Objective To discuss the influence of the smooth of bile duct examined by choledochoscope during the coInnlon bile duct exploration on the biliary tract theology.Methods Forty patients who were to undergo common bile duct exploration were divided into the control group and the test group with 20 eases in each group.The smooth of the distal common bile duct was examined by choledochoscope in the test group while by routine method in the control group.The T tube drainage volume for 24 h,the pressure,flow volume and resistance of common bile duct and amylase content of drainage were monitored in the two groups within 72 h.Results The T tube drainage volume of the second day increased.the pressure and the resistance of the common bile duct decreased,the flow volunle and amylase content of drainage reduced in the control group,which had statistical difference from those of the test group(P＜0.05).Condusion Avoidance of damaging examination of the distal common bile duct,monitoring of the pressure;flow volume and resistance of the common bile duct within 72 h after operation contributed to the confirmation of the time for clamping T tube early.

Objective To analyze satisfaction of the clinical practice content of nursing postgraduates with different characteristic, and to provide transformative suggestions for the construction of clinical practice scheme of nursing postgraduates. Methods Using judgment sampling and snowball sampling, the questionnaire survey was conducted among 101 nursing postgraduates, and comparing satisfaction of clinical practice content of postgraduates with different age, work experience and teaching mode. SPSS 17.0 software package was used for data description and t test. Results The total satisfaction of clinical practice content of nursing postgraduates was low, and different postgraduates′satisfaction was different. On practical operation opportunity,> 30 years old of postgraduates′satisfaction was (3.95±0.87), which was higher than those 20~30 years old, (3.35±0.90), and the difference was statistically significant, t=2.748, P<0.01. On clinical practice assessment methods and frequency, the satisfaction of postgraduates with a fixed teacher was higher than those without a fixed teacher (3.40±0.74) vs. (2.83±0.87), and the difference was statistically significant, t=3.310, P<0.01. Conclusions At present, the clinical practice content of nursing postgraduates is in shortage, and need to be further improved.

Objective To asscess cognitive changes of patients with Obstructive Sleep Apnea-Hypopnea Syndrome(OSAHS)by the Expansive Scale of Dementia(ESD),and to compare ESD to Mini Mental Status Examenation(MMSE)in cognitive function.Methods 90 OSAHS patients were investigated in our study.All patients were divided into three groups,according to apnea-hypopnea index(AHI),including mild group,moderate group and severe group.The cognitive function was evaluated by MMSE and ESD.Results The parameters,including AHI,Longest apnea time(LAT)and percentage of time spend when oxygen saturation lower than 0.9(SLT 90%) in severe OSAHS group were significantly higher than those in mild and moderate groups(P0.05).The total score of MMSE and subtest scores of MMSE in memory,attention,calculation and short-and long-term memory were significantly lower in severe OSAHS group than those in mild and moderate groups(P0.05).Conclusion There was the obvious decrease in cognitive function in patients with severe OSAHS,especially in leaning,memory,calculation and constructive function.Both ESD and MMSE could be used to evaluate the cognitive function in OSAHS patients,especially ESD.

Objective The aim of this study is to evaluate clinical application of BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index in patients with chronic obstructive pulmonary disease (COPD). Methods Forty patients with stable COPD in Xuanwu Hospital of Beijing during September 2003 to December 2007, were recruited in the study, including 25 men and 15 women, aged 38 to 85 years (with a mean of 62 ± 13 years). BODE index was measured for each patient, one year and three years after recruitment, respectively. Severity of COPD, including number and duration of episodes, length of each hospital stay and times of hospitalization due to acute exacerbation of COPD (AECOPD), were recorded. All data were statistically analyzed with SPSS 13.0 software for windows. Results ①There was a remarkable difference in COPD severity between patients with BODE score equal to or greater than five and these with less than five (P <0.01 ). ①BODE score inversely correlated with forced expired volume at the first second ( FEV1 ) in COPD patients (P < 0.01 for those with BODE score equal to or greater than five and P <0.05 for these with BODE score less than five, respectively). ③BODE score positively correlated with number and duration of acute exacerbation, length of hospital stay and times of hospitalization due to AECOPD (P <0. 01 for those with BODE score equal to or greater than five and P < 0. 05 for those with BODE score less than five, respectively). For patients with COPD, their BODE score in the first year positively correlated with that in the third year ( r = 0.834, P < 0.01 ). Conclusions BODE index is a better indicator to evaluate their condition severity in patients with COPD.

Objective We tried to explore nursing postgraduates' expectations of clinical practice,and build a set of practicable clinical practice program which contributed to cultivate comprehensive ability of nursing postgraduate.Methods Using judgment sampling and snowball sampling,the questionnaire survey was conducted among 111 nursing postgraduates,and expectations of clinical practice of postgraduates with dif-ferent ages and different work experiences were compared.Results Most nursing postgraduates hold that the clinical practice was necessary.Nursing postgraduates with different ages and work experiences had different expectations of chnical practice,and the differences were statistically significant,x2 value was 11.594 and 4.416,P ＜ 0.05.Nursing postgraduate with different working experience showed statistical difference in clinical expectation of total practice time,x2=1 1.290,P ＜ 0.05.Conclusions Nursing post-graduates with different ages and work experiences have different expectations of clinical practice.Colleges should build a set of reasonable clinical practice program,based on training objectives,research direction,practice expectations of nursing postgraduates.

Objective To analyze cellular immunological function of cancer patients in order to provide an evidence for immunological treatment to malignant tumors.Methods T lymphocyte subgroups(total T lymphocytes,Th,Ts,Th/Ts and NK)were determined by flow cytometry in 54 patients with lung cancer,42 with gynecologic cancer,44 with gastrointestinal cancer and 30 healthy individuals.Statistical data were analyzed by SPSS.Results T helper lymphocytes covered(29.41?9.24)%,(34.62?10.27)%,and(32.48?11.64)% respectively in lung,gynecologic and gastrointestinal cancer,significantly lower than that of health people(P

Objective To investigate the evaluation of cardiopulmonary exercise test (CPET) in the patients with chronic obstructive pulmonary disease (COPD), and the relationship with the pulmonary function test (PFT). Methods 26 COPD patients and 30 normal controls were examined with CPET and PFT. Results The parameters of CPET, including maximum oxygen uptake (VO2max), anaerobic threshold (AT), maximum minute ventilation (VEmax) and breathing reserve (BR) were lower in COPD group than those in control group (P<0.05). There were no significant differences in Wmax, oxygen pulse (O2pulse) between two groups (P>0.05). VO2max, AT, VEmax and BR were positively correlated with forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) in COPD group （P<0.05）, but were not correlated with forced vital capacity (FVC) and FEV1/FVC (P>0.05).Conclusion The pulmonary function of COPD patients can be evaluated with CPET, especially VO2max, AT, VEmax and BR.

Objective To explore the changes of serum lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) and the level of lipids in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods A total of 94 candidates with sleep disorders between January-July 2011 at outpatient department were monitored with polysomnography.According to apnea-hypopnea index (AHI),they were divided into mild-to-moderate OSAHS (5 ≤ AHI ≤ 30) (n =27),severe OSAHS (AHI ＞ 30) (n =37) and normal control groups (AHI ＜ 5) (n =30).After polysomnography,their blood samples were obtained to measure the levels of serum LOX-1,triglycerides (TG),cholesterol (TC),high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C).Results The serum level of LOX-1 in severe OSAHS group was significantly higher than that in the mild-to-moderate and control groups (P ＜ 0.01).The serum level of LOX-1 in OSAHS patients was positively correlated with AHI and longest apnea time (LAT)(r =0.645 & 0.501 respectively,both P ＜ 0.01) and was negatively correlated with SaO2 (r =-0.647,P ＜0.01).No significant difference existed in serum lipids in all groups (P ＞ 0.05).Conclusions Intermittent hypoxia caused by OSAHS increases the level of LOX-1 to further promote the formation and development of atherosclerotic in patients with OSAHS.The levels of lipid can not effectively predict the severity of lipid metabolism disorder in patients with OSAHS.

Objective To evaluate the cognitive function of chronic obstructive pulmonary disease (COPD) stable patients with ExtendedScale for Dementia (ESD). Methods 37 patients with stable COPD (COPD group) and 40 healthy persons (control group) were enrolled.The COPD patients were divided into different groups as their PaO2. They were assessed with ESD and Mini Mental Status Examination(MMSE). Results The total score of ESD and the subtest scores of ESD in leaning, memory, calculation, constructive function were significantlylower in the COPD group than in the control group (P<0.001). The total score of MMSE and the subtest scores of MMSE in memory,attention and calculation, short- and long-term memory were significantly lower in the COPD group than in the control group (P<0.05). Thetotal score and the subtest scores in learning, memory, calculation of ESD were lower in patients with PaO2<60 mmHg than those withPaO2≥60 mmHg (P<0.05), same as the total score and the subtest scores in memory, attention and calculation, short- and long-term memoryof MMSE (P<0.05). Both ESD and MMSE correlated significantly with PaO2 (P<0.01). Conclusion ESD can be used as an evaluationtool for cognitive function in stable patients with chronic obstructive pulmonary disease.

Objective To investigate the evaluation of high-resolution computed tomography (HRCT) in patients with chronic obstructive pulmonary diseases (COPD), and the relationship with the pulmonary function test and BODE index.Methods 32 COPD patients and 22 normal controls were examined by pulmonary function test (PFT) and HRCT. The data of two groups were compared.Results The volume and pixel index (PI) in forced expiration were higher in the COPD group than those in the control group ( P<0.01), but there was no significant difference in Vin between two groups ( P>0.05). In the COPD group, Vex and Vin were negatively correlated with FEV1/FVC ( P<0.05) respectively. There were no correlation between Vin, Vex and FEV1% pre in the COPD patients ( P>0.05) respectively. Vin and Vex were not correlated with BODE index (all P>0.05) respectively. The ratio of Vex/Vin was positively correlated with BODE index ( P<0.05), and not correlated with FEV1/FVC ( P>0.05). PI910ex was positively correlated with BODE index ( P<0.01), and negatively correlated with FEV1%pre, FEV1/FVC (all P<0.05) respectively.Conclusion The pulmonary function of COPD patients can be evaluated by HRCT, especially by PI910ex.