This paper summarizes clinical experience in treating depression with a combined approach of acupuncture and herbal medicine under the guiding principle of deficiency and excess. Given the complex pathogenesis of depression， it is proposed that syndrome differentiation based on deficiency and excess should serve as the overarching principle. Acupuncture is prioritized， supplemented by Chinese herbal medicine. Acupuncture is based on the spirit-regulating protocol； for excess syndromes， it is combined with the calming and restoring protocol， while for deficiency syndromes， it is combined with the five zang organs tonification protocol. In cases of mixed deficiency and excess， the two protocols are alternated， and adjustments are made dynamically throughout the treatment based on syndrome evolution. Herbal prescriptions are also guided by the differentiation of deficiency and excess. For excess patterns， dispersion and clearance should be emphasized， focusing on soothing the liver， clearing heat， relieving irritability， regulating qi， transforming phlegm， and calming the mind； for deficiency patterns， tonification is emphasized， aiming to strengthen the spleen， nourish the blood， calm the spirit， tonify qi， and consolidate the root.

Objective:To compare the influence of definition methods of different isocenter on postoperative volumetric modulated arc therapy (VMAT) plans for patients with high-grade glioma (HGG),and to explore the feasibility of determining the treatment isocenter at location stage of computed tomography (CT) simulation system (CT-Sim). Methods:A total of 30 HGG patients who received radiotherapy after surgery in Peking University International Hospital from September 1,2021 to December 31,2022 were selected. 4 kinds of methods,which included center of mass (CT-COM) of target region of tumor bed was delineated by CT-Sim location stage,geometric center of target region of treatment plan system (TPS-Geo),whole brain geometric center of treatment plan system (TPS-Head) and center of mass of target region of TPS (TPS-COM),were respectively adopted to definite treatment isocenter for each patient,and they were respectively set as CT-COM group,TPS-Geo group,TPS-Head group and TPS-COM group to design 4 groups of VMAT treatment. The parameters included dose,conformity index (CI),uniformity index (HI) and machine unite (MU) among 4 groups of target region and organ at risk (OAR) were compared. Results:The doses of target region and OAR of four groups were similar,and all of them can meet the requirements of clinical dosimetry and clinical OAR dose limitation,without statistically significant differences (P>0.05). The covered volumes that brain tissues received 10,20,30,40 and 50 Gy doses in CT-COM group,TPS-Geo group and TPS-COM group closed to the maximum dose,the maximum dose of 2％ volume and mean dose (Dmax,D2％,Dmean) of brainstem,bilateral lens,optic chiasm,bilateral optic nerve and pituitary gland. The V10,V20,V30 of brain tissue,and Dmax,D2％,and Dmean of brainstem in TPS-Head group were slightly higher than those in other three groups,and the Dmean of lens,and Dmax,D2％ and Dmean of optic nerve at health side of TPS-Head group were slightly lower than those of other three groups,without statistically significant differences (P>0.05). Conclusion:The four VMAT plans of defining the treatment isocenter can meet the clinical dosimetric requirements,and can determine the isocenter at CT-Sim location stage,which can effectively avoid the occurrence of errors in the reduction of radiotherapy,and increase precision of delivery of radiotherapy dose,and enhance effective utilization rate of equipment.

Objective:To compare the influence of definition methods of different isocenter on postoperative volumetric modulated arc therapy (VMAT) plans for patients with high-grade glioma (HGG),and to explore the feasibility of determining the treatment isocenter at location stage of computed tomography (CT) simulation system (CT-Sim). Methods:A total of 30 HGG patients who received radiotherapy after surgery in Peking University International Hospital from September 1,2021 to December 31,2022 were selected. 4 kinds of methods,which included center of mass (CT-COM) of target region of tumor bed was delineated by CT-Sim location stage,geometric center of target region of treatment plan system (TPS-Geo),whole brain geometric center of treatment plan system (TPS-Head) and center of mass of target region of TPS (TPS-COM),were respectively adopted to definite treatment isocenter for each patient,and they were respectively set as CT-COM group,TPS-Geo group,TPS-Head group and TPS-COM group to design 4 groups of VMAT treatment. The parameters included dose,conformity index (CI),uniformity index (HI) and machine unite (MU) among 4 groups of target region and organ at risk (OAR) were compared. Results:The doses of target region and OAR of four groups were similar,and all of them can meet the requirements of clinical dosimetry and clinical OAR dose limitation,without statistically significant differences (P>0.05). The covered volumes that brain tissues received 10,20,30,40 and 50 Gy doses in CT-COM group,TPS-Geo group and TPS-COM group closed to the maximum dose,the maximum dose of 2％ volume and mean dose (Dmax,D2％,Dmean) of brainstem,bilateral lens,optic chiasm,bilateral optic nerve and pituitary gland. The V10,V20,V30 of brain tissue,and Dmax,D2％,and Dmean of brainstem in TPS-Head group were slightly higher than those in other three groups,and the Dmean of lens,and Dmax,D2％ and Dmean of optic nerve at health side of TPS-Head group were slightly lower than those of other three groups,without statistically significant differences (P>0.05). Conclusion:The four VMAT plans of defining the treatment isocenter can meet the clinical dosimetric requirements,and can determine the isocenter at CT-Sim location stage,which can effectively avoid the occurrence of errors in the reduction of radiotherapy,and increase precision of delivery of radiotherapy dose,and enhance effective utilization rate of equipment.

Children and adults differ significantly in physiology,biochemistry and immune function,which leads to sig-nificant differences in blood transfusion strategies between children and adults.To guide the clinical transfusion practice of pediatric patients and improve the prognosis of children,the National Health Commission organized the formulation and re-lease of the health industry standard Guideline for Pediatric Transfusion(WS/T 795-2022).This paper will briefly introduce some concepts that help understand of the Standard and the preparation process of the Standard,and explain and interpret the preparation of the"scope","general provisions"and"factors to consider"of the Standard,hoping to contribute to the understanding and implementation of the Standard.

Objective:To compare the effects of glenosphere offset positions on the impingement-free range of motion (ROM) in reverse total shoulder arthroplasty (RTSA).Methods:Shoulder joint models were reconstructed using shoulder CT scans of 6 patients with primary osteoarthritis. RTSA was performed virtually according to standard surgical procedures, and shoulder movements were simulated. Reverse shoulder models were constructed with 2 lateral offsets (0 and 4 mm) and 6 positional offsets (center, inferior, posterior, anterior, anterior-inferior, and posterior-inferior). The impingement-free ROM and impingement sites for abduction-adduction, flexion-extension, total rotation (sum of internal and external rotation), and total ROM (sum of ROM in all movement modes) were evaluated.Results:All the 12 combinations of different glenosphere offsets achieved 50% of the original shoulder ROM in all movements. In the abduction-adduction motion with 0 and 4 mm lateral offsets, the anterior-inferior offset provided the largest ROM (94.4°±8.7° and 105.3°±6.9°, respectively), but there was no significant difference between the positions ( P>0.05). In the flexion-extension motion with 0 and 4 mm lateral offsets, the posterior-inferior offset showed the largest ROM (194.1°±6.9° and 196.9°±9.7°, respectively), but there was no significant difference between the positions ( P>0.05). In the total rotation motion with 0 and 4 mm lateral offsets, the anterior-inferior offset had the largest ROM (141.5°±5.9° and 160.6°±8.5°, respectively), showing significant advantages over the center, anterior, and posterior offsets ( P<0.05), but insignificant advantages over the inferior and posterior-inferior offsets ( P>0.05). In total ROM, the anterior-inferior offset provided the largest ROM. When the lateral offset was 0 mm, the anterior-inferior offset provided a ROM of 421.8°±16.4°, showing significant advantages over the center and posterior offsets ( P<0.05). Compared with the lateral glenosphere offset of 0 mm, the lateral glenosphere offset of 4 mm significantly improved total shoulder ROM (122.8°±10.6° versus 145.8°±4.8°) and total ROM (390.9°±11.6° versus 428.4°±19.8°) ( P<0.05). Conclusions:The anterior-inferior, inferior, and posterior-inferior glenosphere offsets can improve ROM in all movement patterns. The position and lateral offset of the glenosphere significantly affect the total rotation and total ROM of the shoulder joint. Specifically, the anterior-inferior and inferior offsets show significant advantages over the center position in total rotation and total ROM of the shoulder joint.

Objective To observe the clinical effectiveness of the experience of famous traditional Chinese medicine doctors in the treatment of residual sleep disturbances in patients remitted from major depressive disorder.Methods The 108 patients remitted from major depressive disorder with residual sleep disturbances who were treated in the department of Psychosomatic Medicine,Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University from June 2021 to December 2023,were randomly divided into acupuncture group(acupuncture treatments consisted of 24 sessions duration over 8 weeks)and medication group(patients take estazolam 1 mg daily for 8 weeks),54 cases in each.Assessments were carried out at baseline,4,8,12 and 20 weeks,including the Pittsburgh Sleep Quality Index(PSQI),Insomnia Severity Index(ISI),Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),and SF-36.Results The difference in PSQI,ISI,HAMD,HAMA,and mental health scores(P<0.05)in the acupuncture group was greater than in the medication group.The total effective rate of the acupuncture and medication groups was 72.22%and 14.81%,respectively,and the difference was statistically significant(P<0.05).Conclusion Acupuncture can obviously improve sleep quality,alleviate symptoms of depression and anxiety,and improve quality of life in patients with major depressive disorder.

Objective To observe the clinical effectiveness of the experience of famous traditional Chinese medicine doctors in the treatment of residual sleep disturbances in patients remitted from major depressive disorder.Methods The 108 patients remitted from major depressive disorder with residual sleep disturbances who were treated in the department of Psychosomatic Medicine,Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University from June 2021 to December 2023,were randomly divided into acupuncture group(acupuncture treatments consisted of 24 sessions duration over 8 weeks)and medication group(patients take estazolam 1 mg daily for 8 weeks),54 cases in each.Assessments were carried out at baseline,4,8,12 and 20 weeks,including the Pittsburgh Sleep Quality Index(PSQI),Insomnia Severity Index(ISI),Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),and SF-36.Results The difference in PSQI,ISI,HAMD,HAMA,and mental health scores(P<0.05)in the acupuncture group was greater than in the medication group.The total effective rate of the acupuncture and medication groups was 72.22%and 14.81%,respectively,and the difference was statistically significant(P<0.05).Conclusion Acupuncture can obviously improve sleep quality,alleviate symptoms of depression and anxiety,and improve quality of life in patients with major depressive disorder.

Objective : To explore from the perspective of microorganisms the changes in plaque microbial community of children with severe early childhood caries (S-ECC) before and 3 months after dental treatment. Meanwhile to show the effect of treatment on the maintenance of long- term caries-free state. Methods: S-ECC children completed dental treatment under general anesthesia. We collected plaque from caries-free dental surfaces before treatment (caries, C) and at the postoperative follow-up review time points of 7 days (C-7D), 1 month (C-1 M), and 3 months (C-3 M). We included caries-free children (caries free, CF) as the control group to analyze the dynamic modification process of the plaque microbial community in the short-term pre- and postdental treatment. Results: Species clustering analysis showed that the compositions of the microbial communities of the S-ECC and CF groups were highly similar. The α diversity index was not statistically significant (P>0.05). From the analysis of the relative abundance, Leptotrichia spp. and Aggregatibacter spp. decreased after treatment compared with before treatment (P<0.05). Streptococcus sanguinis in the C-7D group increased compared with that in the C group and gradually decreased within 3 months. Veillonella spp., Actinomyces spp., Allprevotella spp., Capnocytophaga spp., and Streptococcus mutans differed between the C and CF groups (P<0.05), Streptococcus mutans did not differ significantly between the C-7D and C-1 M groups and the CF group after treatment, while C-3 M showed an increase compared with the CF group (P<0.01). Conclusion The rapid change in the structure of the flora of children with S-ECC after treatment. The plaque microbial community structure in a caries-free state gradually starts to be established 1-3 months after treatment. There is a "core microbiota" in the oral plaque community that jointly maintains microecological stability. Veillonella spp., Allprevotella spp. and Streptococcus mutans have potential as possible microbial markers.

AIM: In order to bridge the gap between pharmacogenomic research and its clinical application, we propose the concept of genetic electronic identity, named "GeneFace", and developed an electronic information system which integrated "drug-gene" interactions and recommendations for personalized medicine. METHODS: Based on the self-developed Precision Medicine knowledgebase, which concludes drug directions, guidelines or important literatures with high level of evidence, we developed GeneFace with Java-based open-resource application framework Spring Boot, further developed a mobile App with cross-platform framework Uni-APP. RESULTS: The App includes six modules: genetic testing appointment, genetic knowledge introduction, individualized medication advice, medication records, Geneface interpretation, and Precision Medicine knowledgebase. By detecting the genotype of more than 300 gene loci upon first use, users import the results to form a personal "drug-gene identity card". Then scan or enter the drug name in "GeneFace", the App would automatically give corresponding medication recommendations, including: risks for possible adverse drug reactions, risks for reducing the efficacy or even ineffectiveness, and possibility for dose adjustment, etc., which increase the safety of clinical drug use. People can obtain pharmacogenomics knowledge and basic drug information in the "GeneFace" app. CONCLUSION: Development as a digital therapeutic product, the expanded application of GeneFace can rapidly promote clinical applications of basic pharmacogenomics research and significantly improve drug use safety, which creating a new model for accelerating the clinical application of personalized medicine.

Objective:To assess the value of acoustic radiation force impulse (ARFI) elastography in the diagnosis of children with biliary atresia.Methods:A prospective survey of infants with hepatitis syndrome and hyperbi-lirubinemia in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2017 to December 2018 was performed.The children with hepatitis syndrome were divided into the biliary atresia group( n=45) and non- biliary atresia group( n=30). Thirty children with hyperbilirubinemia were selected as the control group.Shear wave speed (SWS) of all infants was collected by ARFI ultrasound and compared among 3 groups.Receiver ope-rating characteristic curve(ROC curve) was used to analyze the optimal threshold value for SWS in the diagnosis of biliary atresia. Results:The mean SWS values in the biliary atresia group, non-biliary atresia group and the control group were (1.79±0.29) m/s, (1.26±0.12) m/s and (1.08±0.06) m/s, respectively.Compared with the control group, the mean SWS values in the biliary atresia group and non-biliary atresia group were significantly higher ( t=165.43, 15.75, all P<0.05). The mean SWS value in the non-biliary atresia group was significantly lower than that in the biliary atresia group ( t=90.27, P<0.05). With the non-biliary atresia group as reference, the area under the ROC curve of SWS for diagnosis of biliary atresia was 0.98(95% CI: 0.95-1.00), the optimal threshold was 1.45 m/s, and the sensitivity and specificity were 88.9% and 96.7%, respectively. Conclusions:Rapid non-invasive ARFI elastography is effective in the diagnosis of biliary atresia, and thus has important value for early diagnosis and treatment in clinical practice.