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@#Abstract: Objective To establish a risk prediction model for nosocomial infection in preterm very low birth weight infants, and conduct internal validation. Methods A total of 206 cases of very low birth weight premature infants hospitalized in the Department of Neonatology of Union Hospital Affiliated to Tongji Medical College from January 2018 to June 2020 were included in this study, factors that may affect the nosocomial infection of children were collected, and the infants were divided into two groups according to whether there is nosocomial infection. The influencing factors were compared between the two groups, and multivariate Logistic regression analysis was performed after screening variables with LASSO regression. According to the results of multi factor analysis, the nomogram model was constructed and verified internally. Results A total of 29 of 206 children had nosocomial infection (14.08%), and 33 pathogenic bacteria were detected, including 23 Gram-negative bacteria, 9 Gram-positive bacteria and 1 fungus. The results of multivariate logistic regression analysis based on LASSO regression showed that the risk factors for nosocomial infection of VLBW premature infants were 28-31+6 weeks of gestation, amniotic fluid pollution, mechanical ventilation, indwelling gastric tube, unreasonable use of antibiotics, and hospitalization time ≥ 7 days. The protective factors were Apgar score ≥ 7 points at 1 min and breast feeding accounting for 50% or more (P<0.05). The Area Under Curve (AUC) of ROC curve of nomogram model was 0.946 [95%CI(0.923, 1.000)]. The calibration curve showed that the probability of hospital infection predicted by the model was basically consistent with the actual probability. The decision curve showed that when the probability threshold of nomogram model to predict the risk of nosocomial infection of very low birth weight premature infants was 0-0.85, the net rate of return was greater than 0. Conclusion Preterm infants with extremely low birth weight are at high risk of nosocomial infection, mainly affected by factors such as gestational weeks, hospitalization time, amniotic fluid pollution, etc. The nomogram model constructed by the above factors has high accuracy and discrimination for predicting nosocomial infection in such children.
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Objective@#To evaluate the prevalence and consistency of screening myopia, non-cycloplegic myopia and cycloplegic myopia in children and adolescents, and to provide references for exploring the factors affecting the consistency of different definition methods.@*Methods@#A total of 3 868 children and adolescents aged 6 to 17 years from seven schools were included in a school based cross sectional study in Shandong Province in September 2020. The prevalence of screening myopia, non cycloplegic refraction, and cycloplegic refraction at different ages and all children and adolescents were analyzed. With cycloplegic spherical equivalent ≤-0.50 D as the gold standard for myopia, and Kappa test and area under the ROC curve were used to evaluate the consistency.@*Results@#The prevalence of cycloplegic myopia and screening myopia were 36.7% and 38.3% among children and adolescents. The prevalence of non cycloplegic myopia was 62.4%, which was significantly higher than screening myopia and cycloplegic myopia two methods in primary and junior high schools. Among 3 868 subjects, there were 3 628 (93.8%) subjects with screening myopia and 2 862 (74.0%) subjects with non cycloplegic myopia who were consistent with the gold standard for myopia. The Kappa values of screening myopia and non cycloplegic myopia were 0.87 and 0.51, and the area under the ROC curve was 0.94 (95% CI =0.93-0.95) and 0.79 (95% CI =0.78-0.81). Compared with other groups, children and adolescents aged 8 to 17 years, in junior or high school, urban residence, better presenting distance visual acuity, and astigmatism ≤1.50 D had a higher consistency in the application of screening myopia ( P <0.05).@*Conclusion@#The consistency between screening myopia and cycloplegic myopia is high, and the consistency between non cycloplegic objective myopia is low.
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Objective@#To compare the effect of different orthokeratology lenses in controlling the progression of low myopia in children, and to provide a reference for exploring effective prevention measures for eyesight of children.@*Methods@#A total of 175 cases (350 eyes) aged 8-12 years old who were fitted with orthokeratology lenses were collected in this retrospective study. The differences in the changes of the axis length (AL) and the spherical equivalent refraction (SER) were analyzed after wearing different orthokeratology lenses for one year, and the relationship between the change of AL, SER and gender, age was also analyzed.@*Results@#In the Mouldway group, Alpha group, Lucid group and CRT group, the Median ( P 25 , P 75 ) of AL changes were 0.23 ( 0.12 , 0.41), 0.30 (0.17, 0.45), 0.35 (0.16, 0.41) and 0.33 (0.23, 0.41)mm, and there were no statistical significant difference between four groups ( Z =7.70, P >0.05); The Median ( P 25 , P 75 ) of SER changes were -0.31 (-1.00, 0.28), -0.38 ( -1.22 , 0.13), -0.25 (-0.84, 0.13) and -0.63 (-1.13, 0.25)D, and there were no statistical significant difference between four groups ( Z =2.15, P >0.05). The age had negative correlation with the change of AL ( r =-0.26, P <0.05), but has nothing to do with the change of SER ( r =0.10, P >0.05). There was no statistically significant difference in the change of AL ( Z =2.25, P > 0.05 ) and SER ( Z =-1.50, P >0.05) among children of different genders.@*Conclusion@#Different orthokeratology lenses have no differences in controlling the growth of the AL and changing the SER.
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@#The morphology of the gingival papilla plays an important role in the aesthetics of oral soft tissue. Gingival papilla recession forms a visible black triangle, causing a series of problems such as aesthetic defects, pronunciation disorders and food impaction and even endangering the health of periodontal tissue. Gingival papilla reconstruction is an effective way to eliminate the black triangle. However, the treatment of lost or collapsed gingival papilla is unsuccessful. Reconstruction of the interdental papilla for aesthetics zone is the most difficult and challenging periodontal treatment. In this article, we review the past literature and summarize the factors affecting the appearance of gingival papilla, including the distance between the contact point and the alveolar crest, the distance between roots, divergent roots, interdental width, embrasure morphology, crown shape, and gingival biotype. The classification of the gingival papilla based on the loss of papillary height and the nonsurgical and surgical methods for the reconstruction of gingival papilla are reviewed to provide a reference for doctors to reconstruct the gingival papilla.