BACKGROUND:Sarcopenia obesity is characterized by the coexistence of sarcopenia and obesity with a continuously increasing prevalence.Aerobic exercise can alleviate the progression of sarcopenic obesity,but the overall metabolic changes in skeletal muscle after exercise are still unclear.OBJECTIVE:To investigate the effects of exercise on various aspects of the energy metabolic pathways in the skeletal muscle of mice with sarcopenic obesity.METHODS:Male C57BL/6J mice were randomly divided into normal control(normal diet)and model(high-fat diet)groups.After 12 weeks of feeding,sarcopenic obesity model mice were screened by body mass and behavior assessments.The sarcopenia obesity mice were then divided into the sedentary and exercise groups.Mice in the exercise group were subjected to treadmill training on the basis of a high-fat diet.After 8 weeks of intervention,body mass,lipid metabolism,muscle volume of calf muscle group of the hind limb,skeletal muscle morphology,and expressions of energy metabolic pathway-related genes were detected.RESULTS AND CONCLUSION:Compared with the normal control group,the levels of triglycerides,total cholesterol,and free fatty acid in the sedentary group were significantly increased,along with significantly increased lipid droplets in skeletal muscle(P<0.05).Compared with the sedentary group,all of the above indicators in the exercise group showed a significant decreasing trend(P<0.05).Compared with the normal control group,grip strength and fatigue latency time,muscle volume,and fiber cross-sectional area were significantly decreased in the sedentary group,but the mRNA expression of Atrogin-1 and Murf-1 was elevated(P<0.05).Compared with the sedentary group,grip strength and fatigue latency time,muscle volume,and fiber cross-sectional area were significantly improved in the exercise group(P<0.05),while the mRNA expression of Atrogin-1 and Murf-1 was reduced(P<0.05).Compared with the normal control group,the mRNA expression of intramuscular transcription factors Pparα and Pgc-1α was decreased in the sedentary group(P<0.05),the mRNA expression of fatty acid synthesis-related enzymes Srebp1c and Fasn was elevated(P<0.05),and the mRNA expression of the β-oxidation system Cpt1β,Acox1,Acox3 and fatty acid metabolism Arf1 and Plin3 was decreased(P<0.05).Compared with the sedentary group,the abnormal expression of the above genes was significantly reversed in the exercise group(P<0.05).To conclude,aerobic exercise can alleviate lipid deposition and improve muscle quality and strength of sarcopenic obesity mice by regulating the expression of genes in the intramuscular energy metabolism network.

Objective To determine the effect of knee extension constraint training on bilateral knee biomechanics and bilateral symmetry in running after anterior cruciate ligament reconstruction(ACLR).Methods A total of 33 male patients with unilateral ACL injuries were randomly assigned to a BRACE group of 14 wearing a brace with limitation of knee extension,a PLACEBO group of 10 wear-ing a brace without limitation of knee extension,and a CONTROL group of 9,wearing no brace.All groups underwent unilateral hamstring-auto graft ACLR surgery,immediately followed by 12-week rou-tine rehabilitation.Between week 13 and 48,both the BRACE and PLACEBO groups wore braces for one hour on Mondays.Then,running biomechanical tests were performed at the ends of Week 12 and Week 48,and the bilateral knee extension/flexion angle,moment and inter-leg difference(ILD)were calculated.One-dimensional statistical parametric mapping(SPM1d)two-way ANOVA with repeated measures on one factor was used to identify differences in bilateral knee biomechanics and ILD among the three groups before and after the intervention.Results There was no significant interaction effect of group and time on bilateral knee flexion angle,knee extension moment,and ILD in running(P>0.05).Moreover,no significant effect of group was found on the bilateral knee biomechanics and ILD in running(P>0.05).Additionally,significant effects of time were observed on bilateral knee flexion angle and extension moment in running.However,bilateral knee flexion angle decreased during termi-nal stance(ACLR leg:89%～100%,P=0.036;non-ACLR leg:94%～100%,P=0.046),while the bi-lateral knee extension moment increased during mid-stance(ACLR leg:17%～59%,P<0.001;non-ACLR leg:38%～61%,P<0.001)between week 12 and 48.Conclusion In this study,no improvement was found in the abnormal knee biomechanics and symmetry during running in male patients after uni-lateral ACL reconstruction through long-term knee extension constraint training.Moreover,within one year after ACL reconstruction,the knee extension moment of the surgical limb increased gradually over time,with no changes in the knee flexion angle of the surgical limb and bilateral knee symme-try,suggesting that abnormal knee biomechanics and bilateral symmetry should be paid attention to in the post-surgery rehabilitation.

Objective To determine the effect of knee extension constraint training on bilateral knee biomechanics and bilateral symmetry in running after anterior cruciate ligament reconstruction(ACLR).Methods A total of 33 male patients with unilateral ACL injuries were randomly assigned to a BRACE group of 14 wearing a brace with limitation of knee extension,a PLACEBO group of 10 wear-ing a brace without limitation of knee extension,and a CONTROL group of 9,wearing no brace.All groups underwent unilateral hamstring-auto graft ACLR surgery,immediately followed by 12-week rou-tine rehabilitation.Between week 13 and 48,both the BRACE and PLACEBO groups wore braces for one hour on Mondays.Then,running biomechanical tests were performed at the ends of Week 12 and Week 48,and the bilateral knee extension/flexion angle,moment and inter-leg difference(ILD)were calculated.One-dimensional statistical parametric mapping(SPM1d)two-way ANOVA with repeated measures on one factor was used to identify differences in bilateral knee biomechanics and ILD among the three groups before and after the intervention.Results There was no significant interaction effect of group and time on bilateral knee flexion angle,knee extension moment,and ILD in running(P>0.05).Moreover,no significant effect of group was found on the bilateral knee biomechanics and ILD in running(P>0.05).Additionally,significant effects of time were observed on bilateral knee flexion angle and extension moment in running.However,bilateral knee flexion angle decreased during termi-nal stance(ACLR leg:89%～100%,P=0.036;non-ACLR leg:94%～100%,P=0.046),while the bi-lateral knee extension moment increased during mid-stance(ACLR leg:17%～59%,P<0.001;non-ACLR leg:38%～61%,P<0.001)between week 12 and 48.Conclusion In this study,no improvement was found in the abnormal knee biomechanics and symmetry during running in male patients after uni-lateral ACL reconstruction through long-term knee extension constraint training.Moreover,within one year after ACL reconstruction,the knee extension moment of the surgical limb increased gradually over time,with no changes in the knee flexion angle of the surgical limb and bilateral knee symme-try,suggesting that abnormal knee biomechanics and bilateral symmetry should be paid attention to in the post-surgery rehabilitation.

BACKGROUND:Sarcopenia obesity is characterized by the coexistence of sarcopenia and obesity with a continuously increasing prevalence.Aerobic exercise can alleviate the progression of sarcopenic obesity,but the overall metabolic changes in skeletal muscle after exercise are still unclear.OBJECTIVE:To investigate the effects of exercise on various aspects of the energy metabolic pathways in the skeletal muscle of mice with sarcopenic obesity.METHODS:Male C57BL/6J mice were randomly divided into normal control(normal diet)and model(high-fat diet)groups.After 12 weeks of feeding,sarcopenic obesity model mice were screened by body mass and behavior assessments.The sarcopenia obesity mice were then divided into the sedentary and exercise groups.Mice in the exercise group were subjected to treadmill training on the basis of a high-fat diet.After 8 weeks of intervention,body mass,lipid metabolism,muscle volume of calf muscle group of the hind limb,skeletal muscle morphology,and expressions of energy metabolic pathway-related genes were detected.RESULTS AND CONCLUSION:Compared with the normal control group,the levels of triglycerides,total cholesterol,and free fatty acid in the sedentary group were significantly increased,along with significantly increased lipid droplets in skeletal muscle(P<0.05).Compared with the sedentary group,all of the above indicators in the exercise group showed a significant decreasing trend(P<0.05).Compared with the normal control group,grip strength and fatigue latency time,muscle volume,and fiber cross-sectional area were significantly decreased in the sedentary group,but the mRNA expression of Atrogin-1 and Murf-1 was elevated(P<0.05).Compared with the sedentary group,grip strength and fatigue latency time,muscle volume,and fiber cross-sectional area were significantly improved in the exercise group(P<0.05),while the mRNA expression of Atrogin-1 and Murf-1 was reduced(P<0.05).Compared with the normal control group,the mRNA expression of intramuscular transcription factors Pparα and Pgc-1α was decreased in the sedentary group(P<0.05),the mRNA expression of fatty acid synthesis-related enzymes Srebp1c and Fasn was elevated(P<0.05),and the mRNA expression of the β-oxidation system Cpt1β,Acox1,Acox3 and fatty acid metabolism Arf1 and Plin3 was decreased(P<0.05).Compared with the sedentary group,the abnormal expression of the above genes was significantly reversed in the exercise group(P<0.05).To conclude,aerobic exercise can alleviate lipid deposition and improve muscle quality and strength of sarcopenic obesity mice by regulating the expression of genes in the intramuscular energy metabolism network.

Objective:To explore the application of low opioid dose afentanil induced laryngeal mask intubation in patients undergoing breast cancer surgery and its effects on postoperative cognition and mood.Methods:A retrospective study was conducted on 80 patients with radical mastectomy admitted to our hospital from Jan. 2020 to Jun. 2024. Clinical data of the patients were statistically analyzed, and they were divided into control group (47 cases with sufentanil as intravenous sedative drug) and observation group (33 cases with afentanil as intravenous sedative drug) according to different anesthesia methods. The scores of MMSE and Hospital Anxiety and Depression Scale (HAD) before anesthesia and 24 and 48h after anesthesia were compared between the two groups, and the observation group was divided into different subgroups with different doses of afentanil, and the changes of MMSE and HAD scores were observed.Results:There was no significant difference in age, cancer type, clinical symptoms and BMI between 2 groups ( t=0.12, 0.25, P=0.902, 0.801, χ 2=0.05, 2.08, 0.30, 1.69, 0.32, 0.05, 0.08, P=0.978, 0.149, 0.586, 0.193, 0.571, 0.820, 0.960) . At 24h and 48h after surgery, the MMSE score of the 2 groups was significantly decreased, but the score at 48h after surgery was higher than that at 24h after surgery. Meanwhile, the score at 24h after surgery of the observation group) and the score at 48h after surgery, was higher than that of the control group, and the difference was statistically significant ( t=4.15, 4.48, P<0.001) . At 24h and 48h after surgery, the HAD score of the two groups was significantly increased, and the HAD score of the control group at 48h after surgery was significantly higher than that of the control group at 24h after surgery, but the observation group was significantly lower than the control group at 48h, with statistical significance ( t=6.22, P<0.001) . At the induction stage of anesthesia, MMSE scores were significantly higher in the 50-75 μg/kg group than in the 25-50μg/kg group, and HAD scores were significantly lower 48 hours after surgery. At the same time, the MMSE score of 0.5-1.0 μg·kg -1·min -1 group was significantly higher than that of 1.0-2.0 μg·kg -1·min -1 group 48h after anesthesia maintenance, and the HAD score was significantly lower than that of 1.0-2.0 μg·kg -1·min -1 group 48h after anesthesia, with statistical significance ( t=8.80, P<0.001) . Conclusion:Afentanil induced laryngeal mask intubation has high application value in breast cancer surgery patients, which can effectively restore patients' cognitive ability and relieve patients' anxiety, and the effect of low-dose intervention is more obvious, which is worthy of clinical promotion and application.

Objective By applying the long short-term memory(LSTM)neural network model and using lower body landmark coordinates obtained from a markerless motion capture system as inputs,to estimate ground reaction force(GRF)curves during running.Methods The video images and GRF data of 59 amateur runners during running were collected by the markerless motion capture system and three-dimensional(3D)force plates.The LSTM model was established,and the 3D coordinates of 11 lower body landmarks,obtained via the Theia3D markerless system,were used as inputs to estimate the 3D GRF curves during the stance of running.The estimation performance was evaluated using correlation coefficients r,root mean square error(RMSE),and normalized root mean square error(nRMSE)by comparing LSTM model estimation and force plate measurement.Statistical parametric mapping was used to analyze differences in GRF curves estimated by the LSTM model and measured by the force plate,while paired t-tests were used to assess differences in GRF characteristics between model estimation and actual measurement.Results A strong correlation(r＞0.85,P＜0.001)and lower error(RMSE＜0.3 body weight,nRMSE＜15％)was found between the LSTM model estimation and actual measurements.No significant difference was found in GRF curve intervals between LSTM model estimation and actual measurements.There was no significant difference in GRF characteristics between LSTM model estimation and actual measurements(P＞0.05).Conclusions Based on the LSTM model,the 3D GRF curves can be effectively estimated by lower body landmark coordinates obtained from the makerless motion capture system,thereby acquiring the highly accurate GRF characteristics.The LSTM model developed in this study can be used to monitor injury risks during running in outdoor environments.

Objective:To explore the application of low opioid dose afentanil induced laryngeal mask intubation in patients undergoing breast cancer surgery and its effects on postoperative cognition and mood.Methods:A retrospective study was conducted on 80 patients with radical mastectomy admitted to our hospital from Jan. 2020 to Jun. 2024. Clinical data of the patients were statistically analyzed, and they were divided into control group (47 cases with sufentanil as intravenous sedative drug) and observation group (33 cases with afentanil as intravenous sedative drug) according to different anesthesia methods. The scores of MMSE and Hospital Anxiety and Depression Scale (HAD) before anesthesia and 24 and 48h after anesthesia were compared between the two groups, and the observation group was divided into different subgroups with different doses of afentanil, and the changes of MMSE and HAD scores were observed.Results:There was no significant difference in age, cancer type, clinical symptoms and BMI between 2 groups ( t=0.12, 0.25, P=0.902, 0.801, χ 2=0.05, 2.08, 0.30, 1.69, 0.32, 0.05, 0.08, P=0.978, 0.149, 0.586, 0.193, 0.571, 0.820, 0.960) . At 24h and 48h after surgery, the MMSE score of the 2 groups was significantly decreased, but the score at 48h after surgery was higher than that at 24h after surgery. Meanwhile, the score at 24h after surgery of the observation group) and the score at 48h after surgery, was higher than that of the control group, and the difference was statistically significant ( t=4.15, 4.48, P<0.001) . At 24h and 48h after surgery, the HAD score of the two groups was significantly increased, and the HAD score of the control group at 48h after surgery was significantly higher than that of the control group at 24h after surgery, but the observation group was significantly lower than the control group at 48h, with statistical significance ( t=6.22, P<0.001) . At the induction stage of anesthesia, MMSE scores were significantly higher in the 50-75 μg/kg group than in the 25-50μg/kg group, and HAD scores were significantly lower 48 hours after surgery. At the same time, the MMSE score of 0.5-1.0 μg·kg -1·min -1 group was significantly higher than that of 1.0-2.0 μg·kg -1·min -1 group 48h after anesthesia maintenance, and the HAD score was significantly lower than that of 1.0-2.0 μg·kg -1·min -1 group 48h after anesthesia, with statistical significance ( t=8.80, P<0.001) . Conclusion:Afentanil induced laryngeal mask intubation has high application value in breast cancer surgery patients, which can effectively restore patients' cognitive ability and relieve patients' anxiety, and the effect of low-dose intervention is more obvious, which is worthy of clinical promotion and application.

Objective By applying the long short-term memory(LSTM)neural network model and using lower body landmark coordinates obtained from a markerless motion capture system as inputs,to estimate ground reaction force(GRF)curves during running.Methods The video images and GRF data of 59 amateur runners during running were collected by the markerless motion capture system and three-dimensional(3D)force plates.The LSTM model was established,and the 3D coordinates of 11 lower body landmarks,obtained via the Theia3D markerless system,were used as inputs to estimate the 3D GRF curves during the stance of running.The estimation performance was evaluated using correlation coefficients r,root mean square error(RMSE),and normalized root mean square error(nRMSE)by comparing LSTM model estimation and force plate measurement.Statistical parametric mapping was used to analyze differences in GRF curves estimated by the LSTM model and measured by the force plate,while paired t-tests were used to assess differences in GRF characteristics between model estimation and actual measurement.Results A strong correlation(r＞0.85,P＜0.001)and lower error(RMSE＜0.3 body weight,nRMSE＜15％)was found between the LSTM model estimation and actual measurements.No significant difference was found in GRF curve intervals between LSTM model estimation and actual measurements.There was no significant difference in GRF characteristics between LSTM model estimation and actual measurements(P＞0.05).Conclusions Based on the LSTM model,the 3D GRF curves can be effectively estimated by lower body landmark coordinates obtained from the makerless motion capture system,thereby acquiring the highly accurate GRF characteristics.The LSTM model developed in this study can be used to monitor injury risks during running in outdoor environments.

Objective: To investigate the occupational health status of medical radiation workers in Hangzhou City, so as to provide the basis for their occupational health risk assessment. Methods: Data on medical radiological workers who underwent occupational health examinations from 2021 to 2022 were collected through the Physical Examination Information Management System of the Hangzhou Occupational Disease Prevention and Control Hospital. The physical examination data including blood routine, eye lens, thyroid ultrasound, thyroid function, liver function, renal function and blood lipid were collected, and the abnormal rates of occupational health examinations among workers with different genders, working years and occupational exposure types were analyzed. Results: A total of 3 968 medical radiation workers were investigated, including 2 310 males (58.22%) and 1 658 females (41.78%). There were 2 039 (51.39%), 821 (20.69%) and 1 108 (27.92%) workers with 1-<6, 6-<10 years and 10 years and above of work, respectively. Diagnostic radiology was the predomenant type of exposure, with 2 240 workers accounting for 56.45%. The abnormal rates of thyroid ultrasound and blood lipid were 47.73% and 45.21%, respectively, which were relatively higher than other items. The abnormal rates of micronucleus rate, thyroid ultrasound, thyroid function and renal function were higher in females than in males, while the abnormal rates of lymphocyte count, liver function and blood lipid in males were higher in males than in females (all P<0.05). With the increase of working years, the abnormal rates of micronucleus rate and blood lipid showed upward trends (both P<0.05). There were statistically significant differences in the abnormal rates of thyroid ultrasound, liver function and blood lipid among different occupational exposure types (all P<0.05). Conclusion Long-term low-dose ionizing radiation environment affects the thyroid, micronucleus rate and blood lipid of medical radiation workers in Hangzhou City, with differences observed among workers with different genders and occupational exposure types.

Objective : To explore the mechanism of isorhamnetin (Iso) in the treatment of oral squamous cell carcinoma (OSCC) using network pharmacology and molecular docking methods and to verify it in vitro. Methods : The key targets were obtained by constructing the PPI protein interaction network based on the common intersection targets of Iso-OSCC. At the same time, gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) were used to analyze the related signaling pathways of the intersection targets. Iso and core targets were also analyzed through molecular docking and visualization. Colony formation assay and Transwell assay were used to identify the effect of Iso on the proliferation and invasion of Cal-27 cells. Western blot was used to analyze the regulatory effects of different concentrations of Iso on estrogen receptor-1 (ESR1), phosphoinositide-3-kinase regulatory subunit-1 (PIK3R1), Src tyrosine kinase (SRC), and phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway proteins. Results: A total of 269 potential intersection targets of Iso-regulated OSCC were obtained. According to the degree obtained by topological analysis, PIK3R1, AKT1, SRC, ESR1, and other core targets were screened out. KEGG analysis showed that 165 signaling pathways were enriched in the intersection targets of Iso-OSCC, among which the PI3K/AKT signaling pathway played an important role in the treatment of OSCC with Iso. Molecular docking results showed that the absolute value of binding energy between target proteins PIK3R1, AKT1, SRC, ESR1, and Iso was high. After Cal-27 cells were treated with Iso, the number of cell colony formations, the number of transmembrane cells, and the expression of PIK3R1, ESR1, SRC, p-PI3K, and p-AKT were negatively correlated with the increase in Iso concentration (P < 0.05). Conclusion Iso can inhibit PI3K/AKT signal transduction and influence the expression of PIK3R1, AKT1, SRC, and ESR1 proteins, thereby inhibiting the occurrence and development of OSCC.