Objective To investigate the health behavior level of elderly patients with coronary heart disease (CHD) in order to instruct nurses how to give health education to them. Methods By con-venient sampling, 71 elderly patients with CHD in four hospitals in Wuhan were surveyed with the ques-tionnaire of health promoting lifestyle profile Ⅱ of FANG Heng-ying. The investigation results were ana-lysed. Results The findings showed that mean total score of health behavior of elderly patients with CHD obtained from the questionnaire was only 2.40,the level of health behavior was low. There were statistically significant differences among scores of elderly patients with CHD at different levels of family income and at different occupations before retirement. Conclusions The general level of health behavior of elderly pa-tients with CHD was low, especially in the aspect of health responsibility. Moreover, Patients with lower family income, peasants, and as a worker before retirement have lower health behavior level. This survey suggests that nurses should enhance the health education of the elderly patients with CHD, especially the poor and elderly farmer patients with CHD to improve their health behavior level.

Objective To assess the face and construct validity of a full procedural transurethral prostate resection simulator (TURPSimTM) in the training of transurethral resection of the prostate. Methods Ten experienced and thirteen inexperienced urologists (TURP experience ≥ 30 and ≤ 3 respectively) were included for TURP training on TURPSimTM. Each participant filled out a questionnaire regarding their previous experience and opinion of the usefulness of the simulator before and after performing six full procedures at level-2 difficulty. Performance was evaluated between the two groups and pre- /post-training, including GRS and objective parameters recorded on the simulator. Results The experienced group had higher GRS scores (16.3±2.6 vs 12.9±4.0, P=0.024) and prostate resection rate [(94.6±2.8)% vs (89.8±4.4)%, P=0.006]. Less blood loss [(78 ml vs 115 ml, P=0.208) and less capsule resection rate [(27.6±5.4)% vs (29.1±6.2)%, P=0.558] were detected in the experienced group than in the inexperienced group with no significant differences. After training, GRS and coagulation precision increased (14.4±3.8 vs 20.0±3.4, P<0.001; 93% vs 100%, P=0.001) ,while capsule resection rate [(28.4±5.8)% vs (20.8±3.9)%, P<0.001), blood loss (86 ml vs 76 ml, P=0.039) and injury of sphincter (5.5±2.2 vs 3.2±1.7, P<0.001) decreased in both groups. Conclusions Proof of face and construct validity is shown for this full procedural simulator to simulate the skills necessary to perform TURP. The surgical skills of urologists may be enhanced after training on the simulator.

Objective To compare the safety and clinical efficiency between minimally invasive percutaneous nephrolithotomy(MPCNL)in supine position and flexible ureteroscopy(FURS)in management of proximal ureteral calculi.Methods From Oct.2010 to May.2012,76 patients with single proximal ureteral calculus between 10-20 mm failed in SWL or other conservative therapy accepted MPCNL (32 cases)or FURS(44 cases).There was no significant difference between the groups in base-line parameters.Stone sizes were(15.6±2.5)mm and(14.9±2.3)mm,P＞0.05.Procedural time,post-operative hospitalization stay,complication rates(Clavien degree Ⅱ or over)and stone free rates were compared.Results In these two groups,procedural time was(49.3± 11.7)and(67.2± 17.3)min,P＜0.05,postoperative hospitalization stay were(4.2±1.1)and(1.8±0.8)days,P＜0.05,complication rates were 12.5％ and 6.8％,P＞0.05 and stone free rates(residual fragments≤3 mm)were 93.7％ and 84.1％,P＞0.05.Conclusions For patients with surgically indicated proximal ureteral calculi,both minimally invasive percutaneous nephrolithotomy in supine position and flexible ureteroscopy are effective and safe therapeutic modalities.Patients treated with flexible ureteroscopy have faster postoperative recovery.

Objective To evaluate the effect of pregnancy and delivery after renal transplantation (RT)on recipients,graft and offspring.Methods Clinical data of 6 pregnancies in 5 recipients were retrospectively studied and literature was reviewed.Results Among them,6 pregnancies and 4 deliveries occurred in 5 female RT recipients.The mean age at pregnancy was 31.1 years,with a mean interval between RT and pregnancy being 3.6 years.Preeclampsia developed in two pregnancies and hyperlipemia in one pregnancy.One RT recipient who discontinued immunosuppressant following pregnancy on her own exhibited subsequent renal failure.She underwent a second RT and delivered a healthy baby two years following the second RT.One RT recipient decreased the immunosuppressant dose to half after the pregnancy on her own and developed renal failure thereafter.Four patients underwent a Cesarean section at 38 th,35 th,35 th,and 38 th week,respectively.The mean birth weight was 3262.5 g with all Apgar scores of 10.Conclusion Our data coupled with prior reports suggest that for the recipients with normal renal function,successful pregnancy is achievable if immunosuppressant was taken correctly,but the pregnancy is at high risk,and careful monitoring is needed.

Objective To measure the parameters of ealeaneal quantitative ultrasound(QUS)in nomal Hubei Yichang subjects.which were compared between different age groups after standardization by body mass index(BMI).Methods Calcaneal parameters were measured by UBIS5000 in 2912 normal Hubei Yichang subjects,from 20 to 82 years old women 1450,men 1462).Results The peak values of broadband ultrasound attenuation(BUA)and stiffness(STI)of the calcaneal were both in 45-49 year group for women.The peak value of BUA was in 50-54 year group for men.Standardized by BMI,the peak value of BUA、STI and sound of speed(SOS)were both in 20-24 year groups for women and men.Conclusion BUA、SOS and STI of the calcaneal may change with age.After the influence of body mass is eliminated,the change still exists obviously,and the parameters may gradually reduce with increasing age.

ObjectiveTo assess the validity of virtual-reality simulator UroMentorTM in skill training of ureteroscopy. MethodsThirty urologists were included and divided into groups A (n =18) and B (n =12 ) based on former ureteroscopy experience ( ≥ 20 or ＜ 20).Participants were assessed on their ability to perform cystoscopy,gnidewire insertion,semirigid ureteroscope advancement and basket extraction of a distal ureteric stone on the simulator.A blinded examiner assessed the subjects' performance using global rating scale (GRS).In addition,computer-generated parameters including time to complete the task,endoscope and instrument trauma,and the number of attempts to insert a guidewire were recorded as pretest.After 2 days of simulator training,they were retested with the same task. ResultsAll participants had reduced time to completion (333 ± 32 s & 228 ± 18 s,P =0.001 ) and improved GRS (24.4 ± 2.1 & 28.1 ±1.2,P =0.010).Differences were significant between the two groups in the time to completion (before 405 ±40 s & 262 ±22 s,P =0.014; after 276 ± 12 s & 179 ±9 s,P =0.000),and GRS (before 19.6 ±2.5 & 29.2 ± 1.3,P =0.009 ; after 25.0 ± 1.1 & 31.2 ± 0.7,P =0.002).Previous ureteroscopy experience was correlated to GRS (before r=0.705,after r=0.756). ConclusionThe UroMentor virtual-reality simulator is an appropriate and useful tool in training and assessing the skills of ureteroscopy.

Objective To investigate the efficacy of using three-dimensional (3D) printing technique on surgical planning and its function in enhancing the physician-patient rapport before surgery.Methods From June 2013 to January 2014,10 patients with T1 renal tumors,who were received laparoscopic partial nephrectomy,were selected in study.Left renal tumor was found in 3 cases and right renal tumor was found in 7 cases.The location of tumor included upper part of kidney in 5 cases,lower part of kidney in 3 cases and renal hilum in 2 cases,4 cases were diagnosed as T1a stage and 6 cases were diagnosed as T1b stage.64-slice enhanced CT scan was performed preoperatively.Data of DICOM format was sent for post processing.The final data was then output to 3 d printer for generating kidney models using thermoplastic plastics.After generating the model,different colors were put on the model,including pink in kidney,yellow in pelvis and ureter,red in renal artery and blue in renal vein.Plotted questionnaires were designed for medical professionals and patients,respectively.4 urological experts make the scores by this questionnaire in order to evaluate the efficacy and fidelity of the model.2 surgeons evaluated the efficacy of model after operation by comparing the actual tumor size with that measured on the models.Meanwhile,the model was used for conversation before operation.The questionnaires were also used for evaluating the effectiveness of conversion.Results 10 kidney models fabricated successfully with 3D-printing.The tumor size,position,renal vascular and collecting system could be clearly presented.Being evaluated by 4 experts and 2 performing urologists,and the mean scores was 7.8 ± 0.7.Intraoperative correlation was advocated by the performing urologists.The mean evaluation score was 7.5.The bias between real diameter of renal carcinoma and that of 3 d model was 3.4± 1.3 mm.Patients and family members preferred the demonstration of the disease and the procedure with a visual and tactilediseased organ.The scores of satisfactory were 9.0 ± 0.8.Conclusions The 3d printed model could exhibit the relationship between tumor and renal,clearly.It can help the urologists in making surgical plan,effectively.Patients' Understandings from patients and family members of the disease and the procedure to be used can be upgraded with this novel technology.

Objective To study the effect of continuous subcutaneous insulin injection(CSII) in treatment of type two diabetic patients with pulmonary infections. Methods From January 2001 to December 2005,83 type two diabetic patients with pulmonary infections were randomized to group CSII (42 cases) and group MSII(41 cases). The period of normalization of the blood glucose and cure of the pulmonary infections, cost and morbidity of low blood glucose were observed. Results Blood glucose of all patients in two groups reduced significantly. Significant difference was observed in the period of cure of the pulmonary infections, usage amount of insulin and morbidity of low blood glucose. In group CSII HbA1c, CRP and CHOL reduced significantly. Fasting CRP and high density lipoprotein-C (HDL-C) were remarkably increased. Conclusions Consecutive subcutaneous insulin pump injection is able to control the blood glucose better, to correct metabolic disorder, reduce the cost and hospital day and decrease the morbidity of low blood glucose. CSII is a better of method.

Objective To investigate the status of diabetes in fasting state on different therapies.Methods 244 type 2 diabetic patients were divided into four groups according to different insulins:60 for insulin pump group(A),64 cases for insulin glargine group(B),59 cases for microinjection pump group(C),61 cases for isophane insulin suspension group.Then the time when blood glucose was up to standard,the usage of insulin and the rate of hypoglycemia were abserved.Results A group was(2.89 ± 1.32)d on the time when blood glucose was up to standard,B group was(3.14 ±1.25)d,C group was(4.91 ±2.81)d and D group was(5.62 ±2.52)d.There were significant differences between A and other groups( P ＜ 0.05 ) on time.There were significant differences between B and C group,B and D group,but there was no difference between C and D group.A group was(30.61 ±2.21) IU/don the usage of insulin,B group was ( 31.12 ± 3.38 ) IU/d,C group was ( 42.25 ± 4.01 ) IU/d and D group was (44.31 ±3.22)IU/d.There were significant differences between A and C group,A and D group,B and C group,B and D group(P ＜0.05)on usage of insulin,but there were no differences between A and B group,C and D group.A group was 3.3％ on the rate of hypoglycemia,B group was 4.7％,C group was 15.2％ and D group was 16.4％.There were significant differences between A and C group,A and D group,B and C group,B and D group ( all P ＜ 0.05 ) on usage of insulin,but there were no differences between A and B group,C and D group.Conclusion Compared to other insulin therapies,insulin pump had obviously superiority,which could be generalized to diabetics in fasting state.

Objective To evaluate the efficacy and safety of sorafenib in the treatment of Chi-nese patients with metastatic renal cell carcinoma. Methods This muhicenter phase Ⅱ clinical trial was performed from May 2006 to December 2006. Sixty-two patients with metastatic renal cell carci-noma not suitable for curative treatment were enrolled. All patients received oral sorafenib as single a-gent at the dose of 400 mg twice a day until disease progression or intolerable toxicities occurred. Re-salts Partial responses were recorded as best response in 11 patients, while complete remission was found in 1 patient and stable diseases were found in another 35 patients. According to the intents-to-treatment population, the overall response rate was 19.4% (12/62), and the disease control rate was 77.4%(48/62). The median progression free survival time was 9.6 months with 1-year progression-free survival rate of 41.9%. However, the median survival time had not reached due to the short fol-low-up. The most frequent adverse events included alopecia (66.1%), diarrhea (62.9%), hand-foot syndrome (58.1%), anorexia (40.3%), rash(37.1%), fatigue (37.1%), hypertension (35.5%), hoarseness(32.3%), joint pain (25.8%), hypophosphatemia (21.0%), fever (19.4%), nausea (19.4%), abnormal transeaminase( 11.3% ), elevated total bilirubicin( 16.1% ), leucopenia( 12.9% ), bleeding under nail(16.1%), and gum bleeding(11.3%). Grade 3 adverse events included hand-foot syndrome (16.1%), hypertension (12.9%), diarrhea(6.5%), hypophosphatemia (4.8%), joint pain (3.2%), and leucopenia(3.2%). Conclusions Sorafenib has prominent anti-tumor activity in Chi-nese metastatic renal cell cancer patients with most adverse events being grade 1 or 2. More attention should be paid to hypertension and cardio-cerebral vascular events during the application of sorafenib.