Objective To explore the effect of separate management of income and expenditure (SMIE) on standard community healthcare services. Methods Health management records of 137 community health service ( CHS) institutions in Beijing during 2006 and 2009 were retrospectively analyzed. Paired t test was used to compare annual healthcare services at urban and rural areas before or after SMIE was adopted. Results The standard community healthcare services was reduced from 1 081 965. 53 to 971 793. 98 at urban areas and from 157 492. 23 to 149 305. 25 at rural areas (P >0. 05). Urban healthcare center-based standard services was decreased from 59. 94% to 52. 14% (P < 0. 05 ); while out-hospital services were increased from 13. 50% to 18. 88% (P<0. 05). In urban areas,standard services for women healthcare, chronic disease profiling, health education and information management were significantly increased (I <0. 05). However,Temporary observation and endemic disease prevention and treatment were the main job of rural healthcare. Conclusions SMIE in CHS institutions could accommodate to the need of health management, supporting policies should be further improved.

Objective To evaluate the application value of 256 slice spiral CT angiography (CTA)in the bridge vessels lesions af-ter grafts operation in lower extremity arteriosclerosis obliterans patients.Methods Taken DSA as the gold standard,using 256 slices spiral CTA to analysis the post-processing image of 76 article Bridge vascular which can be assessed in 65 cases patients with lower extremity arteriosclerosis obliterans,and to evaluated the diagnosis accuracy,sensitivity,specificity,positive predictive rate and negative predictive rate of postoperative bridge intravascular lesions.Results Using 256 slices spiral CTA,the bridge vascular of grafts operation patients can be clearly displayed,stenosis or unobstructed,and the anastomosis of the bridge vascular.5 graft occlu-sion,22bridge intravascular plaque were diagnosed correctly,3 vascular lesions were undiscovered.The accuracy,sensitivity,speci-ficity,positive predictive rate and negative predictive rate were 98.15%,96.15%,97.90%,92.59% and 97.96% respectively. Conclusion Using 256 slices spiral CTA can clearly show the endovascular lesions of lower extremity arteriosclerosis obliterans after grafts operation,and has high accuracy and specificity.It can be safely used as one of noninvasive follow-up means after grafts oper-ation.

Objective To develop infant thermal container with forced protection circuit so as to ensure its security. Methods Temperature database was set in thermal container and Cygnal F005 was used as intelligent controller. The state of the sensor was judged by comparison precisely. Double temperature controller was adopted to ensure normal working temperature. When the container went wrong, it could automatically switch to protection circuit to keep the temperature for infant. Results With precise temperature control and steady working station, the new type thermal container for infant could provide a safe and comfortable condition with clean air and fitting temperature and humidity. Conclusion The container is steady, accurate, safe and convenient.

Objective To monitor the antifungal resistance of clinical isolates of Candida spp.in the East China region.Methods MALDI-TOF MS or molecular methods were used to re-identify the strains collected from January 2018 to December 2022.Antifungal susceptibility testing was performed using the broth microdilution method.The susceptibility test results were interpreted according to the breakpoints of 2022 Clinical and Laboratory Standards Institute(CLSI)documents M27 M44s-Ed3 and M57s-Ed4.Results A total of 3 026 strains of Candida were collected,65.33％of which were isolated from sterile body sites,mainly from blood(38.86％)and pleural effusion/ascites(10.21％).The predominant species of Candida were Candida albicans(44.51％),followed by Candida parapsilosis complex(19.46％),Candida tropicalis(13.98％),Candida glabrata(10.34％),and other Candida species(0.79％).Candida albicans showed overall high susceptibility rates to the 10 antifungal drugs tested(the lowest rate being 93.62％).Only 2.97％of the strains showed dose-dependent susceptibility(SDD)to fluconazole.Candida parapsilosis complex had a SDD rate of 2.61％and a resistance rate of 9.42％to fluconazole,and susceptibility rates above 90％to other drugs.Candida glabrata had a SDD rate of 92.01％and a resistance rate of 7.99％to fluconazole,resistance rates of 32.27％and 48.24％to posaconazole and voriconazole non-wild-type strains(NWT),respectively,and susceptibility rates above 90％to other drugs.Candida tropicalis had resistance rates of 29.55％and 26.24％to fluconazole and voriconazole,respectively,resistance rates of 76.60％and 21.99％to posaconazole and echinocandins non-wild-type strains(NWT),and a resistance rate of 2.36％to echinocandins.Conclusions The prevalence and species distribution of Candida spp.in the East China region are consistent with previous domestic and international reports.Candida glabrata exhibits certain degree of resistance to fluconazole,while Candida tropicalis demonstrates higher resistance to triazole drugs.Additionally,echinocandins resistance has emerged in Candida albicans,Candida glabrata,Candida tropicalis,and Candida parapsilosis.