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:How to improve the accuracy of puncture,reduce surgical damage,and improve surgical efficiency during vertebroplasty is currently one of the focuses of exploration and improvement in vertebroplasty techniques. OBJECTIVE:To explore the clinical significance of application of mixed reality technology in percutaneous vertebroplasty for spinal fractures. METHODS:Two patients with osteoporotic vertebral compression fracture in Dalian Second People's Hospital in June 2023 were selected.Before operation,128-row CT scanning of the lumbar spine was performed and the original data of digital imaging and communications in medicine(DICOM)were obtained.Visual Volume software was used to build the three-dimensional network model of vertebral compression fracture.Holographic imaging glasses were used to accurately map 3D network model images to the real world,assist the surgeon in completing preoperative simulation,explaining preoperative conditions and treatment plans,and guiding puncture and bone cement injection during surgery. RESULTS AND CONCLUSION:(1)Precise puncture was achieved with the assistance of a mixed reality technology.Postoperative imaging examination showed good bone cement filling and no obvious leakage.The postoperative symptoms of the patient were alleviated well,and they were able to move to the ground on the same day after surgery.(2)It is concluded that a mixed reality technology is helpful for preoperative surgical design and communication efficiency with patients and their families.Assisting with precise puncture during surgery,shortening surgical time,and reducing side injuries is a new and effective clinical diagnosis and treatment model,which has development potential in minimally invasive,precise,and personalized treatment of spinal surgery.

Non-invasive brain stimulation (NIBS) is one of the fastest-growing fields of medicine today. Recent studies have highlighted the potential of NIBS as an innovative, safe, and cost-effective treatment method applied to insomnia. Starting from treatment mechanism and clinical effect, we summarize the current research status of repetitive transcranial magnetic stimulation and transcranial electrical stimulation, the two most common NIBSs used in insomnia treatment, and analyze the existing research limitations and its future development direction, in order to provide references for further promoting the clinical application of NIBS in insomnia treatment.

OBJECTIVE：To investigate the effect of increasing efficacy and decreasing toxicity of Limax extract （LE）on cyclophosphamide（CTX）in the treatment of hepatocellular carcinoma. METHODS ：The mice were randomly divided into normal group，model group ，CTX group （0.02 g/kg），LE low-dose ，medium-dose and high-dose groups （LEL，LEM，LEH group ，0.6，1.2，2.4 g/kg），CTX+LE low-dose ，medium-dose and high-dose combination groups （CTX+LEL，CTX+LEM，CTX+ LEH group ，the same dose as single drug group ），with 10 huangrenbin518@163.com mice in each group. Except for normal group ，other groups were inoculated with hepatoma cells H 22 in the left ar mpit to establish tumor bearing models. After 24 h of inoculation ，normal group and model group were intragastrically given normal saline ， and administration groups were intragastrically given corresponding drugs ，once a day ，for 10 days. On the second day after the last administration ，the general conditions of mice in each group were observed ；the body mass ，thymus index （LI），spleen index （SI）were measured ；the tumor inhibition rate was detected. The effect （q）of combination therapy was evaluated by King ’s formula . The counts of WBC ，RBC and PLT ，serum contents of ALT ，ALT，Scr and BUN were detected in model group ，CTX group and combination groups ，and the contents of MDA，SOD and GSH ，the levels of VEGF ，TNF-α and IL-6 in the tumor tissue were detected by colorimetry and ELISA in above groups. The protein expression of oncogenes （p53，Bcl-2 and Bax ）were detected by immunohistochemical method in model group，CTX group and CTX+LEM group. RESULTS ：The mice in the model group were in poor spirit and had symptoms of excessive drinking and eating ；although the body weight ，TI and SI were not significantly abnormal compared with normal group （P＞0.05），WBC count and AST content were significantly increased ，ALT and BUN contents were significantly decreased （P＜ 0.05 or P＜0.01）. Compared with model group ，above symptoms of mice were all improved in administration groups. The tumor weight of administration groups ，TI and SI of CTX group and TI of combination groups were decreased significantly ，but tumor weight of LEL group and LEH group ，TI and SI of LE single groups and combination groups were significantly higher than CTX group；tumor weight of combination groups were significantly lower than CTX group （P＜0.05 or P＜0.01）. The tumor inhibition rates of administration groups were 29.58％-72.08％. The q values of CTX+LEL group ，CTX+LEM group and CTX+LEH group were 1.03，0.97 and 0.86，respectively. Compared with model group ，WBC count ，AST and BUN contents of CTX group ，MDA contents of combination groups ，VEGF，TNF-α and IL-6 levels of administration groups ，the protein expression of Bcl- 2 in CTX group and CTX+LEM group were decreased significantly ；the activities of SOD and GSH of administration groups ，the protein expression of p 53 in CTX+LEM group and Bax in CTX group ，CTX+LEM group were increased significantly （P＜0.05 or P＜ 0.01）；WBC counts and AST contents of administration groups ，ALT content of CTX+LEM group ，SOD activity of CTX+LEH group and GSH activity of CTX+LEM group were all significantly higher than those of CTX group ；MDA content of CTX+LEH group，VEGF and TNF-α levels of CTX+LEM group and CTX+LEH group，IL-6 levels of administration groups were all significantly lower than CTX group （P＜0.05 or P＜0.01）. CONCLUSIONS ：LE combined with CTX can increase the anti-tumor effect，and LE can reduce the toxicity of CTX induced immunosuppression and bone marrow suppression in mice ，with effect of increasing efficacy and decreasing toxicity. The effect may be related to antioxidant stress ，inhibition of angiogenesis and secretion of inflammatory factors ，and regulation of apoptosis protein expression.

Objective:To explore the correlations among coping style, self-consistency and stigma in bipolar disorder depression patients.Methods:From June 2017 to December 2018, this study selected 217 bipolar disorder depression inpatients of Department of Mental Health at a Class Ⅲ Grade A hospital in Taiyuan by convenience sampling. All of them were investigated with the general information questionnaire, Perceived Devaluation-Discrimination Scale (PDD) , Self-Consistency and Congruence Scale (SCCS) and the Simplified Coping Style Questionnaire (SCSQ) . Amos 22.0 was used to path analysis.Results:The scores of PDD, SCSQ and positive coping style and negative coping style were (30.92±6.41) , (101.54±16.99) , (21.63±6.46) and (13.36±5.03) respectively. Pearson correlation analysis showed that positive coping style of patients had negative correlations with the self-consistency and stigma ( r=-0.748, -0.655; P<0.01) ; negative coping style had positive correlations with the self-consistency and stigma ( r=0.553, 0.742; P<0.01) ; self-consistency had a positive correlation with the stigma ( r=0.763, P<0.01) . Mediating effect test showed that self-consistency only had partial mediating role between the negative coping style and stigma and the mediating effect accounted for 40.54% of the total effect. Conclusions:The negative coping style not only has a direct impact on the stigma in bipolar disorder depression patients, but also has an indirect impact on stigma by self-consistency. Medical staff can carry out intervention based on this path to reduce the stigma of bipolar disorder depression patients.

The research of central mechanism of internet addiction disorder ( IAD) has become a trend gradually .Mostly the researches are available on the executive function of IAD based on experimental paradigms .This paper is a brief review of the main ex-perimental paradigms of executive function on the research of IAD .

Objective To analyze Chinese oncology papers included by Chinese biomedical literature database (CBM) and science citation index (SCI),and to comprehensively and objectively reflect the current situation of Chinese oncology literatures published in domestic and international journals.Methods Chinese oncology papers were retrieved by using CBM and SCI.A comparison analysis was made from the respects of subject distribution,district distribution,organization distribution and high citation situation.Results 67 071 papers of 2012 were retrieved from CBM database,while 9226 papers were indexed by SCI.In terms of district distribution,the first three districts were Jiangsu (6707),Guangdong (4897) and Beijing (2214) in CBM database,while in SCI database,they were Beijing (2214),Shanghai (2008) and Guangdong (1393).The institute with the most amount of literature is university,respectively 9725 and 5755.Moreover,the mostly funded project is National Natural Science Foundation (4710,35.38％ ; 3290,35.68％).Conclusion The 2012 Chinese oncology literatures published in domestic journals has advantage with respect to quantity,compared with the international published journals.However,there exists a bigger difference in terms of quality.Through the comparative analysis,the medical researchers in our country will have some implications in the research orientation.

Objective To analyze Chinese oncology papers of 2012 included by Science Citation Index (SCI) and to facilitate domestic oncology researchers to better master the foreign periodical information and publish research results.Methods Chinese oncology papers included by SCI in 2011 and 2012 were retrieved,by using SCI-Expanded database.The periodical distribution,subject distribution,organization distribution,fund and citations were analyzed.Results In 2011,6570 papers were included by SCI,while 9226 were included in 2012,with the increase rate of 40.426％.The major language was English,and the most frequent literature type was article.The amount of source journals increased from 668 in 2011 to 749 in 2012.PLoS One published the most amount of literature both in 2011 and in 2012.The periodical with the highest impact factor (IF) in 2011 was Nature Genetics (IF =35.209),while in 2012 was Nature (IF =38.597).The university with the most amount of published literature was Sun Yat-sen University (653,7.078％),and the corresponding medical institution was PLA General Hospital (113,0.932％) and the corresponding research institute was Chinese Academy of Medical Sciences (316,3.425％).The most funded project was National Natural Science Foundation with the rate of 46.339％ (1949/4206) in 2011 and 40.000％ (3290/8225) in 2012.The total citation frequency was 36 569 in 2011 and 18 945 in 2012.Conclusion Over the past two years,Chinese oncology papers included by SCI make great progress,in terms of quantity and quality.English is the main written language,and there are more source journals but less journals with high IF.

Objective:This study aimed to observe the differences of tooth inclinations among post treatment good cases of different malocclusions and untreated normal occlusions in order to give references on clinical adjusting of tooth inclinations. Methods:157 post treatment good cases were chosen and tooth inclinations were measured on post treatment casts using YM 2115 three dimensional measurement instrument. The measurement results were compared with those of untreated normal occlusions. Results:The inclination values of upper and lower incisors of Class Ⅰ groups are most close to those of untreated normal occlusions, which of upper central and lateral incisors are 9.6? and 8.7?, and of lower central and lateral incisors are 1.1? and-1.1?. In Class Ⅱ groups, lower incisors are markedly proclined (5.6? and 2.1?) and upper incisors are similar with untreated normal occlusions. In Class Ⅲ groups, upper incisors are markedly proclined (15.2? and 12.1?) and lower incisors are markedly retroclined (-3.7? and-4.9?). Conclusion:In order to achieve normal overjet and overbite, it is necessary to adjust the inclinations of upper and lower incisors when treated Class Ⅱ and Class Ⅲ malocclusions only by the method of orthodontic treatment.

40? or 40?)comprised 10 cases and the hypodivergent group (MP-SN