Objective To evaluate the efficiency of health resource allocation in 22 types of hospital institutions in Guangdong Province from 2018 to 2022,identify their strengths and shortcomings in resource utilization,and offer evidence-based recommendations for optimizing medical resource allocation and policymaking.Methods The efficiency of health resource allocation was assessed using the DEA-BCC model and the DEA-Malmquist index model across the 22 hospital categories.Results In 2022,the overall resource allocation efficiency of the 22 types of hospital institutions in Guangdong Province was suboptimal,with an average score of 0.657.From 2018 to 2022,the mean total factor productivity(TFP)change index for these hospitals was 0.968,with only 6 categories exhibiting a TFP index exceeding 1.Conclusion The efficiency of health resource allocation in Guangdong's hospitals remains inadequate.Government authorities should enhance macro-level planning for regional resource distribution,accelerate advancements in medical technology,and establish a real-time monitoring framework.Concurrently,policy interventions and incentive mechanisms should be reinforced to ensure both scientifically sound allocation and effective utilization of medical resources.

Objective To evaluate the efficiency of health resource allocation in 22 types of hospital institutions in Guangdong Province from 2018 to 2022,identify their strengths and shortcomings in resource utilization,and offer evidence-based recommendations for optimizing medical resource allocation and policymaking.Methods The efficiency of health resource allocation was assessed using the DEA-BCC model and the DEA-Malmquist index model across the 22 hospital categories.Results In 2022,the overall resource allocation efficiency of the 22 types of hospital institutions in Guangdong Province was suboptimal,with an average score of 0.657.From 2018 to 2022,the mean total factor productivity(TFP)change index for these hospitals was 0.968,with only 6 categories exhibiting a TFP index exceeding 1.Conclusion The efficiency of health resource allocation in Guangdong's hospitals remains inadequate.Government authorities should enhance macro-level planning for regional resource distribution,accelerate advancements in medical technology,and establish a real-time monitoring framework.Concurrently,policy interventions and incentive mechanisms should be reinforced to ensure both scientifically sound allocation and effective utilization of medical resources.

Objective:To study the expressions of C-C class chemokine 17 (CCL17), C-C class chemokine 22 (CCL22), and C-C chemokine receptor 4 (CCR4) in newly diagnosed multiple myeloma (NDMM) for analyzing their correlations with clinical features and to preliminarily explore their roles in the development of NDMM.Methods:The study included 40 patients with NDMM and 20 healthy volunteers from the Department of Hematology of the Affiliated Hospital of Zunyi Medical University from July 2020 to December 2022. Peripheral blood, bone marrow, and bone marrow biopsy tissue samples were collected from the two groups. The expression levels of CCL17, CCL22, and CCR4 in patients with NDMM were analyzed using real-time quantitative reverse transcriptase polymerase chain reaction (RQ-PCR), enzyme-linked immunosorbent assay (ELISA), and immunohistochemistry. The mRNA expression levels of CCL17, CCL22, and CCR4 in the bone marrow mononuclear cell (BMMNC) of patients with NDMM were analyzed to assess their correlations with clinical indicators.Results:The mRNA expression levels of CCL17, CCL22, and CCR4 in BMMNC were higher in patients with NDMM than in controls (all P<0.05). The protein expression levels of CCL17 and CCL22 in peripheral blood supernatants and bone marrow supernatants were higher in patients with NDMM than in controls (all P<0.05). The expression levels of CCL17, CCL22, and CCR4 in bone marrow biopsy tissues were higher in patients with NDMM than in controls (all P<0.05). The mRNA expression level of CCL17 was increased in NDMM patients with combined anemia, bone damage, renal damage, and M protein level ≥30 g/L (all P<0.05). The mRNA expression level of CCL22 was increased in NDMM patients with combined anemia, bone damage, and renal damage (all P<0.05). The mRNA expression level of CCR4 was increased in NDMM patients with combined anemia and renal damage (all P<0.05) . Conclusion:CCL17, CCL22, and CCR4 were highly expressed in clinical samples from patients with NDMM compared to those from controls, and they may be involved in the occurrence and development of NDMM.

Traditional microtubule inhibitors fail to significantly enhance the effect of colorectal cancer;hence,new and efficient strategies are necessary.In this study,a supramolecular nanoreactor(DOC@TA-Fe3+)based on tannic acid(TA),iron ion(Fe3+),and docetaxel(DOC)with microtubule inhibition,reactive oxygen species(ROS)generation,and glutathione peroxidase 4(GPX4)inhibition,is prepared for ferroptosis/apoptosis treatment.After internalization by CT26 cells,the DOC@TA-Fe3+nanoreactor escapes from the lysosomes to release payloads.The subsequent Fe3+/Fe2+conversion mediated by TA reducibility can trigger the Fenton reaction to enhance the ROS concentration.Additionally,Fe3+can consume gluta-thione to repress the activity of GPX4 to induce ferroptosis.Meanwhile,the released DOC controls microtubule dynamics to activate the apoptosis pathway.The superior in vivo antitumor efficacy of DOC@TA-Fe3+nanoreactor in terms of tumor growth inhibition and improved survival is verified in CT26 tumor-bearing mouse model.Therefore,the nanoreactor can act as an effective apoptosis and ferroptosis inducer for application in colorectal cancer therapy.

Abstract OBJECTIVE To clarify the resource status and diversity of endemic medicinal plants in Shaanxi province. METHODS The species specificity, species composition, faunal composition, family and genus types, medicinal value and endangerment degree of endemic medicinal plants in Shaanxi province were studied by literature review.RESULTS There were 713 species of 331 genera and 101 families endemic to Chinese medicinal plants in the study area. Fifteen species were naturally distributed only in Shaanxi province, and the remaining 698 species were also naturally distributed in other provinces of China. Among the 713 species, 233 species(69 families, 159 genera) were not collected from the fourth resource census in Shaanxi province. There were 11 species of pteridophytes in 7 families and 11 genera, 14 species of gymnosperms in 4 families and 10 genera, 627 species of dicotyledons in 82 families and 278 genera, and 59 species of monocots in 8 families and 32 genera. The endemic life forms of medicinal plants in the study area were mostly herbaceous, followed by shrubs and trees, and semi-shrubs and epiphytes accounted for the least. There were 9 families with ≥ 20 species and 4 families with ≥ 10 species in the study area. The 90 families belonging to the endemic species of medicinal plants in Shaanxi province were divided into 13 distribution types and 9 variations, and the tropical distribution(2-7 categories) had a total of 34 families. There were 5 endemic species of medicinal plants in the study area under the national class I key protection, and 14 species under the national class II key protection. There were 26 species of plants under local key protection in Shaanxi province. There were 21 plants that could be used as original plants for medicinal materials included in the Pharmacopoeia of the People's Republic of China(2020 edition). CONCLUSION The endemic species of medicinal plants in Shaanxi province are rich in resources and have good medicinal value. However, the growing environment of some plants is harsh and human damage is serious. Multiple protection measures should be taken to maintain the species diversity and sustainable development of resources in the study area.

[摘 要] 目的：探究瑞戈非尼（regorafenib，Rego）对人肝癌SMMC-7721细胞增殖、凋亡的影响及其可能的机制。方法：将SMMC-7721细胞分为对照组及Rego组，分别用0、10 μmol/L Rego处理48 h后，流式细胞术检测各组细胞凋亡率，qPCR检测细胞中miR-122的表达。采用脂质体转染的方法将合成的hsa-miR-122-5p模拟物转染SMMC-7721细胞构建miR-122过表达的overExp-miR-122细胞，并将细胞分为对照组、Rego组、overExp-NC组、overExp-NC+Rego组、overExp-miR-122组及overExp-miR-122+Rego组，采用MTT法检测细胞活性，流式细胞术检测细胞凋亡率、WB法检测细胞中Bcl2、cleaved caspase-3、RAS、RAF1、p-ERK1蛋白表达水平。结果：与对照组相比，Rego处理后细胞凋亡率显著升高（P<0.05），且miR-122表达量显著上升（P<0.01）；与overExp-NC组比较，overExp-miR-122组细胞增殖抑制率、凋亡率和cleaved caspase-3表达均显著升高（均P<0.01），RAS蛋白表达显著下降（P<0.05），Bcl2、RAF、p-ERK1蛋白表达均显著下降（均P<0.01）；与overExp-miR-122组相比，overExp-miR-122+Rego组细胞中各检测指标变化进一步显著增加（P<0.01）。结论：Rego可抑制SMMC-7721细胞增殖、促进凋亡，其作用可能与调控miR-122、凋亡相关因子的表达和抑制RAS/RAF/ERK信号通路有关。

Objective:To analyze the potential specificity of broad neutralizing antibodies (bNAbs) in one patient (DRVI01) with chronic HIV-1 infection.Methods:Sequences of the envelope glycoprotein (Env) obtained from DRVI01 at different time points were analyzed by comparing with the key amino acids of reported HIV-1 bNAbs in HIV Database. After reverse mutation of key amino acids that had frequently mutated to wild type, the neutralizing sensitivity of autologous plasma against wild-type and mutated Env-pesudoviruses was compared and the potential bNAbs in DRVI01 were speculated.Results:Reported key amino acids of 10 bNAbs classes were detected in 155 Env sequences derived from DRVI01. Frequent mutations were found in key amino acids of two bNAbs classes of gp41 fusion domain and gp120/gp41 interface. Neutralizing sensitivity of the contemporaneous autologous plasma and the plasma collected at the next time point against the mutated pesudoviruses was significantly increased as compared with wild-type pesudoviruses.Conclusions:Potential NAbs with similar key amino acids to those of gp41 fusion domain and gp120/gp41 interface might present in the HIV-1 infected patient with broad neutralizing antibodies.

Objective: To investigate the efficacy and safety of Rivaroxaban for elderly patients with thrombotic diseases. Methods: This was a retrospective study.A total of 301 elderly patients taking Rivaroxaban from October 2012 to November 2017 at the Second Medical Center of the Chinese PLA General Hospital were consecutively selected.The ages ranged from 60 to 102 years, with an average age of(86.5±8.4)years.Anticoagulation regimens were developed based on comprehensive evaluation of indications, creatinine clearance, ischemia and bleeding risk.Patients were divided into a Rivaroxaban 2.5-5.0 mg/d group(n=72), a 10.0 mg/d group(n=205), and a 15.0-20.0 mg/d group(n=24). Hepatic function, renal function, and coagulation indexes were measured before and after the administration of Rivaroxaban.Fatal bleeding, cardiovascular deaths, all-cause deaths, non-fatal bleeding and thromboembolic events were recorded during the follow-up period. Results: The average dose of Rivaroxaban was(9.3±3.0)mg/d, and the minimum dose was 2.5 mg/d.The average follow-up time was(14.9± 13.9)months and the longest follow-up time was 48 months.One patient had intracranial bleeding.Twenty patients(6.6%)died with a cumulative incidence of 25.2%, three(1.0%)died of cardiac events, and 55.0% died of pneumonia and multiple organ failure.Forty patients(13.3%)had non-fatal hemorrhagic events with a cumulative incidence of 42.4%.Seven patients(2.3%)had thromboembolic events with a cumulative incidence of 16.0%, including 2 cases of non-fatal myocardial infarction, 3 cases of cerebral infarction and 2 cases of deep vein thrombosis.After treatment, levels of prothrombin time and fibrinogen significantly increased while levels of D-dimer significantly deceased(P<0.05). Conclusions Compared with previous reports, low-dose Rivaroxaban is safe and effective for elderly patients with thrombotic diseases.However, the risk of bleeding and ischemia should be comprehensively evaluated, and appropriate doses of Rivaroxaban should be selected individually.

Objective: To explore the effects of noscapine (Nos) on the expression of cadherin 17 (CDH17) in colon cancer SW480 cells and the mechanism of Nos on cell migration. Methods: SW480 cells were divided into the control group, empty vector (si-EV) group, CDH17 interference (si-CDH17) group, Nos treatment group, and CDH17 interference+Nos treatment (si-CDH17+Nos) group. Small interfering RNA (siRNA) was used to knockdown CDH17, and the selected concentration of Nos was (55.30±2.21) µg/ml (IC50). The mRNA expression of CDH17 was detected by qPCR; the apoptosis and migration abilities of SW480 cells were observed by Hoechst33258 staining and Transwell assay; the contents of VEGF, MMP2 and MMP9 in SW480 cells were measured by ELISA, and the protein expressions of CDH17, Wnt3a and β-catenin were determined by WB. Results: Compared with the control group, mRNA and protein expressions of CDH17 obviously decreased, cell apoptosis and migration significantly reduced, while the contents of VEGF, MMP2 and MMP9 as well as the protein expressions of Wnt3a and β-catenin significantly decreased in Nos treatment group, siCDH17 group and si-CDH17+Nos treatment group (all P<0.01).The effect of si-CDH17+Nos treatment was more significant than that of si-CDH17 (P<0.01). Conclusion: Nos induces apoptosis and inhibits the migration of human colon cancer SW480 cells, which may be related to the down-regulation of CDH17 expression and inhibition of the Wnt3a/β-catenin signaling pathway.

In recent years, through the measurement and analysis of size ratio(SR), inflow angle (IFA), volume-to-ostium ratio(VOR), flow angle(FA), parent-daughter angle(PDA), A1- A2 diameter ratio(A1/A2), a ratio of aneurysm volume to bounding sphere volume(AVSV), a ratio of aneurysm surface to bounding sphere surface (AASA), some international scholars assessed aneurysm rupture risk, and had made some preliminary progress. Research showed that the geometry parameters had the objective significance for the evaluation of the risk of aneurysm rupture, and the bigger the SR, IFA, VOR, FA, A1/A2, AVSV, AASA, the easier the rupture of aneurysms. The smaller the PDA, the easier the rupture of the aneurysms.