Objective:To investigate and analyze the employment status of college graduates majoring in health service and management in China.Methods:From April 2023 to June 2024, a cross-sectional survey was conducted on undergraduate graduates majoring in health service and management from 34 universities in China using convenient sampling method. General information was collected (such as gender, household registration at graduation, only child status, average monthly family income, previous experience as a student cadre, average grade point, part-time job experience, entrepreneurial experience, whether a first batch graduate of the university and the major, self-assessment of professional competence level) alongside employment status. Statistical descriptive analysis was employed to analyze the graduates′ basic employment situation, job competence and professional skill demand, types of certificates valued by employers, factors influencing job selection, evaluation of work and profession, and perceptions of professional employment prospects. A total of 1 417 questionnaires were collected in this study, with 1 315 valid responses (92.8%). Chi-square tests were used to compare employment differences among various factors, and binary logistic regression was used to analyze factors influencing employment outcomes.Results:Among 564 employed graduates in the Health Services and Management field, 98 (17.4%) work in health management companies and 97 (17.2%) in hospitals. Regarding important job competencies, 413 (73.2%), 409 (72.5%), and 364 (64.5%) respectively emphasized the importance of information collection and statistical analysis, organizational coordination, and communication skills. Key professional skills highly valued by employers included health risk assessment 175 (66.3%), health measurement 160 (60.6%), and health education and promotion 152 (57.6%). Additionally, 281 (49.8%) highlighted the importance of Health Management Professional Qualification Certificates. Factors influencing job choices included salary and benefits 454 (80.5%) and personal interests and hobbies 279 (49.5%). While 397 (70.4%) of the graduates provided positive feedback on their profession, only 274 (48.6%) were optimistic about their future job prospects. Binary logistic regression analysis indicated significant correlations (all P<0.05) between employment outcomes and factors such as part-time work experience ( OR=1.31) and average grade point ( OR=0.61, 0.68). Conclusions:The employment rate of undergraduate graduates majoring in health service and management in China is low in the health service market, with a low degree of job specialization matching. Graduates are not optimistic about the future employment prospects in their field, possibly due to unclear positioning in talent cultivation in universities and an imperfect job market.

Objective: To construct a competency evaluation model for health managers based on the grounded theory, so as to provide insights into the training and evaluation of health managers. Methods: From December 2022 to March 2023, health managers with three years and more of working from health management center of a tertiary hospital, a health management enterprise and a university with a top-tier ranking for the major of "Health Services and Management" were invited, and a semi-structured interview on competency was conducted based on grounded theory. Coding techniques were applied to analyze the interview data, including open coding, axial coding, selective coding and theoretical saturation testing using NVivo12 software. Based on the coding results and drawing inspiration from McClelland's "Iceberg Competency Model Structure", a competency evaluation model for health managers was formulated. Results: Twenty-one health managers participated in the study, including 8 participants from the hospital, 7 participants from the enterprise and 6 participants from the university, 14 females, 17 participants with 3-10 years of working, and 6 participants with the rank of associate senior professional title or above. The interview yielded 5 main categories, from which the competency evaluation model for health managers was developed with five dimensions: professional development, health management capability, communication and coordination, humanistic care, and personal traits. professional development and health management capability constituted the overt competencies of health managers, while communication and coordination, humanistic care, and personal traits formed their implicit competencies. Conclusions The competency evaluation model for health managers constructed in this study includes explicit competency and implicit competency, which is expected to serve as a reference for the effective selection and cultivation of health managers.

Objective To explore the current situation,research hotspots and future development direction of medical community in our country.This paper puts forward some suggestions for the future development of medical community in our country,and provides the research reference.Methods A total of 1 329 articles on medical community published by CNKI from February 2016 to July 2016 were 2023 by NoteExpress and CiteSpace,from the point of view of medical service homogeneity,this paper analyzes the general situation,research hotspots and research trends of the medical community domain literature,this paper reviews the research from the perspectives of medical expense payment,medical personnel training and health file management.Results The research topics of the medical community are gradually diversified and characterized,the research methods of the medical community are diversified,and the research perspectives of the medical community are differentiated.Conclusion Fu-ture research should focus on the following aspects:the scope of medical community research topics,health records management,government support system,medical integration in the post-epidemic era.

Objective To study the effects of different types of fluid resuscitation on mesenteric microcirculation and inflammatory factors in rabbits with hemorrhagic shock.Methods The model of hemorrhagic shock rabbits was established by reducing the basic mean arterial pressure by 40%through draining the blood from the common carotid artery.Animals were randomly divided into control group,saline group,lactate Ringer group,acetic acid Ringer group,hydroxyethyl starch group and succinyl gelatin group with 8 animals in each group.Mesenteric microcirculation was monitored with microcirculation monitor.Mean arterial pressure(MAP),heart rate(HR),microvascular perfusion ratio(PPV)and microvascular blood flow index(MFI)were recorded before bleeding(T0),at hemorrhagic shock(T1),at the beginning of fluid resuscitation(T2),at the completion of fluid resuscitation(T3),and at the end of the experiment(T4).The contents of tumor necrosis factor-α(TNF-α),interleukin-1(IL-1)and lactic acid(Lac)were measured at T0,T2 and T4.Results Compared with hydroxyethyl starch group,there were statistically significant differences in T3 MAP(P<0.05),except for succinyl gelatin group,hydroxyethyl starch group had higher MAP at T4 than other groups,the difference was statistically significant(P<0.05).The differences in MAP between experimental control group and other groups were statistically significant at T4(P<0.05).PPV and MFI of hydroxyethyl starch group and succinyl gelatin group were higher than those of normal saline group,lactic acid Ringer group and acetic acid Ringer group at T4(P<0.05),and the lactic acid value of hydroxyethyl starch group at T4 was the lowest,compared with lactic acid Ringer group and normal saline group,the difference was statistically significant(P<0.05).There were statistical significances between all groups and experimental control group at T4(P<0.05).There were no significant differences in TNF-αand IL-1 in T0,T2 and T4 among all groups(P<0.05).Conclusion Hydroxyethyl starch solution and succinyl gelatin solution can improve the microcirculation of rabbits with hemorrhagic shock,but can not improve the level of inflammatory factors.

Objective:To evaluate the present situation and future development for undergraduate major construction of health service and management.Methods:One hundred and twenty-three domestic universities with undergraduate health service and management major were selected as the research subjects. This paper analyzed the present situation of major distribution and aim setting, faculty, curriculum system, construction of teaching material, enrollment number, graduate destination, among other areas, using network data collection, questionnaire survey, and descriptive analysis methods. It also analyzed the development trend of this major with regards to the national policy guidance and discipline development dynamics.Results:The results showed that the number of domestic universities with undergraduate major for health service and management had increased from 5 in 2016 to 123 at present, with an average annual growth rate of 472.0%. The curriculum system of various universities covered 13 core courses, such as management and introduction to basic medicine. The total credits required for graduation ranged from 149 to 224, and the proportion of practical teaching in the teaching plan ranged from 12.1% to 45.1%. The credit requirements varied greatly; moreover, the proportion of practical teaching in most universities was not high and the content was narrow. Among the 21 universities participating in the questionnaire survey, 47.6% of them focused their education on cultivating versatile talents, 52.4% had 4-6 full-time teachers, 47.2% of all full-time teachers were 31-40 years old, 42.9% universities had teachers with senior professional titles accounting for 30%-40% of the faculty, and 28.6% universities had teachers with doctoral degrees comprising ≥50% of the faculty. The aim setting of most universities was more or less vague, the number of full-time teachers couldn′t meet the needs of major development, and the connotation construction lagged relatively.Conclusions:The inconsistency of the rapid increasing number of universities with the connotation construction of major has become a key barrier to the connotative development of undergraduate major of health service and management. In the future, building the quality of teaching according to national standards; advancing the integration of government, industry, university, research, and implementation; improving faculty quality; and optimizing the curriculum system will be part of the development trend.

OBJECTIVE To discuss the correlation between effectual time and the curative effect in patients with all frequency descending sudden deafness. METHODS According to effectual time,the subjects were divided into first week effectual group and second week effectual group and the curative effect of each group was compared. RESULTS In patients with flat descent sudden deafness, the curative rate of the first week effectual group was higher than that of the second week effectual group, but there was no significant difference between the two groups(χ2=1.599, P =0.206). Meanwhile, the total significant effective rate of the first week effectual group was higher than that of the second week effectual group, without obvious difference between the two groups(χ2=0.124, P =0.725). Furthermore, in patients with total deafness type of sudden deafness, the curative rate of the first week effectual group was higher than that of the second week effectual group, showing no remarkable difference between the two groups(χ2=2.493, P =0.114). Besides, there was no remarkable difference in the comparison of the total significant effective rate (χ2=2.308, P =0.129), which was higher in the first week effectual group than that in the second week effectual group. CONCLUSION The course of treatment should be at least 2 weeks in patients with all frequency descending sudden deafness after onset.

Objective To guide the fluid resuscitation in patients with severe sepsis and septic shock by monitoring the central venous oxygen saturation(ScvO2),and to improve the rescue success rate and prognosis of patients with sepsis.Methods Based on the standard of ScvO2 of 6h,45 patients with severe sepsis and septic shock were divided into two groups:observation group(n=28) and control group(n=17).The ScvO2,mean arterial pressure(MAP) and central venous pressure(CVP) levels were measured in the two groups after fluid resuscitation,and then the mortality,MAP compliance rate and CVP compliance rate were compared between the two groups.Results Compared with mortality in the control group(52.94%),the mortality in the observation group(14.29%) was significantly lower,the difference was significant (x2=5.927,P=0.015),but after 6h's fluid resuscitation,the MAP and CVP standard number in the two groups did not exist significant difference(x2=1.182,P>0.05).Conclusion ScvO2 with or without reaching the standard level(more than 65%) was positively correlated with the severity of the disease after fluid resuscitation in patients with severe sepsis and septic shock.Therefore,the monitoring of ScvO2 plays an important role in guiding the treatment of fluid resuscitation and judging the prognosis.

Objective To investigate the effects of bedside blinding method of active indwelling of nasojejunal tube combined with the nasogastric tube gastrointestinal decompression for patients with severe stroke.Methods 50 patients with severe stroke were selected and divided into two groups by using random number tables,which are the observation group and the control group,with 25 cases in each group.The patients in the observation group were treated with bedside blinding method of active indwelling of nasojejunal tube combined with the nasogastric tube gastrointestinal decompression,while the patients in the control group simply received bedside indwelling of nasogastric tube.The enteral nutritional goal -rate of target feeding volume on the 7th day and the 14th day after admission and trace the incidence of gastric stasis,the reflux and aspiration,the aspiration pneumonia in the patients of the two groups within 14 days and the situation of the days of mechanical ventilation,the days in ICU and the 30 -day mortality of patients were compared in the two groups.Results The enteral nutritional goal -rate of target feeding volume on the 7th day and the 14th day in the observation group were superior to those of the control group[The goal -rate of target feeding volume on the 7th day:88% vs.64%,χ2 =3.947,P =0.047;the goal -rate of target feeding volume on the 14th day:80% vs.52%,χ2 =4.367,P =0.037].Meanwhile the incidence of gastric stasis,the reflux and aspiration,the aspiration pneumonia in the patients of the observation group within 14 days were significantly lower than those in the patients of the control group within 14 days[The gastric retention rate:8% vs.56%(14 /25 ),χ2 =10.784,P =0.001;the reflux rate:0% vs.24%(6 /25),χ2 =4.735,P =0.03;the aspiration rate:8% vs.32%,χ2 =4.500,P =0.034;the incidence of aspiration pneumonia:24% vs.68%,χ2 =9.742,P =0.002].The days of mechanical ventilation and the days in ICU of the patients in the observation group are far less than those of the patients in the control group[The days of mechanical ventilation:(11.16 ±4.86)d vs.(13.72 ±3.67)d,t =-2.101,P =0.041;the days in ICU:(15.36 ±5.66)d vs.(18.72 ±2.99)d,t =-2.625,P =0.012].While there was no significant difference between the two groups on the 30 -day mortality(24% vs.32%,χ2 =0.397,P =0.529).Conclusion The bedside blinding method of active indwelling of nasojejunal tube combined with the nasogastric tube gastrointestinal decompression can significantly improve the enteral nutritional goal -rate of target feeding volume for patients with severe stroke and greatly reduce the incidence of gastric stasis,the reflux and aspiration,the aspiration pneumonia,and limit the days of mechanical ventilation and the days in ICU.Accordingly,it has the value of popularization in the clinical application.

Objective To investigate the expression and clinical features of amplified in breast cancer 1 (AIB1) and epithelial mesenchymal transition (EMT) markers in human hepatocellular carcinoma and to observe the effect of AIB1 silencing by RNA interference (RNAi) on expression of EMT markers and invasiveness of HepG2 cells.Methods In this study,expression of AIB1,E-cadherin,Vimentin,ZO-1,and N-cadherin protein in 81 hepatocellular carcinomas were assessed through immunohistochemistry and clinicopathological significance was analyzed.After the lentiviral vector of AIB1 RNA interference was transfected into HepG2 cells,the expression of AIB1 and EMT markers was detected by real-time PCR and Western blot.The invasion and metastasis was evaluated by Transwell analysis.Results The expression of AIB1 protein was significantly up-regulated in the hepatocellular carcinoma tissue compared to the normal tumor adjacent tissue.The frequency of AIB1 overexpression in hepatocellular carcinomas with lymph node metastasis is 63％ (P ＜ 0.05).Correlation analysis demonstrated that the AIB1 protein expression was inversely correlated with E-cadherin,and positively correlated with Vimentin in hepatocellular carcinomas.After transfection with AIB1 targeting siRNA,the expression of AIB1 mRNA and protein decreased significantly (P ＜ 0.05).Knockdown of AIB1 expression increased the expression of E-cadherin and inhibited the expression of Vimentin.In addition,the invasion of HepG2 cells silenced AIB1 were significantly descented.Conclusion Above data suggests that overexpression of AIB1 might promote invasiveness and metastasis of cancer cells through regulation of E-cadherin and Vimentin expression in hepatocellular carcinomas.

Objective To evaluate the effects of adiponectin on the mitochondrial damage in septic rats with lung injury .Methods Sixty male Wistar rats ,aged 7-8 weeks ,weighing 180-220 g ,were randomly divided into 3 groups (n=20 each) using a random number table :sham operation group (S group) ,sepsis group (SEP group) and adiponectin group (APN group) .The animals were anesthetized with intraperitoneal 2% pentobarbital sodium 50 mg/kg .Sepsis was produced by cecum ligation and puncture (CLP) .In APN groups ,gene recombinant adiponectin 6 mg/kg was injected intraperitoneally at 12 h after CLP .At 24 h after the operation ,10 rats from each group were chosen and sacrificed ,and lungs were removed for detection of interleukin-6 (IL-6 ) and high-mobility group box-1 (HMGB1 ) contents . The mitochondria of lung samples were isolated for measurement of the malondialdehyde (MDA ) content and degree of mitochondrial swelling and mitochondrial activity . The survival rates within 7 days after operation were recorded in the left 10 rats in each group .Results Compared with S group , IL-6 and HMGB1 contents in lung tissues and MDA content in the mitochondria were significantly increased ,the degree of mitochondrial swelling was increased , and the mitochondrial activity and survival rates within 7 days after operation were decreased in SEP group ( P<0.05 ) . Compared with SEP group , IL-6 and HMGB1 contents in lung tissues and MDA content in the mitochondria were significantly decreased ,the degree of mitochondrial swelling was reduced ,and the mitochondrial activity and survival rates within 7 days after operation were increased in APN groups ( P< 0.05 ) .Conclusion Adiponectin can attenuate lung injury and raise the survival rates in septic rats ,and reduction of mitochondrial damage in lung tissues is involved in the mechanism .