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Xiao-Yan Wang,1 Xiao-Jing Zhang,2 Xiao Xia,3 Shu-Zhen Chang,4 An-Zhao Wu4 1Infectious Diseases Department II, Shandong Public Health Clinical Center, Jinan, 250000, People’s Republic of China; 2Public Health Department, Shandong Public Health Clinical Center, Jinan, 250000, People’s Republic of China; 3Medical Insurance Office, Shandong Public Health Clinical Center, Jinan, 250000, People’s Republic of China; 4TCM & Western Medicine Department, Shandong Public Health Clinical Center, Jinan, 250000, People’s Republic of ChinaCorrespondence: An-Zhao Wu, TCM & Western Medicine Department, Shandong Public Health Clinical Center, 2999 Gangxing West Road, High Tech District, Jinan, 250000, People’s Republic of China, Tel +86 531-86568184, Email anzhaowu564@outlook.comObjective: This study aimed to analyze the epidemiological and clinical characteristics of measles in Jinan, Shandong, China, over a 32-year stage to facilitate measles prevention in the future.Methods: Data on measles cases from 1991 to 2022 were obtained from the public health department and medical records of patients at Shandong Public Health Clinical Center. Retrospective analysis was conducted on the distribution of measles cases in different years, months, and age groups, and observation of the differences in clinical manifestations and complications among different age groups.Results: From January 1991 to December 2022, 7531 measles cases were recorded at Shandong Public Health Clinical Center. During the 32-year period, there were two outbreaks of measles in 2008 and 2016, respectively. During the COVID-19 pandemic period from 2020 to 2022, the number of cases reached the lowest point in the past 30 years. The number and percentage of cases in the 0– 1y groups was significantly higher than in other age groups, and 97.75% patients in this group did not receive measles vaccine. Complications such as pneumonia and myocarditis appeared more frequent in patients under 12 years of age, but liver function damage is more common in adult patients.Conclusion: Although the measles epidemic has been greatly controlled since the use of measles vaccine, intermittent outbreaks still exist, so there is still a long way to go to eliminate measles. The proportion of infants under the age of 1 without measles vaccine and adults over 24 years old accounts for nearly 80% of the total. This group of people should be of concern, and feasible measures should be designated to protect these susceptible populations.Keywords: measles, epidemiology, clinical characteristics, vaccination, China

Background Herbal Reference Extracts (HREs) have been used for the overall quality control (QC) of Traditional Chinese Medicines (TCMs) and used as an effective strategy for solving the shortage of reference standards in quality evaluation of TCMs in recently years. But the preparation and evaluation of it has rarely been reported. The ideal HREs should be a combination of Chemical Reference (CR) and Efficacy Reference (ER). However, it is not realistic to achieve "completely extracted" of TCMs at the present stage. Quality markers (Q-markers) provides a series of effective and scientific strategies for QC of TCMs. And Q-markers-based HREs should be a meaningful attempt to promote the standardization of quality evaluation system for TCMs. Purpose Preparation adequate HREs based on the principles of Q-markers, and used for quality evaluation of relevant preparation products. Then propose the general procedure for establishing HREs used for identification. Methods The authenticity, specificity, consistency and stability (ASCS) were the four essential principles of HREs. In this study, we chose Aurantii Fructus as an example, Firstly, selected 7 Q-markers of it which has the properties of specificity, effectiveness and testability based on the combination of analytic hierarchy process and entropy weight method (AHP-EWM). Secondly, preparated its reference extract which is called Orange Fruit Reference Extract (OFRE) based on ASCS and its Q-markers. Thirdly, established the QC method of OFRE according to its usage requirements. And finally, demonstrated its application of the thin layer chromatography (TLC) identification and characteristic chromatogram identification in the Orange fruit formula granule (or called Zhiqiao Peifangkeli, ZQPK). Results Compared with the Herbal Reference Substance (HRS) which with characteristic appearance or morphological structure, OFRE can be used for TLC identification of ZQPK conveniently, without complicated extraction or purification steps. And in the analysis of characteristic chromatogram of ZQPK, the OFRE can provid a rather simple profile, the main naringin, neohesperidin, nobiletin and tangeretin were clearly separated, which indicated that the OFRE could be used to identify the characteristic chromatogram of ZQPK and reduce the use of Chemical Reference Substance (CRS). And finally, we propose the general procedure for establishing HREs used for identification. Conclusion In summary, Q-markers-based HREs is feasibility, and should have a broader application prospect. And this research concept can serve as a reference for study on preparation, evaluation and application of HREs used for identification.