Objective: To explore the effectiveness of collaborative care model-based continuous nursing on the postpartum posttraumatic stress disorder(PPTSD), to provide reference for postpartum clinical nursing. Methods: A total of 100 cases of postpartum puerpera in Beijing Luhe Hospital of Capital Medical University were assigned to the intervention group and the control group according to the random number table method with 50 cases each. In the control group, patients received continuous nursing, however, collaboration care model-based continuous nursing care was carried out in the intervention group. The PPTSD status and psychological resilience between the two groups was assessed by Posttraumatic stress Checklist-Civilian version (PCL-C) and Connor-Davidson Resilience Scale (CD-RISC), respevtively. Results: Before intervention, symptoms scores and total scores of PCL-C and CD-RISC between the two group was no statistical difference (P>0.05). After intervention, the scores of increased arousal symptoms (7.22±1.09), avoidance/numbing (9.77±2.41), re-experiencing symptoms (5.66±1.17) and PCL-C total scores (22.64±3.02) were significantly decreased in the intervention group compared to the control group (8.32 ± 1.05), (11.46 ± 2.87), (6.36 ± 1.25), (26.14 ± 3.27), and there were significant differences between the two groups (t=2.899-5.559, all P<0.01). However, the scores of tenacity (24.90 ± 4.83), strength (14.91 ± 2.25), optimism (7.18 ± 1.61) symptoms and CD-RISC total scores (46.99 ± 6.30) were remakedly increased in the intervention group compared to the control group (23.22 ± 2.69), (13.61 ± 1.75), (6.14 ± 0.91), (42.97 ± 3.30), there were significant differences between the two groups (t=2.154-4.011, P<0.05 or 0.01). Conclusions Collaboration care model-based continuous nursing care can promote the psychological resilience and alliviate PPTSD.

Unroofed coronary sinus syndrome (UCSS), also named coronary sinus septal defect, is a rare type of atrial septal defect with the incidence less than 1% of the total number of atrial septal defects. It is caused by incomplete formation of left atrial venous folds during embryonic development. Here we reported a patient with UCSS, who was treated in the Second Xiangya Hospital of Central South University. The patient was 50 years old and the main clinical manifestations were fatigue and shortness of breath after repeated exercise. Color Doppler echocardiography showed coronary sinus dilatation (17 mm×14 mm), indicating the possibility of permanent left superior vena cava. Pulmonary angiography showed that the left ventricle and coronary sinus were developed at the same time while the atrial septum was intact after the development of the left atrium, followed by the right atrium and right ventricle, indicating a partial anomalous pulmonary venous drainage (intracardiac type). Finally, the cardiac computed tomograhic angiography showed that 4 pulmonary veins and permanent left superior vena cava (PLSVC) went into the left atrium and the coronary sinus, respectively, while the coronary sinus septum was absent and the PLSVC was connected with the left atrium. The patient was later treated with the correction of non-parietal sinus syndrome in the Cardiovascular Surgery Department of our hospital.
Coronary Sinus ; Heart Atria ; Heart Septal Defects, Atrial ; Humans ; Middle Aged ; Vena Cava, Superior

OBJECTIVES: Type 2 diabetes (T2DM) is a common comorbidity in patients with degenerative aortic stenosis (AS).As a key item of the American Society of Thoracic Surgeons (STS) score, it has a vital impact on the clinical prognosis of traditional thoracic surgery. T2DM has an adverse effect on the morbidity and mortality of cardiovascular diseases. At the same time, studies have shown that T2DM are associated with myocardial hypertrophy and remodeling, decreased left ventricular function, and worsening heart failure symptoms in the AS patients. Transcatheter aortic valve replacement (TAVR) as an interventional method to replace the aortic valve has better safety for middle and high risk patients in surgery, but the impact of T2DM on the clinical outcome of TAVR in AS patients is not clear.By analyzing the clinical and image characteristics of patients with AS and T2DM who received TAVR treatment, so as to explore the effect of T2DM on the perioperative complications and prognosis of TAVR. METHODS: A total of 100 consecutive patients with severe AS, who underwent TAVR treatment and were followed up for more than 1 month, were selectedin the Second Xiangya Hospital of Central South University from January 2016 to December 2020.Among them, 5 patients who were treated with TAVR due to simple severe aortic regurgitation were not included, therefore a total of 95 patients with severe aortic stenosis were enrolled in this study.The age of the patients was (72.7±4.8) years old, and there were 58 males (61.1%), and the patients with moderate or above aortic regurgitation had 30 cases (31.6%). The patients were divided into a diabetic group and a non-diabetic group according to whether they were combined with T2DM.There was no statistical difference in age, gender, body mass index (BMI), STS score, and New York Heart Association (NYHA) cardiac function classification between the 2 groups (all P>0.05). The primary end point was defined as a composite event consisting of all-cause death and stroke one month after surgery, and the secondary end point was defined as TAVR-related complications immediately after surgery and one month after surgery.The preoperative clinical data, cardiac ultrasound data, CT data, postoperative medication and the incidence of each endpoint event were compared between the 2 groups.The predictive model of adverse events was constructed by single factor and multivariate logistic regression. RESULTS: Compared with the non-diabetic group, the diabetic group had high blood pressure and chronic renal insufficiency.There was no significant difference in preoperative ultrasound echocardiography between the 2 groups. Preoperative CT evaluation found that the anatomical structure of the aortic root in the diabetic group was smaller than that in the non-diabetic group, and there was no significant difference in the incidence of bicuspid aortic valve between the 2 groups (all P<0.05). In terms of postoperative medication, the use of statins in the diabetes group was significantly higher than that in the non-diabetic group. In the diabetes group, 6 patients (37.5%) received insulin therapy, and 9 patients (56.3%) received oral medication alone.Univariate logistic regression analysis showed that the all-cause death and stroke compound events was increased in the diabetes group in 30 days after TAVR (OR=6.86; 95% CI: 2.14 to 21.79; P<0.01). Heart disease (OR=2.80; 95% CI: 0.99 to 7.88; P<0.05) and chronic renal insufficiency (OR=3.75; 95% CI: 1.24 to 11.34; P<0.05) were also risk factors for all-cause death and stroke compound events.In a multivariate analysis, after adjusting for age, gender, BMI, comorbidities, N-terminal pro-B type natriuretic peptide (NT-proBNP), total calcification score, ejection fraction, and degree of aortic regurgitation, T2DM was still a risk factor for all-cause death and stroke compound events in 30 days after TAVR (OR=12.68; 95% CI: 1.76 to 91.41; P<0.05). CONCLUSIONS T2DM is a risk factor for short-term poor prognosis in patients with symptomatic severe AS after TAVR treatment. T2DM should play an important role in the future construction of the TAVR surgical risk assessment system, but the conclusions still need to be further verified by long-term follow-up of large-scale clinical studies.
Aged ; Aortic Valve/surgery* ; Aortic Valve Insufficiency/surgery* ; Aortic Valve Stenosis/surgery* ; Diabetes Mellitus, Type 2/complications* ; Female ; Humans ; Male ; Renal Insufficiency, Chronic/complications* ; Risk Factors ; Severity of Illness Index ; Stroke ; Transcatheter Aortic Valve Replacement/methods* ; Treatment Outcome ; United States