Objective To observe the influence of optimized nursing process on the clinical effect and quality of life of patients with cerebral infarction received intravenous thrombolysis.Methods Sixty-two cerebral infarction patients with thrombolytic therapy in Panzhihua Central Hospital were treated as control group from January 2013 to June 2014,74 cases cerebral infarction patients with thrombolytic therapy as the observation group from July 2014 to October 2015.The control group received routine nursing,the observation group were given optimized nursing process on the basis of routine nursing.The clinical effect and quality of life were compared between the two groups.Results The triage time,referral time and hospital stay time of the observation group were significantly shorter than the control group,the differences were statistically significant (P ＜0.05).The effective rate in the control group was 70.97％,that of the observation group was 87.84％,the effective rate in observation group was significantly better than that of the control group,the difference was statistically significant (P ＜0.05).Compared with before treatment,the life quality of two groups were significantly improved after treatment,the difference was statistically significant (P＜0.05);after treatment,the quality of life in observation groups were better than that of the control groups,the difference is statistically significant (P＜0.05).Conclusion Nursing process optimization can effectively improve the therapeutic effect for the patients with cerebral infarction intravenous thrombolytic therapy,shorten the treatment time and hospitalization time,and can significantly improve the patient' s quality of life.It is valuable for clinical application.

Objective To explore the clinical application value of ultrasound-guided intrahepatic biliary puncture combined with internal double biliary stenting under DSA in elderly patients with malignant hilar biliary obstruction (MHBO).Methods Totally 108 elderly MHBO patients received interventional treatment were analyzed retrospectively.Half of patients were treated with ultrasound-guided intrahepatic biliary puncture (ultrasound group),and another 54 patients were treated with DSA intrahepatic biliary puncture (DSA group).After successful puncture,the patients received percutaneous transhepatic cholangial drainage (PTCD) with 4 methods under DSA guidance,namely internal double biliary stenting,contralateral external PTCD with single biliary stenting,complete external PTCD and external PTCD on the dominant side.The recent complications of intrahepatic biliary puncture at two groups and the curative effect with four methods were observed.Results The frequency of intrahepatic biliary puncture,the dosage of contrast agent,the incidence of pain at the puncture point and hemobilia in ultrasound group were all lower than those in DSA group (all P＜0.05),the successful rate of intrahepatic biliary puncture in first time was significantly higher compared with DSA group (P＜0.05).The liver function indicators at 14 days postoperation and total bilirubin at 21 days postoperation had statistical differences between any two biliary drainage methods (all P＜ 0.05).Conclusion Ultrasound-guide intrahepatic biliary puncture combined with internal double biliary stenting under DSA can significantly benefit elderly patients with MHBO.

Objective To explore the accuracy and influencing factors of contrast-enhanced spectral mammography(CESM)and MRI in the dimension measurement of breast lesions.Methods A retrospective analysis was performed on 104 patients with breast lesions who underwent CESM and MRI examinations within one week.The pathological size was used as the gold standard to com-pare the accuracy of the two measurement methods.Logistic regression analysis was used to compare the influencing factors of the measurement accuracy of CESM and MRI.Results The measured values of CESM,MRI and pathology were 1.70 cm(1.20-2.70 cm),1.65 cm(1.20-2.28 cm),1.75 cm(1.00-2.50 cm),respectively,and there were no statistically significant differences between the two measurement methods and the pathological results(P＞0.05).Bland-Altman plot analysis showed that 95.2％(99/104)of the differences in CESM fell within the consistency interval,and 93.3％(97/104)of the differences in MRI fell within the consistency interval.Logistic regression analysis showed that the independent risk factors affecting the accuracy of CESM and MRI measurement were lesion size and enhancement type.Conclusion Both CESM and MRI show good accuracy.As a potential alternative to MRI technology,CESM can be used for imaging evaluation of breast lesion size.