OBJECTIVE To analyze the risk factors contributing to piracetam-associated thrombocytopenia and develop a predictive model for risk prediction. METHODS The electronic medical record information of inpatients treated with piracetam was collected retrospectively from the First Affiliated Hospital of Guangxi Medical University from January 2021 to December 2023， including gender， age， underlying diseases， combined medication， and laboratory data， etc. Patients were divided into the occurrence group and the non-occurrence group according to whether thrombocytopenia occurred， and the differences in clinical data between the two groups were compared. The independent risk factors were determined through univariate/multivariate Logistic regression analysis. A nomogram was drawn to visually present the independent risk factors， and a risk prediction model was constructed. The predictive efficacy of the model was evaluated using the receiver operating characteristic （ROC） curve， Bootstrap internal validation and calibration curve. RESULTS A total of 224 patients were included， among which 196 cases were in the non- occurrence group and 28 cases in the occurrence group. The incidence of thrombocytopenia was 12.50%. The results of the univariate Logistic regression analysis showed that the proportion of patients using three or more combined antibiotics and the level of serum creatinine in the occurrence group were significantly higher than those in the non-occurrence group， while the level of hemoglobin was significantly lower （P＜0.05）. The results of the multivariate Logistic regression analysis revealed that the use of three or more combined antibiotics， low hemoglobin level and high serum creatinine level were independent risk factors for piracetam-associated thrombocytopenia （P＜0.05）. The constructed risk prediction model was LogitP＝ －1.114+1.256×three or more combined antibiotics－0.017×hemoglobin level+0.009×serum creatinine level. The AUC of the ROC curve of this model was 0.757， and the optimal cut-off value was 0.474； the AUC of the ROC curve of the Bootstrap internal validation was 0.733； the apparent curve and the bias-corrected curve were close to the ideal curve. CONCLUSIONS The use of three or more antibiotics， along with low hemoglobin level and high serum creatinine level， are identified as independent risk factors for piracetam-associated thrombocytopenia. The developed risk prediction model demonstrates good predictive value.

BACKGROUND: The mechanisms distinguishing metabolically healthy from unhealthy phenotypes within the same BMI categories remain unclear. This study aimed to investigate the associations between regional fat distribution and metabolically unhealthy phenotypes in Chinese adults across different BMI categories. METHODS: This cross-sectional study involving 11833 Chinese adults aged 20 years and older. Covariance analysis, adjusted for age, compared the percentage of regional fat (trunk, leg, or arm fat divided by whole-body fat) between metabolically healthy and unhealthy participants. Trends in regional fat percentage with the number of metabolic abnormalities were assessed by the Jonckheere-Terpstra test. Odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated by logistic regression models. All analyses were performed separately by sex. RESULTS: In non-obese individuals, metabolically unhealthy participants exhibited higher percent trunk fat and lower percent leg fat compared to healthy participants. Additionally, percent trunk fat increased and percent leg fat decreased with the number of metabolic abnormalities. After adjustment for demographic and lifestyle factors, as well as BMI, higher percent trunk fat was associated with increased odds of being metabolically unhealthy [highest vs. lowest quartile: ORs (95%CI) of 1.64 (1.35, 2.00) for men and 2.00 (1.63, 2.46) for women]. Conversely, compared with the lowest quartile, the ORs (95%CI) of metabolically unhealthy phenotype in the highest quartile for percent arm and leg fat were 0.64 (0.53, 0.78) and 0.60 (0.49, 0.74) for men, and 0.72 (0.56, 0.93) and 0.46 (0.36, 0.59) for women, respectively. Significant interactions between BMI and percentage of trunk and leg fat were observed in both sexes, with stronger associations found in individuals with normal weight and overweight. CONCLUSIONS Trunk fat is associated with a higher risk of metabolically unhealthy phenotype, while leg and arm fat are protective factors. Regional fat distribution assessments are crucial for identifying metabolically unhealthy phenotypes, particularly in non-obese individuals.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Adipose Tissue ; Body Fat Distribution ; Body Mass Index ; China/epidemiology* ; Cross-Sectional Studies ; Health Surveys ; Phenotype

Objective To ensure the effectiveness and improve the capacity of laboratories in the measurement of γ spectra of radionuclides. Methods A statistical analysis was performed using relative deviation, accuracy, precision, and relative combined uncertainty for the nationwide assessment of radionuclide γ spectrum measurement. Results In the assessment from 2018 to 2020, our laboratory showed qualified or above results, and the performance in 2019 was excellent. The maximum relative deviation of 11 measurements from 2018 to 2020 was 18.01%. The assessment showed |Z_test|≤1 and U_test≤2.58 in 2018, |Z_test|≤1 and U_test≤1 in 2019, and U_test≤1 and U_rel≤20% in 2020. Conclusion Our laboratory employs the correct method for radionuclide γ spectrum measurement, and the analysis data are accurate and reliable.

Objective:To investigate the methods and effects of judging and surgically correcting the Asian wide and bulbous nasal tip.Methods:For shrinking the tip of nose and making the nose look more harmonious, we not only dealt with the nasal tip, also the nasal dorsum, nasal alar, nasal threshold, inside pedal and nasal base. In two years, we measured the changes before and after operation in 60 patients (10 males and 50 females, age arange from 18 to 48 years, with average of 29 years. Group A included 30 cases, using auricular cartilage and nasal septum as support; Group B included 30 cases and costal cartilage was used.Results:The prominence of nasal tip, the length of nose were increased ( t=20.831, 13.029, P<0.05); the width of the nose and nasal aral basal and nasal tips were reduced ( t=8.461, 11.877, 16.122, P<0.05). After the follow-up, 55 patients were satisfied, 3 were dissatisfied, and 2 were lost to follow-up. Conclusions:The nasal tip hypertrophy is obviously corrected by using this procedure with a natural and harmonious appearance.

Carcinoma of pancreatic body and tail is a high invasive disease with a low resectability rate.It was once believed that celiac axis infiltration usually contraindicated resection.Distal pancreatectomy with en bloc celiac axis resection (DP-CAR) is described as a new treatment method of this disease.In recent years,more and more literatures have reported this operation,but they were case reports or small sample retrospective study,the results of which differed according to the different treatments and perioperative managements in different centers.The advantages and disadvantages of DP-CAR are still controversial.Research progress of DP-CAR is reviewed in this article.

OBJECTIVE: To analyze the clinical characteristics and genetic basis of a child affected with Glass syndrome. METHODS: Clinical manifestations and auxiliary examination results of the child were analyzed. Potential mutation was detected with next generation sequencing and validated by Sanger sequencing. RESULTS: The child has featured growth and mental retardation, delayed speech, cleft palate, crowding of teeth, and downslanting palpebral fissures. DNA sequencing revealed a de novo heterozygous missense mutation c.1166G>A (p.R389H) in exon 8 of the SATB2 gene in the child. CONCLUSION The heterozygous mutation c.1166G>A (p.R389H) of the SATB2 gene probably account for the Glass syndrome in the patient.
Abnormalities, Multiple ; genetics ; Child ; Chromosome Deletion ; Chromosomes, Human, Pair 2 ; Humans ; Intellectual Disability ; genetics ; Matrix Attachment Region Binding Proteins ; genetics ; Mutation ; Transcription Factors ; genetics

Health Impact Assessment (HIA) is an important tool for promoting health in all policies.HIA helps decision-makers foresee how different factors can affect health,and to make choices between alternatives and improvements to prevent disease/injury,as well as to actively promote health.The Healthy China 2030 Planning Outline proposed the establishment of overall health impact assessment systems to systematically assess the potential health effects of various economic and social development programs and policies and important engineering projects on a population.This paper introduces international research on the definition,origin,development,function,contents,and implementation of HIA,as well as two typical practical examples,namely the HIA in Urban Design and Planning of Manukau,NZ,and the HIA of the Healthy Families Act of 2009,USA.Finally,the authors put forward suggestions for exploring and establishing the Chinese HIA system.Specifically,to strengthen the guidance of HIA to the direction of law and regulation,to promote the publicity and awareness of the HIA concept,and carry out research on HIA evaluation methodology and technical tools.

Objective:To assess the association between preoperative neutrophil–lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and red cell distribution width (RDW) and the tumor pathological features in gastric cancer (GC) patients. Methods: We re-viewed the records of 434 patients from 2012 to 2014 in Fujian Cancer Hospital. All patients were admitted to the hospital for the first time, and no patients received any cancer-specific pretreatment. For comparison, 309 age-and gender-matched healthy individuals who underwent annual physical examination at the hospital and 342 patients with chronic atrophic gastritis were enrolled. Results:GC patients had higher NLR, PLR, and RDW than the controls (P<0.000 1). Elevated NLR, PLR, and RDW were associated with the develop-ment of tumor stages as indicated by the Kruskal-Wallis analysis. However, no similar association was observed between the tumor dif-ferentiation grade and location and those three markers. Multivariate regression analysis further revealed that both NLR and PLR were independent predicting factors for either the tumor TNM or T stage (P<0.000 1). ROC curve analysis showed that NLR and PLR had a certain diagnostic effect on the preoperative T staging of GC. Conclusion:The preoperative NLR and PLR levels are closely correlated with the tumor TNM stages in GC patients. Both these parameters have potential values as markers to assist either in early diagnosis or preoperative tumor stage evaluation in GC.

Objective To investigate the efficacy of implantation of radioactive iodine-125 (125I) seeds combined with chemotherapy in treatment of stage Ⅲb and Ⅳ non-small cell lung cancer (NSCLC).Methods Ninety patients with stage Ⅲb and Ⅳ NSCLC were divided into two groups.The combined group (n=43) received chemotherapy with TP (paclitaxe plus cispla tin) or GP (gemcitabine plus cisplatin) 3 days after 125I particles implantation,and the control group (n=47) only received TP or GP chemotherapy.The effective rate,1-year and 2-year survival rate,the median survival time were compared between the 2 groups.Results The total effective rates of the combined group and the control group of stage Ⅲ b NSCLC were 84.00％ and 48.28％,and the effective rates of stage Ⅵ NSCLC were 72.22％ and 33.33％ (both P＜0.05).The 1-year and 2-year survival rate of the combined group and control group of stage Ⅲb NSCLC were 67.80％,36.00％ and 37.90％,13.83％,respectively (both P＜0.05).The median survival time was 15.7 months and 8.6 months.However,the survival rates of the combined group and the control group of stage Ⅳ NSCLC were 44.44％,16.70％ and 22.22％,11.10％,respectively,while the difference was not statistically significant (P＞0.05).The median survival time was 8.9 and 6.0 months.Conclusion The implantation of radioactive 125I seeds combined with chemotherapy can obtain a significant efficacy in the treatment of stage Ⅲb and stage Ⅳ NSCLC.For patients with stage Ⅲb NSCLC,combined therapy can improve the survival rate.

OBJECTIVE To observe the effect of natrin from Naja naja atra(Chinese cobra)on intracellular free calcium overload,and to discuss the protective effect and the possible mechanism of natrin on myocardium calcium(Ca2+)and potassium(K+)ion channels in the primary cardiomyocytes of SD neonatal rats. METHODS The primary cardiomyocytes of SD neonatal rats were used,which were respectively pretreated with natrin 5,25 and 125 mg · L-1 for 24 h before injury was induced by H2O2 0.3 mmol · L- 1. The dynamic variation of intracellular calcium was monitored by laser confocal microscopy using Fluo-3 as Ca2+fluorescence probe. Additionally,the cardio myocytes of neonatal rats were pretreated for 24 h using different concentrations of natrin 5,25,125 mg · L-1 and verapamil 5 nmol · L-1,followed by exposure to H2O2 0.3 mmol · L-1 for 15 min. Then,the mRNA expressions of calcium channels subunits Cav1.2,Calm,RyR2 and potassium channel Kir6.2 were analyzed by FQ-PCR method. RESULTS Laser confocal microscopy revealed that H2O2 obviously caused calcium overload in cardiomyocytes, giving rise to 49.37% fluorescence increase in intracellular calcium compared with the control group(P<0.01). However,natrin 5,25 and 125 mg·L-1 resulted in 27.52%, 12.71% and 5.15% fluorescence increase in intracellular calcium,respectively,compared with the control group(P<0.01). Moreover, the PCR results showed that the mRNA expressions of Cav1.2, Calm and RyR2 in the myocardial cells treated with H2O2 were increased 2.78,2.26,and 5.34 times as compared with the control group,while Kir6.2 displayed a 1.79-fold expression level(P<0.01). By contrast, the combination of natrin and verapamil significantly decreased the mRNA expression of Cav1.2,Calm and RyR2,compared to the H2O2-treated group(P<0.01). Meanwhile,the expression of Kir6.2 was considerably higher than that of the H2O2-treated group(P<0.05). CONCLUSION Natrin can reduce the intracellular calcium overload of cardiomyocytes induced by H2O2 and shows a protective effect against oxidative damage for cardiomyocytes. The possible mechanism is that natrin can decrease the mRNA expression of Cav1.2,Calm,RyR2 and increase the expression of Kir6.2 of the H2O2-induced cardiomyocytes.