Objective:To explore the effect of arrhythmia in early and intermediate postoperative stages of the Fontan procedure.Methods:Patients undergoing Fontan procedure at Shanghai Children's Medical Center within 2015 to 2018 were included.Identified data obtained from retrospective，observational dataset including demographic information，patient diagnoses，baseline characteristics，operation details，ECG data，ultrasound cardiograph data，in-hospital medical intervention，in-hospital mortality，out-patient medical intervention，readmission，and complications.Results:Among the 277 children，early arrhythmia occurred in 173 cases（62.5%），medium- and long-term arrhythmia occurred in 35 cases（12.6%），and 69 cases（24.91%）had no arrhythmia，of which only 55 cases（19.9%）needed early intervention with drugs.Malignant arrhythmia was an independent predictor of poor prognosis（ OR 5.835 95% CI 1.738-19.596, P=0.004）.Among all arrhythmia，atrioventricular junction arrhythmia had the highest incidence.During the follow-up，we found that most of the arrhythmia that had occurred in the early postoperative period could return to normal in three months after the operation，while the rhythm gradually stabilized at four years after the operation，the persistent arrhythmia almost no longer returned to normal，and the normal rhythm basically did not recur.For patients who did not develop arrhythmia in the early postoperative period，the peak of new arrhythmia occurred within one year after surgery，and most of them were persistent arrhythmia. Conclusion:The development of an arrhythmia is associated with a heightened risk of subsequent failure of the Fontan circulation，especially malignant arrhythmia.However，the incidence of malignant arrhythmia is not high.In addition，most of the arrhythmias that had occurred in the early postoperative period could return to normal in three months after surgery，and the rhythm gradually stabilized in four years after surgery.While no arrhythmia in the early postoperative period，the peak of new arrhythmia occur within one year after surgery，and most of them are persistent arrhythmia.

Objective:To explore the effect of arrhythmia in early and intermediate postoperative stages of the Fontan procedure.Methods:Patients undergoing Fontan procedure at Shanghai Children's Medical Center within 2015 to 2018 were included.Identified data obtained from retrospective，observational dataset including demographic information，patient diagnoses，baseline characteristics，operation details，ECG data，ultrasound cardiograph data，in-hospital medical intervention，in-hospital mortality，out-patient medical intervention，readmission，and complications.Results:Among the 277 children，early arrhythmia occurred in 173 cases（62.5%），medium- and long-term arrhythmia occurred in 35 cases（12.6%），and 69 cases（24.91%）had no arrhythmia，of which only 55 cases（19.9%）needed early intervention with drugs.Malignant arrhythmia was an independent predictor of poor prognosis（ OR 5.835 95% CI 1.738-19.596, P=0.004）.Among all arrhythmia，atrioventricular junction arrhythmia had the highest incidence.During the follow-up，we found that most of the arrhythmia that had occurred in the early postoperative period could return to normal in three months after the operation，while the rhythm gradually stabilized at four years after the operation，the persistent arrhythmia almost no longer returned to normal，and the normal rhythm basically did not recur.For patients who did not develop arrhythmia in the early postoperative period，the peak of new arrhythmia occurred within one year after surgery，and most of them were persistent arrhythmia. Conclusion:The development of an arrhythmia is associated with a heightened risk of subsequent failure of the Fontan circulation，especially malignant arrhythmia.However，the incidence of malignant arrhythmia is not high.In addition，most of the arrhythmias that had occurred in the early postoperative period could return to normal in three months after surgery，and the rhythm gradually stabilized in four years after surgery.While no arrhythmia in the early postoperative period，the peak of new arrhythmia occur within one year after surgery，and most of them are persistent arrhythmia.

Objective:To analyze the prevalence of parturiophobia and its association with preferred mode of delivery in pregnant women in Changning District, Shanghai.Methods:A cross- sectional study was conducted among 1 560 pregnant women in the third trimester who had their antenatal examination in Changning Maternity and Infant Health Hospital from September 2020 to March 2021. Fear of childbirth was measured with a validated Chinese version of Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ-A). Based on the W-DEQ-A scores, the participants were divided into two groups: non-clinical parturiophobia group [<85 scores, including mild (≤37 scores), moderate (38-65 scores) and severe (66-84 scores) parturiophobia] and clinical parturiophobia group (≥85 scores). Rank-sum test, Chi-square test and t-test were used for univariate analysis. Multivariate binary logistic regression was used to analyze the factors associated with fear of childbirth and its relationship with preferred mode of delivery. Results:The detection rates of mild, moderate, severe and clinical parturiophobia were 18.8% (294/1 560), 44.9% (700/1 560), 31.1% (485/1 560) and 5.2% (81/1 560), respectively. Multivariate binary logistic regression showed that the participants who were supported by relatives and friends to have cesarean section ( OR=3.45, 95% CI: 1.29-9.22) or had antenatal anxiety ( OR=4.73, 95% CI: 2.49-8.97) were more likely to have clinical parturiophobia, while those with planned pregnancy ( OR=0.49, 95% CI: 0.29-0.82), high intensity physical activity ( OR=0.36, 95% CI: 0.18-0.72) or better/well understanding of the delivery process ( OR=0.42, 95% CI: 0.19-0.97) were less likely to develop clinical parturiophobia (all P<0.05). Compared with the non-clinical parturiophobia women, those with clinical parturiophobia were more likely to choose cesarean section ( OR=2.15, 95% CI: 1.22-3.78, P=0.008). Conclusions:The detection rates of severe and clinical parturiophobia are 31.1% and 5.2% in Changning District, Shanghai. The associated factors mainly include the attitudes of relatives and friends towards the mode of delivery, antenatal anxiety, planned pregnancy or not, physical activity level and the understanding of delivery process. Clinical parturiophobia might be an important factor for cesarean section on maternal request.

Objective To analyze the clinical efficacy of levocarnitine combined with Yougui Capsule on oligospermia and asthenospermia in male patients and its adverse effects. Methods Eighty male patients with oligospermia admitted to our hospital were randomly divided into study group and control group, with 40 cases in each group. The control group was treated with levocarnitine alone, and study group was additionally given Yougui Capsule. The total effective rate, incidence of adverse reactions, semen quality parameters and changes of sex hormones were compared between the two groups after 3 months of treatment. Results The total effective rate, plasma testosterone (T) level, and follicle stimulating hormone (FSH) in the study group were 87. 50％, (812. 3 ±130. 2) ng/dL, and (9. 1 ± 3. 5) IU/L, respectively, which were superior to 65. 0％, (778. 4 ±113. 2) ng/dL, (8. 0 ± 2. 1) IU/L, in the control group (P ＜ 0. 05). The incidence rate of adverse reactions in the study group was significantly lower than that of the control group (2. 50％ vs.20. 00％, P ＜ 0. 05). The semen quality parameters of the study group were significantly better than the control group (P ＜ 0. 05). Conclusion The combination of levocarnitine and Yougui Capsule can effectively improve the sex hormone level and sperm quality, improve the reproductive function, which have fewer adverse reactions, and is safe and reliable.

Objective To analyze the clinical efficacy of levocarnitine combined with Yougui Capsule on oligospermia and asthenospermia in male patients and its adverse effects. Methods Eighty male patients with oligospermia admitted to our hospital were randomly divided into study group and control group, with 40 cases in each group. The control group was treated with levocarnitine alone, and study group was additionally given Yougui Capsule. The total effective rate, incidence of adverse reactions, semen quality parameters and changes of sex hormones were compared between the two groups after 3 months of treatment. Results The total effective rate, plasma testosterone (T) level, and follicle stimulating hormone (FSH) in the study group were 87. 50％, (812. 3 ±130. 2) ng/dL, and (9. 1 ± 3. 5) IU/L, respectively, which were superior to 65. 0％, (778. 4 ±113. 2) ng/dL, (8. 0 ± 2. 1) IU/L, in the control group (P ＜ 0. 05). The incidence rate of adverse reactions in the study group was significantly lower than that of the control group (2. 50％ vs.20. 00％, P ＜ 0. 05). The semen quality parameters of the study group were significantly better than the control group (P ＜ 0. 05). Conclusion The combination of levocarnitine and Yougui Capsule can effectively improve the sex hormone level and sperm quality, improve the reproductive function, which have fewer adverse reactions, and is safe and reliable.