Objective To identify risk factors of progressive pulmonary fibrosis(PPF)development in patients with primary Sj?gren's syndrome-associated interstitial lung disease(pSS-ILD),and to develop and validate a clinically applicable nomogram prediction model.Methods Enrolled 168 pSS-ILD patients from Three Gorges Hospital affiliated to Chongqing University from January 2019 to January 2023,randomly allo-cated into training(n=117)and internal validation(n=51)cohorts at 7∶3 ratio.The training cohort was stratified into the PPF group(n=38)and the non-PPF group(n=79)based on one-year radiographic pro-gression.An external validation cohort(n=24)was prospectively enrolled from February 2023 to April 2024.Multivariable analyses incorporated demographic characteristics,clinical manifestations,laboratory parame-ters,pulmonary function tests,and high-resolution CT(HRCT)imaging features.A nomogram was developed using independent predictors identified through logistic regression.Receiver operating characteristic(ROC)curve,area under curve(AUC),calibration curve,Hosmer-Lemeshow test and decision curve were used to e-valuate the prediction efficiency of the model.Results PPF developed in 31.0%(52/168)of patients within one year.Univariate and multivariate logistic regression analysis showed that age,25 hydroxyvitamin D level and high resolution CT fibrosis score were independent risk factors for PPF phenotype in pSS-ILD patients(P＜0.05).Based on the above predictors,a column-line diagram was constructed.Internal verification showed that the column-line differentiation ability was good(AUC=0.88,95%CI:0.79-0.98),and exter-nal verification showed that the predicted probability of the calibration curve was close to the actual probabili-ty(HL test χ2=9.516,P=0.301),indicating that the model had good consistency.Conclusion Age,serum 25 hydroxyvitamin D level and high resolution CT fibrosis score are independent risk factors for PPF phenotype in pSS-ILD patients.The nomogram model constructed according to the above three predictors has good differentiation and consistency,and could provide a reference for the clinical prediction of PPF in pSS-ILD patients.

Nuanjian Jian(Decoction for Warming Liver Meridian),originating from Jing Yue Quan Shu(Jingyue's Complete Works)written by Zhang Jingyue,is composed of Angelicae Sinensis Radix(Danggui),Lycii Fructus(Gouqizi),Poria(Fuling),Fructus Foeniculi(Xiaohuixiang),Cinnamomi Cortex(Rougui),Linderae Radix(Wuyao),and Aquilariae Lignum Resinatumd(Chenxiang)or Aucklandiae Radix(Muxiang).Nuanjian Jian is a widely-used classical formula for warming the liver and kidneys,promoting qi circulation and alleviating pain.It was included in the Ancient Classical Formulas Catalog(First Batch)published by the National Administration of Traditional Chinese Medicine in 2018,and was primarily used to treat lower abdominal pain,hernia,and other disorders differentiated as the syndrome of cold stagnation in the liver and kidneys.Based on the principles of key information verification for classical formulas,this article systematically reviewed the ancient and modern literature on Nuangan Jian,and conducted a comprehensive textual research and analysis of its origin,composition,dosage,method of making a decoction and taking medicines,processing,modifications,historical and modern applications,and experimental studies.The study concluded that the composition and dosage of this formula are relatively clear.The contemporary single-dose equivalents are calculated as Danggui 9.33 g,Gouqizi 11.19 g,Fuling 7.46 g,Xiaohuixiang 7.46 g,Rougui 5.60 g,Wuyao 7.46 g,and Chenxiang 3.73 g.The decoction is prepared by adding 300 mL of water and 4 g of ginger,boiling until reduced to 140 mL,and taken 2-3 times daily,2 hours after meals.Modern practitioners have expanded the indications of this formula,extending its use from hernia and lower abdominal pain to various disorders in andrology,gynecology,and gastroenterology.The indications have the core pathogenesis of cold stagnation in the liver meridian,and usually affect the liver while also involve the spleen,kidneys,and lower energizer.Diseases of the lower abdomen,genitals,and breasts belonging to the region of the liver-meridian route,are also commonly treated with Nuangan Jian.The findings of this study provide a reference for the further development of this classical formula.

AIM: To investigate the application value of immunotherapy combined with anti-angiogenic drugs and chemotherapy in negative driver gene and advanced non-small cell lung cancer (NSCLC). METHODS: A total of 48 patients with advanced NSCLC and negative driver genes were included and randomly divided into two groups according to 1:1. The observation group received immunotherapy combined with anti-angiogenic drugs and chemotherapy. The control group received conventional standard chemotherapy. The differences between the two groups were analyzed in drug toxicity, side effects and survival status. RESULTS: Objective response rate (ORR) and disease control rate (DCR) were compared to evaluate the short-term efficacy. There was no statistical difference in ORR between the two groups. DCR in the observation group was higher than that in the control group, the difference was significant (P<0.05). The probability of hypertensive proteinuria and hand-foot syndrome in the observation group was significantly higher than that in the control group (P< 0.05). Compared with the control group, the observation group could prolong the mPFS mOS of the patients (P<0.05). CONCLUSION: Immunotherapy combined with anti-angiogenic drugs and chemotherapy can improve the efficacy of negative driver gene and advanced NSCLC, which is tolerated by patients and worthy of clinical application.

From April 1987 to December 1995,146 patients (Pts) with coronary artery disease (CAD) underwent PTCA. There were 133 male & 13 female with a mean age of 58 (33-76) yrs. The total lesions were 425 including 34 (8.0%) lesions in type A,214 (50. 4%) in type B &. 91 (41. 6%) in type C. The PTCA target lesions were 339 with 37 (8. 7%) total occlusion lesions. Twenty-two lesions had severe dissection following balloon dilatation & successful coronary stenting were done immediately. Another 40 stents were implanted for de novo severe proximal vessel lesions. Five Pts underwent rotational ablation & 3 underwent direct coronary atherectomy. Success dilatation was 95. 9% of total Pts & 95. 6 % of total lesions. The average stenosis in diameter reduced from 89. 1% to 9.8% (P