To investigate the diagnostic value of p16/Ki-67 double staining based on cell block technology for cervical intraepithelial neoplasia (CIN) higher than grade 2 (≥ CIN2) for patients with atypical squamous cells of undetermined significance (ASC-US)/low-grade squamous intraepithelial lesions (LSIL).

From January 2021 to December 2021, a total of 222 patients with cervicitis who underwent colposcopy biopsy, DNA ploidy analysis and high risk human papillomarirus (HR-HPV) testing were selected from Beijing Haidian Maternal and Child Health Hospital. Cytological results of all cases were ASC-US/LSIL. The remaining liquid based cytology (LBC) specimens of patients were stained with p16/Ki-67 double staining based on cell block technology, and the diagnostic value of p16/Ki-67 double staining compared with DNA ploidy analysis and HR-HPV for ≥ CIN2 lesions were analyzed by receiver operating characteristic curve (ROC).

The Kappa value of p16/Ki-67 double staining in cell block was 0.835, which was highly consistent with the pathological diagnosis of biopsy. The area under ROC (AUC) of p16/Ki-67 double staining was 0.900 (the specificity and sensitivity were 94.16% and 85.45%, respectively), which was significantly higher than that of HR-HPV testing (AUC was 0.557, with the specificity and sensitivity were 13.17% and 98.18%, respectively) (Z = 11.387, P < 0.001) and DNA ploidy analysis (AUC was 0.583, with the specificity and sensitivity were 32.93% and 83.64%, respectively) (Z = 7.476, P < 0.001), with significant differences. Compared with HR-HPV testing and DNA ploidy analysis, the NRI values of p16/Ki-67 double staining were 1.470 (95%CI: 1.246-1.470, P < 0.001) and 1.278 (95%CI: 1.049-1.278, P < 0.001), respectively. The IDI values were 0.609 (95%CI: 0.525-0.692, P < 0.001) and 0.633 (95%CI: 0.554-0.713, P < 0.001), respectively.

The p16/Ki-67 double staining based on cell block has a better predictive ability for the correct classification of patients ≥ CIN2, and is a good method for the triage of patients with ASC-US/LSIL, which can effectively avoid the over-diagnosis and treatment.

To investigate the clinical characteristics and laboratory examinations of hospitalized children with influenza, and to provide evidence-based basis for early identification of severe influenza.

Total of 357 children with influenza admitted to Xi’an Children’s Hospital and Xi’an Central Hospital from December 2018 to April 2020 were selected as case group, and divided into mild group (207 cases) and severe group (150 cases) according to disease severity. The clinical data of the case group were analyzed, retrospectively, and the differences of clinical characteristics and laboratory examinations were analyzed, respectively. Meanwhile, 180 healthy children who were randomly selected for physical examination in the same period were selected as control group. Serum 25-(OH)D level was measured by chemiluminescence. The relationship between serum 25-(OH)D level and severe influenza was analyzed.

Among the 357 children with influenza, the male to female ratio was 1.29︰1, and the age ranged from 1 month and 10 days to 12 years old, with 276 cases (77.3%) younger than 5 years old. There were 308 (86.3%) cases of influenza A and 49 (13.7%) cases of influenza B. Patients with underlying diseases (χ² = 5.988, P = 0.014), wheezing (χ² = 5.272, P = 0.022), vomiting (χ² = 6.080, P = 0.014) symptoms in the severe group were more than those in the mild group, with significant differences. The white blood cell count (Z = -2.429, P = 0.015), neutrophil count (Z =-3.106, P = 0.002), C-reactive protein (Z =-4.031, P = 0.001), procalcitonin (Z =-0.970, P = 0.016) in the severe group were significantly higher than those in the mild group, while the lymphocyte count (Z =-3.239, P = 0.001), monocyte count (Z =-2.208, P = 0.027) were lower than those in the mild group, with significant differences. In comparison of serum 25-(OH)D levels, the mild group was significantly lower than that of the control group [(30.47 ± 11.23) ng/ml vs. (44.74 ± 12.57) ng/ml: t =-7.783, P < 0.001], the severe group was lower than that of the control group [(26.33 ± 6.88) ng/ml vs. (44.74 ± 12.57) ng/ml: t = -8.884, P < 0.001], and the severe group was significantly lower than that of the mild group [(26.33 ± 6.88) ng/ml vs. (30.47 ± 11.23) ng/ml: t = 2.311, P = 0.013]. The best cut-off value of serum 25-(OH)D for predicting severe influenza was 22.21 ng/ml which determined by ROC curve, the area under the curve was 0.691, the sensitivity was 68.0%, and the specificity was 65.3%. Multivariate Logistic regression analysis showed that underlying diseases (OR = 2.698, P = 0.028), wheezing (OR = 3.764, P = 0.017), vomiting (OR = 3.455, P = 0.018), serum 25-(OH)D < 22.21 ng/ml (OR = 4.251, P = 0.003) were all risk factors of severe influenza. After oral oseltamivir antiviral and symptomatic treatment, 355 (99.4%) children improved or were cured and discharged, and 2 (0.6%) children in the severe disease group who were not cured were signed out. The mean length of hospitalization was 6.2 days.

Children under 5 years old are susceptible to influenza, and influenza virus infection among children is mainly influenza A. Children with underlying diseases, wheezing and vomiting symptoms during the course of the disease, and lower serum 25-(OH)D are more likely to progress to severe cases, and serum 25-(OH)D cannot be used as a independent predictor of severe influenza.

To preliminatively investigate the changes of inflammatory factors and microbial flora distribution in the environment around implants following photodynamic therapy (PDT) combined with subgingival sandblasting therapy, and to provide theoretical basis for the application of PDT in the treatment of peri-implant inflammation.

A single-center prospective, open-label, randomized controlled study were adopted. Total of 9 patients and 16 implants were recruited from February 1st, 2018 to February 1st, 2019 in the Department of Stomatology of Beijing Chaoyang Hospital, Capital Medical University. Gingival crevicular fluid (GCF) was extracted from patients with peri-implantitis before combined therapy and after different treatment times, the changes of microflora in GCF were detected by amplifiers. Furthermore, changes of microflora distribution in GCF were revealed by bioinformatics analysis, in order to analyze the possible mechanism of PDT in the treatment of peri-implantitis from the point of view of pathogenic bacteria. In Alpha diversity analysis, R software was used for difference analysis, and rank-sum test was used for test.

All patients completed the planned follow-up. The α diversity analysis of GCF samples of patients before and after combined treatment showed that Observed species, Chao and Ace index of 5 groups of patients were all higher than before treatment, and Chao index showed significant difference among groups (χ² = 5.688, P = 0.033). β diversity analysis showed no significant difference in community diversity among groups (all P > 0.05). The principal coordinate analysis based on the unweighted Unifrac distance showed that the difference between the two groups was significant at 24 weeks after treatment. The pairwise comparison between the two groups confirmed that the β diversity was significantly different from that of the other five groups (P: χ² = 7.751, P = 0.005; W1: χ² = 6.471, P = 0.011; W2: χ² = 4.997, P = 0.025; W4: χ² = 3.612, P = 0.0415; W12: χ² = 3.125, P = 0.0486), indicating that colony diversity was significantly different from that of the former group at 24 weeks after treatment without considering abundance information.

There was no significant change in the composition of GCF in patients before and after combined therapy. The species diversity at 24 weeks after treatment was significantly higher than before, mainly reflected in the increase of non-dominant bacteria, which provides a theoretical basis for further study of the role of this therapy in the regulation of local microecological environment and long-term maintenance of peri-implantitis.

To investigate the clinical features and influencing factors of chronic respiratory failure combined with pulmonary Candida infection.

The clinical data, including demographic characteristics, underlying diseases, laboratory indicators, and treatment measures of 80 patients with chronic respiratory failure combined with pulmonary Candida infection admitted to Beijing Tongren Hospital, Capital Medical University, from October 2019 to October 2021 (observation group) were analyzed, retrospectively, and 80 patients with chronic respiratory failure without pulmonary Candida infection during the same period were selected as control group. The risk factors influencing chronic respiratory failure combined with pulmonary Candida infection were analyzed by Univariate and multifactorial Logistic regression.

Among patients in observation group, the majority were male (53 cases, 66.25%), aged from 31 to 86 years old, with a mean age of (57.86 ± 10.53) years old, with the majority of patients over 60 years old (56 cases, 70.00%); the mean body mass index (BMI) was (22.26 ± 3.15) kg/m²; the mean average body mass index (BMI) was (22.26 ± 3.15) kg/m²; the average duration of disease was (9.45 ± 1.28) years; most patients smoked (63 patients, 78.75%) and drank alcohol (57 patients, 71.25%); all patients’ respiratory rates and heart rates were above the normal range; 51 (63.75%) patients had undergone invasive diagnostic and treatment operations. The most common underlying disease was pulmonary diseases [33 cases (41.25%)], followed by cardiovascular diseases [28 cases (35.00%)]; laboratory indicators included abnormal levels of white blood cells (WBC), neutrophils (NEUT), lymphocytes (LYMP), C-reactive protein (CRP) and calcitoninogen (PCT), which were higher than normal range. Among the previous treatments, 55 (68.75%) patients had long-term application of glucocorticoids, 59 (73.75%) patients had long-term use of antibacterial drugs, and 42 (52.50%) patients had undergone mechanical ventilation. Patients in the observation group over 60 years old [56 (70.00%) vs. 40 (50.00%)], invasive diagnostic and treatment operations [51 (63.75%) vs. 32 (40.00%)], pulmonary disease [33 (41.25%) vs. 18 (22.50%)], cardiovascular diseases [28 (35.00%) vs. 16 (20.00%)] and long-term use of glucocorticoids [55 (68.75%) vs. 42 (52.50%)], long-term use of antibacterial drugs [59 (73.75%) vs. 43 (53.75%)], and mechanical ventilation [42 (52.50%) vs. 26 (32.50%)] were significantly higher than the control group, with significant differences (all P < 0.05). LYMP [(0.53 ± 0.02) × 10⁹/L vs. (0.92 ± 0.04) × 10⁹/L], CRP [(91.25 ± 10.23) mg/L vs. (72.58 ± 8.64) mg/L] and PCT [0.82 (0.23, 4.63) μg/L vs. 0.39 (0.11, 0.92) μg/L] levels were significantly higher than those of control group, with significant differences (t = 78.000, P = 0.001; t = 12.471, P = 0.001; Z = 2.558, P = 0.011). Multifactorial Logistic regression analysis showed that invasive diagnostic and treatment operations (OR = 3.115, 95%CI: 1.243-5.423, P = 0.012), combined lung diseases (OR = 3.144, 95%CI: 1.499-5.847, P < 0.001), PCT (OR = 3.134, 95%CI: 1.259-4.186, P = 0.018), long-term use of glucocorticoids (OR = 3.17, 95%CI: 1.628-5.186, P < 0.001), long-term use of antimicrobial drugs (OR = 2.169, 95%CI: 1.114-3.798, P = 0.021) and mechanical ventilation (OR = 3.104, 95%CI: 2.001-5.364, P < 0.001) were all independent risk factors for chronic respiratory failure combined with pulmonary Candida infection.

Chronic respiratory failure combined with pulmonary Candida infection is most common in elderly men, and pulmonary and cardiovascular diseases are the common underlying diseases, invasive diagnostic and treatment operations such as mechanical ventilation are important medical factors for the development of this disease, and long-term use of glucocorticoids and antibacterial drugs are the risk factors.

To investigate the clinical characteristics of patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) combined with hepatitis B virus (HBV) and (or) hepatitis C virus (HCV) infection.

Clinical data of 8 369 patients with HIV/AIDS hospitalized in Nanning Fourth People’s Hospital from January 2014 to December 2017 were collected, including the incidence rates of HIV/AIDS combined with HBV and (or) HCV co-infection and severe liver disease, HIV RNA load, CD4⁺ T cell count, fatality rate and occupation, ethnic distribution, et al. Among whom, 2 145 cases were female and 6 224 cases were male. Total of 3 220 cases were with complete clinical data and all tested for HIV RNA and T lymphocyte subsets. The cases with co-infection were divided into HIV/HBV group (317 cases), HIV/HCV group (326 cases), HIV/HBV/HCV group (39 cases) and HIV/AIDS group (2 538 cases). HIV RNA for the overall comparison of groups were analyzed by ANOVA, and for every two groups were compared by LSD-t test, indicators of cell immune function (CD4⁺ T and CD8⁺ T) were analyzed by rank sum test of non-parametric, and rates of incidence and fatality of severe liver disease were analyzed by Chi-square test.

The rates of HBV infection, current HCV infection, liver cirrhosis, hepatocellular carcinoma and liver failure of patients with HIV/AIDS were 4.90% (410/8 369), 5.07% (424/8 369), 13.98% (1 170/8 369), 0.32% (27/8 369) and 0.44% (37/8 369), respectively. The top three ethnic distribution of patients with HIV/AIDS combined with HBV and (or) HCV infection were 11.74% (254/2 164) for Zhuang nationality, 8.67% (522/6 021) for Han nationality, and 4.29% (6/140) for Yao nationality; the top three occupational distribution were 15.42% (218/1 414) for unemployed, 12.34% (84/681) for freelance and 12.2% (5/41) for commercial attendants. The HIV RNA load of patients in HIV/HBV group, HIV/HCV group and HIV/HBV/HCV group were (5.51 ± 0.22) log₁₀copies/ml, (5.31 ± 0.23) log₁₀copies/ml and (5.04 ±0.12) log₁₀copies/ml, respectively, which were significantly higher than that of HIV/AIDS group [(4.02 ± 0.20) log₁₀copies/ml] (t = 123.633, 107.676, 31.758, all P < 0.001). The median CD4⁺ T cell count of patients in HIV/HBV group, HIV/HCV group and HIV/HBV/HCV group were 10.85 (65.36, 150.78) cells/μl, 232.47 (178.56, 277.98) cells/μl and 152.69 (101.25, 200.35) cells/μl, respectively, which were significantly lower than that of HIV/AIDS group [(278.35 (231.65, 325.74) cells/μl] (Z = 24.400, 8.284 and 8.046, all P < 0.001). The median CD8⁺ T cell count of patients in the above groups were 387.25 (285.45, 452.35) cells/μl, 654.23 (412.87, 798.56) cells/μl and 545.87 (301.95, 654.56) cells/μl, respectively, which were significantly lower than that of HIV/AIDS group[725.14 (500.47, 879.89) cells/μl] (Z = 18.560, 3.142, 5.754, all P < 0.001). The median CD8⁺ T cells were compared between HIV/HCV group and HIV/HBV group [654.23 (412.87, 798.56) cells/μl vs. 387.25 (285.45, 452.35) cells/μl; Z = 13.250, P < 0.001], HBV/HIV group and HIV/HCV/HBV group [387.25 (285.45, 452.35) cells/μl 545.87 (301.95, 654.56) cells/μl; Z = 3.235, P < 0.001], all with significant differences. There were also significant differences in the median counts of CD4⁺ T cells between HIV/HCV group and HIV/HBV group [232.47 (178.56, 277.98) cells/μl vs. 110.85 (65.36, 150.78) cells/μl; Z = 16.117, P < 0.001], HIV/HBV group and HIV/HCV/HBV group [110.85 (65.36, 150.78) cells/μl vs. 152.69 (101.25, 200.35) cells/μl, Z = 24.400, P < 0.001], HIV/HCV group and HIV/HBV/HCV group [232.47 (178.56, 277.98) cells/μl vs.152.69 (101.25, 200.35) cells/μl; Z = 5.810, P < 0.001]. The rates of severe liver diseases (including liver cirrhosis, hepatocellular carcinoma and liver failure) of patients in HIV/HBV group, HIV/HCV group and HIV/HBV/HCV group were 14.44% (53/367) (χ² = 500.40, P < 0.001), 13.91% (53/381) (χ² = 510.42, P < 0.001) and 62.79% (27/43) (Fisher’s exact test: P < 0.001), respectively, which were significantly different from that of HIV/AIDS group [ (48/7 578, 0.01%)] (χ² = 500.40, 510.42, 1695.28; all P < 0.001); and there was significant difference in overall comparison of the four groups (χ² = 648.84, P < 0.001). The total mortality of enrolled patients was 8.09% (677/8 369), and the mortality of HIV/HBV group, HIV/HCV group and HIV/HBV/HCV group were 2.1% (11/367), 3.15% (12/381) and 13.95% (6/43), respectively, which were significantly different compared with that of HIV/AIDS group (5/7 578, 0.07%) (Fisher’s exact test: all P < 0.001), and there was significant difference in overall comparison of the four groups (χ² = 348.48, P < 0.001).

Patients with AIDS in our hospital, especially Zhuang and Han nationality, the unemployed, freelancers had high co-infection rate of HBV and (or) HCV, which may increase HIV RNA replication, cause severer decrease in cellular immune function, result in increased incidence of severe liver diseases such as liver cirrhosis, hepatocellular carcinoma and liver failure.

To investigate the clinical characteristics of a fulminant respiratory infection caused by human adenovirus type 55 (HAdV-55) in Beijing, and to raise the awareness and level of diagnosis and treatment of HAdV-55 respiratory infection.

Total of 48 patients diagnosed as acute HAdV-55 respiratory tract infection were treated in The 8th Medical Center of PLA General Hospital. The clinical information of patients were collected and analyzed, retrospectively, including symptoms, signs, results of laboratory examination [including blood routine, erythrocyte sedimentation rate, C-reactive protein (CRP), blood biochemistry, pathogen nucleic acid detection, etc.], treatment methods and prognosis. Patients were divided into pneumonia group (18 cases) and upper respiratory tract infection group (30 cases) according to with or without variative lung lesions on CT image. Data with normal distribution of before and after treatment of the two groups were compared with paired t test, and the proportion of symptom distribution were analyzed by chi-square test or Fisher exact probability test.

The average age of 48 patients was (20.6 ± 1.8) years old, and 83.3% (40/48) cases were initial entry to Beijing from urban or rural areas below secondary level. There were 58.3% (28/48) patients with the highest body temperature > 39℃, including 12 cases in pneumonia group and 16 cases in upper respiratory tract infection group (χ² = 0.823, P = 0.346); 84.6% (22/26) patients with sputum had yellow sputum, including 11 cases in pneumonia group and 11 cases in upper respiratory tract infection group (χ² = 0.142, P = 0.706), both without significant differences. Excepte for 6 patients treated for longer than 4 d, the average number of peripheral white blood cells in 42 patients was (9.03 ± 0.37) × 10⁹/L, there was no significant difference between pneumonia group [(9.08 ± 3.01) × 10⁹/L] and upper respiratory tract infection group [(9.01 ± 2.02) × 10⁹/L](t =-0.086, P = 0.932). Leukocyte count in 38.1% (16/42) patients were > 10 × 10⁹/L. The average CRP of 42 patients at first visit was (29.0 ± 17.2) mg/L, but there was no significant difference between pneumonia group [(30.2 ± 13.7) mg/L] and upper respiratory tract infection group [(28.3 ± 19.0)mg/L](t =-0.338, P = 0.737). The focus of pneumonia was basically located in the extrapulmonary zone, close to or connected to the pleura. Seven days after the patient’s temperature returned to normal, 7 cases were positive for HAdV nuclear acid among the 8 cases re-measured.

With high fever, yellow sputum, increased white blood cell and neutrophil count, and normal lymphocyte count, acute respiratory infection caused by HAdV-55 showed the characteristics of bacterial infection. The virus nucleic acid remains contagious within one week after the recovery of body temperature.

To establish a nomogram model for preoperative prediction of infectious kidney stones.

Total of 350 patients with kidney stones diagnosed in Wujin Hospital Affiliated to Jiangsu University (Wujin Clinical College of Xuzhou Medical University) from February 2020 to February 2023 were summarized, retrospectively, and were randomly divided into a modeling set (245 cases) and a validation set (105 cases) according to 7︰3. The modeling focused on 91 cases with infectious kidney stones and 154 cases with non-infectious kidney stones, and verified 39 cases of concentrated infectious kidney stones and 66 cases of non-infectious kidney stones. The clinical data of patients in infective kidney stone group and non-infective kidney stone group were compared in the modeling set. The minimum absolute convergence and selection operator regression (Lasso) model and multi-factor Logistic regression model were used to screen the risk factors of infective kidney stone. The nomographic model was established and verified by 1 000 self-repeated samples through R software.

Univariate comparison showed that female, recurrent kidney stones and staghorn stones in the infectious kidney stones group were more, the stone area was larger, while the Hounsfield unit (HU) of stones was significantly fewer; positive preoperative bladder urine culture (PBUC), urine white blood cell count (WBC) and bacterial count, urine protein positive, urine nitrite positive, positive urine leukocyte esterase (ULE), urine pH value, and urine turbidity positive were significantly higher, while urine specific gravity was significantly lower; blood uric acid was lower, while blood phosphorus and magnesium were higher (all P < 0.05). Lasso screened 8 most differential indicators, namely female, recurrent kidney stones, stone area ≥ 601 mm², HU value < 1 000, positive PBUC, positive ULE, urine pH and urine turbidity positive. Logistic regression showed that female (OR = 1.568, 95%CI: 1.231-1.902, P < 0.001), recurrent kidney stones (OR = 3.023, 95%CI: 2.568-3.467, P < 0.001), stone area ≥ 601 mm² (OR = 2.123, 95%CI: 1.756-2.569, P < 0.001), HU value < 1 000 (OR = 3.856, 95%CI: 3.456-4.325, P < 0.001), positive PBUC (OR = 1.895, 95%CI: 1.623-2.325, P < 0.001), positive ULE (OR = 1.754, 95%CI: 1.326-2.124, P < 0.001), urinary pH > 6.5 (OR = 1.323, 95%CI: 1.102-1.889, P < 0.001) and positive urine turbidity (OR = 1.602, 95%CI: 1.314-1.956, P < 0.001) were the risk factors to infectious kidney stones. R software was used to establishe a nomogram model, with a total score of 220 points. The receiver operating curve (ROC) showed that the area under the curve (AUC) of the nematic model was 0.856 (95%CI: 0.810-0.912, P < 0.001), the sensitivity and specificity were 79.8% and 83.2%, respectively, indicating that the diagnostic areas of the model were better. The calibration curve and decision curve also showed that the model had a good fit and clinical net benefit ratio.

Female, recurrent kidney stones, stone area ≥ 601 mm², HU value < 1 000, positive PBUC, positive ULE, urine pH and positive urine turbidity could assist in assessing the risk of infectious kidney stones. A nomogram model that has good application potential to guide clinical practice was established.

To investigate the effect of maternal syphilis infection and perinatal outcome after standardized mother-to-child block treatment.

Total of 485 pregnant women and their newborns diagnosed as complicated syphilis during pregnancy were recruited from the Department of Obstetrics and Gynaecology, Beijing Ditan Hospital, Capital Medical University from January 1st, 2015 and June 30th, 2020. The 485 pregnant women were classified to TRUST ≥ 1︰16 group (100 cases with high titre) and TRUST ≤ 1︰8 group (385 cases with low titre) according to TRUST titre of syphilis before delivery. While the 485 pregnant women were divided to standardized treatment group (405 cases) and unstandardized treatment group (80 cases) according to whether received standard treatment of syphilis or not. TRUST titers in pregnant women and newborns, and adverse outcomes (preterm delivery, low birthweight infants, intrauterine or neonatal death, birth defects, neonatal infection, intrauterine distress, neonatal asphyxia, congenital syphilis) of mother and infants were analyzed by Pearson chi-square test, continuous-corrected chi-square test or Fisher’s exact probability method.

For the cases in TRUST ≥ 1︰16 group, the incidence of congenital syphilis in newborns were 12.0% (12/100) and 0% (0/385) (χ² = 47.372, P < 0.001), the incidence of birth defects were 17% (17/100) and 1.7% (6/385) (χ² = 41.9, P < 0.001), the incidence of preterm birth were 13.0% (13/100) and 5.1% (20/385) (χ² = 7.626, P = 0.009), the incidence of neonatal infection were 39.0% (39/100) and 2.7% (10/385) (χ² = 115.82, P < 0.001), the incidence of low birth weight infants was 6.0% (6/100) and 1.3% (5/385) (χ² = 7.915, P = 0.013) compared to those of TRUST ≥ 1︰8 group, all with significant differences. The cases in standardized treatment group compared to those of unstandardized treatment group, the decrease of pregnant TRUST titers compared to pretreatment were 68.0% (276/405) and 33.3% (27/80) (χ² = 33.717, P < 0.001), the negative rate of TRUST titer at birth were 57.8% (235/405) and 28.6% (23/80) (χ² = 22.995, P < 0.001), the incidence of preterm birth were 5.10% (21/405) and 14.3% (12/80) (χ² = 10.148, P = 0.003), the incidence of low-weight infants were 1.48% (6/405) and 6.25% (5/80) (χ² = 6.853, P = 0.022), the incidence of birth defects were 1.7% (7/405) and 20.0% (16/80) (χ² = 45.409, P < 0.001), the incidence of neonatal infection were 1.4% (6/405) and 53.7% (43/80) (χ² = 200.948, P < 0.001), the innate syphilis infection rate were 0% (0/405) and 15% (12/80) (χ² = 56.23, P < 0.001), all with significant differences.

The higher the maternal serum TRUST titer before birth, the higher incidences of neonatal birth defects, congenital syphilis, neonatal infection, premature birth, and low birthweight children; standard drug treatment during pregnancy could effectively treat syphilis during pregnancy, patients could obtain good pregnancy outcomes and neonatal outcomes.

To develop a nomogram model for guiding clinical accurate evaluation on the severity of adenovirus pneumonia in children, and carry out the internal validation.

Total of 128 children with adenoviral pneumonia diagnosis in Xuzhou Children’s Hospital Affiliated to Xuzhou Medical University from August 2019 to August 2021 were included, retrospectively, who all met the criteria of the guideline for the diagnosis and treatment of adenoviral pneumonia in children (2019 Edition). During hospitalization, according to the diagnostic criteria of community-acquired pneumonia, 128 cases were divided into severe group (50 cases) and non-severe group (78 cases). The gender, age, weight, premature delivery, duration of fever, peak body temperature, basic diseases, serum leukocyte count, percentage of neutrophils and lymphocytes, C-reactive protein (CRP), lactic acid, interleukin (IL)-6, lactate dehydrogenase (LDH), procalcitonin (PCT), percentage of CD4⁺ T and CD8⁺ T lymphocytes, CD4⁺/CD8⁺, CD16⁺CD56⁺ and CD19⁺ T lymphocytes, and mixed infection were compared between the two groups. The dimension of risk factors was reduced by LASSO regression, then the independent risk factors were screened by multivariate Logistic regression analysis, nomogram predictive model was drawn according to the regression coefficient (β). The area under the curve (AUC) of model for severe adenovirus pneumonia (SAP) prediction was calculated by receiver operating curve (ROC), and the goodness of fit of the model was evaluated by Hosmer-Lemeshow test, consistency and benefit of the model were evaluated by calibration curve and decision curve.

Compared with non-severe group, Univariate comparison showed that the duration of fever was longer [5.2 (3.0, 8.5) d vs. 2.9 (1.0, 5.0) d; Z = 8.326, P < 0.001], concentrations of IL-6 [45.6 (35.4, 56.9) pg/ml vs. 30.2 (25.2, 38.6) pg/ml; Z = 15.326, P < 0.001] and LDH were higher [452.6 (385.6, 523.4) U/L vs. 365.9 (302.1, 445.2) U/L; Z = 9.625, P < 0.001], levels of CD4⁺ T [31.2 (27.8, 34.2)% vs. 35.5 (33.2, 38.9)%; Z = 7.526, P < 0.001] and CD4⁺/CD8⁺ were lower [1.2 (1.0, 1.4) vs. 1.4 (1.1, 1.6); Z = 5.230, P = 0.004], and the rate of mixed infection was higher in severe group [46.0% (23/50) vs. 19.2% (15/78); χ² = 10.460, P = 0.001]. LASSO regression screened four variables with non-zero coefficients, namely duration of fever, IL-6 concentration, CD4⁺ T lymphocyte percentage and mixed infection. Multivariate Logistic regression analysis showed that duration of fever (OR = 3.125, 95%CI: 2.565-3.896, P < 0.001), IL-6 concentration (OR = 2.012, 95%CI: 1.428-2.639, P < 0.001), CD4⁺ T lymphocyte percentage (OR = 0.369, 95%CI: 0.124-0.678, P = 0.009) and mixed infection (OR = 1.457, 95%CI: 1.124-1.895, P = 0.001) were the independent risk factors for SAP. The total score of nomogram model was 160. ROC showed that the AUC value of nomogram for predicting SAP was 0.852 (95%CI: 0.779-0.901, P < 0.001). The Hosmer-Lemeshow test value was 0.786, suggesting that the goodness of fit of the model was high. The calibration curve and decision curve showed that the consistency and benefit of the model were acceptable.

The main factors affecting the severity of adenovirus pneumonia in children are the duration of fever, the concentration of IL-6, the percentage of CD4⁺ T lymphocytes and mixed infection. The developed nomogram prediction model to evaluate SAP has simple operation and strong visualization effect. It has high efficacy and goodness of fit, good consistency and benefit, and has good clinical application value.