Objective To investigate the clinical treatment of congenital heart disease complicated with infective endocarditis effective programs, joint analysis of the clinical efficacy of the use of antibiotics in surgery on the basis of providing a basis for clinical treatment.MethodsAnalysis of January 2009 to December 2016 in our hospital with congenital heart disease complicated with infective endocarditis clinical data of 78 cases of patients were randomly divided into observation group and control group of 39 cases, The control group was given appropriate antimicrobial treatment, patients in the observation group according to the samples of culture and drug sensitivity test choose appropriate broad-spectrum antibiotics for treatment, observation after treatment and the clinical efficacy of the two groups were analyzed.According to the medical staff were given psychological psychological counseling for patients to explain the importance of disease related knowledge and related treatment, timely eliminate / alleviate the negative emotion of patients with, to ensure that patients with a good attitude to face treatment.Results78 cases of congenital heart disease complicated with infective endocarditis clinical infection germs mainly Staphylococcus aureus and Streptococcus viridans, in addition to a small number of patients infected with Enterococcus faecalis, Staphylococcus epidermidis, gram-negative bacteria and mixed bacteria.Two groups of patients after treatment statistical clinical efficacy results show 56.41% cure rate in patients in the observation group, the effective rate was 97.43% clinical cure rate was 35.90% in the control group of patients, clinical effective rate was 79.49%, a statistically significant difference between groups (P<0.05).Statistical quality of life of patients after two scores, statistics of daily living, psychological feelings, general health, drug dependence and pain and discomfort five indicators, pain and discomfort, and two indicators of the overall health of patients in the observation group was significantly better than the control group (P<0.05), no significant difference.ConclusionThe clinical administration congenital heart infection endocarditis surgical treatment of broad-spectrum antibiotics combined with substantial clinical efficacy, safety, reliability, patients were recovering well, can be clinical.

Objective To review and summarize the experiences of transcatheter closure of left ventricular-right atrium communication,and discuss the feasibility of interventional therapy for this kind of cardiac abnormalitis.Methods 22 patients who suffered from left ventricular-right atrium communication underwent transcatheter interventional therapy with ventricular septal defect(VSD) occluder.The operating procedures were performed as like as the transcatheter closure of VSD:established the pathway from femoral artery to femoral vein through left ventricle,VSD,right atrium (or from left ventricle to right atrial through the communication) and inferior vena cava,then inserted the polysheath from femoral vein,introduced by the pathway to left ventricle,and implanted VSD occluder through the polysheath to close the shunt.Results The operation succeeded in 21 patients.The cardiac murmur was disappeared in all patients,and there was no residual shunt or aortic regurgitation that conformed by postoperative ventriculography and echocardiography in follow up phase,and the tricuspid regurgitation was lessened than preoperative.The operation abort in 1 patient because of aortic regurgitation after implanting occluder.Conclusions Transcatheter closure of left ventricular-right atrium communication is feasible as the selected occluder is accordant,and atrioventricular block,aortic regurgitation and tricuspid regurgitation can be avoided.

The gait rehabilitation robots for stroke are responding to the development of the understanding of stroke rehabilitation, but still some challenges for application may be faced to, as found in AutoAmbulator. Some advices were dicussed from the view of the practice.

The morbidity of scoliosis in adolescents in China is about 3%-5%, 80%-85% of the patients are adolescent idiopathic scoliosis (AIS), whose etiology is unknown. Scoliosis is a structural spine disease occurring during puberty or before skeletal maturation. Scoliosis has a greatly negative impacton not only the growth and development of adolescent spine, but also the mental health of adolescents. Ocular disease is a common clinical disease in which the eye ball and its accessory structures have structural abnormalitiesordys function. Ocular disease snotonly bring in convenience to patients's life, but also may induce diseases in other organs. Recent studies have shown that various ocular diseases may have a potential impact on scoliosis, and quite a fewof patients with certain ocular diseases have higher incidence rate of scoliosis. Therefore, in this article, the etiological relationship between eye diseases and scoliosis will be summarized, which provides guidance and direction for the etiological research of scoliosis and eye diseases. After sorting out, we found that the relationship between ophthalmic diseases and scoliosis mainly concentrated in the following four aspects: choroidal thickness and scoliosis, Goldenhar syndrome, gene level and strabismus. Among them, the genetic relationship is the most complex, about 40 kinds of gene or chromosome abnormalities have been found to cause ocular diseases and scoliosis; Goldenhar syndrome, also known as oculo-auriculo-vertebral spectrum, first revealed the relationship between ocular diseases and scoliosis, but the current statistical relationship is still very vague. There are few studies on choroidal thickness and strabismus at home and abroad, which are statistical studies, only revealing the relationship between choroidal thickness and scoliosis, and there are many defects in the study of choroidal thickness, which need further research.

Objective To analyze the age difference of gram negative isolates(GNB)from blood culture and antibiotic resistance profile between children and adults. Methods Age difference of pathogen distribution of GNB isolated from blood culture during 2015-2017 were retrospectively analyzed. WHONET 5.6 and Graphpad Prism 6 were used to perform Chi-square test on the pathogen proportion and antibiotic resistance rate. Results A total of 20 145 bacterial strains were isolated in Chongqing from 2015 to 2017. The top three strains of GNB were E. coli(56.7％, 6 688/11 799), K. pneumoniae(19.6％, 2 308/11 799), and P. aeruginosa(4.4％, 522/11 799). The resistant rate of E. coli to carbapenems was less than 1％. The resistant rate of K. pneumoniae to carbapenems was about 5％, while the resistant rate of S. marcescens was approximately 9％, similar to E. cloacae. The overall resistance rates of E. coli from adult patients to most antiobiotic agents were significantly higher than those of children, but the overall resistance rate of K. pneumoniae from children was higher than those of adults. The drug resistance rate of A. baumannii was higher than P. aeruginosa. A. baumannii isolates from adult patients were highly resistant to all drugs tested and more resistant than those from pediatric patients. Conclusions Majority of GNB strains isolated from blood culture were E. coli and K. pneumoniae, for which carbapenems are still active. More attention should be paid to carbapenem-resistant K. pneumoniae from children and A. baumannii from adults. National surveillance of nosocomial bloodstream infection should be highly evaluated.

The expert panel of American Association for the Study of Liver Diseases published Practice guidance on acute-on-chronic liver failure and the management of critically ill patients with cirrhosis on November 9， 2023 in Hepatology. This practice guidance elaborates on the definition of acute-on-chronic liver failure， prediction models， and the management of liver cirrhosis comorbid with acute-on-chronic liver failure and organ failure in critically ill patients， and this article gives an excerpt of the key points in the practice guidance.