OBJECTIVE To formulate the Expert Consensus on the Implementation and Management of Drug Selection for Centralized Volume-Based Procurement in Medical Institutions of Guangxi （hereinafter referred to as the “ Consensus ”）， and to provide decision-making support and practical guidance for the drug selection and management of centralized volume-based procurement （hereinafter referred to as “centralized procurement”） drugs in medical institutions at all levels in Guangxi. METHODS A systematic review was conducted on the materials from previous batches of centralized procurement implemented in Guangxi. A comprehensive search was carried out for drug-related works and books， along with a systematic collation of guidelines on drug selection， expert consensus on centralized procurement， and policy documents. Through three rounds of specialized seminars， combined with existing evidence-based data and the practical drug selection experiences of medical institutions at various levels， this Consensus was formulated after thorough discussion and successive rounds of revision. RESULTS & CONCLUSIONS The Consensus systematically outlines the three key stages in the implementation of centralized procurement in medical institutions： procurement volume reporting， confirmation of agreed procurement volume， and procurement and usage implementation. It proposes drug selection strategies for centralized procurement bas ed on multiple dimensions， including specifications， dosage forms， packaging materials， fill volume， and manufacturing enterprises. In response to practical challenges encountered in the selection process， corresponding countermeasures are proposed， such as establishing a regularized information reserve mechanism， strengthening information technology support， and implementing categorized selection approaches. The Consensus advocates for medical institutions to construct an integrated “policy， data， and quality” decision-making system to promote full-cycle management of centralized procurement. This Consensus will provide scientific and practical guidance for medical institutions at all levels in Guangxi in the drug selection of centralized procurement， facilitating the smooth implementation and sustainable development of centralized procurement policies at the institutional level.

Objective To investigate the prevalence of soil-transmitted nematode human infections in Hubei Province from 2016 to 2023, so as to provide insights into formulation of soil-transmitted nematodiasis control strategies and evaluation of soil-transmitted nematodiasis control effectiveness. Methods There were 10 surveillance points established in Hubei Province for soil-transmitted nematodiasis each year from 2016 to 2023. The surveillance points were divided into eastern, western, southern, northern and central regions according to geographical locations, and one administrative village was sampled from a township in each region as a surveillance point. Then, at least 200 permanent residents at ages of over 3 years were randomly sampled at each point, with at least 1 000 individuals sampled. Soil-transmitted nematode infection was detected using a modified Kato-Katz thick smear method (two slides for one stool sample), and Enterobius vermicularis infection was additionally detected with a cellophane tape test among children at ages of 3 to 9 years. The prevalence of soil-transmitted nematode human infections was descriptively analyzed. Results A total of 80 547 individuals underwent surveillance for soil-transmitted nematodiasis in Hubei Province from 2016 to 2023, and a total of 262 individuals were detected with soil-transmitted nematode infections, including two cases with mixed infections, yielding an overall prevalence rate of 0.33% (262/80 547). The prevalence rates of hookworm, Ascaris lumbricoides, Trichuris trichiura, and E. vermicularis infections were 0.02% (20/80 547), 0.07% (55/80 547), 0.02% (15/80 547) and 0.22% (174/80 547), respectively, appearing a parasite species-specific prevalence rate (χ² = 250.235, P < 0.05), and the prevalence rates of soil-transmitted nematode infections were 0.50%(51/10271),0.37%(34/9120),0.39%(39/10099),0.40%(41/10168), 0.36% (37/10 234), 0.45% (46/10 211), 0.03% (3/10 238) and 0.11% (11/10 206) in Hubei Province from 2016 to 2023, respectively, showing a year-specific prevalence rate (χ² = 60.589, P < 0.05). Soil-transmitted nematode infections were detected across 36 surveillance points, and there was a significant difference in the prevalence of soil-transmitted nematode infections among surveillance points (0.02% to 3.30%, P < 0.001). In addition, the differences in prevalence rates of human soil-transmitted nematode infection among different age groups (χ² = 531.091, P < 0.05), occupations (P < 0.001), and education levels (P < 0.001) were all statistically significant. Among these, the children at ages of 3 to 9 years old (1.40%, 174/12 461), nursery-school children (1.69%, 90/5 312) and preschool-aged children (1.56%, 93/5 969) were relatively high. Conclusions The overall prevalence of soil-transmitted nematodiasis was low in Hubei Province from 2016 to 2023; however, the prevalence varied across regions and among populations, with E. vermicularis as the predominant species of soil-transmitted nematode. Soil-transmitted nematodiasis control should be given a high priority in key areas in Hubei Province, and preschool children, primary school students, and individuals with a low educational level are recommended as key target populations for health education and interventions.

Objective: To analyze the incidence of statutory and keymonitored infectious diseases among school students in Beijing from 2016 to 2020, so as to provide a reference for developing the prevention and control of infectious diseases in schools. Methods: A descriptive statistical analysis was conducted on student cases aged 6-22 years in Beijing from 2016 to 2020 selected from the China Disease Surveillance Information Reporting Management System. Rate comparisons were performed using the 2 test and trend 2 test. Results: From 2016 to 2020, the overall incidence of statutory and keymonitored infectious diseases among students in Beijing showed an upward trend (χ2trend=582.42), the incidence rates of Category B and other infectious diseases exhibited a downward trend (χ2trend=82.71, 18.34), while Category C infectious diseases demonstrated a significant upward trend (χ2trend=911.75) (P<0.01). Among Category B infectious diseases, scarlet fever, bacillary dysentery, tuberculosis, and HIV/AIDS were predominant, with annual average incidence rates of 61.33/100 000, 35.38/100 000, 13.88/100 000, and 3.78/100 000, respectively. Except for HIV/AIDS, the reported incidence rates of other infectious diseases showed a declining trend. Among Category C infectious diseases, influenza, other infectious diarrhea, hand-foot-mouth disease, and mumps were predominant, with annual average incidence rates of 956.13/100 000, 114.39/100 000, 111.37/100 000, and 28.24/100 000, respectively. Influenza showed a significant upward trend (χ2trend=1 508.30), while the other infectious diarrhea, hand-foot-mouth disease, and mumps exhibited a downward trend (χ2trend=13.84, 25.78, 6.13) (P<0.05). Among other infectious diseases, varicella was predominant (χ2trend=17.47, P<0.05). Scarlet fever, influenza, hand-foot-mouth disease, and mumps had higher incidence rates among primary and middle school students; other infectious diarrhea and varicella were more prevalent among high school students; tuberculosis and bacillary dysentery were more common among high school and college students; and HIV/AIDS had higher incidence rates among college and high school students. Conclusion From 2016 to 2020, the incidence of Category B infectious diseases among students in Beijing showed a declining trend, while influenza, a Category C infectious disease, exhibited a significant upward trend.

Objective: To investigate the levels of knowledge and skills in infectious diseases among school doctors and health teachers in Beijing s primary and secondary schools in 2023, and analyze the influencing factors, so as to provide a reference basis for enhancing the professional competencies of school doctors and health teachers. Methods: From October to November 2023, a census method was used to conduct a questionnaire survey among all school doctors and health teachers in 16 districts of Beijing. Chi-square tests and multivariate Logistic regression analysis was used perform statistical analysis. Results: The awareness rate of infectious diseaserelated knowledge among school doctors and health teachers in primary and secondary schools in Beijing in 2023 ranged from 34.44 % to 98.57%, while the behavior formation rate ranged from 65.90% to 98.64%. The proportions of those with literacy in infectious disease knowledge and behavior among school doctors and health teachers were 82.76% and 85.70%, respectively. Multivariate Logistics regression analysis showed that being a full-time employee, having a bachelor s degree or above, and holding a senior professional title were positively correlated with having literacy in infectious disease knowledge ( OR =1.76, 2.57, 1.42 , P <0.01). Compared to medical professionals, those in education and other professions were negatively correlated with having literacy in infectious disease knowledge ( OR =0.37, 0.55, P <0.01). Being a full-time employee, being female, and age were positively correlated with having literacy in infectious disease behavior ( OR =1.66, 2.18, 1.02, P <0.01). Conclusions The level of health literacy for infectious diseases among school doctors in Beijing primary and secondary schools is relatively high. Targeted training on key professional knowledge and skills should be prioritized for individuals with deficiencies in infectious disease prevention and control.

Objective To investigate the epidemiological characteristics and diagnosis of imported Plasmodium malariae and P. ovale malaria cases in Anhui Province, Hubei Province, Zhejiang Province, Guangxi Zhuang Autonomous Region and Henan Province from 2014 to 2021, so as to provide insights into malaria control in these five provinces. Methods All data pertaining to malaria cases reported in five provinces of China were captured from Chinese Disease Control and Prevention Information System from 2014 to 2021, and the epidemiological characteristics of imported P. malariae and P. ovale malaria cases were analysed using a descriptive epidemiological method. The duration from onset of malaria to initial diagnosis, duration from initial diagnosis to definitive diagnosis, institutions of initial and definitive diagnoses, and proportion of correct malaria diagnosis at initial diagnosis were statistically analyzed. Results A total of 1 223 imported P. malariae and P. ovale malaria cases were reported in Anhui Province, Hubei Province, Zhejiang Province, Henan Province and Guangxi Zhuang Autonomous Region from 2014 to 2021, there were 158 P. malariae malaria cases (12.92%) and 1 065 P. ovale malaria cases (87.08%). Totally 98.53% (1 205/1 223) of the imported malaria cases were from Africa, with Angola (18.99%, 30/158), Nigeria (11.39%,18/158), Cameroon (10.76%, 17/158), Ghana (10.13%, 16/158) and the Democratic Republic of the Congo (10.13%,16/158) as predominant countries where P. malariae malaria cases were from, and Ghana (23.19%, 247/1 065), Cameroon (14.74%, 157/1 065), Nigeria (9.39%, 100/1 065) and Angola (6.95%, 74/1 065) as predominant countries where P. ovale malaria cases were from. There were significant differences in the duration from onset of malaria to initial diagnosis (χ² = 27.673, P = 0.000) and duration from initial diagnosis to definitive diagnosis of P. malariae and P. ovale malaria cases (χ² = 29.808, P = 0.000), and the proportions of correct initial diagnosis of P. malariae and P. ovale malaria cases were 38.61% (61/158) and 56.53% (602/1 065). There were 74.69% (118/158) of P. malariae malaria cases with definitive diagnosis in county-, city-, and province-level medical institutions, and 79.25% (844/1 065) of P. ovale malaria cases with definitive diagnosis in county- and city-level medical institutions and county-level centers for disease control and prevention. Conclusions The imported P. malariae and P. ovale malaria cases in Anhui Province, Hubei Province, Zhejiang Province, Henan Province and Guangxi Zhuang Autonomous Region from 2014 to 2021 were mainly returned from Africa and the proportion of correct diagnosis of P. malariae and P. ovale malaria was low at initial diagnosis. Persistent improvements in the diagnostic capability of malaria are required in medical institutions.

Objective: To investigate the knowledge and practice levels on infectious disease among primary and middle school students, so as to provide a basis for targeted infectious disease in health education and infectious disease prevention and control in schools. Methods: The stratified cluster random sampling was used to select 25 670 primary and middle school students from 6 urban area and 10 suburban area in Beijing from October to November in 2020. A questionnaire survey on knowledge and practice of students related to infectious disease prevention and control was conducted using the questionnaire compiled by the Chinese Center for Disease Control and Prevention. Chisquare test was used for group comparison. Results: During the past two weeks, 8.64% students reported sickness absence. The awareness rates of knowledge on infectious disease were 37.64%-93.56%, and the formation rates of practice on infectious disease were between 62.22%-98.74%. The overall awareness rate of knowledge on infectious diseases was 58.58%, and the overall formation tate of practice on infectious disease prevention was 78.19%, with boys (54.14%,73.67%) lower than girls (63.25%,82.94%),urban areas (62.88%,79.12%) higher than suburbans areas (55.30%,77.48%), vocational high school studengs (43.51%,68.13%) lower than nonvocational high school students (elementary school: 56.05%, 85.19%; middle school: 61.66%, 78.63%; high school: 66.72%, 72.77% ), residential students (55.21%,71.59%) lower than nonresidential students (59.32%,79.64%), students living with parents (59.22%,79.30%) higher than those not with parents (54.60%,71.34%), and the differences were statistically significant (χ2=219.08, 148.95, 514.34, 26.44, 27.12; 323.26, 9.91, 536.11, 144.32, 114.11, P<0.05). Conclusions The levels of knowledge and practice regarding relative infectious disease among primary and middle school needs to be improved. Health education on the weak links in knowlege and practice of infectious disease prevention and control should be strengthened to reduce the incidence and transmission of infectious diseases.

Cancer toxin is a specific pathogenesis leading to the heterogeneity of breast cancer.The nature and virulence of the cancer toxin determine the differences in the heterogeneity of breast cancer,which can dynamically evolve over time and space,resulting in varying invasion abilities and characteristics of the tumor.Cancer cells in the primary lesion possess"toxicity"that targets specific organs for metastasis,and cancer toxins can influence the metastatic propensity of different types of breast cancer.Therefore,breast cancer treatment strategies based on the theory of cancer toxins emphasize the continuous eradication of the cancer toxin,focusing on differentiating its strength and nature,protecting unaffected areas first,identifying the state based on symptoms,and targeting accordingly to combat resistance arising from tumor heterogeneity.This article aims to provide a new theoretical basis for the treatment strategies of different types of breast cancer.

Abstract Flood disasters are the common public health emergencies, mainly leading to environmental damage, water pollution, food pollution, vector breeding, infectious disease epidemic and other risk factors of sanitary and anti epidemic work. The guideline has been formulated with reference to the technical documents such as Guideline for Environmental Sanitation Disposal and Preventive Disinfection in Flooded Areas and Technical Proposal for Sanitary and Anti epidemic Measures after Flood Disasters, as well as the latest research progress at home and abroad. In order to guide the sanitary and anti epidemic measures in flooded areas, protect the health and safety of students and teachers and ensure the normal educational and teaching order, the guideline introduces the key measures that should be taken by schools, teachers and students in flood striken areas.

Objective To understand the number and prevalence of chronic filariasis patients in Hubei Province, and to provide a basis for effective care for patients. Methods The chronic filariasis patients registered in Hubei Province were interviewed to investigate the general condition of patients, the results of previous microfilaria examinations, and the current clinical symptoms, signs and onset of illness. Results A total of 487 chronic filariasis patients were investigated. The youngest was 32 years old, the oldest was 97 years old, and the average age was 76 years old. The 80-89 years old group had the largest number, accounting for 44.97%. The male accounted for 46.61%, and the female accounted for 54.39%. The occupation was dominated by farmers, accounting for 89.94%. Patients with lymphangitis accounted for 72.28%, with dermatitis accounted for 89.12%, with chyluria accounted for 11.29%, and with hydrocele accounted for 6.16%. Among the 352 patients with lymphangitis/lymphadenitis, the site of the attack was mainly at groin and lower limbs, accounting for 96.02%. Among the 433 patients with lymphedema/elephantiasis, the disease staging of the left and right legs was mainly concentrated in stage I-III, and there was no stage VII patient. Among the 55 patients with chyluria, the dysuria accounted for 30.91%. Of the 30 patients with hydrocele, 17 had tenderness, and 8 had positive light transmission tests. Conclusions Chronic filariasis patients in Hubei Province gradually decreased with the natural attrition. More care should be given by CDC at all levels and primary medical units to patients with chronic filariasis to alleviate their symptoms and improve their quality of life. Since the filariasis has not been eliminated globally, it is still necessary to strengthen the surveillance of migrant workers who go abroad to filariasis-endemic areas.

Objective To evaluate the effectiveness of the application of Wondfo Rapid Diagnostic Kit (RDTs) in the diagnosis of imported malaria cases in the Malaria Reference Laboratory of Hubei Provence. Methods The complete blood samples of malaria cases and negative card deletion cases reported in Hubei Province from January 2015 to June 2018 were collected and retrospectively analyzed. The results of the provincial malaria reference laboratory were used as the standard, and were compared with those results detected by RDTs, microscopic examination and nested PCR. The differences were statistically analyzed. Results A total of 440 complete samples were collected by the Malaria Reference Laboratory of Hubei Provence, of which 418 samples were confirmed as positive, and 22 samples were confirmed as negative. In terms of the identification ability of P. falciparum, RDTs performed the best, with a coincidence rate of 100.00%, and the coincidence rates nested PCR and microscopic examination were 97.49% and 91.40%, respectively. In terms of the identification specificity for another 3 species of Plasmodium (P. vivax, P. ovarian and P. vivax), nested PCR was the best, the microscopy method was the second best, and RDTs was the lowest. Based on the comprehensive analysis of 12 individual indicators, RDTs had the highest score (32), while the microscopic examination and nested PCR scored 24 and 19, respectively. Conclusion RDTs had certain advantages in the detection of malaria, but they had a low identification specificity for different species. Thus, they can be used as auxiliary tools for microscopic examination and widely used in surveillance work after malaria elimination in Hubei Province.