Objective To investigate the effects of Nel-like type 1 molecule(NELL-1)on the proliferation and osteogenic differenti-ation of stem cells from human exfoliated deciduous teeth(SHEDs).Methods SHEDs was isolated,cultured,and identified.The third generation SHEDs were used for subsequent experiments.SHEDs were divided into 4 groups,and NELL-1 was added to each group at concentrations of 0(control group),50,100,and 200 ng/mL.Cell activity was measured by CCK-8 assay and crystal violet staining.The changes in osteogenic ability were detected by alkaline phosphatase activity.The expression levels of osteogenesis-related genes ALP,OCN and Runx-2 by RT-qPCR were detected.Western blot was used to detect the expression of osteogenesis-related pro-teins ALP,Runx-2 and Col-Ⅰ.Results SHEDs exhibited stem cell characteristics,and 50 ng/mL of NELL-1 protein had a promo-ting effect on SHEDs proliferation(P＜0.01).Alkaline phosphatase activity assay showed that after the addition of NELL-1,the osteo-genic effect of each group was better than that of the control group and 50 ng/mL of NELL-1 was the best(P＜0.05).RT-qPCR and Western blot results showed that 50 ng/mL of NELL-1 significantly promoted the expression of osteoblast-related genes including ALP,OCN and Runx-2 and the protein expression of ALP,Runx-2 and Col-Ⅰ(P＜0.05).Conclusion NELL-1 can promote the prolifera-tion and osteogenic differentiation of SHEDs.

Objective To analyze the implementation effect of medical risk early warning monitoring based on closed-loop complaint management.Methods A total of 453 patients admitted to the Second People's Hospital of Guizhou Province from January 2022 to December 2023 were selected retrospectively.Among them,222 patients admitted to the departments where the medical risk early warning monitoring system based on closed-loop complaint management was implemented were included in the observation group.231 patients admitted to the departments where routine medical care and complaint management were implemented were included in the control group.Risk events,complaints,medical service quality and patient satisfaction were compared between the two groups.Results The incidence rates of pressure ulcers,phlebitis,falls and other risk events were lower in the observation group than in the control group(P＜0.05),the complaint rates of examination departments and auxiliary departments and total were lower in the observation group than in the control group(P＜0.05),the complaint rates of service attitude,communication problems and medical dispute were lower in the observation group than in the control group(P＜0.05),the satisfaction rate of the observation group was higher than that of the control group(P＜0.05),the observation group had higher scores than the control group in terms of health education,communication and notification,coping capacity,specialist skills,basic skills,infection prevention and total(P＜0.05).Conclusion The medical risk early warning monitoring system based on closed-loop complaint management can reduce risk events and complaints,and improve medical service quality and satisfaction,it can achieve significant effects in practice.

Objective To analyze the risk factors and effective predictive indicators for postpartum hemor-rhage(PPH)in pregnant women with severe pre-eclampsia(sPE)in singleton pregnancies.The findings will serve as a valuable reference for the clinical prevention and management of PPH in these patients.Methods A retrospective analysis was conducted on 932 pregnant women with sPE at two tertiary hospitals in Guangzhou from January 1,2016,to December 31,2022.Among these,95 cases were complicated by PPH.A comparative analysis was performed between the sPE group and the sPE with PPH group.Results(1)The incidence of assisted reproductive technology,intrapartum blood loss,placental abruption,elevated D-dimer levels,increased monocyte counts,and higher SIRI levels were significantly higher in the PPH group,whereas platelet counts were significantly lower(P<0.05).(2)The results indicated that intrapartum blood loss,D-dimer levels,and platelet counts were inde-pendently associated with PPH in pregnant women with sPE.(3)The area under the curve(AUC)for intrapartum blood loss,D-dimer,and platelet counts were 0.805,0.717,and 0.571,respectively.The optimal cutoff value for D-dimer was determined to be 2.295 μg/mL.The combined AUC for intrapartum blood loss and D-dimer was 0.859.(4)Intrapartum blood loss values were significantly higher in the PPH group for both vaginal delivery and cesarean section(P<0.001).The corresponding optimal cutoff values were 285 mL and 375 mL,respectively.Conclusions Intrapartum haemorrhage,D-dimer levels,and platelet count were identified as independent risk factors for PPH in pregnant women with sPE.Specifically,pregnant women with sPE who experienced blood loss exceeding 285 mL during vaginal delivery or 375 mL during caesarean section,along with a D-dimer level greater than 2.295 μg/mL,demonstrated an increased likelihood of developing PPH.Therefore,it is crucial to enhance clinical monitoring of these relevant indicators in high-risk populations.

Objective To analyze the implementation effect of medical risk early warning monitoring based on closed-loop complaint management.Methods A total of 453 patients admitted to the Second People's Hospital of Guizhou Province from January 2022 to December 2023 were selected retrospectively.Among them,222 patients admitted to the departments where the medical risk early warning monitoring system based on closed-loop complaint management was implemented were included in the observation group.231 patients admitted to the departments where routine medical care and complaint management were implemented were included in the control group.Risk events,complaints,medical service quality and patient satisfaction were compared between the two groups.Results The incidence rates of pressure ulcers,phlebitis,falls and other risk events were lower in the observation group than in the control group(P＜0.05),the complaint rates of examination departments and auxiliary departments and total were lower in the observation group than in the control group(P＜0.05),the complaint rates of service attitude,communication problems and medical dispute were lower in the observation group than in the control group(P＜0.05),the satisfaction rate of the observation group was higher than that of the control group(P＜0.05),the observation group had higher scores than the control group in terms of health education,communication and notification,coping capacity,specialist skills,basic skills,infection prevention and total(P＜0.05).Conclusion The medical risk early warning monitoring system based on closed-loop complaint management can reduce risk events and complaints,and improve medical service quality and satisfaction,it can achieve significant effects in practice.

Objective To investigate the effects of Nel-like type 1 molecule(NELL-1)on the proliferation and osteogenic differenti-ation of stem cells from human exfoliated deciduous teeth(SHEDs).Methods SHEDs was isolated,cultured,and identified.The third generation SHEDs were used for subsequent experiments.SHEDs were divided into 4 groups,and NELL-1 was added to each group at concentrations of 0(control group),50,100,and 200 ng/mL.Cell activity was measured by CCK-8 assay and crystal violet staining.The changes in osteogenic ability were detected by alkaline phosphatase activity.The expression levels of osteogenesis-related genes ALP,OCN and Runx-2 by RT-qPCR were detected.Western blot was used to detect the expression of osteogenesis-related pro-teins ALP,Runx-2 and Col-Ⅰ.Results SHEDs exhibited stem cell characteristics,and 50 ng/mL of NELL-1 protein had a promo-ting effect on SHEDs proliferation(P＜0.01).Alkaline phosphatase activity assay showed that after the addition of NELL-1,the osteo-genic effect of each group was better than that of the control group and 50 ng/mL of NELL-1 was the best(P＜0.05).RT-qPCR and Western blot results showed that 50 ng/mL of NELL-1 significantly promoted the expression of osteoblast-related genes including ALP,OCN and Runx-2 and the protein expression of ALP,Runx-2 and Col-Ⅰ(P＜0.05).Conclusion NELL-1 can promote the prolifera-tion and osteogenic differentiation of SHEDs.

Objective To analyze the risk factors and effective predictive indicators for postpartum hemor-rhage(PPH)in pregnant women with severe pre-eclampsia(sPE)in singleton pregnancies.The findings will serve as a valuable reference for the clinical prevention and management of PPH in these patients.Methods A retrospective analysis was conducted on 932 pregnant women with sPE at two tertiary hospitals in Guangzhou from January 1,2016,to December 31,2022.Among these,95 cases were complicated by PPH.A comparative analysis was performed between the sPE group and the sPE with PPH group.Results(1)The incidence of assisted reproductive technology,intrapartum blood loss,placental abruption,elevated D-dimer levels,increased monocyte counts,and higher SIRI levels were significantly higher in the PPH group,whereas platelet counts were significantly lower(P<0.05).(2)The results indicated that intrapartum blood loss,D-dimer levels,and platelet counts were inde-pendently associated with PPH in pregnant women with sPE.(3)The area under the curve(AUC)for intrapartum blood loss,D-dimer,and platelet counts were 0.805,0.717,and 0.571,respectively.The optimal cutoff value for D-dimer was determined to be 2.295 μg/mL.The combined AUC for intrapartum blood loss and D-dimer was 0.859.(4)Intrapartum blood loss values were significantly higher in the PPH group for both vaginal delivery and cesarean section(P<0.001).The corresponding optimal cutoff values were 285 mL and 375 mL,respectively.Conclusions Intrapartum haemorrhage,D-dimer levels,and platelet count were identified as independent risk factors for PPH in pregnant women with sPE.Specifically,pregnant women with sPE who experienced blood loss exceeding 285 mL during vaginal delivery or 375 mL during caesarean section,along with a D-dimer level greater than 2.295 μg/mL,demonstrated an increased likelihood of developing PPH.Therefore,it is crucial to enhance clinical monitoring of these relevant indicators in high-risk populations.

Exosomes are vesicles with a diameter of about 50-150 nm released by a variety of cells and contain miRNA, mRNA, and protein, with the potential to regulate the signal transduction pathways in receptor cells. Exosomes provide nucleic acids and proteins to coordinate cell-cell communication and microenvironment regulation. This article summarizes the latest research advances in the role of exosomes in hepatocellular carcinoma (HCC) and analyzes the effect of exosomes on the development and progression of HCC, including chemotherapy resistance, epithelial-mesenchymal transition, angiogenesis, metastasis, and immune response. The analysis shows that exosomes have a promising future in the treatment of HCC.

OBJECTIVE: To evaluate the effects of the pestle needling therapy on the vibration perception threshold (VPT) and the quality of life (QOL) in the patients of high-risk diabetic foot. METHODS: A total of 132 patients of high risk diabetic foot were randomized into an observation group and a control group, 66 cases in each one. In the control group, the routine treatment and nursing for diabetes were applied. In the observation group, on the base of the treatment as the control group, the pestle needling therapy was used at , , , Zusanli (ST 36), Yongquan (KI 1), Sanyinjiao (SP 6) and Taixi (KI 3). The intervention with the pestle needling therapy was given once every day, consecutively for 4 weeks. The follow-up visit was conducted in 3 months and 6 months after the intervention. Vibration perception threshold (VPT) was observed before and after intervention in the two groups. Separately, before intervention, at the end of intervention, 3 months after intervention and 6 months after intervention, the type 2 diabetes mellitus quality life scale (DMQLS), the revised edition was adopted to compare the QOL between the two groups. The effects were evaluated in the two groups. RESULTS: After intervention, the VPT and QOL were all improved in the two groups (<0.01, <0.05). In the observation group, after intervention, VPT at the first toes and the dorsum of the feet was lower than the control group at the same time point (all <0.01). In the observation group, the total scores and the score of each dimension item in the DMQLS of the revised edition were all lower than the control group correspondently at the end of intervention, 3 months after intervention and 6 months after intervention (<0.01, <0.05). The repeated ANOVA results showed that the differences were significant in the total scores and the score of each dimension in the aspects of time, inter-group and interaction effect (<0.01, <0.05). The total scores and score of each dimension item in the DMQLS were lower than those the earlier time point (<0.01, <0.05). The total effective rate was 100.0% in the observation group, which was superior to 95.1% (59/62) in the control group (<0.05). CONCLUSION The pestle needling therapy reduces the foot VPT and improves the sensory nerve function of the foot and the QOL in the patients of high-risk diabetic foot.
Acupuncture Therapy ; Diabetes Mellitus, Type 2 ; Diabetic Foot ; therapy ; Humans ; Perception ; Quality of Life ; Vibration

Objective To investigate the current prevalence of pubertal development in healthy Shanghai schoolchildren.Methods This study was a cross-sectional investigation focused on current pubertal development conducted in healthy Shanghai schoolchildren by multi-stage cluster sampling.The sample included 17 571 children in grades 1-5 investigated in June 2014.The data were weighted by inverse probability weighting (IPW) to make them more representative.At examination,stages of breast and pubic hair development were rated according to the Tanner method.Testicular volume was determined.Data on menarche and spermatorrhea were collected by the status quo method.The rates of precocious puberty,breast,and pubic hair development of Tanner stage ≥ Ⅱ in girls aged 6-7 years,menarche in girls aged 6-9 years,and testicular volume ≥4 ml and pubic hair development of Tanner stage ≥ Ⅱ in boys aged 6-8 years were calculated.All the data were weighted by IPW.Results After data processing,16 197 children's data were analyzed.In girls aged 6-7 years,17.2％ and 2.5％ showed evidence of breast and pubic hair development at Tanner stage ≥ Ⅱ,respectively.In girls aged 6-9 years,0.3％ had experienced menarche.Schoolgirls' rate of menarche was 4.7％.In girls aged 6-7 years,19.0％ were diagnosed with precocious puberty according to the classic criteria.In boys aged 6-8 years,1.7％ had testicular volume ≥4 ml,and 0.6％ showed evidence of pubic hair development at Tanner stage ≥ Ⅱ.Schoolboys' incidence rate of spermatorrhea was 0.1％.In boys aged 6-8 years,2.3％ were diagnosed with precocious puberty according to the classic criteria.All the numbers above were weighted.Conclusion Proper education on adolescence and sex is essential for Shanghai schoolchildren.

Objective To investigate the current prevalence of pubertal development in healthy Shanghai schoolchildren.Methods This study was a cross-sectional investigation focused on current pubertal development conducted in healthy Shanghai schoolchildren by multi-stage cluster sampling.The sample included 17 571 children in grades 1-5 investigated in June 2014.The data were weighted by inverse probability weighting (IPW) to make them more representative.At examination,stages of breast and pubic hair development were rated according to the Tanner method.Testicular volume was determined.Data on menarche and spermatorrhea were collected by the status quo method.The rates of precocious puberty,breast,and pubic hair development of Tanner stage ≥ Ⅱ in girls aged 6-7 years,menarche in girls aged 6-9 years,and testicular volume ≥4 ml and pubic hair development of Tanner stage ≥ Ⅱ in boys aged 6-8 years were calculated.All the data were weighted by IPW.Results After data processing,16 197 children's data were analyzed.In girls aged 6-7 years,17.2％ and 2.5％ showed evidence of breast and pubic hair development at Tanner stage ≥ Ⅱ,respectively.In girls aged 6-9 years,0.3％ had experienced menarche.Schoolgirls' rate of menarche was 4.7％.In girls aged 6-7 years,19.0％ were diagnosed with precocious puberty according to the classic criteria.In boys aged 6-8 years,1.7％ had testicular volume ≥4 ml,and 0.6％ showed evidence of pubic hair development at Tanner stage ≥ Ⅱ.Schoolboys' incidence rate of spermatorrhea was 0.1％.In boys aged 6-8 years,2.3％ were diagnosed with precocious puberty according to the classic criteria.All the numbers above were weighted.Conclusion Proper education on adolescence and sex is essential for Shanghai schoolchildren.