Objective To investigate the level of caregivers′burden and the coping style among parents of cancer children. Methods Totally, 229 parents of cancer children participated in the investigation by Chinese version of zarit burden interview (ZBI), Chinese version of coping health inventory for parents (CHIP) and self-designed general information questionnaire. The associations between caregivers′burden and coping styles were tested by Spearman correlation analysis. Results The caregiver′s burden on the parents was in the middle level with a total score of (30.50 ± 12.24). The coping style the parents took most frequently was to unite the family and keep a positive attitude and regard it as most effective. The caregiver′s burden was negatively associated with the positive coping style . Conclusion The parents of cancerous children suffer from middle level of burden . Nurses should assess the caregiver′s burden, provide targeted interventions to relieve it, help the to establish effective coping style and change their psychological and mental state and ultimately improve their quality of life.

Objective:To analyze the echocardiographic features of operation-related aorto-cardiac fistula(ACF) after surgery or transcatheter procedure, to explore the value of echocardiography on diagnosis of operation-related ACF, and summarize the key points of its diagnosis.Methods:Eight patients with operation-related ACF who were admitted to Fuwai Hospital were collected from July 2002 to December 2020. Echocardiographic features of the 8 patients with operation-related ACF were reviewed and analyzed. The diagnosis methodology was summarized.Results:Of the 8 patients with operation-related ACF, 3 had aortic right atrial fistula and 5 had aortic right ventricular fistula. The fistula was single, which can be located but not limited to the aortic sinus. The median size of the fistula was 4 mm (range: 3-5 mm). There was no aneurysmal dilation of the aortic sinus where the fistula was located. The fractured end of the fistula did not thin, and the fistula had a regular shape. Six of the 8 patients undertook cardiac catheterization and occlusion. One patient received surgical repairment. One patient was treated conservatively.Conclusions:Echocardiography can help diagnose operation-related ACF and provide valuable information for further clinical diagnosis and treatment. Sonographers should avoid missed diagnosis and pay attention to distinguishing from other causes of aortic-cardiac shunt disease.

Objective:To review the patients with supramitral ring (SMR) and summary echocardiographic features and operative prognosis in these patients.Methods:Clinical and echocardiographic data of 53 patients with SMR treated in Fuwai Hospital from Jan 2016 to Jan 2020 were reviewed. Patients were divided into simple group( n=28) and complex group( n=25) based on mitral apparatus normal or not. The echocardiographic characteristics, morphology of the rings, procedure′s results and follow-up data were recorded and assessed. Results:There was no significant difference in age, peak and mean mitral value(MV) gradient before surgery between the two groups (all P>0.05). Patients with mitral regurgitation and left outflow tract obstruction in complex group were more than in simple group (all P<0.05). All patients underwent cardiac operation. The average follow-up were(14.69±11.14)months. The overall missed diagnosis was 13%. The missed diagnosis rate in complex group was higher(20% vs 7%). The peak and mean MV gradient in all patients after surgery were reduced (all P<0.05), but the gradients in complex group were higher than simple group(all P<0.05). Restensis occurred in 3 patients in each group after surgery, in which 3 patients in complex group accepted reoperation. Conclusions:Echocardiography can diagnose different types of SMR and associated malformations, evaluate surgical outcomes, and follow up for recurrence of SMR. Patients with simple SMR have better surgical results, but there is still a certain recurrence rate of stenosis.

Objectives:To evaluate the diagnostic value of echocardiography in unroofed coronary sinus syndrome(UCSS)with endocardial cushion defect(ECD). Methods:The echocardiographic data of 43 patients of UCSS with ECD who underwent surgical treatment in our hospital from July 2017 to May 2022 were retrospectively analyzed.The diagnostic accuracy was evaluated by comparing the echocardiographic findings with the intraoperative exploration results. Results:According to Kirklin and Barratt-Boyes classification,there were 26 cases of type Ⅰ(60.5%),9 cases of type Ⅱ(20.9%),2 cases of type Ⅲ(4.7%),4 cases of type Ⅳ(9.3%),and 2 cases of type Ⅲ combined with type Ⅳ(4.7%).There were 26 cases(60.5%)of partial ECD,7 cases(16.3%)of intermediate ECD,10 cases(23.3%)of total ECD.Twenty two cases(51.2%)were associated with single atrium.Twenty seven cases(62.8%)were associated with persistent left superior vena cava(PLSVC).Other coexisting complicated malformations were as follows:2 cases of double outlet of right ventricle,1 case of pulmonary atresia,1 case of total anomalous pulmonary venous connection,and 1 case of aplenia syndrome.The coexisting simple malformations included 4 cases of ostium secundum atrial septal defect,2 cases of ventricular septal defect,3 cases of patent ductus arterial,and 6 cases of patent foramen ovale.Other abnormalities included 5 cases of absence of hepatic segment of inferior vena cava,1 case of hypoplasia of right superior vena cava,1 case of absence of right superior vena cava,3 cases of cor triatriatum,1 case of isolated levocardia,1 case of mirror image dextrocardia,4 cases of right aortic arch.Of the 43 patients,30(69.8%)were correctly diagnosed by preoperative echocardiography and 13(30.2%)by intraoperative exploration.UCSS was misdiagnosed as inferior vena cava type sinus septal defect and PLSVC was missed in 1 case.UCSS was missed in 12 cases,and PLSVC was missed in 3 cases of them. Conclusions:Diagnosis UCSS with ECD by echocardiography is valuable and challenging.It is necessary to strengthen the understanding of the embryonic development and pathological anatomy characteristics of these malformations to improve the diagnostic accuracy.