Objective To explore the effects of exosomes loaded with ginsenoside Rh2 on the biological functions of hepatocellular carcinoma cells. Methods Both Huh7 and PLC/PRF/5 cell were equally divided into control group, exosome group (Exos group), drug group (G-Rh2 group), and exosomes-loaded-with-ginsenoside Rh2 group (Exos@G-Rh2 group). The effects of each group on the viability, clonogenic ability, migration ability, invasion ability, and apoptotic level of hepatocellular carcinoma cells were detected through CCK-8 assay, colony formation assay, cell scratch assay, Transwell assay, and flow cytometry. Results Compared with the control group, the Exos@G-Rh2 group and G-Rh2 group showed significantly decreased cell viability, clonogenic ability, and migration and invasion capabilities, along with a markedly increased cell apoptosis rate (P<0.05). These changes were more pronounced in the Exos@G-Rh2 group than in the G-Rh2 group (P<0.05). Conclusion Exos@G-Rh2 can effectively inhibit the viability and clonogenic, migration, and invasion abilities of liver cancer cells and induce cell apoptosis. This effect is stronger than that of free G-Rh2 at the same concentration.

Objective Starting from the actual numbers of health personnel of tertiary public hospitals of Traditional Chinese Medicine(TCM),to quantitatively analyze the influencing factors on the allocation of human resources and obtain a prediction model.Methods The balanced panel data from 517 Tertiary Public TCM Hospitals in the period of 2011-2020 were collected,and the two-way fixed effects model was used to empirically analyze the impact of scale,demand and other factors on the actual number of health personnel in these hospitals.Result The number of beds is a key factor affecting the human resource allocation of Public TCM Hospitals,and various factors such as de-mand,policy,price,efficiency,and administrative management also have significant impacts on the allocation.The demand for outpatient services,government financial support,and efficiency of resource utilization are all promoting factors,while the increase in human resource prices,income generation efficiency,and administrative manage-ment levels have negative effects.A prediction model is proposed.Conclusion The planning principle of matching bed numbers with human resources allocation is in line with the actual environment.When predicting the total personnel allocation or authorized strength,various factors should also be fully considered,which can provide reference for the formulation of human resource policies in Public TCM Hospitals.

Objective:To explore the predictive value of different critical values of slow gait speed on adverse outcomes in elderly maintenance hemodialysis (MHD) patients.Methods:The study was a prospective cohort study. The clinical data of elderly patients (≥ 60 years old) who received MHD treatment in the Third Affiliated Hospital of Guangzhou Medical University from March 1 to June 30, 2021 were collected, including demographic characteristics, diseases-related data and laboratory examination results. The follow-up period was one year. The six-meter walking test was used to measure the gait speed (m/s), and 0.6 m/s, 0.8 m/s and 1.0 m/s were used as the different critical values of the gait speed for grouping. The differences of clinical data between different groups were compared. Logistic regression analysis method was used to assess the association of slow gait speed with adverse outcomes (falls and hospitalization) in elderly MHD patients. The receiver operating characteristic (ROC) curve was performed to evaluate the best critical value of slow gait speed to predict the risk of falls and hospitalization.Results:A total of 108 elderly patients with MHD were included, with 57 males and 51 females. There were 43 patients (39.8%) of falls and 34 patients (31.5%) of hospitalization. There were statistically significant differences in age, Charlson's comorbidity index, and the proportions of hypertension, family support needed in daily life, walking aids needed, falls and hospitalization events among the four groups of the patients grouped according to gait speed (all P < 0.05). Multivariate logistic regression analysis results showed that the risk of falls predicted by gait speed of 0.6- < 0.8 m/s was higher than that by gait speed of > 1.0 m/s ( OR=3.973, 95% CI 1.116-14.136, P=0.033). The risk of hospitalization predicted by gait speed < 0.6 m/s was higher than that by gait speed > 1.0 m/s ( OR=9.147, 95% CI 1.658-50.453, P=0.011). The logistic regression analysis was performed with the critical values of 0.6 m/s, 0.8 m/s and 1.0 m/s as the classification variables, and the results showed that the gait speed of < 0.8 m/s was an influencing factor of the falls risk in elderly MHD patients (≥ 0.8 m/s as reference, OR=3.200, 95% CI 1.099-9.318, P=0.033). The gait speed < 0.8 m/s and < 0.6 m/s were influencing factors of hospitalization (≥ 0.8 m/s as reference, OR=3.899, 95% CI 1.355-11.216, P=0.012; ≥ 0.6 m/s as reference, OR=4.226, 95% CI 1.107-16.140, P=0.035). The area under the ROC curve for gait speed of < 0.6 m/s, < 0.8 m/s and < 1.0 m/s to predict the risk of falls were 0.605(95% CI 0.493-0.717, P=0.065), 0.668(95% CI 0.562-0.774, P=0.003), and 0.634 (95% CI 0.529-0.739, P=0.019), respectively. The best critical value of slow gait speed to predict the risk of fall was 0.73 m/s, and the area under the ROC curve was 0.720(95% CI 0.623-0.817, P < 0.001), with the sensitivity and specificity of 0.846 and 0.512, respectively. The area under the ROC curve for gait speed of < 0.6 m/s, < 0.8 m/s and < 1.0 m/s to predict the risk of hospitalization were 0.629(95% CI 0.509-0.749, P=0.032),0.683(95% CI 0.573-0.793, P=0.002), and 0.608(95% CI 0.497- 0.719, P=0.073). The best critical value of slow gait speed to predict the risk of hospitalization was 0.81 m/s, and the area under the ROC curve was 0.688(95% CI 0.576-0.800, P=0.002), with the sensitivity and specificity of 0.689 and 0.676, respectively. Conclusion:The critical value of gait speed 0.8 m/s can be used to predict the risk of falls and hospitalization in elderly MHD patients.

Undergraduates in colleges and universities have great academic potential. In order to cultivate undergraduate innovative scientific research talents, the key is to improve the cultivation mode of undergraduates and stimulate students' academic potential. Taking the evidence-based medicine research group of Guangdong Medical University as an example, this paper systematically analyzes the specific measures and relevant practical experiences of the research team in the cultivation of undergraduates. The research team creatively uses the methods of "student guidance system", "PBL" mode and real-time feedback mechanism, and a complete talent training system has formed to explore a group of excellent undergraduate talents. Through innovative scientific research training, these undergraduates have made many achievements in academic research. This paper hopes these strategies and experiences can provide some reference for the cultivation of undergraduates in colleges and universities all over the country.

OBJECTIVE: To explore the bidirectional regulation of acupuncture based on a subgroup analysis of multicenter randomized controlled trial of acupuncture with METHODS: A total of 519 patients were included in the analysis, including 137 patients with constipation type irritable bowel syndrome (IBS-C) (92 cases in the acupuncture group and 45 cases in the polyethylene glycol [PEG] group), and 382 patients with diarrhea type irritable bowel syndrome (IBS-D) (252 cases in the acupuncture group and 130 cases in the pinaverium group). The patients in the acupuncture group were given acupuncture at Baihui (GV 20), Yintang (GV 29), Tianshu (ST 25), Shangjuxu (ST 37), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) once every other day, 3 times a week. The patients in the PEG group received polyethylene glycol 4000 powder orally, and the pinaverium group received pinaverium bromide tablets orally. All were treated for 6 weeks. The IBS symptom severity score (IBS-SSS) was assessed at baseline, treatment period (2, 4, 6 weeks of treatment) and 12 weeks of follow-up, and the IBS quality of life (IBS-QOL) score was evaluated at the baseline period, 6 weeks of treatment and 12 weeks of follow-up. RESULTS: The total IBS-SSS scores of the two groups of IBS-C patients at 2, 4, 6 weeks of treatment and follow-up of 12 weeks were lower than those in the baseline period ( CONCLUSION Acupuncture with
Acupuncture Points ; Acupuncture Therapy ; Diarrhea ; Humans ; Irritable Bowel Syndrome/therapy* ; Quality of Life ; Treatment Outcome

Hepatic failure is one of serious complications after hepatectomy. The individual′s preoperative physical health status, laboratory indicators, liver diseases, surgical factors, portal hypertension, and drug factors are all risk factors for hepatic failure. The author summarizes the risk factors for post hepatectomy liver failure(PHLF), analyzes the existing liver function scoring models, proposes the perioperative management strategy for patients undergoing hepatectomy according to the score index, so as to reduce the incidence of PHLF, improve the prognosis and long-term survival of patients.

Objective To investigate a potential radiation biodosimetry based on multiple gene expressions.Methods Human peripheral blood were exposed to 60Co γ-rays at doses from 0 to 8 Gy.The mRNA expression levels of 10 selected genes were detected 6 and 12 h after irradiation by RT-PCR.Individual variation was also examined.An optimal mathematical model of the dose response of these gene expression levels at each time point was obtained by the stepwise regression method.A blind test was conducted to validate the statistical accuracy of dose estimation.Results The 10 selected genes expression levels at each time point were significantly increased along with dose from 0.5 to 8 Gy (R2 =0.61-0.97,P ＜ 0.05).Individual variations were evident in the gene expressions of TNFSF4,PHPT1 and FDXR.The gene expression levels of PCNA,CCNG1,TNFSF4,PHPT1,GADD45A and FDXR were incorporated into the model at 6 h after exposure (R2 =0.88,F =54.8,P ＜ 0.001);the gene expression levels of PCNA,CCNG1,TNFSF4,MDM2,GDF15 and TNFRSF10B were included in the model at 12 h after irradiation (R2 =0.82,F =42.767,P ＜ 0.001).These two statistical models can be utilized for the dose estimation accurately.Conclusions The multiple gene expressions have a potential as a radiation biodosimetry.

Objective To explore the influences of the final concentration and adding time of Cytochalasin-B (Cyt-B) on radiation-induced nucleoplasmic bridges (NPB) in cytokinesis-block assay.Methods Hunan peripheral blood samples were divided into 5 final concentration groups (group 2,4,6,8,10 μg/ml) according to different final concentrations of Cyt-B.Moreover,blood samples were divided into 4 adding time groups (group 0,28,40,44 h) according to different adding times of Cyt-B.Blood samples were irradiated with 0 (sham irradiation) and 2 Gy 60Co-rays in vitro,at a dose rate of 1 Gy/min.A cytokinesis-block assay was carried out to prepare NPB samples.The percentages of mononucleated,binucleated and multinucleated cells,as well as the frequencies of NPB and micronucleus (MN) in binucleated cells were analyzed using an optical microscope.Results Nuclear division index (NDI) and the percentages of binucleated cells increased with increased concentration of Cyt-B,and decreased with delayed adding time of Cyt-B (except group 0 h) in both final concentration groups and adding time groups.After exposed to 2 Gy,NPB frequencies were no significant difference (except group 0 h).MN frequencies had the trend of decreased with the increased concentration of Cyt-B,but no significant difference with adding time of Cyt-B.Conclusions In cytokinesis-block assay,different final concentration and adding time of Cyt-B may induce to the variation of NPB frequencies,but there was no significant difference.Appropriate increased final concentration or ahead adding time of Cyt-B can increase the percentage of binucleated cells that help to improve the efficiency of analysis.

Objective To investigate the clinical effect of laparoscopic splenectomy combined with pericardial devascularization for the treatment of portal hypertension.Methods The retrospective cross-sectional study was conducted.The clinical data of 310 patients with portal hypertension who underwent laparoscopic splenectomy combined with pericardial devascularization in the Tangdu Hospital of Fourth Military Medical University between January 2012 and June 2016 were collected.All the patients underwent laparoscopic splenectomy combined with pericardial devascularization.Observation indicators:(1) surgical and postoperative situations;(2) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the gastrointestinal rebleeding and postoperative survival of patients up to January 2017.Measurement data with normal distribution and skewed distribution were respectively represented as average number (range) and M (range).Results (1) Surgical and postoperative situations:all patients underwent successful operation.Twelve patients converted to open surgery due to intractable bleeding and 298 underwent totally laparoscopic splenectomy combined with pericardial devascularization.Average operation time,average volume of intraoperative blood loss,average time of gastrointestinal function recovery and average time of postoperative abdominal drainage-tube removal of 310 patients were 192.5 minutes (range,120.0-300.0 minutes),402.3 mL (range,150.0-1 200.0 mL),2.4 days (range,1.0-4.0 days) and 4.2 days (range,2.0-8.0 days),respectively.Among 11 of 310 patients with postoperative complications,1 died of acute severe hemorrhage of upper digestive tract,5 with intra-abdominal bleeding received successful hemostasis (3 undergoing reoperation and 2 undergoing conservative treatment),2 with pleural effusion were improved by thoracentesis and drainage,2 with pancreatic leakage and 1 with pulmonary infection were cured by conservative treatment.Other 299 patients didn't have postoperative complications.Duration of postoperative hospital stay of 310 patients was 6.4 days (range,5.0-9.0 days).(2) Follow-up situations:260 of 309 patients were followed up for 6-60 months,with a median time of 26 months.During the follow-up,1 patient died of acute portal vein thrombosis at 1 month postoperatively;15 with gastrointestinal rebleeding and melena were cured by conservative treatment;other patients had survival.Conclusion Laparoscopic splenectomy combined with pericardial devascularization for the treatment of portal hypertension is safe and effective.