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A | CARACAS, Venezuela -- Early returns in the Venezuelan opposition's presidential primary gave a big lead to former legislator Maria Corina Machado early Monday, and she quickly claimed victory as the voters' choice to lead the campaign to end the decade-long, crisis-ridden presidency of Nicolás Maduro. The independent National Primary Commission, which organized the primary, did not release any results until long after polling stations closed Sunday, blaming internet censorship. The organizers said that in the first 601,110 ballots counted, about 93% picked Machado, who had entered the vote as a strong front-runner. The rest of the votes were scattered among the other nine candidates. There was no indication of how many people cast ballots in all, and organizers were expected to release additional results throughout Monday.“Today, very powerful forces have been unleashed," Machado told supporters gathered outside her campaign headquarters in the capital, Caracas. “Today, we have shown ourselves what we are capable of doing in the face of all the obstacles, in the face of all the abuses.”Holding Venezuela’s first presidential primary since 2012 required the deeply fractured opposition to work together. Venezuelans, in turn, showed up at voting centers in and outside of their homeland to make it count, enthusiastically lining up for hours despite scorching sun and torrential rain.Still, what they saw as a monumental exercise in democracy could still prove futile, if Maduro’s government wishes.While the administration agreed in principle to let the opposition choose its candidate for the 2024 presidential election, it also has already barred Machado from running for office. Maduro’s government has in the past bent the law, retaliated against opponents and breached agreements as it sees fit.Hundreds of people gathered at voting centers in neighborhoods across Caracas even before polls opened. They stayed in line despite a rainstorm that left them soaking wet. They carried umbrellas, folding stools and coffee to ease the expected waits, and leaned against buildings or stood under marquees to try to avoid the rain. Caracas resident Stephanie Aguilar, 34, cried while she waited to vote. She described the primary as the only “salvation” for her country, her daughter and son, and the millions of Venezuelans who decided they had to emigrate due to the nation’s economic and political turmoil. “We want a better country, a free country, for my children ... who have grown up in this government,” Aguilar, a housewife, said as she wiped tears from her face. “They ask, ‘Mom, can we go out to eat?’ No, there is no money. ‘Mom, can we do this thing?’ No, there is no money. It is unfortunate that a society grows up under those conditions.”Venezuelans typically vote at public schools, but the independent commission that oversaw the primary opted to use homes, churches, private schools and other facilities after electoral authorities did not respond to requests for help in a timely manner.Jesús María Casal, head of the National Primary Commission, blamed the hours-long delay in issuing election results on internet restrictions. “Once we began the process of counting the results ... we detected that our server that functioned as a transmission channel was blocked, which prevents us from completing this process as scheduled,” he said.The London-based internet monitoring firm NetBlocks tweeted metrics showing “a disruption to internet connectivity in #Venezuela with high impact to Caracas." It added that a state-owned internet service provider claimed “an issue with its energy backup system.”David Smilde, an expert on Venezuelan politics at Tulane University, said the primary was a “significant achievement” for several reasons, including forcing political leaders and parties within the opposition “to reach out and speak to the people.”“And it has generated considerable enthusiasm and mobilization in a population that has been skeptical of the opposition leadership of late,” he said.Machado, a proponent of free-market economic policies, is a longtime critic of the governing United Socialist Party of Venezuela. She maintained a somewhat low profile for years but dominated the primary campaign by connecting with the same voters she consistently urged to boycott previous elections.The presidential election is expected to be scheduled for the second half of 2024. Maduro is looking to extend his presidency until 2030, which would surpass the time that Hugo Chávez, his mentor, governed and established his self-described socialist policies.Maduro’s allies ridiculed and dismissed the primary all year. Still, both the government and its opponents used the contest as a bargaining chip to extract concessions from each other as part of a negotiation process meant to end the country’s complex social, economic and political crisis. Maduro and an opposition faction backed by the U.S. government last week agreed to work together on basic conditions for the presidential contest. That prompted the government to release six political prisoners and the Biden administration to lift key economic sanctions. As part of the agreement, Maduro’s administration and the opposition are supposed to “recognize and respect the right of each political actor to select” a presidential candidate freely.If organizers declare Machado the primary's winner, the focus will shift to Maduro to see if the government reverses its ban on her seeking public office. In June, the government issued an administrative decision prohibiting Machado from running, alleging fraud and tax violations and accusing her of seeking the economic sanctions the U.S. imposed on Venezuela in the last decade. The U.S., holding up the threat of renewed sanctions, has given Venezuela until the end of November to establish a process for reinstating all candidates expeditiously.A U.N.-backed panel investigating human rights abuses in Venezuela said last month that Maduro’s government has intensified efforts to curtail democratic freedoms ahead of the 2024 election. That includes subjecting some politicians and other opponents to detention, surveillance, threats, defamatory campaigns and arbitrary criminal proceedings.All registered voters in Venezuela were allowed to participate in the primary, as well as tens of thousands living in several other countries.“This is unprecedented,” said a smiling María de los Ángeles León, 31, the coordinator of Mexico City’s voting site. “People know that we have no guarantees that the winner of this election will be able to advance to the presidential election, but we keep trying.”___Associated Press writer María Verza in Mexico City contributed to this report.。 AI摘要三明沙县区上线AI检验结果互认平台，通过实时质控确保数据同质化，实现全区医疗机构检查结果互认。

B | 此举消除重复检查，减轻患者负担，节约医保基金，推动医改红利惠及基层。东南网8月25日报道（福建日报记者庄紫怡通讯员吴伟）8月17日上午9点，三明市沙县区总医院内科诊室。63岁的刘秀英卷起袖子，露出青色的血管，眼神里却透着一丝抗拒。“医生，我昨天在湖源卫生院刚抽了血，胳膊还青着呢，今天还要再扎一针吗？” 刘秀英家住沙县区最偏远的湖源乡，距离城区40多公里。为了这次复查，她天没亮就坐上了首班农村客车，辗转一个多小时才到医院。沙县区总医院健康管理部负责人、急诊科主任李志强看了一眼检查报告，然后在键盘上轻敲几下，电脑屏幕随即弹出一个绿色的标识，显示“可比对”。

C | “不用了，卫生院的结果我们认。”李志强的话音刚落，刘秀英随即舒展开眉头，长长地松了一口气。“太好了！省得遭罪，还省钱。” 这句看似轻松的“我们认”，背后连接着的，是2025年11月沙县区总医院完成三期建设的检验结果互认实时智能监控平台（以下简称“AI-HR平台”）。这个覆盖全区14家医疗机构、276个互认项目的小小系统，正悄然改变当地百姓的就医体验。

D | 为何“跑”不通 “认”这个字，说起来容易，做起来难。在过去很长一段时间里，检验结果互认是医疗卫生界公认的“硬骨头”。对于刘秀英这样的基层患者来说，“重复检查”曾是家常便饭。“上面不放心下面的结果，大医院不认小医院的单子。”这句抱怨背后，是医患双方共同的隐痛。 “以前看到基层传来的报告，我们心里确实要打鼓。”从事检验工作36年的沙县区总医院临床检验中心主任乐香珠，对此记忆犹新。她忘不了那些场景：乡镇患者拎着化验单辗转而来，却被告知要再抽一管血。患者看着针头，满脸不解与委屈，那一声声“为啥刚抽完又要抽”的埋怨，像针一样扎在医患关系上，让原本就紧张的就诊氛围变得更加沉重。此外，尽管医共体成立后设备统一采购，但基层医疗机构人员流动性大、技术培训不到位、质控体系不完善，导致检验结果“准确度”不够、“精密度”不一。

E | “那时候，我们每年都要下乡督导，拿着放大镜挑毛病，但那是‘人盯人’，总有死角。”沙县区总医院临床检验中心副主任徐俊峰说，在医改进入3.0版“全域健康管护”的阶段，如果不能解决检验结果的同质化问题，就无法真正实现“管健康”的承诺。医患之间的信任链条断了，医保基金的浪费也成了无解的难题。 AI如何把关信任要靠技术手段来托底。

F | 走进沙县区总医院AI-HR平台监控大厅，两面大屏幕泛着幽蓝的光。

G | 乐香珠与徐俊峰并肩而立，目光紧紧锁住屏幕。右侧大屏上，各类波形图谱密密麻麻铺开，右下角“目前暂无失控次数”的字样格外醒目。

H | 左侧大屏则实时滚动着基层分院与总院仪器的比对数据。 “你看，湖源卫生院的数据刚传上来，平台已完成自动比对，完全达标。”乐香珠指向一片绿色柱图，语气释然。

I | 整套系统如精密的神经中枢，正无声守护着全区检验数据的科学性。

J | 这套AI-HR平台不仅“传输快”，而且“脑子活”——它依托AI算法与5G技术，建立了5078个实时质控模型，24小时不间断地监控着全区32台检验设备的“一举一动”。它是如何“看懂”检验结果的？徐俊峰举了个例子：传统的室内质控，只能监控检测质控当时的质量；而AI监控，则是给每台仪器装上了“心电图”和“预言家”。

K | 它不仅能识别当前的数值是否在正常范围，更能通过分析海量历史数据，预判仪器性能的“漂移趋势”。 “几个月前，系统突然发出预警，提示郑湖分院的血细胞分析仪结果出现系统性偏低。”徐俊峰说，“AI没有直接报警，而是给出了‘决策指引’——提示有没有可能是红细胞通道堵塞。工程师远程排查，果然如此。从预警到维护再到结果回稳，全程不到半小时。

L | ” 这种“治未病”的能力，彻底改变了检验质控的模式。如今，屏幕上的绿色代表“在控”，黄色代表“警告”，红色代表“失控”。每一个跳动的绿色光点，都是一份被大数据盖章认证的“信任凭证”。基层有了“靠山” 技术的温度，最终要扎根在基层的泥土里。近日，记者驱车沿着蜿蜒山路，颠簸了近1小时，抵达距离总院43公里的湖源分院。作为沙县区总医院医共体最偏远的末梢，这里曾是医疗质量的“薄弱点”，如今成了AI-HR平台覆盖的“最后一公里”。在分院检验科，31岁的主管技师茅家湘正专注地操作一台全自动血细胞分析仪。“以前最怕遇到复杂的标本，心里没底，特别是碰到危急值，手心里全是汗，生怕哪里操作不规范。”他坦言，过去为了保险起见，遇到拿不准的结果，只能立刻打电话回总院请教，有时专家忙，患者就得干等着。如今，茅家湘的腰杆挺直了。“现在我有‘靠山’了。”他笑着说。

M | 除了每日做室内质控外，再加上总院通过AI系统实时监控患者数据，他就敢放心地在报告单上签字。“感觉总院的专家团队就在我身后站着，隔着40公里帮我盯着数据。

N | ” 一管血的顺畅“漫游”，表面看是技术的进步，深层次却是医改逻辑的重构。

o | 长期以来，检查结果互认推不动，在以药养医、以检养医的旧模式下，医院缺乏减少检查的动力。随着DRG（按疾病诊断相关分组付费）与DIP（按病种分值付费）的落地，医院收入的“水龙头”被拧紧了。 “现在是通过‘结余留用’的机制，倒逼医院主动控费。”沙县区总医院副院长花旺春介绍，在总额预付的前提下，医院通过减少不必要的重复检查，节省下来的资金可以留存在医院用于发展和绩效分配。同时，医院将“互认率”和“质控合格率”纳入医务人员的绩效考核，取代了以往单纯以业务量为指标的分配方式。这就形成了良性循环：AI-HR平台显著降低了质控成本，减少了医保基金的浪费，减轻了患者负担，而医院也因此获得了更好的绩效评价和运营效益。此外，平台还打破了“数据孤岛”，实现了人、机、料、法、环的全流程同质化管理。