Objective To explore the predictive value of four risk scoring systems for cardiovascular complications during pregnancy in patients with congenital heart disease (CHD). Methods Computer searches were conducted in PubMed, EMbase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP, and China Biology Medicine disc (CBM). Relevant studies on risk scoring systems for cardiovascular complications during pregnancy in CHD patients at home and abroad were comprehensively collected. The retrieval period was from the establishment of the databases to January 1, 2025, and the retrieval was updated on March 26, 2025. After two reviewers independently screened the literature and extracted the data, the quality assessment was carried out, and meta-analysis was performed using MedCalc software. Results A total of 11 studies were included, with a total of 4 987 patients. The incidence of cardiovascular complications during pregnancy in CHD patients ranged from 6.72% to 28.84%. The QUADAS-2 scoring tool results showed that 2 studies had unclear risk of bias, and 9 studies were determined to have a high risk of bias. The results of the meta-analysis showed that the CARPREGⅠ score [AUC=0.709, 95%CI (0.672, 0.745), P<0.001], CARPREGⅡ score [AUC=0.757, 95%CI (0.720, 0.794), P<0.001], ZAHARA score [AUC=0.732, 95%CI (0.674, 0.790), P<0.001], and mWHO classification system [AUC=0.681, 95%CI (0.617, 0.745), P<0.001] could independently predict cardiovascular complications during pregnancy in CHD patients. Conclusion The existing evidence indicates that all four scoring systems can be used to predict cardiovascular complications during pregnancy in CHD patients. Although the CARPREGⅡ score has the highest accuracy, the number of included studies is small. It is recommended to give priority to using the ZAHARA score for risk stratification and pregnancy management of women with CHD before pregnancy. In view of the limitations of the quality of the included studies, this study needs to be further confirmed by high-quality studies.

Objective     To analyze the relationship between preoperative anemia and postoperative infection and death in children with acyanotic congenital heart disease (CHD) after elective cardiac surgery. Methods     Medical records and follow-up data of 3 859 children with acyanotic CHD who underwent elective cardiac surgery in our hospital from 2011 to 2018 were retrospectively collected, including 2 081 males and 1 778 females with a median age of 32.2 (13.7, 61.5) months. The relationship between preoperative anemia and postoperative infection and death within 90 days was analyzed by univariate and multivariate regression analyses. Results     Preoperative anemia was found in 325 (8.4%) patients. There were 716 (18.6%) patients of postoperative infection, including 281 (7.3%) patients of confirmed infection and 435 (11.3%) patients of suspected infection. Forty-six (1.2%) patients died within 90 days after the operation. Univariate analysis showed that age, infection history within 3 months before admission, degree of pulmonary hypertension, the risk adjustment in congenital heart surgery-1 (RACHS-1) score, cardiopulmonary bypass (CPB), disease diagnosis,  chromosome abnormality, preoperative left ventricular ejection fraction (LVEF)<55% and preoperative anemia were associated with postoperative infection. Age, degree of pulmonary hypertension, RACHS-1 score, CPB, disease diagnosis and preoperative LVEF<55% were associated with postoperative death within 90 days. Logistic regression analysis showed that preoperative anemia was significantly associated with confirmed postoperative infection [OR=1.82, 95%CI (1.18, 2.82), P=0.007], suspected infection [OR=1.60, 95%CI (1.11, 2.30), P=0.012] and total infection [OR=1.64, 95%CI (1.20, 2.24), P=0.002]. The results of modified Poisson regression analysis showed that there was no significant association between preoperative anemia and death within 90 days after the surgery [RR=1.59, 95%CI (0.69, 3.69), P=0.276]. Conclusion     Preoperative anemia may be a risk factor for infection after elective cardiac surgery in children with acyanotic congenital heart disease.

Objective    To analyze the perdictive value of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) for malnutrition or postoperative complications in children with critical congenital heart disease (CHD). Methods    A total of 875 children with critical CHD who were hospitalized in West China Hospital, Sichuan University form August 2019 to February 2021, including 442 males and 433 females with a median age of 30 (12, 48) months, were assessed by STAMP in Health Information System. Clinical data of postoperative complications were collected. Results    (1) Based on World Health Organization Z-score as gold standard, 24.5% had malnutrition risk, and 34.3% were diagnosed with malnutrition. According to STAMP, the children were with medium malnutrition risk of 37.9% and high malnutrition risk of 62.1%. There was a statistical difference of incidence rate of malnutrition and detection rate of STAMP malnutrition risk in gender, age, ICU stay or length of mechanical ventilation (P<0.05); (2) with the optimal cut-off point of 5.5 in STAMP for malnutrition, the sensitivity, specificity, positive predictive value, negative  predictive value and area under the curve (AUC) were 68.3%, 84.3%, 48.1%, 88.3% and 0.82, respectively; (3) 12.0% of the children were with postoperative complications; (4) with the optimal cut-off point of 5.5 in STAMP for postoperative complications, the sensitivity, specificity, positive predictive value, negative predictive value and AUC were 83.8%, 73.1%, 18.8%, 99.1% and 0.85, respectively. Conclusion    Children with critical CHD have a higher incidence of malnutrition risk and postoperative complications. STAMP has a good perdictive value for malnutrition or postoperative complications, however, the sensitivity and specificity of STAMP are affected by the gold standard or the cut-off point.

Objective To investigate the high-risk factors of stroke in Anqing area, and to analyze the value of standard treatment for the intervention of high-risk population for stroke. Methods A total of 3 062 permanent residents over 40 years of age in Anqing were surveyed by a questionnaire for the high-risk population of stroke. Physical examination was carried out for people at a high risk of stroke. The physical examination included general physical examination, laboratory tests, and carotid artery color Doppler ultrasound examination. People at a high risk of stroke were investigated on whether or not they received standardized symptomatic treatment and prevention interventions. Results Hypertension or taking antihypertensive drugs accounted for the highest risk factors of stroke in Anqing area, followed by smoking and seldom physical exercise. The abnormal rates of body mass index, blood pressure, contents of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL) , homocysteine (HYC), and blood glucose (GLU), as well as intimal thickening, plaque and carotid artery stenosis in people at high risk of stroke receiving standardized treatment were significantly lower than those in people receiving no standardized treatment, and the difference was statistically significant (P<0.05). The standard treatment was an independent factor influencing the body mass index, blood pressure, TC, TG, LDL, HDL, HYC, GLU, intimal thickening, plaque and carotid artery stenosis (P<0.05). Conclusion Hypertension accounted for the highest proportion of high-risk factors for stroke in Anqing area. Standardized symptomatic treatment can effectively control the physical indicators, laboratory test indicators and carotid artery state of stroke high-risk populations, which can play a positive role in the prevention of stroke.

Objective    To provide recommendations for the management of intensive care unit patients without novel coronavirus disease 2019 (COVID-19). Methods    We set up a focus group urgently and identified five key clinical issues through discussion. Total 23 databases or websites including PubMed, National Guideline Clearing-House, Chinese Center for Disease Control and Prevention and so on were searched from construction of the library until February 28, 2020. After group discussion and collecting information, we used GRADE system to classify the evidence and give recommendations. Then we apply the recommendations to manage pediatric intensive care unit in the department of  critical care medicine in our hospital. Results    We searched 13 321 articles and finally identified 21 liteteratures. We discussed twice, and five recommendations were proposed: (1) Patients should wear medical surgical masks; (2) Family members are not allowed to visit the ward and video visitation are used; (3) It doesn’t need to increase the frequency of environmental disinfection; (4) We should provide proper health education about the disease to non-medical staff (workers, cleaners); (5) Medical staff do not need wear protective clothing. We used these recommendations in intensive care unit management for 35 days and there was no novel coronavirus infection in patients, medical staff or non-medical staff. Conclusion    The use of evidence-based medicine for emergency recommendation is helpful for the scientific and efficient management of wards, and is also suitable for the management of general intensive care units in emergent public health events.

Objective:To systematically evaluate the experience of parents caring for children with congenital heart disease (CHD) .Methods:Qualitative researches on experience of parents caring for children with CHD were retrieved in Chinese National Knowledge Infrastructure (CNKI) , VIP, WanFang Data, Chinese Biomedical Database, Web of Science, Embase, Cochrane Library, PubMed, Joanna Briggs Institute Library and CINAHL by computer from building database to July 2019. The "Australia JBI Critical Appraisal Tool for qualitative studies" was used to evaluation and convergent integration was used to the result integration.Results:A total of 8 researches were included and 29 clear results were extracted. Similar results were summarized into 8 new categories and synthesized into two integrative results. The first integrative result: roles of caregiver grew through self-regulation; the second integrative result: caregivers were with gratitude and hoped to get social support.Conclusions:Nurses should pay attention to mental state of parents of CHD children, provide the necessary care knowledge and skill instruction, help parents to fill the role of caregiver to improve the family-centered care quality in CHD children.

Objective To investigate effect of cluster nursing for children with severe pneumonia in ICU.Methods A total of 88 patients with severe pneumonia were randomly divided into two groups,the control group received routine care,and the experimental group conducted cluster nursing.Blood gas analysis results after intervention,adjuvant effect of nursing,related clinical indicators,VAP,mortality and nursing satisfaction were compared.Results The experimental group had higher levels of p (O2),SaO2 and pH,lower p (CO2) level,ventilation time,ICU time and length of hospital stay and incidence of VAP than the control group (P ＜ 0.01).The experimental group had higher total efficiency and nursing satisfaction,and lower mortality than the control group (P ＜ 0.05).Conclusion Cluster nursing for children with severe pneumonia in ICU has significant efficacy,and can significantly improve nursing satisfaction.

Objective To discuss the influence of water colloid dressing on the skin of tracheal intubation in less than 6 months newborns with congenital heart disease.Methods A total of 80 newborns with congenital heart disease accepted therapy in our hospital were selected and were divided into control group and experimental group,with 40 cases in each group.3 M elastic tape was used to fix tracheal intubation in control group while water colloid dressing was used to protect the cheek and then 3 M elastic tape was applied to fix catheter in experimental group.The skin condition of the cheek was compared after intubation.Results The skin condition of experimental group was significantly better than control group (P ＜ 0.05).Conclusion Water colloid dressing could protect the skin and decrease the rate of avulsion injury of skin and pressure sores.

Objective To investigate effect of cluster nursing for children with severe pneumonia in ICU.Methods A total of 88 patients with severe pneumonia were randomly divided into two groups,the control group received routine care,and the experimental group conducted cluster nursing.Blood gas analysis results after intervention,adjuvant effect of nursing,related clinical indicators,VAP,mortality and nursing satisfaction were compared.Results The experimental group had higher levels of p (O2),SaO2 and pH,lower p (CO2) level,ventilation time,ICU time and length of hospital stay and incidence of VAP than the control group (P ＜ 0.01).The experimental group had higher total efficiency and nursing satisfaction,and lower mortality than the control group (P ＜ 0.05).Conclusion Cluster nursing for children with severe pneumonia in ICU has significant efficacy,and can significantly improve nursing satisfaction.

Objective To discuss the influence of water colloid dressing on the skin of tracheal intubation in less than 6 months newborns with congenital heart disease.Methods A total of 80 newborns with congenital heart disease accepted therapy in our hospital were selected and were divided into control group and experimental group,with 40 cases in each group.3 M elastic tape was used to fix tracheal intubation in control group while water colloid dressing was used to protect the cheek and then 3 M elastic tape was applied to fix catheter in experimental group.The skin condition of the cheek was compared after intubation.Results The skin condition of experimental group was significantly better than control group (P ＜ 0.05).Conclusion Water colloid dressing could protect the skin and decrease the rate of avulsion injury of skin and pressure sores.