This paper summarizes Professor DING Ying's clinical experience in the treatment of systemic lupus erythematosus （SLE） through differentiation of three states， yin fire， latent fire， and fire toxin. It is proposed that fire pathogenic factors constitute a key pathological element running throughout the entire disease course of SLE. The evolution of its pathogenesis centers on these three states， spleen-kidney deficiency with the initial emergence of yin fire as the onset of disease， damage to yin by medicinal toxicity with internal blazing of latent fire as the driver of disease progression， and the interlocking of blood stasis and heat with intense scorching by fire toxin as the critical factor leading to severe and life-threatening conditions. Corresponding to these three stages， targeted prescriptions are formulated， Jiuwei Yishen Formulation （九味益肾方） to tonify the spleen and kidney， raise yang， and disperse fire； Ziyin Xiehuo Decoction （滋阴泄火汤） to nourish yin and fluids while clearing latent fire； and Santeng Changluo Jiedu Decoction （三藤畅络解毒汤） to dispel blood stasis， unblock the collaterals， detoxify， and restrain fire. This staged and integrated therapeutic strategy aims to address both root and branch and to achieve overall regulation， providing valuable guidance for the clinical differentiation and treatment of SLE.

Purpose: Due to the preservation of the entire stomach after endoscopic resection, the occurrence of metachronous gastric cancer (MGC) remains a possibility. In this study, we investigated the incidence and risk factors for MGC in patients with early gastric cancer who underwent endoscopic submucosal dissection (ESD) and successfully eradicatedHelicobacter pylori. Materials and Methods: A retrospective analysis was conducted of 1,191 patients who underwent ESD and successfully eradicated H. pylori at the Affiliated Drum Tower Hospital of Nanjing University. Endoscopic surveillance was performed at 3, 6, and 12 months post-resection, and annually thereafter. MGC was defined as the development of a new cancer at a site other than the primary gastric cancer site, at least 1 year after the initial endoscopic resection. Results: A total of 77 patients were diagnosed with MGC during a median follow-up of 41.5 months. Kaplan-Meier analysis showed a 5-year cumulative incidence of MGC of 9.4% after successful H. pylori eradication. Multivariate analysis of the training set using Cox proportional hazards models identified male sex, severe atrophic gastritis, multiple gastric cancers before H. pylori eradication, and smoking history as independent risk factors for MGC.The nomogram exhibited favorable discrimination, with area under the curves of 0.767 and 0.822 in the training set and 0.724 and 0.745 in the testing set at 3 and 5 years, respectively. Conclusions Patients with gastric cancer who undergo endoscopic resection, even after successful H. pylori eradication, should undergo annual and continuous endoscopic surveillance for MGC.

Objective:To compare the lung shunt fraction (LSF) of 90Y imaging after 90Y-selective internal radiation therapy (SIRT) and preoperative 99Tc m-macroaggregated albumin (MAA) imaging in patients with liver malignant tumors, and compare the volume and visual score of intrahepatic distribution of both nucleins on SPECT/CT images. Methods:A total of 91 patients with liver malignant tumors (78 males, 13 females; age (56.7±13.7)years; 99 cases) who underwent 90Y-SIRT in the Second Affiliated Hospital of Guangzhou Medical University from November 2022 to June 2024 were retrospectively collected. All patients underwent preoperative 99Tc m-MAA simulation and postoperative 90Y distribution verification by whole-body planar scintigraphy and hepatic SPECT/CT imaging. ROIs of the liver and lungs under the anterior-posterior position were delineated on the planar scintigraphy and LSF of 99Tc m-MAA and 90Y were calculated. The volume of interest (VOI) was drawn on the SPECT/CT images to calculate the nuclide distribution volume of both 99Tc m-MAA and 90Y within the liver. Wilcoxon signed rank test was used to compare the difference between two groups. In addition, the liver was divided into five lobes, namely left lateral lobe, left medial lobe, caudate lobe, right anterior lobe and right posterior lobe. Visual assessment of 90Y and 99Tc m-MAA radioactive distribution was performed ( 90Y and 99Tc m-MAA uptakes were graded on a scale of 0-3, where 0 indicated no nuclide accumulation and 3 indicated heavy accumulation). Kappa consistency test was used to analyze the scores of the corresponding lobes between two groups. Results:LSF for 99Tc m-MAA was 11.60%(4.27%, 15.03%), and LSF for 90Y was 11.80%(9.70%, 13.30%), without significant difference ( Z=-1.50, P=0.134). The distribution volume of 99Tc m-MAA within the liver was 542.63(204.00, 818.00)ml, which was significantly different from that of 90Y (688.69(287.00, 954.00)ml; Z=-7.37, P<0.001). Kappa values of the score of each lobe between 99Tc m-MAA imaging and 90Y imaging were 0.469-0.740 (all P<0.001). Conclusions:99Tc m-MAA simulation is reliable for assessing LSF for 90Y-SIRT. The distribution volume of 99Tc m-MAA is generally smaller than that of 90Y, but the consistency of the visual score of radioactive distribution is high. Overall, 99Tc m-MAA may well simulate the distribution pattern of 90Y-SIRT.

Aging is a physiological process characterized by the gradual decline of the body's functions over time.In recent years, the emergence of molecular hydrogen(H 2)medicine has introduced novel approaches to the field of anti-aging.Numerous animal experiments and clinical trials have demonstrated that H 2 possesses considerable potential to regulate oxidative stress, inflammation, organelle energy metabolism, and programmed cell death, while also offering protective effects on various organs and systems.Currently, H 2 is being utilized in the prevention and treatment of various age-related diseases, thereby opening new avenues for anti-aging interventions.

Objective:To analyze the factors influencing the prognoses of stroke survivors with pseudobulbar palsy (PBP) dysphagia and construct a prediction model.Methods:Data on two hundred and fifty-one stroke survivors with PBP dysphagia were collected and analyzed retrospectively. The subjects were divided into a good prognosis group ( n=164) and a poor prognosis group ( n=87) according to the results of Kubota water swallowing tests administered at discharge. Their clinical data were analyzed using univariate correlation analysis, and the statistically significant independent variables found were further analyzed using multivariate logistic regression to obtain the important predictors of prognosis. R software was then used to assemble the useful factors into a nomogram prediction model. The area under the receiver operating characteristics (ROC) curve was employed to verify the model′s predictive power. Results:According to the univariate correlation analysis, significant differences were found between the two groups′ average National Institutes of Health Stroke Scale (NIHSS) scores, mouth opening grades and ages. The multivariate logistic regression analysis showed that NIHSS score, mouth opening grade and age could be useful and independent predictors of poor prognosis. The ROC curve analysis showed that the area under the curve for the nomogram model was 0.727, with a sensitivity of 59.8% and a specificity of 81.6%, suggesting that the model had good predictive power and was properly calibrated.Conclusions:NIHSS score, mouth opening grade and age are independent predictors of prognosis for stroke patients with PBP dysphagia. The nomogram model constructed in this study is of great value in developing a prognosis for such patients, which is helpful in the prevention and treatment of post-stroke dysphagia.

Objective:To analyze the factors influencing the prognoses of stroke survivors with pseudobulbar palsy (PBP) dysphagia and construct a prediction model.Methods:Data on two hundred and fifty-one stroke survivors with PBP dysphagia were collected and analyzed retrospectively. The subjects were divided into a good prognosis group ( n=164) and a poor prognosis group ( n=87) according to the results of Kubota water swallowing tests administered at discharge. Their clinical data were analyzed using univariate correlation analysis, and the statistically significant independent variables found were further analyzed using multivariate logistic regression to obtain the important predictors of prognosis. R software was then used to assemble the useful factors into a nomogram prediction model. The area under the receiver operating characteristics (ROC) curve was employed to verify the model′s predictive power. Results:According to the univariate correlation analysis, significant differences were found between the two groups′ average National Institutes of Health Stroke Scale (NIHSS) scores, mouth opening grades and ages. The multivariate logistic regression analysis showed that NIHSS score, mouth opening grade and age could be useful and independent predictors of poor prognosis. The ROC curve analysis showed that the area under the curve for the nomogram model was 0.727, with a sensitivity of 59.8% and a specificity of 81.6%, suggesting that the model had good predictive power and was properly calibrated.Conclusions:NIHSS score, mouth opening grade and age are independent predictors of prognosis for stroke patients with PBP dysphagia. The nomogram model constructed in this study is of great value in developing a prognosis for such patients, which is helpful in the prevention and treatment of post-stroke dysphagia.

Objective:To compare the lung shunt fraction (LSF) of 90Y imaging after 90Y-selective internal radiation therapy (SIRT) and preoperative 99Tc m-macroaggregated albumin (MAA) imaging in patients with liver malignant tumors, and compare the volume and visual score of intrahepatic distribution of both nucleins on SPECT/CT images. Methods:A total of 91 patients with liver malignant tumors (78 males, 13 females; age (56.7±13.7)years; 99 cases) who underwent 90Y-SIRT in the Second Affiliated Hospital of Guangzhou Medical University from November 2022 to June 2024 were retrospectively collected. All patients underwent preoperative 99Tc m-MAA simulation and postoperative 90Y distribution verification by whole-body planar scintigraphy and hepatic SPECT/CT imaging. ROIs of the liver and lungs under the anterior-posterior position were delineated on the planar scintigraphy and LSF of 99Tc m-MAA and 90Y were calculated. The volume of interest (VOI) was drawn on the SPECT/CT images to calculate the nuclide distribution volume of both 99Tc m-MAA and 90Y within the liver. Wilcoxon signed rank test was used to compare the difference between two groups. In addition, the liver was divided into five lobes, namely left lateral lobe, left medial lobe, caudate lobe, right anterior lobe and right posterior lobe. Visual assessment of 90Y and 99Tc m-MAA radioactive distribution was performed ( 90Y and 99Tc m-MAA uptakes were graded on a scale of 0-3, where 0 indicated no nuclide accumulation and 3 indicated heavy accumulation). Kappa consistency test was used to analyze the scores of the corresponding lobes between two groups. Results:LSF for 99Tc m-MAA was 11.60%(4.27%, 15.03%), and LSF for 90Y was 11.80%(9.70%, 13.30%), without significant difference ( Z=-1.50, P=0.134). The distribution volume of 99Tc m-MAA within the liver was 542.63(204.00, 818.00)ml, which was significantly different from that of 90Y (688.69(287.00, 954.00)ml; Z=-7.37, P<0.001). Kappa values of the score of each lobe between 99Tc m-MAA imaging and 90Y imaging were 0.469-0.740 (all P<0.001). Conclusions:99Tc m-MAA simulation is reliable for assessing LSF for 90Y-SIRT. The distribution volume of 99Tc m-MAA is generally smaller than that of 90Y, but the consistency of the visual score of radioactive distribution is high. Overall, 99Tc m-MAA may well simulate the distribution pattern of 90Y-SIRT.

Aging is a physiological process characterized by the gradual decline of the body's functions over time.In recent years, the emergence of molecular hydrogen(H 2)medicine has introduced novel approaches to the field of anti-aging.Numerous animal experiments and clinical trials have demonstrated that H 2 possesses considerable potential to regulate oxidative stress, inflammation, organelle energy metabolism, and programmed cell death, while also offering protective effects on various organs and systems.Currently, H 2 is being utilized in the prevention and treatment of various age-related diseases, thereby opening new avenues for anti-aging interventions.

Objective:To observe the clinical efficacy of intermittent feeding through an oral to esophageal (IOE) tube for persons with a late-onset swallowing disorder after radiotherapy for nasopharyngeal carcinoma.Methods:Fifty-six patients with late-onset swallowing difficulties after radiotherapy for nasopharyngeal carcinoma were divided at random into an observation group and a control group, each of 28. In addition to conventional therapy, the controls were fed through an indwelling nasogastric tube (NGT) while an IOE tube was used in the observation group. The nutritional status of the two groups was compared after 20 hours and after 15 days of treatment. Depression, oral feeding ability, leakage and aspiration, and life quality were evaluated using patient health questionnaire-9 (PHQ-9), a functional oral feeding scale (FOIS), a leakage-aspiration scale (PAS), and a swallowing-quality of life (SWAL-QOL) evaluation. From the 3rd day after admission the daily amount fed was recorded.Results:At admission there were no significant differences between the two groups. After 15 days, however, there was significantly greater improvement observed in the average serum albumin, hemoglobin, serum total protein, serum prealbumin level, body mass index(BMI) and SWAL-QOL score of the experimental group compared to the control group, with significantly fewer members suffering from depression. From the 4th day after admission the observation group′s members ate a significantly larger proportion of the target feeding amount.Conclusion:IOE feeding can improve the nutritional status, psychological status, and life quality of persons with a late-onset swallowing disorder more effectively than NGT feeding, with a lower incidence of adverse events.