Objective To analyze the layout and shielding effectiveness of medical accelerator vaults, and to provide a reference for the layout, shielding design, and optimization of protection of medical accelerator vaults. Methods Four medical accelerator radiotherapy vaults were selected. The layouts of these vaults were compared with the layout requirements in the radiation therapy protection standards. For each vault, the dose rates at four points of interest outside the shielding were calculated, including the primary shielding area, secondary shielding area, maze outer wall, and lateral shielding area. These values were then compared with the actual measurements obtained using a dose rate meter. Results All four vaults were located on the ground floor of the building and included a maze, with the auxiliary rooms all placed outside the treatment rooms. However, one vault was not located at one end of the building, and in another vault, the control room was exposed to direct irradiation of the useful beam. The calculated dose rates outside the primary shielding area ranged from 0.04 μSv/h to 0.62 μSv/h, while the measured values ranged from 0.10 μSv/h to 0.66 μSv/h, with the measured values being higher than the calculated ones. The calculated dose rates outside the secondary shielding area ranged from 0.0005 μSv/h to 0.12 μSv/h, those outside the maze outer wall ranged from 0.06 μSv/h to 0.18 μSv/h, and those outside the lateral shielding area ranged from 0.009 μSv/h to 0.15 μSv/h; the measured values were all below the detection limit. Conclusion Inadequate layouts were observed in some of the accelerator vaults. The calculated and measured dose rates at points of interest outside the vaults were both significantly lower than the shielding protection requirements in standards, indicating that the shielding designs were overly conservative. Construction units should follow the principle of optimization of radiation protection to design the layout and shielding reasonably and pay attention to the underestimation of dose rates outside the primary shielding caused by the tenth value layer.

Objective To evaluate the ambient dose equivalent rates of photons and neutrons inside and outside the door of a 10 MV accelerator room, and to report the shielding effect of boron-containing polyethylene as maze wall lining. Methods The ambient dose equivalent rates of photons and neutrons inside and outside the door of an accelerator room were taken as the research subject. The Kersey, Falcão, and modified Kersey methods were used to calculate the ambient dose equivalent rates of neutrons and neutron capture gamma rays inside and outside the door of the room before and after renovation. Measurements were made using an X-ray/γ-ray dose rate instrument and a neutron ambient dose equivalent rate meter. Calculated and measured results were compared. Results Before renovation, the measured neutron dose rate inside the door was 409 μSv/h, while the calculated values were 323 μSv/h (Kersey method), 428 μSv/h (Falcão method), and 219 μSv/h (modified Kersey method). The Falcão method yielded a value closest to the measured value, while the Kersey and the modified Kersey methods underestimated the value by 21% and 46%, respectively. After the installation of boron-containing polyethylene plates, the measured neutron dose rate inside the door was 190 μSv/h, with a 54% reduction. The neutron and photon ambient dose equivalent rates outside the door were 5.8 μSv/h and 6.0 μSv/h, respectively, before renovation, and 0.14 μSv/h and 1.6 μSv/h, respectively, after renovation. Conclusion For a 10 MV accelerator room, neutron shielding and protection measurements are necessary, especially for rooms with short mazes. The Falcão method provides the best estimate of neutron dose rates inside and outside the door. Using boron-containing polyethylene plates as maze wall lining is an economical and effective shielding method.

Objective: To systematically evaluate the influencing factors for repeated implantation failure (RIF) after in vitro fertilization-embryo transfer (IVF-ET) in China, so as to provide the evidence for prevention of RIF. Methods: Literature on influencing factors for RIF in China were retrieved from CNKI, Wanfang Data, VIP, China Medical Literature Service System, PubMed, Web of Science, Cochrane Library and Embase from inception to September, 2024. A meta-analysis was performed using RevMan 5.3 and Stata 14.0 softwares. Literature were excluded one by one for sensitivity analysis. Publication bias was evaluated using Egger's test. Results: Initially 4 836 relevant articles were retrieved, and 12 of them were finally included, with a total sample size of 11 554 individuals. There were 10 case-control studies, 1 cohort study, and 1 cross-sectional study; and 10 high-quality studies and 2 medium-quality studies. The meta-analysis showed that factors including advanced age (OR=1.121, 95%CI: 1.035-1.215), prolonged infertility duration (OR=1.237, 95%CI: 1.091-1.403), abnormal hysteroscopy findings (OR=2.205, 95%CI: 1.119-4.348), positive anti-nuclear antibody (ANA) (OR=2.393, 95%CI: 1.473-3.886), and positive anti-beta2 glycoprotein Ⅰ antibody (β2-GPⅠ-Ab) (OR=2.824, 95%CI: 1.987-4.013) were associated with an increased risk of RIF; while factors including the large number of embryos transferred (OR=0.309, 95%CI: 0.098-0.973), thicker endometrium (OR=0.601, 95%CI: 0.556-0.650), and higher granulocyte colony-stimulating factor (G-CSF) levels (OR=0.657, 95%CI: 0.511-0.845) were associated with a reduced risk of RIF. Conclusion IVF-ET RIF is associated with age, infertility duration, number of embryos transferred, endometrial thickness, hysteroscopy findings, G-CSF levels, ANA and β2-GPⅠ-Ab.

Objective:To investigate the inhibitory effect of tripartite motif-containing 25 (TRIM25) on the replication of Japanese encephalitis virus (JEV) in cells and its molecular mechanism.Methods:Human glioma cells (U251 cells) and Kunming mice were infected with JEV, and then the cells and brain tissue samples were collected. The transcription levels of six TRIM genes were detected by real-time PCR, and the expression of TRIM25 in cells was detected by Western blot. U251 and A549 cells overexpressed with TRIM25 and U251 cells knocked out with TRIM25 gene were constructed. Cells were infected with JEV, and the replication of JEV was detected by viral plaque assay, real-time PCR and Western blot. The interaction of TRIM25 with viral proteins was investigated by co-immunoprecipitation (Co-IP) and indirect immunofluorescence assay. The expression of IFN-β in overexpressed TRIM25 cells was detected by real-time PCR and ELISA.Results:JEV infection promoted the expression of TRIM25 in cells and mouse brain tissues. TRIM25 overexpression restricted JEV replication in U251 and A549 cells, while TRIM25 knockout enhanced JEV replication. TRIM25 overexpression upregulated the level of IFN-β in cells. TRIM25 interacted with JEV capsid protein and promoted the degradation of capsid protein.Conclusion:TRIM25 can inhibit the replication of JEV in cells by upregulating IFN-β and promoting the degradation of JEV C protein.

Objective To investigate the factors influencing mood and sleep among special operation personnel,so as to provide evidence for the prevention and intervention of related issues.Methods A total of 600 special operation personnel during their special duty were enrolled by random sampling method.Basic information was collected by a general information questionnaire.Mood and sleep status were evaluated by self-rating anxiety scale(SAS),self-rating depression scale(SDS),and Pittsburgh sleep quality index scale(PSQI).Results Spearman correlation analysis showed that factors associated with anxiety were years of work experience(r=0.099,P=0.016),family residence(r=-0.153,P＜0.001),and sleep status(r=0.199,P＜0.001);the factors associated with depression were relationship with parents(r=-0.134,P=0.001),family residence(r=-0.144,P＜0.001),and sleep status(r=0.122,P=0.003);and the factors associated with sleep were age(r=0.088,P=0.031),years of work experience(r=0.079,P=0.049),and number of children(r=0.083,P=0.043).Binary logistic regression analysis showed that depression was not an influencing factor of sleep(odds ratio[OR]=1.302,95%confidence interval[95%CI]0.759-1.758,P=0.086),while anxiety was an influencing factor of sleep(OR=2.187,95%CI 1.608-4.695,P=0.001).Conclusion The sleep status of special operation personnel investigated in this survey is related to age and years of work experience,and is influenced by anxiety.Therefore,greater attention should be given to sleep issues in the occupational health support of special operations.Additionally,years of work experience,family residence,relationship with parents,and sleep status are related to anxiety and depression among special operation personnel.It is necessary to focus on the mental health of older workers and those with longer tenure.

Lactate, the end product of glycolysis within the central nervous system (CNS), functions not only as a crucial neuronal energy source but also as a potent signaling molecule. Recently, lactate-mediated protein lactylation has been recognized as a novel post-translational modification influencing CNS pathophysiology. Lactate-mediated protein lactoylation modification regulates key pathological processes such as neuroinflammation and oxidative stress by modulating the structure and function of histones and non-histones, thereby influencing the occurrence and development of CNS diseases. This article reviews the research progress on mechanism of lactylation modification in CNS diseases, aiming to explore the regulatory potential of lactylation modification in CNS diseases and provide new ideas for the study of CNS diseases.

Patients with diabetes mellitus are at a significantly elevated risk of developing cognitive impairment,which adversely impacts their quality of life and imposes a substantial burden on the healthcare system.Novel antidiabetic agents,including sodium-glucose cotransporter 2 inhibitors(SGLT-2i),dipeptidyl peptidase-4 inhibitors(DPP-4i),glucagon-like peptide-1 receptor agonists(GLP-1RAs),and dual glucagon-like peptide-1 receptor/glucose-dependent insulinotropic polypeptide receptor agonists(e.g.,Tirzepatide),have been shown to not only effectively regulate glycemic control but also mitigate cognitive decline by inhibiting inflammation,reducing oxidative stress,preventing apoptosis,attenuating amyloid β-protein(Aβ)deposition,and suppressing tau protein phosphorylation.

Autoimmune encephalitis(AE)generally refers to a group of encephalitides mediated by autoimmune mechanisms.The current treatment for AE relies on immunotherapy,typically following a stepwise escalation regimen.A minority of patients may still be refractory to treatment,thus posing a major clinical challenge.In the pathogenesis of AE,B cells play a role through antibody secretion and cytokine regulation,whereas T cells contribute by promoting B cell differentiation and mediating neuronal attack.In recent years,immunotherapies targeting different antigens have become a research focus and emerged as a new treatment option for AE patients.This article summarizes the mechanisms of action of different targeted drugs and the progress of their clinical application in AE,and provides an outlook on future research directions.

Atherosclerosis and its complications are one of the diseases with the highest incidence and mortality in the world,and its early diagnosis and treatment are very important.At present,a variety of physiological and biochemical indicators have been used to diagnose atherosclerosis.However,the accuracy and ease of use of existing diagnostic indi-cators still cannot meet the clinical needs,and new,reliable and easy to measure biomarkers for early diagnosis and judg-ment of atherosclerosis and the risk of serious cardiovascular and cerebrovascular events caused by atherosclerosis are still very scarce.This article summarized the latest research progress of biomarkers related to atherosclerosis,such as hematol-ogy,genetics and omics,in order to provide basis for early diagnosis and treatment of atherosclerosis and related cardiovas-cular and cerebrovascular diseases induced by atherosclerosis.

Objective:To retrieve, evaluate and summarize the best evidence on the use of bedside ultrasound by ICU nurses to assess the lungs of adult critically ill patients, and to provide a reference for clinical practice and the construction of related processes and protocols.Methods:Based on the "6S" pyramid model, a computer-based search was conducted on relevant computer decision support system, guideline networks, professional associations, and domestic and international databases, the search time limit was from the establishment of the database to June 5, 2024. The panel members who had been trained in the evidence-based course evaluated the included literature with corresponding tools, extracted evidence according to the theme.Results:Twenty-five papers were finally included, including 6 guidelines, 8 expert consensus, 2 expert opinion, 3 clinical decision-making, 3 systematic evaluation, and 3 randomized controlled trials. A total of 35 pieces of evidence were formed from 4 aspects, including personnel training, operation specifications, clinical application (including dyspnea screening, intervention implementation, efficacy evaluation, diaphragm function evaluation) and precautions.Conclusions:The best evidence for lung assessment and intervention in adult critically ill patients based on bedside ultrasound can provide a reference for the adjustment and decision-making of nursing measures for adult critically ill patients. In the subsequent process of evidence transformation, attention should be paid to combining clinical practice and the joint cooperation of medical staff.