Objective:To explore the effect of "Internet +" canal management led by special disease nurses in home care of patients undergoing percutaneous transhepatic cholangial drainage (PTCD) .Methods:From March 2021 to December 2022, convenience sampling was used to select 120 patients who underwent PTCD and were discharged with drainage tubes at the First Affiliated Hospital of Zhengzhou University. The patients were divided into a control group and an observation group using a random number table method, with 60 cases in each group. The control group adopted the routine home follow-up management after PTCD, and the observation group adopted the"Internet +"canal management led by special disease nurses for home care, with the intervention of three months. This study used the Chronic Disease Self-Management Scale (CDSMS) to evaluate the self-management ability and self-efficacy of two groups of patients, and recorded and compared the incidence of canal-related complications, unplanned readmission rate, and unplanned return visit rate between the two groups.Results:One patient in the control group died, and a total of 119 patients completed the study. The total score of CDSMS, self-management behavior score, and self-efficacy score of the two groups of patients after intervention were higher than those before intervention, and the differences were statistically significant ( P<0.05) . After intervention, the total CDSMS score, self-management behavior score, and self-efficacy score of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . In the observation group and the control group, the total incidences of canal-related complications were 18.33% (11/60) and 44.07% (26/59) , and the unplanned readmission rates were 6.67% (4/60) and 23.73% (14/59) , and the unplanned return visit rates were 10.00% (6/60) and 35.59% (21/59) , respectively, and the differences were statistically significant ( P<0.05) . Conclusions:The "Internet +"canal management led by special disease nurses can effectively improve the self-management ability and self-efficacy of PTCD patients at home, reduce the incidence of canal-related complications, unplanned readmission rate and return visit rate.

This paper reports a case of severe sinus bradycardia (39 beats/min) in a schizophrenic patient after abrupt clozapine withdrawal. And his heart rate returned to normal after taking theophylline extended-release tablets combined with the Xinbao pill.

Objective:To explore the diagnostic value of chromosome karyotype analysis, chromosomal microarray analysis (CMA) and whole exome sequencing (WES) in microcephaly.Methods:A total of 9 cases of microcephaly fetuses diagnosed by prenatal ultrasound or children with microcephaly diagnosed after birth were selected from the Sixth Affiliated Hospital of Guangzhou Medical University from January 2014 to August 2022.Karyotype analysis and/or CMA were used to detect. The cases with negative karyotype analysis and CMA results were further sequenced by trio-based WES (Trio-WES). Then the coding genes contained in the pathogenic copy number variation (CNV) fragments were analyzed by gene ontology (GO) enrichment. The genes related to the development of the central nervous system contained in the pathogenic CNV and the pathogenic genes found by Trio-WES were combined for gene interaction network analysis.Results:In this study, 9 cases of microcephaly were recruited, with the time of diagnosis ranged from 23 weeks of gestation to 7 years after birth, and the head circumference of fetus or children ranged from 18.3 to 42.5 cm (-7SD to -2SD). Karyotype analysis was detected in all 9 cases and no abnormality result was found. Eight cases were detected by CMA, and one abnormal was found. Five cases were detected by Trio-WES, and two cases were detected with likely pathogenic genes. The GO enrichment analysis of the coding gene in the 4p16.3 microdeletion (pathogenic CNV) region showed that: in biological process, it was mainly concentrated in phototransduction, visible light; in terms of molecular function, it was mainly concentrated in fibroblast growth factor binding; in terms of cell components, it was mainly concentrated in rough endoplasmic reticulum. Gene interaction network analysis suggested that CDC42 gene could interact with CTBP1, HTT and ASPM gene.Conclusions:CMA could be used as a first-line detection technique for microcephaly. When the results of chromosome karyotype analysis and/or CMA are negative, Trio-WES could improve the detection rate of pathogenicity of microcephaly.

This paper reports a case of severe sinus bradycardia (39 beats/min) in a schizophrenic patient after abrupt clozapine withdrawal. And his heart rate returned to normal after taking theophylline extended-release tablets combined with the Xinbao pill.

Objective:To explore the status quo and influencing factors of anxiety among caregivers of children with cancer during chemotherapy to provide a reference for clinical intervention.Methods:In this cross-sectional study, 133 caregivers of children with cancer during chemotherapy admitted at the First Affiliated Hospital of Zhengzhou University between May and August 2020 were selected by convenient sampling and investigated with the General Information Questionnaire, Generalized Anxiety Disorder-7 (GAD-7) , and Chinese version of Cognitive Fusion Questionnaire (CFQ) . In this study, a total of 133 questionnaires were distributed and 124 valid ones were returned, accounting for an effective response rate of 93.2%.Results:The GAD-7 score of the 124 caregivers was 10.50 (6.00, 15.75) ; the incidence of anxiety was 84.68% (105/124) ; and the Chinese version of CFQ score was 42.00 (32.00, 50.00) . There was a positive correlation between the GAD-7 and CFQ scores ( r=0.639, P<0.01) . Binary logistic regression analysis showed that cognitive fusion was a risk factor for anxiety among caregivers of children with cancer during chemotherapy ( P<0.01) . Conclusions:The anxiety and cognitive fusion levels among caregivers of children with cancer during chemotherapy are relatively high and positively correlated with each other. Targeted interventions should be provided in clinical practice for the cognitive fusion of caregivers of children with cancer during chemotherapy to reduce their anxiety and improve the quality of care for children.