Objective To study the application effect of discharge planning combined with continuous nursing in patients with chronic obstructive pulmonary disease (COPD).Methods From May 2014 to April 2015,92 cases of COPD patients in our hospital were selected as the research object,and they were divided into the observation group and the control group according to random number table,with 46 cases in each group. Patients in the control group received continuous nursing,while patients in the observation group were given discharge planning guidance on the basis of continuous nursing. The level of self-efficacy,anxiety, depression,and the treatment compliance of patients before and after intervention were compared between two groups.Results After intervention,the self-efficacy scores of safe behavior,environment and temperature, physical activity,emotional fluctuations,and dyspnea management in the observation group [(3.45±0.15), (2.96±0.24),(2.92±0.26),(2.97±0.24),(2.91±0.23)] were significantly higher than those in the control group [(3.15±0.17),(2.72±0.17),(2.81±0.18),(2.76±0.17),(2.83±0.14)] (P<0.05). The scores of self-rating depression scale (SDS) and self-rating anxiety scale (SAS) in the observation group were significantly lower than the control group [(21.45±2.02),(31.21±3.45) VS (35.43±2.54),(44.46±4.21)] (P<0.05). The treatment compliance in the observation group was significantly better than that in the control group (P<0.05). Conclusions For patients with COPD,discharge planning combined with continuous nursing can obviously improve patient's level of self-efficacy,anxiety,depression,and improve patients' treatment compliance to a certain extent. The effect is good with strong feasibility.

Objective:To explore the diagnostic accuracy and application value of 3.0 T non-contrast coronary magnetic resonance angiography (CMRA) in evaluating coronary artery in children with Kawasaki disease (KD).Methods:From May 2019 to January 2022, 75 children diagnosed with KD in our hospital were enrolled. All the patients underwent CMRA and transthoracic echocardiography (TTE) in one week, twenty-six of whom underwent coronary CT angiography (CCTA) or invasive coronary angiography (ICA) within two weeks. The diagnostic performance of CMRA and TTE was evaluated with CCTA/ICA as reference standard by per-patient basis, per-vessel basis, per-segment basis. Sensitivity and specificity of CMRA and TTE was compared by paired chi square test.The distribution of coronary artery aneurysm (CAA), thrombosis and other pathological changes of coronary artery were recorded and compared between two methods. The patients′ height and weight were collected to calculate the Z value. Z value>2.5 was defined as CAA.Results:All patients successfully completed CMRA examinations. Among the 26 patients, the sensitivity of CMRA was significantly higher than that of TTE by per coronary artery[97.7%(43/44)vs.84.1%(37/44), χ2=4.17, P<0.05]. CMRA showed a higher sensitivity than that of TTE both by proximal segments and middle/distal segments [97.7%(43/44)vs. 84.1%(37/44), 100%(21/21) vs. 52.4%(11/21), χ2=10.08, 7.11, both P<0.05). A total of 115 CAAs was found by CMRA, while only 87 (75.7%) CAAs were observed by TTE. Of the 28 (24.3%) CAAs missed by TTE, 16 (57.1%) were located in right coronary artery (RCA), 2(7.1%) in left main coronary artery, 7(25.0%) in left anterior ascending coronary artery (LAD) and 3(10.7%) in left circumflex coronary artery (LCX). Eleven (39.3%) missed CAAs by TTE were located in the proximal segment of RCA, LMCA, LAD and LCX, and 17 (60.7%) missed CAAs were located in the middle and distal segments. TTE missed coronary thrombosis in 5 patients compared with CMRA. Conclusions:3.0 T non-contrast CMRA is non-invasive and non-radiation, and the image quality can meet the needs of diagnosis, especially for detection of CAAs in RCA or in middle and distal segments of coronary artery in KD patients.