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 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.

ObjectiveTo explore the possible mechanisms of Shoutai Wan （寿胎丸） in treating recurrent miscarriage （RSA） from the perspective of immune tolerance under the acidic microenvironment at the maternal-fetal interface. MethodsFemale CBA/J mice were randomly divided into normal group， model group， progesterone group， and Shoutai Wan group， with 15 mice in each group. The mice in the normal group and model group were given 0.2 ml distilled water by gavage each day， the Shoutai Wan group given Shoutai Wan decoction 0.15 g/（10 g·d） by gavage， the progesterone group given progesterone tablets 0.44 mg/（10 g·d） by gavage. After gavage for 14 days， the mice were cohabited. Female CBA/J mice in the normal group were mated with male BALB/c mice at a ratio of 2∶1， and female CBA/J mice in the other groups were mated with male DBA/2 mice at a ratio of 2∶1 to establish the RSA mouse model. Vaginal smears were taken from the female mice the next morning， and the appearance of a large number of spermatozoa and the presence of a vaginal plug were considered as the first day of pregnancy. After the appearance of the plug， the mice were continued to be administered according to the previous method until the 10th day of pregnancy. On the 10th day of pregnancy， maternal-fetal interface tissues were collected from each group of mice， and lactate dehydrogenase colorimetric method was used to detect lactate （LA） content； qPCR method and Western blot method were used to detect the expression of immune-related factors interleukin-4 （IL-4）， interferon-gamma （IFN-γ）， transforming growth factor beta 1 （TGF-β1）， and forkhead box protein 3 （Foxp3） mRNA and protein； flow cytometry was used to detect the numbers of helper T lymphocyte 1 （Th1）， helper T lymphocyte 2 （Th2）， regulatory T cell （Treg）， classical macrophage （M1）， and alternative macrophage （M2）. The bivariate Pearson test was used to analyze the correlation between LA content and the numbers of Th1， Th2， Treg， M1， and M2 cells， as well as the correlation between LA content and the expression of IL-4， IFN-γ， TGF-β1， Foxp3 protein， and mRNA. ResultsOn the 10th day of pregnancy， compared with the normal group， the LA content decreased in the model group， and the expression of IL-4， TGF-β1， Foxp3 protein and mRNA in the maternal-fetal interface tissues decreased， while the expression of IFN-γ protein and mRNA increased. The numbers of Th1 and M1 cells increased， while the numbers of Th2， Treg， and M2 cells decreased （P＜0.05 or P＜0.01）. Compared with the model group， the LA content increased in the Shoutai Wan group and progesterone group. The expression of IL-4， TGF-β1， Foxp3 protein and mRNA in the maternal-fetal interface tissues increased， while the expression of IFN-γ protein and mRNA decreased. The numbers of Th1 and M1 cells decreased， while the numbers of Th2， Treg， and M2 cells increased （P＜0.05 or P＜0.01）. The LA content was positively correlated with the numbers of Th2， Treg， and M2 cells， and the expression of IL-4， TGF-β1， Foxp3 protein， and mRNA （P＜0.05 or P＜0.01）； the LA content was negatively correlated with the numbers of Th1， M1 cells， and the expression of IFN-γ protein and mRNA （P＜0.05 or P＜0.01）. ConclusionShoutai Wan may improve immune tolerance by regulating the expression of immune-related factors in the acidic microenvironment at the maternal-fetal interface of RSA model mice， thereby exerting its role in preventing miscarriage.

ObjectiveTo explore the molecular mechanism implicated in the treatment of primary myelofibrosis （PMF） using Chinese medicinal herbs （CMH） by bioinformatics and molecular dynamics. MethodsData mining was performed to find the high-frequency CMH in treating PMF between the year of 1985 and 2024 by searching CNKI， Chinese Science and Technology Journal Database （CCD）， and China Academic Journal Database （CSPD）. TCMSP， SwissTargetPrediction and related reports were used to collect the main active ingredients of high-frequency CMH and their targets. The PMF datasets GSE44426 and GSE124281 were downloaded from GEO database， and R software was used for data normalization and differentially expressed genes （DEGs） screening. Key module hub genes were obtained by weighted gene co-expression network analysis （WGCNA） analysis. The common intersection genes of active ingredient targets， DEGs and key module hub genes of CMH were selected， and the target network was generated using Cytoscape 3.9.2 software. The core target network was generated by topological analysis， while key pathways were selected by GO and KEGG pathway enrichment analysis， and protein interaction relationships were obtained from the String database， so as to construct drug-ingredient-target network and protein interaction network （PPI） relationship diagrams. Discovery Studio 2020 software was used to perform molecular docking， and the GROMACS program was used to perform molecular dynamics simulation. ResultsA total of 21 prescriptions were collected involving 121 herbs. There were 9 herbs with a frequency ≥10 times， which were Danshen （Radix et Rhizoma Salviae Miltiorrhizae）， Huangqi （Radix Astragali）， Baizhu （Rhizoma Atractylodis Macrocephalae）， Danggui （Radix Angelicae Sinensis）， Dangshen （Radix Codonopsis）， Gancao （Radix et Rhizoma Glycyrrhizae）， Baishao （Radix Paeoniae Alba）， Fuling （Poria） and Shudihuang （Radix Rehmanniae Praeparata） from high- to low-frequency. A total of 98 active ingredients and 1125 potential targets were obtained from 9 high-frequency CMH. GSE44426 and GSE124281 data sets screened out 24 gene samples， including 14 of the healthy control group and 10 of the PMF group， and identified 319 DEGs between the two groups， including 122 up-regulated genes and 197 down-regulated genes. WGCNA screened out 24 co-expression module genes and found that the five modules closely related to the onset of PMF were MEpink， MEdarkred， MEblack， MEgrey， and MEturquoise， involving 7112 key module hub genes. The GO and KEGG enrichment analyses indicated that lipids and the atherosclerosis pathways were mainly involved in the mechanism of above high-frequency CMH in treating PMF， which included six hub protein targets： HSP90AA1， HSP90AB1， SRC， MAPK1， IL1B and IL10. From the drug-ingredient-target network， seven active ingredients of CMH targeting at these six hub targets were found， including verbascoside， verbascos isoflavone， kaempferol， luteolin， naringenin， quercetin and pachymic acid. The molecular docking and molecular dynamics analyses showed that the key CMH were Shudihuang， Huangqi， Baishao， Danshen， Gancao and Fuling， and among the seven active ingredients， calycosin had the highest binding affinity with HSP90AB1. ConclusionThe main CMH for the treatment of PMF may be Shudihuang， Huangqi， Baishao， Danshen， Gancao and Fuling， and the active ingredients include verbascoside， verbascos isoflavones， kaempferol， luteolin， naringenin， quercetin and pachymic acid. The relevant targets are HSP90AA1， HSP90AB1， SRC， MAPK1， IL-10， and IL-1β， and the most critical pathways are lipid and atherosclerosis pathways.

[Objective]To elucidate the meridian manipulations described in the Han bamboo slips of Zhangjiashan from a meridian perspective,providing a theoretical foundation for the application of ancient meridian manipulations in modern clinical practice.[Methods]Based on the records in the unearthed literature and cultural relics of the pre-Qin,Qin and Han Dynasties,this paper summarizes the Daoyin technique in the pre-Qin,Qin and Han Dynasties,explores the in-depth relationship between Daoyin technique and meridian muscles,and selects the common orthopedic diseases in modern clinic,such as neck pain,ankle pain,knee pain and shoulder pain,which are closely related to meridian muscles.The original text and Daoyin movements are analyzed,and the Daoyin movements are discussed from the perspective of meridian muscles.[Results]It is found that the Daoyin described in the pre-Qin,Qin and Han Dynasties is mainly simple body movements.The meridians described in the Book of Pulse are mostly meridiansand tendons,so the theory of meridians and tendons may be more suitable for the thinking of the physicians at that time.Using the theory of meridians and tendons to analyze the Daoyin in Yinshu,it is found that the Daoyin therapy for neck pain in the book should be mainly treated for the neck pain of the sun meridian muscles;the treatment of lateral ankle pain is mainly adjusted by the Shaoyang meridian muscles of the foot,and the treatment of medial ankle pain is mainly adjusted by the Taiyin meridian muscles of the foot;the Daoyin therapy for knee pain is used to adjust the meridian muscles of the six meridians of the foot;the treatment of shoulder pain,the use of"Yuanxing three hundred"to treat the shoulder pain caused by the Shaoyang and Yangming meridian muscles of the hand,the use of"Qianyuan"to treat the shoulder pain caused by the sun meridian muscle disease,the use of"Zhiluo"to treat the shoulder pain caused by the sun meridian muscle disease,and the use of"Houfu"to treat the shoulder pain caused by the Taiyin meridian muscle disease.It is more reasonable to explain the treatment principles of Daoyin using the theory of meridian sinew,which can further elucidate the treatment principles of Daoyin and clarify the corresponding disease indications for different Daoyin.[Conclusion]Looking at the Daoyin manipulations in Yinshu from the perspective of meridians and tendons can further clarify the diseases treated by Daoyin manipulation,make the treatment more accurate and effective,and provide more ideas for the clinical application of Daoyin manipulation in modern traditional Chinese medicine.

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.

Objective:To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test.Methods:This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ2 test. A kappa test was used to compare the consistency between groups. Results:After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea ( Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences ( P < 0.001). Conclusion:The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.

Background Female office workers are prone to fatigue due to work and life stress. The natural environment has a positive effect on health, but little research has focused on the effects of forest therapy on physical and mental health of female office workers. Objective To explore the effect of forest therapy on the mental health of fatigued female office workers. Methods In this study, two environments, urban and forest, were selected. A total of 12 subjects with fatigue were recruited and randomly divided into two groups, urban and forest, six subjects in each group, with mean ages of 24.7 and 28.4 years, respectively, all of whom were company employees. The Brief Mood Scale, the Chinese version of Stress Self-Rating Scale, and the Fatigue Self-Rating Scale were distributed to assess baseline psychological indexes of mood, fatigue, and stress status. Higher scores indicate higher levels of negative mood, fatigue, and stress, respectively. The forest group participated in an on-site experiment using forest therapy (forest walks and sits in a forest environment), and the urban group followed the same schedule as the forest group conducting walks and sits in an urban environment. Salivary cortisol was used as the physiological index. Baseline physiological indices were collected on the first day of the experiment, and the on-site forest therapy experiment and collecting physiological and psychological indices were conducted on the second day; physiological indices were collected in the morning before the walk and physiological and psychological indices were collected after the walk, physiological indices were collected in the afternoon before and during the sitting, and psychological indices were collected after the sitting. Subjects' mood and fatigue status were followed up one week after the activity. Mann-Whitney U test and Wilcoxon signed rank test were used to assess the changes of the indicators. Results As to the physiological indicator, the salivary cortisol concentrations before and after the morning walk in the forest group were lower than the corresponding baseline values (both P=0.043); and the decreases were 2.21 and 1.86 nmol·L⁻¹ respectively. Differences between groups showed a trend towards a greater decrease in salivary cortisol concentrations in the forest group than in the urban group after walking and at the 15 th min of sitting (both P=0.068). Among the mood indicators, the forest group showed a greater decrease than the urban group in fatigue dimension after walking (P=0.065) and after sitting (P=0.024); the forest group showed a greater decrease than the urban group in vitality dimension after walking (P=0.054) and after sitting (P=0.045); and the forest group showed a greater decrease than the urban group in "total mood disorder" after sitting (P=0.054). Among the fatigue indicators, the forest group showed a greater decrease in "physical fatigue", "mental fatigue", "consequences of fatigue", and "general fatigue" after walking and sitting than the urban group (all P<0.05). Among the stress indicators, there were not statistically significance of "tension", "loss of control", and "total stress score" between the two groups after sitting (both P>0.05). After one week after the activity, there were not statistically significant differences of mood and fatigue between the two groups (both P>0.05). Conclusion Forest therapy has a regulating effect on symptoms of negative mood, and fatigue in fatigued female office workers, but the effects of a short-term forest therapy last for a limited duration.

Small proteins specifically refer to proteins consisting of less than 100 amino acids translated from small open reading frames (sORFs), which were usually missed in previous genome annotation. The significance of small proteins has been revealed in current years, along with the discovery of their diverse functions. However, systematic annotation of small proteins is still insufficient. SmProt was specially developed to provide valuable information on small proteins for scientific community. Here we present the update of SmProt, which emphasizes reliability of translated sORFs, genetic variants in translated sORFs, disease-specific sORF translation events or sequences, and remarkably increased data volume. More components such as non-ATG translation initiation, function, and new sources are also included. SmProt incorporated 638,958 unique small proteins curated from 3,165,229 primary records, which were computationally predicted from 419 ribosome profiling (Ribo-seq) datasets or collected from literature and other sources from 370 cell lines or tissues in 8 species (Homo sapiens, Mus musculus, Rattus norvegicus, Drosophila melanogaster, Danio rerio, Saccharomyces cere-visiae, Caenorhabditis elegans, and Escherichia coli). In addition, small protein families identified from human micro-biomes were also collected. All datasets in SmProt are free to access, and available for browse, search, and bulk downloads at http://bigdata.ibp.ac.cn/SmProt/.

Objective To explore the expression changes of SIRT1 and related inflammatory regula-tors in peripheral blood of patients with major depressive disorder and analyze the correlation between SIRT1, depression and inflammatory regulators. Methods Forty patients with major depressive disorder and forty healthy controls were selected. Hamilton Depression Scale (HAMD-17) was used to assess the degree of de- pression in patients with depressive disorder. Quantitative Real-time PCR( RT-PCR) was used to detect the relative expression levels of SIRT1,Elf-1,NF-κB,IL-1β,GM-CSF mRNA,and enzyme linked immunosorbent assay(ELISA) was used to detect the expression levels of SIRT1,Elf-1,NF-κB,IL-1β,GM-CSF proteins. The correlation between the severity of depression disorder and SIRT1 and the correlation between SIRT1 and Elf-1 and NF-κB were analyzed. Results (1)Compared with the control group,SIRT1 mRNA expression significantly decreased in the case group (P<0. 01),while Elf-1,NF-κB,IL-1β,GM-CSF mRNA expression significantly increased in the case group (P<0. 01). ( 2) The expression of plasma SIRT1 protein((8. 23± 1. 78)ng/ml) in the case group was lower than that in the control group (P<0. 01). The expressions of plas-ma Elf-1 protein((1 921. 67±271. 07)pg/ml),NF-κB protein((2 057. 29±260. 44)pg/ml),IL-1β protein ((186. 60±31. 00) pg/ml) and GM-CSF protein((183. 69±28. 87) pg/ml) were higher than those in the control group((1 512. 92±284. 54)pg/ml,(1537. 18±313. 82) pg/ml,(144. 79±31. 48) pg/ml,(162. 82± 27. 90) pg/ml,respectively,all P<0. 01). (3) SIRT1 mRNA expression level was negatively correlated with the severity of major depressive disorder (r=-0. 51, P<0. 01) and was negatively correlated with the mRNA expression levels of Elf-1 and NF-κB (r=-0. 66,P<0. 01,r=-0. 64,P<0. 01). Conclusion The expres-sion level of SIRT1 in peripheral blood of patients with major depressive disorder is correlated with the sever-ity of depression. This may be related to the decrease of SIRT1 expression in peripheral blood leukocytes of patients with major depressive disorder,which activates the pathway of NF-κB and Elf-1 and increase expres-sion of GM-CSF and IL-1β.