Objective:To summarize the clinical characteristics of multisystem inflammatory syndrome in children（MIS-C）related to SARS-CoV-2 and analyze the risk factors for hypotension.Methods:The clinical data of children with MIS-C who visited Beijing Children's Hospital from January 2023 to March 2023 were retrospectively collected,and the clinical characteristics and risk factors for hypotension were analyzed.Results:Thirty-six patients were included,the median age was 3.1 (2.3,5.8) years; 61.1% were boys.All cases had a history of SARS-CoV-2 infection between 1 and 9 weeks before onset.Clinical symptoms included fever (100.0%); rash (94.4%); bilateral conjunctival congestion (88.8%); lips/oral cavity changes (100.0%); swollen hands and foot (61.1%); cervical lymphadenopathy (88.8%); acute gastrointestinal symptoms (61.1%) of diarrhea,abdominal pain and vomiting; neurologic manifestations (33.3%) of lethargy,headache,and convulsions; respiratory symptoms(41.6%) of cough,sore throat and shortness of breath.Nineteen (52.8%) cases developed hypotension and needed vasoactive drugs support to maintain blood pressure.Mechanical ventilation was required in four(11.1%) cases,and one patient was intubated and treated with continuous renal replacement therapy.The level of ferritin in hypotension group was significantly higher than those in normal blood pressure group( P＜0.05),while the levels of platelet count,serum sodium and potassium in hypotension group were significantly lower than those in normal blood pressure group( P＜0.05).Logistic regression multivariable analysis found the elevated serum ferritin ( OR=20.000,95% CI:2.750-145.481, P=0.003) was an independent risk factor for hypotension. Conclusions:MIS-C may be observed following SARS-CoV-2 infection.Various symptoms and signs,including fever,multiple organ dysfunction,and hypotension,may occur in children with MIS-C.Elevated ferritin is a risk factor for hypotension.

Objectives To determine maximal tolerated dose(MTD)and dose-limiting toxicity (DLT) of oxaliplatin(L-OHP)when combined with constant dosing of 5-Fu、Lv and concurrent radiotherapy in postoperative patients with rectal cancer.Methods A total of 21 patients with stage Ⅱ or Ⅲ rectal adenocarcinoma after curative surgery were treated with radiotherapy to a total dose of 50 Gy in 5 weeks.L-OHP was administered at a dosge of 45 mg/m2(n=3),55 mg/m2(n=3),65 mg/m2(n=3),75 mg/m2(n=6),and 85 mg/m2(n=6)once a week for 2 weeks(first cycle)followed by a second cycle after a 14-day break.5-Fu and LV at a fixed dose of 5-Fu 300 mg/m2 ivdrip for 2 h,then 500 mg/m2 ivdrip within 22 h,d1,d2.LV 200 mg/m2 ivdrip 2 h d1,d2.DLT was defined as grade Ⅲ or Ⅳ hematologic and nonhenmologic toxicity. Results Grade Ⅰ-Ⅲ leukopenia,diarrhea,and nausea/vomiting were the most common toxic side effects.and most were of grade 1-2.DLT was first observed in 2 of 3 patients at 75 mg/m2(1 of grade Ⅲ diarrhea and 1 of grade Ⅲ leukopenia).L-OHP at dosage of 85 mg/m2 caused DLT in 4 of 6 patients(2 of grade Ⅲ leukopenia and 1 of grade Ⅲ diarrhea and 1 of grade Ⅲ diarrhea).Conclusions Diarrhea was the most common dose-limiting toxicity(DLT).Tlle maximal tolerated dose(MTD)of L-OHP in this setting was 75 mg/m2 which was comparable to the maximal tolerated dose of L-OHP seen in the neoadjuvant setting.