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.

To thoroughly implement the strategic deployment outlined in the Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance and Innovative Development of Traditional Chinese Medicine regarding research on dominant diseases of traditional Chinese medicine and to uphold the development philosophy of equal emphasis on traditional Chinese medicine and western medicine，the China Association of Chinese Medicine has fully played a leading academic role by systematically organizing and conducting a series of academic youth salons on clinical dominant diseases of traditional Chinese medicine. On September 13，2024，the 36^th Youth Salon on Clinical Dominant Diseases was successfully held in Nanjing，focusing on the advantages of traditional Chinese medicine and the integrative traditional Chinese medicine and western medicine in the diagnosis and treatment of erectile dysfunction （ED）. The conference brought together leading experts from traditional Chinese medicine，western medicine，and interdisciplinary fields，facilitating in-depth multidisciplinary discussions that led to key consensus on optimizing traditional Chinese medicine treatment protocols for ED，researching and developing new drugs of traditional Chinese medicine，and advancing interdisciplinary development in traditional Chinese medicine. This salon systematically sorted out the clinical strengths and distinctive features of traditional Chinese medicine in the diagnosis and treatment of ED. Based on current research foundations and clinical needs，it identified key directions for future scientific layout and scientific research tackling： （1） Standardization of syndrome differentiation system of traditional Chinese medicine for ED. （2） Optimization and standardization of intervention methods of integrated traditional Chinese medicine and western medicine. （3） High-quality clinical research guided by evidence-based medicine. （4） In-depth analysis of the pharmacological mechanisms of traditional Chinese medicine in the treatment of ED. （5） Clinical translation and application promotion of new drugs of traditional Chinese medicine. （6） Interdisciplinary integration and innovation in traditional Chinese medicine. For each research direction，key focus areas，expected objectives，and clinical value were further refined，along with the establishment of a scientifically sound priority funding level evaluation system. Therefore，building on the series of salons on the ED-focused dominant diseases of traditional Chinese medicine，this paper provides standardized guidance for clinical practice of traditional Chinese medicine in ED management，effectively contributing to the high-quality development of traditional Chinese medicine. It serves as a valuable reference for national scientific and technological strategic layout， research and development decision-making in new drugs of traditional Chinese medicine，research topic planning，and clinical guideline formulation.

The core pathogenesis of pediatric IgA vasculitis （IgAV） is considered to involve qi movement disorder， with the failure of clear-turbid separation and internal generation of turbid pathogens. Accordingly， the viewpoint of "qi disorder causing turbidity" is proposed. In clinical practice， the disease is divided into the acute， persistent， and stable stages. The acute stage is characterized by impaired dispersion of wei （卫） qi and the internal generation of heat turbidity， while the persistent stage by congestion of ying （营） qi and retention of stasis-turbidity， and the stable stage by depletion of pectoral qi with lingering latent turbidity. In clinical practice， regulating qi and transforming turbidity is taken as the basic therapeutic principle， and the self-formulated Tiaoqi Huazhuo Decoction （调气化浊汤） is used as the basic prescription for staged treatment with flexible modifications. Specifically， the acute stage is treated with the method of dispersing wei qi and clearing heat-turbidity； the persistent stage is recommended to harmonize ying qi and purging stasis-turbidity； and the stable stage should focus on securing pectoral qi and venting latent turbidity.

Objective: To determine the clinical efficacy and mechanism of Piwei Peiyuan Pill (PPP) combined with moxibustion for treating patients with chronic atrophic gastritis (CAG) with spleen and stomach weakness syndrome. Methods: Ninety-six CAG patients with spleen and stomach weakness syndrome who met the inclusion and exclusion criteria were enrolled at the Department of Spleen and Stomach Diseases of the Second Affiliated Hospital of Anhui University of Chinese Medicine from June 2022 to December 2023. The patients were randomly divided into a control, a Chinese medicine, and a combined group using a random number table method, with 32 cases in each group (two cases per group were excluded). The control group was treated with rabeprazole combined with folic acid tablets (both thrice daily), the Chinese medicine group was treated with PPP (8 g, thrice daily), and the combined group was treated with moxa stick moxibustion (once daily) on the basis of the Chinese medicine group for 12 consecutive weeks. Gastric mucosa atrophy in the three groups was observed before and after treatment. The gastric mucosal pathological score was evaluated. The Patient Reported Outcome (PRO) scale was used to evaluate the patients′ physical and mental health status and quality of life.An enzyme-linked immunosorbent assay was used to detect serum tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-4, IL-10, IL-37, and transforming growth factor (TGF)-β levels in each group. Real-time fluorescence PCR was used to detect the relative expression levels of signal transducer and activator of transcription 3 (STAT3) and mammalian target of rapamycin (mTOR) mRNA in each group. Western blotting was used to detect the relative expression levels of proteins related to the STAT3/mTOR signaling pathway, and the adverse drug reactions and events were recorded and compared. Results: There was no statistical difference in age, gender, disease duration, family history of gastrointestinal tumors, alcohol consumption history, and body mass index among the three groups of patients.The total therapeutic efficacy rates of the control, Chinese medicine, and combined groups in treating gastric mucosal atrophy were 66.67% (20/30), 86.67% (26/30), and 90.00% (27/30), respectively (P<0.05). Compared to before treatment, the pathological and PRO scale scores of gastric mucosa in each group decreased after treatment, and TNF-α, IL-1β, IL-37, and TGF-β levels decreased. The relative STAT3 and mTOR mRNA expression levels, as well as the relative STAT3, p-STAT3, mTOR, and p-mTOR protein expression levels decreased (P<0.05), whereas the IL-4 and IL-10 levels increased (P<0.05). After treatment, compared to the control group, the pathological score of gastric mucosa, PRO scale score, TNF-α, IL-1β, IL-37, TGF-β content, relative STAT3 and mTOR mRNA expression levels, and relative STAT3, p-STAT3, mTOR, and p-mTOR protein expression levels in the Chinese medicine and combined groups after treatment were reduced (P<0.05), whereas the IL-4 and IL-10 levels increased (P<0.05). After treatment, compared to the Chinese medicine group, the combined group showed a decrease in relative STAT3, mTOR mRNA expression levels, and STAT3, p-STAT3, mTOR, and p-mTOR protein expression levels (P<0.05). Conclusion The combination of PPP and moxibustion may regulate the inflammatory mechanism of the body by inhibiting the abnormal activation of the STAT3/mTOR signaling pathway, upregulating related anti-inflammatory factor levels, downregulating pro-inflammatory factor expression, and increasing related repair factor expression, thereby promoting the recovery of atrophic gastric mucosa, reducing discomfort symptoms, and improving the physical and mental state of CAG patients with spleen and stomach weakness syndrome.

Phosphodiesterase type 5(PDE5)participates in the physiological functions of multiple organs by regulating the nitric oxide(NO)-cyclic guanosine monophosphate(cGMP)pathway.As a long-acting PDE5 inhibitor,tadalafil has been used clinically for over 20 years and is approved for the treatment of male erectile dysfunction and lower urinary tract symptoms associated with benign prostatic hyperplasia.Furthermore,tadalafil maintains cGMP levels by inhibiting PDE5,thereby activa-ting the downstream NO-cGMP signaling pathway to exert multiple effects,including relaxing smooth muscle,exerting antioxidant actions,regulating apoptosis,and modulating metabolism.Clinical evidence indicates that tadalafil shows promising therapeutic potential in multi-organ system diseases such as pulmonary arterial hypertension,heart failure,type 2 diabetes,cognitive impair-ment,female infertility,and fetal growth restriction.This article systematically reviews the action mechanisms and research pro-gress of tadalafil in treating diseases beyond erectile dysfunction,aiming to summarize its potential for cross-disease system clini-cal applications and provide references for optimizing treatment strategies for patients with chronic diseases.

Objective:To investigate the analgesic effect of Opisthoplatia orientalis Burm. polypeptides (OOBP) on postherpetic neuralgia (PHN) induced by resiniferatoxin (RTX) in rat models, and its effect on the phosphatase and tensin homologue deleted on chromosome ten (PTEN) -induced kinase 1/Parkin (PINK1/Parkin) signaling pathway. Methods:Thirty-two special pathogen-free rats were randomly divided into 2 groups: a blank control group ( n = 8) receiving intraperitoneal injections of physiological saline (0.20 mg/kg) , and a model group ( n = 24) receiving intraperitoneal injections of RTX (0.20 mg/kg) to establish the PHN rat model. The rats' paw withdrawal mechanical threshold (PWMT) was measured on days 1, 4, 7, and 10 after RTX injections. After 10 days of RTX treatment, rat models were randomly assigned to 3 subgroups: PHN group, OOBP group, and gabapentin group, with 8 rats in each group. The OOBP group and gabapentin group were gavaged with OOBP (equivalent to 0.9 g raw drug per kg) and gabapentin (27 mg/kg) respectively, while the PHN group and control group were gavaged with physiological saline. All treatments lasted for 3 weeks, during which PWMT was continuously monitored. One hour after the final dose, rats were sacrificed, and spinal cord tissues and serum samples were collected. Hematoxylin-eosin (HE) staining was performed to observe spinal pathological changes, enzyme-linked immunosorbent assay (ELISA) to detect serum levels of interleukin-10 (IL-10) , tumor necrosis factor-α (TNF-α) , β-endorphin (β-EP) , and calcitonin gene-related peptide (CGRP) , and Western blot analysis to determine the expression of PINK1, Parkin, and ubiquitin-binding protein P62 in rat spinal cord tissues. The entropy weight method was applied to comprehensively evaluate the effect of OOBP on the above cytokines, proteins and other pharmacodynamic indicators in rat models of PHN. Results:From day 1 to day 10 after modeling, PWMT values in the model group were significantly lower than those in the blank control group (all P < 0.05) , and also significantly lower than baseline values prior to modeling (all P < 0.05) . Histopathological analysis of rat spinal cord tissues showed less pathological changes (such as Nissl body swelling and neuronal necrosis) but more normal Nissl bodies in both the gabapentin group and OOBP group compared with the PHN group. ELISA revealed significantly decreased serum levels of TNF-α and CGRP but significantly increased serum levels of β-EP and IL-10 in the OOBP group compared with the PHN group (all P < 0.05) . Western blot analysis showed that expression levels of PINK1 and Parkin were significantly lower in the gabapentin group (0.441 ± 0.061, 0.597 ± 0.180, respectively) and the OOBP group (0.666 ± 0.117, 0.481 ± 0.073, respectively) than in the PHN group (1.033 ± 0.085, 1.088 ± 0.040, respectively, all P < 0.05) ; in contrast, the P62 expression significantly increased in the gabapentin group (0.810 ± 0.086) and OOBP group (0.902 ± 0.153) compared with the PHN group (0.543 ± 0.082, both P < 0.05) . The entropy weight analysis showed that the comprehensive scores were 0.222 and 0.229 in the OOBP group and the gabapentin group respectively, suggesting a greater overall therapeutic effect of OOBP. Conclusion:OOBP may exert analgesic effects in rat models of PHN by downregulating the expression of inflammatory factors and pain-related factors and modulating the PINK1/Parkin signaling pathway, thereby inhibiting mitochondrial autophagy in spinal neurons and reducing inflammatory responses.

Objective Depression,a most common psychiatric disease,is defined in Traditional Chinese Medicine(TCM)as Yu Syndrome,i.e.,depression disorder,or Baihe Disease,i.e.,lily bulb disease,a category of emotional disorders treated with lily-based TCM preparations.In TCM,depression is managed through syndrome differentiation and treatment,which is characterized by high efficacy and safety.However,there is no unified standard for the classification of depression syndromes,which leads to a disconnection between the analysis of patients'medication patterns and their actual syndromes and hinders the study of medication patterns specific to particular syndromes.Therefore,this study is focused on investigating the medication patterns of different sub-types of depression patients based on an objective classification system of depression.Methods We searched for and retrieved clinical literature on TCM formulas for depression from relevant databases,including China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP Database,Sinomed,Web of Science,and PubMed.Information on patient symptoms and medication was standardized.Then,the symptoms and the medication frequency of depression patients were statistically analyzed.We used the K-means clustering method combined with implicit structural analysis to objectively categorize depression patients into sub-types.In addition,the main symptoms and core TCM formulas of each sub-type of depression patients were identified.On the basis of objective classification system,we also statistically analyzed the characteristics of herbs used on depression patients,including the 4 basic properties,the 5 flavors,the attributes,the therapeutic efficacy,and the co-occurrence patterns,which may help reveal the medication patterns.Results A total of 3 537 publications and 4 434 prescriptions were included in the analysis.By using the K-means algorithm and latent structure analysis methods,patients with depression were categorized into 9 sub-types,with Cluster 6 accounting for the largest proportion.The most common symptoms among depression patients were insomnia and a depressed mood.Medication frequency analysis showed that Radix Bupleuri(Chai Hu),Radix Paeoniae Alba(Bai Shao),Poria(Fu Ling),Rhizoma Chuanxiong(Chuan Xiong),and Radix Curcumae(Yu Jin)were the most commonly used TCM herbs.For the depression sub-types of Clusters 1,2,and 6,blood-activating and stasis-dissolving herbs were used most often.The depression sub-types of Clusters 3,4,5,8,and 9 were mainly treated with qi-regulating herbs,while the depression sub-type of Cluster 7 was treated with qi-supplementing herbs.Depression patients were mostly treated with herbs that were cold or warm in nature and had sweet,bitter,and pungent flavors.Moreover,treatments for Cluster 1 and Cluster 6 mainly targeted the spleen meridian,while those for Cluster 2,Cluster 3,Cluster 4 and Cluster 5 mainly targeted the heart meridian.The treatments for the other sub-types mainly targeted the liver meridian.The core TCM formulas for the 9 depression sub-types included Zishui Qinggan Decoction,Danzhi Xiaoyao Powder,Huanglian Wendan Tang,Chaihu Guizhi Tang,Modified Xiaoyao Powder,Qinggan Jieyu Tang,Xiaoyao Powder,Xuefu Zhuyu Decoction,and Bazhen Decoction.The most commonly used Chinese herbal medicinal formulas were Gan Cao-Chai Hu,Bai Shao-Chai Hu,and Chen Pi-Chai Hu.Conclusion Based on machine learning,this study reveals the scientific aspects of TCM typing and syndrome-based treatment.It clarifies the rationale for targeting different symptoms in depression treatment and provides theoretical support for clinicians to make medication prescriptions.It also presents a new perspective for investigating TCM medication patterns.

Objective To characterize the clinical features of the group of gout patients to facilitate earlier identifi-cation,and optimize the diagnosis and treatment of the condition.Methods The retrospective study analyzed 24 gout patients with shoulder joint(s)involved and consulted by physicians of Peking Union Medical College Hospital from March 2021 to April 2025,while 70 outpatient gout patients matched by clinical course duration and sex were enrolled as control group.Clinical data including medical history,laboratory tests,therapeutic interventions.Prog-nosis was systematically collected to delineate the distinctive clinical manifestations of the patients.Results All 24 gout patients with shoulder joints involved were male,aged(43.16±13.13)years and had an average BMI of 27.70±4.63.The duration of gout was 8(5,12)years while of those patients had an early onset before 30 years old.The maximal serum uric acid concentration was(754.15±175.79)μmol/L.It was shown by case review that 16.67％of the patients were asymptomatic,and 79.17％suffered from shoulder pain.A quarter of the patients developed subcutaneous tophi.All the patients affected(P＜0.05).The affected joints ascended from lower extremities to the upper averagely took 4.72±2.80 years and had heavier burden of hyperuricemia(P＜0.05),while no significant difference was found in renal function and inflammation level.Conclusions Gout patients with shoulder joints involvement are older and have atypical manifestation.The diagnosis needs support of imaging or ar-throcentesis.

Objective:To investigate the analgesic effect of Opisthoplatia orientalis Burm. polypeptides (OOBP) on postherpetic neuralgia (PHN) induced by resiniferatoxin (RTX) in rat models, and its effect on the phosphatase and tensin homologue deleted on chromosome ten (PTEN) -induced kinase 1/Parkin (PINK1/Parkin) signaling pathway. Methods:Thirty-two special pathogen-free rats were randomly divided into 2 groups: a blank control group ( n = 8) receiving intraperitoneal injections of physiological saline (0.20 mg/kg) , and a model group ( n = 24) receiving intraperitoneal injections of RTX (0.20 mg/kg) to establish the PHN rat model. The rats' paw withdrawal mechanical threshold (PWMT) was measured on days 1, 4, 7, and 10 after RTX injections. After 10 days of RTX treatment, rat models were randomly assigned to 3 subgroups: PHN group, OOBP group, and gabapentin group, with 8 rats in each group. The OOBP group and gabapentin group were gavaged with OOBP (equivalent to 0.9 g raw drug per kg) and gabapentin (27 mg/kg) respectively, while the PHN group and control group were gavaged with physiological saline. All treatments lasted for 3 weeks, during which PWMT was continuously monitored. One hour after the final dose, rats were sacrificed, and spinal cord tissues and serum samples were collected. Hematoxylin-eosin (HE) staining was performed to observe spinal pathological changes, enzyme-linked immunosorbent assay (ELISA) to detect serum levels of interleukin-10 (IL-10) , tumor necrosis factor-α (TNF-α) , β-endorphin (β-EP) , and calcitonin gene-related peptide (CGRP) , and Western blot analysis to determine the expression of PINK1, Parkin, and ubiquitin-binding protein P62 in rat spinal cord tissues. The entropy weight method was applied to comprehensively evaluate the effect of OOBP on the above cytokines, proteins and other pharmacodynamic indicators in rat models of PHN. Results:From day 1 to day 10 after modeling, PWMT values in the model group were significantly lower than those in the blank control group (all P < 0.05) , and also significantly lower than baseline values prior to modeling (all P < 0.05) . Histopathological analysis of rat spinal cord tissues showed less pathological changes (such as Nissl body swelling and neuronal necrosis) but more normal Nissl bodies in both the gabapentin group and OOBP group compared with the PHN group. ELISA revealed significantly decreased serum levels of TNF-α and CGRP but significantly increased serum levels of β-EP and IL-10 in the OOBP group compared with the PHN group (all P < 0.05) . Western blot analysis showed that expression levels of PINK1 and Parkin were significantly lower in the gabapentin group (0.441 ± 0.061, 0.597 ± 0.180, respectively) and the OOBP group (0.666 ± 0.117, 0.481 ± 0.073, respectively) than in the PHN group (1.033 ± 0.085, 1.088 ± 0.040, respectively, all P < 0.05) ; in contrast, the P62 expression significantly increased in the gabapentin group (0.810 ± 0.086) and OOBP group (0.902 ± 0.153) compared with the PHN group (0.543 ± 0.082, both P < 0.05) . The entropy weight analysis showed that the comprehensive scores were 0.222 and 0.229 in the OOBP group and the gabapentin group respectively, suggesting a greater overall therapeutic effect of OOBP. Conclusion:OOBP may exert analgesic effects in rat models of PHN by downregulating the expression of inflammatory factors and pain-related factors and modulating the PINK1/Parkin signaling pathway, thereby inhibiting mitochondrial autophagy in spinal neurons and reducing inflammatory responses.

Objective:To evaluate the efficacy of pre fenestration vs left common carotid-left subclavian artery(LCCA-LSA) bypass for left subclavian artery (LSA) reconstruction in Stanford B aortic dissection patients undergoing thoracic endovascular repair(TEVAR).Methods:The clinical and follow-up data of 120 patients with Stanford type B aortic dissection who were treated with TEVAR and reconstructed by pre fenestration or LCCA-LSA bypass from Jul 2009 to Aug 2023 at the Department of Vascular surgery of Provincial Hospital, Shandong First Medical University were analyzed retrospectively.Results:Patients were retrospectively divided into pre fenestration group (40 cases) and hybrid repair (bypass) group (80 cases). The average operation time [(146.9±37.6) vs.(332.4±106.2)min, P<0.001] and hospital stay [(15.8±5.6) vs. (22.9±9.0)d P<0.001] in the pre fenestration group were lower than those in the hybrid repair group, and the preoperative complications in the pre fenestration group were slightly higher than that in hybrid repair group (97.5% vs. 91.3%). One patient in the pre fenestration group failed the surgery, and the technical success rate was 97.5%. The postoperative complications in the pre fenestration group were lower than hybrid repair group (22.5% vs. 26.3%). There was one experiencing secondary intervention in the pre fenestration group and 6 in the hybrid repair group. Two patients died postoperatively, all in hybrid repair group. Conclusion:Both pre fenestration and left common carotid-left subclavian artery(LCCA-LSA) bypass(hybrid procedure) are safe and feasible methods for reconstruction of LSA in Stanford B aortic dissection patients undergoing TEVAR.