Objective:To analyze the status quo and influencing factors of post-traumatic growth of parents of children and adolescents with type 1 diabetes mellitus (T1DM) .Methods:The convenient sampling method was used to select parents of children with T1DM who were admitted to the diabetes care consultation clinic of Beijing Children's Hospital, Capital Medical University from March 2022 to March 2023 as the research objects. The parents of children were investigated by general information questionnaire, Posttramnatic Growth Inventory, Simplified Coping Style Questionnaire and Perceived Social Support Scale.Results:A total of 200 questionnaires were sent out in this study, and 187 were effectively collected, with an effective recovery rate of 93.5% (187/200). The total score of Posttramnatic Growth Inventory for parents of T1DM children was (60.28±18.37). The positive coping score in Simplified Coping Style Questionnaire was (22.40±6.94) and the negative coping score was (8.94±4.58). The total score of Perceived Social Support Scale was (57.39±14.57). The results of multiple linear regression analysis showed that HbA1c, monthly family income, educational level, positive coping strategies and perceived social support were the influencing factors for the post-traumatic growth of parents of T1DM children, explaining 33.8% of the variation in post-traumatic growth of parents of T1DM children.Conclusions:The post-traumatic growth of parents of T1DM children is at a moderate level. Medical staff should pay more attention to parents of children with poor blood sugar control, low educational level and low monthly family income, guide them from the perspective of positive psychology, encourage parents to adopt positive and effective coping strategies and emphasize the importance of social support, so as to improve the level of post-traumatic growth of parents of children with T1DM.

Objective:To summarize the clinical features of 8 cases with intramycardial hematoma(IMH) following congenital cardiac surgery in children.Methods:We retrospectly searched 8 patients with intramycardial hematoma after congenital cardiac surgery in Guangzhou Women and Children’s Medical Center from 2008 to 2024.Results:Mean age and mean weight at surgery were(13±15) months and(7.8±3.5)kg respectively. 6 of 8 cases were interventricular septal hematoma. In the other 2 patients, intramycardial hematoma was located in left ventrical free wall. All IMH were postoperatively detected by transthoracic echocardiaography. Two patients were managed with ECMO intraoperatively. Finally, all patients were discharged successfully with good clinical results. Mean time to IMH resolution in six patients was(33.5±4.6) days and mean left ventricular ejection fraction(LVEF) was 0.60±0.09. Another patient was followed up for 3 months and the IMH was not absorbed. One patient was lost to follow-up.Conclusion:IMH is a rare complication after congenital heart disease. The absorption of hematoma is a dynamic process and mean time to IMH resolution is about 1month. In IMH patients with hemodynamic instability, ECMO can be a good treatment to create opportunities for hematoma absorbtion.

Objective:To evaluate the clinical efficacy of percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) in the treatment of obstructive hypertrophic cardiomyopathy (HOCM) with mild septal hypertrophy.Methods:Forty-five HOCM patients with mild septal hypertrophy (the maximal left ventricular wall thickness is 15-19 mm) who were treated with PIMSRA between November 2016 to February 2021 in the Hypertrophic Cardiomyopathy Center of Xijing Hospital of Air Force Military Medical University were enrolled, and their clinical datas were collected and analyzed. The clinical symptoms and NYHA functional class before operation, 6 months and 1 year after operation were collected. Interventricular septum thickness, left ventricular outflow tract pressure gradient, left ventricular outflow tract diameter, mitral regurgitation, left ventricular systolic and diastolic function were evaluated by transthoracic echocardiography before operation, 6 months and 1 year after operation, intraoperative complications were monitored and recorded. Postoperative arrhythmias were monitored by routine 12 lead ECG and 24-hour ambulatory ECG.Results:All patients successfully completed PIMSRA procedure.No clinical adverse events such as death, bleeding and stroke occurred during and around the operation.No left bundle branch block, complete atrioventricular block and malignant arrhythmia occurred after the operation. All patients did not need permanent pacemaker implantation.NYHA functional class and clinical symptoms of patients were significantly improved after 6 months compared with values before operation (all P<0.001, respectively), it remained stable for 1 year after operation; Anterior interventricular septum, posterior interventricular septum, maximal left ventricular wall thickness all significantly decreased (all P<0.001, respectively), left ventricular outflow tract diameter widened ( P<0.001), continuous improvement 1 year after operation; left ventricular outflow tract gradient and provoked left ventricular outflow tract gradient all significantly decreased, mitral regurgitation decreased and SAM classification reduced after 6 months compared with values before operation (all P<0.001, respectively); left ventricular end-diastolic diameter widened and left atrial diameter decreased (all P<0.001, respectively), it remained stable for 1 year after operation. Left atrial volume index decreased ( P<0.001), with continuous improvement 1 year after operation; The ratio of early diastolic mitral valve velocity to early diastolic mitral annulus velocity (E/e′) decreased ( P=0.001), it remained stable for 1 year after operation. There were no significant differences in left ventricular end diastolic volume, left ventricular end systolic volume and left ventricular ejection fraction among the three groups (all P>0.05). Conclusions:PIMSRA is effective in the treatment of obstructive hypertrophic cardiomyopathy with mild ventricular septal hypertrophy.

Objective:To investigate the effect of percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) guided by echocardiography on the Lown classification of ventricular arrhythmias in patients with hypertrophic obstructive cardiomyopathy (HOCM).Methods:A total of 85 patients with HOCM who received PIMSRA treatment at Xijing Hospital of Air Force Military Medical University from May 2017 to October 2019 were retrospectively selected. All patients underwent 24-hour Holter examinations before and 1 year after PIMSRA to obtain parameters related to Lown classification. The changes in Lown grades after PIMSRA were analyzed. The patients were divided into improved group and unimproved group according to whether there was significant improvement in Lowen′s grades, and the difference of the parameters related were compared. The influencing factors of the changes in Lown classification were analyzed.Results:Compared with before PIMSRA, there was a significant improvement in the Lown classification after PIMSRA ( P=0.001). The patients with Lown grade Ⅰ increased significantly ( P=0.001), and the patients with grade Ⅲ decreased significantly ( P=0.005). There were no significant changes in patients with Lown grades 0, Ⅱ, and Ⅳ (all P>0.05). The proportion of patients with family history of hypertrophic cardiomyopathy (HCM), the baseline Lown classes, the reduction rate of the maximum left ventricular wall thickness and the reduction rate of the provocative left ventricular outflow tract gradient (LVOTG) were higher in the improved group than the unimproved group (all P<0.05). Multivariate Logistic regression results showed that HCM family history ( OR=3.95, 95% CI=1.34-11.64, P=0.013), baseline Lown classes ( OR=2.01, 95% CI=1.25-3.22, P=0.004) and the reduction rate of the provocative LVOTG gradient ( OR=1.02, 95% CI=1.00-1.04, P=0.041) were independent factors of postoperative Lown classification improvement. Conclusions:The Lown classes of HOCM patients after PIMSRA is significantly improved.HCM family history, the baseline Lown classes, and the reduction rate of postoperative provocative LVOTG are independent influencing factors for the improvement of Lown grade.

Objective: To understand potential categories of lifestyle behaviors and its association with traditional Chinese medicine (TCM) constitution among higher vocational medical students, so as to provide reference for the physical health management of them. Methods: From October to December 2022, 2 720 medical students from three higher vocational medical colleges in Anhui Province were selected by stratified cluster sampling method and were investigated with a questionnaire of lifestyle and TCM body constitution. Potential category analysis (LCA) and multiple linear regression were used to explore the relationship between potential categories of lifestyle behaviors and TCM constitutions. Results: The lifestyle behavior of vocational medical students were classified into three potential categories:general health group (83.60%), smoking and drinking group (4.85%) and diet preference group (11.55%). There were significant differences in the distribution of TCM constitution types among the three groups ( χ 2=46.32, P < 0.01 ). The proportion of general health group was the higher in balanced constitution (46.39%), and the proportion of smoking and drinking type was higher in phlegm dampness (25.00%). The dietary preferences were higher in phlegm dampness (20.38%), Yin deficiency (15.92%) and damp heat (20.70%). Taking balanced constitution as a reference, the occurrence risk of phlegm and dampness in smoking and drinking type and diet preference type was 1.75 times higher (95% CI =1.09-2.77) and 1.78 times higher (95% CI = 1.26-2.49) than that in general health group ( P <0.05). Conclusion There are certain aggregation characteristics in lifestyle behaviors among higher vocational medical students, which show significant relations with TCM constitutions. Targeted intervention should be carried out according to the demographic characteristics of higher vocational medical students, potential categories of behavior and lifestyle characteristics and TCM constitutions.

Objective:To retrieve and analyze evidence on exercise-related hypoglycemia prevention in children with type 1 diabetes mellitus (T1DM) and summarize the best evidence.Methods:BMJ Best Practice, UpToDate, NICE, JBI, SIGN, Cochrane Library, RNAO, IDF, ADA, Web of Science, PubMed, Embase, Medlive, Wanfang database, China National Knowledge Infrastructure (CNKI) and China Biology Medicine disc (CBM) were searched by computer for guidelines, evidence summary, recommended practice, systematic review, clinical decision-making and expert consensus on the prevention of exercise-related hypoglycemia in children with T1DM in the recent 6 years (2015-2020) .Results:A total of 13 papers were included, including 6 guidelines, 3 expert consensus papers and 4 clinical decision papers. Finally, 32 pieces of best evidence were formed, including 7 aspects such as characteristics of exercise-related hypoglycemia, the prevention strategies of hypoglycemia before, during and after exercise, and nocturnal hypoglycemia, hypoglycemia prevention strategies and health education.Conclusions:The best evidence of exercise-related hypoglycemia prevention strategy for T1DM children selected in this study is comprehensive and specific, based on which nursing staff can conduct health education on exercise-related hypoglycemia prevention for out-of-hospital type 1 diabetes children and their parents.

Objective:To construct an out-of-hospital health management content system for children with type 1 diabetes (T1DM) to provide a basis for clinical nursing staff to carry out targeted health education and evaluation.Methods:A research group was established in April 2019. Guided by mobile health, the first draft of out-of-hospital health management system for children with T1DM was constructed through literature review, semi-structured interviews and expert meetings. A total of 20 experts were selected from pediatric wards of 11 Class Ⅲ Grade A children's specialties or general hospitals in Beijing, Shanghai, Henan Province, Zhejiang Province and other provinces, and the Delphi method was applied for 2 rounds of consultation. The out-of-hospital health management content system for T1DM children based on mobile health was constructed and revised to form the final draft.Results:After 2 rounds of expert consultation, the opinions of 20 experts reached consensus. The recovery rates of the 2 rounds of expert consultation questionnaire were both 100.0%, the expert familiarity was 0.96, the expert judgment basis was 0.98 and the authority coefficient was 0.97. Finally, out-of-hospital health management content system for T1DM children consisted of 6 first-level indicators, 14 second-level indicators and 69 third-level indicators.Conclusions:The out-of-hospital health management content system for T1DM children in this study is scientific and comprehensive, which can provide theoretical references and unified standards for clinical nurses to conduct out-of-hospital health management and evaluation effect based on mobile health.

Objective:To explore the psychological resilience of adolescent leukemia survivors and analyze its influencing factors.Methods:From October 2018 to August 2020, convenience sampling was used to select adolescent leukemia survivors in the routine follow-up group and follow-up group for children with leukemia who stopped taking medication in Beijing Children's Hospital affiliated to Capital Medical University as the research object. The General Information Questionnaire, Resilience Scale for Chinese Adolescents, and the General Self-Efficacy Scale were used to investigate adolescent leukemia survivors. A total of 110 questionnaires were issued, and 106 valid questionnaires were returned, with the effective response rate of 96.36%.Results:Among 106 adolescent leukemia survivors, the total score of psychological resilience was (97.83±14.93) . The results of multiple linear regression analysis showed that disease risk, duration of drug withdrawal, and general self-efficacy were the influencing factors of psychological resilience in adolescent leukemia survivors, and the difference was statistically significant ( P<0.05) . Conclusions:The psychological resilience level of adolescent leukemia survivors is at an upper-middle level. Medical and nursing staff, the family and friends of adolescent leukemia survivors should pay active attention to survivors whose disease risk is medium or high risk or whose duration of drug withdrawal is less than 5 years, and provide them with a lot of support and help. At the same time, pay attention to the general self-efficacy of survivors, provide targeted self-care guidance or substantive help for the survivors to return to school and society so as to improve their psychological resilience.

Objective:To explore the current situation of psychological resilience and emergency rescue knowledge, attitudes and practice of pediatric nurses during public health emergencies, and analyze the influencing factors of psychological resilience, aiming at providing a basis for nursing managers to formulate strategies to improve psychological resilience, so as to further improve nursing staff's response to public health emergencies level.Methods:This study was a cross-sectional study. From February to April 2020, convenience sampling was adopted to select the pediatric nurses of the national children's hospitals or general hospitals as the research object. The General Information Questionnaire, the Connor-Davidson Resilience Scale (CD-RISC) and the Knowledge, Attitude and Practice Questionnaire for Medical Practitioners about Emergency Rescue of Public Health Events were used for investigation. A total of 13 091 questionnaires were distributed, and 12 750 valid questionnaires were returned with the valid response rate of 97.4%.Results:Among 12 750 nurses, the total score of CD-RISC was (65.53±15.55) . Multiple stepwise regression analysis showed that age, fertility, position, title, years of pediatric work, economic zone of the hospital, basic knowledge, psychological knowledge, other knowledge, emergency rescue attitude and emergency rescue practice were the main influencing factors of the psychological resilience of pediatric nurses during public health emergencies ( P<0.05) . Conclusions:The psychological resilience level of pediatric nurses in my country during public health emergencies needs to be improved. We should pay attention to nurses ≤40 years old, have no child, junior professional title, no positions, 6-10 years of pediatric work, and in the western region, and strengthen emergency rescue basic knowledge, psychological knowledge and other knowledge training, and improve their emergency rescue attitudes and behaviors, so as to improve the psychological resilience of pediatric nurses during public health events.

Objective:To evaluate the effect of acupoint stimulation on the prevention of anticipatory chemotherapy-induced nausea and vomiting by using Cochrane systematic review method.Methods:Wanfang database, China National Knowledge Infrastructure (CNKI) , VIP Chinese Science and Technology Journal Full-text Database, SinoMed, Cochrane Library, PubMed, EMbase, Elsevier, Springer, ClinicalKey for Nursing were searched by computer, which were supplemented by Internet retrieval, and the retrieval time was from set of these databases to November 2019. All randomized controlled trials and semi-randomized controlled trials that explored acupoint stimulation for the prevention of anticipated chemotherapy-induced nausea and vomiting were collected. The quality was evaluated by reference to Cochrane Handbook 5.1.0, and the data were analyzed with RevMan 5.0 software.Results:A total of 5 papers were included (544 adult tumor inpatients, 269 in the intervention group and 275 in the control group) , of which 2 were randomized controlled trials and 3 were semi-randomized controlled trials. All literatures were grade B in quality. There were 3 kinds of acupoint stimulation involved, which were auricular therapy, acupoint massage and acupoint application. Meta-analysis results showed that only the subgroup analysis of acupoint application (184 patients) showed that the intervention group was superior to the control group in terms of the control effect of chemotherapy-induced nausea and vomiting ( RR=1.12, 95% CI 1.03-1.23, P=0.01) . Other results showed no statistically significant difference between the intervention group and the control group, either in the Meta-analysis of all literatures, or in the subgroup analysis based on different types of nausea and vomiting, different time of occurrence, whether the intervention group combined with antiemetic drugs or auricular therapy intervention ( P>0.05) . In the Meta-analysis of adverse reactions, 3 literatures analyzed the occurrence of adverse reactions, among which 2 literatures did not observe adverse reactions, and 1 literature showed that the incidence of adverse reactions in the intervention group (22%) was lower than that in the control group (52%) . In the Meta-analysis of depression scores, two literatures (260 patients) evaluated depression scores, using random effect model. The results showed that the depressive symptoms score of the intervention group was lower than that of the control group ( MD=-11.72, 95% CI -19.82-3.62, P=0.005) . In the Meta-analysis of quality of life, 2 literatures evaluated the improvement of quality of life. Since the data could not be combined and only descriptive analysis was performed, the results suggested that auricular therapy could improve quality of life of patients. Conclusions:Acupuncture point stimulation is not yet considered to relieve anticipatory chemotherapy-induced nausea and vomiting, but it does not increase the risk of adverse reactions and it can reduce depressive symptoms.