Autism spectrum disorder (ASD) is a neurodevelopmental condition originating in early life, presenting significant challenges for affected families and society. ASD is characterized by atypical brain development occurring throughout gestation. Maternal diet during pregnancy plays a crucial role in ASD pathogenesis. Specifically, prenatal multivitamin supplementation and adequate vitamin D intake may reduce ASD risk; similar protective effects have been associated with polyunsaturated fatty acid (PUFA) and iron consumption. Although research findings are inconsistent, prenatal nutritional interventions represent a promising strategy for mitigating the future risk of mental health and other disorders in offspring. Therefore, this article reviews key nutrients implicated in ASD risk during pregnancy, to provide a theoretical foundation for developing precise perinatal nutritional intervention plans.

Attention Deficit Hyperactivity Disorder (ADHD) is a chronic neurodevelopmental disorder with an estimated prevalence of approximately 6.4% among children and adolescents aged 6 to 16 in China. The etiology and pathogenesis of ADHD remain incompletely understood, and conventional treatment methods often have limited effectiveness. With advances in research into the etiology of ADHD, nutritional intervention has emerged as a potential adjunctive treatment and has garnered widespread attention. Multiple studies have demonstrated the potential effectiveness of nutritional interventions for ADHD. This review aims to summarize the progress in nutritional interventions for pediatric ADHD, particularly focusing on nutrient-level interventions (including polyunsaturated fatty acids, minerals, and vitamins), nutrition-related factors (such as probiotics), as well as the combined use of multiple nutrients and dietary nutrition (including dietary patterns). We will analyze and discuss the effectiveness of different nutritional interventions to provide a valuable reference for clinical nutritional diagnosis and treatment of the disease.

Autism spectrum disorder (ASD) is a neurodevelopmental condition originating in early life, presenting significant challenges for affected families and society. ASD is characterized by atypical brain development occurring throughout gestation. Maternal diet during pregnancy plays a crucial role in ASD pathogenesis. Specifically, prenatal multivitamin supplementation and adequate vitamin D intake may reduce ASD risk; similar protective effects have been associated with polyunsaturated fatty acid (PUFA) and iron consumption. Although research findings are inconsistent, prenatal nutritional interventions represent a promising strategy for mitigating the future risk of mental health and other disorders in offspring. Therefore, this article reviews key nutrients implicated in ASD risk during pregnancy, to provide a theoretical foundation for developing precise perinatal nutritional intervention plans.

Attention Deficit Hyperactivity Disorder (ADHD) is a chronic neurodevelopmental disorder with an estimated prevalence of approximately 6.4% among children and adolescents aged 6 to 16 in China. The etiology and pathogenesis of ADHD remain incompletely understood, and conventional treatment methods often have limited effectiveness. With advances in research into the etiology of ADHD, nutritional intervention has emerged as a potential adjunctive treatment and has garnered widespread attention. Multiple studies have demonstrated the potential effectiveness of nutritional interventions for ADHD. This review aims to summarize the progress in nutritional interventions for pediatric ADHD, particularly focusing on nutrient-level interventions (including polyunsaturated fatty acids, minerals, and vitamins), nutrition-related factors (such as probiotics), as well as the combined use of multiple nutrients and dietary nutrition (including dietary patterns). We will analyze and discuss the effectiveness of different nutritional interventions to provide a valuable reference for clinical nutritional diagnosis and treatment of the disease.

Objectives:Present study aimed to use quantitative flow ratio based on Murray's law to analyze the risk factors of impaired side branches perfusion without naked eye visible slowing of blood flow in branches after interventional treatment of true bifurcation lesions of the coronary arteries. Methods:A total of 211 patients with non-left main coronary artery true bifurcation coronary artery disease who underwent percutaneous coronary intervention(PCI)in Hunan Provincial People's Hospital from June 2022 to September 2023 were continuously enrolled,with a total of 234 bifurcation lesions.The general clinical indicators,anatomical characteristics of coronary artery bifurcation lesions,branch protection methods,postoperative branch TIMI blood flow and other data were collected,and quantitative flow ratio(μQFR)was measured for postoperative branch blood vessels.Post-PCI μQFR<0.8 was considered as impaired branch perfusion and was included in the postoperative impaired branch perfusion group(n=51,53 branch lesions).Patients with μQFR≥0.8 were included in the postoperative normal branch perfusion group(n=160,181 branch lesions).Multivariate Logistic regression analysis was used to evaluate the effects of various clinical and anatomical factors on branch perfusion after PCI. Results:The post-PCI branch flow grading of all patients was TIMI grade Ⅲ.The postoperative branch μQFR of 53 vessels(22.6％)in the group with impaired postoperative branch perfusion was 0.70±0.10,and 0.93±0.05 in the group with normal postoperative branch perfusion,and the difference between the two groups was statistically significant(P<0.001).Compared with the postoperative group with normal branch perfusion,the postoperative group with impaired branch perfusion was featured with an elevated branch lesion length,branch reference diameter,postoperative branch opening diameter stenosis rate,postoperative branch narrowest lumen diameter stenosis rate,and a lower main branch-to-branch diameter ratio,preoperative branch narrowest lumen diameter stenosis rate,and preoperative main branch μQFR,all of which were statistically significant(all P<0.05).The postoperative branch opening diameter stenosis rate(r=-0.490,P<0.001),postoperative branch narrowest lumen diameter stenosis rate(r=-0.788,P<0.001),preoperative branch narrowest lumen diameter stenosis rate(r=-0.280,P<0.001),branch narrowest lumen diameter(r=-0.469,P<0.001),branch lesion length(r=-0.157,P=0.016)were negatively correlated with postoperative branch μQFR,and branch reference diameter(r=0.173,P=0.008),main branch/side branch diameter ratio(r=0.194,P=0.003),and branch opening diameter(r=0.328,P<0.001)were positively correlated with postoperative branch μQFR,and none of them were significantly correlated with clinical baseline data(all P>0.05).Multifactorial logistic regression analysis showed that following four factors were independent risk factors for impaired branch perfusion:postoperative stenosis of the narrowest branch lumen diameter(OR=1.228,95％CI:1.144-1.318,P<0.001),postoperative stenosis of the branch opening diameter(OR=1.110,95％CI:1.055-1.168,P<0.001),postoperative stenosis of the narrowest lumen diameter of the main branch(OR=1.115,95％CI:1.042-1.192,P=0.001),and length of the branch lesion(OR=1.121,95％CI:1.021-1.231,P=0016). Conclusions:Some of the patients whose branch flow reached TIMI grade Ⅲ after PCI are still faced the risk of hemodynamical impairment and should be functionally evaluated after PCI.The postoperative stenosis rate of the narrowest branch lumen diameter,postoperative stenosis rate of the branch opening diameter,postoperative stenosis rate of the narrowest lumen diameter of the main branch,and branch lesion length are the risk factors of branch perfusion impairment after PCI for coronary bifurcation lesions.

Objectives:to analyze the efficacy of percutaneous coronary intervention(PCI)for complex left main(LM)lesions combined with chronic total occlusion(CTO)of the right coronary artery. Methods:Ninety patients with complex left main lesions hospitalized in Hunan Provincial People's Hospital from January 2019 to December 2022 were consecutively included.According to the coronary angiographic vascular lesions,patients were divided into complex left main lesions combined with right coronary artery CTO(observation group,n=30)and complex left main lesions without right coronary artery CTO(control group,n=60).The baseline clinical data,intraoperative conditions,angiographic results,and postoperative follow-up results of the patients were analyzed and compared between the two groups. Results:Fifty-eight(64.4%)out of the 90 patients were male.There was no statistically significant difference between the two groups in terms of baseline clinical data(all P>0.05),left main lesion condition(P=1.000),left main calcification condition(P=0.249),and preoperative TIMI flow grading(P=1.000).In the comparison between observation group and the control group,intraoperative occurrence of no-reflow(3.3%vs.5.0%,P=1.000),hypotension(10.0%vs.8.3%,P=1.000),pericardial effusion(3.3%vs.0%,P=0.333),the percentage of intravascular ultrasound(IVUS)use(86.7%vs.90.0%,P=0.635),and the use of circulatory assist device(P=0.699),and the proportion of intraoperative coronary spinning(26.7%vs.21.7%,P=0.597)were all similar between the two groups.The median follow-up time was 14.50(11.83,15.85)months,and the differences in the incidence of major adverse cardiovascular events(MACE)such as recurrent angina,acute myocardial infarction,rebleeding,readmission for heart failure,and cardiac death(31.0%vs.32.1%,P=1.000)were not statistically significant between the observation group and the control group. Conclusions:PCI revascularization may be a viable approach for elderly patients with complex LM lesions with multiple underlying disease,and combined right coronary artery CTO,intolerance and reluctance to CABG.

Objectives:To analyze the safety of coronary artery stent rotational atherectomy due to stent underexpansion,in-stent restenosis,stent deformation,stent damage,and guide wire entrapment. Methods:A total of 19 patients with coronary artery disease who underwent coronary artery stent rotational atherectomy for the above reasons in 7 large heart centers in China from 2016 to 2022 were collected.Their baseline data,procedure process data,procedural complications,the occurrence of procedure-related adverse events(type 4a myocardial infarction,emergency coronary artery bypass grafting,and all-cause death)during hospitalization and major adverse cardiovascular events(MACE,including target vessel revascularization,stroke,all-cause death,and recurrent myocardial infarction)during post-discharge follow-up were retrospectively collected. Results:The mean age of the 19 patients was 70(64,73)years,and 13 patients were males.The mean left ventricular ejection fraction was(56.89±8.76)%.Radial artery approach was used in 13 patients,11 patients used 1 burr during the intervention period,6 patients used 2 burrs,and 2 patients used 3 burrs.The average times of burr passing through the lesion was(7.00±4.23)times.The surgical success rate was 100%,and the immediate lumen acquired area was(1.23±0.78)mm2.Drug-eluting stents were successfully implanted in all patients after spinning.Coronary slow blood flow occurred in 1 case after rotational grinding,which was improved after drug treatment.The burr was entrapmented in 3 cases and successfully pulled out after operation.No coronary artery perforation,coronary artery dissection,coronary artery spasm,emergency thoracotomy,or death occurred during the operation,and no procedure-related adverse events occurred during hospitalization.During 3 to 24 months of follow-up,1 patient underwent target vessel revascularization,and there were no MACE in other patients. Conclusions:Coronary artery stent rotational atherectomy in patients with stent underexpansion,in-stent restenosis,stent deformation,stent damage,and guide wire entrapment,is a feasible option,with a high surgical success rate and satisfactory safety.None of the patients experienced MACE during long-term follow-up.

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.

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.