[Objective]To re-examine ZHU Danxi's"Theory of Ministerial Fire"under the influence of the Neo-Confucian doctrine of"cultivating moral nature and controling emotion wth moral consciousness",tracing its philosophical origins,revealing its philosophical connotations,clarifying its philosophical value,and guiding its medical applications.The aim is to refine the theoretical research on the Theory of Ministerial Fire and enhance its clinical utility.[Methods]Based on ZHU Danxi's medical works such as Gezhi Yulun(Supplemental Treatise on Extending Knowledge Through Scrutiny of Principles)and Jufang Fahui(Elucidation of the Formulas of the Imperial Pharmacy Bureau),supplemented by medical theories from Huangdi Neijing(The Inner Canon),LIU Wansu,and others,as well as Neo-Confucian writings by ZHOU Dunyi,ZHU Xi,and others,this study employs methodologies from traditional Chinese medicine(TCM)and Chinese philosophy,including literature review and comparative analysis.It explores key questions such as the origin of ministerial fire in the human body,what governs it,and how it is regulated.[Results]The philosophical foundation of ZHU Danxi's"Theory of Ministerial Fire"lies in his intellectual lineage from the"Beishan school"and his inheritance of"CHENG-ZHU Neo-Confucianism".Among these influences,ZHU Xi's doctrine of"cultivating moral nature and controling emotion wth moral conscious-ness"had a particularly profound impact on Danxi's theory.This doctrine posits that human consciousness and perception("the mind")can cultivate moral essence("nature")and regulate emotional-desire activities("emotions").The philosophical connotation of Danxi's"Theory of Ministerial Fire"is that"ministerial fire"arises from desire-driven"emotions"but is rooted in moral"nature".The sovereign fire represents the conscious"mind",which governs ministerial fire.Danxi advocates using Neo-Confucian moral cultivation methods such as"tranquility and desirelessness"and"letting the moral mind prevail"to restrain the"reckless movement"of ministerial fire while maintaining its"constant motion".The philosophical value of Danxi's theory lies in its embodiment of the Zhejiang academic tradition of"practical statecraft",its reflection of the Yuan Dynasty's intellectual trend of"harmonizing ZHU Xi and LU Xiangshan's philosophies",and its influence on later medical developments that"invoking Neo-Confucianism to guide medicine".In medical practice,to sustain the"constant motion"of ministerial fire and ensure health,Danxi emphasizes both moral cultivation and the use of herbal formulas,such as Dabuyin Piu(Great Yin Supplementation Pill)to nourish Yin and suppress fire.This approach earned him recognition as the founder of the"Nourishing Yin school".[Conclusion]The"Theory of Ministerial Fire"is a core medical theory of ZHU Danxi shaped by Song-Yuan Neo-Confucianism and a key representative of the"invocation of Neo-Confucianism to guide medicine"during the Jin-Yuan period,remaining relevant to modern medical practice.Rich in philosophical depth,the theory's essence lies in unifying"moral cultivation"and"health preservation",asserting that nurturing virtue is synonymous with preserving life.This not only infuses ZHU Xi's doctrine of"cultivating moral nature and controling emotion wth moral consciousness"with tangible medical significance,guiding clinical practice,but also constructs a metaphysical philosophical framework for Danxi's theory,illuminating its Neo-Confucian brilliance.

Guided by ZHANG Jiebin's "water-fire of life gate theory"， this paper explored the etiology， pathoge-nesis， and syndrome differentiation-based treatment approach for esophageal cancer. It is proposed that the core pathogenesis of esophageal cancer， derived from the imbalanced state of water and fire in life gate， can be summarized into three manifestations. Firstly， decline of life gate fire leads to failure of qi transformation and accumulation of phlegm and blood stasis； secondly， fire fails to warm the earth resulting in dysfunctional ascending and descending， and qi stagnation and blood stasis； thirdly， deficiency of life gate water contributs to proliferation of cancerous toxins and physical deterioration. In terms of treatment， guided by ZHANG's treatment principles for dysphagia， three treatment methods are proposed， warming and tonifying kidney yang to promote qi transformation through steaming action， warming and nourishing the spleen and stomach to restore central pivot movement， and nourishing kidney water to replenish essence and blood， then support bodily nourishment. Clinical case examples are provided to illustrate the application of these methods.

Objective:The impact and mechanism system of the National Centralized Volume-Based Procurement(NCVBP)on innovation investment in pharmaceutical companies.Methods:Based on listed company data from 2015 to 2023,it uses the first eight rounds of NCVBP as a quasi-natural experiment and applies a staggered difference-in-differences model to control the industries and year fixed effects,test the impact of NCVBP on innovation investment in pharmaceutical companies,conduct the parallel trend and placebo test,and verify the robustness of the results.Results:The innovation investment of the winning enterprises was significantly increased by NCVBP.The ratio of Research&Development expenses to operating revenues of winning firms in the next quarter increases by 1.4%.The centralized procurement promotes innovation investment by enhancing the cost efficiency of enterprises and strengthening market competition in the industry.Conclusion:Collective purchasing significantly increases the innovation investment of winning enterprises,the improvement of cost efficiency is an important influence path to improve the innovation investment of enterprises.The industry market competition has a significant moderating effect on the collective purchasing and the innovation investment of enterprises;the national drug collective purchasing system can be improved from the aspects of innovation incentives,communication system,market competition,and so on.

[Objective]To explore Professor XU Guangxing's experience in differentiating and treating gastric cancer based on the"Yangming Weihe(stomach closed)"theory.[Methods]Through clinical shadowing,organizing and analyzing medical cases,and studying relevant literature,combined with Professor XU Guangxing's understanding of gastric cancer,this paper summarizes his experience in differentiating and treating gastric cancer based on the"Yangming Weihe"theory from the perspectives of theoretical connotation,etiology,pathogenesis and medication strategies.A medical case is included for validation.[Results]The theory of"Yangming Weihe"originates from the opening-closing-pivot theory.The Yangming closing mechanism serves as a component of the ascending and descending movement of Qi in the human body.Together with the Taiyin opening mechanism and the Jueyin closing mechanism,it collectively regulates the physiological functions of the stomach.Professor XU Guangxing proposes that the etiology and pathogenesis of gastric cancer can be categorized into three patterns:dysfunction of the Yangming closing mechanism;impaired Taiyin-Yangming opening-closing coordination;dual dysfunction of the Jueyin-Yangming closing mechanisms.His therapeutic strategies focus on:clearing heat,moistening dryness and promoting descending with bitter flavors to unblock Yangming;strengthening the spleen and harmonizing the middle-Jiao to support the opening-closing mechanism;dispersing wind pathogens and consolidating dissipation to restore the dual closing mechanisms.The attached medical case involved a postoperative gastric cancer patient,diagnosed as dual Jueyin-Yangming closing mechanism failure according to the"Yangming Weihe"theory.The treatment protocol emphasized:clearing dryness,nourishing Yin and unblocking-tonifying Yangming;dispersing wind,astringing dissipation and consolidating-descending Jueyin.The herbal regimen achieved stable and positive outcomes.[Conclusion]Professor XU Guangxing's approach to treating gastric cancer based on the"Yangming weihe"theory is characterized by unique insights into the etiology and pathogenesis,distinctive features in syndrome differentiation and treatment,and notable clinical efficacy.This methodology merits further research and broader promotion.

Objective:The impact and mechanism system of the National Centralized Volume-Based Procurement(NCVBP)on innovation investment in pharmaceutical companies.Methods:Based on listed company data from 2015 to 2023,it uses the first eight rounds of NCVBP as a quasi-natural experiment and applies a staggered difference-in-differences model to control the industries and year fixed effects,test the impact of NCVBP on innovation investment in pharmaceutical companies,conduct the parallel trend and placebo test,and verify the robustness of the results.Results:The innovation investment of the winning enterprises was significantly increased by NCVBP.The ratio of Research&Development expenses to operating revenues of winning firms in the next quarter increases by 1.4%.The centralized procurement promotes innovation investment by enhancing the cost efficiency of enterprises and strengthening market competition in the industry.Conclusion:Collective purchasing significantly increases the innovation investment of winning enterprises,the improvement of cost efficiency is an important influence path to improve the innovation investment of enterprises.The industry market competition has a significant moderating effect on the collective purchasing and the innovation investment of enterprises;the national drug collective purchasing system can be improved from the aspects of innovation incentives,communication system,market competition,and so on.

[Objective]To re-examine ZHU Danxi's"Theory of Ministerial Fire"under the influence of the Neo-Confucian doctrine of"cultivating moral nature and controling emotion wth moral consciousness",tracing its philosophical origins,revealing its philosophical connotations,clarifying its philosophical value,and guiding its medical applications.The aim is to refine the theoretical research on the Theory of Ministerial Fire and enhance its clinical utility.[Methods]Based on ZHU Danxi's medical works such as Gezhi Yulun(Supplemental Treatise on Extending Knowledge Through Scrutiny of Principles)and Jufang Fahui(Elucidation of the Formulas of the Imperial Pharmacy Bureau),supplemented by medical theories from Huangdi Neijing(The Inner Canon),LIU Wansu,and others,as well as Neo-Confucian writings by ZHOU Dunyi,ZHU Xi,and others,this study employs methodologies from traditional Chinese medicine(TCM)and Chinese philosophy,including literature review and comparative analysis.It explores key questions such as the origin of ministerial fire in the human body,what governs it,and how it is regulated.[Results]The philosophical foundation of ZHU Danxi's"Theory of Ministerial Fire"lies in his intellectual lineage from the"Beishan school"and his inheritance of"CHENG-ZHU Neo-Confucianism".Among these influences,ZHU Xi's doctrine of"cultivating moral nature and controling emotion wth moral conscious-ness"had a particularly profound impact on Danxi's theory.This doctrine posits that human consciousness and perception("the mind")can cultivate moral essence("nature")and regulate emotional-desire activities("emotions").The philosophical connotation of Danxi's"Theory of Ministerial Fire"is that"ministerial fire"arises from desire-driven"emotions"but is rooted in moral"nature".The sovereign fire represents the conscious"mind",which governs ministerial fire.Danxi advocates using Neo-Confucian moral cultivation methods such as"tranquility and desirelessness"and"letting the moral mind prevail"to restrain the"reckless movement"of ministerial fire while maintaining its"constant motion".The philosophical value of Danxi's theory lies in its embodiment of the Zhejiang academic tradition of"practical statecraft",its reflection of the Yuan Dynasty's intellectual trend of"harmonizing ZHU Xi and LU Xiangshan's philosophies",and its influence on later medical developments that"invoking Neo-Confucianism to guide medicine".In medical practice,to sustain the"constant motion"of ministerial fire and ensure health,Danxi emphasizes both moral cultivation and the use of herbal formulas,such as Dabuyin Piu(Great Yin Supplementation Pill)to nourish Yin and suppress fire.This approach earned him recognition as the founder of the"Nourishing Yin school".[Conclusion]The"Theory of Ministerial Fire"is a core medical theory of ZHU Danxi shaped by Song-Yuan Neo-Confucianism and a key representative of the"invocation of Neo-Confucianism to guide medicine"during the Jin-Yuan period,remaining relevant to modern medical practice.Rich in philosophical depth,the theory's essence lies in unifying"moral cultivation"and"health preservation",asserting that nurturing virtue is synonymous with preserving life.This not only infuses ZHU Xi's doctrine of"cultivating moral nature and controling emotion wth moral consciousness"with tangible medical significance,guiding clinical practice,but also constructs a metaphysical philosophical framework for Danxi's theory,illuminating its Neo-Confucian brilliance.

[Objective]To explore Professor XU Guangxing's experience in differentiating and treating gastric cancer based on the"Yangming Weihe(stomach closed)"theory.[Methods]Through clinical shadowing,organizing and analyzing medical cases,and studying relevant literature,combined with Professor XU Guangxing's understanding of gastric cancer,this paper summarizes his experience in differentiating and treating gastric cancer based on the"Yangming Weihe"theory from the perspectives of theoretical connotation,etiology,pathogenesis and medication strategies.A medical case is included for validation.[Results]The theory of"Yangming Weihe"originates from the opening-closing-pivot theory.The Yangming closing mechanism serves as a component of the ascending and descending movement of Qi in the human body.Together with the Taiyin opening mechanism and the Jueyin closing mechanism,it collectively regulates the physiological functions of the stomach.Professor XU Guangxing proposes that the etiology and pathogenesis of gastric cancer can be categorized into three patterns:dysfunction of the Yangming closing mechanism;impaired Taiyin-Yangming opening-closing coordination;dual dysfunction of the Jueyin-Yangming closing mechanisms.His therapeutic strategies focus on:clearing heat,moistening dryness and promoting descending with bitter flavors to unblock Yangming;strengthening the spleen and harmonizing the middle-Jiao to support the opening-closing mechanism;dispersing wind pathogens and consolidating dissipation to restore the dual closing mechanisms.The attached medical case involved a postoperative gastric cancer patient,diagnosed as dual Jueyin-Yangming closing mechanism failure according to the"Yangming Weihe"theory.The treatment protocol emphasized:clearing dryness,nourishing Yin and unblocking-tonifying Yangming;dispersing wind,astringing dissipation and consolidating-descending Jueyin.The herbal regimen achieved stable and positive outcomes.[Conclusion]Professor XU Guangxing's approach to treating gastric cancer based on the"Yangming weihe"theory is characterized by unique insights into the etiology and pathogenesis,distinctive features in syndrome differentiation and treatment,and notable clinical efficacy.This methodology merits further research and broader promotion.

[Objective]To explore the connotation of neo-Confucianism in ZHU Danxi medicine.[Methods]Combining the research methods of medicine and philosophy,based on ZHU Danxi's medical writings and related knowledge of neo-Confucianism,the connotation of neo-Confucianism of Danxi medicine was discussed from three aspects:"cognition view""sports view""cultivation view".[Results]ZHU Danxi was influenced by the thought of"one principle and different justics"and regarded medicine as the way to practice Confucian ideal.Using the understanding method of"thinking phyics",ZHU Danxi put forward some important medical theories such as"the theory of excess of Yang and deficiency of Yin"and"the theory of fire".Based on the concept of"movement was the heart of heaven and earth",the important significance of Qi movement and constant movement of"Xiang fire"to human life was realized.Based on the sports concept of"extreme things must be reversed"and"the gentleman should be careful to move",the author realized the great harm to the human body caused by the rash movement of"fire"and advocated the idea of"careful movement"for health preservation.Based on the cultivation view of"heart regulating temperament",the author put forward"king fire mastering prime minister fire",emphasized the active role of"heart"of"king fire",cultivated the"nature"of morality,controlled the"emotion"of desire,and maintained the constant movement of"corresponding fire"and supplemented life.Applying the cultivation view of"mastering static without desire"to health but disease required that through tempering appetite and lust,people's natural desires conformed to the Confucian"reason",in order to be no severely ill and spend the whole life.[Conclusion]ZHU Danxi's medical science is rich in connotation,which is a powerful witness of the influence of the reform of Confucianism on medical innovation in Song and Yuan Dynasties.On the one hand,Danxi's"aid theory into medicine"built a strong support for medical innovation,and made his medical theory rise to the height of"heaven theory",so that he was convinced in the Jinyuan period of medical contention;On the other hand,it also demonstrated the all-encompassing universality and supreme authority of"heavenly principles"as cosmic laws.

Objective:To explore the value of clinical and biparametric magnetic resonance imaging(bpMRI)in diagnosing extraprostatic ex-tension(EPE)of prostate cancer(PCa).Methods:This retrospective study assigned 107 patients into EPE(n=42)and organ-limited(n=65)groups based on their postoperative pathology after radical prostatectomy from August 2018 to May 2024 at Wuhu Second People's Hospit-al.The differences in the following clinical risk indicators were compared between the groups:age,total prostate specific antigen(tPSA),pro-state volume,prostate specific antigen density(PSAD)and International Society of Urological Pathology(ISUP)score for prostate puncture.The differences in MRI indicators,prostate imaging reporting and data system(PI-RADS)score and bpMRI were also identified.Binary Logist-ic regression analysis was used to construct clinical and joint models for diagnosing EPE,and screening independent influencing factors.The ROC curve analyze the independent influencing factors and diagnostic performance of the models.The DeLong test was used to compare the differences between the AUC models.A nomogram was draw,and performance evaluated.Results:The differences in tPSA,PSAD,ISUP score for prostate puncture,PI-RADS score,and bpMRI were statistically significant between the two groups(P<0.05).The clinical model AUC was 0.821;while the AUCs of the combined model and independent influencing factors PSAD(OR=25.992),ISUP score for prostate puncture(OR=1.676),and bpMRI(OR=10.729)were 0.899,0.813,0.770,and 0.793 respectively(P<0.001).The combined model was superior to the clinical model(Z=2.502 and P=0.012).The average AUC for 5-fold cross-validation was 0.887,with high model calibration and a threshold range of 5%-85%,indicating clinical benefits.Conclusions:The combined model nomogram derived from clinical and bpMRI indicators is highiy valuable for diagnosing PCa EPE.

Objective:To analyze the effect of meteorological conditions on mortality and population susceptibility of patients with acute myocardial infarction (AMI) in the Shantou area and to provide a scientific basis for the local public health system to prevent AMI.Methods:The AMI mortality data recorded in the resident cause of death surveillance database of Shantou from January 1, 2015, to December 31, 2020, were collected and the distribution lag nonlinear model was used to analyze the diurnal temperature range (DTR) and relative humidity (RH) on AMI mortality and the lag effect.Results:There were 13 932 deaths due to AMI in Shantou during the study period, with a male-to-female sex ratio of 1.3∶1. There was a significant association between high diurnal temperature difference exposure and low RH exposure and AMI deaths, with both single-day lag effects appearing and reaching a maximum at lag 2 day ( RR=1.019, 95% CI: 1.000-1.039; RR=1.018, 95% CI: 1.003-1.034); the cumulative lag effect was all maximal at lag 0-14 day ( RR=1.199, 95% CI: 1.025-1.401; RR=1.279, 95% CI: 1.117-1.465). The elderly (≥75 years) and female populations were susceptible to high DTR exposure and low RH exposure conditions. Conclusions:There was a significant association between DTR and RH and mortality of AMI in Shantou with a significant lag in their effects. Both female and elderly populations ≥75 years old were susceptible populations under high DTR and low RH exposure conditions.