Initial studies suggested a low prevalence of nodal metastases in T1 lung cancer.However,several recent studies have reported a relatively high prevalence of mediastinal lymph node metastases.The extrathoracic metastases in T1 lung cancer differs widely(0%-24%).In this article,we discuss the thinsection CT and FDG-PET findings in T1 non-small cell lung cancer and also discuss the correlation of CT findings with prognosis and survival,the correlation between tumor size and survival,and extrathoracic metastasis of T1 lung cancer.

Objective:To evaluate right heart remodeling and right heart function change after pulmonary resection by echocardiography (ECG) .Methods:A total of 50 patients undergoing pneumonectomy received ECG examination to evaluate right ventricular structure and right heart function change before and after partial pulmonary resection .Re-sults:(1) Compared with before operation , there were no significant changes in right ventricular anterior free wall thickness ,right ventricular ejection fraction on 7d and 30d after operation;(2) Compared with before treatment , there were significant rise in pulmonary artery systolic pressure [PASP ,(20.52 ± 2.46) mmHg vs .(49.65 ± 2.17) mmHg] ,pulmonary artery diastolic pressure [PADP ,(10.82 ± 2.04) mmHg vs .(21.93 ± 1.26) mmHg] and pul-monary artery mean pressure [PAMP ,(13.78 ± 3.67) mmHg vs .(26.67 ± 3.28) mmHg] ,and significant rise in pulmonary vascular resistance [PVR ,(187.69 ± 12.46) dyn .s .cm-1 vs .(368.72 ± 11.94) dyn .s .cm-1 ] on 7d after pulmonary resection , P<0.05 all;all above indexes recovered to normal on 30d after treatment ;(3) Com-pared with before operation ,right ventricular Tei index significantly rose [ (0.36 ± 0.05) vs .(0.69 ± 0.13) , P=0.04] on 7d after operation ,the Tei index recovered to normal on 30d after treatment ,P=0.20. Conclusion:Com-pared with before operation , the PASP ,PADP and PAMP significantly rise on 7d after operation ,they recover to normal on 30d after treatment ;there are no significant change in right ventricular structure .

Objective:To explore the effect of multi-channel health education model by professional team on drug compliance, disease knowledge and recurrence in rate of inflammatory bowel disease (IBD) patients, so as to provide basis for formulating scientific health education measures.Methods:From February 2016 to February 2019, IBD patients visited First Affiliated Hospital of Kunming Medical University were selected. According to whether they received health education, the patients were divided into intervention group (100 cases) and control group (138 cases). Morisky medication adherence scale-8 (MMAS-8) and Chinese version of Crohn′s and colitis knowledge score (CCKNOW) were used to evaluate treatment compliance and disease knowledge. The score of MMAS-8, the proportion of poor drug compliance, CCKNOW score and recurrence rate at 48 weeks of follow-up were compared between the intervention group and control group. Two sample t test and chi-square test were used for statistical analysis. Results:The total scores of MMAS-8 and CCKNOW of the intervention group were both higher than those of the control group (5.58±1.96 vs. 4.47±1.44, 10.87±4.21 vs. 9.23±4.65), and the differences were statistically significant ( t=-5.06 and -2.79, both P<0.05). The proportion of patients with poor drug compliance and recurrence rate at 48 weeks of follow up of the intervention group were both lower than those of the control group (56.0%, 56/100 vs. 86.2%, 119/138; 20.0%, 20/100 vs. 31.9%, 44/138), and the differences were statistically significant ( χ2=38.18 and 4.17, both P<0.05). Conclusions:Multi-channel health education by professional team can effectively improve the drug compliance and disease knowledge in IBD patients, improve patient self-management ability, and reduce the recurrence rate.

Objective: To explore independent risk factors of coronary artery calcification (CAC) and analyze correlation among risk factors of CAC and serum osteopontin (OPN) level. Methods: According to results of 64-slice spiral computed tomography (MSCT) coronary angiography, a total of 65 patients were continuously enrolled and divided into CAC group (n=37) and non-CAC control group (n=28). Enzyme linked immunosorbent assay (ELISA) was used to measure serum level of OPN. Single factor and multiple factor Logistic regression analysis’s were used to analyze risk factors of CAC. Spearman’s straight line analysis was used to analyze correlation between risk factors of CAC and serum OPN. Results: 1、 The age, hypertension, diabetes, poor eating habits，lack of exercise, overweight, etc., which were independent risk factors of CAC （OR=3.47～12.96, P=0.018～0.003）by single factor Logistic regression analysis, were inducted to multiple factor Logistic regression analysis, its result showed that age, overweight, poor sleep quality, poor eating habits were independent risk factors of CAC, OR=35.31～5.17, P＜0.01～0.05; 2、Serum level of OPN in CAC group was significant higher than that of non-CAC control group ［(39.919±11.879) μg /L vs. (24.000±6.000) μg /L，P<0.01］; 3、The Spearman straight line correlation analysis indicated that serum level of OPN was correlated with risk factors of CAC : positively correlated with LDL-C, overweight, age, TC（r=0.487～0.286,P＜0.001～＜0.05）, and positively correlated with poor sleep quality, diabetes, poor eating habits, lack of exercise（r=4.10～2.24， P<0.01～0.05）; negatively correlated with HDL-C（r=-0.250,P＜0.05）. Conclusion: Correlation analysis indicates that age, overweight, poor sleep quality, poor eating habits etc. are independent risk factors of CAC；Serum OPN level is correlated with LDL-C, overweight，age, diabetes, lack of exercise etc., so these indicate that must decrease OPN level and risk factors of CAC to relieve CAC and slow down its development.

Objective:To study the improving effect of curcumin on cardiac function and its influence on myocardial collagen concentration in rats with myocardial infarction (MI).Methods:A total of 60 healthy adult male SD rats were randomly divided into sham operation group (n=10,survived rats n=9)and operation group [n=50,left an-terior descending artery was ligated,they were randomly divided into following four groups,on 28 d the treatment and survived rats in every group were:myocardial infarction (MI)group (n=9),control group (received intraper-itoneal injection of mixed solution,n= 10)and curcumin group (received intraperitoneal injection of curcumin, 100mg·kg-1 · d-1 n= 12)].After four weeks,M-mode echocardiography was used to measure left ventricular shortening fraction (LVFS),left ventricular ejection fraction (LVEF)and heart rate (HR).Masson staining was used to detect the myocardial fibrosis alteration after MI.Immunohistochemistry was used to measure expressions of myocardial collagen type Ⅰ and Ⅲ,and ratio of collagen Ⅰ/Ⅲ.Results:Compared with MI group and control group,after four weeks,there were significant rise in LVFS [(17.23±1.97)%,(19.34±0.83)% vs.(26.70± 1.15)%]and LVEF [(42.08±5.50)%,(41.63± 1.81)% vs.(56.76±2.49)%],significant reductions in HR [(433.16±20.05)beats/min,(433.04±24.17)beats/min vs.(403.96±7.08)beats/min],concentrations of myo-cardial collagen Ⅰ and Ⅲ,and ratio of collagen Ⅰ/Ⅲ [(13.5±0.9),(13.9±1.0)vs.(10.3±1.6)]in curcumin group,P <0.01 all.Masson staining indicated that acute myocardial infarction can cause significant left ventricular interstitial fibrosis.Conclusion:Curcumin could significantly improve cardiac function and inhibit myocardial fibro-sis level in rats with acute myocardial infarction.

Objective To evaluate the prognostic significance of MMP-2 , MMP-9 and Cathepsin-D expression in lymph node-negative human breast carcinoma. Methods Specimens from the primary breast tumors of 270 axillary lymph node negative breast cancer patients were studied for MMP-2 , MMP-9 and Cathepsin-D protein expression by immunohistochemical staining. Results The positive expression of MMP-2, MMP-9 and Cathepsin-D was 56.7%(153/270),59.6%(161/270) and 55.6%(150/270), respectively. In univariate analysis, MMP-2, MMP-9 and the co-expression of MMP-2 and MMP-9 were significantly associated with tumor free survival. In multivariate analysis, co-expression of MMP-2 and MMP-9 was unfavorablely related with tumor free survival(RR=2.487; P

Objective To discuss the expression of mitochondrial phosphate carrier (PiC) in myocardial injury caused by doxorubicin, and the protective mechanism of curcumin in myocardial injury caused by doxorubicin .Methods 60 adult SD rats were randomly divided into three groups:control group, doxorubicin group, curcumin+doxorubicin group.Control group was injected 0.9% sodium chloride injection (2.5 mL/kg) by rat tail vein injection, one times per week, 6 times in total.Doxorubicin group was injected with 0.5 mg/mL doxorubicin which diluted with 0.9% sodium chloride injection by rat tail vein injection, and the dosage was 1.25 mg/kg(about 0.5 mL).Curcumin+doxorubicin group was injected the same dose doxorubicin as doxorubicin group.After that, 12 mg/mL curcumin injection was added with 30mg/kg by rat tail vein injection.one times per week, 6 times in total.The glutathione peroxidase (Gpx) assay kit, superoxide dismutase (SOD) assay kit and malondialdehyde (MDA) detection kits were used to test the oxidative stress levels in myocardial cells of SD rats.Flow cytometry is used to test the SD rat cardiomyocytes transferred level. Application of Western blot and Real-time PCR technology were used to detect expression of PiC.ResuIts The Gpx activity and SOD vitality in myocardial cells of SD rats in curcumin with doxorubicin group all significantly increased compare with those of doxorubicin group, and all decreased compare with those of control group.But the rate of myocardial apoptosis, content of malondialdehyde and expression of Slc25a3 gene and PiC protein from myocardial cells of SD rats from curcumin with doxorubicin group all significantly increased compare with those of control group , and all decreased compare with those of doxorubicin group.ConcIusion Doxorubicin could increase the expression of PiC in myocardial mitochondria, the levels of oxidative stress, and the apoptosis of myocardial cells, and the effect of curcumin could be effective against the injury induced by doxorubicin .

Objective To assess medication literacy status of outpatients and analyze the effect of medication literacy on medication adherence. Methods Outpatients were investigated with Medication Literacy Assessment scale and Medication Adherence Scale in Tianjin Chest Hospital, Tianjin Huanhu Hospital and the Second Hospital of Tianjin Medical University in August 2017. Results The average score of Medication literacy scale of 200 outpatients was 7.60 ± 2.98. There were significant differences among the scores of Medication Literacy Assessment scale of different ages(F=9.444, P＜0.05) and education levels(F=26.682, P＜0.05). Logistic regression analysis showed that medication literacy had an impact on medication adherence in outpatients (P＜0.05). The medication compliance of outpatients with high medication literacy was 2.336 times as high as who with medium medication literacy and 18.529 times as high as who with low medication literacy, and the medication compliance of outpatients with medium medication literacy was 7.925 times as high as who with low medication literacy. Conclusion The medication literacy of outpatients was at the middle level, and most of the outpatients were poor in adherence. The higher the medication literacy level was, the better the medication adherence was; the lower medication literacy level was, the poorer medication adherence was. The medical staff could improve the medication adherence by improving the medication literacy to ensure the health of outpatients.

Objective To evaluate the clinical effects of autologous osteochondral transplantation for talar lesions after anterolateral tibial osteotomy.Methods Between October 2011 and June 2015,10 patients with osteochondral lesions on the lateral talar dome underwent autologous osteochondra] transplantation after anterolateral tibial osteotomy.All donor grafts were harvested from the lateral femoral condyle of the ipsilateral knee.They were 6 men and 4 women,aged from 25 to 54 years(average 35.8 years).According to Hepple classification,7 patients belonged to stage Ⅴ and 3 to stage Ⅳ.The lesion areas ranged from 110 mm2 to 247 mm2,averaging 178.6 mm2;the lesion depths ranged from 6 mm to 11 mm,averaging 7.8 mm.The ankle function and pain were assessed according to American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS) preoperatively and postoperatively.Results The 8 patients were followed up for an average of 31.6 months (from 18 to 51 months).All the patients achieved bone union 6 weeks after operation and were free of infection,malunion or hardware failure.The average AOFAS and VAS scores were improved from preoperative 65.5 and 6.9 to 91.3 and 1.3 at the last follow-up,respectively.Four cases were rated as excellent and 4 as good.Conclusions Anterolateral tibial osteotomy can provide excellent exposure of the lateral talar lesions for autologous osteochondral transplantation without problems related to the osteotomy itself.Also it may lead to good functional recovery in a short term.

Objective:To explore the relationship between triglyceride-glucose(TyG)index and bone mineral density(BMD)in elderly patients with type 2 diabetes mellitus(T2DM).Methods:Elderly inpatients with T2DM in Department of Geriatrics of the Second Xiangya Hospital of Central South University were enrolled from January 2019 to December 2021.General clinical characteristics and the calculated TyG index were collected.BMDs at the lumbar spine, femoral neck, and total hip were measured using dual-energy X-ray absorptiometry.Multiple linear regression was used to detect the correlation between TyG index and BMDs; Logistic regression analysis was used to analyze the relationship between TyG index and osteoporosis(OP)risk.Results:A total of 822 subjects were included in this study.In elderly men with T2DM, TyG index was significantly positively correlated with BMDs of lumbar spine( β=0.465, P=0.004), femoral neck( β=0.348, P=0.031)and total hip( β=0.317, P=0.022)after adjusting for confounders, but these results were not observed in elder women with T2DM(all P>0.05). Binary Logistic regression analysis showed that in elderly men with T2DM, after adjusting for confounders, the TyG index was a protective factor for osteoporosis( OR=0.349, 95% CI: 0.144-0.846, P=0.020). However, in elderly women with T2DM, the TyG index was not significantly associated with the risk of osteoporosis( OR=1.748, 95% CI: 0.782-3.912, P=0.174). Conclusions:TyG index, which is used to evaluate insulin resistance, is strongly and correlated with BMDs of lumbar spine, femoral neck and total femoral in elderly male patients with T2DM, and is a protective factor for osteoporosis.