Objective:To investigate the effects of marathon exercise on knee cartilage volume and T2 relaxation time (T2 value) based on MRI.Methods:From December 2018 to December 2021, 25 healthy volunteers without long-distance running habits and 32 non-professional marathon runners with long-term long-distance running were recruited to undergo knee MRI 3D water-selective excitation (three dimensional water-selective excitation, 3D-WATS) and T2 mapping imaging were performed, and the cartilage volumes in 5 knee areas and T2 values in 42 subareas were extracted for analysis. To compare the cartilage volume and its ratio to body surface area of knee joint of healthy volunteers and non-professional marathon runners, the T2 value of cartilage in each subregion, and the correlation between marathon exercise intensity and the volume and T2 value of cartilage in different regions.Results:Compared with healthy volunteers, there was no significant difference in cartilage volume or the ratio of body surface area to body volume of non-professional marathon runners ( P>0.05). There were significant differences between healthy volunteers and non-professional marathon runners in cartilage T2 values of the median layer of medial condyle of femur (47.61±5.65 ms and 44.29±6.10 ms) and the deep layer of medial condyle of femur (36.82±9.05 ms and 31.67±7.59 ms), deep precondylar area of medial femur (38.37±4.68 ms and 34.09±4.19 ms), shallow area of medial condylar area of femur (52.17±11.11 ms and 45.51±7.76 ms), middle layer of medial condylar area of femur (49.09±5.08 ms and 45.63±5.04 ms), medial layer of anterior condylar region of lateral femur (45.69±4.68 ms and 42.57±5.77 ms), superficial layer of posterior condylar region of lateral femur (55.42±18.41 ms and 47.99±8.39 ms), deep layer of anterior tibial medial plateau (33.40±7.76 ms and 29.03±5.69 ms), deep layer of posterior tibial medial plateau (31.28±5.02 ms and 27.92±5.99 ms), deep layer of patellofemoral surface (35.65±6.99 ms and 32.30±5.28 ms), respectively ( P<0.05). In non-professional marathon runners, the medial tibial plateau cartilage volume was negatively correlated with step frequency ( r=-0.371, P=0.035), the lateral femoral condylar cartilage volume was negatively correlated with step frequency ( r=-0.365, P=0.043), and the lateral tibial plateau cartilage volume was negatively correlated with step frequency ( r=-0.550, P=0.001). The T2 value of the medial layer cartilage in the anterior tibial medial plateau region was negatively correlated with body weight ( r=-0.277, P=0.039) and body mass index ( r=-0.290, P=0.030). The T2 value of the superficial layer of patellofemoral surface was negatively correlated with the amount of running in 3 months ( r=-0.457, P=0.010). The superficial T2 value in the posterior lateral plateau of the tibia was negatively correlated with stride length ( r=-0.437, P=0.014), and the medial layer cartilage T2 value in the anterior condylar area of the lateral femur was negatively correlated with stride frequency ( r=-0.380, P=0.035). Conclusion:Marathon exercise had little effect on the knee cartilage volume, but had a certain effect on the cartilage T2 value, resulting in changes in cartilage structure. The higher the step frequency, the smaller the cartilage volume. The greater the body weight or body mass index, the greater the amount of running in 3 months, and the greater the stride length, the lower the cartilage T2 value.

Objective:To analyze the compliance and related factors of low-dose computed tomography (LDCT) screening among the high-risk population of lung cancer in three provinces participating in the cancer early diagnosis and early treatment program in urban areas of China.Methods:From October 2017 to October 2018, 17 983 people aged between 40 and 74 years old at high risk of lung cancer were recruited from Zhejiang, Anhui and Liaoning provinces. The basic demographic characteristics, living habits, history of the disease and family history of cancer were collected by using a cancer risk assessment questionnaire, and the data of participants examined by LDCT were obtained from the hospitals participating in the program. The screening compliance was quantified by the screening participation rate, and it was calculated as the proportion of participants completing LDCT scan among high-risk population. The related factors of LDCT screening compliance were analyzed by using a multivariate logistic regression model.Results:The age of 17 983 participants was (56.52±8.22) years old. Males accounted for 51.9% (N=9 332), and 69.5% (N=12 495) had ever smoked, including former smokers and current smokers. A total of 6 269 participants were screened by LDCT, and the screening participation rate was 34.86%. The results of multivariate logistic regression analysis showed that the age group of 50 to 69 years old, female, passive smokers, alcohol consumption, family history of lung cancer and history of chronic respiratory diseases were more likely to be screened by LDCT, while the compliance of LDCT screening in current smokers was low.Conclusions:The LDCT screening compliance of the high-risk population of lung cancer in urban areas of China still needs to be improved. Age, sex, smoking, drinking, family history of lung cancer and history of chronic respiratory disease are associated with screening compliance.

Objective:To analyze the compliance and related factors of low-dose computed tomography (LDCT) screening among the high-risk population of lung cancer in three provinces participating in the cancer early diagnosis and early treatment program in urban areas of China.Methods:From October 2017 to October 2018, 17 983 people aged between 40 and 74 years old at high risk of lung cancer were recruited from Zhejiang, Anhui and Liaoning provinces. The basic demographic characteristics, living habits, history of the disease and family history of cancer were collected by using a cancer risk assessment questionnaire, and the data of participants examined by LDCT were obtained from the hospitals participating in the program. The screening compliance was quantified by the screening participation rate, and it was calculated as the proportion of participants completing LDCT scan among high-risk population. The related factors of LDCT screening compliance were analyzed by using a multivariate logistic regression model.Results:The age of 17 983 participants was (56.52±8.22) years old. Males accounted for 51.9% (N=9 332), and 69.5% (N=12 495) had ever smoked, including former smokers and current smokers. A total of 6 269 participants were screened by LDCT, and the screening participation rate was 34.86%. The results of multivariate logistic regression analysis showed that the age group of 50 to 69 years old, female, passive smokers, alcohol consumption, family history of lung cancer and history of chronic respiratory diseases were more likely to be screened by LDCT, while the compliance of LDCT screening in current smokers was low.Conclusions:The LDCT screening compliance of the high-risk population of lung cancer in urban areas of China still needs to be improved. Age, sex, smoking, drinking, family history of lung cancer and history of chronic respiratory disease are associated with screening compliance.

Objective:To explore the clinical efficacy of Budesonide and Formoterol Fumarate Powder in the treatment of patients with bronchial asthma and its effect on the serum levels of inflammatory factors.Methods:123 cases treated and diagnosed as bronchial asthma in our hospital from February,2014 to February,2016 were randomly divided into the observation group (65 cases) and control group (58 cases).The serum levels of IL-17,IL-33,MMP-9,pulmonaryfunction,quality of life,total effective rate and incidence of adverse reactions were compared between the two groups.Results:The total effective rate of observation group was 92.3％,which was significantly higher than that of the control group (81.03％,P＜0.05).After therapy,the serum level ofIL-17,IL-33 in both groups were largely decreased compared with those before therapy (p＜0.05),and those of observation group were significantly lower than the control group (p ＜0.05);the serum level of MMP-9 in both groups showed no statistical difference compared with that of before therapy.Similarly,the level of FEV1,PEF and FEV1/FVC of observation group were obviously increased compared with those before therapy (p＜0.05) and were significantly higher than those of the control group (p＜0.05);the quality of life in the observation group was better than that of the control group based on the SGRQ score (p ＜0.05).Conclusion:Budesonide and Formoterol Fumarate Powder was effective on the patients with chronic bronchial asthma,which could control the inflammatory reactions,improve the pulmonary function as well as the quality of life.

AIM: To investigate the effects of metformin on airway inflammation, remodeling and neovascularization in a mouse model of chronic asthma and its possible mechanisms.METHODS: BALB/c mice were randomly divided into saline group, ovalbumin (OVA) group and OVA+metformin group, with 8 in each.At the end of OVA exposure, blood and bronchoalveolar lavage fluid (BALF) were collected for the measurement of OVA specific IgE and leukocyte counts.Lung tissue sections were stained with hematoxylin-eosin, periodic acid-Schiff and Masson's trichrome to detect inflammatory cell infiltration, goblet cell hyperplasia, and collagen deposition around the airway, respectively.Immunohistochemistry was used to evaluate the number and percentage area of new blood vessels (CD31+), and the protein level of phosphorylated AMP-activated protein kinase (p-AMPK) in the airway.RESULTS: Compared with saline group, the eosinophil percentage and OVA specific IgE in serum in OVA group were all increased obviously (P<0.01).Metformin inhibited the above increases (P<0.05).Compared with control group, a marked increase in inflammation infiltration, PAS+ cells and collage deposition in the airway mucosa in OVA group were observed.Metformin partially relieved the above changes.CD31+ vessels in the wall of bronchi showed the abundance of blood vessels observed in OVA group compared with control group, which was suppressed by the treatment with metformin (P<0.05).The protein level of p-AMPK was reduced in the lung tissue challenged with OVA as compared with control group (P<0.05), while metformin increased the protein level of p-AMPK (P<0.01).CONCLUSION: The protein level of p-AMPK in the airway in OVA group is attenuated.Metformin effectively inhibits airway inflammation, remodeling and neovascularization possibly via activating AMPK signaling pathway.

Objective To investigate the effects of dexmedetomidine continuous intravenous infusion on the hemodynamic response of ephedrine and the recovery process of patients undergoing neck surgery under general anesthesia.Methods Select elective fitting line surgery under general anesthesia of 100 patients with cervical disease from January 2015 to December 2015 in the First People's Hospital of Yongkang,randomly divided into low dose group and high dose group, 50 cases in each group, before induction of anesthesia, patients received continuous intravenous pumping of dexmedetomidine 0.4μg/kg in low dose group or 0.8μg/kg in high dose group,after ten mins 0.4μg/kg prior to anesthesia induction,until the end of operation withdrawal;5 min after laryngeal mask insertion, ephedrine 0.1 mg/kg were intravenous administered in two groups.Observe the following indicators:the after entering the operation room ( T0 ) , anesthesia before induction ( T1 ) , after induction ( T2 ) , administration of ephedrine ( T3 ) , the maximum value time(TBP,THR) of heart rate and blood pressure in 10 minutes.Increased of HR,SBP,DBP,recovery related indicators.Results HR, SBP and DBP levels compared no significant difference of T0 with two groups,T1, T2 and T3,HR,SBP, DBP were lower than T0 with two groups(P<0.05),high dose group were lower than low dose group of HR, SBP, DBP(P <0.05);TBP and THR no significant difference of two groups,high dose group were higher than low dose group of Increased of HR,SBP,DBP(P<0.05);high dose group were lower than low dose group of after extubation cough score and sedation agitation score(P<0.05).Spontaneous breathing recovery time and extubation time, called the open time, orientation recovery time,the difference between the two groups was not statistically significant.Conclusion 0.8μg/kg dexmedetomidine continuous intravenous injection of ephedrine in patients with neck pressor effect stronger than the 0.4μg/kg,0.8μg/kg compared with 0.4μg/kg can reduce the recovery period of cough and restlessness,different doses had no effect on recovery.

Objective To assess the health-related quality of life in elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods The patients were collected from the outpatient department,a tertiary hospital in ShaanXi Province.The demographic characteristics such as age,gender,weight and height were collected.Spirometry was performed for every patient after salbutamol 400 μg was inhaled.6-minute walk test was done according to the guidelines which developed by American Thoracic Society in 2002.Four questionnaires,including COPD Assessment Test (CAT),Clinical COPD Questionnaire-week Version (CCQ),St George's Respiratory Questionnaire for COPD Patients (SGRQ-C) and Chronic Respiratory Questionnaire-Self Administered Standardized Activities-First Administration Version (CRQ-SAS),were answered by every participant.Results Totally 90 participants were enrolled between September 2013 and September 2014.75 cases(83.3％) were male and 70 cases (77.8％) were smokers or ex-smokers,the mean age was (67.8±9.7)years,and the mean educational history was (8.9±3.0)years.The mean body mass index was (23.3 ± 3.6) kg/m2,and the mean post-brochodilator FEV1 was (51.2 ± 18.7) ％ predicted.The average 6-minute walk distance was (424.5 ± 99.1) meters.The average scores of CAT and CCQ were(20.4±6.9) and (2.4±0.8),respectively.The mean SGRQ-C score was (38.5 ± 16.2).The symptoms,activity and impacts average scores of SGRQ-C were (64.3± 18.8),(45.1 ±21.3) and (25.7 ± 16.1).For CRQ-SAS,the average scores of dyspnea,fatigue,emotional function and mastery were (2.9±1.3),(2.9±1.1),(3.0±1.1) and (2.9±1.1),respectively.There was a weak correlation between FEV1 and each questionnaire scores.There was a moderate correlation between 6-minute walk distance and SGRQ-C,CCQ and CRQ-SAS.However,there was a weak correlation between CAT and 6-minute walk distance.For 6-minute walk distance,activity score of SGRQ-C,impacts score of SGRQ-C and history of coronary artery disease were independent influencing factors.For BODE index,activity and impacts score of SGRQ-C were independent influencing factors.Conclusions CAT,CCQ,SGRQ-C and CRQ-SAS are suitable to assess health-related quality of life for elderly patients with stable COPD,among four questionnaires,SGRQ-C is the best one.

Objective To evaluate the effect of preoperative sleep disturbance on efficacy of postoperative analgesia and comfort in patients undergoing colorectal cancer resection surgery.Methods 60 colorectal cancer patients with elective anesthesia laparoscopic radical resection were selected.According to the presence or absence of preoperative sleep disorders,they were divided into the sleep disorder group (group A) and non-sleep disorders group (group B),30 patients in each group.Two groups of patients used the same method to maintain anesthesia induction.Intraoperative intravenous nicardipine controlled hypotension in parallel to maintain MAP 60-75mmHg,HR 65-95times/min.The patients received PCIA pump at the end of surgery.Postoperative 24h VAS scores were maintained VAS score ≤3 points,when VAS score ＞ 3 points,given the pressing PCA analgesia remedy.The remedy situation within 24 hours after surgery and comfort analgesic score were recorded.Results Compared with group B,postoperative PCIA pressing number of group A significantly increased [A group:(11 ± 5),group B:(6 ± 5),t =2.44,P ＜ 0.05].At the end of surgery,postoperative 2h,4h,8h pain scores of group A were (2.8 ± 0.4),(2.5 ± 0.7),(3.2 ± 0.6),(3.5 ± 0.5),respectively,which were significantly higher than those of group B [(1.8 ± 0.5) points,(1.8 ± 0.4) points,(1.9 ± 0.3) points,(2.9 ± 0.3) points; at the end of surgery t =5.78,postoperative 2h t =4.56,postoperative 4h t =4.17,postoperative 8h t =2.09,all P ＜ 0.05],but postoperative 12h,24h had no significant change in pain scores (P ＞ 0.05).Compared with group B,the comfort scores of A group at the end of surgery,postoperative 2h,4h,8h,12h[group A:(2.8 ±0.3) points,(2.5 ±0.9)points,(2.6 ±0.9) points,(2.5 ±0.5) points,(2.9 ± 0.6) points ; group B:(3.8 ± 0.4) points,(3.3 ± 0.5) points,(3.6 ± 0.8) points,(3.3 ± 0.3) points,(3.3 ± 0.6) points] were significantly lower (at the end of surgery t =9.87 ; postoperative 2h t =4.94 ; postoperative 4h t =6.87 ; postoperative 8h t =7.61 ; postoperative 12h t--2.79,all P ＜ 0.05),after 24h comfort score had no significant change (P ＞ 0.05).Conclusion Preoperative sleep disorders can affect laparoscopic colorectal cancer after radical surgery analgesia and comfort of patients.

Objective To evaluate the value of MR threedimensional arterial spin labeling (3D-ASL) perfusion imaging and intravoxel incoherent motion(IVIM) DWI in differential diagnosis and quantitative analysis of musculoskeletal tumors.Methods Forty-four patients with musculoskeletal tumors were included.According to pathologic results,there were 12 cases of benign tumors,10cases of intermediate tumors and 22 cases of malignant tumors.3D-ASL and IVIM DWI were both performed on forty-four patients to gain tumor blood flow (TBF),standard ADC (ADCstandard),slow ADC (ADCslow)and fast ADC (ADCfast).Immunohistochemical staining of specimens was performed by using CD34 monoclonal antibody to calculate microvessel density (MVD) counts.MVD,TBF,ADCfast and ADCslow of different groups were compared by one-way ANOVA analysis.ADCstandard was compared by Kruskal-Wallis test.ROC curve was used to analyze ASL and IVIM DWI,in order to determine the threshold and diagnostic reliability.Results The MVD of benign tumors was 10±4,the MVD of intermediate tumors was 15±6,and malignant tumors was 33 ± 1 1.There was significant difference among three groups of MVD(F=28.33,P＜0.05).There was better intra-observer agreement for ADCstandard,ADCfast,ADCslow and TBF(ICC=0.970,0.885,0.778,0.891,respectively,P＜0.05).The TBF of benign tumors was(30±10)ml· min-1· 100 g-1,intermediate tumors was(30± 12) ml·min 1· 100 g-1,and malignant tumors was(84±29)ml·min 1· 100 g-1.There was significant difference among three groups of TBF(F=32.34,P＜0.05).According to the ROC analysis,when the cut-offvalue of TBF was 45.5 ml·min-1· 100 g-1,the area under ROC curve was 0.95 1,and the sensitivity and specificity of TBF in diagnosing malignant tumors were 90.9％ and 95.5％ respectively.There was no significant difference among three groups of ADCstandard,ADCfastand ADCslow of benign tumors were(9.9±5.1)× 10-3,(1.9±0.5) × 10-3mm2/s respectively.ADCfast and ADCalow of intermediate tumors were(8.2 ± 3.6) × 10-3,(1.5 ± 0.6) × 10-3mm2/s respectively.ADCfast and ADCalow of malignant tumors were (16.9 ± 5.8) × 10 3,(1.4 ± 0.6) × 10-3mm2/s respectively.There were significant difference of ADCfast and ADCslow among three groups (F=12.75,5.60,P＜ 0.05).According to the ROC analysis,when the cut-off value of ADCfast was 9.4× 10-3mm2/s,the area under ROC curve was 0.861,the sensitivity and specificity of them in diagnosing malignant tumors were 95.5％ and 68.2％ respectively.Conclusion 3D-ASL and IVIM DWI are valuable in the differential diagnosis of musculoskeletal tumors.

Objective To investigate the effects of dexmedetomidine combined with sevoflurane on elderly patients with postoperative recovery quality.Methods Selected 60 cases of abdominal rectal cancer resection for elderly patients,which were ASA I or II,were randomly divided into two groups by a random number table method, while each groupincluded 30 cases:the control group( group N) and the dexmedetomidine group( group D) .Before the induction of anesthesia,group D vein was injected with micro pump ( more than 10 min) of dexmedetomidine 1μg/kg ( which was formulated with physiological saline as 4μg/mL) ,and then was given to maintain the dexmedetomidine 0.5μg/h and N group was injected with micro pump of the same volume of normal saline.The two groups of anesthesia were same,by which the static inhalation of composite general anesthesia.Observation were recorded before induction of anesthesia(T0),given dexmedetomidine(TI),after intubation 1 min(T1),5 min(T2),drawing tube immediately (T3),extubation after 5min(T4),30min(T5)the time of HR,BP,SpO2,BIS;propofol and remifentanil dosage,opera-tive time,operation time,a nesthesia time,recovery time,drawing tube time,extubation after Ramsay Sedation score, pain score,patient satisfaction and adverse reactions were recorded.Results In T3 period,the changes of HR (82 ± 14)times/min,SBP (130 ±8)mmHg,DBP (85 ±13)mmHg in group N were more obvious than (70 ±12)timse/min, SBP (121 ±7)mmHg,DBP (79 ±9)mmHg in group D,the difference between the two groups had statistical signifi-cance(t=6.28,4.63,2.08,all P<0.05).In T5 period,the levels of blood glucose (5.3 ±1.1)mmol/L and cortisol (402 ±78) nmol/L and ( 0.260 ±0.044 ) ng/L in group D were significantly lower than ( 5.9 ±1.2 ) mmol/L, (550 ±92)nmol/L,IL-6 (0.300 ±0.066)ng/L in group N(t=2.02,6.72,2.76,all P<0.05).However,the composite of dexmedetomidine group D patients with respiratory recovery time(7.5 ±2.3)min,calling the eyes open time(7.8 ±2.5) min,pull out the time of endotracheal tube (14.2 ±3.3) min compared with groups N of patients with respiratory recovery time (7.8 ±2.5)min,calling the eyes (14.8 ±3.2)min,pull out the time of endotracheal tube (13.9 ±3.1)min,showed no statistical significance (t=0.88,0.44,0.36,all P>0.05).In group N,postoper-ative restlessness in 8 cases,nausea and vomiting in 10 cases,chills in 9 cases,which were significantly higher than 2 cases,2 cases,2 cases in group D(χ2 =4.32,6.67,5.45,all P<0.05).At the same time,the satisfaction score of patient in group D (3.0 ±0.3)point,which was significant higher than (2.7 ±0.5)points in group N (t=1.88,P<0.05).Conclusion Dexmedetomidine detomidine composite sevoflurane anesthesia can improve the postoperative re-covery quality of elderly patients with rectal cancer radical surgery.