Objective:To analyze the medical service utilization preference of middle-aged and elderly residents (aged 45 and above) in Chongqing,and provide references for the local government to further promote the hierarchical diagnosis and improve the equity and efficiency of medical service utilization. Methods:Using a discrete choice experiment method,the preferences of 576 Chongqing residents,middle-aged and elderly,under conditions of mild and severe illness were measured for 6 attributes:medical service level,doctor's level,medical service mode,registration difficulty,drug supply and medical expenses. Results:Among patients with mild conditions,the attribute level most valued is"ability to register on the same day or the next day"(β=0.298,P<0.001) . They also prefer services from lower-level medical institutions and general practitioners (β=-0.200),as well as medical services with less cost (β=-0.003) . For patients with severe conditions,the attribute level they value the most is the medical service level (authoritative hospitals)(β=0.401,P<0.001),and they prefer services with ample drug supply (β=0.223),specialists (β=0.210),specialized departments (β=0.153),and higher costs (β=0.002) . The willingness to pay for patient shows an overall lower tendency for mild conditions and a higher one for severe conditions. Conclusion:Primary healthcare institutions have played a positive role in diverting patients,yet the tiered diagnosis and treatment system still requires ongoing improvement. Patients with mild conditions prefer convenient medical services,whereas those with severe conditions favor high-quality medical services. Under the burden of serious illness,medical expenses is a secondary factor influencing patients' choice of medical care. It is recommended to enhance the capacity and accessibility of high-quality medical resources,improving infrastructure and equipment at the primary level,expanding the availability of medications at these facilities,increasing the efficiency of specialist utilization,and strengthening the coordination among healthcare delivery,medical insurance,and pharmaceutical services—the"three-medicine linkage",address the difficulties and high costs of medical treatment experienced by the public,and achieve the goal of enabling residents to access affordable,high-quality health services locally.

Objective:To construct evaluation indicators for the effectiveness of curriculum ideology and politics education in medical colleges and universities based on the Center for the Study of Evaluation (CSE) model.Methods:Based on the CSE-based theoretical framework of "needs evaluation, program evaluation, formative evaluation, and summative evaluation", semi-structured interviews were conducted to select indicators. The Delphi method was used to conduct two rounds of questionnaire-based consultation with 29 experts to establish a set of indicators for evaluating the effects of curriculum ideology and politics teaching of medical colleges and universities. The priority diagram was used to calculate and determine the weight of each index.Results:The authority coefficient of the 29 experts included in this study was 0.85. The Kendall's coefficients of concordance for the two rounds of expert consultation were 0.361 and 0.577 ( P<0.05), respectively. Finally, an evaluation system for the effectiveness of curriculum ideology and politics teaching was formed, including 4 first-level indicators, 9 second-level indicators, and 18 evaluation observation points. The 4 first-level indicators were "implementation objectives", "implementation plans", "implementation process", and "implementation effects". Conclusions:The CSE model is suitable as a theoretical framework for constructing the evaluation system of curriculum ideology and politics teaching in medical schools, which employs scientific indicator construction methods, follows the basic principles of course evaluation, and conforms to the current concept of ideological and political construction of medical curricula, showing certain feasibility and guiding significance.

To implement the strategy of healthy China and promote the construction of "new medicine science", it is urgent to focus on new needs and challenges to advance the reform of medical education curricula in China. Using literature research methods, we summarize the process of modern medical education curriculum reforms in the United States, and discuss the main features of the third-round reforms—introducing the concept of value-based medicine, offering health systems science courses, and promoting the curriculum system reform from the perspectives of learning time, curriculum integration, and learning methods. Based on these features, we put forward the enlightenment for the reform of medical education curricula in China.

Objective:To construct a scientific and systematic indicator system for the ideological and political construction of medical professional courses in military medical universities, and to provide a reference for the teaching management department of military medical universities to guide and manage the ideological and political construction of courses, as well as for medical professional course instructors to carry out the ideological and political teaching of courses.Methods:On the basis of literature research and case studies, a framework of the indicator system was established for the ideological and political construction of medical professional courses in military medical universities, and six experts in the field of military medical education were invited for pre-consultation. A preliminary draft of the indicator system was formed after discussion within the research group. A total of 25 experts, who had intermediate or above professional titles and long-term experience in military medical education, teaching and management, military academy education management, and military ideological and political education in military academies, were invited to conduct two rounds of Delphi expert consultation, and a statistical analysis was performed for the consultation results to determine the indicator system for the ideological and political construction of medical professional courses in military medical universities. The percentage weight method and the product method were used to calculate the weight coefficient of each indicator and combined weight coefficient.Results:In the two rounds of expert consultation, the expert positivity coefficient was 100%, the expert authority coefficient was 0.883, and the Kendall harmony coefficients were 0.254 and 0.268, respectively ( P<0.05). Finally, an indicator system was established for the ideological and political construction of medical professional courses in military medical universities, which consisted of 5 primary indicators, 12 secondary indicators, and 31 tertiary indicators. The 5 primary indicators were the teaching objectives, teaching team, teaching resources, teaching implementation, and teaching effect of curriculum ideology and politics, with a weight coefficient of 0.210, 0.202, 0.197, 0.202, and 0.189, respectively. Conclusions:The indicator system constructed in this study is scientific, reliable, systematic, and comprehensive and has a certain guiding significance for the ideological and political construction of medical professional courses in military medical universities.

Objective:To explore the application of a scenario-based onsite first-aid skills station in objective structured clinical examination (OSCE).Methods:Based on common scenarios and cases in medical practice, an evaluation framework of the OSCE onsite first-aid skills station—containing assessment indicators, exam room setting, examiner training, and assessment process—was designed to evaluate the onsite first-aid competencies of medical graduates of the five-year program for three consecutive years. SPSS 24.0 was used to perform the Kruskal-Wallis test and Pearson correlation analysis to calculate the correlation between course examination scores and OSCE onsite first-aid skills station assessment scores. Excel was used to calculate the difficulty index and discrimination index of test items.Results:The graduates' OSCE onsite first-aid skills station assessment scores were improved year by year, with a mean score of about 80 points. The station assessment items showed a moderate difficulty level (0.7-0.8), a good discrimination level (>0.4), and good internal consistency (Cronbach's α>0.7). The examiners and examinees had a high recognition of the design and effectiveness of this station assessment method. There was a positive correlation between the OSCE scores and corresponding course scores (2016, r=0.245, P=0.001; 2017, r=0.108, P=0.026; 2018, r=0.198, P=0.006). Conclusions:Through scientific scoring and strict examination management, the OSCE scenario-based onsite first-aid skills station can effectively evaluate examinees' injury treatment competencies in different situations, which can provide a reference for course teaching.

Objective:To analyze the medical service utilization preference of middle-aged and elderly residents (aged 45 and above) in Chongqing,and provide references for the local government to further promote the hierarchical diagnosis and improve the equity and efficiency of medical service utilization. Methods:Using a discrete choice experiment method,the preferences of 576 Chongqing residents,middle-aged and elderly,under conditions of mild and severe illness were measured for 6 attributes:medical service level,doctor's level,medical service mode,registration difficulty,drug supply and medical expenses. Results:Among patients with mild conditions,the attribute level most valued is"ability to register on the same day or the next day"(β=0.298,P<0.001) . They also prefer services from lower-level medical institutions and general practitioners (β=-0.200),as well as medical services with less cost (β=-0.003) . For patients with severe conditions,the attribute level they value the most is the medical service level (authoritative hospitals)(β=0.401,P<0.001),and they prefer services with ample drug supply (β=0.223),specialists (β=0.210),specialized departments (β=0.153),and higher costs (β=0.002) . The willingness to pay for patient shows an overall lower tendency for mild conditions and a higher one for severe conditions. Conclusion:Primary healthcare institutions have played a positive role in diverting patients,yet the tiered diagnosis and treatment system still requires ongoing improvement. Patients with mild conditions prefer convenient medical services,whereas those with severe conditions favor high-quality medical services. Under the burden of serious illness,medical expenses is a secondary factor influencing patients' choice of medical care. It is recommended to enhance the capacity and accessibility of high-quality medical resources,improving infrastructure and equipment at the primary level,expanding the availability of medications at these facilities,increasing the efficiency of specialist utilization,and strengthening the coordination among healthcare delivery,medical insurance,and pharmaceutical services—the"three-medicine linkage",address the difficulties and high costs of medical treatment experienced by the public,and achieve the goal of enabling residents to access affordable,high-quality health services locally.

The ideological and political construction of medical courses reveals the educational essence of "truth, goodness, and beauty" in medicine. Scientificity and humanity are the embodiment of "seeking truth" and "advocating goodness" in medicine, and the unity of their content and form reaches the highest level of "advocating beauty". Studying the ideological and political construction of medical courses plays an important role in implementing the fundamental task of fostering virtue through education, and carrying out the Healthy China initiative. In terms of teaching objectives, the goals of ideological and political education in medical courses should not only include the goals of basic literacy goals, such as political literacy, cultural literacy, legal literacy, and moral cultivation, but also include professional literacy goals, such as medical humanistic cultivation. Thus, a "five in one" model of ideological and political education in medical courses will be established. In the practical path, it is suggested to explore from five aspects that changing the educational concept and strengthening the educational awareness, establishing teaching objectives and clarifying education direction, digging deeply into the ideological and political elements and clearing teaching content, innovating teaching methods and improving teaching effectiveness, and constructing evaluation indicators and evaluating teaching effectiveness scientifically.

Objective:To explore the research hotspot and development trend of ideological and political education of medical courses , analyze the existing problem, and provide a reference for the future development of ideological and political education of medical courses.Methods:The CNKI database was searched for the literature on ideological and political education of medical courses included from 2017 to 2021. Excel and CiteSpace were used for visual analysis of the publication time, publication quantity, main authors, research institutions, keywords, and mutated words of 1 257 articles included in the study.Results:In recent five years, the number of articles on ideological and political education of medical courses was on the rise; Zhao Wenxing, Liu Ruiting, and Yang Hongmei published a relatively large number of papers, while Heze Medical College, Fujian Health College, and Shanghai University of Medicine & Health Sciences published a relatively large number of papers. Keywords with high frequency included "teaching reform, "biochemistry", and "ideological and political education". The keywords with strong mediating centrality included "practical teaching", "ideological and political course", "medical English", and "humanistic quality". The keywords with high mutation intensity included ideological and political education, ideological and political curriculum, and professional quality.Conclusion:The ideological and political education is currently a hotspot of medical education. The current research topics include teaching reform and teaching practice. Clarifying the logic of curriculum ideological and political evaluation and gradually building the evaluation system and mechanism of curriculum ideological and political evaluation will be a hot research topic in the future.

Objective:To compare research hotspots in digital transformation of higher education in China and abroad and analyze the research trends through the bibliometric method and text analysis method, and to offer advice and suggestions for digital transformation of higher education in China.Methods:The relevant literature in Web of Science and China National Knowledge Infrastructure from the establishment of the databases to April 1, 2023 were retrieved. Citespace and VOSviewer were used to visually compare the research hotspots and trends in digital transformation of higher education in China and abroad from the perspectives of number of published papers, journal, author, country, cooperation network, keyword co-occurrence and clustering, and keyword burst.Results:The results showed that both international and domestic researchers paid attention to the practical significance and development model of digital transformation of higher education in the context of rapid development of science and technology and the post-pandemic era. International researchers emphasized the advantages and disadvantages of digital transformation from the aspects of connotation, practice logic, and theoretical framework, while Chinese researchers focused on clarifying the principles related to digital transformation, summarizing the experience of other countries, and exploring the development path. The application of educational technology and the digital literacy of teachers and students had become research hotspots in China and abroad.Conclusion:The research on digital transformation of higher education has gradually shifted from theoretical system to practice effect. In the future, with the continuous deepening of theoretical research, how to improve the effectiveness of digital transformation of higher education is a research direction worthy of attention.

Objective:To compare and analyze the differences of exercise cardiopulmonary function and the correlation of different cardiopulmonary function indexes among different aircraft types in pilots.Methods:Retrospective study was used. The exercise cardiopulmonary function of 68 Air Force pilots who were qualified for flight in aeromedical identification were tested with the Italian Cosmed exercise cardiopulmonary function tester at a power increasing rate of 25 W/min. The subjects were divided into fighter group and other aircraft group according to aircraft types. The differences of exercise cardiopulmonary function between 2 groups were compared. The correlation between maximal oxygen uptake and age, body mass index, and the correlation between heart rate recovery and exercise endurance were analyzed.Results:There were significant differences in maximal heart rate, respiratory quotient and heart rate recovery value at 1 min after exercise between fighter group (32 cases) and other aircraft group (36 cases) ( t=2.28, 2.50, 2.37, P=0.026, 0.049, 0.021). There was no significant difference in other indexes. The maximal oxygen uptake was negatively correlated with age and body mass index ( r=-0.329, -0.339, both P<0.001). The values of heart rate recovery at 2 min and 3 min after exercise were positively correlated with maximal oxygen uptake and maximal exercise power ( r=0.284, 0.290, 0.306, 0.268, P=0.001, 0.026, 0.002, 0.002). Conclusions:The indexes of exercise cardiopulmonary function have significant differences among pilots in different aircraft types, and there are significant changes with age and weight gain. The heart rate after exercise can monitor the changes of cardiopulmonary function under different training conditions.