With the continuous evolution and refinement of the healthcare insurance system,there arises a heightened de-mand for the standardization and efficacy of healthcare insurance management.This paper takes a prominent public hospital in Guangzhou City as a case study to delve into the establishment and enhancement of an intelligent monitoring system for healthcare insurance.Initially,an analysis is conducted from the perspectives of the national,policy,and institutional levels to underscore the imperative and urgency of constructing an intelligent monitoring system for healthcare insurance.Subsequently,a comprehen-sive review of the current research landscape,both domestically and internationally,is presented,highlighting the challenges faced by domestic intelligent auditing systems in terms of their level of intelligence,the sophistication of hospital-level intelligent monitoring,and the standardization of rule libraries.Following this,the paper elaborates on the practical endeavors undertaken by large public hospitals in Guangzhou City regarding the construction and optimization of the intelligent monitoring system for healthcare insurance.This encompasses aspects such as the structure of the intelligent monitoring system,collaborative manage-ment in operational modes,and the standardization of rule libraries.Finally,the paper concludes by summarizing the positive im-pact of these practices on the regulation of medical service behaviors and the enhancement of efficiency in healthcare insurance quality management,while also offering insights into future research directions.

AIM: To investigate the effects of age, gender, duration of medication and combined medication on the steady-state blood concentration of tacrolimus in patients with autoimmune diseases, and to establish the reference range of steady-state blood concentration of tacrolimus in combination with liver and kidney function, so as to provide theoretical basis for clinical individual medication. METHODS: A total of 107 patients with autoimmune diseases treated with tacrolimus in the department of rheumatology and immunology of our hospital from August 2017 to June 2021 were included. Their gender, age, dose, drug combination, blood concentration, and liver and kidney function were statistically analyzed by SPSS 22.0 statistical software. RESULTS: In the treatment of autoimmune diseases with tacrolimus, there was statistical significance in the blood concentration of different genders (P<0.05), but there was no statistical significance in the blood concentration of different ages (P>0.05) and a statistically significant difference in the dosage of tacrolimus (P<0.05), the duration of medication did not affect the effective dose, target blood concentration, liver and kidney functions. There was a weak correlation between tacrolimus dose and blood concentration (r=0.115, P=0.047). When the blood concentration of tacrolimus ranged from 4.20 to 9.48 ng/mL, the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and urea increased significantly. When tacrolimus blood concentration ranged from 0.08 to 4.20 ng/mL, there was no significant difference in serum creatinine, AST, ALT, albumin, total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL). CONCLUSION: Tacrolimus is used for the treatment of autoimmune diseases, and the blood concentration varies greatly among individuals. To avoid the risk of potential damage to liver and kidney function. It is recommended that clinicians control the blood concentration at 0.08-4.20 ng/mL, and adjust the dose and optimize the dose according to the patient's gender, age, and clinical efficacy.

Objective: To investigate and analyze the amount and the type of fluid intake in spring among male college athletics in a university in Beijing, and to provide scientific basis and reference data for fluid intake-related education and formulating adequate water intake. Methods: A simple random sampling method was used to select 109 male sports crowd from a college in Beijing. The information on amount and types of fluid intake were recorded using the validated 7-day fluid specific diary. Results: The median amount of daily fluid intake among participants was 1 789 mL. The number of participants who reached the amount of adequate water intake for Chinese adult residents 60, which accounted for 55.1% of the total participants. There was difference on the amount of fluid intake among different participants after grouped by the quartiles of exercise consumption(χ2=9.20, P=0.03). There were also differences in the percentage of fluid intake reaching the recommended amount on adequate water intake(χ2=18.27, P=0.04). The median amount of plain water, dairy products, sports beverages, and other sugary beverages were 1 180, 40, 65, and 383 mL, respectively; which accounted for 67.1%, 2.2%, 3.7%, and 22.2% of daily fluid intake. There was difference on the amount of sports beverages among different participants after grouped by the quartiles of BF%(χ2=8.59, P=0.04). There was difference on the amount of sports beverages (χ2=8.25, P=0.00) and other sugar-sweetened beverages (χ2=8.57, P=0.02) among different participants after grouped by the quartiles of energy expenditure. Conclusion Among male sports population in a university in Beijing, the amount of fluid intake differed among different participants after grouped by the quartiles of exercise consumption. As the exercise consumption of participants increased, the water consumption increased. Participants mainly drink plain water, and there were differences on the types of fluid intake among participants with different BF% and different energy expenditure.

Objective: To understand the knowledge, attitudes and practices of drinking water among college students of Hebei Province, to provide evidence for health education. Methods: A total of 715 subjects were selected from a university in Baoding City, Hebei Province in March 2017 by random cluster sampling. Knowledge, attitude and behavior of drinking water among college students were investigated by self-designed questionnaires. Results: The awareness rate of water consumption of 1 500-1 700 mL was 19.0%, the awareness rate of drinking modes was 95.0%, the awareness rate of suitable drinking time was 30.1%, the awareness rate on drinking water was higher among girls and medical major sutdents (χ2=22.16, 12.49, P<0.05); the awareness rate on the relationship between insufficient drinking water and stroke, hypertension and coronary heart disease was generally low, with sophornore higher than freshman (χ2=11.10, P<0.05). The most common medium for accessing drinking water knowledge among the respondents was network (60.0%), followed by campus publicity/classroom teaching (48.3%). 99.6% of the respondents believed that drinking water was important to health, 98.3% were willing to change their drinking habits, 93.0% were willing to pay attention to drinking water education, and the proportion of female students was higher than that of male students (χ2=5.46, 6.49, 8.01, P<0.05). In real life, 48.4% of the respondents drank water on an empty stomach in the morning and 40.7% before going to bed. 45.5% of the respondents drank water when they thought of it. Conclusion College students in Hebei province are generally lack of appropriate awareness on water drinking, which varied in sex, grade and major. While the attitude towards water drinking is satisfactory, drinking behavior need to be improved.

Objective: To investigate and analyze the fluids intake, urine output and hydration status during spring among male college athletics from one university in Beijing, and to provide scientific evidence for launching targeted health education. Methods: A simple random sampling method was used to select 109 male students in college with habit of exercise.Total drinking fluids was assessed by 7-day 24-hour fluid intake questionnaire. The water from food was assessed by the duplicate portion method and the weight method. The urine samples of 24-hour was collected for 3 consecutive days, and the volume, osmolality and specific gravity of urine were measured. The energy expenditure in exercise was estimated by using the exercise plan. Results: The median drinking fluids intake, water from food, total fluids intake and urine volume were 1 789, 955, 2 701, 850 mL/d, respectively. 15.6% of the subjects were in proper hydration status, and 43.1% of the subjects were in dehydration. The differences between drinking fluids intake, water from food, total fluids intake and urine volume of subjects in the different BMI and BF% levels were not significant(P>0.05). The differences between drinking fluids intake and total fluids intake of subjects in the different energy expenditure in exercise levels were significant(χ2=9.20, 8.43, P<0.05). Conclusion Comparing with the normal college students, the drinking fluids intake and total fluids intake of male sports people were higher, the volume of urine was lower, and the hydration status was worse. The targeted health education about water intake was recommended.

Objective: To understand snack food consumption among students of grade four and grade five in six cities of China, and to provide evidence for conducting nutritional education and making intervention strategies. Methods: A multi-stage stratified cluster random sampling method was used to select 12 197 primary school students in grade four and grade five from 72 primary schools in Beijing,Guangzhou,Nanjing,Chongqing,Jinan,Harbin. All the participants were administered with a self-administered questionnaire survey on dietary behaviors. Results: The proportion of pupils who consumed snack food at home, school and elsewhere was 96.4%, 59.4% and 75.5% respectively. The most popular snacks at home were fruits & vegetables, milk, cereals (72.0%, 71.1%, 68.6%), the most popular snacks at school were fruits & vegetables, milk, cereals (30.0%, 28.2%, 23.8%), the most popular snacks in other places were sugars, cereals and beverages (36.6%, 36.2%, 35.7%). The top five reasons for snack food was being delicious, healthy/nutritious, clean, choices of peers and family members (68.5%, 49.3%, 42.2%, 24.7%, 17.8%, respectively). Conclusion Snack food consumption is popular among primary students, most of which are unhealthy. Nutrition education for students and parents should be encouraged to promote students to consume snacks reasonably and develop healthy eating behaviors.

Objective: To understand the status on beverages consumption among grade 4 and grade 5 primary school students in six cities of China, and to provide evidence for nutrition education and intervention strategies. Methods: A multi-stage stratified cluster random sampling method was used to select 12 197 grade 4 and grade 5 primary school students from 72 primary schools in Beijing, Guangzhou, Nanjing, Chongqing, Jinan and Harbin. All the participants were investigated with a self-administered questionnaire survey of dietary behaviors. Results: The proportion of students who consumed beverages at home, school and elsewhere was 92.5%, 51.4% and 70.6% respectively. The most popular beverages at home were milk, fruit & vegetable drinks, tea drinks (69.4%, 46.6%, 39.6%); the most popular beverages at school were milk, fruit & vegetable drinks, tea drinks (30.5%, 13.0%, 12.7%) while the most popular beverages in other places were milk, tea drinks, fruit & vegetable drinks(37.4%, 29.6%, 28.1%). The top five reasons for choosing beverages were taste delicious, healthy & nutritious, clean, choice of peers and family members(72.3%, 50.8%, 38.4%, 21.9%, 21.6%, respectively). Conclusion Consumption of drinking beverages is popular among students, most of which are unhealthy. Therefore, nutrition education for students and parents should be encouraged aiming to help students choose healthy drinks and eating behaviors.

Objective: To investigate students’ satisfaction on school feeding program in 8 cities in China, and to provide the basis for improving school feeding management and lunch quality. Methods: Multi-stage random cluster sampling method was used to randomly select the second, fifth and eighth-grade students from 67 primary and middle schools in 8 cities including Beijing, Shanghai, Harbin, Shijiazhuang, Guangzhou, Changsha, Bengbu and Pinghu. Results: A total of 15 475 students participated in the survey, 15 170(98.0%) of which were valid questionnaires. A total of 13 297(87.7%) students had lunch in school. Twenty-six(38.8%), 14(20.9%) and 27(40.3%) schools served lunch by self-run canteens, custody canteens, and food delivery companies respectively. Twenty-one schools provided milk or yogurt for lunch, accounting for 31.3%. The reported rates of very satisfied, satisfied, moderate, dissatisfied, and extremely dissatisfied among students were 40.8%, 28.1%, 20.1%, 7.3%, and 3.6%, respectively. The satisfaction rate of the eighth-grade students was lower than that of the second-and fifth-grade(56.9% vs 77.1% vs 73.5%). The satisfaction rate among students from schools with self-run canteen was higher than that of custody canteens and food delivery companies(73.8% vs 60.5% vs 66.2%). The satisfaction rate of school lunch is highest in dining surrounding (75.3%), followed by amount of meals(71.6%), food hygiene(71.1%), food combination(65.4%), and the appearance of the food(60.5%), and food taste(55.9%). Conclusion The satisfaction rate of students for school lunch was acceptable. The food taste is the main factor for students’ dissatisfaction. Schools should be encouraged to provide lunch in the self-run canteens with tasty food while meeting the nutritional standard.

Objective: To understand rural students’ perception and satisfaction of the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES), and to provide basis for promoting students’ participation in the school feeding program and improving the acceptability of school feeding. Methods: In 3 national pilot counties and 2 local pilot counties of NIPRCES, 1 middle school and 1 primary school were randomly selected. Two classes of 2 364 students from grade 4 to grade 9 were randomly selected and investigated with questionnaires. Results: Students were aware of the policy, with 78.9% of the students reported to be familiar with NIPRCES. The awareness rate of students at the national pilot areas was higher than that in local pilot areas(P<0.05). Students showed positive attitude towards NIPRCES. The median score of students’ understandings of the influence of NIPRCES was 20.0 (18.0, 20.0) points. Students in national pilot areas showed a more positive attitude toward the program than those in local pilot areas(P<0.05). Moderate satisfaction was reported in school feeding, 78.7% of students thought that school provided adequate amount of food, and 60.9% of the students enjoyed the food very much. The main reasons for leftovers were too much in amount(27.4%), repetition of food types (22.8%) and food aversions(9.2%). Conclusion Students are quite aware of NIPRCES and show moderate satisfaction in school feeding. The awareness and satisfaction are relatively higher among students in national pilot areas than those in local pilot areas. Health promoting schools should be established and students and parents should be advocated to take part in the program, health education need to be promoted in schools. Experiences sharing between different places could help improve the quality and acceptability of school feeding program.

Objective: To understand nutrition knowledge,related attitude and behavior among primary students in six cities of China, and to provide evidence for nutrition education and intervention strategies. Methods: A multi-stage stratified cluster random sampling method was used to select 12 197 grade 4 and grade 5 primary school students from 72 primary schools in 6 cities of China, whom were administered with a questionnaire survey on nutrition knowledge, practice and practice. Results: Average nutritional knowledge was relatively low (12.0±6.4), practice score was moderate(11.4±2.4), while nutritional attitude was relatively high(17.0±2.4). The nutritional KAP scores of girls were higher than those of boys; the nutritional knowledge and practice scores of urban students were higher than those of suburban students; the nutritional knowledge score of fifth-grade students was higher than that of fourth-grade students(P<0.05). The overall nutritional knowledge awareness rate was 26.1%, with the highest in knowledge of whole grains(73.9%). About 83.5% of the students held positive nutritional attitude, 97.6% considered nutritional knowledge important. The overall rate of healthy eating behavior of students was 88.1%. Most students had breakfast almost every day(88.5%). About 34.9%, 38.0%,46.1% and 50.5% were reported of rarely consumption in snacks, fast food and drinks. Students in urban area and grade 5 were more likely have breakfast. Girls reported higher rates of having breastfast and low consumption of snack food and beverage while boys reported higher consumption of fast food. Students from suburban areas reported high consumption of western fast food but lower beverage(P<0.05). The score of students’ nutritional knowledge was positively correlated to attitude, so as attitude and practice(P<0.05). Conclusion Insufficient nutritional knowledge and unhealthy dietary behavior is observed in primary school students in China. Nutritional K-A-P varies in students with different gender, area and grade. Specific nutritional education in school-setting should be developed accordingly to culture healthy lifestyle among primary school students.