While cranial radiotherapy effectively kills tumor cells and significantly prolongs patient survival, it often leads to progressive cognitive decline. To date, the specific mechanisms underlying radiation-induced cognitive decline have not been fully elucidated, which greatly limits the development of related therapeutic strategies. Therefore, this article provides a comprehensive analysis of post-radiation changes in neurogenesis, neuronal synaptic plasticity, myelin injury plasticity, and parenchymal cells such as microglia in the brain, systematically elucidates the potential mechanisms of radiation-induced cognitive decline, and summarizes feasible therapeutic approaches. These findings provide a solid foundation for developing novel strategies to mitigate radiation-induced cognitive decline.

Ensuring food security requires new green pesticides. Double-stranded RNA (dsRNA) pesticides trigger RNA interference by exogenous dsRNA specifically targeting pests and diseases. They can inhibit the expression of key genes in pathogens or pests, thereby achieving effective control of specific pests and diseases. DsRNA pesticides are environmentally friendly, with strong specificity and efficient gene silencing ability, while they have problems such as high production costs. Using engineering strains to produce dsRNA is a feasible strategy, whereas currently there is no cost-effective engineering strain for producing dsRNA. This article reviews the research progress and production strategies of using microorganisms to produce dsRNA, hoping to provide reference for dsRNA production.
RNA, Double-Stranded/genetics* ; Genetic Engineering/methods* ; RNA Interference ; Pesticides ; Animals

OBJECTIVE Aimed to construct a corpus for a developing auditory-verbal communication training system tailored for the elderly and to grade the difficulty of sentence materials.The ultimate goal is to meet the diverse needs of trainees with varying hearing and speech capabilities.METHODS A training corpus,encompassing 3 627 sentences across 12 distinct topics,was systematically established.During the pre-experimental phase,12 adult subjects with normal hearing were recruited.They were tasked with conducting speech recognition rate tests on 100 randomly selected test sentences under four different signal-to-noise ratio(SNR)conditions.By plotting the performance-intensity(P-I)function curve,the SNR50 value,specifically-6.5 dB,was accurately determined.In the formal experiment,17 additional subjects were recruited.All sentences within the corpus were then subjected to speech recognition rate tests in a noisy environment under the established SNR50 condition.The average recognition rate was computed,and both the recognition rate-frequency histogram and the normal distribution curve were plotted.Leveraging the area beneath the normal curve,the segmentation points of the speech recognition rate were calculated,enabling the classification of sentences into three difficulty levels:easy,medium,and difficult.RESULTS The task of classifying the difficulty of sentences within the corpus was successfully accomplished.Specifically,there were 1 144 easy sentences,constituting 33%of the total;1 099 medium sentences,accounting for 32%;and 1 212 difficult sentences,representing 35%.CONCLUSION This research has successfully concluded the establishment of a corpus for the elderly's auditory-verbal communication ability training system and its associated difficulty grading.The obtained grading results are found to be in accordance with the principle of partitioning the difficulty gradient based on area.This study explores an effective method for grading the difficulty of auditory training sentences,ensuring that the training content matches the level of the trainer's competence.This not only enhances the training effectiveness but also improves the overall user experience.

Objective: To investigate whether melatonin (MT) secretion in different parts of the gastrointestinal tract (GIT) exhibits seasonal variations and its correlation with immune regulation. Methods: Sixty Sprague-Dawley rats were divided into control and model groups, and the pineal gland was removed in the model group. Stomach, jejunum, ileum, and colon tissues were obtained during the spring equinox, summer solstice, beginning of autumn, autumn equinox, and winter solstice. The levels of MT, MT receptors (MR), arylalkylamine N-acetyltransferase (AANAT), hydroxyindole-O-methyltransferase (HIOMT), interleukin-2 (IL-2), and interleukin-10 (IL-10) in the GIT were measured using enzyme-linked immunosorbent assay. Results: Except for the stomach, the jejunum, ileum, and the colon showed seasonal tendencies in MT secretion. In the control group, MT secretion in the jejunum and ileum was the highest in the long summer, and colonic MT secretion was the highest in winter. In the model group, MT levels in the colon were highest in the summer. The seasonal rhythms of the MR, AANAT, HIOMT, IL-2, and IL-10 in the colon were roughly similar to those of MT, and changed accordingly after pinealectomy. Conclusions Gastrointestinal MT secretion is related to seasonal changes, and MT secretion in each intestinal segment is influenced by different seasons. The biological effects of MT in the gut are inextricably linked to the mediation of MR, and a hormone-receptor linkage exists between MT and MR. The effect of seasonal changes on the gastrointestinal immune system may be mediated through the regulation of seasonal secretion of MT.

To review the concept development,characteristics,measurement tools,influencing factors,effects,and cultivation of moral resilience among medical staff at home and abroad.The characteristics of moral resilience of medical staff include personal integrity,adaptability,self-regulation,self-management,and moral efficacy of medical personnel,as well as the relational integrity of the medical team.The influencing factors of medical staff's moral resilience include the support system of the medical team,personal qualities of medical staff,and their understanding of events.Moral resilience can promote the physical and mental health of medical staff,effectively cope with moral injury,reduce occupational fatigue and turnover intention of medical staff,as well as alleviate the moral dilemmas of medical staff.Cultivate moral resilience to enhance the ability of medical staff to resist moral dilemmas.

Objective To explore the application efficacy and safety of oblique ultrasound-guided techniques in PICC puncture,in order to provide guidance and references for clinical application.Methods Through convenient sampling,654 patients from a tertiary A hospital in Zhejiang Province from March to December 2022 were selected as the study subjects.The random numbers were generated through Excel table functions and they were randomly grouped into 3 groups:A,B,and C.The ultrasound short axis method,long axis method,and oblique axis method were employed to guide PICC puncture catheterization,respectively.The success rate of PICC puncture,the number of subcutaneous adjustments of the puncture needle,puncture time,and the occurrence of puncture complications(such as hematoma,puncture of the posterior wall of blood vessels,accidental injury to arteries,and accidental injury to nerves)were recorded during the catheterization process in 3 groups.Results A total of 654 patients completed the study,including 215 in group A,219 in group B,and 220 in group C.The success rate of first-time puncture in the group C(86.36％)was higher than that in group A(73.95％)and group B(63.93％),and there was a statistically significant difference among 3 groups(P＜0.001).The subcutaneous adjustment frequency of the puncture needle was 1(1,1)in group C,1(1,2)in group A,and 1(1,2)in group B.The difference between 3 groups was statistically significant(P＜0.001);the puncture time of group C was shorter than that of group A and group B,and the difference was statistically significant(P＜0.001).There was a statistically significant difference in the puncture time between 3 groups(P＜0.017);the pairwise comparison of the number of subcutaneous needle adjustments and the success rate of a puncture between 3 groups showed that there was a statistical difference between group C and group A,and between group C and group B(P＜0.017),while there was no statistical difference between group A and group B(P＞0.017).There was statistical significance(P＜0.05)among 3 groups in terms of complications such as accidental nerve injury and puncture of the contralateral vascular wall by puncture needle,but there was no statistical significance in terms of accidental arterial injury and hematoma occurrence among 3 groups.Conclusion Compared with the short axis approach and the long axis approach,the ultrasound oblique axis approach guided PICC puncture has statistical differences in the success rate of a puncture and the incidence of puncture complications,etc.It is recommended to use the ultrasound oblique axis approach during PICC puncture.

Objective To study the infection of multidrug-resistant organism(MDRO)in elderly pa-tients with catheter-associated urinary tract infection(CAUTI)and analyze the infection factors.Methods The medi-cal records of 175 elderly patients with CAUTI admitted to Jiangsu Province Hospital from January 2021 to July 2022 were selected,the distribution of MDRO infection in elderly patients with CAUTI was analyzed,and the influencing factors of MDRO infection were analyzed.The predictive value of independent risk factors for rele-vant nosocomial infections was analyzed by receiver operating characteristics(ROC)curves.Results Among the 175 elderly patients with CAUTI,87 cases(49.71％)developed MDRO infection and were included in the MDRO infection group),and 88 cases(50.29％)had no MDRO infection and were included in the non-MDRO infection group.A total of 432 MDRO pathogens were detected in the MDRO infection group,inclu-ding 415 strains of Gram-negative bacteria,accounting for 96.06％,186 strains of carbapenem-resistant Acine-tobacter baumannii(43.06％),147 strains of carbapenem-resistant Klebsiella pneumoniae(34.03％),79 strains of carbapenem-resistant Pseudomonas aeruginosa(18.29％)and 3 strains of carbapenem-resistant Escherichia coli(0.69％).There were 17 strains of Gram-positive bacteria(3.94％),all of which were methi-cillin-resistant Staphylococcus aureus.Multivariate analysis showed that the use of carbapenems,tigecycline,polymyxin,and days of central venous intubation were considered as independent risk factors.The area under the curve of MDRO infection was 0.883.Conclusion For elderly patients with CAUTI,it is necessary to take strict antimicrobial management measures,master the indications of antimicrobial application,shorten the hos-pitalization time of patients and reduce the incidence of MDRO infection.

Group B Streptococcus(GBS)is a major member of the Gram-positive Streptococcus family,which occupies a dominant position in the infection spectrum of newborns and young infants.GBS infections occurring 0?6 days after birth are called GBS early-onset disease(GBS-EOD),and those occurring 7?89 days are called GBS late-onset disease(GBS-LOD).With the use of intrapartum antibiotic prophylaxis,the incidence of neonatal GBS-EOD has declined without a notable impact on GBS-LOD,which brings great pressure and challenge to clinical diagnosis and nursing work.However,the specific mechanisms by which GBS transmission triggers illness in newborns and young infants are not fully elucidated.Some factors,such as maternal GBS colonization,maternal characteristics(age,weight and ethnicity),preterm birth,GBS infection in multiple births,and exposure to human immunodeficiency virus,have been identified as risk factors for GBS-LOD.To prevent maternal and infant GBS infection,some measures,such as vaccination of pregnant women,gut microbiota regulation and lactoferrin supplementation,are developing.In addition,strengthening maternal health care and health education,along with some other conventional infection control strategies(including enhancing hand hygiene awareness among caregivers and making good disinfection of the environment and equipment)is also effective in the prevention of GBS-LOD.This review elaborates the prevalence,transmission,risk factors and prevention of GBS-LOD in infants,aiming to improve the understanding and clinical practice ability of the medical staff.