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 evaluate the left ventricular myocardial strain in patients with light chain cardiac amyloidosis (AL-CA) with normal left ventricular ejection fraction (LVEF) by three-dimensional speckle tracking imaging(3D-STI), and to explore the clinical value of 3D-STI in predicting the prognosis of AL-CA patients with normal LVEF.Methods:A total of 80 patients with AL-CA and LVEF≥50% were retrospectively analyzed in the Xijing Hospital of Air Force Military Medical University from October 2014 to May 2020.According to whether the patients had endpoint events, they were divided into endpoint event group and non-endpoint event group. The clinical data, conventional echocardiographic parameters, 3D-STI related parameters and follow-up results were collected. Cox regression proportional hazards model was used to analyze the survival status of AL-CA patients with univariate and multivariate regression analyses, in order to find the relevant indicators of conventional echocardiography and 3D-STI to predict adverse events.Results:All patients were followed up for 20(7.3, 40.8) months. At the end of follow-up, 25 patients had all-cause deaths. Compared with the non-endpoint group, the endpoint event group had significantly increased left ventricular end diastolic maximum wall thickness (MLVWT), peak early diastolic flow velocity/peak early diastolic velocity at mitral annulus(E/e′) (all P<0.05), and decreased LVEF, left ventricular global longitudinal strain (GLS) and basal segment longitudinal strain (LS) (all P<0.05). Multivariate cox regression analysis after adjusting for age and gender showed that basal segment LS ( HR=0.812, 95% CI=0.675-0.976, P=0.026) was an independent predictor of end-point events in patients with AL-CA. Kaplan-Meier survival curve showed that AL-CA patients with basal segment LS≤13.07% were more likely to have endpoint events. Conclusions:Basal segment LS can be used as a predictor of endpoint events in patients with AL-CA.

Objective To explore the effects of growth group therapy on psychological factors related to interpersonal relationships in college students. Methods Volunteers from a medical university and a non-specialized university in Shenyang participated in growth group therapy once a week for 12 weeks. Before and after the intervention, the 48 volunteers completed the RFQ-54, emotion regulation questionnaire (ERQ), self-esteem scale (SES), and coping style questionnaire (CSQ). Results The RFQ-C, cognitive reappraisal, and SES scores were significantly different before and after intervention (20.54±8.88 vs 23.19±10.85, P ＜ 0.05), (27.27±5.22 vs29.19±4.69; 29.67±4.59 vs 31.48±4.20, P ＜ 0.01), as were the scores of the CSQ subscales, such as problem-solving, seeking support, withdrawal, rebuking oneself, and fantasy (0.72±0.17 vs 0.80±0.15; 0.60±0.25 vs 0.71±0.24; 0.35±0.21 vs 0.28±0.18; 0.36±0.25 vs 0.28±0.20; 0.48±0.23 vs 0.39±0.19, P ＜ 0.01). Conclusion Growth group therapy is effective in college students. It can improve abilities of mentalizing, emotional regulation, self-esteem, and coping in college students.

Objective To understand the family management and resilience in nephrotic syndrome children to explore the influence of family management on resilience so as to provide a reference for family management and environmental support for chronic disease children. Methods From April 2017 to April 2018, we selected 130 nephrotic syndrome children and main caregivers at a Class Ⅲ Grade A comprehensive children's hospital as subjects by convenience sampling. The investigation was carried out with the general information questionnaire, Chronic Illness Children's Resilience Scale (CICRS) and Family Management measure (FaMM). A total of 130 questionnaires were sent out and 127 valid questionnaires were collected with 97.69% for the valid recovery rate. Results Among those 127 nephrotic syndrome children, the total score of resilience was (99.84±12.53). There were 15 (11.81%) children with the high level of resilience, 102(80.31%) children with medium level and 10 (7.87%) children with the low level. Results showed that the score of child daily life had a positive correlation with the total score of children's resilience (P＜0.05); scores of family members' fears of disease and difficulty of disease management had negative correlations with the score of children's coping style (P＜ 0.05); score of family members' management ability had a positive correlation with the score of children's coping style (P＜0.05); score of disease burn out was negatively correlated with the score of interpersonal relation (P＜0.05); score of supporting each other of parents were positively correlated with the scores of children's individual characteristics and children's perceived family influence (P＜ 0.05). Conclusions Resilience and family management of nephrotic syndrome children need to be improved. Nurses should pay attention to the influence of family support and environmental support on psychological factors in children, and guide children to improve their coping capacity and family members to positively perceive children's school function, interpersonal relation and family environment to improve children's psychological health.

Objective: To compare the efficacy and safety of Cardi-O-fix patent foramen ovale (PFO) occluder and Amplatzer PFO occluder for the treatment of patients with PFO. Methods: A total of 246 consecutive patients (105 males and 141 females) with PFO were prospectively enrolled from May 30, 2013 to March 30, 2015 in our hospital. PFO interventional closure was applied according to the anatomical structure of the disease and patients′ wishes.Cardi-O-fix PFO occluder was used in 180 cases (COF group), Amplatzer PFO occluder was used in the remaining 66 cases (Amp group). Post-procedure safety including recurrent stroke, transient ischemic attack, death, and complete closure rate, and efficacy including procedure related complications of different devices were compared during the 12 months follow-up. Results: (1) Rate of transient ischemic attack was similar between COF group and Amp group at 12 months after procedure(1.1%(2/180) vs. 1.5%(1/66), P=1.000). There was no recurrent stroke and death during the 12 months follow-up period.Complete closure rate was similar between COF group and Amp group at 12 months after the procedure(90.6%(163/180)vs. 86.4%(57/66), P=0.355). (2) Three cases(1.7%) of paroxysmal atrial fibrillation were observed in COF group during the 12 months follow-up period, 1 patient converted spontaneously to sinus rhythm and 2 patients received successful pharmacologic conversion and converted to sinus rhythm. One patient(1.5%)developed paroxysmal atrial fibrillation and was pharmacologically converted to sinus rhythm in the Amp group. There was no significant difference in rate of paroxysmal atrial fibrillation between the two groups(P=1.000). There was no complications such as occluder translocation, erosion, pericardial effusion and puncture site bleeding in the 2 groups during the 12 months follow-up. Conclusion Efficacy and safety are similar for PFO treatment with Cardi-O-fix PFO occluder or Amplatzer PFO occluder in this patient cohort.

Objective To examine the reliability and validity of the Chinese version of the metacognition assessment scale 2009 (MAS-R 2009).Methods Sixty college students from a medical university in Shenyang were enrolled in the study.All the subjects were required to fill in the basic information questionnaire,IRI-C,SPM,and the Chinese version of the MAS-R 2009 and had to be interviewed.Two to four weeks later,6 college students were randomly selected to be interviewed again.Results Cronbach'sα coefficient of the Chinese version of MAS-R 2009 was 0.934,test-retest reliability of the scale was 0.935 (r ＜ 0.01),and inter-rater reliability of the scale was 0.832 (P ＜ 0.01).The Chinese version of the MAS-R 2009 had good content validity.The correlation coefficient between the items and the subscales in MAS-R 2009 showed high correlation,and the correlation coefficient ranged from 0.456 to 0.905.Conclusion The results indicate that the reliability and validity of the Chinese version of the revised metacognitive assessment scale 2009 has satisfied the psychometric requirements.It has a certain application value for domestic research and scientific research on the ability of mentalization.

Objective To evaluate the reliability and validity of reflective functioning questionary-54 (RFQ-54) in China.Methods School sample:a total of 635 students were selected for the study.Clinical patients:another 75 patients with borderline personality trait who visited Department of Psychiatry in Shengjing Hospital of China Medical University were recruited.All subjects filled the RFQ-54,MIS-BPD,TAS,FFMQ.44 students accepted the retest after three weeks.Results The internal consistency for RFQ-C and RFQ-U were both 0.628.The test-retest reliability was 0.835,0.683,respectively.The correlations with TAS,FFMQ,MIS-BPD supported its validity.The RFQ subscales scores were significant1y different between only-child and non-only child,urban and country,school group and clinical group (22.11 ± 1.34 vs 18.97 ± 1.22,22.59 ± 1.36 vs 17.61 ± 1.12,21.39 ± 1.32 vs 15.34 ± 1.08,10.95 ± 8.43 vs 13.58 ± 8.19,10.95 ± 8.36 vs 13.88 ± 8.26,11.47 ± 8.02 vs 22.43 ± 1.24,respectively.P ＜ 0.01).Conclusion The Chinese version of RFQ-54 shows good reliability and validity,which can be used to assess the reflective function of adults in China.

ObjectiveTo evaluate the effect of aspirin in preventing peripherally inserted central venous catheter (PICC)-related thrombosis by Cochrane systematic review method.Methods The relevant randomized controlled trials,quasi-randomized controlled trials and case-control study were searched in the Wang Fang Databases, VIP, CNKI, CINAHL, Elsevier, Cochrane Database of Systematic Reviews, EBSCO and Pub Med. The studies were selected according to the inclusion and exclusion criteria by two reviewers, and the quality of included studies was evaluated according to Cochrane Handbook 5.1.0 and Newscastle-Ottawa scale. Meta-analysis was conducted by using RevMan5.0.Results A total of 9 articles included three randomized controlled trials, five quasi-randomized controlled trials and one case-control study involving 3064 patients. The results of Meta-analysis showed that the control group had a significantly higher incidence of thrombosis than experimental group(OR=3.66,95%CI=0.42-0.77,P=0.0002); control group had a significantly higher incidence of thrombosis within one week than experimental group(OR=2.99,95%CI=0.14-0.67,P=0.003); control group had a significantly higher incidence of unplanned removal than experimental group (OR=2.63,95%CI=0.04-0.63,P=0.008). Control group had a significantly higher incidence ofphlebitis than experimental group (OR=4.47,95%CI=0.16-0.49,P<0.05).Conclusions Aspirin can be used as an efficient way to prevent PICC associated thrombosis, while the side effect should be closely observed.