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In recent years,with the continuous expansion of graduates enrollment,the problem of graduates employment has attracted wide attention from all walks of life.As medical graduate students with favorable employment situation in the past,the pressure of employment now is increasing year by year,and the employment contradiction become more and more severe.In this paper,a survey of the graduates employment in the past five years in Medical University of Chongqing was conducted,and based on the analysis of the medical graduates employment situation and the characteristics of medical graduates training,six kinds of methods to improve employability for medical graduates were explored in order to achieve better employment of medical graduates.
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Objective To assess the factors associated with the restoration of spontaneous circulation (ROSC) and 2-year survival prognosis in patients with cardiac arrest (CA) after acute myocardial infarction (AMI),and after ROSC,the effects of various factors on midian survival time and on 2-year survival.Methods In a registry study from January 2005 to January 2015,all consecutive AMI-induced CA patients treated with cardiopulmonary resuscitation (CPR) admitted to our hospital were enrolled.The survivors were followed-up for 2 years.Univariate analysis was applied to evaluate factors associated with rate of ROSC and 2-year survival.Multivariable logistic regression analysis was applied to evaluate statistically significant factors in the univariate analysis.Medians with inter-quartile ranges were used to describe 2-year survival time affected by various factors after ROSC.Kaplan-Meier survival curve analysis was used to evaluate the effect of factors on 2-year survival.Results A total of 254 cases with CA after AMI were enrolled,including 129 cases of ROSC and 71 cases of 2-year survival.Univariate analysis showed age ≥ 70 years,CA occurred during 22:00-8:00,the duration time ofCPR ≥ 15 min and adrenaline dosage ＞ 5 mg were unfavorable predictors of ROSC;while,left ventricular ejection fraction (LVEF) ≥ 40％ before CA,shockable rhythm and percutaneous coronary intervention (PCI) therapy were favorable predictors.Besides,age ≥ 70 years,intubation during CPR,adrenaline dosage ＞ 5 mg and cardiogenic shock were unfavorable predictors of 2-year survival;While,male,normal daily activity before CA and PCI treatment were favorable predictors.Multivariable analysis showed age,the duration of CPR,adrenaline dosage,LVEF before CA,the rhythm during CPR and PCI therapy were independent predictors of ROSC.Age and PCI therapy were independent predictors of 2-year survival.Among patients,the survival time was affected by various factors after ROSC,and the factors with minimum 25％ and small median value were associated with cardiac rupture,cancer,adrenaline dosage ＞ 5 mg and cardiogenic shock.The factor with maximum 25％ value was PCI treatment (216 days).Kaplan-Meier survival analysis suggested that age ≥ 70 years was an unfavorable factor of 2-years survival (Log-rank test,P=0.007);while,PCI treatment was a favorable factor (Log-rank test,P＜0.01).PCI-related prognosis analysis showed that the effectiveness of PCI was related to the timing of PCI,the number of infarctrelated artery and the difference in culprit lesion.Conclusions The age ≥ 70 years was disadvantageous to both ROSC and 2-year survival.PCI treatment was favorable to both ROSC and 2-year survival.
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Objective To investigate the effect of abdominal breathing combined with acupoint massage to relieve abdominal distention after laparoscopic surgery.Methods One hundred and eighty patients with abdominal distention after laparoscopic surgery were randomly divided into control group and observation group with 90 patients in each group. The control group was given conventional perioperative nursing and the observation group combined with acupoint massage including Zusanli, Shangjuxu,Xiajuxu,and Neiguanxue based on the use of abdominal breathing to relieve postoperative abdominal distension. Result The abdominal distension of the observation group was significantly lower than that in the control group,the recovery time of intestinal peristalsis and anus exhaust time were significantly shorter than those of the control group after 3 d(all P<0.01).Conclusion Abdominal breathing combined with acupoint massage can relieve abdominal distension of patients after laparoscopic surgery and promote intestinal function recovery.