Usefulness of sequential organ failure assessment score on admission to predict the 90-day mortality in patients with exertional heatstroke: An over 10-year intensive care survey.

BACKGROUND AND OBJECTIVES: Despite a growing understanding of exertional heatstroke (EHS), there is a paucity of clinical evidence for risk-stratification of patients with EHS. The objective of this study was to identify an appropriate scoring system for prognostic assessment of EHS. METHODS: This was a retrospective cohort study of all patients with EHS admitted to intensive care unit (ICU) of the General Hospital of Southern Theatre Command of PLA between October 2008 and May 2019. Inflammatory indices and organ function parameters at admission, the Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, Sequential Organ Failure Assessment (SOFA) scores, and Glasgow Coma Scale (GCS) score were collected. Risk factors for 90-day mortality were identified using multivariate Cox proportional hazard risk regression model. RESULTS: 189 patients (all male) were finally included, with a median age of 21.0 years (IQR 19.0-27.0), median APACHE II score of 11.0 (IQR 8.0-16.0), median SOFA score of 3.0 (IQR 2.0-6.0), and median GCS score of 12.0 (IQR 7.0-14.0). There were 166 survivors (87.8%) and 23 non-survivors (12.2%). Compared with survivor group, non-survivors had higher incidence of severe organ damage, including rhabdomyolysis (46.1% vs 63.6%), disseminated intravascular coagulation (25.6% vs 90.0%), acute liver injury (69.4% vs 95.7%), and acute kidney injury (36.6% vs 95.7%). Multivariate Cox risk regression model showed that SOFA score was an independent risk factor for 90-day mortality, with an optimal cutoff score of 7.5. CONCLUSIONS: SOFA score may be a clinically useful predictor of death in EHS. Prospective studies are required to confirm the effectiveness of SOFA score and the optimal cutoff level.

Non-Close-Packed Particle Arrays Based on Anisotropic Red Blood Cell (RBC) like Particles via Stretching Deformation Method.

Non-close-packed (NCP) particle arrays have potential applications in many fields such as photonics and sensors. However, due to thermodynamic stability, it is still a challenge to produce NCP arrays by the traditional approach. Here, we demonstrated a facile method to fabricate hexagonal close-packed (HCP) arrays with different orientations from that of the Janus particles. After that, the HCP arrays can be easily tuned by stretching deformation of polyethylene film. By tuning the stretching elongations, NCP arrays with five Bravais lattice structures were obtained. Besides, to fabricate the complex structure, these arrays were used as templates to assemble binary particle arrays. Such tunable crystal lattice and binary self-assembly crystal can be useful for fabricating more flexible structures and more open systems.

Asiatic acid enhances intratumor delivery and the antitumor effect of pegylated liposomal doxorubicin by reducing tumor-stroma collagen.

Tumor-targeted drug delivery systems (Tt-DDSs) are proposed as a promising strategy for cancer care. However, the dense collagen network in tumors stroma significantly reduces the penetration and efficacy of Tt-DDS. In order to investigate the effect of asiatic acid (AA) on antitumor effect of pegylated liposomal doxorubicin (PLD) by attenuating stroma-collagen, colon cancer xenograft mice (SW620 cell line) were treated by PLD, AA, or combined regimes, respectively; the collagen levels were estimated by Sirius red/fast green dual staining and immunohistochemistry (IHC) staining; the intratumor exposure of doxorubicin was visualized by ex vivo fluorescence imaging and quantified by HPLC/MS analysis. In addition, the impact of AA on collagen synthesis of fibroblast cell (HFL-1) and cytotoxic effect of PLD and doxorubicin to cancer cell (SW620) were studied in vitro. In the presence of AA (4 mg/kg), the intratumor collagen level was restricted in vivo (reduced by 22%, from 4.14% ± 0.30% to 3.24% ± 0.25%, P = 0.051) and in vitro. Subsequently, doxorubicin level was increased by ~30%. The antitumor activity of PLD was significantly improved (57.3% inhibition of tumor growth and 44% reduction in tumor weight) by AA combination. Additionally, no significant improvement in cytotoxic effect of PLD or doxorubicin induced by AA was observed. In conclusion, AA is a promising sensitizer for tumor treatment by enhancing intratumor drug exposure via stromal remodeling.

The estimation of prevalence and risk factors of hepatitis B virus infection among blood donors in Chengdu, China.

The reported positive rates of hepatitis B virus surface antigen (HBsAg) among Chinese blood donors generally do not include data from pre-donation rapid tests. The aim of this study was to estimate the prevalence of serologic markers for HBsAg and risk factors among blood donors from Chengdu, China. From April 2010 to March 2011, a total of 16,875 blood donors were enrolled. Data from HBsAg tests before and after donations were collected to estimate the prevalence of HBsAg. A case-control study was conducted in 265 unique HBsAg-positive blood donors and 530 seronegative donors between January 2011 and October 2012. The odds ratio (OR) and 95% confidence interval (CI) were calculated using conditional logistic regression. The population attributable risk (PAR) was estimated. The prevalence of HBsAg was 3.17% (95%CI, 2.91-3.43%). The following risk factors were associated with HBV infection: non-vaccination for HBV (OR = 4.236; 95%CI, 2.72-6.60%), razor sharing (OR = 2.370; 95%CI, 1.46-3.84%), dental treatment (OR = 1.714; 95%CI, 1.21-2.43%), acupuncture (OR = 1.983; 95%CI, 1.20-3.28%), a family history of HBV infection (OR = 2.257; 95%CI, 1.32-3.86%), and endoscopy (OR = 2.17; 95%CI, 1.04-4.51%). The PAR values of the risk factors were 42.77%, 31.78%, 13.68%, 6.18%, 6.09%, and 2.85%, respectively, and the total PAR was 68.78%. The prevalence of HBsAg among Chinese blood donors is still high. HBV vaccinations can provide protection. Blood contact from sharing instruments is still a high risk route of transmission for HBV. Immunization programs and behavioral interventions should be used to prevent blood donation infections and improve blood safety.

Reduced Crystallization Temperature Methodology for Polymer Selection in Amorphous Solid Dispersions: Stability Perspective.

API-polymer interactions, used to select the right polymeric matrix with an aim to stabilize an amorphous dispersion, are routinely studied using spectroscopic and/or calorimetric techniques (i.e., melting point depression). An alternate selection tool has been explored to rank order polymers for formation of stable amorphous dispersions as a pragmatic method for polymer selection. Reduced crystallization temperature of API, a parameter introduced by Zhou et al.,1 was utilized in this study for rank ordering interactions in API-polymeric systems. The trends in reduced crystallization temperature monitored over polymer concentration range of up to 20% polymer loading were utilized to calculate "crystallization parameter" or CP for two model systems (nifedipine and BI ABC). The rank order of CP, i.e., a measure of API-polymer interaction, for nifedipine followed the order PVP > PVP-VA > Soluplus > HPMCAS > PV Ac > PAA. This rank ordering was correlated to published results of molecular interactions and physical stability for nifedipine. A different rank ordering was observed for BI ABC: PAA > PVP > HPMCAS > Soluplus > PVPV-VA > PVAc. Interactions for BI ABC were not as differentiated when compared to nifedipine based on CP trends. BI ABC dispersions at drug loadings between 40 and 60% were physically stable for prolonged periods under ICH conditions as well as accelerated stress. We propose that large CP differences among polymers could be predictive of stability outcomes. Acceptable stability at pharmaceutically relevant drug loadings would suggest that the relative influence of downstream processes, such as polymer solubility in various solvents, process suitability and selection, and more importantly supersaturation potential, should be higher compared to stability considerations while developing compounds like BI ABC.

Development of Tablet Formulation of Amorphous Solid Dispersions Prepared by Hot Melt Extrusion Using Quality by Design Approach.

The objective of the study was to identify the extragranular component requirements (level and type of excipients) to develop an immediate release tablet of solid dispersions prepared by hot melt extrusion (HME) process using commonly used HME polymers. Solid dispersions of compound X were prepared using polyvinyl pyrrolidone co-vinyl acetate 64 (PVP VA64), Soluplus, and hypromellose acetate succinate (HPMCAS-LF) polymers in 1:2 ratio by HME through 18 mm extruder. A mixture design was employed to study effect of type of polymer, filler (microcrystalline cellulose (MCC), lactose, and dicalcium phosphate anhydrous (DCPA)), and disintegrant (Crospovidone, croscarmellose sodium, and sodium starch glycolate (SSG)) as well as level of extrudates, filler, and disintegrant on tablet properties such as disintegration time (DT), tensile strength (TS), compactibility, and dissolution. Higher extrudate level resulted in longer DT and lower TS so 60-70% was the maximum amount of acceptable extrudate level in tablets. Fast disintegration was achieved with HPMCAS-containing tablets, whereas Soluplus- and PVP VA64-containing tablets had higher TS. Crospovidone and croscarmellose sodium were more suitable disintegrant than SSG to achieve short DT, and MCC was a suitable filler to prepare tablets with acceptable TS for each studied HME polymer. The influence of extragranular components on dissolution from tablets should be carefully evaluated while finalizing tablet composition, as it varies for each HME polymer. The developed statistical models identified suitable level of fillers and disintegrants for each studied HME polymer to achieve tablets with rapid DT (<15 min) and acceptable TS (≥1 MPa at 10-15% tablet porosity), and their predictivity was confirmed by conducting internal and external validation studies.

Dialdehyde modified and cationic aerogel for efficient microplastics adsorption from environmental waters.

Recent reports had shown that microplastics could be transferred to organisms through various channels, severely and adversely affecting organisms' health and their physiological functions. Therefore, there remained an urgency to adopt an effective and environmentally friendly method to extract microplastics from water. In this paper, a cationic-modified d-DCPG aerogel with a three-dimensional network structure was successfully prepared by a directional freeze-drying technology in which double-aldehyde-modified cellulose nanofiber (CNF) was used as the matrix, betaine chloride hydrazide (GT) provided modification, and polyvinyl alcohol (PVA) provided cross-linking function. Aerogels had an excellent adsorption capacity (145.05 mg/g) for microplastics in aqueous environment, and when the pH was from 10 to 4, it exhibited an excellent adsorption efficiency from 90.01 % to 97.61 %; an excellent adsorption efficiency after 8 cycles (>89 %); pseudo-second-order kinetics and Freundlich adsorption isotherm had a high fitting effects on the adsorption process and adsorption results, respectively. And ultraviolet analysis also verified the occurrence of adsorption behavior. These results showed that d-DCPG aerogels had an excellent application prospects in microplastics removal in river, lake, reservoir, and marine environments.

Particle transfer mediates dermal exposure of consumers to plasticizers in eraser and pen accessories.

Dermal exposure to chemicals released from daily consumer products is a rising concern, particularly for children who are susceptible to unintentional hand-to-mouth transfer and related chemical exposure risk. However, chemical transfer induced by tiny particles of intact products has yet to be adequately addressed. The objective of the present study was to determine the potentiality of particles release from intact erasers and pen grips upon dermal contact by measuring the migration rates of the embedded plasticizers (phthalates and its alternatives). The results showed that billions of particles were released from erasers (0.6-1.2 × 109) and pen grips (0.2-1.6 × 108) upon dermal contact at ambient temperature, with sizes mainly smaller than 1 µm. The composition of eraser leachates was identical to that of the corresponding bulk eraser, as confirmed by Fourier-transform infrared spectroscopy and pyrolysis. Migrated hydrophobic plasticizers may be used as indicators of particle release from erasers and pen grips. The potentiality of particle release was negatively correlated with the total plasticizer contents (r = -0.51; p < 0.05) for both erasers and pen grips. These findings indicated that particles directly released from school supplies and accessories could be a non-negligible source of human exposure to plasticizers.

Origin of two modes of non-isothermal crystallization of glasses produced by milling.

PURPOSE: To mechanistically explain the origin of two distinct non-isothermal crystallization modes, single-peak (unimodal) and two-peak (bimodal), of organic glasses. METHODS: Glasses of ten organic molecules were prepared by melt-quenching and cryogenic milling of crystals. Non-isothermal crystallization of glasses was monitored using differential scanning calorimetry and powder X-ray diffractometry. RESULTS: The non-isothermal crystallization of glass, generated by milling, is either unimodal or bimodal, while that of melt-quenched glass without being milled is always unimodal. The mode of crystallization of amorphous phase depends on the relative position of the crystallization onset (T ( c )) with respect to glass transition temperature (T ( g )), and can be explained by a surface crystallization model. Bimodal crystallization event is observed when T ( c ) is below or near T ( g ), due to the fast crystallization onset at milled glass surfaces. Unimodal crystallization is observed when T ( c ) is well above T ( g ). We have verified this model by intentionally inducing flip between the two crystallization modes for several compounds through manipulating glass surface area and T ( c ). CONCLUSIONS: The two modes of crystallization of organic glasses is a result of the combined effects of faster surface crystallization and variation in specific surface area by milling.

Prevalence of and risk factors for hepatitis C virus infection among blood donors in Chengdu, China.

The objectives of the study were to estimate the prevalence of anti-hepatitis C virus (HCV) positivity among blood donors from Chengdu, China, and to determine risk factors associated with infection. In this study, data were collected from volunteer blood donors between July 2006 and June 2007. Anti-HCV test was performed in 119,518 donors. To identify risk factors associated with HCV infections a case-control study was conducted in 305 unique HCV-seropositive blood donors and 610 seronegative donors matched for age and sex. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression. The population attributable risk (PAR) to risk factor was estimated according to the Bruzzi's formula. The prevalence of anti-HCV positivity was 0.53% (95% CI: 0.489-0.572%). The final multivariate model included the following independent HCV risk factors: razor sharing (OR=29.16; 95% CI: 12.89-66.00), blood transfusion (OR=20.84; 95% CI: 3.76-115.45), acupuncture (OR=8.01; 95% CI: 3.16-20.30), a history of hospitalization, injections >10 years earlier, a family history of hepatitis B, dental treatment, and ear piercing. The PAR of risk factors are 68.4%, 6.3%, 14.1%, 23.1%, 29.5%, 29.3%, 38.9%, and 27.8%, respectively, and the total PAR is 98.3%. Infection with HCV among blood donors in Chengdu is associated with iatrogenic risk factors and beauty treatment-related risk. Razor sharing is an important risk factor for HCV infection. These results indicate that infection control measures in healthcare settings may reduce the burden of HCV infection and there is a need for development of effective educational programs to improve HCV knowledge among beauty culture professionals, barber cosmetologists, and the general public to avoid risk behaviors.

[Study on the pharmacokinetics of tashinone II(A) -loaded polylactic acid nanoparticles in rabbit].

OBJECTIVE: To establish a HPLC method for measuring tashinone II(A) concentration in rabbit plasma and study the pharmacokinetics of tashinone II(A) -loaded polylactic acid nanoparticles and tashinone II(A) injection in rabbits. METHODS: A single dose of TS-PLA-NP and TS II(A) injection was administered to 8 healthy rabbits via the ear-edge vein, at the set time withdrew the blood and prepared. The concentrations of tashinone II(A) in plasma were measured by HPLC with gemfibrozil as the internal standard. The pharmacokinetic parameters of TS-PLA-NP and tashinone II(A) injection were calculated by program DAS2.0. RESULTS: The average retention times of gemfibrozil and tashinone II(A) were 10.5 and 14.5 min, respectively. The half-life was prolonged from 2. 573 h of free tashinone II(A) to 4. 117 h and MRT(0-infinity) from 2.585 h to 6.033 h. The max concentration of tashinone II(A) was reduced from 0.21 to 0.134 mg/L. CONCLUSION: The method for the pharmacokinetic research of tshinone II A in rabbit plasma is accuracy, rapid and sensitive. TS-PLA-NP shows significant characteristic of delayed-release.

[Preparation and cytocompatibility study of poly (epsilon-caprolactone)/silk sericin nanofibrous scaffolds].

Three-dimensional poly (epsilon-caprolactone)/silk sericin (PCL/SS) porous nanofibrous scaffolds were prepared by electrospinning. The structure and properties of the scaffolds were characterized by Scanning Electron Microscope (SEM), Transmission Electron Microscope (TEM), Fourier Transform Infrared Spectroscopy (FTIR) and water contact angle instrument. Studies on cell adhension and proliferation were carried out by culturing human primary skin fibroblast cells (FEK4) on these scaffolds using SEM and MTS. The experimental results showed that the PCL/SS nanofibrous scaffolds with SS nanoparticles had porous non-woven mesh structure with nanofibrous cross-linked with each other. Fiber diameter was very uniform and precise, and the secondary structure of SS protein had not been changed. Furthermore, the capability of hydrophile increased with the SS addition, which improved FEK4 cells adhesion and proliferation on the scaffolds.

Characterization of 30 microsatellite markers for distylous Primula denticulata (Primulaceae) using HiSeq sequencing.

Primula denticulata exhibits considerable variation in floral morphology and flowering phenology along elevational gradients in SW China. We isolated 30 microsatellite markers from P. denticulata to facilitate further investigation of population genetics and floral evolution in this species. We used the HiSeq X-Ten sequencing system to develop a set of markers, and measured polymorphism and genetic diversity in a sample of 72 individuals from three natural populations of P. denticulata subsp. denticulata. The markers displayed relatively high polymorphism, with the number of alleles ranging from two to seven (mean = 3.567). The observed and expected heterozygosity ranged from 0 to 1.000 and 0.041 to 0.702, respectively. Twenty-eight of the loci were also successfully amplified in P. denticulata subsp. sinodenticulata. The microsatellite markers we have identified will provide valuable tools for investigations of the population genetic structure, mating systems and phylogeography of the P. denticulata complex, and will help to address questions concerning the ecological and genetic mechanisms responsible for the evolution of reproductive traits in the species.

Inhibitory effects of polystyrene microplastics on caudal fin regeneration in zebrafish larvae.

Microplastic pollution is pervasive in aquatic environments, but the potential effects of microplastics on aquatic organisms are still under debate. Given that tissue damage is unavoidable in fish and the available data mostly concentrate on healthy fish, there is a large chance that the ecotoxicological risk of microplastic pollution is underrated. Therefore, in this study, the effects of microplastics on the regenerative capacity of injured fish were investigated using a zebrafish caudal fin regeneration model. After fin amputation at 72 h post fertilization, the larvae were exposed to polystyrene microplastics (0.1-10 mg/L) with diameters of 50 or 500 nm. Microplastic exposure significantly inhibited fin regeneration, both morphologically and functionally. Furthermore, the signaling networks that regulate fin regeneration, as well as reactive oxygen species signaling and the immune response, both of which are essential for tissue repair and regeneration, were altered. Transcriptomic analyses of the regenerating fin confirmed that genes related to fin regeneration were transcriptionally modulated in response to microplastic exposure and that metabolic pathways were also extensively involved. In conclusion, this study demonstrated for the first time that microplastic exposure could disrupt the regenerative capacity of fish and might eventually impair their fitness in the wild.

[Experimental study of prostheses modified by three dimensions porous Ti combined bone morphogenetic proteins].

OBJECTIVE: To observe bone ingrowth of artificial femur which three dimensions (3-D) porous Ti combined bone morphogenetic proteins (BMPs) integrating on the prostheses surface in dogs. METHODS: The prostheses integrated 3-D porous Ti on the surface, which combined BMPs directly or through FG, were implanted canine. And fluorescent labeling was done at 2, 5 weeks after that, and then the prostheses with femurs were taken out in 3, 6 weeks after operation. These specimens were treated, then observed through microscopy. RESULTS: At 3 weeks, bone growing 1/2 of full thickness in 3-D porous Ti, but bone growing full thickness in 3-D porous Ti at 6 weeks. Bone formation was obviously higher at 6 weeks than at 3 weeks. CONCLUSION: The prostheses modified 3-D porous Ti can accelerate osteogenesis and improve bone formation so that mechanical interlock and integration can be come true.

Description of two new species of Lysmata Risso, 1816 (Decapoda, Lysmatidae) from the China seas, with remarks on Lysmata vittata (Stimpson 1860).

Two new species of Lysmata Risso, 1816 are described and illustrated from the China seas. L. brevrostrus sp. nov. is characterized by the short rostrum not reaching the distal margin of the eyes, and the rostral ventral margin unarmed with tooth; L. parvispinosus sp. nov. is characterized by the dactylus of posterior three pereiopods tapering (not biunguiculate) and the flexor margin of the dactylus bearing two basal inconspicuous spinules. A morphologically variable species, L. vittata (Stimpson 1860), is discussed based on specimens collected from the China seas.

A new species of the genus Alvinocaris Williams and Chace, 1982 (Crustacea: Decapoda: Caridea: Alvinocarididae) from the Manus Basin hydrothermal vents, Southwest Pacific.

One new species of alvinocaridid Alvinocaris kexueae sp. nov. is described from hydrothermal vents on the Manus Basin, Southwest Pacific. This is the fifteenth species in Alvinocaris Williams & Chace, 1982. The new species is easily recognized by the combination of the rostrum distinctively overreaching the distal end of the antennular peduncle, and the armature of its dorsal and ventral margins; the unarmed third abdominal segment, and by the posterior margin of the telson having one triangular tooth medially and 6 pairs unequal spines. It is morphologically most similar to A. brevitelsonis Kikuchi & Hashimoto, 2000 described from Minami-Ensei Knoll, Okinawa Trough, but can easily be distinguished from it by the proportionally longer rostrum, by the dorsal teeth of the rostrum, by the shape of the chela of the first pereiopod, and by the teeth on the fourth abdominal segment. The genetic divergence of COI gene analyzed clearly supports the new taxon.

Correlation of MDR1 gene polymorphisms with anesthetic effect of sevoflurane-remifentanil following pediatric tonsillectomy.

BACKGROUND: The motive of this study was to investigate the collaboration between MDR1 gene polymorphisms and anesthetic effects following pediatric tonsillectomy. METHODS: All together 178 children undergoing tonsillectomy with preoperative sevoflurane-remifentanil anesthesia were selected. In order to determine MDR1 gene polymorphisms of 3435C > T, 1236C > T, and 2677G > T/A, polymerase chain reaction-restriction fragment length polymorphism was used. Mean arterial pressure (MAP), diastolic blood pressure (DBP), systolic blood pressure (SBP), and heart rate (HR) at T0 (5 mins after the repose), T1 (0 min after tracheal intubation), T2 (5 mins after the tracheal intubation), T3 (0 min after the tonsillectomy), T4 (0 min after removal of the mouth-gag) and T5 (5 min after the extubation) were observed. The visual analog scale (VAS), the face, legs, activity, cry, and consolability (FLACC) pain assessment, and Ramsay sedation score were recorded after the patients gained consciousness. The adverse reactions were also observed. RESULTS: As compared to the CT + TT genotype of MDR1 1236C > T, the time of induction, respiration recovery, eye-opening, and extubation of children with the CC genotype was found to be shorter (all P <.05); the MAP, SBP, DBP, and HR were significantly reduced at T5 in children that possessed the CC genotype (all P <.05), the VAS at postoperative 1, 2, 4, and 8 hours and Ramsay sedation score were decreased, while the FLACC score increased (all P <.05). It was found that the adverse reaction rate was lower in children bearing the CC genotype (P <.05). CONCLUSION: It could be concluded that anesthetic effect in patients with the MDR1 1236C > T CC genotype was found to be superior to those carrying the CT + TT genotype.

Proteomic analysis reveals an impaired Ca2+/AQP5 pathway in the submandibular gland in hypertension.

Hypertension is a systemic disorder that affects numerous physiological processes throughout the body. Improper sodium transport is a common comorbidity of hypertension, and sodium transport is also critical for maintaining the secretion of submandibular glands, whether the function of submandibular glands is affected by hypertension remains unclear. To determine whether hypertension induces changes in the protein expression of submandibular glands, we compared the proteome of submandibular glands from 14-week-old spontaneously hypertensive rats (SHR) and Wistar Kyoto (WKY) rats using LC-MS/MS. The results revealed that 95 proteins displayed different levels of expression between the submandibular glands from the SHRs and WKYs. Among these, 35 proteins were more abundant, and 60 proteins were less abundant in the SHR compared with the WKY rats. Specifically, aquaporin 5 and parvalbumin, which are correlated with water transport and intracellular Ca2+ signal transduction, were verified to exhibit differences in protein abundance. Impaired Ca2+ response to carbachol was confirmed in the acinar cells from SHRs, and hyposecretion by the submandibular glands was further confirmed by in vivo saliva collection. In conclusion, the proteomic analysis of the submandibular glands of SHRs revealed novel changes in protein abundance that provides possible mechanisms connecting hypertension and hyposecretion in submandibular glands.

Alendronate-anchored PEGylation of ceria nanoparticles promotes human hepatoma cell proliferation via AKT/ERK signaling pathways.

Previous work has suggested that ceria nanoparticles (CNPs) have regenerative antioxidant properties, which have motivated researchers to consider CNPs as therapeutic agents for treating a number of diseases, including cancer. Recent studies have shown CNPs to be toxic to cancer cells, to inhibit invasion and sensitize cancer cells to radiotherapy. In addition, several hydrophilic polymers have been used to coat the CNP surface in order to enhance its properties of extensive biocompatibility and systemic nontoxicity to normal cells and tissues. However, the results of previous studies were based on high CNP doses (10 µg/mL or more), and these doses may cause serious side effects in clinical applications. The impact of low CNP doses on tumor cells remains unknown. In this study, we report experiments indicating that CNPs-AL- polyethylene glycol (PEG)600, a type of surface-modified CNP that is more stable and less toxic than traditional CNPs could promote proliferation of hepatoma cells in a dose-dependent manner. In addition, further research showed that a low dose (0.01 µg/mL) of CNPs-AL-PEG600 could reduce hepatoma cell apoptosis and activate AKT/ERK signaling pathways. These results may provide information that is important for using CNPs-AL-PEG600 as a therapeutic agent in clinical cancer treatments.