Objective To investigate the nutritional risk,undemutrition,and nutrition support in inpatients with early and middle stage gastrointestinal cancer undergoing radical surgery in a tertiary hospital in Weifang,Shandong Province.Methods A total of 8390 inpatients who were treated in the departments of oncological surgery,enterohepatic surgery,and general surgery in our hospital were consecutively recorded from December 2010 to August 2011 and from November 2011 to October 2012.After 153 patients were excluded for hospital length of stay less than 24 hours,age less than 18 years old or more than 90 years old,obnubilation,and/or refusal to participate in the research,8237 patients were sampled.After patients who did not meet the scheduled diagnosis were excluded,300 pathology-confirmed patients with early or middle stage gastrointestinal cancer were enrolled.Nutritional Risk Screening 2002 (NRS 2002) was performed within the first 48 hours after admission and nutrition support was evaluated until the discharge.Results A total of 300 early and middle stage gastrointestinal cancer patients (141 cases of gastric cancer and 159 cases of colorectal carcinoma) who underwent radical surgery met the inclusion criteria.Among them 185 (61.7％) were at nutritional risk.The undernutrition rate was 12.3％ (37/300) if evaluated from the score of nutritional defect part of NRS 2002,and 10.0％ (20/300) if based on body mass index ＜18.5 kg/m2.Totally 165 patients (89.2％) at nutritional risk and 99 patients (86.1％) without nutritional risk received nutrition support.The average ratio of parenteral nutrition to enteral nutrition was 82:1.The intake of calories was (78.1±24.8) k1/(kg,d) [(18.6±5.9)kcal/(kg·d)] and that of nitrogen was (0.10±0.06) g/(kg · d),yielding a ratio of calories vs.nitrogen of (244 ± 164)∶1.Conclusions Inpatients with early and middle stage gastrointestinal cancer tend to have high nutritional risk.The undernutrition rate is 10％-12.3％ in this population.Meanwhile,the application of nutrition support should be further standardized,particularly for patients without nutritional risk.

Objective: To evaluate the prognostic value of the thrombolysis in myocardial infarction (TIMI) and global registry of acute coronary events (GRACE) risk scores for in-hospital mortality in Chinese non-ST-segment elevation myocardial infarction (NSTEMI) patients. Methods: Data of present study derived from the prospective, multi-center registry trial of Chinese AMI (CAMI). Among 31 provinces, municipalities or autonomous districts in China, at least one tertiary and secondary hospital was selected. From January 2013 to September 2014, 5 896 consecutive non-ST-segment elevation myocardial infarction patients who were admitted to 107 hospitals within 7 days of symptom onset were enrolled. For each patient, TIMI and GRACE risk scores were calculated using specific variables collected at admission. Their prognostic value was evaluated by the endpoint of in-hospital mortality. Results: Among 5 896 NSTEMI patients (age was (65.4±12.1) years old), 68.2% (n=4 020) were males. The in-hospital mortality was 6.0% (n=353) and the median length of hospital stay was 10.0 (7.0, 13.0) days. The incidence of pre-hospital cardiac arrest was 3.6% (n=213) among 5 896 NSTEMI patients. Six hundreds and forty five patients (10.9%) received primary percutaneous coronary intervention, and 6 patients underwent emergent coronary artery bypass grafting surgery (0.1%), and the median time of reperfusion was 529.5 (256.0, 1 065.0) minutes. The prescription percentage of statins, β-blocker, angiotensin converting enzyme inhibitors or angiotensin Ⅱ receptor blockers, and aldosterone antagonists were 94.8% (n=5 587), 71.7% (n=4 228), 65.5% (n=3 864) and 26.0% (n=1 533) respectively. The area under the curve of GRACE risk score for in-hospital mortality (0.7930 (95%CI 0.767-0.818)) was better than that of TIMI risk score (0.5588 (95%CI 0.532-0.586), P<0.001). Conclusion GRACE risk score demonstrates better predictive accuracy than TIMI risk score for in-hospital mortality in NSTEMI patients in this patient cohort.

Accurate and applicable reference intervals can provide important information for disease diagnosis, efficacy evaluation, and health monitoring. Age-dependent trends exist for many clinical laboratory indicators, and the interpretation of such indicators should consider the effect of age carefully. However, age-specific reference intervals have certain limitations in clinical application. Continuous reference intervals can not only help accurate interpretation of laboratory test results, but also provide a baseline value for dynamic monitoring of their changing trends. Based on the researches on pediatric reference intervals from our team, this paper introduces different algorithms for establishing continuous reference intervals, and their applicable conditions and implementation steps. The aim of this paper is to provide methodological guidance for the establishment of continuous reference intervals, so as to improve the quality of laboratory reports and the accuracy of clinical diagnosis in China.

Cohort and case-control studies are important types of study design in clinical and epidemiological researches. Although they are both methods to study associations between an exposure and a disease, their core logic is completely different.In order to evaluate the association between an exposure and an outcome, cohort studies group the populations by the research factor (exposure or not), and compare the event rate of the outcome in exposure and control groups through follow-up. Cohort studies are sequential from cause to effect. On the contrary, case-control studies derive cause from effect. Case-control studies group the populations by the outcome (occurrence or not), and compare the distributions of the exposure in case and control groups through retrospective investigation or collection of exposure information from historical records. This paper declares the logic that should be followed in statistical analysis of these two types of studies, as well as the specifications that should be followed in formulating statistical analysis plans and reporting results. The aim of this paper is to enhance the scientific nature of the research and improve the readability of the literature.

Objective To assess and compare the incidence,clinical characteristics,treatment,and prognosis of acute heart failure patients from different grades hospitals in Beijing.Methods In this prospective internet prognosis registered study (Beijing AHF Registry),a total of 3 335 consecutive patients admitted to 14 emergency departments in Beijing from January 1st 2011 to September 23rd 2012 were enrolled.According to hospital grade,these patients were divided into two groups,349 patients were from secondary hospitals,and 2 956 patients were from tertiary hospitals.Results Among the 3 335 patients,the medium age was 71 (58,79) years,and male accounted for 53.16％.The most common underlying disease were coronary disease (43.27％),hypertension (17.73％),cardiomyopathy (16.07％) etc.The average treatment time in Emergency Department was 66.82 h.The emergency department mortality rate was 3.81％ (127 cases).The 30-day and 1-year cumulative all-cause mortality were 15.3％ and 32.27％,respectively.The 30-day and 1-year cumulative all-cause readmission were 15.64％ and 46.89％,respectively.Compared with patients in tertiary hospitals,patients in secondary hospitals had more onset acute heart failure patients (63.64％ vs.49.93％),shorter emergency department treatment time (12 h vs.41 h),lower discharge rate (3.43％ vs.37.45％) and emergency department mortality(1.58％ vs.4.09％).Compared with those in tertiary hospitals,1-year cumulative all-cause mortality (25.6％ vs.33.2％),cardiovascular disease mortality (20.2％ vs.26.0％),aggravated heart failure mortality (22.4％ vs.28.8％) were lower in secondary hospitals.Following propensity score matching,compared to tertiary hospitals,patients in secondary hospitals showed lower utilization rate of beta-blockers and ACEFARB (4.51％ vs.28.17％,1.41％ vs.9.58％),except the pironolactone.Conclusion Acute heart failure in emergency department is associated with a high mortality rate and readmission rate.There is still a big gap between guidelines recommend medication current treatments for acute heart failure.