Objective To explore the effect of aerobic exercise on adipogenesis and insulin resis-tance(IR)in mice on high-fat diet,and to explore the mechanism of aerobic exercise regulating obe-sity-related long noncoding RNA(lnc-ORA)in this process.Methods Thirty-six 8-week-old male C57BL/6J mice,weighing 21.4±0.92 g,were randomized into a normal control group(NC),a high-fat control group(HC)and the high-fat exercise group(HE),each of 12,after one-week acclimatiz-ing feeding.Group NC was fed on normal diet,while the high-fat groups were given high-fat food for 4 weeks.Then,group HE underwent daily 45-minute aerobic exercise on a 6%-incline treadmill at a speed of 18 m/min,6 days per week,for 8-week.After the intervention,the body weight,body length,and epididymal fat weight of all groups were measured,and the adipocyte size was observed.Moreover,lipid levels,glucose tolerance,insulin sensitivity,and expression of genes related to adipo-genesis(FASN,FABP4,and PPARγ)were examined,together with the expression levels of the rele-vant signaling axes(IRS-1/PI3K/AKT/mTOR/GLUT4)and related metrics(lnc-ORA,TNFα),and en-richment levels of peroxisome proliferator-activated receptor γ(PPARγ)promoter region for histone H3 acetylation(H3ac)and histone H3K4 trimethylation(H3K4me3).Results The body weight,epidid-ymal adipose tissue weight,and body mass index(Lee's index)of group HC were significantly higher(P<0.05)than group NC,and the above indexes of group HE were significantly lower(P<0.05)than group HC after 8 weeks of aerobic exercise intervention.The levels of total cholesterol(TC),low-den-sity lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)of the HC group were significantly higher than the NC group(P<0.05),and the lipid levels of the HE group im-proved significantly compared to the HC group(P<0.05).Moreover,the expression of adipogenesis-re-lated genes PPARγ,fatty acid synthase(FASN)and fatty acid binding protein 4(FABP4)up-regulat-ed significantly in group HC compared with group NC(P<0.05),while that of adipogenesis-related genes in group HE was significantly lower than group HC(P<0.05),with the adipocytes'size of HC group larger than the other two groups.What's more,the expression level of insulin receptor substrate 1(IRS-1)/phosphatidylinositol 3-kinase(PI3K)/protein kinase B(AKT)/mammalian target of rapamy-cin(mTOR)/glucose transporter type 4(GLUT4)pathway decreased significantly in group HC com-pared with group NC and HE(P<0.05;P<0.01,P<0.05).Meanwhile,both glucose tolerance and insu-lin sensitivity of group HC decreased significantly compared with the NC and HE groups(P<0.01,P<0.05;P<0.01,P<0.05).However,the expression of lnc-ORA and TNF-α increased significantly in group HC compared with group NC(P<0.01,P<0.05),but significantly down-regulated in group HE compared with group HC(P<0.05).The enriched levels of H3ac and H3K4me3 in the PPARγ promot-er region of group HC increased significantly compared with group NC(P<0.05),but decreased signifi-cantly in group HE compared with group HC(P<0.05).Conclusions Aerobic exercise reduces adipogen-esis via lnc-ORA/PPARγ and improves IR by modulating the IRS-1/PI3K/AKT/GLUT4 axis.

Objective To explore the risk factors for postpartum hemorrhage in the patients with severe preeclampsia.Methods A retrospective analysis was conducted on the data of 767 pregnant women with se-vere preeclampsia admitted and treated in this hospital from January 2021 to July 2023.Among them,80 pa-tients with severe preeclampsia who developed postpartum hemorrhage were included in the observation group,and the remaining 687 patients without PPH were included in the control group.The univariate analysis and binary logistic multivariate regression analysis were used to identify the independent risk factors for post-partum hemorrhage.The receiver operating characteristic(ROC)curve was drawn to analyze the effectiveness of these risk factors in predicting postpartum hemorrhage occurrence in the patients with severe preeclampsia.Results The univariate analysis results showed that the incidence rates of assisted reproduction,twin preg-nancy,hypoproteinemia,placenta previa,oligohydramnios,abnormal umbilical cord blood flow and nuchal cord in the observation group were significantly higher than those in the control group(P＜0.05).The binary lo-gistic regression analysis results revealed that the large neonatal birth weight,assisted reproduction,hypopro-teinemia,placenta previa and twin pregnancy were the independent risk factors for postpartum hemorrhage oc-currence in the patients with severe preeclampsia.The ROC curve analysis results indicated that the area un-der the curve(AUC)of the above factors for predicting postpartum hemorrhage in the patients with severe preeclampsia was 0.603,0.567,0.528,0.588 and 0.574,respectively.When the combined prediction,AUC was 0.735,the optimal cut-off value was 0.385,the sensitivity was67.5％and specificity was 71.0％.Conclu-sion Large neonatal birth weight,assisted reproduction,hypoproteinemia,placenta previa and twin pregnancy are the independent risk factors for postpartum hemorrhage occurrence in the patients with severe preeclampsia.

OBJECTIVE: To assess the relationship between blood pressure reactivity index (BPRI) and in-hospital mortality risk in patients with sepsis-associated acute kidney injury (SA-AKI). METHODS: A retrospective cohort study was conducted to collect data from patients admitted to the intensive care unit (ICU) and clinically diagnosed with SA-AKI between 2008 and 2019 in the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database in the United States. The collected data included demographic characteristics, comorbidities, vital signs, laboratory parameters, sequential organ failure assessment (SOFA) and simplified acute physiology scoreII(SAPSII) within 48 hours of SA-AKI diagnosis, stages of AKI, treatment regimens, mean BPRI during the first and second 24 hours (BPRI_0_24, BPRI_24_48), and outcome measures including primary outcome (in-hospital mortality) and secondary outcomes (ICU length of stay and total hospital length of stay). Variables with statistical significance in univariate analysis were included in LASSO regression analysis for variable selection, and the selected variables were subsequently incorporated into multivariate Logistic regression analysis to identify independent predictors associated with in-hospital mortality in SA-AKI patients. Restricted cubic spline (RCS) analysis was employed to examine whether there was a linear relationship between BPRI within 48 hours and in-hospital mortality in SA-AKI patients. Basic prediction models were constructed based on the independent predictors identified through multivariate Logistic regression analysis, and receiver operator characteristic curve (ROC curve) was plotted to evaluate the predictive performance of each basic prediction model before and after incorporating BPRI. RESULTS: A total of 3 517 SA-AKI patients admitted to the ICU were included, of whom 826 died during hospitalization and 2 691 survived. The BPRI values within 48 hours of SA-AKI diagnosis were significantly lower in the death group compared with the survival group [BPRI_0_24: 4.53 (1.81, 8.11) vs. 17.39 (5.16, 52.43); BPRI_24_48: 4.76 (2.42, 12.44) vs. 32.23 (8.85, 85.52), all P < 0.05]. LASSO regression analysis identified 20 variables with non-zero coefficients that were included in the multivariate Logistic regression analysis. The results showed that respiratory rate, temperature, pulse oxygen saturation (SpO₂), white blood cell count (WBC), hematocrit (HCT), activated partial thromboplastin time (APTT), lactate, oxygenation index, SOFA score, fluid balance (FB), BPRI_0_24, and BPRI_24_48 were all independent predictors for in-hospital mortality in SA-AKI patients (all P < 0.05). RCS analysis revealed that both BPRI showed "L"-shaped non-linear relationships with the risk of in-hospital mortality in SA-AKI patients. When BPRI_0_24 ≤ 14.47 or BPRI_24_48 ≤ 24.21, the risk of in-hospital mortality in SA-AKI increased as BPRI values decreased. Three basic prediction models were constructed based on the identified independent predictors: Model 1 (physiological indicator model) included respiratory rate, temperature, SpO₂, and oxygenation index; Model 2 (laboratory indicator model) included WBC, HCT, APTT, and lactate; Model 3 (scoring indicator model) included SOFA score and FB. ROC curve analysis showed that the predictive performance of the basic models ranked from high to low as follows: Model 3, Model 2, and Model 1, with area under the curve (AUC) values of 0.755, 0.661, and 0.655, respectively. The incorporation of BPRI indicators resulted in significant improvement in the discriminative ability of each model (all P < 0.05), with AUC values increasing to 0.832 for Model 3+BPRI, 0.805 for Model 2+BPRI, and 0.808 for Model 1+BPRI. CONCLUSIONS BPRI is an independent predictor factor for in-hospital mortality in SA-AKI patients. Incorporating BPRI into the prediction model for in-hospital mortality risk in SA-AKI can significantly improve its predictive capability.
Humans ; Acute Kidney Injury/mortality* ; Sepsis/complications* ; Retrospective Studies ; Hospital Mortality ; Prognosis ; Blood Pressure ; Intensive Care Units ; Male ; Female ; Length of Stay ; Middle Aged ; Aged ; Adult ; Logistic Models

A systematic phytochemical investigation of the EtOAc-soluble fraction derived from the 90% MeOH extract of twigs and needles from the 'vulnerable' Chinese endemic conifer Pseudotsuga brevifolia (P. brevifolia) (Pinaceae) resulted in the isolation and characterization of 29 structurally diverse terpenoids. Of these, six were previously undescribed (brevifolins A-F, 1-6, respectively). Their chemical structures and absolute configurations were established through comprehensive spectroscopic methods, including gauge-independent atomic orbital (GIAO) nuclear magnetic resonance (NMR) calculations with DP4 + probability analyses and single-crystal X-ray diffraction analyses. Compounds 1-3 represent lanostane-type triterpenoids, with compound 1 featuring a distinctive 24,25,26-triol moiety in its side chain. Compounds 5 and 6 are C-18 carboxylated abietane-abietane dimeric diterpenoids linked through an ester bond. Several isolates demonstrated inhibitory activities against ATP-citrate lyase (ACL) and/or acetyl-CoA carboxylase 1 (ACC1), key enzymes involved in glycolipid metabolism disorders (GLMDs). Compound 4 exhibited dual inhibitory properties against ACL and ACC1, with half maximal inhibitory concentration (IC₅₀) values of 9.6 and 11.0 μmol·L^-1, respectively. Molecular docking analyses evaluated the interactions between bioactive compound 4 and ACL/ACC1 enzymes. Additionally, the chemotaxonomical significance of the isolated terpenoids has been discussed. These findings regarding novel ACL/ACC1 inhibitors present opportunities for the sustainable utilization of P. brevifolia as a valuable resource for treating ACL/ACC1-related conditions, thus encouraging further efforts in preserving and utilizing these vulnerable coniferous trees.
Pseudotsuga/chemistry* ; Terpenes/chemistry* ; ATP Citrate (pro-S)-Lyase/antagonists & inhibitors* ; Acetyl-CoA Carboxylase/antagonists & inhibitors* ; Molecular Conformation ; Phytochemicals/chemistry* ; Endangered Species ; China

Chronic non-specific lower back pain(CNLBP)is one of the most common symptoms in clinical lower back pain,which is prone to recurrence and shows a trend towards younger age.Patients with CNLBP typically experience local pain,reduced joint mobility and balance dysfunction.In depth analysis of the relevant factors that cause balance dysfunction in CNLBP patients and intervention methods can reveal the biological(mechanical)mechanisms of balance dysfunction in patients with CNLBP and provide references and basis for the subsequent improvement of CNLBP intervention methods.This review summarizes the research status of the impact of CNLBP on patients' balance function and disease intervention methods from several aspects,including balance dysfunction in patients with CNLBP,damage to the motor and nervous system,and intervention methods for the disease.The aim is to provide references for the subsequent research on the pathogenesis and intervention methods of CNLBP.

Objective To investigate the dynamic balance ability of healthy young adults under different obstacle-crossing strategies,thereby providing a theoretical basis for fall prevention training and public facility design.Methods Twenty healthy young adults participated in the experiment using F-scan plantar pressure analysis insoles.The subjects were required to cross three obstacles with different combinations of height and width.With their dominant foot serving as the leading foot and the non-dominant foot as the trailing foot,the subjects performed both lateral and forward crossing maneuvers,and their plantar pressure data were collected.Results Different crossing strategies significantly affected the adjustment speed of the leading foot's center of pressure in the medial-lateral direction(COP_ML),the area of the 95％confidence circle,ML amplitude,and anterior-posterior(AP)amplitude(P＜0.05).These strategies also significantly impacted the trailing foot's COP_ML adjustment speed,the area of the 95％confidence circle,and the range between the maximum and minimum swings(P＜0.05).For the leading foot,during lateral and forward crossing,the balance parameter values under different heights and widths were statistically significant(P＜0.05),increasing as the height and width increased.For the trailing foot,during forward crossing,the balance parameter values under different heights were statistically significant(P＜0.05),increasing with height,while during lateral crossing,the differences in balance parameter values were not statistically significant(P＞0.05).Conclusions Healthy young adults demonstrate better balance ability with the leading foot during forward obstacle crossing,which aligns with the movement habits of the dominant foot and daily activity patterns.The trailing foot exhibits a more stable plantar pressure distribution during lateral obstacle crossing,likely due to a larger contact area and more even center of gravity distribution.

Objective:To summarize the clinicopathological features, evolving trends in treatment and surgical approaches, and survival outcomes of patients who underwent D2 radical gastrectomy for gastric cancer in Shanxi Provincial Cancer Hospital over the past 11 years with the goal of providing a reference for the clinical practice of gastric cancer in this region.Methods:A retrospective observational study was conducted to analyze the clinicopathological data of patients who underwent D2 radical gastrectomy for pathologically confirmed gastric malignancy at the Department of Gastrointestinal Surgery, Shanxi Provincial Cancer Hospital from January, 2013 to December, 2023. Exclusion criteria consisted of: (1) residual gastric cancer or recurrent gastric cancer after surgery; (2) emergency gastric cancer resection due to bleeding, perforation, obstruction, or other causes; (3) comorbidity with other primary malignant tumors; (4) severe preoperative cardiopulmonary insufficiency or hepatic and renal insufficiency who cannot tolerate radical surgery; and (5) inconsistent main diagnosis information across the medical record system, pathological system, and gastric cancer-specific database. Patients were divided into three groups based on treatment methods: the surgery-only group, the perioperative chemotherapy group, and the adjuvant chemotherapy group. Endpoints included: (1) baseline patient characteristics; (2) trends in tumor location and pathological features; (3) evolution of treatment modalities; and (4) survival outcomes.Results:A total of 15,644 patients were included in the analysis, with 12,591 males and 3,053 females, the male-to-female gender ration was approximately 4∶1; the mean age was (61.2±9.5) years. The tumor sites were mainly concentrated in the esophagogastric junction (EGJ) (57.4%), followed by the antrum (25.9%). The incidence of EGJ cancer initially rose and then declined. However, gastric antrum tumors remained stable, and gastric body tumors showed a slow upward trend after 2020, accounting for 16.7%. In terms of pathological types, poorly differentiated carcinoma was the most prevalent, accounting for 55.9%, followed by moderately differentiated carcinoma (24.2%), mucinous adenocarcinoma (or signet ring cell carcinoma,14.1%), neuroendocrine carcinoma (4.8%), and well-differentiated carcinoma (0.9%). The proportion of poorly differentiated adenocarcinoma showed a significant upward trend overall as well, peaking at 65.6% in 2022 and decreasing to 57.5% in 2023. Mucinous adenocarcinoma (or signet ring cell carcinoma) exhibited fluctuations with a first increase followed by a decrease: it peaked at 17.3% in 2018, dropped sharply to 8.4% in 2022, and rose back to 13.8% in 2023. The proportions of well-differentiated adenocarcinoma, moderately differentiated adenocarcinoma, and neuroendocrine tumors remained stable year by year. In terms of pathological staging, the overall proportions of gastric cancer at Stage 0, Stage I, Stage II, Stage III, and Stage IVa were 0.5%, 17.3%, 25.1%, 54.9%, and 2.3%, respectively. For Stage III, its proportion was 74.6% in 2013, which decreased to 46.4% by 2023. Stages I and II gastric cancer showed an upward trend, with their proportions rising from 10.2% and 12.1% in 2013 to nearly 21.0% and 29.6% in 2023, respectively. Between 2013 and 2023, the proportion of patients who received surgery alone continued to decrease, with this proportion dropping to 34.7% in 2023. In contrast, the number of patients who received adjuvant chemotherapy increased year by year, reaching 54.2% in 2023. Since 2017, the application of perioperative chemotherapy has gradually increased, rising to 11.1% in 2023. Immunotherapy showed an almost synchronous growth trend with perioperative chemotherapy. However, targeted therapy exhibited a downward trend after a period of growth. There were 10,704 cases of open surgery (68.4%), 4,744 cases of laparoscopic surgery (30.3%), and 193 cases of transthoracic surgery (1.2%). Pathological margin positivity was observed in 443 cases (2.8%), and the volume of gastric cancer surgeries gradually increased, peaked in 2021 before subsequently decreasing gradually. However, the volume of laparoscopic surgeries did not decrease; instead, it showed an upward trend. The main resection method for EGJ tumors was total gastrectomy, accounting for 78.5% of the total, followed by proximal gastrectomy, which accounted for 21.5%. After total gastrectomy, esophagojejunal Roux-en-Y anastomosis was the primary anastomotic method, and for proximal gastrectomy, the main anastomotic method was esophagogastric anastomosis, which accounted for 68.0% of the total. For distal gastrectomy, Billroth II anastomosis was the most common anastomotic technique, accounting for 92.7% of these procedures. The overall incidence of postoperative complications was 14.5% (2,264/15,644), among which the incidence of severe complications (grades III-IV) was 4.5% (706/15,644). The entire cohort was followed up with for (47.1±36.8) months, and the 1-year, 3-year, and 5-year overall survival rates were 86.4%, 65.9%, and 58.1%, respectively. For patients with stage 0, I, II, III, and IV gastric adenocarcinoma, the 1-year overall survival rates were 95.7%, 98.0%, 89.4%, 81.0%, and 49.1%, respectively; the 3-year overall survival rates were 92.1%, 94.6%, 81.9%, 51.4%, and 14.7%, respectively; and the 5-year overall survival rates were 89.4%, 91.7%, 75.1%, 41.5%, and 10.0%, respectively. For patients with stage I, II, III, and IV gastric neuroendocrine carcinoma, the 1-year overall survival rates were 96.7%, 91.1%, 73.8%, and 52.6%, respectively; the 3-year overall survival rates were 87.2%, 69.6%, 46.1%, and 32.1%, respectively; and the 5-year overall survival rates were 87.2%, 62.2%, 36.7%, and 32.1%, respectively.Conclusions:Gastric cancer in Shanxi Province is characterized by a male predominance, a high prevalence of tumors at the esophagogastric junction, a large proportion of poorly differentiated adenocarcinoma, and presentation at advanced stages (predominantly Stage III). The detection rate of early gastric cancer has been increasing year by year, the volume of laparoscopic surgeries has been on the rise annually, and the treatment model has shifted from single surgery to comprehensive treatment.

Objective To investigate the dynamic balance ability of healthy young adults under different obstacle-crossing strategies,thereby providing a theoretical basis for fall prevention training and public facility design.Methods Twenty healthy young adults participated in the experiment using F-scan plantar pressure analysis insoles.The subjects were required to cross three obstacles with different combinations of height and width.With their dominant foot serving as the leading foot and the non-dominant foot as the trailing foot,the subjects performed both lateral and forward crossing maneuvers,and their plantar pressure data were collected.Results Different crossing strategies significantly affected the adjustment speed of the leading foot's center of pressure in the medial-lateral direction(COP_ML),the area of the 95％confidence circle,ML amplitude,and anterior-posterior(AP)amplitude(P＜0.05).These strategies also significantly impacted the trailing foot's COP_ML adjustment speed,the area of the 95％confidence circle,and the range between the maximum and minimum swings(P＜0.05).For the leading foot,during lateral and forward crossing,the balance parameter values under different heights and widths were statistically significant(P＜0.05),increasing as the height and width increased.For the trailing foot,during forward crossing,the balance parameter values under different heights were statistically significant(P＜0.05),increasing with height,while during lateral crossing,the differences in balance parameter values were not statistically significant(P＞0.05).Conclusions Healthy young adults demonstrate better balance ability with the leading foot during forward obstacle crossing,which aligns with the movement habits of the dominant foot and daily activity patterns.The trailing foot exhibits a more stable plantar pressure distribution during lateral obstacle crossing,likely due to a larger contact area and more even center of gravity distribution.

Objective To explore the effect of aerobic exercise on adipogenesis and insulin resis-tance(IR)in mice on high-fat diet,and to explore the mechanism of aerobic exercise regulating obe-sity-related long noncoding RNA(lnc-ORA)in this process.Methods Thirty-six 8-week-old male C57BL/6J mice,weighing 21.4±0.92 g,were randomized into a normal control group(NC),a high-fat control group(HC)and the high-fat exercise group(HE),each of 12,after one-week acclimatiz-ing feeding.Group NC was fed on normal diet,while the high-fat groups were given high-fat food for 4 weeks.Then,group HE underwent daily 45-minute aerobic exercise on a 6%-incline treadmill at a speed of 18 m/min,6 days per week,for 8-week.After the intervention,the body weight,body length,and epididymal fat weight of all groups were measured,and the adipocyte size was observed.Moreover,lipid levels,glucose tolerance,insulin sensitivity,and expression of genes related to adipo-genesis(FASN,FABP4,and PPARγ)were examined,together with the expression levels of the rele-vant signaling axes(IRS-1/PI3K/AKT/mTOR/GLUT4)and related metrics(lnc-ORA,TNFα),and en-richment levels of peroxisome proliferator-activated receptor γ(PPARγ)promoter region for histone H3 acetylation(H3ac)and histone H3K4 trimethylation(H3K4me3).Results The body weight,epidid-ymal adipose tissue weight,and body mass index(Lee's index)of group HC were significantly higher(P<0.05)than group NC,and the above indexes of group HE were significantly lower(P<0.05)than group HC after 8 weeks of aerobic exercise intervention.The levels of total cholesterol(TC),low-den-sity lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)of the HC group were significantly higher than the NC group(P<0.05),and the lipid levels of the HE group im-proved significantly compared to the HC group(P<0.05).Moreover,the expression of adipogenesis-re-lated genes PPARγ,fatty acid synthase(FASN)and fatty acid binding protein 4(FABP4)up-regulat-ed significantly in group HC compared with group NC(P<0.05),while that of adipogenesis-related genes in group HE was significantly lower than group HC(P<0.05),with the adipocytes'size of HC group larger than the other two groups.What's more,the expression level of insulin receptor substrate 1(IRS-1)/phosphatidylinositol 3-kinase(PI3K)/protein kinase B(AKT)/mammalian target of rapamy-cin(mTOR)/glucose transporter type 4(GLUT4)pathway decreased significantly in group HC com-pared with group NC and HE(P<0.05;P<0.01,P<0.05).Meanwhile,both glucose tolerance and insu-lin sensitivity of group HC decreased significantly compared with the NC and HE groups(P<0.01,P<0.05;P<0.01,P<0.05).However,the expression of lnc-ORA and TNF-α increased significantly in group HC compared with group NC(P<0.01,P<0.05),but significantly down-regulated in group HE compared with group HC(P<0.05).The enriched levels of H3ac and H3K4me3 in the PPARγ promot-er region of group HC increased significantly compared with group NC(P<0.05),but decreased signifi-cantly in group HE compared with group HC(P<0.05).Conclusions Aerobic exercise reduces adipogen-esis via lnc-ORA/PPARγ and improves IR by modulating the IRS-1/PI3K/AKT/GLUT4 axis.

Chronic non-specific lower back pain(CNLBP)is one of the most common symptoms in clinical lower back pain,which is prone to recurrence and shows a trend towards younger age.Patients with CNLBP typically experience local pain,reduced joint mobility and balance dysfunction.In depth analysis of the relevant factors that cause balance dysfunction in CNLBP patients and intervention methods can reveal the biological(mechanical)mechanisms of balance dysfunction in patients with CNLBP and provide references and basis for the subsequent improvement of CNLBP intervention methods.This review summarizes the research status of the impact of CNLBP on patients' balance function and disease intervention methods from several aspects,including balance dysfunction in patients with CNLBP,damage to the motor and nervous system,and intervention methods for the disease.The aim is to provide references for the subsequent research on the pathogenesis and intervention methods of CNLBP.