BACKGROUND:Acute exercise tends to cause skeletal muscle tissue damage and lipid metabolism disorders in vivo,but the mechanism by which acute exercise combined with electroacupuncture modulates metabolic and autophagic pathways in vivo is unclear. OBJECTIVE:To observe the changes in metabolic enzymes and autophagy levels in skeletal muscle of rats subjected to acute exercise by electroacupuncture at the acupoints of"Zusanli"and"Huantiao." METHODS:Fifty male Sprague-Dawley rats were randomly divided into three groups:quiet control group(n=10),model group(n=20),and reverse electroacupuncture group(n=20).The latter two groups were set up with two time points,i.e.immediate and 3 hours after exercise groups(n=10 per time point).The model group and the reverse electroacupuncture group underwent acute exercise training after adaptive treadmill training.The rats in the reverse electroacupuncture group underwent electroacupuncture treatment(parameters:electroacupuncture on both sides of the rats at the acupoints of"Zusanli"and"Huantiao,"continuous wave,frequency of 2 Hz,intensity of 2 mA,leaving the needle in the body for 30 minutes,once a day for 7 consecutive days)before treadmill training.Bilateral gastrocnemius muscle tissues were taken under anesthesia immediately after exercise and 3 hours after exercise,and hematoxylin-eosin staining was used to observe the histopathological changes of rat skeletal muscle.ELISA kit was used to detect the activities of hepatic lipase,fatty acid synthase,hormone-sensitive lipase,and carnitine palmitoyltransferase 1 in rat skeletal muscle tissues.Immunohistochemistry and western blot were used to detect the changes in the expression of autophagy genes. RESULTS AND CONCLUSION:After hematoxylin-eosin staining,the arrangement of gastrocnemius muscle fibers in the model group was disturbed,swollen and ruptured immediately after exercise and 3 hours after exercise.In the reverse electroacupuncture group,gastrocnemius muscle fibers were tightly arranged and the number of swollen and ruptured cells was greatly reduced immediately after exercise and 3 hours after exercise,and there was no significant difference when compared with the quiet control group.Compared with the quiet control group,the activities of hepatic lipase and fatty acid synthase were lower while the activities of lipoprotein lipase,hormone-sensitive lipase,and carnitine palmitoyltransferase 1 were higher in the model group and the reverse electroacupuncture group 3 hours after exercise(P＜0.05 or P＜0.01).Compared with the model group,the activities of lipoprotein lipase and carnitine palmitoyltransferase 1 were higher in the reverse electroacupuncture group immediately after exercise(P＜0.05),while the activity of lipoprotein lipase was higher and the activity of hormone-sensitive lipase was lower in the reverse electroacupuncture group 3 hours after exercise(P＜0.01).Immunohistochemical results showed that compared with the quiet control group,the expression of P62,autophagy-related gene 5 and autophagy-related gene 7 was higher in the model group immediately and 3 hours after exercise,as well as in the reverse electroacupuncture group immediately after exercise(P＜0.05 or P＜0.01);compared with the model group,the expression of P62 and autophagy-related gene 7 was lower in the reverse electroacupuncture group immediately and 3 hours after exercise(P＜0.05).Western blot results showed that the protein expression of P62 and autophagy-related gene 7 in the reverse electroacupuncture group was lower than that in the model group immediately after exercise(P＜0.05);the protein expression of Parkin in the model group was higher than that in the quiet control group immediately and 3 hours after exercise(P＜0.05);and the protein expression of Parkin in the reverse electroacupuncture group was lower than that in the model group immediately and 3 hours after exercise(P＜0.05).To conclude,acute exercise induces disorders,swelling and rupture of gastrocnemius muscle fibers in rats and electroacupuncture on both sides of the acupoints of"Zusanli"and"Huantiao"can improve the level of lipid metabolism and regulate autophagy cells in rat skeletal muscle,preventing the disorders of lipid metabolism and damage of gastrocnemius muscle tissues caused by acute exercise.The mechanism may be closely related to the regulation of autophagy-related factor P62,autophagy-related gene 5,autophagy-related gene 7,and Parkin protein expression to promote the occurrence of autophagy or regulate the autophagy pathway in rat skeletal muscle cells.

Obesity, as a chronic recurrent disease, has become a major public health challenge in China. To implement the requirements of the Healthy China Initiative (2019—2030), under domestic guidelines or consensus statements on overweight and obesity, and in alignment with the latest scientific advances globally, the Quality control protocol for adult overweight and obesity screening in health management (examination) institutions (2025 edition) was developed. This protocol was drafted by the Health Management Center of Shanghai Changzheng Hospital and formulated through multiple rounds of deliberation by experts in China’s health examination quality control field. The protocol establishes unified standards for screening facilities, personnel qualifications, and measurement or testing procedures. It defines specific screening items, outlines a standardized screening pathway, and sets requirements for the final medical review, ensuring the scientific validity, effectiveness, and safety of the screening process. The implementation of this protocol will enhance the consistency of weight management practices for adults across health examination institutions and strengthen the quality control of overweight and obesity screening programs.

Objective:To investigate the association between serum ferritin (SF), blood lipid levels and hyperuricemia in middle-aged and elderly individuals with normal body mass(BMI).Methods:A retrospective study was conducted on 1 671 participants with normal BMI from health check-ups at Wusong Hospital of Zhongshan Hospital, Fudan University from January 2019 to December 2021. Collected data included fasting plasma glucose (FPG), uric acid, creatinine (CREA), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and SF levels. SF, TC, LDL-C, and HDL-C were grouped by quartiles, linear regression and Pearson correlation analysis used to assess their associations with hyperuricemia.Results:Among 1 671 normal-weight middle-aged and elderly individuals, 250 cases of hyperuricemia were identified, yielding a prevalence of 14.96% (250/1 671). Pearson analysis revealed: a moderate positive correlation between SF and uric acid levels ( r = 0.500, P<0.01); a weak positive correlation between TC and uric acid levels ( r = 0.250, P<0.01); a moderate negative correlation between HDL-C and uric acid levels ( r = - 0.333, P<0.01); a weak-to-moderate positive correlation between LDL-C and uric acid levels ( r = 0.380, P<0.01). Additionally, male gender showed a moderate positive correlation with uric acid levels ( r = 0.575, P<0.01), while CREA demonstrated a positive correlation with uric acid ( r = 0.620, P<0.05). Conclusions:In normal-weight middle-aged and elderly populations, gender, TG, TC, LDL-C and SF exhibite positive correlations with uric acid levels, with stronger associations observed for gender, CREA, and SF. HDL-C show a negative correlation with uric acid levels.

Objective:To investigate the effects of target-oriented liquid therapy on the treatment outcomes of skin grafting in patients with severe burns.Methods:A total of 60 patients with severe burns (total burn area over 20%, and deep second-degree burn area ≥ 10%) who were scheduled for skin graft surgery at the Marine Police Corps Hospital of Chinese People's Armed Police Force from January 2019 to January 2022 were included in this cohort study. The patients were randomly divided into a control group (conventional fluid therapy) and an observation group (target-oriented fluid therapy) using a random number table method, with 30 patients in each group.The levels of lactate (Lac) and high-sensitivity cardiac troponin I (cTnI) were compared between the two groups. The usage of colloid and crystalloid fluids, urine output, length of hospital stay, and the incidence of complications were compared between the two groups.Results:At the end of the surgery, the levels of Lac and cTnI in the observation group were (1.13 ± 0.22) mmol/L and (0.95 ± 0.25) μg/L, respectively, both of which were significantly lower than those in the control group [(1.52 ± 0.34) mmol/L, (1.10 ± 0.31) μg/L; t = 5.24, 0.83, P < 0.001, P = 0.044]. The differences in Lac and cTnI levels in the observation group were (0.53 ± 0.36) and (0.13 ± 0.07), respectively, which were significantly greater than those in the control group [(0.23 ± 0.16), (0.02 ± 0.01), t = -4.17 and -3.45, P < 0.001, P = 0.001]. The volumes of colloid and crystalloid fluids and the length of hospital stay in the observation group were (960.25 ± 153.32) mL, (1 680.52 ± 253.08) mL, and (51.36 ± 17.25) days, respectively. These values were significantly lower or shorter than those in the control group [(1 459.73 ± 203.41) mL, (2 401.89 ± 301.23) mL, (81.05 ± 25.08) days, t = 10.74, 10.04, 5.34,all P < 0.001]. The incidences of postoperative infection, pneumonia, and arrhythmia in the observation group were 33.33% (10/30), 16.67% (5/30), and 16.67% (5/30), respectively, which were significantly lower than those in the control group [63.33% (19/30), 46.67% (14/30), 30.00% (15/30); χ2 = 5.41, 6.24, 7.50, P = 0.020, P = 0.013, P = 0.006]. However, there was no statistically significant difference in acute lung injury, heart failure, and myocardial injury between the two groups ( χ2 = 1.36, 1.92, 0.29; P = 0.243, 0.166, 0.592). Conclusions:Compared with traditional fluid replacement therapy, target-oriented fluid therapy has a more significant therapeutic effect on patients with severe burns. It not only reduces fluid usage and the length of hospital stay but also decreases the incidence of infection, pneumonia, and arrhythmia in these patients.

Objective:To investigate the association between serum ferritin (SF), blood lipid levels and hyperuricemia in middle-aged and elderly individuals with normal body mass(BMI).Methods:A retrospective study was conducted on 1 671 participants with normal BMI from health check-ups at Wusong Hospital of Zhongshan Hospital, Fudan University from January 2019 to December 2021. Collected data included fasting plasma glucose (FPG), uric acid, creatinine (CREA), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and SF levels. SF, TC, LDL-C, and HDL-C were grouped by quartiles, linear regression and Pearson correlation analysis used to assess their associations with hyperuricemia.Results:Among 1 671 normal-weight middle-aged and elderly individuals, 250 cases of hyperuricemia were identified, yielding a prevalence of 14.96% (250/1 671). Pearson analysis revealed: a moderate positive correlation between SF and uric acid levels ( r = 0.500, P<0.01); a weak positive correlation between TC and uric acid levels ( r = 0.250, P<0.01); a moderate negative correlation between HDL-C and uric acid levels ( r = - 0.333, P<0.01); a weak-to-moderate positive correlation between LDL-C and uric acid levels ( r = 0.380, P<0.01). Additionally, male gender showed a moderate positive correlation with uric acid levels ( r = 0.575, P<0.01), while CREA demonstrated a positive correlation with uric acid ( r = 0.620, P<0.05). Conclusions:In normal-weight middle-aged and elderly populations, gender, TG, TC, LDL-C and SF exhibite positive correlations with uric acid levels, with stronger associations observed for gender, CREA, and SF. HDL-C show a negative correlation with uric acid levels.

Objective:To investigate the effects of target-oriented liquid therapy on the treatment outcomes of skin grafting in patients with severe burns.Methods:A total of 60 patients with severe burns (total burn area over 20%, and deep second-degree burn area ≥ 10%) who were scheduled for skin graft surgery at the Marine Police Corps Hospital of Chinese People's Armed Police Force from January 2019 to January 2022 were included in this cohort study. The patients were randomly divided into a control group (conventional fluid therapy) and an observation group (target-oriented fluid therapy) using a random number table method, with 30 patients in each group.The levels of lactate (Lac) and high-sensitivity cardiac troponin I (cTnI) were compared between the two groups. The usage of colloid and crystalloid fluids, urine output, length of hospital stay, and the incidence of complications were compared between the two groups.Results:At the end of the surgery, the levels of Lac and cTnI in the observation group were (1.13 ± 0.22) mmol/L and (0.95 ± 0.25) μg/L, respectively, both of which were significantly lower than those in the control group [(1.52 ± 0.34) mmol/L, (1.10 ± 0.31) μg/L; t = 5.24, 0.83, P < 0.001, P = 0.044]. The differences in Lac and cTnI levels in the observation group were (0.53 ± 0.36) and (0.13 ± 0.07), respectively, which were significantly greater than those in the control group [(0.23 ± 0.16), (0.02 ± 0.01), t = -4.17 and -3.45, P < 0.001, P = 0.001]. The volumes of colloid and crystalloid fluids and the length of hospital stay in the observation group were (960.25 ± 153.32) mL, (1 680.52 ± 253.08) mL, and (51.36 ± 17.25) days, respectively. These values were significantly lower or shorter than those in the control group [(1 459.73 ± 203.41) mL, (2 401.89 ± 301.23) mL, (81.05 ± 25.08) days, t = 10.74, 10.04, 5.34,all P < 0.001]. The incidences of postoperative infection, pneumonia, and arrhythmia in the observation group were 33.33% (10/30), 16.67% (5/30), and 16.67% (5/30), respectively, which were significantly lower than those in the control group [63.33% (19/30), 46.67% (14/30), 30.00% (15/30); χ2 = 5.41, 6.24, 7.50, P = 0.020, P = 0.013, P = 0.006]. However, there was no statistically significant difference in acute lung injury, heart failure, and myocardial injury between the two groups ( χ2 = 1.36, 1.92, 0.29; P = 0.243, 0.166, 0.592). Conclusions:Compared with traditional fluid replacement therapy, target-oriented fluid therapy has a more significant therapeutic effect on patients with severe burns. It not only reduces fluid usage and the length of hospital stay but also decreases the incidence of infection, pneumonia, and arrhythmia in these patients.

Objective To observe the effects of exercise combined with probiotic intervention on glycolipid metabolism,oxidative stress,and skeletal muscle satellite cell expression in type 2 diabetic rats.Methods From 60 8-week-old SPF-grade SD male rats,10 rats were randomly selected as the normal control group(NC),and the rest were injected intraperitoneally with streptozotocin,establishing a rat model of type 2 diabetes mellitus.The diabetic rats were randomly divided into model(TN),exercise+diabetes(YTN),probiotic+diabetes(GTN),and exercise+probiotics+diabetes(YGTN)groups.The exercise groups were subjected to 6 weeks of incremental load aerobic treadmill exercise(speed of 15 m/min for 30 min in week 1,15 m/min for 60 min in week 2,and 19.3 m/min for 60 min in weeks 3～6,with continuous training until week 6,5 days/week).The GTN and YGTN groups were administered 10.0 mL/(kg·d)of Lactibiane Iki probiotic solution(concentration of 107 CFU/mL)one hour before training.Glycolipid metabolism indexes,oxidative stress indexes,and expression of skeletal muscle satellite cell proteins were measured in rats.Results(1)The levels of fasting plasma glucose(FBG),fasting serum insulin(FINS),hemoglobin Alc(HBA1C)and(homeostasis model assessment-insulin resistance index(HOMA-1R)were higher in the TN,YTN,GTN,and YGTN groups than in the NC group(P＜0.01).The levels of FBG in the YGTN group were lower than those in the TN,YTN,GTN,and YGTN groups(P＜0.05).Serum FINS levels in YTN,GTN and YGTN groups were all decreased compared with those in the TN group(P＜0.01).Serum HBA1C levels were lower in the YGTN group than the TN,YTN,and GTN groups(P＜0.01).The HOMA-IR indices of rats in the YGTN group decreased more significantly compared with those in the TN,YTN,and GTN groups(P＜0.01).The result showed that FBG,FINS,HBA1C,and HOMA-IR decreased more significantly in rats in the aerobic exercise combined with probiotic intervention group than the other intervention groups.(2)Serum total cholesterol(T-CHO),triglyceride(TG),low density lipoprotein cholesterol(LDL)and free fatty acid(FFA)levels in the TN group were higher than those in the NC group(P＜0.05),and those of the YGTN group were lower than those of the TN group(P＜0.05)and basically restored to the level of the NC group.Serum high density lipoprotein cholesterol(HDL)levels were lower in the TN group than the NC group(P＜0.05),Serum HDL levels of rats in TN group were lower than those of the NC group(P＜0.05),and those in the YGTN group were higher than those of TN group(P＜0.05),which were basically restored to the level of NC group.The result showed that aerobic exercise combined with probiotic intervention reduced serum T-CHO,TG,LDL,FFA levels and increased HDL levels more significantly than other interventions in diabetic rats.(3)Serum malondialdehyde(MDA)and 8-iso-prostaglandin F2α(8-isoPGF2α)levels of rats in the TN group were higher than those in the NC group(P＜0.05 or P＜0.01),and those of rats in the YGTN group were lower than those in the TN group(P＜0.05 or P＜0.01).Serum catalase(CAT),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)and total antioxidant capacity(T-AOC)in the TN group were lower than those in the NC group(P＜0.01),and those of rats in the YGTN group were higher than those of the NC group(P＜0.01)and were basically restored to the levels of NC group.(4)The protein expression levels of paired box gene 7(Pax7),myogenic determination gene(MyoD),myogenin(MyoG)and myogenic factor 5(Myf5)in the skeletal muscle of rats in the TN group were lower than those in the NC group(P＜0.05 or P＜0.01),and these levels were higher in the YGTN group than the TN group(P＜0.05 or P＜0.01);basically,the levels were restored to those of the NC group.In the TN group,myostatin(MSTN)protein expression was higher in the TN group than the NC group(P＜0.05),and that in the YGTN group was lower than that in the TN group(P＜0.05)and basically restored to the level of the NC group.Conclusions The result showed that probiotics and aerobic exercise had a synergistic effect in improving blood glucose and insulin levels,attenuating insulin resistance,improving lipids and oxidative radicals,and preventing the phenomenon of disturbed glucose metabolism,thus achieving dynamic equilibrium regulation in type 2 diabetic rats.Aerobic exercise combined with probiotics also promoted myoblast differentiation,which played a role in preventing T2DM-induced loss of muscle mass and strength as well as muscle tissue complications.

Artificial vascular graft(AVG)fistula is widely used for hemodialysis treatment in patients with renal failure.However,it has poor elasticity and compliance,leading to stenosis and thrombosis.The ideal artificial blood vessel for dialysis should replicate the structure and components of a real artery,which is primarily maintained by collagen in the extracellular matrix(ECM)of arterial cells.Studies have revealed that in hepatitis B virus(HBV)-induced liver fibrosis,hepatic stellate cells(HSCs)become hyperactive and produce excessive ECM fibers.Furthermore,mechanical stimulation can encourage ECM secretion and remodeling of a fiber structure.Based on the above factors,we transfected HSCs with the hepatitis B viral X(HBX)gene for simulating the process of HBV infection.Subsequently,these HBX-HSCs were implanted into a polycaprolactone-polyurethane(PCL-PU)bilayer scaffold in which the inner layer is dense and the outer layer consists of pores,which was mechanically stimulated to promote the secretion of collagen nanofiber from the HBX-HSCs and to facilitate crosslinking with the scaffold.We obtained an ECM-PCL-PU composite bionic blood vessel that could act as access for dialysis after decellularization.Then,the vessel scaffold was implanted into a rabbit's neck arteriovenous fistula model.It exhibited strong tensile strength and smooth blood flow and formed autologous blood vessels in the rabbit's body.Our study demonstrates the use of human cells to create biomimetic dialysis blood vessels,providing a novel approach for creating clinical vascular access for dialysis.

Objective:To compare the efficacy of standardized incision and conventional incision for reduction and internal fixation of multiple rib fracture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 192 patients with multiple rib fracture treated in 909th Hospital of Joint Logistics Support Force (Affiliated Dongnan Hospital of Xianmen University Medical College) from January 2020 to January 2022. There were 101 males and 91 females; aged 32-94 years [(51.5±16.6)years]. The patients underwent open reduction and internal fixation with nickel-titanium shape memory alloy embracer via standard incision such as anterior axillary longitudinal incision (standard incision group, n=96) or conventional incision such as posterolateral incision (conventional incision group, n=96). The incision length, operation time, intraoperative blood loss, number of fixed fractures, indwelling time of closed thoracic drainage tube, postoperative thoracic drainage volume, postoperative spontaneous ambulation time and length of hospital stay were compared in the two groups. The visual analogue scale (VAS) was used to evaluate pain at 1 month after operation. Postoperative complications were recorded. Results:All patients were followed up for 1-16 months [4.0(3.0, 10.5)months]. The operation time, intraoperative blood loss, indwelling time of closed thoracic drainage tube, postoperative thoracic drainage volume, postoperative spontaneous ambulation time, length of hospital stay and VAS at postoperative 1 month in standard incision group [(12.1±1.6)cm, (51.4±13.0)minutes, (191.5±16.8)ml, (2.8±0.6)days, (568.9±109.0)ml, (4.1±0.7)days, (11.4±1.7)days, (2.5±0.7)points] were better than those in conventional incision group [(13.7±1.9)cm, (62.0±8.8)minutes, (248.9±65.4)ml, (4.8±1.1)days, (655.9±121.9)ml, (5.2±0.9)days, (15.3± 1.7)days, (3.5±0.7)points] ( P<0.05 or 0.01). There was no statistical difference in the number of fixed fractures between standard incision group and conventional incision group (5.1±0.8 vs. 5.4±0.9) ( P>0.05). In standard incision group, there were 3 patients with poor wound healing, 5 with pulmonary infection, 3 with atelectasis and 3 with small pleural effusion. In conventional incision group, there were 11 patients with poor wound healing, 9 with pulmonary infection, 7 with atelectasis and 7 with small pleural effusion. The incidence of postoperative complications was 14.6% (14/96) in standard incision group and 35.4% (34/96) in conventional incision group ( P<0.01). Conclusion:For multiple rib fracture, standard incision is superior to conventional incision reduction in shortening the incision length, operation time, indwelling time of drainage tube, postoperative spontaneous ambulation time and length of hospital stay, reducing the intraoperative blood loss and postoperative thoracic drainage volume, alleviating the pain and reducing the postoperative complications.

Zinc is one of the essential trace elements for human. It is essential for human health. In recent decades, the distribution and transport of zinc in human body have gradually become more evident. The immunomodulatory effects of zinc on the immune system have also been elucidated. Zinc is involved in regulating the cellular signaling pathways of immune cells and affecting the development of immune organs, the physiological state and function of immune cells and the secretion of cytokines. It is an indispensable element in the immune system and plays an important role in maintaining the integrity and stability of the immune system. This article briefly introduced the distribution and transportation of zinc in the human body, with the emphasis on the relationship between zinc and the development and function of immune cells.