Objective To analyze the characteristics of pattern elements and the distribution of patterns of femoral head necrosis, hip osteoarthritis, and hip rheumatoid arthritis, in order to provide a theoretical basis for the "different diseases with the same pattern" of chronic bone diseases. Methods A cross-sectional survey was conducted to select patients with femoral head necrosis Association Research Circulation Osseous Ⅰ-Ⅱ stages, hip osteoarthritis Kellgren & Lawrence Ⅰ-Ⅱ stages, and acute or subacute hip rheumatoid arthritis who visited the Minimally Invasive Arthrology Department, Traumatology Department, and Rheumatology and Immunology Department of Beijing University of Chinese Medicine Third Affiliated Hospital from June 2020 to June 2022. The " case report form - traditional Chinese medicine pattern manifestation scale" previously developed by our team was used to collect the pattern manifestations, which were included into an Excel 2020 spreadsheet to establish a database. SPSS 20.0 software was used for factor analysis and cluster analysis to extract pattern element information, such as disease nature and location, in order to summarize the characteristics of pattern elements, the distribution of patterns, and the similarities and differences of the three kinds of early hip joint diseases.Results A total of 410 patients were included, including 150 patients with femoral head necrosis, 160 patients with hip osteoarthritis, and 100 patients with hip rheumatoid arthritis. The pattern elements of the disease nature of femoral head necrosis include phlegm (dampness), blood stasis, yang deficiency, essence deficiency, and qi deficiency. The pattern types were initially divided into four categories: syndrome of meridian obstruction (43.33％), syndrome of phlegm and blood stasis blocking collaterals (38.00％), syndrome of liver and kidney deficiency (12.00％), and syndrome of kidney essence deficiency (6.67％). The pattern elements of the disease nature of hip osteoarthritis include phlegm (dampness), blood stasis, qi deficiency, essence deficiency, yang deficiency, and cold (dampness). The pattern types were preliminarily divided into five categories: syndrome of spleen and kidney deficiency (37.50％), syndrome of meridian obstruction (26.87％), syndrome of cold and dampness obstruction (18.75％), syndrome of phlegm and blood stasis obstruction (9.38％), and syndrome of liver and kidney deficiency (7.50％). The pattern elements of the disease nature of hip rheumatoid arthritis include phlegm (dampness), blood stasis, qi deficiency, yin and yang deficiency, cold (dampness), and essence deficiency. The pattern types were preliminarily divided into four categories: syndrome of phlegm and blood stasis obstruction (34.00％), syndrome of cold and dampness obstruction (28.00％), syndrome of blood stasis blocking collaterals (23.00％), and syndrome of liver and kidney deficiency (15.00％). Overall, the top five pattern manifestations of the three kinds of hip joint diseases were hip joint pain (96.59％), tenderness (93.90％), fixed pain (87.56％), heavy joints (85.37％), and sourness of lower limbs (75.37％). The pattern elements of the disease nature include phlegm (dampness), blood stasis, qi deficiency, etc. The pattern types were preliminarily divided into five categories: syndrome of phlegm stasis blocking collaterals (33.17％), syndrome of meridian obstruction (31.95％), syndrome of cold dampness obstruction (21.46％), syndrome of liver and kidney deficiency (7.32％), and syndrome of spleen and kidney deficiency (6.10％). There were 21 similar pattern manifestations in the three kinds of early hip joint diseases, with blood stasis and spleen deficiency being the main pattern.Conclusion The common pattern characteristics of three kinds of early hip joint diseases are spleen deficiency and blood stasis. In addition, femoral head necrosis is accompanied with phlegm-dampness pattern, hip osteoarthritis is accompanied with kidney deficiency and phlegm-dampness pattern, hip rheumatoid arthritis is accompanied with kidney deficiency and cold-dampness pattern.

ObjectiveTo investigate the improvement of the efficacy of Osteoking in patients with knee osteoarthritis in the onset and remission stage and to systematically explore its potential intervention mechanism， so as to provide a certain reference for improving the clinical application value of Osteoking and guiding its clinical rational drug use. MethodThrough the real-world study of the treatment of knee osteoarthritis with Osteoking， the data was obtained and entered into the "Osteoking for the treatment of knee osteoarthritis case registration system"， and 105 patients with episodic and remission knee osteoarthritis from the outpatient or inpatient orthopedic department of 20 medical institutions， including the Third Affiliated Hospital of Beijing University of Chinese Medicine， Peking Union Medical College Hospital， Wangjing Hospital of the Chinese Academy of Chinese Medical Sciences and Hunan Aerospace Hospital， from May 1， 2020 to December 31， 2021， were selected in the system. It included 60 patients treated with Osteoking and joint injection， and 45 patients treated with joint injection alone. The WOMAC osteoarthritis index score， visual analogue （VAS） pain score， individual types of pain symptoms （cold pain， hot pain， tingling， dull pain， soreness） and other TCM symptoms were observed and compared between the two groups， and statistically analyzed. In order to further elucidate the potential molecular mechanism of Osteoking combined with joint injection in the treatment of knee osteoarthritis in the treatment of onset and remission， this study used the "Bone Injury Cross Database （http：//bone-xtrans.com/database，BX-Data）" to collect the gene set of knee osteoarthritis disease， the traditional Chinese medicinal materials， chemical composition， material base， candidate target， candidate target， sodium hyaluronate candidate target data for screening， and constructed an interaction network of "disease target". ResultsAmong the 105 patients with knee osteoarthritis enrolled， 15.24% （16/105） were in the episodic period， 84.76% （89/105） were in remission， and there were no convalescent patients. There were 72 cases （68.57%） in women， 33 cases （31.43%） more than men， 60 cases in the observation group and 45 cases in the control group in 105 patients. There were 20 patients with a VAS score of 5 and 19 patients with a score of 6 in the observation group， accounting for 65.00% of the observation group. The comparative results of VAS scores between groups before and after treatment showed that the scores of the two groups were （4.42±1.01） scores， （5.00±1.02） scores.4 weeks after treatment， and （3.12±1.04） scores and （3.56±1.08） scores，8 weeks after treatment， respectively， which were lower than those before treatment （6.23±1.28） scores，（ 6.02±1.22） scores （P<0.05）， and the comparative results of the pain properties of the two groups showed that the improvement rates before and after thermal pain and tingling in the observation group were 3.3%（2/60） and 16.7%（10/60）， respectively. The control group was 2.2% （1/45）and 15.6%（7/45）［（χ²=4.034、13.583，P<0.05）］， respectively， and the improvement rate of cold pain and soreness in the observation group was 5.0%（3/60） and 3.3%（2/60）， which was higher than that of the control group . The results of comparing the WOMAC scores before and after treatment of the two groups showed that the difference between the stiffness score before and after treatment in the observation group was （1.68±1.42） scores， the difference between the score before and after treatment in the control group was （1.20±1.60） scores （P<0.05）， and the pain score before and after treatment was （3.43±2.88） scores， the difference before and after daily activity score was （12.37±10.21） scores， and the total score before and after treatment was （17.48±12.76） scores， which were also higher than those in the control group （2.82±3.29）， （10.80±9.63），（14.82±12.62） scores. The results of comparing the improvement of other symptoms before and after treatment showed that the improvement rate of less sleep and more dreams in the observation group was 28.3%（17/60）， which was significantly higher than that of the control group of 2.2%（1/45）（χ²=5.914，P<0.05）， and the improvement rates of the five symptoms of thirst and drinking， irritability， dry mouth and pharynx， dull complexion and hand， foot and mouth fever in the observation group were 3.3%（2/60）， 10.0%（6/60）， 8.3%（5/60）， 10.0%（6/60） and 5.0%（3/60）， respectively， which were higher than those in the control group -2.2%（1/45）， 2.2%（1/45）， 2.2%（1/45）， 4.5%（2/45）， -6.7%（3/45）. Through network analysis， it was found that the enrichment pathway of Henggu bone wound healing agent mainly acted on the three mechanisms of bone improvement， energy metabolism and anti-inflammatory and analgesic， and the sodium hyaluronate enrichment pathway mainly acted on the anti-inflammatory and analgesic mechanism. ConclusionThe efficacy of Osteoking combined with intra-articular injection of sodium hyaluronate in the treatment of patients with knee osteoarthritis in attack and remission is better than that of sodium hyaluronate alone， especially in anti-inflammatory and analgesic， and the two drugs have synergistic effect. Osteoking may play its role in relieving the symptoms of joint stiffness， tingling， heat pain， and less sleep and more dreams by improving bone quality and regulating the body's energy metabolism pathways， which is worthy of clinical promotion.

Objective To study the association of maternal calcium supplementation and dietary calcium intake with the preterm birth so that to provide scientific basis for effective intervention of preterm birth. Methods Normal pregnant women who were followed up all through to childbirth in Gansu Provincial Maternity and Child Care Hospital were selected. Multivariate logistic regression was used to evaluate the associ-ation of calcium supplementation and intake with preterm birth. Results After confounding factors were adjus-ted, pregnant women who took calcium supplement for more than 3 months before and/or during pregnancy had the risk of preterm birth reduced by 14% which was dose-responding ( OR=0. 86, 95% CI=0. 77-0. 96, P<0. 05). Through stratifying by trimesters of pregnancy, it was found that calcium supplement in the third trimes-ter was a protective factor for preterm birth and especially significant in early and very early pregnancy ( OR=0. 75, 95% CI=0. 62-0. 92, P<0. 05). Through stratifying by dietary calcium intake, pregnant women who took dietary calcium more than 465. 55 mg/d had the risk of preterm birth significantly reduced which was shown by the reduction of preterm birth of different degrees, controlled preterm labor and spontaneous premature dilivery (OR=0. 66, 95% CI=0. 53-0. 82, P<0. 05). Conclusion Appropriate calcium supplementation or dietary calcium intake before and during pregnancy can reduce the risk of preterm birth, which is especially sig-nificant in late pregnancy.

Objective:To optimize the flash extraction process of Isatidis Radix by Box-Behnken experimental design. Methods:A flash extraction method was used with the extraction voltage, material-liquid ratio and extraction time as the independent variables. A Hassan’s method was used to calculate the normalized value(OD) of comprehensive evaluation of the dry extract yield and the epi-goitrin extraction rate in order to establish the mathematical relationship between the comprehensive evaluation OD and the independent variables, and the response surface method was used to predict the best process conditions. Results:The optimum process conditions were as follows:voltage of 88 V, material-liquid ratio of 19. 62, and extraction time of 2. 03 min. The rate of dry extract and epigoitrin extraction was 37. 902% and 0. 1887%, respectively. Conclusion:The measured value is close to the predicted one,which indicates the comprehensive flash extraction parameters optimized by Box-Behnken experimental design can be used for the extraction for Isatidis Radix.

We investigated the carrying status of the virulence genes of Salmonella from different sources in Shijiazhuang City,China,to provide the basic data for the further risk assessment of Salmonella.A total of 186 isolates of Salmonella from different sources were collected and identified serotypes in the area of Shijiazhuang from 2011 to 2016.PCR was performed for eight virulence genes (invA,sopE,agfA,spvR,hilA,stn,pefA,shdA).These Salmonella bacteria were detected in 13 kinds of serotypes.Enteritidis is a significant advantage of the group.The above 8 virulence genes were analyzed,and the virulence genes hilA,stn and invA were the most frequently carried,their respective carrying rate were 90.3％ (168/186),86.6％ (161/186) and 82.8％ (154/186) respectively.We found the virulence genes of Salmonella from different sources were different.It is necessary to take measures to strengthen the food hygiene supervision and prevention and control of the storage and sale of raw poultry stalls in the morning market in Shijiazhuang area.

Objective To study the safety of transfusion of itraconazole through PICC and to evaluate the effect of different amount of blood transfusion before and after the infusion. Methods Patients were recruited from January 1, 2014, until December 31, 2015, in the Hematology hematopoietic stem cell transplantation ward. Thiry-two patients were recruited in the control group. Ninety patients wererecruited in the experience group. They were randomly assigned to three groups with 30 cases each, extracting different amounts of itraconazole before infusion, back phlebotomize in group A, B, C respectively was 10.0, 0.5, 1.0 ml. Comparing the phlebitis and obstruction after ten days from the transfusion day on. Results Catheter obstruction was not observed in any case. There was a significant difference between control group (21.9%,7/32) and observation group (0) regarding the incidence of phlebitis (χ2=21.157,P < 0.05). No statistical difference was noted among the observation groups regarding the incidence of phlebitis (P>0.05). Conclusions Drawing a small amount of blood volume before itraconazole injection through PICC can effectively avoid the drug-induced catheterobstruction. What′s more, transfusion through PICC can significantly reduce the incidence of phlebitis compared with peripheral infusion.

Objective To investigate the differences and characteristics of virulence genes carried by Salmonella enteritidis from different sources in Shijiazhuang City.Methods One hundred and twenty-four strains of Salmonella enteritidis isolated from morning markets of raw and poultry stalls,slaughterhouses and food poisoning specimens in Shijiazhuang area were collected.Eight virulence genes (invA,sopE,agfA,spvR,hilA,stn,pefA,shdA) were detected by polymerase chain reaction (PCR).Results Salmonella enteritidis might have different virulence gene profiles.The above eight virulence genes were detected in different strains.The carrying rate of virulence genes invA,sopE,stn,hilA,spvR and pefA in the food poisoning strains was higher than 94％.There was no difference in the carrying rate of 8 virulence gene between the morning raw poultry stalls isolates and the patient strains,but was different with the slaughterhouse strains.Conclusion There were more risks of food poisoning caused by Salmonella enteritidis from morning markets,and the hygiene supervision should be strengthened to prevent and control foodborne disease.

Objective To improve the quality of the clinical hematologic examination laboratories in national free preconception health examination project by using randomized blind sample test in the external quality assessment (EQA ) schemes .Methods Blind samples for clinical hematologic examination were prepared as higher ,middle ,lower three levels .Samples were dispensed in u‐nified way which included 4 times conventional EQA and in random way which included 1 time blind sample test .Samples will be tested by Clinical hematologic examination laboratories in national free preconception health examination project .The feedback re‐sults were summarized and analyzed by EQA organizer .Results In 4 times of conventional EQA ,the rates of accepted score of 134 laboratories were 72 .4% ,97 .8% ,97 .0% and 98 .5% respectively .The rates of accepted score in last three times were statistically significant higher than that in the first time(P<0 .05) .However ,the rates of accepted score (84 .3% ) in randomized blind sample test were significant lower than that(97 .0% ) in conventional EQA which was conducted at the same time(P<0 .05) .Conclusion The use of randomized blind sample test may help the EQA organizer to find the problems in laboratories participated EQA and find effective way to improve the quality of the laboratories .

Background and objective hTis study aims to explore the effect of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKIs) on the lymphangiogenesis of lung cancer withEGFR mutation, as well as to determine the function of EGFR targeted therapy in relation to the inhibition of lymphangiogenesis during lung cancer treatment.Methods hTeEGFR double mutant lung cancer cell line NCI-H1975 is used to construct lung cancer xenogratf models. hTe models are divided into two groups:the solvent control group and the EGFR-TKI treatment group. Each group includes ifve mice. hTe inhibitory effect of EGFR-TKI on the growth of transplanted tumors was observed. Immunohistochemical method and lymphatic endothelium speciifc antibody D2-40 were used in the experiment to observe the inlfuence of EGFR-TKI on lymphangiogenesis in lung cancer.Results hTe weight and relative volume of tumors in the EGFR-TKI treated group were less than those in the solvent control group. hTe average lymphatic ves-sel density of EGFR-TKI-treated mice was 6.44 per case. hTis value was 10.70 per case in the solvent control group. Lower density of lymphangiogenesis was found in the EGFR-TKI treated group (P=0.023). hTe area and longest diameter of neonatal lymphatic vessel of the EGFR-TKI treated group were less than those of the solvent control group. Moreover, EGFR-TKI exhibited no signiifcant effect on the invasion of tumor cells into the lymphatic vessel (P=0.519).Conclusion EGFR-TKI can inhibit lymphangiogenesis inEGFR mutant lung cancer while suppressing vessel diameter and expansion area.

OBJECTIVETo develop a LC-MS/MS method for determination of astragalin in rat plasma and study its pharmacokinetics in rats.

METHODSThe analytical column was packed with ZORBAX SB-C18, and the mobile phase was methanol-water containing 10 mmol/L ammonium acetate-formic acid (80:20:0.15, V/V/V). Quercetin was used as the internal standard (IS). Multiple reaction monitoring (MRM) mode was employed, and the transition of m/z was m/z 449.1→m/z 287.1 for astragalin, and m/z 301.1→m/z 151.1 for IS.

RESULTSA good liner relationship was obtained within the range of 1.00-1000 ng/ml (r(2)=0.9929), and the lower limit of quantification of astragalin was 1.00 ng/ml in rat plasma. The extraction recoveries were all above 93%. After oral administration of astragalin, the maximum plasma concentration of astragalin was 231.1∓67.3 ng/ml and the time to reach this value was 0.5∓0.1 h, with a half-life of 3.9∓1.3 h and an AUC of 782.6∓152.8 ng·h/ml.

CONCLUSIONThe method is highly sensitive, selective and rapid for determination of the concentration of astragalin in rat plasma to facilitates the study of its pharmacokinetics.