0.378, P＜0.05) was negatively corelated with the spleen volume in 24 hours of onset, at 48 hours of stroke and at four days of stroke; the level of T4, B and natural killer lymphocytes were negatively corelated with the spleen volume in 24 hours of stroke and at 48 hours of stroke.Conclusion After the acute cerebral infarction onset, the spleen volume tends to reduce and then increases , the levels of platelet reactivity , inflammatory factors and lymphocyte subsets are correlated with the spleen volume , and the spleen may aggravate the brain injury by releasing platelets inflammatory factors and lymphocyte subsets.

Objective To investigate the effect of pyrin domain 3 (NLRP3) inflammasome in the process of contrast induced human kidney cell apoptosis.Methods Human kidney 2 (HK-2) cells were cultured in DMEM-F12 medium with 5％ FBS.Cells were divided into control group,Contrast group (O group),NLRP3-siRNA+Iohexol group (si-NLRP3+O group),ASC-siRNA+Iohexol group (si-ASC+O group),and mannitol group (M group).Different concentrations of hypotonic contrast agent were added to HK-2 cell culture plates for 24,48 and 72 h.Flow cytometry was used to detect apoptosis.NLRP3 and ASC mRNA expressions were detected by RT-PCR.The expressions of NLRP3,ASC,caspase-8/cleaved caspase-8,Bcl-2/Bax,caspase-1/cleaved caspase-1,and caspase-3/cleaved caspase-3 protein were detected by Western blot.The levels of interleukin (IL) 1β and IL-18 in supernatant were detected by ELISA.Results Compared with the control group,the rate of apoptotic cells,as well as the expressions of NLRP3,ASC and cleaved caspase-1 proteins were increased in HK-2 cells of contrast group.The expressions of NLRP3 and ASC mRNA in the contrast group also increased,so did IL-1β and IL-18 levels (all P＜0.05),suggesting that NLRP3 inflammasome in HK-2 cells was activated by contrast.Compared with the control group,the expressions of cleaved caspase-8,Bax and cleaved caspase-3 protein were increased,and the expression of anti-apoptotic protein Bcl-2 was decreased (all P ＜ 0.05).Compared with the contrast group,the rate of apoptotic cells in the si-NLRP3 + contrast group and si-ASC + contrast group was significantly decreased;the expression of cleaved caspase-1 was decreased;the expressions of Bax and cleaved caspase-3 were decreased,and Bcl-2 level was increased.The expressions of IL-1β and IL-18 in the supernatant of cells were decreased (all P ＜ 0.05).Conclusion Contrast agent can activate the NLRP3 pathway in HK-2 cells and induce apoptosis,which could be reduced by blocking the NLRP3 pathway.

Objective To observe the effects of tumor necrosis factor-or (TNF-α) and platelet derived growth factor (PDGF) on vascular neointimal hyperplasia on matrix metalloproteinase 9/2 gene knockout (MMP9/2-/-) mice and explore related mechanisms.Methods Mice of control group,MMP9-/-group,MMP2-/-group and MMP9/2-/-group were studied.Femoral artery was injured by transluminal wire,the mRNA expression levels of TNF-o and PDGF on femoral artery were detected by RT-PCR;the protein expression of MMP9 and MMP2 were assessed by Western blot on day 0,1,3,7,14and 28 post injury.Mice in control group received TNF-α(5 ng/ml,0.10 ml),TNF-α(0.05 ml) + MMP inhibitor SB-3CT (0.50 ng/ml,0.05 ml) injection,or PDGF-bb (10 ng/ml,0.10 ml) and PDGF-bb (0.05 ml) + SB-3CT(0.05 ml) injection around injured artery,intimal hyperplasia at 2 and 4 weeks after injury was observed.Intimal hyperplasia at 2 and 4 weeks after injury was also observed in MMP9/2-/-mice.TNF-α(5 ng/ml,0.10 ml) was injected to MMP2-/-mice,PDGF-bb (0.1 ml) was injected to MMP9-/-mice around injured artery,intimal hyperplasia at 2 and 4 weeks after injury was observed.The degree of neointimal hyperplasia were observed by the Elastica-van Gieson staining and the area of neointima and media of the arteries were measured by SigmaPlot and intima ratio was calculated.Vascular smooth muscle cell (VSMC) mediums of MMP9-/-and MMP2-/-mice were stimulated by TNF-α and PDGF-bb,respectively,and migration assay,and proliferation assay were performed,relative migration and proliferation cells numbers were counted.Results (1) mRNA expression of TNF-o (235.33 ± 23.68) and PDGF-bb (3.30 ±0.56) in femoral arteries peaked at 1 day after injury,while MMP9 or MMP2 protein expression peaked at 7 or 28 days after injury.(2) In control mice,TNF-α intervention significantly enhanced intimal hyperplasia at 2 weeks after injury (2.21 ±0.05 vs.1.55 ±0.03 in blank control group,P ＜ 0.05),while PDGF-bb intervention significantly enhanced intimal hyperplasia at 4 weeks after injury (2.60 ± 0.07 vs.1.89 ± 0.04,P =0.03).(3) Intima hyperplasia was significantly higher in control group than in MMP9/2-/-group at 2 weeks (1.63 ± 0.05 vs.0.46 ± 0.01,P =0.008) and 4 weeks (2.24 ±0.06 vs.0.51 ±0.01) after injury(P =0.005).(4) TNF-o intervention stimulated intimal hyperplasia in MMP2-/-mice (intimal ratio at 2 weeks after injury:1.73 ± 0.05 vs.1.23 ± 0.03,P =0.02) and PDGF-bb intervention stimulated intimal hyperplasia in MMP9-/-mice(intimal ratio at 4 weeks after injury:2.32 ± 0.06 vs.1.35 ± 0.03,P =0.03).(5) Reduced VSMC migration was evidenced in MMP9-/-mice post TNF-α stimulation (1.45 ±0.03 vs.2.16 ±0.04 in control group,P =0.03),while reduced VSMC proliferation post PDGF was seen in MMP2-/-group (1.15 ± 0.02 vs.1.82 ± 0.04 in control group,P =0.03).Conclusions TNF-o induced MMP9 activation plays a major role on promoting VSMC migration at the first 2 weeks after vascular injury,while PDGF induced MMP2 activation plays a crucial role on VSMC proliferation on the following 2 weeks after vascular injury in this mice model.Thus,the axis of TNF-α-MMP9-VSMC migration axis and PDGF-MMP2-VSMC proliferation axis are the two major working mechanisms responsible for intimal hyperplasia post vascular injury.

Objective:To explore the diagnostic value of homebred capsule endoscope (CE) for middle‐aged and elderly patients with suspected intestinal diseases .Methods:The clinical data of all patients aged≥50 ,with suspected intestinal diseases ,who underwent endoscopy with homebred OMOM CE between January 2010 and March 2014 ,were retrospectively analyzed .There were 43 cases enrolled .Results:The overall diagnostic yield was 74 .4% (32/43) ,including intestinal mucosal inflammatory changes 21 .9% (7/32) ,intestinal ulcer 18 .8% (6/32) ,intestinal vascular ectasias 28 .1% (9/32) ,intestinal polyps 12 .5% (4/32) ,intestinal lymphoid nodular hyperplasia 9 .3% (3/32) ,and Crohn's disease 9 .3% (3/32) .Conclusions:Homebred OMOM CE showed high diagnostic value for middle‐aged and elderly patients with intestinal diseases .

Objective Serologic proteome analysis method (SERPA) was used to compare the different of the serum proteins between normal and pancreatic cancer patients' serum, and to find a new specific pancreatic cancer marker. Methods HPLC was used to eliminate albumin from the serum, two-dimensional electrophoresis was used to separate the proteins. After imaging collection and analysis, the different proteins between pancreatic cancer and normal subjects were cut for mass spectrometry. Results Four discrepancy proteins were obtained. Guanylate cyclase-activating protein 2 was highly expressed in normal serum but not pancreatic cancer. Hp2-alpha, transthyretin and KIAA1018 protein were highly expressed in cancer patients'serum but not normal people. Conclusions KIAA1018 may become a promising tumor marker for screening and early diagnosis of pancreatic cancer.

Objective To analyze the perinatal outcomes of those women experienced hypoglycemia during 75 g oral glucose tolerance test(OGTT).Methods A retrospective study was conducted in 774.pregnant women who underwent OGTT and delivered in our institution from January 2005 to January 2006.The distribution of glucose levels of the fasting,1 h,2 h and 3 h of the OGTT was analyzed.Plasma glucose level below the 5th percentile and above the 1h percentile was defined as hypoglycemia and those below the 1th percentile as exceeding hypoglycemia.Perinatal outcomes including birth weight,birth height,obstetric complications,the incidence of small for gestational age (SGA)were compared between women with hypoglycemia or exceeding hypoglycemia. Results The birth weight in exceeding hypoglycemia group of fasting glucose was significantly lower than that of the others [(2817±764)g vs(3439±487)g,t=3.344,P＜0.01]and the incidence of SGA in this group was also higher(3/7 vs 3.4%,x2=22.78,P＜0.01);the proportion of babies with birth weight＜3000 g in the same group was higher than the others(5/7 vs 14.73%,P＜0.01).The newhorns height was significantly shorter in the hypoglycemia group at 2 h than the normal glycemic group [(49.03±1.68)cm vs(49.48±1.65)cm,P＜0.05].Conclusions The plasma glucose 1evel is associated with the newborns'birth weight and height.Women with hypoglycemia during OGTT are more likely to have babies with lower birth weight and height.

The idea of moral heath deserves our attention and consideration.Moral health contains deep humanistic meaning and value pursuit.The aim for college education includes instructing the students to think about the basic questions for life and humanity.Education for moral health is necessary for achieving moral health and we have so much work to do.