Abstract To investigate the intervention effects of digital exercise on insufficient physical activity (PA) and sedentary behavior among college students, aiming to enhance PA levels and reduce sedentary behavior. The study systematically reviews the application characteristics of digital exercise intervention, the intervention effects of digital exercise intervention (training websites and applications, social media, wearable devices, emerging interactive technologies) on PA levels and sedentary behavior among college students.Through behavioral modification elements such as goal setting, self monitoring, and feedback support, the approach significantly enhances college students PA levels and improves sedentary behaviors, so as to provide evidence for the design and optimization of future intervention programs.

Objective To investigate the effects of cinnamic aldehyde(CA)on Bcl-2-associated X protein(Bax)and Bcl-2 homologous antagonist/killer(Bak)in vascular endothelial cells of diabetic ulcer wound tissues,as well as on cell apoptosis.Methods ① Forty-eight healthy SPF-grade male SD rats(5 weeks old,weighing 180～220 g)were randomly assigned to a control group(12 rats)and a diabetes group(36 rats).The diabetic model was established with an intraperitoneal injection of 50 mg/kg STZ-citrate sodium solution and high-fat diet feeding.The diabetes group was further randomly divided into Model group,CA group,and the rb-bFGF group,with 12 animals in each group.Wounds in the Con and Model groups were disinfected and topically treated with normal saline,CA group received topical application of 4 μmol/L CA in PEG 400 gel,and those of the rb-bFGF group were treated with bevacizumab gel.The wound healing rate of each group was calculated at 3,7 and 14 d after intervention.At 14 d after intervention,pathological changes in the wounds were observed with HE staining,and the expression levels of Bax and Bak were detected by Western blotting.② Human umbilical vein endothelial cell line EA.hy926 was treated with 175 mmol/L glucose for 48 h to establish a cell model of high glucose injury.The experimental cells were divided into control group,model group and CA treatment group.Cell scratch test and tube formation test were performed respectively to determine the migration ability and angiogenesis of the cells.The expression levels of Bax and Bak was detected with immunofluorescence assay,and cell apoptosis was detected by TUNEL staining.Results ①The diabetic rats in the Model group exhibited significantly higher blood glucose level(P<0.05),declined wound healing rate at 7 and 14 d after intervention(P<0.05),and enhanced expression levels of Bax and Bak(P<0.05)when compared with the control group.Pathological observation revealed that,at 14 d after intervention,accompanied with inflammatory reactions,dense infiltration of inflammatory cells,fewer new blood vessels,and continuous fluid exudation in the wound were observed in the Model group,but the control group presented complete epithelialization in full-thickness skin.Compared with the conditions in the Model group,both CA and rb-bFGF treatment improved the epithelialization process,with mature granulation tissues,showing good healing condition,promoted wound healing rate(P<0.05),and decreased the expression levels of Bax and Bak(P<0.05).② The results of cell experiments showed that the cells of the model group showed significantly reduced migration ability and tube formation ability(P<0.05),reduced protein levels of Bax and Bak(P<0.05),and lower apoptotic rate(P<0.05)when compared with the cells in the model group.Conclusion CA can inhibit the expression of apoptosis-related proteins Bax and Bak,promote the migration and tube formation of vascular endothelial cells,and inhibit the cell apoptosis under high glucose condition,which may be an important reason for its promoting wound healing in diabetic ulcer rats.

Objective:To construct a novel clinical prognosis signature for hepatocellular carcinoma (HCC) patients using T cell-related ubiquitination genes.Methods:Transcriptome and clinical data of 371 liver cancer and 50 normal samples were obtained from the TCGA database, and microarray sequencing data of 221 liver cancer samples were selected from the GSE14520 dataset. Single-cell RNA sequencing (scRNA-seq) data of HCC patients were analyzed to identify T cell-related marker genes. These were combined with ubiquitination-related genes. Weighted gene co-expression network analysis (WGCNA) was performed on TCGA transcriptome data to select key genes, resulting in the identification of T cell-related ubiquitination genes. A prognostic model was then constructed using LASSO-Cox regression. Finally, a nomogram was created by combining risk scores and clinical parameters. Count data were expressed by examples and percentages(%). Spearman correlation test was used for correlation analysis. Kaplan-Meier method and Log-rank test were used for survival analysis.Results:Initially, 1 458 T cell-related marker genes were identified. Intersection with 797 ubiquitination-related genes led to the identification of 94 common genes. WGCNA analysis revealed the prognosis-related module MEturquoise. After performing differential gene analysis, Kaplan-Meier analysis, and COX regression, 16 candidate genes were confirmed. LASSO-COX algorithm accurately selected five key genes- UBE2S, PSMD1, FBXL5, UBE2E1, and PSMA7—to construct the prognostic model. Kaplan-Meier analysis indicated that the risk score of the prognostic model was significantly associated with the prognosis of HCC patients (Log-rank test=0.001). Both univariate and multivariate COX regression analysed demonstrated that the risk score was an independent prognostic factor for HCC patients( P<0.05). Finally, a nomogram was constructed by combining the risk score and clinical parameters, providing a more accurate prediction of patient prognosis. Conclusion:The T cell-related ubiquitination gene prognostic model can effectively predict the prognosis of patients with liver cancer.

Objective To discuss the application value of CT and DSA multimodal image fusion technology in endovascular interventional therapy for arterial occlusive lesions of lower extremities and to evaluate its efficacy and safety so as to provide a scientific basis for clinical decision-making.Methods A total of 283 lower limbs with arterial complete occlusive lesions,who received treatment at Affiliated Baiyun Hospital of Guizhou Medical University hospital from January 2020 to December 2023,were selected for this study.The 283 diseased lower limbs were randomly divided into study group(n=142)and control group(n=141).In the study group the endovascular interventional therapy assisted by CT and DSA multimodal image fusion technology was adopted,while in the control group the traditional DSA-guided endovascular interventional therapy was employed.The imaging parameters,surgical success rates,X-ray exposure doses,time spent for operation,incidence of postoperative complications,changes of ankle-brachial index(ABI),primary patency rate,assisted primary patency rate,and secondary patency rate were compared between the two groups.Results The surgical success rate in the study group was 96.47％,which was significantly higher than 87.94％in the control group(P＜0.05).The mean time spent for operation in the study group was(125.42±23.74)minutes,which was shorter than(147.81±29.33)minutes in the control group.The mean X-ray exposure dose in the study group was(2 856.34±427.82)mGy·cm2,which was lower than(3 674.53±512.60)mGy·cm2 in the control group.The incidence of postoperative complications in the study group was 4.23％,which was significantly lower than 12.57％in the control group(P＜0.05).The ABI values of the affected limbs in the study group and control group increased from preoperative(0.65±0.15)and(0.60±0.18)respectively to postoperative(1.09±0.32)and(0.90±0.28)respectively.The postoperative ABI value in the study group was higher than that in the control group(P＜0.05).The postoperative 12-month primary patency rate,assisted primary patency rate and secondary patency rate in the study group were 78.17％,85.92％and 90.14％respectively,which were better than 67.38％,75.89％and 80.85％respectively in the control group.Conclusion For arterial occlusive lesions of lower extremities,endovascular interventional therapy with the help of CT and DSA multimodal image fusion technology has high surgical success rates,low incidence of complications,and satisfactory revascularization rate.This technology provides new idea and method for the treatment of arterial occlusive lesions of lower extremities with high clinical safety.Therefore,this technology is worthy of clinical promotion and application.

BACKGROUND:The pathogenesis of patellofemoral pain is complex,and poor movement patterns and incorrect muscle activation patterns have been suggested to increase patellofemoral joint stress and cause injury,but the results of current studies are not uniform.Current biomechanical studies of step-down test in patients with patellofemoral pain have focused on kinematic characteristics,and there is a lack of research on surface electromyographic characteristics.In addition,there are no studies that analyze the differences in biomechanical performance between the healthy and affected sides of patellofemoral pain patients compared with healthy subjects during the downward step test.OBJECTIVE:To investigate the kinematic and surface electromyographic characteristics of patients with patellofemoral pain during bilateral lower extremity step-downs.METHODS:Twenty-one men with patellofemoral pain and 21 healthy men were recruited,and both groups of subjects underwent a step-down test.Kinematic,kinetic and surface electromyographic data were synchronously collected using a three-dimensional dynamic capture system,a force platform and a surface electromyographic tester.RESULTS AND CONCLUSION:(1)Kinematics:Compared with the healthy control group,the affected and healthy sides of the patellofemoral pain group showed a smaller hip flexion angle(P=0.005,P=0.011),a larger hip internal rotation angle(P=0.033,P=0.039),and a larger knee valgus angle(P=0.001,P=0.001),and the affected side of the patellofemoral pain group exhibited a larger hip internal rotation angle(P=0.013),a smaller knee flexion angle(P=0.043),and a smaller ankle dorsiflexion angle(P=0.002);and compared with the healthy side,the affected side exhibited a smaller ankle dorsiflexion angle(P=0.002).(2)Surface electromyography:Compared with the healthy control group,the patellofemoral pain group showed reduced activation of the vastus medialis oblique(P=0.002),reduced activation of the gluteus medius(P=0.015),and a decreased vastus medialis oblique/vastus lateralis ratio(P=0.010)on the affected side;and compared with the healthy side,there was a reduced activation of the gluteus medius on the affected side(P=0.008).(3)The results indicate that patients with patellofemoral pain have abnormal lower limb biomechanical characteristics during step-down test,which are mainly manifested as changes in kinematic and indexes of the lower limb joints in the sagittal and frontal planes as well as changes in activation levels of the medial femoral and gluteus medius muscles.These changes reflect the fact that patients with patellofemoral pain adopt a stifflanding pattern during step-downs and show pronation of other joints of the lower extremity.In addition,abnormal lower extremity biomechanical characteristics are also present in the healthy limbs of patients with patellofemoral pain,and bilateral lower extremity asymmetry exists in such patients.

BACKGROUND:The pathogenesis of patellofemoral pain is complex,and poor movement patterns and incorrect muscle activation patterns have been suggested to increase patellofemoral joint stress and cause injury,but the results of current studies are not uniform.Current biomechanical studies of step-down test in patients with patellofemoral pain have focused on kinematic characteristics,and there is a lack of research on surface electromyographic characteristics.In addition,there are no studies that analyze the differences in biomechanical performance between the healthy and affected sides of patellofemoral pain patients compared with healthy subjects during the downward step test.OBJECTIVE:To investigate the kinematic and surface electromyographic characteristics of patients with patellofemoral pain during bilateral lower extremity step-downs.METHODS:Twenty-one men with patellofemoral pain and 21 healthy men were recruited,and both groups of subjects underwent a step-down test.Kinematic,kinetic and surface electromyographic data were synchronously collected using a three-dimensional dynamic capture system,a force platform and a surface electromyographic tester.RESULTS AND CONCLUSION:(1)Kinematics:Compared with the healthy control group,the affected and healthy sides of the patellofemoral pain group showed a smaller hip flexion angle(P=0.005,P=0.011),a larger hip internal rotation angle(P=0.033,P=0.039),and a larger knee valgus angle(P=0.001,P=0.001),and the affected side of the patellofemoral pain group exhibited a larger hip internal rotation angle(P=0.013),a smaller knee flexion angle(P=0.043),and a smaller ankle dorsiflexion angle(P=0.002);and compared with the healthy side,the affected side exhibited a smaller ankle dorsiflexion angle(P=0.002).(2)Surface electromyography:Compared with the healthy control group,the patellofemoral pain group showed reduced activation of the vastus medialis oblique(P=0.002),reduced activation of the gluteus medius(P=0.015),and a decreased vastus medialis oblique/vastus lateralis ratio(P=0.010)on the affected side;and compared with the healthy side,there was a reduced activation of the gluteus medius on the affected side(P=0.008).(3)The results indicate that patients with patellofemoral pain have abnormal lower limb biomechanical characteristics during step-down test,which are mainly manifested as changes in kinematic and indexes of the lower limb joints in the sagittal and frontal planes as well as changes in activation levels of the medial femoral and gluteus medius muscles.These changes reflect the fact that patients with patellofemoral pain adopt a stifflanding pattern during step-downs and show pronation of other joints of the lower extremity.In addition,abnormal lower extremity biomechanical characteristics are also present in the healthy limbs of patients with patellofemoral pain,and bilateral lower extremity asymmetry exists in such patients.

Objective:To predict the status of microvascular invasion (MVI) in intrahepatic cholangiocarcinoma (ICC) patients preoperatively based on the radiomics analysis of contrast-enhanced CT to provide imaging evidence for early identification of patients at high risk of recurrence.Methods:Clinical data of 40 ICC patients who underwent radical hepatectomy at Nanjing Drum Tower Hospital from January 2021 to May 2024 were retrospectively collected. Patients were divided into the MVI group ( n=8) and the non-MVI group ( n=32) according to the MVI status of the postoperative pathology report. Whether there were differences in each pathological index between the groups and the efficacy of radiomics analysis of contrast-enhanced CT for the preoperative prediction of MVI were analyzed. The regions of interest (ROI) were outlined on the arterial and venous phase images using the 3D Slicer software. Then, radiomics features were extracted from each ROI based on Python. Finally, the LASSO regression and glm function were used to screen radiomics features and establish a prediction model based on the R language. The established predictive model′s diagnostic efficacy, calibration, and net clinical benefit were evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA), respectively. Normally distributed measurement data were expressed as mean±standard deviation ( ± s) and compared using the t-test. Count data were expressed as frequency and compared using the chi-square test. Results:Patients in the MVI group had more poorly differentiated tumors and a significantly higher proportion of lymph node metastases ( P<0.05). The established radiomics prediction model included six features, 1 first-order statistical feature and 5 gray texture features. The area under the ROC curve was 0.87, the sensitivity was 75.0%, and the specificity was 90.6%. The calibration curve showed good agreement between the predicted MVI and actual MVI status, and the decision curve demonstrated that the model could provide a large net clinical benefit. Conclusion:Radiomics analysis of contrast-enhanced CT can identify the MVI status of ICC patients preoperatively and aid in clinical decision-making, providing vital evidence for individualized and precise treatment of ICC.

Purpose: Whether patients suffering liver oligometastases from pancreatic ductal adenocarcinoma (LOPDA) should undergo surgical treatment remains controversial. Methods: PubMed and Embase databases were systematically reviewed until 2023 June. Survival data were collected from the Kaplan-Meier curves. Safety and survival were evaluated using primary outcomes such as 1-year, 3-year, and 5-year survival rates, and 30-day mortality and morbidity. A subgroup meta-analysis was conducted to compare survival rates post-synchronous resection and resection post-neoadjuvant chemotherapy in LOPDA. Results: Our analysis of 15 studies involving 1,818 patients (surgical group, 648 and nonsurgical group, 1,170) indicates that radical hepatectomy for LOPDA notably improved 1-year (odds ratio [OR], 3.24; 95% confidence interval [CI], 2.45–4.28; P < 0.001), 3-year (OR, 5.74; 95% CI, 3.36–8.90; P < 0.001), and 5-year (OR, 4.89; 95% CI, 2.56–9.35; P < 0.001) overall survival (OS) rates. A separate analysis of 6 studies with 750 patients demonstrated the safety of LOPDA surgery, with no increase in postoperative complications (P = 0.26 for overall morbidity and P = 0.99 for mortality) compared to the patients with no metastatic disease from the pancreatic ductal adenocarcinoma (NMPDA) group. The NMPDA group showed superior 1-year and 3-year OS rates, but not 5-year OS rates compared to the LOPDA group. Conclusion Surgical treatment apparently offers a survival advantage to LOPDA by comparing with nonsurgical groups in 1-, 3-, and 5-year OS rates. Radical resection for LOPDA is a safe treatment without more postoperative complications than NMPDA.

OBJECTIVE It's known that post-retrieval extinction but not extinction alone could erase fear memory.However,whether the coding pattern of original fear engrams is remod-eled or inhibited remains largely unclear.Here we try to investigate whether the coding pattern of memory engrams is altered during post-retrieval extinction induced memory updating.METHODS To answer the question,by using activity-depen-dent neuronal-tagging technology,neuronal trac-ing technique combined with optogenetic manipu-lation and in vivo calcium imaging,we identified the fear and extinction cells in PrL and BLA and investigated the dynamic encoding of memory engram ensembles in the PrL and BLA during CS versus US initiated memory updating.RESULTS We found increased reactivation of engram cells in the prelimbic cortex and basolat-eral amygdala during memory updating.More-over,conditioned stimulus and unconditioned stimulu sinitiated memory updating depend on the engram cells reactivation in the prelimbic cor-tex or basolateral amygdala respectively.Finally,we found memory updating causes increased overlapping between fear and extinction cells and the original fear engrams encoding was altered during memory updating.CONCLUSION Our data provide the first evidence to show the overlapping ensembles between fear and extinc-tion cells and functional reorganization of original engrams underlying conditioned stimulus and unconditioned stimulus initiated memory updating.

Hepatolithiasis is a common biliary tract disease in China and other Asian countries.It has insidious onset,recurrent disease,and may lead to biliary cirrhosis or even cancer in the late stage without inter-vention.At present,surgery is considered to be the best choice for treatment.In the 21st century of minimally inva-sive surgery,traditional procedures such as partial hepatectomy,choledochotomy,cholangioenterostomy and liver transplantation can be performed with the assistance of laparoscopy and da Vinci robots,and emerging endoscopic techniques such as endoscopic retrograde cholangiopancreatography(ERCP)and percutaneous transhepatic cho-ledochoscopic lithotripsy(PTCSL)have also been developed,bringing better treatment for patients with hepatoli-thiasis.As treatment options are becoming more varied,there are also some clinical problems that need to be addressed.In this article,we would like to briefly review the current surgical treatment modalities in order to provide a theoretical basis for optimizing the treatment modalities.