To investigate the influence of biliary surgery on gastrointestinal motility, electrogastrography (EGG) and gastrointestinal manometry were performed in a series of 17 patients who underwent biliary operation. EGG was done in all the patients in preoperative day, the operative day and the first, second and third postoperative day for at least one hour. Gastrointestinal manometry was done in eight patients in the operative day and the first, second and third postoperative day for 4－5 hours. Recording and analysis of EGG and gastrointestinal manometry were done by computer. Results: as compared with the preoperative day, the percentage of EGG normal wave in the operative day was obviously lower (Ｐ＜0.001)，and percentage of EGG bradygastria and tachygastria was remarkable higher (Ｐ＜0.01). From the first postoperative day, EGG frequency became normal. The EGG power was obviously low after operation till the third postoperative day. After operation, MMC in upper jejunum was rarely recorded, and in the third part of duodenum was most often recorded. Duration of phase Ⅲ of MMC ranged from 4－7 min. Contractive power and area of phase Ⅲ of MMC in the third part of duodenum changed obviously (Ｐ＜0.01),and the other had no changes. Conclusion: there were good correspondence between EGG and gastric manometry. Postoperative gastrointestinal dysfunction of stomach may be mainly caused by its fast wave. There were obvious changes of gastroduodenojejunal MMC after surgery which suggested that postoperative gastrointestinal dysfuntion might be caused by abnormal MMC. Improving the recovery of MMC may shorten the duration of postoperative gastrointestinal dysfunction.
ObjectiveTo analyze independent factors for treatment-requiring retinopathy of prematurity (TR-ROP) and establish a predictive nomogram model for TR-ROP. MethodA retrospective cohort study. A total of 6 998 preterm infants who were born at Guangdong Women's and Children's Hospital between January 1, 2012 and March 31, 2022 and were screened for retinopathy of prematurity (ROP) were included in the study. TR-ROP was defined as type 1 ROP and aggressive ROP; 22 independent factors including general information, maternal perinatal conditions, interventions and neonatal diseases related to ROP were collected. The infants were divided at the level at an 8:2 ratio according to clinical experience, with 5 598 in the training cohort and 1 400 in the validation cohort. t test was used for comparison of quantitative data and χ2 test was used for comparison of counting data between groups. Multivariate logistic regression analysis was carried out for the indicators with differences in the univariate analysis. The visualized regression analysis results of R software were used to obtain the histogram. The accuracy of the nomogram was verified by C-index and receiver operating characteristic curve (ROC curve). ResultsAmong the 6 998 children tested, 4 069 were males and 2 920 were females. Gestational age was (33.69±3.19) weeks; birth weight was (2 090±660) g. There were 376 cases of TR-ROP (5.4%, 376/6 998). The results of multivariate logistic regression analysis showed that gestational age [odds ratio (OR) =0.63, 95% confidence interval (CI) 0.47-0.85, P=0.002], intrauterine distress (OR=0.30, 95%CI 0.10-0.99, P=0.048), bronchopulmonary dysplasia (OR=0.23, 95%CI 0.09-0.60, P=0.003), hypoxic-ischemic encephalopathy (OR=5.40, 95%CI 1.45-20.10, P=0.012), blood transfusion history (OR=4.05, 95%CI 1.50-10.95, P=0.006) were the independent influencing factors of TR-ROP. Based on this and combined with birth weight, a nomogram prediction model was established. The C-index of the training set and validation set were 0.940 and 0.885, respectively, and the area under ROC curve were 0.945 (95%CI 0.930-0.961) and 0.931 (95%CI 0.876-0.986), respectively. The sensitivity and specificity were 86.2%, 94.0% and 83.2%, 93.3%, respectively. ConclusionsGestational age, intrauterine distress, bronchopulmonary dysplasia, hypoxic-ischemic encephalopathy and blood transfusion history are the independent factors influencing the occurrence of TR-ROP. The TR-ROP nomogram prediction model based on independent influencing factors has high sensitivity and specificity.