From June 2002 to December 2023, there were 5 patients with criss-cross hearts admitted to the General Hospital of Northern Theater Command, including 3 males and 2 females, aged 1.5 to 25 years, and weighing 13-49 kg. There were 5 patients of atrioventricular position, 3 patients of right ventricular loop, 2 patients of left ventricular loop, 3 patients of normal atrioventricular connection, and 2 patients of inconsistent connection. Combined intracardiac malformations: 1 patient of simple ventricular septal defect combined with pulmonary hypertension, 1 patient of corrected transposition of the great arteries combined with ventricular septal defect, atrial septal defect, and pulmonary artery stenosis, 1 patient of corrected transposition of the great arteries combined with ventricular septal defect, atrial septal defect, and left atrioventricular valve insufficiency, and 2 patients of right ventricular double outlet combined with ventricular septal defect and pulmonary artery stenosis. The surgical methods included 2 patients of intracardiac anatomical correction, 1 patient of bidirectional vena cava pulmonary artery anastomosis, and 2 patients of total extracardiac ductal cava pulmonary artery anastomosis. All 5 patients were discharged smoothly.

OBJECTIVE To investigate the distribution and drug resistance of pathogens isolated from the children with bloodstream infection in pediatric intensive care unit(PICU)so as to provide guidance for empirical clinical treatment of infections.METHODS Based on the Pediatric Intensive Care Database(PIC,http://pic.nbscn.org),the etiological data were collected from the PICU children of Children's Hospital,Zhejiang University School of Medicine by R software in 2010-2019 and were retrospectively analyzed.The species,distribution and drug resist-ance of the pathogens isolated from the children were observed.RESULTS Totally 991 strains of pathogens were isolated,727(73.36％)of which were gram-positive bacteria,213(21.49％)were gram-negative bacteria,and 51(5.15％)were fungi.Staphylococcus epidermidis(320 strains,32.29％)was the predominant species of the gram-positive bacteria,followed by Staphylococcus hominis(118 strains,11.91％),Staphylococcus capitis(55 strains,5.55％)and Enterococcus faecium(Group D,33 strains,3.33％);Klebsiella pneumoniae(59 strains,5.95％),Escherichia coli(58 strains,5.85％),Acinetobacter baumannii(25 strains,2.52％)and Pseudo-monas aeruginosa(18 strains,1.82％)were the major species of gram-negative bacteria.The analysis of drug re-sistance showed that the gram-positive bacteria were generally resistant to β lactams and maintained sensitive to vancomycin and linezolid;the gram-negative bacteria showed high drug resistance rates,especially,A.baumannii and P.aeruginosa,showed multi-drug resistance.CONCLUSIONS The gram-positive bacteria are dominant among the pathogens isolated from the PICU children with bloodstream infections.The empirical treatment should be performed based on the distribution and drug resistance data of the pathogens,and sensitive drugs should be cho-sen for optimization of the treatment regimen.

On the occasion of the 110th Anniversary of the establishment of the Chinese Medical Association, the third conference of the Fourth Editorial Board of Chinese Journal of Digestive Surgery, and the Second Elite Group of Chinese Journal of Digestive Surgery, was successfully held in Kunming on July 4, 2025. This conference systematically summarizes the development experience of the journal over the past 20 years from three aspects: the role of ecological construction of thought in the discipline construction of digestive surgery, the display of the latest academic achievements in the field of digestive surgery, the development difficulties, and breakthrough paths of the discipline, and strategically plans the path of discipline construction in the new era.

Objective To explore and analyze the application value of correcting of nasal septum deviation under nasal endoscopy combined with temperature-controlled ablation radio-frequency in treatment of chronic sinusitis.Methods From June 2020 to June 2023,200 patients with chronic sinusitis and nasal septum deviation who underwent nasal endoscopic sinus surgery were randomly divided into control group(combined with nasal endoscopic sinus surgery)and observation group(combined with temperature-controlled ablation radio-frequency),100 cases in each group.The efficacy,nasal mucosal function,olfactory function,airway responsiveness and complications were compared between the two groups.Results The observation group has a better therapeutic effect than that in control group,the difference was statistically significant(P＜0.05);After surgery,compared with the control group,the observation group had a shorter saccharin clearance time(SCT),faster mucociliary clearance transport(MCT),higher nasal mucociliary transport rate(MTR),the differences were statistically significant(P＜0.05);After surgery,the observation group had better olfactory function grading than the control group,the difference was statistically significant(P＜0.05);The airway resistance at 5 Hz(R5),airway resistance at 20 Hz(R20),and resonance frequency(Fres)of the observation group were lower than those of the control group,the differences were statistically significant(P＜0.05);There was no significant difference in complications between the two groups(P＞0.05).Conclusion The combination of endoscopic nasal septum correction and temperature-controlled ablation radio-frequency for the treatment of chronic sinusitis has better clinical efficacy than endoscopic sinus surgery.It has significant advantages in improving nasal mucosal function,olfactory function,and reducing airway responsiveness,and is highly safe.It is worthy of clinical promotion and application.

OBJECTIVE To investigate the distribution and drug resistance of pathogens isolated from the children with bloodstream infection in pediatric intensive care unit(PICU)so as to provide guidance for empirical clinical treatment of infections.METHODS Based on the Pediatric Intensive Care Database(PIC,http://pic.nbscn.org),the etiological data were collected from the PICU children of Children's Hospital,Zhejiang University School of Medicine by R software in 2010-2019 and were retrospectively analyzed.The species,distribution and drug resist-ance of the pathogens isolated from the children were observed.RESULTS Totally 991 strains of pathogens were isolated,727(73.36％)of which were gram-positive bacteria,213(21.49％)were gram-negative bacteria,and 51(5.15％)were fungi.Staphylococcus epidermidis(320 strains,32.29％)was the predominant species of the gram-positive bacteria,followed by Staphylococcus hominis(118 strains,11.91％),Staphylococcus capitis(55 strains,5.55％)and Enterococcus faecium(Group D,33 strains,3.33％);Klebsiella pneumoniae(59 strains,5.95％),Escherichia coli(58 strains,5.85％),Acinetobacter baumannii(25 strains,2.52％)and Pseudo-monas aeruginosa(18 strains,1.82％)were the major species of gram-negative bacteria.The analysis of drug re-sistance showed that the gram-positive bacteria were generally resistant to β lactams and maintained sensitive to vancomycin and linezolid;the gram-negative bacteria showed high drug resistance rates,especially,A.baumannii and P.aeruginosa,showed multi-drug resistance.CONCLUSIONS The gram-positive bacteria are dominant among the pathogens isolated from the PICU children with bloodstream infections.The empirical treatment should be performed based on the distribution and drug resistance data of the pathogens,and sensitive drugs should be cho-sen for optimization of the treatment regimen.

Objective:To evaluate the short-term efficacy of surgical treatment for severe pulmonary stenosis(PS) in infants and young children, and to clarify the impact of different surgical timings on the efficacy of PS treatment.Methods:A retrospective analysis was conducted on 24 infants and young children who underwent surgical treatment for severe PS at the General Hospital of Northern Theater Command, PLA, from January 1, 2020, to October 1, 2024. Among them, 13 were males and 11 were females. The average weight of the patients was(9.2±3.6) kg, the average gestational age was(39.3±1.7) weeks, and the average age was(15.0±13.5) months. Preoperative clinical symptoms and signs(e.g., cyanosis, shortness of breath), transpulmonary valve pressure gradient(TPVPG), right ventricular systolic pressure(RVSP), and Em/Am were recorded. The patients were divided into two groups based on surgical timing: the infant group(under 1 year old, n=12) and the toddler group(1-3 years old, n=12).Results:There were no deaths among all patients. The postoperative ICU stay was significantly longer in the infant group compared to the toddler group( P<0.05). Compared to preoperative values, surgical treatment significantly improved TPVPG, reduced RVSP, and enhanced right ventricular diastolic function, which stabilized by 3 months postoperatively( P<0.05). Intergroup comparisons revealed that the infant group had significantly lower TPVPG at 6 months postoperatively compared to the toddler group. Additionally, right ventricular diastolic function improved significantly in the infant group postoperatively, while no significant improvement was observed in the toddler group. Younger age and reduced right ventricular diastolic function were identified as major risk factors for prolonged mechanical ventilation(>24 hours). Conclusion:Surgical treatment for PS during infancy and early childhood is safe and effective. Comprehensive preoperative evaluation is crucial, and early surgical intervention is recommended for patients with impaired right ventricular function to improve prognosis.

On the occasion of the 110th Anniversary of the establishment of the Chinese Medical Association, the third conference of the Fourth Editorial Board of Chinese Journal of Digestive Surgery, and the Second Elite Group of Chinese Journal of Digestive Surgery, was successfully held in Kunming on July 4, 2025. This conference systematically summarizes the development experience of the journal over the past 20 years from three aspects: the role of ecological construction of thought in the discipline construction of digestive surgery, the display of the latest academic achievements in the field of digestive surgery, the development difficulties, and breakthrough paths of the discipline, and strategically plans the path of discipline construction in the new era.

Objective To explore the current status of penile erection hardness and its influencing factors in patients with non-obstructive azoospermia.Methods From January to December 2024,450 patients with non-obstructive azoospermia were surveyed at the Reproductive Medicine Center of Hospital.A self-made general information questionnaire was used to collect their demographic data.The Erectile Hardness Scale(EHS)was employed to investigate the current status of their penile erection hardness,and a self-made questionnaire was utilized to explore the influencing factors.Results Among the 450 patients with non-obstructive azoospermia,during sexual intercourse,35.3%of the patients reported that their penile erection hardness could reach grade 4(normal state),54.5%reported that it only reached grade 3(sub-optimal state),9.3%reported that it only reached grade 2(slight penile erection),and 0.9%reported that it only reached grade 1(inability to achieve an erection).In the survey of satisfaction with sexual life quality,among the 450 patients,only 24.9%were very satisfied with their sexual life quality;57.3%were basically satisfied;9.6%considered it average;4.0%were dissatisfied;3.1%were very dissatisfied;and 1.1%had no sexual life.alcohol consumption(OR=2.393,95%CI:1.493～3.836),satisfaction with the quality of sexual life(OR=1.455,95%CI:1.118～1.894),educational attainment(OR=0.709,95%CI:0.549～0.917),and the sleep quality in the past month(OR=0.641,95%CI:0.452～0.907).Conclusions Clinical studies have shown that factors such as drinking habits,sexual life satisfaction,sleep quality,and educational attainment collectively influence the penile erection hardness in patients with non-obstructive azoospermia.Therefore,the medical team needs to customize personalized intervention plans and educational materials based on individual differences among patients.Through psychological counseling and lifestyle guidance,they can improve erectile function and the quality of sexual life,promote harmonious marital relationships,and enhance the overall life experience of the patients.

AIM:A strain was isolated and identified as the H3N8 subtype of the avian influenza virus from a sick chicken at a farm in Yangjiang,Guangdong Province,named A/chicken/Yangjiang/552/2023(abbreviated as YJ/552).The aim of this research is to determine its genetic evolution,biological properties and pathogenicity in hamsters.This study may provide a theoretical strategy for preventing and treating the H3N8 subtype avian influenza virus-induced epidemic.METHODS:A strain of H3N8 avian influenza virus from chickens was characterised by phylogenetic analy-sis,antigenic diversity,receptor-binding specificity,neuraminidase activity,replication,and transmission in hamsters and a systematic pathological analysis was conducted.RESULTS:This novel avian influenza virus was generated through complex recombination of Eurasian avian H3 genes,North American avian N8 genes and six internal genes of H9N2 sub-type AIV.The cleavage site of the outer protein,HA,was PEKQTR↓GLF,which is characteristic of the low pathogenic avian influenza virus.The HA gene of YJ/552 exhibited the highest nucleotide homology with A/China/ZMD-22-2/2022(H3N8)at 99.09%,while the NA gene showed the highest homology with A/chicken/Dongguan/879/2022(H3N8)at 99.01%.This strain preferentially binds to avian-type receptors and could bind to human-type receptors.This virus could effectively replicate in the trachea and lungs of inoculated and contact hamsters.CONCLUSION:YJ/552 is a recombi-nant H3N8 avian influenza virus replicated in the upper respiratory system and transmitted in hamsters.This study pro-vides data support for the early warning and prevention of H3 subtype avian influenza viruses.

Objective To explore and analyze the application value of correcting of nasal septum deviation under nasal endoscopy combined with temperature-controlled ablation radio-frequency in treatment of chronic sinusitis.Methods From June 2020 to June 2023,200 patients with chronic sinusitis and nasal septum deviation who underwent nasal endoscopic sinus surgery were randomly divided into control group(combined with nasal endoscopic sinus surgery)and observation group(combined with temperature-controlled ablation radio-frequency),100 cases in each group.The efficacy,nasal mucosal function,olfactory function,airway responsiveness and complications were compared between the two groups.Results The observation group has a better therapeutic effect than that in control group,the difference was statistically significant(P＜0.05);After surgery,compared with the control group,the observation group had a shorter saccharin clearance time(SCT),faster mucociliary clearance transport(MCT),higher nasal mucociliary transport rate(MTR),the differences were statistically significant(P＜0.05);After surgery,the observation group had better olfactory function grading than the control group,the difference was statistically significant(P＜0.05);The airway resistance at 5 Hz(R5),airway resistance at 20 Hz(R20),and resonance frequency(Fres)of the observation group were lower than those of the control group,the differences were statistically significant(P＜0.05);There was no significant difference in complications between the two groups(P＞0.05).Conclusion The combination of endoscopic nasal septum correction and temperature-controlled ablation radio-frequency for the treatment of chronic sinusitis has better clinical efficacy than endoscopic sinus surgery.It has significant advantages in improving nasal mucosal function,olfactory function,and reducing airway responsiveness,and is highly safe.It is worthy of clinical promotion and application.