Objective: To explore the risk factors for Type 1 cardio-renal syndrome (CRS1) atfer ST-segment elevation myocardial infarction (STEMI). Methods: A total of 378 patients with STEMI were divided into two groups: a CRS1 group (n=98) and a non-CRS1 group (n=280). Clinical characteristics in the 2 groups were compared, and independent risk factors for CRS1 after STEMI were analyzed, and the effect of emergency Results: In the 378 STEMI patients, CRS1 was found in 98 patients (25.9%). Between the 2 groups, there was significant difference in 12 parameters, including age, history of diabetes, admission mean arterial pressure, admission systolic blood pressure, admission heart rate, Killip classification, left ventricular ejection fraction, baseline serum creatinine, baseline evaluated glomerular ifltration rate (eGFR), emergency PCI, β-blockers and angiotensin converting enzyme inhibitor/angiotensin, receptor antagonist (ACEI/ARB) application (allP<0.05). Multivariate logistic regression showed that age, history of diabetes, admission systolic blood pressure, Killip classification, reduced left ventricular ejection fraction, reduced eGFR, emergency PCI non-undergo and ACEI/ARB non-use were independent risk factors for CRS1 atfer STEMI. In the 256 patients undergoing emergency PCI, 50 patients (19.5%) had CRS1. hTe door-ball time and the amount of contrast agent in the CRS1 group were signiifcantly higher than those in the non- CRS1 group (bothP<0.05), but there was no signiifcant difference in the blood lfow in the “culprit vessel”atfer the PCI (P>0.05). Conclusion: CRS1 is a common complication of STEMI, which is associated with many factors. Immediate revascularization can reduce the incidence of CRS1 in patients with ST-segment elevation myocardial infarction.

BACKGROUNDRecently chemoradiotherapy becomes a standard treatment of un-resectable advanced non-small cell lung cancer (NSCLC) instead of radiotherapy alone. This study is to evaluate the clinical effect and toxicities of concurrent chemoradiotherapy in patients with stage III NSCLC after 2 cycles of induction chemotherapy with cisplatin-based regimens.

METHODSNinety-two patients with stage III NSCLC were divided randomly into two groups: forty-seven patients received concurrent chemoradiotherapy (chemoradiotherapy group), the other 45 patients received only radiotherapy (radiotherapy group). For both groups, the same radiation technic was given with the conventional fraction. The total dose was 60-65Gy/30-33Fr/6-6.5Wk. For the chemoradiotherapy group, the patients were also given with concurrent chemotherapy (navelbine 15-18mg/m² on the 1st and 8th day, cisplatin 60mg/m² on the 1st day).

RESULTSThe response rate in the chemoradiotherapy group was similar to that in the radiotherapy group (59.6% vs 51.5%, P > 0.05), but the complete response rate in the chemoradiotherapy group was significantly higher than that in the radiotherapy group (14.9% vs 6.7%, P < 0.05). The 1- and 2-year survival rates in the chemoradiotherapy group were similar to those in the radiotherapy group (65.9% and 42.5% vs 53.3% and 33.3%, P > 0.05). The 1- and 2-year local control rates in the chemoradiotherapy group were significantly higher than those in the radiotherapy group (63.8% and 53.2% vs 51.1% and 44.4%, P < 0.05). The incidences of grade III-IV radiation esophagitis and leukopenia in the chemoradiotherapy group were significantly higher than those in the radiotherapy group (21.2% and 12.7% vs 4.4% and 0, P < 0.01).

CONCLUSIONSConcurrent chemoradiotherapy has the potential of improving the survival rate of stage III NSCLC, it can also increase the acute toxic effect, but all patients can tolerate this treatment regimen.

Objective To evaluate the nutrional status and malnutrition risks of hospitalized children with acute lymphoblastic leukemia (ALL),provide nutrition support for subsequent treatment,lower nutritional risks and improve therapeutic effects;to complete the statistical analysis of height and weight across age through data normalization.Methods A total of 592 children diagnosed ALL from August 2014 to September 2016 at Beijing Children's Hospital were enrolled,and the directly measured height and weight which reflected the nutritional status of children were collected and normalized.Nutritional risk screening was completed by STAMP screening tool and the nutritional status was evaluated by three Z scores HAZ＜-2,WAZ＜-2 and WHZ＜-2.The effects of nutrition intervention were investigated by weight,hemoglobin and albumin changes between before and after L-asp treatment.Results The Z score test showed that there was no significant difference between the nutritional status of pretreatment ALL patients (0.34％ growth retardation,2.36％ lower body weight,0.17％ emaciation) and normal healthy children (3％ malnutrition);after comparing the STAMP nutritional risk assessment and t test results for children with ALL,it was found that the proportion of children with high malnutrition risk (score≥4) was 9.71％,which had a strong correlation with body mass index;the children with body mass index less than 0.80 (50％ children having malnutrition) or greater than 1.30 (20％ children having malnutrition) had a higher risk of malnutrition,and the body mass indexof the high-risk group (0.852 kg/m2) were significantly lower than that of the low risk group (1.051 kg/m2,score ≤ 3);there were significant differences in height and weight between children with STAMP ≤ 3 and STAMP ≥ 4 (all P ＜0.05) Nutritional interventions made no significant weight change during treatment;For children with STAMP ≤3 and STAMP ≥4 in L-asp treatment,the hemoglobin value changed from (87.46± 19.27) g/L to (95.12±13.51) g/L and (101.55±21.97) g/L to (95.05±11.22) g/L respectively (all P=0.001);The albumin of children with STAMP≤3 changed from (40.63±4.149) g/L to (41.20±5.266) g/L in treatment and that of children with STAMP ≥4 changed from (40.96±8.429) g/L to (42.17±3.574) g/L in treatment (P=0.20,0.05).Conclusion There are no obvious indications of malnutrition in children with ALL,but nearly 10 ％ of them have malnutrition risks.Special dietary guidance is needed during the treatment.Nutrition intervention is effective in the treatment of L-asp.Normalized data is more convenient to use in statistical analysis with more accurate results,which can be used as a supplementary method for cross-age group statistical analysis of children's height,weight and other parameters.

Objective To validate bioelectrical impedance analysis(BIA) for measuring the area of visceral fat of school-age populations using MRI as a reference method.Methods Sixty healthy children (30 boys and 30 girls) aged 7 to 18 years were enrolled in the study.Both MRI and BIA were completed in seven days.We obtained the indexes of the body composition from BIA and MRI in the morning before the participants had their breakfast.For reference,the navel plane image obtained with MRI was used to analyze the area of adipose tissue.With BIA,the area of visceral adipose tissue could be derived directly.Results Sixty healthy school-age children were enrolled in the study.The average age of the school children was (11.9±4.6) years,and their BMI was (22.8±7.3) kg/m2.The average area of visceral fat obtained with BIA was (85.4±64.2) cm2,which was higher than that obtained with MRI [(49.4±32.4) cm2](t=-6.524,P =0.000).The Pearson correlation coefficient was r=0.806 (P=0.000) and the simple linear regression equation for the areabetween the two was:y=0.41x + 14.78;β (95％CI) was 0.41(0.04-0.81).The Bland-Altman plot was (x-) ±1.96 s:(35.9± 83.7) cm2.Conclusion BIA is comparable to MRI for assessing the area of visceral fat and is a reliable and simple tool to evaluate the visceral fat area in school-age children.