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.

Objectives: To investigate the total fluids intake among college students in spring from Hebei. Methods: In March 2017, the subjects were recruited in a college in Baoding, Hebei Province. 156 students completed the investigation. Total drinking fluids was assessed by 7-day 24-hour fluid intake questionnaire, with a quantitative tool. The water from food was assessed by duplicate portion method. The sources of total fluids intake among subjects were analysed. Results: The age of subjects was (19.8±1.1) years old, including 80 male students. The median amounts of total fluids intake, total drinking fluids and water from food were 2 324, 1 135 and 1 174 ml, respectively. The proportions of total drinking fluids and water from food in total fluids intake were 51%±9% and 49%±10%. Only 19.9% (n=31) and 18.6% (n=29) of college students had adequate total fluids intake and total drinking fluids, according to the recommendation of China. The median amounts of total fluids intake, total drinking fluids and water from food were 3 210, 1 860 and 1 093 ml/d, respectively. The proportion of total drinking fluids in total fluids intake was 61%±7%, which were all higher than those who did not reach the recommended intake (2 158, 1 000, 1 149 ml/d; drinking fluids accounting for 46%±8% of total fluids intake) (P<0.05). Conclusion The amounts of total fluids intake and total drinking fluids of college students in Hebei Province are lower than the recommended intake in China. The contributions of total drinking fluids and water from food to total fluids intake were nearly same.

Objective: To investigate the food source of water of college students from Hebei Province in spring. Methods: In March 2017, the subjects were recruited in a college in Baoding, Hebei Province. 156 students completed the investigation. All foods were collected for 3 consecutive days using duplicate portion study combined with weighing method to test the water content of various foods. To analyze the water content of the food and calculate the proportion to the total amount of food water intake, the edible parts of each meal were divided into staple food, dishes, porridge, soup and snacks. Body mass index (BMI) was grouped according to quartiles, and the differences in food intake and food water sources among subjects of different genders and BMI were compared. Results: The age of subjects was (19.8±1.1) years old, including 80 male students. The median intake of staple food, dishes, porridge, soup and snacks per day was 562 g, 743 g, 111 g, 102 g and 0 g, respectively. The median intake of water from staple food, dishes, porridge, soup and snacks per day was 301 ml/d, 620 ml/d, 97 ml/d, 93 ml/d and 0 ml/d, respectively. The median ratio of water intake to total food water intake of staple food, dishes, porridge, soup and snacks was 27%, 53%, 8%, 8% and 0%, respectively. The median intake of water from staple food and dishes in male students was significantly higher than that of female students (P<0.05). The amount of water intake from porridge of female students was significantly higher than that of male students (P<0.05). There was no significant difference in the water intake from soup and snacks between different genders. There was no significant difference in food intake and food water sources among college students with different BMI (P>0.05). Conclusion The food source of water of college students from Hebei Province in spring is mainly based on dishes and staple foods. The food source of water for boys and girls is different.

Objectives: To investigate the total fluids intake, volume of urine and hydration status among college students from Hebei Province in spring. Methods: In March 2017, the subjects were recruited in a college in Baoding, Hebei Province. 156 students completed the investigation. Total drinking fluids was assessed by 7-day 24-hour fluid intake questionnaire, with a quantitative tool. The water from food was assessed by the duplicate portion method. The urine samples of 24-hour was collected for 3 consecutive days, and the volume, osmolality, pH and specific gravity of urine were measured. Hydration status was grouped to three types according to the urine osmolality (mOsm/kg), namely, optimal hydration (urine osmolality ≤500), middle hydration (500< urine osmolality ≥800) and dehydration (urine osmolality >800), and the differences among subjects in different genders and hydration statuses were compared. Results: The age of all subjects was (19.8±1.1) years old, including 80 male students. The median amounts of total fluids intake, total drinking fluids, water from food and urine volume were 2 324, 1 135, 1 174 and 1 279 ml/d, respectively. The volume of urine among males was 1 272 ml/d, which was not significantly different from that of females (1 304 ml/d) (P>0.05). The osmolality and specific gravity of urine among males were 688 mOsm/kg and 1.017, which were higher than those of females (493 mOsm/kg, 1.014) (P<0.05). But the pH of males was 6.6±0.3, which was lower than that of females (6.7±0.3) (P<0.05). Only 37.2% (n=58) of college students were in optimal hydration status. The median of the amount of total drinking fluids among subjects in optimal hydration status was 301, 448 ml/d higher than that in middle hydration status and dehydration, respectively (P<0.05). The proportion of females in optimal hydration status was 51.3% (n=39), which was higher than that of males 23.8% (n=19) (P<0.05). Conclusion Large proportion of college students in Hebei had lower total drinking fluids than the recommended intake of China, and the volume of urine was equal to the amount of total drinking fluids among the college students. Only 37.2% of college students were in optimal hydration status, and the proportion of female college students in optimal hydration status was larger than that of males.

At present, methods of water-intake survey include government, industry, sector statistics data, dietary survey (24 hours dietary recall, dietary record and food frequency questionnaire), fluid intake survey (retrospective fluid-intake questionnaire, 1-5 days 24 hours fluid-intake survey, 7 days 24 hours fluid-intake record), weighing method with the food composition table, weighing method, duplicate portion method and chemical analysis, and so on. The method of 7 days 24 hours fluid-intake record is an internationally recognized and authoritative method for fluid-intake survey with the highest accuracy, which can reflect the differences of fluid intake between working and non-working days, and can obtain detailed data on behaviors and patterns of fluid water, such as the time, types and places of fluid intake. The method of combining weighing method, duplicate portion method and chemical analysis is used to analyze water intake from food with the highest accuracy, which can be used in an extensive range of population and areas, but with high cost and complex operating steps. It is of great practical significance to compare and evaluate the advantages and disadvantages of different methods about water-intake survey, which will be helpful for researchers to choose appropriate methods for water-intake survey to obtain accurate and representative data in various areas, different population, and complex circumstances.

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.