Objective: To explore the impact of sleep quality, experience of childhood maltreatment, and their interaction on depressive symptoms among middle school students, so as to provide the reference for early intervention of depressive symptoms among middle school students. Methods: From September to December 2023, a questionnaire survey was conducted among 1 231 students from two secondary schools in Harbin, Heilongjiang Province by a convenient sampling method. The survey included general demographic information, Childhood Trauma Questionnaire Short Form, Pittsburgh Sleep Quality Index and Short Version of Center for Epidemiological Studies Depression Scale. The Chi square test was used to analyze the differences in depressive symptom, sleep quality and childhood maltreatment among students with different demographic characteristics. Correlation analysis was conducted using Logistic regression, and interaction analysis was performed by both additive and multiplicative interaction models. Results: The detection rate of depressive symptoms among middle school students was 22.7%, and the rate for high school students (35.2%) was significantly higher than that for middle school students (17.0%) ( χ 2=50.35, P <0.01). The detection rates of depressive symptoms among middle school students with a history of childhood maltreatment and poor sleep quality were 45.8% and 44.0%, respectively. Multivariate Logistic regression analysis showed that compared to students without a history of childhood maltreatment, students with a history of childhood maltreatment had a higher risk of depressive symptoms ( OR =4.49，95% CI =3.31~ 6.09 , P <0.01);students with poor sleep quality had a higher risk of depressive symptoms than students with good sleep quality ( OR = 5.99，95% CI =4.37~8.22, P <0.01).The interaction results showed that the presence of childhood maltreatment and poor sleep quality had an additive interaction on the occurrence of depression in middle school students. Compared with students without childhood maltreatment and having good sleep quality, students with childhood maltreatment and poor sleep quality had a 22.49 times higher risk of developing depression ( OR =22.49，95% CI =14.22~35.59, P <0.01). Conclusion Depressive symptoms among middle school students are associated with childhood maltreatment and poor sleep quality, and there is an additive interaction between childhood maltreatment and poor sleep quality on the impact of depressive symptoms.

Hyperpolarization-activated cyclic nucleotide-gated(HCN)channels are widely expressed in the central and peripheral nervous systems.They can generate hyperpolarization-activated current(Ih)that regulates the resting membrane potential and excitability of neurons.Furthermore,it can affect the precise processing and con-duction of hearing,which plays a crucial role in the accurate analysis of temporal information.Therefore,through the review of HCN channel structure and distribution,as well as electrophysiological effects,the role and mecha-nism of HCN channels in the auditory pathways of the normal and unilateral or bilateral deafness patients will be fur-ther investigated.

Objective　: To verify the feasibility of using a homemade lung phantom for quality control of Cyberknife by comparing the measurement results of the homemade lung phantom and CIRS dynamic phantom in E2E testing of Cyberknife lung tracking.  Methods　 : The patient treatment process was simulated, including CT positioning, plan design, irra- diation implementation, film scanning, and analysis using the homemade phantom and CIRS phantom. The two phantoms were measured five times using MLC under the S7 generation Cyberknife and five times using Iris under the M6 generation Cyberknife. The differences in measurement results between the two phantoms were analyzed using independent sample t-test. Results　: For the S7 generation Cyberknife, the statistical analysis of differences between the two phantoms in the detection values on the X-axis, Y-axis, Z-axis, and total deviation showed P values of 0.236, 0.175, 0.289, and 0.668, respect- ively. For the M6 generation Cyberknife, the statistical analysis showed P values of 0.880, 0.891, 0.573, and 0.433, respect- ively. The P values were all > 0.05. Therefore, there were no statistically significant differences in the detection results between the homemade lung phantom and the CIRS phantom under the S7 and M6 generation Cyberknife. The total deviation values were <1.5 mm. Conclusion　 The homemade lung phantom and CIRS phantom have consistent measurement results in the E2E testing of Cyberknife lung tracking and meet the requirements of Report of AAPM TG-135 and WS 667- 2019 standard. Therefore, the homemade lung phantom is feasible for clinical quality control of Cyberknife.

BACKGROUND:This review explores the current research status and frontier hot spots of functional magnetic resonance imaging(fMRI)in the field of traditional Chinese medicine(TCM)for the treatment of ischemic stroke,and attempts to grasp future research trends,with a view to providing a reference for subsequent research in this field. OBJECTIVE:To visualize and analyze the hotspots and frontiers in the TCM treatment of ischemic stroke based on fMRI using CiteSpace knowledge mapping combined with binary logistic regression equations,in order to grasp the future research trends and further explore the distribution of brain regions with abnormal neural activity related to the types of post-stroke dysfunction. METHODS:CNKI,WanFang,VIP,Chinese Biomedical Literature Database and Web of Science core set database were searched.CiteSpace was used to plot keyword co-occurrence,keyword clustering timeline,burst term detection,co-cited literature mapping to analyze hotpots and frontiers in this field.Binary logistic regression analysis fitted the distribution of brain regions with abnormal neural activity associated with different dysfunction after ischemic stroke. RESULTS AND CONCLUSION:A total of 354 articles were included for CiteSpace knowledge mapping analysis.The number of annual publications showed that the research popularity has been raised from 2000 to 2022 with a good development prospect,but the core strength is mainly concentrated in China.Keywords co-occurrence and clustering time line analysis showed that aphasia,hemiplegia and cognitive impairment are the hot poststroke dysfunction types.Electroacupuncture,acupuncture and head acupuncture are hotspot intervention measures.Functional connectivity is a hotspot analysis method,and resting fMRI is a hotspot scanning technology.The time span of each research hotspot is long,indicating that it has a certain research value and the relevant research is gradually deepening,promoting the research progress in this field.However,acupuncture is the main intervention measure,and there is a lack of research on traditional Chinese medicine,Chinese patent medicine,acupuncture and medicine combination and other TCM therapy.Burst term detection results showed that functional connectivity,graph theory,degree centrality,default mode network,randomized controlled trials have great influence and strong explosive power.They are the current and future frontier hot spots in this field,suggesting that future research should focus on the brain network information integration and strengthen the scientific and rigorous clinical trial design.The results of co-cited literature analysis showed that the epidemiological investigation of ischemic stroke,the safety and effectiveness of acupuncture in the treatment of stroke,the brain activation patterns under different tasks,and the neuropathological mechanism of brain network dysfunction after stroke are the theoretical basis of this field.Future research direction in this field is to explore TCM-targeted brain regions and neural networks to reveal the brain effect mechanism of TCM promoting neural remodeling after stroke.A total of 255 articles were included for binary Logistic regression analysis.The results showed that sensorimotor cortex and premotor area dysfunction are positively correlated with the incidence of motor dysfunction after stroke;hippocampus,cerebellum posterior lobe,precuneus,inferior temporal gyrus and anterior cingulate nerve dysfunction are positively correlated with the incidence of cognitive impairment after stroke;cuneus,angular gyrus and prefrontal lobe neural dysfunction were positively correlated with the incidence of affective disorder after stroke;anterior cingulate,cerebellum posterior lobe neural dysfunction are positively correlated with the incidence of swallowing disorder after stroke.The above brain regions are the core brain regions of the sensorimotor network,default mode network and reward loop,suggesting that functional abnormalities within or between brain networks related to dysfunction may be potential target areas for TCM intervention,but the specific changes in neural activity activation or inhibition still need to be refined.

Ischemic cardiovascular and cerebrovascular diseases， encompassing ischemic heart disease and ischemic cerebrovascular disease， possess the features of high prevalence， disability， and mortality rates， thus ranking as the leading cause of global mortality. The shared etiology of ischemic heart disease and ischemic cerebrovascular disease involves local hypoperfusion caused by vascular stenosis， atherosclerosis， and infarction. Their intricate pathological processes involve various mechanisms such as inflammation， pyroptosis， apoptosis， and autophagy. However， interventions targeting individual pathological pathways offer limited therapeutic effects. There is an urgent need to explore novel treatment strategies or medications capable of simultaneously intervening in multiple pathological pathways. Mesenchymal stem cells， through their paracrine effects， play a role in tissue repair， with exosomes playing an important role. Mesenchymal stem cell-derived exosomes exhibit immunomodulatory and reparative properties similar to their parent cells while also reducing the side effects and infusion toxicity associated with the direct application of stem cells. Thus， they hold broad prospects for the treatment of ischemic cardiovascular and cerebrovascular diseases. Traditional Chinese medicine （TCM） and formulations， with their characteristics of multiple components， targets， and multi-level system regulation， can improve the cellular microenvironment by modulating mesenchymal stem cell-derived exosomes， thereby exerting therapeutic effects on ischemic cardiovascular and cerebrovascular diseases. This viewpoint highlights the concept of microscopic pattern differentiation in modern TCM and represents another significant area of TCM modernization. This article provided a comprehensive overview of the therapeutic effects and mechanisms of mesenchymal stem cell-derived exosomes in ischemic cardiovascular and cerebrovascular diseases while discussing the application of TCM in regulating mesenchymal stem cell-derived exosomes in ischemic cardiovascular and cerebrovascular diseases， offering new insights for the prevention and treatment of ischemic cardiovascular and cerebrovascular diseases using TCM.

Objective We aimed to explore the clinical efficacy of precise electro-acupuncture stimulation in the pterygopalatine fossa for the treatment of chronic sinusitis.Methods In total,40 patients with chronic sinusitis who visited the Xiyuan Hospital,China Academy of Chinese Medical Sciences between January 2022 and January 2023 were selected.The subjects were randomly divided into two groups:the treatment group(receiving precise electro-acupuncture in the pterygopalatine fossa)and the control group(receiving standard western medical treatment),with 20 cases in each groups.The treatments were administered twice a week for a period of 12 weeks.The effectiveness of the treatments was evaluated through computed tomography(CT)of the sinus changes and the Lund-Mackay scoring system.Results In cases of total opacity and partial opacity,there were significant differences between the two patient groups before and after treatment(P<0.05).Intra-group comparison revealed statistically significant improvements in both groups before and after treatment(P<0.05).The treatment group exhibited significant improvement in various sinus conditions(P<0.05),while in the control group,a significant improvement was only observed in the left maxillary sinus(P<0.05).Inter-group comparison also demonstrated that the treatment group's improvements were superior to those of the control group across multiple indicators(P<0.05).Conclusion The precise electro-acupuncture stimulation technique in the pterygopalatine fossa demonstrated significant therapeutic effects in the treatment of chronic sinusitis,with superior outcomes with respect to radiological changes compared to standard western medicine treatment.

OBJECTIVE To reveal the role of the basal forebrain(BF)GABAergic neurons in the regulation of isoflurane anesthesia and to elucidate the underlying neural pathways.METHODS The activity of BF GABAer-gic neurons was monitored during isoflurane anesthesia using a genetically encoded calcium indicator in Vgat-Cre mice of both sexes.The activity of BF GABAer-gic neurons was manipulated by chemogenetic and opto-genetic approaches.Sensitivity,induction time and emer-gence time of isoflurane anesthesia were estimated by righting reflex.The electroencephalogram(EEG)power and burst-suppression were monitored by EEG recording.The effects of activation of GABAergic BF-thalamic reticu-lar nucleus(TRN)pathway on isoflurane anesthesia were investigated with optogenetics.RESULTS The activity of BF GABAergic neurons was generally inhibited during isoflurane anesthesia,obviously decreased during the induction of anesthesia and gradually restored during the emergence from anesthesia.Activation of BF GABAergic neurons with chemogenetics and optogenetics promoted behavioral emergence from isoflurane anesthesia,with decreased sensitivity to isoflurane,delayed induction and accelerated emergence from isoflurane anesthesia.Optogenetic activation of BF GABAergic neurons prom-oted cortical activity during isoflurane anesthesia,with decreased EEG delta power and burst suppression ratio during 0.8%and 1.4%isoflurane anesthesia,respectively.Similar to the effects of activating BF GABAergic cell bod-ies,photostimulation of BF GABAergic terminals in the TRN also strongly promoted cortical activation and behav-ioral emergence from isoflurane anesthesia.CONCLU-SION The GABAergic neurons in the BF is a key neural substrate for general anesthesia regulation that facilitates behavioral and cortical emergence from general anesthe-sia via the BF-TRN pathway.

ObjectiveTo summarize the research progress of mammalian target of rapamycin （mTOR） pathway regulated by traditional Chinese medicine（TCM） and provide reference for visualization and quantitative analysis of related research based on multiple software linkage. MethodLiterature related to TCM regulation of mTOR pathway in Web of Science was taken as the research object. Citespace，VOSviewer，and carrort² were used for biliometric analysis and visualization of the literature. ResultA total of 245 papers that met the requirements were retrieved，and the visual analysis showed that the papers presented a fluctuating increase year by year after 2010，and numerous research results emerged in 2018. China had the most publications. Institutions with a large number of publications were mainly in Beijing and Shanghai，and most of the regional cooperation was centered in Beijing and Nanjing. According to the research direction and focus，it was found that the intervention of TCM in mTOR pathway in recent years mainly concentrated on the anti-tumor，anti-apoptotic and anti-inflammatory aspects， and TCM interfered with mTOR pathway to regulate cell apoptosis，autophagy，proliferation，and death. AMP-activated protein kinase （AMPK） and phosphatidylinositol 3-kinases（PI3K）/protein kinase B（Akt）/mTOR pathway were the current and future research hotspots. ConclusionResearch on the regulation of mTOR pathway by TCM had a good prospect，and the in-depth study might provide new ideas and guidance for the treatment of cardiovascular diseases，tumor and other major diseases.

Objective:To provide reference for establishing the testing method for quality control of neutron beam in boron neutron capture therapy (BNCT) equipment in China by testing the radiation characteristic parameters and dosimetry characteristic parameters of epithermal neutron beam in hospital neutron irradiator (IHNI).Methods:By comparing the uncertainties in the result of various test items with the deviation values recommended by the European Joint Research Center (EC-JRC), the feasibility of the relevant of testing method was analyzed and evaluated.Results:The uncertainty in epithermal neutron fluence rate was 2.7%. The uncertainty in ratio of thermal to epithermal neutron fluence rate was 3.1%. The uncertainty in ratio of fast neutron air kerma to epithermal neutron fluence rate was 9.3%. The uncertainty in ratio of gamma air kerma to epithermal neutron fluence rate was 8.7%. The uncertainty in spatial distribution of neutron fluence rate was 2.7%. The uncertainty in thermal neutron fluence rate in phantom was 1.8%. The uncertainty in neutron and gamma-ray dose rate in phantom was 17.1% and 4.0%, respectively.Conclusions:The uncertainty in neutron dose rate measurement result in phantom is higher, and further research is needed to improve the accuracy of the testing method. The uncertainty in the measurement result of other test items is lower, and the accuracy of the test result is expected to meet the allowable deviation value recommended by the European Joint Research Center, and the test method is feasible.

Objective:To investigate the role and diagnostic value of miRNA-205 in chronic kidney disease (CKD) patients with vascular calcification.Methods:It was divided into in vitro cell experiment and retrospective cohort study. In vitro experiments were conducted by using rat thoracic aortic smooth muscle cells. Alizarin red staining and calcium content detection were used to detect the calcification of vascular smooth muscle cells (VSMCs). Alkaline phosphatase (ALP) test kit was used to measure ALP activity. Western blotting was used to detect the protein expression levels of osteogenic transcription factors runt-related transcription factor 2 (Runx2), α smooth muscle actin (α-SMA) and smooth muscle-22α (SM-22α) in VSMCs. qRT-PCR was used to detect miRNA-205 and Runx2 expression levels. The double luciferase reporter gene assay was used to verify the targeted relationship between miRNA-205 and Runx2. The non-dialysis patients with CKD 3-5 stage from June 2020 to January 2021 in the Department of Nephrology of Fourth Hospital, Hebei Medical University were selected. According to coronary artery calcium score (CACs), the patients were divided into non-calcification group (CACs=0), mild-moderate calcification group (0 400). Spearman correlation analysis was used to analyze the correlation between miRNA-205 and Runx2 and vascular calcification. Logistic regression model and receiver operating characteristic (ROC) curve analysis were used to analyze the ability of miRNA-205 to predict the vascular calcification in patients with CKD. Results:(1)Compared with the control group, calcium nodules were more, and the calcium content, ALP activity and Runx2 protein level were higher, and the expression levels of miRNA-205, α-SMA and SM-22α were significantly lower in high phosphorus group (all P<0.05). Overexpression of miRNA-205 significantly reduced the calcification of VSMCs and Runx2 protein level, and increased the protein levels of α-SMA and SM-22α (all P<0.05). miRNA-205-5p reduced the activity of luciferase in the wild-type Runx2-3'-end non-coding region plasmid. (2) Eighty CKD patients were enrolled, with age of (57.50±14.93) years old and 49 males (61.3%). The results of comparison of miRNA-205 and Runx2 expression levels in non-calcification group ( n=26), mild- moderate calcification group ( n=30) and severe calcification group ( n=24) showed that, the higher degree of calcification, the lower miRNA-205 expression level and the higher Runx2 mRNA expression level (all P<0.05). miRNA-205 was negatively correlated with CACs ( r=-0.50, P<0.01) and Runx2 was positively correlated with CACs ( r=0.55, P<0.01). Multivariate logistic regression analysis results suggested that miRNA-205 ( OR=0.451, 95% CI 0.122-0.873) was an independent influencing factor of vascular calcification in CKD patients. The area under the ROC curve of miRNA-205 and miRNA-205 combined with Runx2 for predicting vascular calcification were 0.796 (95% CI 0.697-0.859) and 0.924 (95% CI 0.866-0.982), respectively. Conclusions:miRNA-205 inhibits vascular calcification by targeting Runx2 to negatively regulate osteogenetic phenotype transformation of VSMCs and is expected to be an early diagnostic marker of vascular calcification in CKD patients.