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The future of cytokine detection is bound to be a red sea. You should know about these clinical applications.

Foreword:

In our bodies, there is a mysterious and powerful system, which always protects us from external pathogens. This system is our immune system, which is composed of many immune cells, like a well-trained army, always ready to resist foreign enemies. In this army, there is a mysterious force playing a role silently, which is cytokine.

Overview of cytokines

Cytokines are a kind of small molecular protein with wide biological activity, which is synthesized and secreted by immune cells (such as monocytes, macrophages, T cells, B cells, NK cells, etc.) and some non-immune cells (such as endothelial cells, epidermal cells, fibroblasts, etc.), and is equivalent to the "messenger" of mutual communication among various cells in human body.

It has many biological functions, such as regulating cell growth, differentiation and maturation, maintaining function, regulating immune response, participating in inflammatory reaction, wound healing and tumor growth and decline.

At present, the detection of cytokines is widely used in infections, kidney diseases, autoimmune diseases, tumors and malignant hematological diseases, which has important clinical significance in the diagnosis of diseases, the judgment of treatment opportunity, the guidance of medication, the monitoring of curative effect, the early warning of cytokine storm risk and the improvement of patients’ treatment efficiency.

Classification and main functions of cytokines

According to their main functions, cytokines can be divided into the following categories: interleukin (ILs), colony stimulating factor (CSFs), interferon (IFNs), tumor necrosis factor (TNFs), growth factor (GFs) and chemokine (CK).

There are both pro-inflammatory factors and anti-inflammatory factors. Pro-inflammatory factors usually regulate the growth, activation, differentiation and homing of immune cells to infected sites, aiming at controlling and eradicating intracellular pathogens (including viruses); Anti-inflammatory cytokines are a series of immunomodulatory molecules that control the response of pro-inflammatory cytokines.

In the development of infection, the interaction between pro-inflammatory factors and anti-inflammatory factors runs through, which has a far-reaching impact on the development direction and outcome of infection.

Clinical application value of cytokines

1, early diagnosis of infection, conducive to disease monitoring.

Shortening the window period helps to realize early diagnosis and win valuable time for treatment; The half-life is short, which is convenient to monitor the efficacy in time and ensure the effectiveness and safety of treatment; Complement with PCT and CRP, improve the accuracy of diagnosis and provide strong support for precise treatment.

Note: In the Expert Consensus on Interpretation of Clinical Significance of Infection-related Biomarkers published in 2017, IL-6 has been regarded as one of the infection-related biomarkers.

2, help to determine the type of infection.

A study showed that IL-6 and IL-10 increased more than 10 times at the same time, suggesting G- bacteria infection; IL-6 increased by 2 times, and IL-10 increased by less than 10 times, suggesting G+ bacteria infection. According to the cytokine spectrum, the effective rate of identifying Gram bacteria to guide antibiotic treatment is close to that of broad-spectrum coverage group, up to 85%, while the effective rate of empirical treatment group is only 60%.

3. Early warning of cytokine storm

During the period of COVID-19, many critically ill patients suffered from uncontrolled release of cytokines such as IL-6, IL-8, TNF-α, IFN-γ, which led to coagulation storm, thrombosis, myocardial infarction and pulmonary embolism, leading to respiratory failure, organ failure and even death.

Although IL-6 is the key cytokine for everyone at present, it should not be the only one. Cytokines is a huge regulatory network, which is coordinated with each other, constantly changing dynamically and changing with the course of disease.

Therefore, it is suggested that patients at risk of cytokine storm should be jointly tested for cytokines during admission and hospitalization.

4. Assess the inflammation and immune status of the body.

Severe patients may have three inflammatory/immune states: SIRS (Systemic Inflammatory Response Syndrome), CARS (Antagonistic Inflammatory Response Syndrome) and MARS (Mixed Antagonistic Response Syndrome).

When infection or other reasons lead to the imbalance of inflammatory response, if the levels of a large number of proinflammatory factors such as IL-1β, IL-6, IL-8, IL-12, IFN-γ, IFN-α and TNF-α are greatly increased, there is a risk of systemic inflammatory response syndrome -SIRS, and the inflammatory response of the body is strong at this time, so it is recommended to give priority to anti-inflammatory treatment; If the endogenous anti-inflammatory reaction is too strong, the anti-inflammatory factors such as IL-4 and IL-10 will be greatly increased, which indicates the risk of CARS. At this time, the immune function of the body is weak, and it is suggested to strengthen the immune treatment. If both pro-inflammatory factors and anti-inflammatory factors increase significantly, it suggests that the body is a mixed antagonistic response syndrome, suggesting that the body has a strong inflammatory response and low immune function, and it is suggested to carry out anti-inflammatory combined with immune enhancement therapy.

5. Cytokines and Tumor

Cytokines are the key proteins of signal transmission in tumor microenvironment (TME), which have pleiotropic effects. In terms of anti-tumor, interferon and TGF-β can directly inhibit the growth of tumor cells, while IFN-γ, IL-2, IL-12 and IL-15 can enhance the cytotoxic activity of lymphocytes or bone marrow cells, thus inhibiting cell growth; In promoting tumor, TGF-β, TNF, IL-1β, CXCL12, etc. can promote the survival and proliferation of tumor cells; TNF, IL-6, etc. can cause the disorder of cytokine regulation and promote the occurrence of tumor inflammation; IL-10, IL-4, TGF-β, etc. are immunosuppressed; TNF, IL-6 and various chemokines can also promote angiogenesis.

Studies have confirmed that IL-6, IL-10 and IL-12 are slightly increased, while IL-2, TNF-α and IFN-γ are significantly decreased, suggesting that there may be early tumor microenvironment progress. Early warning of the occurrence of adverse reaction cytokine release syndrome (CRS) caused by PD-1 therapy /CAR-T therapy.

6. Cytokines and Autoimmunity

Hemophagocytic syndrome (HLH):HLH may be caused by persistent antigen stimulation caused by autoimmune diseases or malignant tumors, with high mortality. IL-2R is one of the diagnostic criteria (from China Expert Consensus on Diagnosis and Treatment of Hemophagocytic Syndrome). In addition, the slight increase of IFN-γ, IL-10 and IL-6 can also distinguish HLH from infection, which is helpful for the treatment of HLH patients.

Systemic lupus erythematosus (SLE): As a chronic autoimmune disease, SLE will affect many organ systems, including but not limited to skin, joints and kidneys. Cytokines in active SLE patients, including IL-8, IL-18, IL-6 and IFN-α, were significantly higher than those in inactive SLE patients. Especially, IL-6 and IL-8 showed better sensitivity and specificity than traditional C3, C4 and Anti-dsDNA.

Henoch-Schonlein Purpura (HSP): A large number of studies show that inflammatory cytokines in HSP patients are out of balance, mainly IL-6, IL-8 and TNF-α. When the cutoff value of IL-6 is set to 7 pg/mL, the sensitivity and specificity can reach 78.0% and 80.5%. The change of IL-8 will be greater, which is 2-10 times of the baseline level of healthy people.

7, cytokines and asthma, allergic diseases and lung diseases.

Generally speaking, children’s allergic diseases such as asthma and allergic rhinitis are mainly mediated by humoral immunity (IgE-mediated type I allergy). IL-4 and IL-5 can promote the secretion of IgE antibodies, aggravate allergic diseases, monitor the levels of IL-4 and other proinflammatory factors, and evaluate the condition and efficacy.

In addition, pro-inflammatory cytokines such as IL-6, IL-8 and TNF-α can promote the progress of airway inflammation such as chronic obstructive pulmonary disease (COPD) and pneumonia, and evaluate the changes of cytokine levels, so as to evaluate the disease progress and drug efficacy monitoring of the above diseases.

8. Cytokines and Reproductive Medicine

Studies have proved that Th1 cytokines are significantly increased and Th2 cytokines are decreased in patients with unexplained recurrent abortion. It has also been reported in the literature that the significant increase of IL-22 concentration may be related to unexplained recurrent abortion.

Advantages and disadvantages of mainstream detection methods for cytokine reagents

1, chemiluminescence method

Advantages: The method is mature and stable in technology, high in sensitivity and wide in linear range, and can efficiently complete single detection in a short time.

Disadvantages: it is impossible to carry out multi-project joint inspection and the sample demand is large, which makes it unable to cope with the large sample size test.

2. Flow fluorescence method

Advantages: As a relatively new detection method, flow fluorescence method stands out for its advantages of realizing multi-item joint inspection with small sample size, especially in large sample size testing, which saves time and cost.

Disadvantages: It may not be as sensitive as the light-emitting platform, and it is difficult to solve the interference problem that may be introduced in the process of multi-joint inspection, which affects the accuracy of its detection to some extent.

3. Enzyme-linked immunosorbent assay

Advantages: The method is mature and stable, with high sensitivity and good stability.

Disadvantages: the reaction time is relatively long, the linear range is narrow, and the detection efficiency is low, so it is more used in scientific research.

Market situation and current situation sharing of cytokine reagents

1. The domestic heat is higher than that of foreign countries.

Through investigation, we found that, for cytokine projects, except IL-6, foreign manufacturers are more respected, and almost no other manufacturers have obtained certificates in China or even CE. At present, only Siemens has obtained the registration certificates for six projects, namely IL-1β, IL-2R, IL-6, IL-8, IL-10 and TNF-α, in China, which is regarded as an early cytokine project company that entered the China market.

The joint inspection of cytokine combination project seems to be a unique project in China, and it is difficult for us to find similar packaged tests in other countries.

From the actual clinical point of view, COVID-19 and sepsis have confirmed the significance of IL-6 detection, and hemophagocytic syndrome has clarified the value of IL-2R detection. However, for other cytokine detection, although everyone is advocating the clinical significance of each index, there is no more recognized expert consensus to explain it. It can only be said that the market prospect is there, but more clinical practice is needed to confirm it.

At present, there are mainly two factions in the detection of cytokines in China, such as the magnetic particle light-emitting platform of Hot Scene Bio, which has obtained the registration certificates of 13 indicators, namely TNF-α, IFN-γ, IL-1β, IL-2, IL-2R, IL-4, IL-5, IL-6, IL-8, IL-10 and IL. At present, the flow fluorescence platform made by Hu Manzhi is generally combined with 12 items, namely TNF-α, IFN-α, IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70 and IL-11.

2. Although there are international standards for each project, the testing situation of each manufacturer is not uniform.

Due to the lack of foreign reagents, it seems difficult to maintain the consistency of test results except IL-6. Although almost every project has international standards, from the data of clinical tests, the test results of various manufacturers deviate seriously, and it is difficult to judge which manufacturer’s test value is more accurate. It may be inferred that the traceability chain of each manufacturer is not particularly strict.

We know that most cytokines can’t be stored stably at room temperature, so the general calibrators are in the form of freeze-drying, which may be due to the loss during freeze-drying, or the interference of composite quality control such as flow platform, or the matrix effect introduced in the dilution process of international standards, which makes the test results of reagents difficult to be unified and leads to confusion in clinical judgment.

Market prospect of cytokine detection reagents

Although we have mentioned the problem that various cytokines form a complex network of communication and restriction between cells, there is no disease-specific guidance for many indicators at present, and it is difficult to unify the test results among manufacturers, but on the other hand, it is a huge opportunity for reagent manufacturers. Why do you say that?

First of all, the broad indications of detection indicators mean that cytokine items can be detected in various departments, with a large volume; Moreover, there are not many manufacturers in this testing field, and compared with conventional testing items, the homogenization is not serious and the market prospect is relatively broad; Moreover, the difference in the test results of manufacturers will inevitably lead to the emergence of benchmark enterprises in this field, so many enterprises can establish their own brand image through this product; It is believed that with the further implementation of the consensus of experts in various fields and the gradual maturity of emerging technologies such as flow fluorescence and single molecule detection, cytokine detection will surely be a red sea.

Today’s sharing is here, I hope it will inspire you. (For more information about cytokine detection reagents, please search the official website of HUMAN Zhizhi and click to inquire.)

About Hu manzhizao

Beijing Human Zhizao Technology Co., Ltd. is a medical technology innovation company integrating R&D, production and sales. With years of experience in materials science, in vitro diagnosis technology and marketing, based on the core of multi-flow fluorescence technology, the company is committed to providing fully automatic multi-flow fluorescence detection platform and supporting reagents with competitive advantages for clinical customers, and has built a "new ecology" for ultra-high-speed immunodiagnosis, focusing on major immune diseases, intractable diseases and rare diseases.

　　Recently, the National Health and Wellness Commission and state administration of traditional chinese medicine organized the revision of the novel coronavirus Diagnosis and Treatment Plan (Trial Ninth Edition) and formed the novel coronavirus Infection Diagnosis and Treatment Plan (Trial Tenth Edition). The key revisions are as follows:

　　The name of the disease has been adjusted.

　　According to the "Overall Plan for Implementing" Class B and B Management "for novel coronavirus Infection by the Comprehensive Group of the State Council Joint Prevention and Control Mechanism, the name of the disease was changed from" novel coronavirus "Renamed "novel coronavirus Infection". With the continuous variation of Covid-19, the virulence of Omicron virus weakened after it became the main epidemic strain. The main symptoms of human infection were cough, fever, sore throat and so on, and only a few infected people would progress to pneumonia.

　　No longer judge "suspected cases"

　　With the increasing richness of diagnostic methods and the continuous improvement of diagnostic efficiency,At present, Covid-19 infection can be diagnosed promptly, quickly and accurately by nucleic acid and antigen detection.In most cases, there will be no cases where the epidemiological history and clinical manifestations are consistent with the characteristics of the disease, but the pathogen detection can not be clear for a long time.

　　Increase the positive test of Covid-19 antigen as diagnostic criteria.

　　Antigen detection has good detection sensitivity for infected people with high viral load.With the maturity of antigen detection technology and the improvement of detection accuracy, Covid-19 infected people, especially those with strong infectivity, can be diagnosed in time through antigen detection.Considering that most infected people are treated at home, the antigen detection operation is simple and convenient, which is convenient for infected people to carry out rapid self-detection.

　　Further optimize "clinical typing"

　　With the constant variation of the virus, especially since the epidemic of Omicron strain, the pathogenicity of the virus has been gradually weakened, and the characteristics of the disease have changed obviously. Most infected people have mild symptoms and the proportion of pneumonia has been greatly reduced.In order to better reflect the characteristics of the disease, the tenth edition of the plan adjusted the clinical classification, mainly according to the severity of the infected person’s illness, divided into "light, medium, heavy and critical", which is more in line with clinical practice.

　　Cases are no longer required to be "centralized and isolated"

　　With the implementation of Class B and B management measures, Covid-19 infected people can choose home treatment or medical institutions according to the needs of treatment, and all kinds of medical institutions can treat Covid-19 infected people.

　　Further improved the treatment method.

　　The anti-Covid-19 drugs that have been approved for marketing in China will be included in the new diagnosis and treatment plan to further enrich the antiviral treatment methods.

　　Further improve the diagnostic criteria and early warning indicators for severe and critical cases, and scientifically and accurately judge severe cases of infection in Covid-19. At the same time,The elderly who have not been vaccinated in the whole process will be added to the high-risk group of severe diseases, and the monitoring of vital signs, especially the monitoring index of finger oxygen saturation after rest and activity, will be added to the early warning index of severe diseases..

　　Further strengthening the concept of co-treatment of Covid-19’s infection and basic diseases, emphasizing the need to strengthen the monitoring of related indicators of infected people’s basic diseases and give corresponding treatment for basic diseases, which is more conducive to promoting patients’ comprehensive recovery.

　　Further optimize the clinical manifestations and treatment-related contents of children’s cases, put forward the characteristics of children infected with Omicron strain in combination with clinical practice, and improved the early warning indicators of severe cases in children.It provides a treatment plan for special situations such as acute laryngitis and nervous system complications that may occur in children infected.

　　Further improved the related content of Chinese medicine treatment.Strengthen the guidance of traditional Chinese medicine treatment for severe and critical cases, and increase the method of medication with symptoms, which is more suitable for clinical practice.On this basis, the Chinese medicine treatment plan for children’s cases is further improved, acupuncture treatment methods are added, and corresponding Chinese medicine treatment measures are provided in combination with the obvious cough of some patients in recovery period.

　　Adjust the "discharge standard"

　　The tenth version of the plan no longer requires the results of nucleic acid detection when the infected person leaves the hospital, but the clinician makes a comprehensive judgment based on the patient’s Covid-19 infection, diagnosis and treatment of basic diseases or other diseases, and health recovery.

　　When the patient’s condition is obviously improved, his vital signs are stable, his body temperature is normal for more than 24 hours, lung imaging shows that acute exudative lesions are obviously improved, and he can be converted to oral medication, and there are no complications that need further treatment, he can consider leaving the hospital.

　　Adjust the prevention and control of infection in medical institutions

　　After the adjustment of the epidemic prevention and control policy, all medical institutions have the possibility to accept cases of Covid-19 infection. The tenth edition of the diagnosis and treatment plan has adjusted the relevant contents of infection prevention and control in medical institutions.

　　Further implement the system of pre-examination and triage for outpatient and emergency departments and do a good job of patient diversion. At the same time, instruct patients and accompanying personnel to wear medical surgical masks or medical protective masks, and provide instructions on hand hygiene, respiratory hygiene and cough etiquette.

　　Strengthen the cleaning, disinfection and ventilation of consultation rooms, wards, offices and duty rooms.

　　Implement personal protection requirements of medical staff according to exposure risks.

　　Standardize the treatment of medical waste and implement terminal disinfection after patients are transferred out or discharged from hospital.

　　▌ This article Source: CCTV News WeChat WeChat official account (ID: CCTV News Center)

　　Producer/Editor-in-Chief Bing Xu/Ma Wenjia

　　Headquarters reporter/Shi Yingchun

　　Editor/Yu Zijing Drawing/Gao Mengru

　　Image source/vision china

　　Xinhua News Agency, Beijing, August 2 nd: The responsible comrades of the Department of Veterans Affairs answered questions on the Opinions on Promoting the Employment and Entrepreneurship of Veterans in the New Era.

　　Xinhua News Agency reporter Mei Shixiong

　　On the occasion of the publication of the Opinions on Promoting the Employment and Entrepreneurship of Retired Soldiers in the New Era (hereinafter referred to as the Opinions), the responsible comrades of the Department of Veterans Affairs answered questions from Xinhua News Agency reporters on the main spirit of the Opinions.

　　1. Why did you issue this Opinion?

　　A: The formulation of the Opinions is mainly based on the following considerations:

　　First, it is an important guarantee to unite the morale of the military and achieve the goal of strengthening the military. Without a people’s army, there would be nothing for the people. At present, the situation at home and abroad is undergoing profound and complex changes, and the security environment challenges facing China are very severe. The task of safeguarding national sovereignty, security and development interests is arduous and arduous, and it is urgent to build a strong people’s army. Retirement and active service are different stages of a soldier’s life. The employment and entrepreneurship of retired soldiers have been done well, and their personal values have been well realized, which not only has a "calming effect" on retired soldiers themselves and their families, but also helps to relieve the worries of the majority of active soldiers, promote them to serve with peace of mind, effectively fulfill the lofty mission of the army in the new era, and help attract more high-quality talents to actively participate in national defense and army building, and truly transform their national defense potential into national defense strength.

　　The second is the inherent requirement of giving full play to the role of talents and boosting economic development. The army is a melting pot and a big school. After the training and training of the army, the vast number of retired soldiers have excellent political quality, will quality and ability style. At present, there are tens of millions of retired soldiers in China, and hundreds of thousands of soldiers are discharged from active service every year, which is an indispensable and important force in socialist modernization. At the same time, the military occupation has its particularity. After retiring to the local area, soldiers have a process of psychological adjustment, role transformation and ability transformation, which needs support and assistance. Formulate and issue the Opinions, improve the employment and entrepreneurship ability of retired military personnel, help them take a key step in job transition, career transformation and life transition, create conditions for them to integrate into society faster and play their role better, and contribute wisdom and strength to socialist modernization.

　　2. What veterans are the Opinions applicable to?

　　A: The Opinions mainly apply to three types of retired soldiers: first, self-employed retired soldiers; The second is to choose jobs independently and turn the army into cadres; Third, demobilized cadres.

　　3. What are the main features of the Opinions?

　　A: The Opinions mainly have four characteristics: First, it is an important declaration. For the first time, it is proposed that the employment and entrepreneurship policy for retired military personnel should be given priority, so as to ensure that retired military personnel will be given preferential treatment on the basis of enjoying inclusive employment and entrepreneurship support policies and public services, fully reflecting the concern and care of the party and the government for retired military personnel, and implementing the important instruction of the Supreme Leader General Secretary on "making military personnel a respected profession of the whole society". The second is problem-oriented. A series of policies and measures are put forward to solve the problems existing in different degrees, such as insufficient employment and entrepreneurship ability, insufficient support and imperfect service system. The third is to make overall plans. According to the existing policies and actual needs of various groups of retired military personnel, a relatively unified, standardized and orderly policy system will be gradually established in line with the principle of high and low. Fourth, innovation in inheritance. On the one hand, make full use of the existing policies and continue to adhere to the relevant policies that are generally welcomed by retired soldiers and have good practical effects; On the other hand, the good policies introduced in some areas have become national policies, and the experience and practices in the work have been solidified into policies; At the same time, according to the new situation and new requirements, some forward-looking innovative measures are put forward.

　　4. What is the general idea of the employment and entrepreneurship of retired military personnel?

　　A: It is clear in the Opinions that the employment and entrepreneurship of retired military personnel in the new era is guided by Socialism with Chinese characteristics Thought of the Supreme Leader in the New Era, and a specific requirement of 32 words is put forward. First, the government promotes and gives priority to policies. The government plays an active role in supporting the employment and entrepreneurship of retired military personnel, and earnestly shoulders its responsibilities in policy support, public service, publicity and guidance, organization and coordination. The second is market orientation and demand traction. In the final analysis, employment and entrepreneurship belong to market behavior. We should give full play to the decisive role of the market in resource allocation and improve the pertinence and effectiveness of employment and entrepreneurship services according to market demand. The third is voluntary choice and independent action. The key to promoting the employment and entrepreneurship of retired soldiers lies in their own efforts, speeding up the transformation of their roles and identities, courageously participating in the tide of reform and opening up, and actively participating in socialist modernization. Fourth, social support and multi-party participation. The employment and entrepreneurship of retired military personnel is a systematic project and the common responsibility of the whole society. It is necessary to mobilize the forces of the government, market and society to jointly promote it.

　　5. What measures are there to improve the employment and entrepreneurship ability of retired military personnel?

　　A: Promoting the employment and entrepreneurship of retired military personnel is the foundation. In recent years, the state has introduced some targeted measures to strengthen the vocational skills training of retired military personnel and enhance their employment and entrepreneurial ability, but there are also problems such as scattered policies, insufficient preferential treatment, low training quality and inflexible training methods. The Opinions put forward six measures:

　　First, improve the multi-level and diversified education and training system. Incorporate the education and training of ex-servicemen into the academic education and vocational education system, and rely on educational resources such as ordinary universities and vocational colleges to promote the connection between the education and training of active servicemen and ex-servicemen, and the academic education and skills training complement each other.

　　The second is to carry out pre-retirement skills reserve training. We will carry out in-depth activities of "sending policies to military camps", strengthen economic and social development and employment situation introduction, policy consultation, psychological adjustment, and "one-on-one" career planning, and strive to turn the qualities tempered by retired soldiers during their service into advantages in employment and entrepreneurship.

　　The third is to strengthen vocational skills training after retirement. Relax the time limit for participating in free training, and relax the current "you can participate in free training within one year after retirement" to "you can participate at any time after retirement"; Relax the geographical restrictions on participating in free training, and allow cross-provincial education and training with the consent of the provincial veterans affairs department.

　　The fourth is to implement lifelong vocational skills training. Encourage employers to regularly organize retired military personnel to participate in job skills upgrading and knowledge updating training; Incorporate laid-off and unemployed veterans into special vocational training plans and vocational skills training, and subsidize them according to regulations.

　　The fifth is to encourage participation in academic education. Encourage all localities to include retired soldiers who meet the requirements for college entrance examination into the enrollment scope of separate examinations in higher vocational colleges; Retired soldiers take part in the college entrance examination and postgraduate examination and enjoy extra care; During their service, military personnel participated in continuing education with open education, self-study exams and other academic qualifications. After retiring, they can continue to complete their studies and obtain the corresponding national higher education diploma.

　　Sixth, strengthen the management of education and training. It is proposed to establish a catalogue of vocational skills training institutions, training enterprises and institutions of higher learning for retired military personnel, and to make it public and implement regular assessment and dynamic management to ensure the teaching level of training units. Strengthen the assessment of the quality of education and training of training units and establish an incentive mechanism.

　　6. What measures are there to support the employment of veterans?

　　A: The Opinions put forward specific measures in terms of relaxing recruitment conditions, broadening employment channels and strengthening employment services.

　　In terms of relaxing the recruitment conditions, it is clear that organs, social organizations, enterprises and institutions recruit retired military personnel, appropriately relax the age and academic qualifications, and give priority to recruitment under the same conditions.

　　In terms of broadening employment channels, the first is to increase the recruitment of civil servants. College graduate soldiers who have served in the army for more than 5 years (inclusive) can apply for the position of orientation examination for service-oriented grassroots project personnel after retirement, and share the orientation examination plan for civil servants with service-oriented grassroots project personnel; All localities, especially border areas and deep poverty-stricken areas, have set up a certain number of grass-roots civil servant positions to recruit veterans in combination with the implementation of strategies such as rural revitalization and poverty alleviation; Party and government organs at all levels should pay attention to selecting and transferring outstanding college students with service experience when organizing the work in Selected Graduates; Broaden the channels for recruiting the people’s police of public security organs from retired soldiers such as anti-terrorism special operations. The second is to encourage enterprises to recruit. Enterprises that absorb the employment of retired military personnel can enjoy tax incentives; Enterprises that have made outstanding contributions to the employment of retired military personnel shall be commended and rewarded. The third is to explore new employment channels. Study and formulate a job directory suitable for the employment of retired military personnel, increase the proportion of retired military personnel recruited for service guarantee and security, and give priority to recruiting retired military personnel under the same conditions for auxiliary police posts; Demobilized soldiers are selected to participate in key tasks such as social governance, stabilizing the border, and tackling poverty, and retired soldiers are encouraged to work as full-time staff in the party’s grassroots organizations and urban and rural communities.

　　In strengthening employment services, it is clear that ex-servicemen enjoy priority treatment in public employment service institutions at all levels, and local people’s governments at or above the county level organize at least two special recruitment activities for ex-servicemen every year. At the same time, it is required to do a good job in follow-up support, establish employment accounts for retired military personnel, implement real-name management, track the employment of retired military personnel, and provide necessary services.

　　7. What measures are there to support veterans’ entrepreneurship?

　　A: Entrepreneurship is a higher level of employment and plays an important role in promoting employment. The "Opinions" highlight the guidance and services for retired military personnel who are willing to start a business. The first is to strengthen entrepreneurship training. All localities should organize and carry out entrepreneurship awareness education, entrepreneurship project guidance, enterprise management and other training for retired military personnel with entrepreneurial will, so as to enhance entrepreneurial confidence and enhance entrepreneurial ability. The second is to give priority to providing entrepreneurial places. Encourage the establishment of business incubation bases, creative spaces and business parks for retired military personnel, solve the problems of lack of venues, funds and technology in a targeted manner, and create conditions for their innovation and entrepreneurship. The third is to enjoy financial and tax incentives. Ex-servicemen who set up small and micro enterprises can apply for business start-up guarantee loans and enjoy loan discount according to regulations, and all localities can increase their support in light of the actual situation. Encourage social capital to set up veterans’ venture funds and broaden the channels of fund guarantee. Ex-servicemen engaged in self-employment can enjoy tax incentives. In the next step, relevant departments will also study and improve the preferential tax policies for employment and entrepreneurship of retired military personnel.

　　8. What measures are there to improve the employment and entrepreneurship service system for retired military personnel?

　　A: According to the requirements of the new situation and the ideas of platform informationization, team specialization and strength diversification, the goal and structure of service system construction are defined. The first is to build an information platform. Emphasis is placed on the supporting role of information construction in accurate service, and it is proposed to speed up the establishment of a nationwide, real-time sharing and up-and-down linkage information platform for retired military personnel’s employment and entrepreneurship services, and make full use of big data to provide accurate services. The second is to build a guidance team. Give play to the guiding team’s role in career planning, entrepreneurship guidance and employment absorption of retired military personnel, and attract entrepreneurs, experts and scholars with rich entrepreneurial experience, caring for retired military personnel and loving public welfare undertakings to improve the professional level of service guidance. The third is to build a training base. In accordance with the principle of classified management, accelerate the establishment of a regional training base with complementary advantages, resource sharing and special service for veterans, and bring it into the scope of national policy support and give appropriate subsidies. The fourth is to make good use of social forces. Advocate the whole society to participate in the employment and entrepreneurship of retired military personnel, combine the government’s provision of public services, supplementary services from social forces and self-service of retired military personnel, and support social organizations that serve the employment and entrepreneurship of retired military personnel to carry out their work according to law.

　　9. What measures does the Opinions take to improve and perfect the employment and entrepreneurship mechanism of retired military personnel?

　　A: There are many departments involved in the employment and entrepreneurship of retired military personnel, and an effective mechanism needs to be established. The Opinions put forward three measures: First, improve the working mechanism. Clarifying the working mechanism led by the Party committee, promoted by the government, led by the veterans affairs department, supported by the relevant military and civilian departments, and participated by all sectors of society, and refining the specific division of labor among departments are conducive to the formation of joint efforts. The second is strict accountability. Take the employment and entrepreneurship of retired military personnel as a political task and incorporate it into the annual performance appraisal of various regions and departments to ensure the implementation of the central policy. Resolutely clean up and correct those who add conditions and raise the threshold outside the central policy; If the policy implementation is not in place and the work is not promoted effectively, timely supervision and supervision will be carried out; Serious violations of policies and regulations, resulting in adverse effects, seriously investigate the responsibility of relevant personnel. The third is to strengthen publicity and education. Emphasis is placed on strengthening the education of retired military personnel’s ideological, political and job-hunting concepts, vigorously publicizing the typical employment and entrepreneurship of retired military personnel, publicizing the advanced deeds of all sectors of society that care for and support the employment and entrepreneurship of retired military personnel, and creating a good atmosphere conducive to the employment and entrepreneurship of retired military personnel.

　　10. What are the requirements for the implementation of the Opinions?

　　A: The vitality of the policy lies in its implementation. Even the best policy will be a castle in the air if it is not implemented. It is a very urgent task at present to publicize and implement the spirit of the Opinions, ensure that all requirements are implemented and benefit the vast number of veterans. The next step is to focus on the following tasks: First, strengthen policy interpretation. Publicly report the Opinions through various media, especially on the issues of concern to veterans, and actively solve doubts and doubts, so that the majority of veterans can accurately grasp the spirit of the policy. The second is to refine policy measures. All localities should formulate specific implementation measures in light of the actual situation and implement the requirements of the Opinions in detail. The third is to pay attention to typical guidance. Summarize and popularize the good practices and experiences implemented in various places in a timely manner, and promote the work from point to area. The fourth is to strengthen supervision and inspection. It is necessary to establish a task ledger, insist on tracking and asking for results, evaluate and check regularly, and promote the work in a strong and orderly manner.