Objective To evaluate the role of nutritional parameters in prognosis,especially in the early and late mortality of hospital-acquired acute kidney injury (AKI) patients.Methods This study was a prospective cohort study conducted in a hospital comprising 1500 beds in Shanghai, China. One hundred ninety-four patients with hospital-acquired AKI, as determined using the RIFLE staging criteria,were enrolled as subjects after obtaining informed consent.Patients with AKI caused by postrenal obstruction,glomerulonephritis,interstitial nephritis or vasculitis were excluded.Nutritional evaluation,including subjective global assessment (SGA),anthropometric and laboratory examination,was conducted. Other laboratory measurements and clinical data were recorded.The primary outcome was early mortality (≤ 7 days) and late mortality (8-28 days) after enrolling into the study. Results AKI patients at enrollment were characterized by a high prevalence of malnutrition as determined by SGA, anthropometric and laboratory examination.Univariate analysis showed that the SGA,the serum levels of prealbumin,cholesterol and total lymphatic cells, and the Maastricht index were significantly different among early mortality,late mortality and survival groups.The serum prealbumin and cholesterol levels in the early death group were significantly lower than those in the survival and late death groups (P＜0.05).Multivariate analysis revealed that SGA,albumin,prealbumin and cholesterol remained independently and significantly associated with early mortality after adjusting for age,sex,dialysis,ventilation,hemoglobin,platelets,bilirubin,and Glasgow coma score.The areas under the receiver operating characteristic curve to predict early mortality for albumin,prealbumin and cholesterol were 0.591,0.736 and 0.603,respectively,with that of prealbumin significantly higher than others (P＜0.05). Conclusion Low levels of serum prealbumin,albumin and cholesterol at enrollment are independtly associated with increased early mortality in hospital-acquired AKI patients.

Objective:Analyze the efficacy and safety of gastric peroral endoscopic myotomy (G-POEM) in the treatment of gastroptosis.Methods:From August 1, 2016 to August 1, 2020, at Zhongda Hospital, Southeast University, the baseline data of 14 patients with gastroptosis who underwent G-POEM were retrospectively collected, including age, weight, length of hospital stay, and modified gastroparesis cardinal symptom index(mGCSI). Regular follow-ups were made, and relevant data were recorded for comparative analysis. The main observation indicators were body weight and mGCSI. Friedman rank sum test and Bonferroni correction test were used for statistical analysis.Results:The age of 14 patients with gastroptosis was 50.0 years old(24.5 years old), the operations were successfully completed in all patients without any serious surgical complications, the time of hospital stay was 10.5 d (5.0 d), and all the postoperative follow-up time was >12 months. There were statistically significant differences in mGCSI and body weight between before operation and at 1st week, 1st month, 3rd month, 6th month, and 12th month after operation (1.94(1.19), 0.78(0.47), 0.36(0.19), 0.17(0.45), 0.13(0.57) and 0.29(0.50), 43.5 kg(5.8 kg), 43.5 kg(5.8 kg), 42.5 kg(7.1 kg), 43.5 kg(6.9 kg), 45.0 kg(8.0 kg) and 45.5 kg(7.5 kg); Z=42.78 and 34.28, both P<0.001). After Bonferroni correction in the pairwise comparison, there were statistically significant differences in the mGCSI of the 14 patients between before operation and at 1st month, 3rd month, 6th month, and 12th month after operation ( Z=4.09, 5.05, 5.00 and 4.14, P=0.001, <0.001, <0.001 and =0.001). The weight of 14 patients at 12th month after operation were compared with the weight before operation, 1st week after operation, and 1st month after operation, and the differences were statistically significant (all Z=-3.64, all P=0.004). Conclusion:G-POEM has a good therapeutic effect on patients with gastroptosis and is expected to become a new treatment for gastroptosis.