ObjectiveTo explore the mechanism of herbal cake-separated moxibustion using the classical formula Xiaoyaosan in alleviating neuroimmune inflammatory responses in chronic fatigue syndrome （CFS） rats， based on the regulation of the toll-like receptor 4 （TLR4）/myeloid differentiation factor 88 （MyD88）/nuclear transcription factor-κB （NF-κB） signaling pathway. MethodsFifty SPF-grade SD rats aged 6-8 weeks were randomly divided into five groups： Normal group， model group， sham herbal cake moxibustion group， Chinese medicine intragastric administration group， and herbal cake-separated moxibustion group， with 10 rats in each group. Except for the normal group， all other groups underwent a 21-day modeling process， followed by behavioral testing. The herbal cake-separated moxibustion and sham herbal cake moxibustion groups received interventions at the Shenque （CV8）， Guanyuan （CV4）， Zusanli （ST36）， and Qimen （LR14） acupoints. The Chinese medicine intragastric administration group was treated with a Xiaoyaosan suspension via gavage. Behavioral tests were conducted after 10 days of continuous intervention. Serum levels of interleukin （IL）-1β， IL-6， and tumor necrosis factor-α （TNF-α）， as well as hippocampal levels of IL-1β， IL-6， TNF-α， and NF-κB， were detected by enzyme-linked immunosorbent assay （ELISA）. Morphological changes in the hippocampus were observed using hematoxylin-eosin （HE） staining. Real-time quantitative polymerase chain reaction （Real-time PCR） was used to detect mRNA expression levels of TLR4， MyD88， and NF-κB in the hippocampus. Western blot analysis was performed to detect the relative expression levels of TLR4， MyD88， NF-κB， and p65 proteins in the hippocampus. ResultsCompared with the normal group， the model group showed a significant decrease in upright times during the open field test （P<0.01）， as well as significant reductions in total movement distance， resting time， and center region duration （P<0.01）. In the tail suspension test， immobility time increased （P<0.01）， and struggle times decreased （P<0.01）. Serum and hippocampal levels of IL-1β， IL-6， and TNF-α， as well as hippocampal NF-κB levels and TLR4， MyD88， and NF-κB mRNA expression， were significantly elevated （P<0.01）. After treatment， compared with the model group， the total movement distance and upright times in the open field test were significantly increased in all treatment groups （P<0.01）， while resting time and center region duration were notably prolonged （P<0.05， P<0.01）. Immobility time in the tail suspension test was significantly shortened （P<0.01）， and struggle times significantly increased （P<0.05）. Serum and hippocampal levels of IL-1β， IL-6， TNF-α， hippocampal NF-κB levels， and TLR4 and NF-κB mRNA expression were significantly reduced （P<0.05， P<0.01）. Compared with the sham herbal cake moxibustion group， the herbal cake-separated moxibustion group showed a significant extension in center region duration during the open field test （P<0.05） and a significant increase in upright times （P<0.01）. In the tail suspension test， immobility time was reduced （P<0.01）， and struggle times increased （P<0.01）. Serum TNF-α levels in the Chinese medicine intragastric administration group were significantly reduced （P<0.01）， while serum IL-6 levels， as well as hippocampal levels of IL-1β， TNF-α， NF-κB， and TLR4， MyD88， and NF-κB mRNA expression， were significantly decreased in both the Chinese medicine intragastric administration group and the herbal cake-separated moxibustion group （P<0.05， P<0.01）. Compared with the Chinese medicine intragastric administration group， the herbal cake-separated moxibustion group exhibited significantly increased upright times in the open field test （P<0.01）. In the tail suspension test， immobility time was reduced （P<0.01）， and struggle times increased （P<0.01）. Serum IL-1β， hippocampal TNF-α levels， and TLR4， MyD88， and NF-κB mRNA expression were significantly decreased （P<0.05， P<0.01）. ConclusionHerbal cake-separated moxibustion effectively improves fatigue and memory function in CFS rats， regulates neuroimmune inflammatory responses， and its mechanism may be related to the modulation of the TLR4/MyD88/NF-κB signaling pathway.

Objective To establish an individualized nomogram model and evaluate its efficacy to provide a possible evaluation basis for the prognosis of lower third and abdominal part of oesophageal adenocarcinoma (EAC). Methods Lower third and abdominal part of EAC patients from 2010 to 2015 were chosen from the SEER Research Plus Database (17 Regs, 2022nov sub). The patients were randomly allocated to the training cohort and the internal validation cohort with a ratio of 7∶3 using bootstrap resampling. The Cox proportional hazards regression analysis was used to determine significant contributors to overall survival (OS) in EAC patients, which would be elected to construct the nomogram prediction model. C-index, calibration curve and receiver operating characteristic (ROC) curve were performed to evaluate its efficacy. Finally, the efficacy to evaluate the OS of EAC patients was compared between the nomogram prediction model and TNM staging system. Results In total, 3945 patients with lower third and abdominal part of EAC were enrolled, including 3475 males and 470 females with a median age of 65 (57-72) years. The 2761 patients were allocated to the training cohort and the remaining 1184 patients to the internal validation cohort. In the training and the internal validation cohorts, the C-index of the nomogram model was 0.705 and 0.713, respectively. Meanwhile, the calibration curve also suggested that the nomogram model had a strong capability of predicting 1-, 3-, and 5-year OS rates of EAC patients. The nomogram also had a higher efficacy than the TNM staging system in predicting 1-, 3-, and 5-year OS rates of EAC patients. Conclusion This nomogram prediction model has a high efficiency for predicting OS in the patients with lower third and abdominal part of EAC, which is higher than that of the current TNM staging system.

BACKGROUND:Immunosuppression leads to impaired body immune function and aggravates the disease.Herb-partitioned moxibustion can effectively regulate immune function and improve immunity in the body,but its regulatory mechanism has not been elucidated. OBJECTIVE:To sequence immunosuppressed model rats treated with herb-partitioned moxibustion using bioinformatics techniques based on transcriptomics and to explore the mechanisms by which it regulates immunity. METHODS:Twenty-four Sprague-Dawley rats were randomly assigned to three groups:control,model,and herb-partitioned moxibustion groups,with eight rats in each group.The model and herb-partitioned moxibustion groups were subjected to establishment of an immune suppression model by intraperitoneal injection of cyclophosphamide at a dose of 35 mg/kg for 3 consecutive days.No interventions were administered to the control and model groups after modeling.In contrast,the herb-partitioned moxibustion group received moxibustion treatment at Zhongwan,Shenque,Guanyuan,and Zusanli acupoints using a combination of moxa and herbal cakes,once a day,for 10 consecutive days,with samples being collected the day after the end of the intervention.Peripheral blood was collected from all groups of rats to measure their white blood cell count.RNA-seq was performed on the Illumina sequencing platform,and differentially expressed genes were selected for bioinformatics analysis using the GO and KEGG databases. RESULTS AND CONCLUSION:Compared with the control group,the model group exhibited a significant decrease in white blood cell count(P<0.001).RNA-seq analysis identified 3 026 differentially expressed genes between the model and control groups,with 1 565 upregulated and 1 461 downregulated.There were 535 differentially expressed genes identified between the herb-partitioned moxibustion group and the model group,with 280 upregulated and 255 downregulated.The Venn diagram analysis revealed that 159 genes were downregulated in the model group compared with the control group.However,after moxibustion with herbal cakes,these genes were upregulated.Protein-protein interaction network analysis identified 10 core targets,including Oasl,Oas2,Isg15,Herc6,Mx2,Helz2,Mx1,Syk,Hspa1a,and Ret.According to GO and KEGG analyses,moxibustion with herbal cakes regulated the body through pathways related to immune response,viruses,angiogenesis,and the autoimmune system.To conclude,there is a significant association between herbal cake-separated moxibustion intervention and immune suppression targets,including Oasl,Oas2,Isg15,Herc6,Mx2,Helz2,and Mx1.The intervention exhibits regulatory effects in the pathways related to immune responses,viral activities,and angiogenesis.

ObjectiveTo explore the effects of the Tai Chi training on bone density， bone turnover markers， and heart rate variability for people with high-risk osteoporosis， and to provide evidence for the prevention of osteoporosis at early stage. MethodsSixty-six cases of people with high risk of osteoporosis were included， and they were divided into 33 cases each in the intervention group and the control group using the random number table method. The control group received osteoporosis health education three times a week， and the intervention group received Tai Chi training under the guidance of a trainer three times a week for 40 mins each time on the basis of the control group， and both groups were intervened for 12 weeks. Dual-energy X-ray absorptiometry was used to measure the bone density of L₁~L₄ vertebrae， bilateral femoral necks and bilateral total hips in the two groups before and after the intervention； enzyme-linked immunosorbent assay was used to determine bone turnover markers before and after the intervention， including pro-collagen type Ⅰ pro-amino-terminal prepropyl peptide （P1NP） and β-collagen type Ⅰ cross-linking carboxy-terminal peptide （β-CTX）. Seven cases with good compliance in the intervention group were selected. After wearing the heart rate sensor， they successively performed Tai Chi training and walking activities recommended by the guideline for 20 mins each， and the heart rate variability （HRV） during exercise was collected， including time-domain indexes such as standard deviation of normal sinus intervals （SDNN）， root-mean-square of the difference between adjacent RR intervals （RMSSD）， frequency-domain metrics such as low-frequency power （LF）， high-frequency power （HF）， and low-frequency/high-frequency power ratio （LF/HF）， as well as nonlinear metrics such as approximate entropy （ApEn）， sample entropy （SampEn）. ResultsFinally， 63 cases were included in the outcome analysis， including 30 cases in the intervention group and 33 cases in the control group. After the intervention， the differences of L₁~L₄ vertebrae， bone density of bilateral femoral neck and bilateral total hip in the intervention group were not statistically significant when compared with those before intervention （P＞0.05）， while the bone density of all parts of the control group decreased significantly compared with that before intervention （P＜0.05）， and the difference in the bone density of the L₁~L₄ vertebrae， bilateral femoral neck， and the right total hip before and after the intervention of the intervention group was smaller than that of the control group （P＜0.05）. The differences in P1NP and β-CTX between groups before and after intervention was not statistically significant （P＞0.05）. Compared with walking exercise， LF decreased， HF increased and LF/HF decreased during Tai Chi exercise （P＜0.05）； the time domain indexes and non-linear indexes between groups had no statistically significant difference （P＞0.05）. ConclusionTai Chi exercise can maintain lumbar， hip， and femoral bone density and improve sympathetic/parasympathetic balance in people at high risk for osteoporosis， but cannot significantly improve bone turnover markers.

Objective To evaluate the efficacy and safety of biomaterial sling in the treatment of female stress urinary incontinence (SUI), so as to explore the possibility of replacing traditional synthetic materials with biomaterials in SUI surgery. Methods Clinical data of 22 SUI patients undergoing retropubic mid-urethral sling surgery in our hospital during Jan.and Dec.2023 were retrospectively collected. Perioperative parameters were analyzed, and all patients were followed up for more than one year. The quality of life was assessed using the incontinence impact questionnaire-short form-7 (IIQSF-7), numerical rating scale (NRS), and urogenital distress inventory-short form-6 (UDI-6). Results All 22 operations were successfully completed. The follow-up was 13-25 (mean 15.2±4.6) months, operation time (47.0±11.1) minutes, hospital stay (0.8± 0.2) days, and pain duration (6.1±4.9) days. One year after surgery, all patients'NRS, IIQSF-7 and UDI-6 scores were significantly reduced (P<0.001). One week after surgery, all patients were improved. No sling exposure or urinary tract infection was found during the follow-up. Conclusion Biomaterial sling is an effective and relatively safe method for the treatment of female SUI, demonstrating satisfactory short-term outcomes. However, the long-term effects still need further research.

Objective:To investigate the differences in hippocampal subfield volumes and structural covariance network properties among patients with mild cognitive impairment (MCI) exhibiting different cognitive outcomes and normal controls (NCs), and to further evaluate the predictive value of these imaging indicators for cognitive deterioration in MCI patients.Methods:A total of 43 NCs, 65 stable MCI (sMCI), and 26 progressive MCI (pMCI) patients enrolled in the Alzheimer′s Disease Neuroimaging Initiative (ADNI) database between December 2012 and May 2016 were included in this study. Baseline demographic information and T 1-weighted magnetic resonance imaging scans were collected. Hippocampal subfield volumes were extracted using freesurfer software, and structural covariance networks of hippocampal subfields were constructed. Multivariate analysis of covariance was used to compare hippocampal subfield volumes among the 3 groups. A general linear model was applied to examine group differences in hippocampal subfield structural covariance network properties. Least absolute shrinkage and selection operator (LASSO)-Logistic regression was employed to identify imaging predictors associated with conversion to Alzheimer′s disease (AD), based on which structural, network-based, and combined predictive models were constructed. Model discrimination was evaluated using the area under the curve (AUC); internal validation was performed using Bootstrap resampling; model calibration was assessed with the Hosmer-Lemeshow test; and clinical utility was evaluated through decision curve analysis. Results:Significant differences in hippocampal subfield volumes (mm3) were observed among the 3 groups (all P<0.05, Bonferroni-corrected). Specifically, left parasubiculum (65.58±13.30, 61.96±17.56, 49.56±11.82, F=9.900), right parasubiculum (65.92±15.21, 59.45±16.65, 47.69±15.48, F=11.612), left presubiculum (277.09±39.85, 258.15±44.86, 224.05±45.05, F=14.513), right presubiculum (262.85±40.43, 247.41±43.27, 209.97±46.11, F=14.500), left subiculum (399.66±32.19, 374.25±55.83, 306.12±51.62, F=32.923), right subiculum (417.93±48.92, 376.59±51.01, 316.82±70.22, F=28.764), left cornu ammonis 1 (CA1) (592.10±83.87, 561.96±94.72, 490.06±86.89, F=13.352), right CA1 (632.15±100.09, 601.24±88.88, 531.05±110.29, F=10.579), left CA3 (191.58±30.08, 180.47±34.66, 155.08±37.82, F=12.182), right CA3 (210.42±28.92, 203.84±34.80, 176.69±41.47, F=9.597), left CA4 (224.61±28.94, 210.49±35.04, 183.98±36.89, F=16.521), right CA4 (238.49±28.14, 227.43±30.65, 200.23±42.74, F=13.702), left granule cell-molecular layer-dentate gyrus (GC-ML-DG) (259.96±36.76, 239.42±41.17, 207.61±41.84, F=19.831), right GC-ML-DG (273.98±35.12, 258.79±36.82, 227.81±49.07, F=14.204), left molecular layer (505.62±66.16, 468.58±75.17, 402.68±75.47, F=22.293), right molecular layer (527.39±72.39, 493.14±70.39, 423.81±88.09, F=19.588), left hippocampal amygdala transition area (HATA) (54.91±9.99, 49.52±9.93, 43.27±9.59, F=13.571), right HATA (58.43±9.83, 54.55±10.80, 47.12±12.54, F=10.037), left fimbria (69.94±25.04, 56.63±23.74, 40.58±19.83, F=14.846), right fimbria (68.61±26.24, 53.95±23.16, 45.25±17.04, F=10.424), left hippocampal tail (488.37±83.44, 463.54±80.33, 393.83±77.73, F=13.570), and right hippocampal tail (519.78±80.22, 498.84±81.68, 419.75±93.29, F=14.339) all showed significant group differences. Significant group differences were also observed in small-worldness metric γ (0.51±0.10, 0.51±0.08, 0.62±0.14, F=9.317), small-worldness metric λ (0.39±0.02, 0.39±0.02, 0.43±0.04, F=9.925), global efficiency (0.19±0.01, 0.20±0.01, 0.18±0.01, F=3.189), local efficiency (0.26±0.02, 0.26±0.01, 0.27±0.01, F=3.068), clustering coefficient (0.23±0.01, 0.23±0.01, 0.24±0.02, F=4.274), and characteristic path length (0.73±0.06, 0.72±0.06, 0.76±0.07, F=4.477) of the hippocampal subfield structural covariance network (all P<0.05). Specifically, the pMCI group exhibited higher γ ( t=3.773, P<0.001), λ ( t=4.060, P<0.001), local efficiency ( t=2.445, P=0.047), and clustering coefficient ( t=2.849, P=0.015) than the NCs group, and higher γ ( t=4.074, P<0.001), λ ( t=4.068, P<0.001), and characteristic path length ( t=2.986, P=0.010) but lower global efficiency ( t=-2.444, P=0.047) than the sMCI group. The AUC of the structural, network, and combined models based on LASSO-Logistic regression was 0.837, 0.861, and 0.899, respectively. After internal validation, the corrected AUC was 0.835, 0.855, and 0.889, respectively. All models demonstrated good calibration ( P>0.05), and decision curve analysis indicated favorable clinical net benefit across models. Conclusions:Both sMCI and pMCI patients exhibit widespread hippocampal subfield atrophy and altered global properties of hippocampal subfield structural covariance networks compared to NCs. The models constructed based on hippocampal subfield volumes and structural covariance networks show strong potential for predicting cognitive decline in MCI patients.

Objective Through studying the chemical composition changes before and after the compatibility of Hedysari Radix Paeparata Cum Melle(HRPCM)-vinegar processed Curcumae Rhizoma(VPCR);To discuss the significance of the compatibility of HRPCM and VPCR;To establish the fingerprints before and after their compatibility.Methods ZORBAX Eclipse Plus C18 column was used;acetonitrile-0.01%phosphoric acid water was set as mobile phase,with gradient elution;column temperature was 30℃;detection wavelength was 214 nm;sample injection was 10 μL,which was used to investigate the content difference of major chemical components such as vanillic acid,calycosin-O-β-D-glucopyranoside,ononin,calycosin,onocerin,curdione,cincumol and germacrone,and establish the fingerprint of HRPCM,VPCR and HRPCM-VPCR.Results HPLC chromatographic conditions were established for the determination of 8 components in HRPCM-VPCR.Meanwhile,fingerprints were established before and after the compatibility of HRPCM-VPCR.26 common peaks were identified,among which 11 components such as vanillic acid were derived from HRPCM,14 components such as curcuma zedoariae were derived from VPCR,and 1 component was shared by both.Conclusion The material basis of the compatibility of HRPCM-VPCR differs from that of HRPCM and VPCR.The content of most chemical components decreases while the content of some components increases.The established HPLC method for content determination and fingerprint is simple,stable and reproducible,which can be used to evaluate and control the quality of HRPCM and VPCR.

Objective:To analyze the differences in emergency rescue service capacities between county-level hospitals in Zhejiang and Jiangsu provinces, and propose targeted improvement suggestions.Methods:Cluster sampling was employed, with representative county-level hospitals recommended by provincial hospital alliances in Zhejiang and Jiangsu. Emergency departments voluntarily submitted data, resulting in 24 hospitals from Zhejiang and 34 from Jiangsu. Data were collected through the China County-Level Hospital Emergency Service Capability Evaluation System. Differences between provinces were analyzed. Spearman correlation analysis explored relationships between multidimensional indicators, and multivariate logistic regression identified factors influencing hospital grade B++ and above.Results:In terms of department scale, Jiangsu had a larger emergency department area (4 853 m 2vs. 1 927 m 2, P<0.001), more beds of comprehensive inpatient wards in the emergency department (25.5 beds vs. 5.5 beds, P=0.011), and higher scores for the ratio of emergency department area to beds (4.8 vs. 3.4, P=0.005) than Zhejiang. In terms of staffing, Jiangsu had a higher proportion of doctors with master's degrees or above (13.8% vs. 0.0%, P<0.001), a higher proportion of frontline emergency medical staff with over three years of clinical experience (100.0% vs. 91.5%, P=0.001), and more doctors (19 vs. 15, P=0.039) and nurses (46 vs. 32, P=0.039). In terms of quality and safety and medical service capacity, Zhejiang had a higher severe trauma resuscitation success rate (92.9% vs. 83.75%, P=0.003), annual emergency surgery volume (1 002 vs. 428, P=0.015), and number of emergency surgery procedures (125 vs. 42, P=0.027), but Jiangsu had a shorter emergency room stay time (87.5 min vs. 136.2 min, P=0.029). In terms of informatization, Zhejiang outperformed Jiangsu in all indicators, especially in patient information interconnection and sharing (100.0% vs. 82.4%, P=0.030) and in-hospital diagnosis and treatment timeline (91.7% vs. 73.5%, P=0.043). Correlation analysis showed that the total specialty scale score was significantly positively correlated with the in-hospital emergency rescue service capacity score ( r=0.576) and the staffing score ( r=0.455). The total evaluation score was significantly positively correlated with the informatization total score ( r=0.397) and the pre-hospital emergency rescue service capacity score ( r=0.322). Binary Logistic regression analysis showed that the emergency rescue service capacity score was significantly positively correlated with hospital grade ( B=1.431, P=0.03, OR=4.185, 95% CI:1.152-15.205). For every 1-unit increase in the emergency department area ( B=0.002, P=0.05), the probability of a hospital being upgraded to B++ or above increased by 0.2% ( OR=1.002, 95% CI:1.000-1.004). Conclusions:Both provinces exhibit distinct advantages in emergency department development. Departmental scale and configuration significantly impact emergency service capabilities, while staffing and quality management constitute core elements for improvement. Informatization construction notably enhances emergency service efficiency and quality.

Objective:To investigate the alterations of individual metabolic brain network properties in patients with mild cognitive impairment (MCI) and their correlations with cognitive function.Methods:One hundred and five participants from Alzheimer's Disease Neuroimaging Initiative (ADNI) database enrolled from March 2012 to February 2016 were chosen, including 61 MCI patients and 44 normal controls (NC). Cognitive assessments, including mini-mental state examination (MMSE), auditory verbal learning test (AVLT), trail making test (TMT), and semantic verbal fluency (SVF) score, were performed in both groups; differences of above scores and clinical data between the participants from the two groups were compared. T1-weighted imaging and fluorodeoxyglucose positron emission tomography (FDG-PET) images were collected in both groups; individual metabolic brain networks were constructed based on differences in effect sizes between brain regions and network properties were calculated. Spatial correlation analysis was used to compare the correlations of metabolic brain networks at the individual and group levels. General linear model was employed to compare the differences in network properties between the two groups. Partial correlation analysis was used to examine the correlations of differential network properties with cognitive function in MCI patients. A support vector machine (SVM) classification model was constructed based on individual metabolic brain network properties, and receiver operating characteristic (ROC) curve was used to explore the diagnostic value of this SVM classification model in MCI.Results:(1) Compared with the NC group, the MCI group had significantly lower MMSE and AVLT-immediate recall scores, and longer TMT-A completion time ( P<0.05). (2) Spatial correlation analysis revealed a positive correlation between individual metabolic brain networks and group-level metabolic brain networks in patients of the MCI group ( r=0.825, P<0.001). No significant differences in global network properties were noted between the two groups ( P>0.05). Compared with the NC group, the MCI group significantly decreased degree centrality in the left A8vl, right A39c, and right V5/MT+ regions, increased degree centrality in the left anterior cuneus, decreased nodal efficiency in the left A8vl, right V5/MT+, and right caudal hippocampus regions, increased nodal shortest path length and nodal clustering coefficient in the left A8vl region ( P<0.05). (3) The degree centrality at the A8vl of ventral part of the left middle frontal gyrus and nodal efficiency in right caudal hippocampus region were positively correlated with AVLT-immediate recall scores ( r=0.331, P=0.010; r=0.282, P=0.030), nodal efficiency in the left A8vl region was negatively correlated with TMT-A completion time ( r=-0.470, P<0.001), and nodal efficiency in the left A8vl region was positively correlated with SVF score ( r=0.263, P=0.044). (4) Area under the curve of SVM classification model in diagnosing MCI was 0.880 (95% CI: 0.813-0.945, P<0.001), with an accuracy rate of 0.790. Conclusions:Patients with MCI have alterations in individual metabolic brain network properties, among which the degree centrality and nodal efficiency of some nodes are closely related to cognitive function changes. Models constructed based on individual metabolic brain network properties can help to effectively diagnose MCI.

Objective:To investigate the interactive effects of loss of the only child and childhood trauma on brain structure, function, and structure-function coupling, and to analyze their association with clinical symptom.Methods:A total of 112 parents who lost their only child and participated in the psychological aid project organized by Local Civil Affairs Department in Sunan aear of Jiangsu Province in China from April 2021 to July 2021 and 36 healthy controls recruited from the community during the same period were selected. Based on childhood trauma questionnaire scores, parents who had lost their only child were divided into those with childhood trauma (group A, n=55) and those without childhood trauma (group B, n=57); similarly, the healthy controls were divided into a group with childhood trauma (group C, n=12) and a group without childhood trauma (group D, n=24). All participants were evaluated by clinical scales such as Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Mini-Mental State Examination (MMSE). MRI 3D-T1 structural images and resting-state functional magnetic resonance imaging data were collected; gray matter volume (GMV) and degree centrality (DC) were calculated by standardized image preprocessing procedure, and ratio of DC to GMV within each voxel was computed to obtain the structure-function coupling map. A two-factor analysis of variance was used to analyze the independent effect and interactive effect of loss of the only child and childhood trauma on GMV, DC, and DC/GMV coupling value. Spearman rank correlation analysis was used to evaluate the associations of above indicators in brain regions with significant difference in independent effect and interactive effect with clinical scale scores. Results:(1) Compared with the participants without childhood trauma (group B+group D), the participants with childhood trauma (group A+group C) showed significantly reduced GMV in the left middle temporal gyrus and right dorsolateral superior frontal gyrus (voxel-level P<0.01, cluster-level P<0.05, Gaussian random field [GRF] corrected). A significant interactive effect of loss of the only child and childhood trauma on GMV in the right precuneus was observed (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). (2) Compared with the healthy controls, parents who had lost their only child exhibited significantly increased DC in the left middle frontal gyrus (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). Compared with participants without childhood trauma, participants with childhood trauma showed significantly increased DC in the right thalamus (voxel-level P<0.01, cluster-level P< 0.05, GRF corrected). A significant interactive effect of loss of the only child and childhood trauma on DC in the left dorsolateral superior frontal gyrus was observed (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). (3) Compared with the healthy controls, parents who had lost their only child showed significantly decreased DC/GMV coupling value in the left middle frontal gyrus (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). Compared with participants without childhood trauma, participants with childhood trauma showed significantly increased DC/GMV coupling value in the right thalamus (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). A significant interactive effect of loss of the only child and childhood trauma on DC/GMV coupling value in the left dorsolateral superior frontal gyrus was observed (voxel-level P<0.01, cluster-level P<0.05, GRF corrected). (4) Correlation analysis revealed that GMV in the right precuneus with significant interactive effect of loss of the only child and childhood trauma was positively correlated with MMSE score ( r s=0.317, P=0.010, Bonferroni corrected). GMV in the left middle temporal gyrus with significant independent effect of childhood trauma was positively correlated with both HAMD score and HAMA score ( r s=0.362, P=0.006; r s= 0.349, P=0.008, Bonferroni corrected). Conclusion:Loss of the only child and childhood trauma can interact to jointly affect the brain structure, function, and structure-function coupling; and some of these brain structure alterations are closely associated with clinical symptoms.