ObjectiveThis study aimed to investigate whether Bushen Tongluo prescription inhibits macrophage polarization by regulating the Wnt3a/β-catenin signaling pathway， thereby reducing epithelial-mesenchymal transition and excessive extracellular matrix deposition， in order to elucidate the anti-pulmonary fibrosis mechanisms of Bushen Tongluo prescription and provide a new theoretical basis for the clinical treatment of pulmonary fibrosis. MethodsFifty male Sprague-Dawley （SD） rats were randomly divided into a blank group， model group， pirfenidone group， and high- and low-dose Bushen Tongluo prescription groups. Except for the blank group， the pulmonary fibrosis model was established by intratracheal instillation of bleomycin. Intervention was initiated on day 28 after modeling. The high- and low-dose Bushen Tongluo prescription groups were administered Bushen Tongluo prescription at doses of 30.88， 15.44 g·kg^-1， respectively， by intragastric gavage. The pirfenidone group was administered pirfenidone capsules at 110 mg·kg^-1 by intragastric gavage. The blank and model groups were given an equal volume of normal saline by gavage， once daily for 90 days. After treatment， the level of transforming growth factor-β₁ （TGF-β₁） in bronchoalveolar lavage fluid （BALF） was detected by enzyme-linked immunosorbent assay （ELISA）. Morphological changes in lung tissue and the collagen volume fraction were compared. The protein distribution and expression of E-cadherin， cytokeratin 19， α-smooth muscle actin （α-SMA）， vimentin， collagen type Ⅰ （Col Ⅰ）， and collagen type Ⅲ （Col Ⅲ） in lung tissue were detected by immunohistochemistry. The protein distribution and expression of CD68， arginase-1 （Arg-1）， inducible nitric oxide synthase （iNOS）， Wnt3a， and β-catenin in lung tissue were detected by immunofluorescence. The protein expression of Wnt3a and β-catenin in lung tissue was detected by Western blot， and the mRNA expression of Wnt3a and β-catenin was detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. ResultsCompared with the blank group， a large number of inflammatory cells infiltrated the airway walls， alveolar spaces， and interstitial tissue in the model group， with obvious fibrous tissue hyperplasia. The level of TGF-β₁ in BALF was significantly increased. The protein expression of E-cadherin and cytokeratin 19 in lung tissue was decreased， whereas the protein expression of α-SMA， Vimentin， Wnt3a， β-catenin， Col Ⅰ， and Col Ⅲ was increased. The fluorescence-positive area ratios of CD68， Arg-1， iNOS， Wnt3a， and β-catenin in lung tissue were increased. The protein and mRNA expression levels of Wnt3a and β-catenin in lung tissue were significantly increased （P<0.01）. Compared with the model group， all treatment groups showed varying degrees of improvement in inflammatory cell infiltration and fibrous tissue hyperplasia in the airway walls， alveolar spaces， and interstitial tissue， decreased TGF-β₁ levels in BALF， increased protein expression of E-cadherin and cytokeratin 19 in lung tissue， decreased protein expression of α-SMA， Vimentin， Col Ⅰ， and Col Ⅲ， decreased fluorescence-positive area ratios of CD68， Arg-1， iNOS， Wnt3a， and β-catenin in lung tissue， and decreased protein and mRNA expression levels of Wnt3a and β-catenin in lung tissue （P<0.05， P<0.01）. ConclusionBushen Tongluo prescription can improve bleomycin-induced pulmonary fibrosis in rats by inhibiting epithelial-mesenchymal transition and reducing excessive extracellular matrix deposition. The mechanism may be related to inhibition of the Wnt3a/β-catenin signaling pathway and the macrophage polarization mediated by this pathway.

Pulmonary sarcoidosis is an immune system disease with an unclear etiology. Guided by the yang-reinforcing method， it is believed that the fundamental pathogenesis of pulmonary sarcoidosis lies in the disharmony between water and fire and the reckless movement of the ministerial fire. The failure of the spleen and stomach to maintain warmth， leading to the production of phlegm and blood stasis， is an important pathogenesis. The invasion of external pathogenic toxins， deeply penetrating into the interior， is considered a triggering factor for the disease. The treatment focuses on supplementing the yang， consolidating the kidney， drawing fire back to its source， warming the yang， benefiting the kidney， and nourishing the spleen to generate metal. It also emphasizes unblocking the yang， transforming turbidity， and eliminating phlegm and blood stasis.

Objective The aim of this study was to analysis the incidence and mortality of malignant tumors in the cancer registration area of Kunming City in 2020,as well as the trend of changes from 2016 to 2020.Methods The malignant tumor data of 12 cancer registration areas in Kunming in 2020 that met the quality criteria were used to analyze the crude incidence,crude mortali-ty,age-standardized incidence/mortality rate by Chinese standard population(ASIRC/ASMRC)of malignant tumors in different gen-ders and regions.The annual percentage change(APC)was calculated using Joinpoint 5.3.0.0 software,the incidence and mortality trends of malignant tumors from 2016 to 2020 were evaluated.Results In 2020,the crude incidence and ASIRC of malignant tumors in cancer registration areas of Kunming City were 234.27/100,000 and 141.68/100,000,respectively.The ASIRC of males was high-er than that of females(146.94/100,000 vs.137.33/100,000,Z=3.459,P<0.001),and that of rural areas was higher than that of urban areas(146.37/100,000 vs.134.09/100,000,Z=-4.462,P<0.001).The crude mortality and ASMRC of malignant tumors were 135.67/100,000 and 73.18/100,000,respectively.The ASMRC of males was higher than that of females(91.65/100,000 vs.55.43/100,000,Z=19.260,P<0.001),and that of rural areas was higher than that of urban areas(76.27/100,000 vs.70.00/100,000,Z=-3.359,P<0.001).There were 81.39%of new cases and 90.36%of deaths of malignant tumors occurred in the popu-lation aged 50 and above.The top 5 cancer incidence in the Kunming City were lung cancer,colorectal cancer,breast cancer,liver cancer and prostate cancer.The top 5 cancer mortality were lung cancer,liver cancer,colorectal cancer,prostate cancer and stomach cancer.The ASIRC(APC=-3.05%,95%CI:-5.91%--0.10%,P=0.046)and ASMRC(APC=-5.47%,95%CI:-8.52%--2.32%,P=0.012)of malignant tumors in urban areas of Kunming showed a downward trend.Conclusions From 2016 to 2020,the ASIRC and ASMRC of malignant tumors in urban areas of Kunming showed a downward trend,but there was no significant changing trend in rural tumor registration areas.Rural areas are key areas for the prevention and treatment of malignant tumors in Kunming city;Lung cancer,colorectum cancer,liver cancer and prostate cancer are the key types of cancer for prevention and treatment.

Objective The aim of this study was to analyze the proportion of disability adjusted life years(DALYs)attributed to aging population in common digestive system malignancies in China,and predict the proportion and the trends of DALYs attributed to aging proportion from 2022 to 2046.Methods Based on the Global Burden of Disease Study 2021,the DALY data of esophageal cancer,stomach cancer,colorectal cancer,pancreatic cancer,liver cancer,gallbladder and biliary tract cancer of Chinese people aged≥25 years from 1990 to 2021 were selected.The age-period-birth models were used to predict the DALY of malignant tumors from 2022 to 2046.The changes of DALY from 1990 to 2046 were decomposed into population growth,population aging,and age-specific DALY rate changes,and analyze the proportion of DALY changes attributable to population aging and its change trend.Results From 1990 to 2021,the DALY change rates of esophageal cancer,stomach cancer,colorectal cancer,pancreatic cancer,liver cancer,gall-bladder and biliary tract cancer in Chinese people aged≥25 years were 18.20％,-0.34％,98.10％,164.16％,58.21％and 90.62％,respectively.Compared with 2021,the proportion of DALY changes attributed to population aging for six types of malignant tumors in 1990 was from-38.32％to-19.72％.The top three cancer types with the highest attribution ratios were stomach cancer(-38.32％),esophageal cancer(-38.07％),gallbladder and biliary tract cancer(-29.78％).The expected change rates of DALY for the six types of malignant tumors from 2021 to 2046 were 20.72％,11.50％,58.19％,57.38％,21.36％and 48.39％,respective-ly.By compared with 2021,the proportion of DALY changes of six malignant tumors attributed to population aging in 2046 was from 18.82％to 47.83％,and the top three cancers attributed to the proportion were gallbladder and biliary tract cancer(47.83％),color-ectal cancer(43.07％)and pancreatic cancer(38.76％).From 2022 to 2046,the proportion of DALY changes attributed to aging pop-ulation for the six types of malignant tumors would continue to rise(P＜0.001).The proportions of colorectal cancer and pancreatic cancer attributed to population aging and the proportion of age-specific DALY rate were both positive and rising(P＜0.001),which would eventually promote the further increase of DALY.Conclusion Population aging has become the main driving factor for the growth of DALY in digestive system malignant tumors in China.The impact on DALY of colorectal cancer and pancreatic cancer will be prominent in the future.Targeted prevention and control strategies should be developed to actively respond to population aging.

Objective The aim of this study was to analyze the proportion of disability adjusted life years(DALYs)attributed to aging population in common digestive system malignancies in China,and predict the proportion and the trends of DALYs attributed to aging proportion from 2022 to 2046.Methods Based on the Global Burden of Disease Study 2021,the DALY data of esophageal cancer,stomach cancer,colorectal cancer,pancreatic cancer,liver cancer,gallbladder and biliary tract cancer of Chinese people aged≥25 years from 1990 to 2021 were selected.The age-period-birth models were used to predict the DALY of malignant tumors from 2022 to 2046.The changes of DALY from 1990 to 2046 were decomposed into population growth,population aging,and age-specific DALY rate changes,and analyze the proportion of DALY changes attributable to population aging and its change trend.Results From 1990 to 2021,the DALY change rates of esophageal cancer,stomach cancer,colorectal cancer,pancreatic cancer,liver cancer,gall-bladder and biliary tract cancer in Chinese people aged≥25 years were 18.20％,-0.34％,98.10％,164.16％,58.21％and 90.62％,respectively.Compared with 2021,the proportion of DALY changes attributed to population aging for six types of malignant tumors in 1990 was from-38.32％to-19.72％.The top three cancer types with the highest attribution ratios were stomach cancer(-38.32％),esophageal cancer(-38.07％),gallbladder and biliary tract cancer(-29.78％).The expected change rates of DALY for the six types of malignant tumors from 2021 to 2046 were 20.72％,11.50％,58.19％,57.38％,21.36％and 48.39％,respective-ly.By compared with 2021,the proportion of DALY changes of six malignant tumors attributed to population aging in 2046 was from 18.82％to 47.83％,and the top three cancers attributed to the proportion were gallbladder and biliary tract cancer(47.83％),color-ectal cancer(43.07％)and pancreatic cancer(38.76％).From 2022 to 2046,the proportion of DALY changes attributed to aging pop-ulation for the six types of malignant tumors would continue to rise(P＜0.001).The proportions of colorectal cancer and pancreatic cancer attributed to population aging and the proportion of age-specific DALY rate were both positive and rising(P＜0.001),which would eventually promote the further increase of DALY.Conclusion Population aging has become the main driving factor for the growth of DALY in digestive system malignant tumors in China.The impact on DALY of colorectal cancer and pancreatic cancer will be prominent in the future.Targeted prevention and control strategies should be developed to actively respond to population aging.

Objective The aim of this study was to analysis the incidence and mortality of malignant tumors in the cancer registration area of Kunming City in 2020,as well as the trend of changes from 2016 to 2020.Methods The malignant tumor data of 12 cancer registration areas in Kunming in 2020 that met the quality criteria were used to analyze the crude incidence,crude mortali-ty,age-standardized incidence/mortality rate by Chinese standard population(ASIRC/ASMRC)of malignant tumors in different gen-ders and regions.The annual percentage change(APC)was calculated using Joinpoint 5.3.0.0 software,the incidence and mortality trends of malignant tumors from 2016 to 2020 were evaluated.Results In 2020,the crude incidence and ASIRC of malignant tumors in cancer registration areas of Kunming City were 234.27/100,000 and 141.68/100,000,respectively.The ASIRC of males was high-er than that of females(146.94/100,000 vs.137.33/100,000,Z=3.459,P<0.001),and that of rural areas was higher than that of urban areas(146.37/100,000 vs.134.09/100,000,Z=-4.462,P<0.001).The crude mortality and ASMRC of malignant tumors were 135.67/100,000 and 73.18/100,000,respectively.The ASMRC of males was higher than that of females(91.65/100,000 vs.55.43/100,000,Z=19.260,P<0.001),and that of rural areas was higher than that of urban areas(76.27/100,000 vs.70.00/100,000,Z=-3.359,P<0.001).There were 81.39%of new cases and 90.36%of deaths of malignant tumors occurred in the popu-lation aged 50 and above.The top 5 cancer incidence in the Kunming City were lung cancer,colorectal cancer,breast cancer,liver cancer and prostate cancer.The top 5 cancer mortality were lung cancer,liver cancer,colorectal cancer,prostate cancer and stomach cancer.The ASIRC(APC=-3.05%,95%CI:-5.91%--0.10%,P=0.046)and ASMRC(APC=-5.47%,95%CI:-8.52%--2.32%,P=0.012)of malignant tumors in urban areas of Kunming showed a downward trend.Conclusions From 2016 to 2020,the ASIRC and ASMRC of malignant tumors in urban areas of Kunming showed a downward trend,but there was no significant changing trend in rural tumor registration areas.Rural areas are key areas for the prevention and treatment of malignant tumors in Kunming city;Lung cancer,colorectum cancer,liver cancer and prostate cancer are the key types of cancer for prevention and treatment.

Refractory chronic cough belongs to the category of "refractory cough" in traditional Chinese medicine， and it is believed that the root cause of intractable chronic cough is wind lodging in the spleen collaterals， with poor spleen yang and deficient kidney essence as the pathologic basis of the disease， which is present throughout the disease. The method advocated is to search the spleen collaterals and eliminate latent wind， warm the spleen yang and smooth the middle jiao， cultivate the kidney essence and consolidate the root， prescribed with modified Fuzi Lizhong Decoction （附子理中汤） plus Erxian Decoction （二仙汤） as the basis. The Fuzi Lizhong Decoction can warm yang and fortify the middle， and smooth the middle jiao， and the Erxian Decoction can cultivate the kidney essence and consolidate the innate. The two prescriptions could combine with Suye （Perilla frutescens）， Jingjie （Dysphania ambrosioides）， Fangfeng （Carum carvi） and other medicinals of cleaning characteristic， or combine with Gouteng （Uncaria rhynchophylla）， Chuanshanlong （Dioscorea nipponica）， Dilong （Kummerowia striata） and other medicinals of worm or cane category， to find the wind and expel pathogen， smooth spleen collaterals.

This article is based on ZHANG Jingyue's theory of yin-yang holism to explore the etiology， pathogenesis， and treatment of acute exacerbation of rheumatoid arthritis-associated interstitial lung disease （RA-ILD）. It is believed that the foundation of acute exacerbation of RA-ILD lies in real yin insufficiency and yin fail to control yang； external pathogen attacking is a common cause of acute exacerbation of RA-ILD. For treatment， it is important to first suppress ministerial fire by prescribing modified Yinhuo Decoction （引火汤）； if ministerial fire submerged， focus should be on nourishing both yin and yang； if real yin deficiency is the main issue， modified Zuogui Pill （左归丸） should be used； if real yang deficiency is prominent as well， modified Yougui Pill （右归丸） can be chosen. When yin and yang balanced， the disease could be solved.

It is believed that the fundamental pathogenesis of the connective tissue diseases-associated interstitial lung disease （CTD-ILD） is kidney essence deficiency， with lung collateral obstruction throughout the disease， and environmental toxin pathogen is the important causative factors for the development of CTD-ILD. This article proposed to restore origin and alleviate bi （痹） for CTD-ILD， for which restoring origin means tonifying the lungs， spleen and kidneys to bank up the roots and consolidate the original qi， with modified Erxian Decoction （二仙汤） plus Liu Junzi Decoction （六君子汤）； alleviating bi means expelling wind and dredging collaterals， and eliminating the mass to restore the smoothness of the lung collaterals， with paired medicines of Chuanshanlong （Dioscorea nipponica）-Dilong （Kalanchoe pinnata）， Vinegar-processed Sanleng （Sparganium stoloniferum）-Vinegar-processed Ezhu （Curcuma zedoaria）， and stem-type medicines， and emphasized on removing the environmental toxin pathogens to facilitate the recovery of healthy qi.