The Compilation Instructions for Expert Consensus on Clinical Application of Dieda Huoxue capsules systematically expound the development methods and evidence-based basis of this consensus. In view of the weak clinical application evidence and ambiguous indications of Dieda Huoxue capsules， the Institute of Basic Research in Clinical Medicine of the China Academy of Chinese Medical Sciences and Wangjing Hospital took the lead and collaborated with 33 experts from 28 medical institutions nationwide. They strictly followed the World Health Organization （WHO） guideline-making norms and the Grading of Recommendations Assessment， Development and Evaluations （GRADE） evidence-grading system and completed the compilation through multidisciplinary cooperation. The workflow included constructing clinical questions （19 items were screened by the nominal group technique）， retrieving evidence （from Chinese and English databases and grey literature）， assessing safety （integrating drug monitoring data and clinical investigations）， and forming recommendations and consensus suggestions （3 recommendations were reached via the GRADE grid method， and 16 consensus suggestions were reached by the majority vote rule）. The results indicate that the consensus clearly states that this medicine （Dieda Huoxue capsules） is applicable to conditions like traumatic injury， blood stasis-induced pain， and sudden lumbar sprains. The recommended dose is 6 capsules each time， twice a day. Combining oral administration with external application can enhance the efficacy， and elderly patients should take the medicine at intervals. Safety monitoring suggests that it should be used with caution in people with a bleeding tendency and those with an allergic constitution. The compilation process involved three rounds of reviews by internal and external experts. Literature analysis， the Delphi method， and clinical applicability tests were employed to ensure methodological rigor. The compilation instructions comprehensively present key aspects such as project approval and registration， conflict-of-interest statements， and evidence evaluation through 12 appendices， providing methodological support for the clinical translation of the consensus. In the future， it will be continuously improved through a dynamic revision mechanism.

ObjectiveTo explore the characteristics of traditional Chinese medicine （TCM） syndromes in the patients with concurrent knee osteoarthritis （KOA） and postmenopausal osteoporosis （PMOP） and provide a scientific basis for precise TCM syndrome differentiation， diagnosis， and treatment of such concurrent diseases. MethodsA prospective， multicenter， cross-sectional clinical survey was conducted to analyze the characteristics of TCM syndromes in the patients with concurrent PMOP and KOA. Excel 2021 was used to statistically analyze the general characteristics of the included patients. Continuous variables were reported as x¯±s， and binary variables were reported as percentages. UCINET and Gephi were used to construct a complex "isease-syndrome-symptom" network for in-depth mining. Topological structure indicators， edge connection information between nodes， and weighted adjacency matrices were calculated by UCINET and Python. Gephi was used for complex network visualization. ResultsA total of 157 patients with concurrent PMOP and KOA from 12 TCM hospitals or community health service centers were selected for the collection of TCM syndrome and symptom information. A total of 4 main TCM syndromes were obtained， which were kidney-Yang deficiency （47.13%）， liver-kidney Yin deficiency （36.94%）， spleen-kidney Yang deficiency （8.92%）， and kidney Yin-Yang deficiency （7.01%）. In addition， 10 concurrent syndromes （mainly Qi stagnation and blood stasis， Qi and blood deficiency， spleen Yang deficiency， and cold-dampness） were identified. Based on the results of comprehensive frequency statistics and complex network analysis， as well as TCM theoretical knowledge and relevant guidelines， the general characteristics of concurrent PMOP and KOA and the main TCM syndromes in the dimensions of physical symptoms， pain， tongue and pulse manifestations， and defecation and urination were obtained. ConclusionThe main TCM syndromes in the patients with concurrent PMOP and KOA may be kidney Yang deficiency， liver-kidney Yin deficiency， spleen-kidney Yang deficiency， and kidney Yin-Yang deficiency， among which kidney Yang deficiency and liver-kidney Yin deficiency are the core TCM syndromes.

ObjectiveTo explore the characteristics of traditional Chinese medicine （TCM） syndromes in the patients with concurrent knee osteoarthritis （KOA） and postmenopausal osteoporosis （PMOP） and provide a scientific basis for precise TCM syndrome differentiation， diagnosis， and treatment of such concurrent diseases. MethodsA prospective， multicenter， cross-sectional clinical survey was conducted to analyze the characteristics of TCM syndromes in the patients with concurrent PMOP and KOA. Excel 2021 was used to statistically analyze the general characteristics of the included patients. Continuous variables were reported as x¯±s， and binary variables were reported as percentages. UCINET and Gephi were used to construct a complex "isease-syndrome-symptom" network for in-depth mining. Topological structure indicators， edge connection information between nodes， and weighted adjacency matrices were calculated by UCINET and Python. Gephi was used for complex network visualization. ResultsA total of 157 patients with concurrent PMOP and KOA from 12 TCM hospitals or community health service centers were selected for the collection of TCM syndrome and symptom information. A total of 4 main TCM syndromes were obtained， which were kidney-Yang deficiency （47.13%）， liver-kidney Yin deficiency （36.94%）， spleen-kidney Yang deficiency （8.92%）， and kidney Yin-Yang deficiency （7.01%）. In addition， 10 concurrent syndromes （mainly Qi stagnation and blood stasis， Qi and blood deficiency， spleen Yang deficiency， and cold-dampness） were identified. Based on the results of comprehensive frequency statistics and complex network analysis， as well as TCM theoretical knowledge and relevant guidelines， the general characteristics of concurrent PMOP and KOA and the main TCM syndromes in the dimensions of physical symptoms， pain， tongue and pulse manifestations， and defecation and urination were obtained. ConclusionThe main TCM syndromes in the patients with concurrent PMOP and KOA may be kidney Yang deficiency， liver-kidney Yin deficiency， spleen-kidney Yang deficiency， and kidney Yin-Yang deficiency， among which kidney Yang deficiency and liver-kidney Yin deficiency are the core TCM syndromes.

Objective:To establish a gas chromatography-mass spectrometry method(GC-MS-MS)for determining the content of methyl p-toluenesulfonate(MTS),ethyl p-toluenesulfonate(ETS),and isopropyl p-toluenesulfonate(IPTS)in tosufloxacin tosylate hydrate.Methods:The HP-1MS(0.250 mm ×30 m,0.50 μm)column was used at progamming temperature,the injection temperature was 250 ℃.The MS conditions were as follow:the ionization mode was EI,the electron voltage was 70 V,the ion source temperature was 250 ℃,the scanning method was MRM,the quantitative ion pairs for MTS,ETS and IPTS were m/z 91 →65,m/z 155→91 and m/z 91→65.Results:The linearity ranges of MTS,ETS and IPTS were 48.779-975.59 ng·mL-1(r=0.998 5),54.586-1 091.7 ng·mL-1(r=0.998 4)and 46.241-924.82 ng·mL-1(r=0.999 8).The average recoveries were 99.47％,99.15％,98.83％(n=9).The MTS,ETS and IPTS were not detected in the 7 batches of tosufloxacin tosylate hydrate.Conclusion:The established method can be used for the determination of MTS,ETS,and IPTS content in tosufloxacin tosylate hydrate.

Objective:To analyze the impact of the universal coverage,integration and DRG/DIP payment method reform of Basic Medical Insurance(BMI)on the equity of the health service utilization and resource allocation.Methods:The 1998-2022 panel data on health service utilization and resources were collected for China.Health equity is measured using the Concentration Index(CI)and Theil index,and the impact of BMI reform on health equity is analyzed by BP neural network and ITSA.Results:Universal coverage,integration,and DRG/DIP payment reform of BMI had a positive effect on the number of health workers,beds,and admissions(P＜0.001),and inhibited the growth of per capita hospitalization costs(P＜0.05).The CI for the number of health workers and beds declined by 0.004 and 0.003 per year after universal coverage of BMI;and both still declined by 0.002 per year with a 5-year lag(P＜0.05).The CI for the hospital admissions fell by 0.014 immediately after the DRG/DIP payment reform and by 0.012 per year thereafter(P＜0.001).Conclusion:BMI reforms not only can contribute to improve the health service utilization and resources,but also it can also improve health equity.In addition,it has a lagged effect on improving health equity.

Objective:To establish a gas chromatography-mass spectrometry method(GC-MS-MS)for determining the content of methyl p-toluenesulfonate(MTS),ethyl p-toluenesulfonate(ETS),and isopropyl p-toluenesulfonate(IPTS)in tosufloxacin tosylate hydrate.Methods:The HP-1MS(0.250 mm ×30 m,0.50 μm)column was used at progamming temperature,the injection temperature was 250 ℃.The MS conditions were as follow:the ionization mode was EI,the electron voltage was 70 V,the ion source temperature was 250 ℃,the scanning method was MRM,the quantitative ion pairs for MTS,ETS and IPTS were m/z 91 →65,m/z 155→91 and m/z 91→65.Results:The linearity ranges of MTS,ETS and IPTS were 48.779-975.59 ng·mL-1(r=0.998 5),54.586-1 091.7 ng·mL-1(r=0.998 4)and 46.241-924.82 ng·mL-1(r=0.999 8).The average recoveries were 99.47％,99.15％,98.83％(n=9).The MTS,ETS and IPTS were not detected in the 7 batches of tosufloxacin tosylate hydrate.Conclusion:The established method can be used for the determination of MTS,ETS,and IPTS content in tosufloxacin tosylate hydrate.

Objective To analyze the dynamic changes and influencing factors of Mycobacterium tuberculosis(TB)infection in grade-1 students in senior high school at the time of enrollment and one year after enrollment.Methods In 2022,TB screening was carried out among grade-2 students in 4 senior high schools in Binhai and Xiqing Districts of Tianjin.Basic information of students was collected,and TB infection detection results of grade-1 students in senior high school at the time of enrollment were collected retrospectively.Positive rate,strong positive rate and positive conversion rate from tuberculin skin test(TST)results of students were compared.Univariate and multiva-riate logistic regression models were used to analyze the relevant influencing factors for positive conversion of TST results.Results The overall positive rate of 1 839 students one year after enrollment was higher than that at the enrollment(46.82％vs 33.12％),while strong positive rate was lower(12.51％vs 13.00％),both with statisti-cally significant differences(both P＜0.001).One year after enrollment,64 out of 1 230 students who were origi-nally negative for TST in their first year of senior high school turned positive,with a positive conversion rate of 5.20％(95％CI:3.93％-6.48％).One year after enrollment,TST results showed that the average diameter of induration was 5(2,8)mm,diameter was 2(0,5)mm at the enrollment of the first year of senior high school,but the difference was not statistically significant(P=0.478).The difference range of average diameter of induration was±21 mm,39.70％of students being within±2 mm.Students with increased and decreased average diameter of induration accounted for 65.09％and 28.49％,respectively.Multivariate logistic regression analysis result showed that students in boarding school had a higher risk of positive conversion compared with non-boarding school students(OR=4.842,95％CI:2.794-8.392).Conclusion The screening of TB infection among grade-2 students in senior high school should be strengthened,with a focus on boarding school students.Early detection of tuberculosis patients and newly infected individuals can provide reference for implementing precise prevention and control.

Objective:To analyze the impact of the universal coverage,integration and DRG/DIP payment method reform of Basic Medical Insurance(BMI)on the equity of the health service utilization and resource allocation.Methods:The 1998-2022 panel data on health service utilization and resources were collected for China.Health equity is measured using the Concentration Index(CI)and Theil index,and the impact of BMI reform on health equity is analyzed by BP neural network and ITSA.Results:Universal coverage,integration,and DRG/DIP payment reform of BMI had a positive effect on the number of health workers,beds,and admissions(P＜0.001),and inhibited the growth of per capita hospitalization costs(P＜0.05).The CI for the number of health workers and beds declined by 0.004 and 0.003 per year after universal coverage of BMI;and both still declined by 0.002 per year with a 5-year lag(P＜0.05).The CI for the hospital admissions fell by 0.014 immediately after the DRG/DIP payment reform and by 0.012 per year thereafter(P＜0.001).Conclusion:BMI reforms not only can contribute to improve the health service utilization and resources,but also it can also improve health equity.In addition,it has a lagged effect on improving health equity.

Objective To analyze the dynamic changes and influencing factors of Mycobacterium tuberculosis(TB)infection in grade-1 students in senior high school at the time of enrollment and one year after enrollment.Methods In 2022,TB screening was carried out among grade-2 students in 4 senior high schools in Binhai and Xiqing Districts of Tianjin.Basic information of students was collected,and TB infection detection results of grade-1 students in senior high school at the time of enrollment were collected retrospectively.Positive rate,strong positive rate and positive conversion rate from tuberculin skin test(TST)results of students were compared.Univariate and multiva-riate logistic regression models were used to analyze the relevant influencing factors for positive conversion of TST results.Results The overall positive rate of 1 839 students one year after enrollment was higher than that at the enrollment(46.82％vs 33.12％),while strong positive rate was lower(12.51％vs 13.00％),both with statisti-cally significant differences(both P＜0.001).One year after enrollment,64 out of 1 230 students who were origi-nally negative for TST in their first year of senior high school turned positive,with a positive conversion rate of 5.20％(95％CI:3.93％-6.48％).One year after enrollment,TST results showed that the average diameter of induration was 5(2,8)mm,diameter was 2(0,5)mm at the enrollment of the first year of senior high school,but the difference was not statistically significant(P=0.478).The difference range of average diameter of induration was±21 mm,39.70％of students being within±2 mm.Students with increased and decreased average diameter of induration accounted for 65.09％and 28.49％,respectively.Multivariate logistic regression analysis result showed that students in boarding school had a higher risk of positive conversion compared with non-boarding school students(OR=4.842,95％CI:2.794-8.392).Conclusion The screening of TB infection among grade-2 students in senior high school should be strengthened,with a focus on boarding school students.Early detection of tuberculosis patients and newly infected individuals can provide reference for implementing precise prevention and control.

Objective:To investigate the risk factors of atrial fibrillation (AF) in patients with typical atrial flutter after radiofrequency ablation.Methods:This study was a case-control study. The clinical data of 120 patients with typical atrial flutter who underwent radiofrequency ablation in Xingtai People′s Hospital from January 2017 to January 2021 were retrospectively analyzed. Patients were followed up every 3-6 months for a period of 2 years, and AF occurred in 30 patients (25.0%). The risk factors of AF were analyzed with univariate and multivariate logistic regressions.Results:The mean age of patients was (62.0±6.5) years and 64(53.3%) were males. No patients in the two groups had complications such as cardiac tamponade, pulmonary embolism and cerebral infarction after radiofrequency ablation. Compared with non-AF patients, patients in AF group had older age and higher CHA 2DS 2-VASC score ( P<0.001). Multivariate regression analysis showed that age ( HR=1.09, 95% CI:1.01-1.17) and CHA 2DS 2-VASC score ( HR=3.84, 95% CI:1.87-7.89) were independent risk factors for the occurrence of atrial fibrillation after radiofrequency ablation in patients with atrial flutter. Conclusion:After radiofrequency ablation of typical atrial flutter, nearly 25% of patients will relapse into AF, old age and higher CHA 2DS 2-VASC score increase the risk of AF recurrent.