Background/Aims: Three-dimensional (3D) flexible endoscopy, a new imaging modality that provides a stereoscopic view, can facilitate endoscopic hand suturing (EHS), a novel intraluminal suturing technique. This ex-vivo pilot study evaluated the usefulness of 3D endoscopy in EHS. Methods: Four endoscopists (two certified, two non-certified) performed EHS in six sessions on a soft resin pad. Each session involved five stitches, under alternating 3D and two-dimensional (2D) conditions. Suturing time (sec/session), changes in suturing time, and accuracy of suturing were compared between 2D and 3D conditions. Results: The mean suturing time was shorter in 3D than in 2D (9.8±3.4 min/session vs. 11.2±5.1 min/session) conditions and EHS was completed faster in 3D conditions, particularly by non-certified endoscopists. The suturing speed increased as the 3D sessions progressed. Error rates (failure to grasp the needle, failure to thread the needle, and puncture retrial) in the 3D condition were lower than those in the 2D condition, whereas there was no apparent difference in deviation distance. Conclusions 3D endoscopy may contribute to increasing the speed and accuracy of EHS in a short time period. Stereoscopic viewing during 3D endoscopy may help in efficient skill acquisition for EHS, particularly among novice endoscopists.

With an increasing proportion of sedentary lifestyle related chronic diseases, an efficient way to help fight the growing world epidemic of non-communicable diseases (NCDs) and promote public health in a fast-changing world is urgently needed. Exercise and medicine science have played an important role in prevention and control of NCDs. However, the current status and future development directions regarding the integration of exercise science and medicine (IESM) in China have not been well discussed. During 2017 Belt and Road Initiative Global Health International Congress & 2017 Chinese Preventive Medicine Association-Chinese Society on Global Health Annual Meeting, Xi'an Jiaotong University Global Health Institute, and the Integration of Sport and Medicine Innovation Research Center, China Institute of Sport Science organized the IESM Forum on September 27. Six leaders and experts from China and abroad presented excellent research reports in the IESM Forum from several aspects. Experts reached a consensus at the end of their discussions that, in the near future, the IESM will be a key part of a sustainable health care system and as such should contribute to prosperity in China and around the world. However, Abstract compared with European, American and Japanese universities, the development of the IESM in China is in its early stages with huge development potential.

While the session-RPE (rating of perceived exertion) method can quantify training volume in athletes, this method is not able to evaluate energy expenditure (EE) during a training session. We developed an RPE-based activity record for assessing EE during athletic training, and we compared its results to those obtained using the flex-heart rate (flex-HR) method. The EE of nine female collegiate endurance runners was assessed by the RPE-based activity record and flex-HR methods during eight days in the normal training season. Subjects were asked to record their RPE in the record at 5-minute intervals, and to wear a HR monitor during training. All subjects also participated in an incremental treadmill exercise test, which was used to determine their RPE-EE and HR-EE regression equations. Although the RPE-based activity record significantly overestimated EE (RPE-activity record, 572 kcal/session; flex-HR method, 499 kcal/session; p = 0.031), it had high validity relative to the flex-HR method (intra-class correlation coefficient, 0.891; 95% confidence interval, 0.845–0.923) and there were no systematic errors in EE estimation between the two methods. Therefore, the RPE-based activity record can be used to assess EE during training in female runners. However, RPE-based activity record might overestimate EE for athletes who have more intermittent activities during training than endurance runners, because RPE takes more time for returning to the resting level than HR when the intensity of activity declines. Further research is needed to verify the validity of the RPE-based activity record for assessing EE during other sporting activities or measurement conditions, and to identify the factors affecting the degree of estimation error associated with this method.

The aim of the present study was to evaluate the relation between basal metabolic rate (BMR) and body composition in 29 Japanese elite male athletes (age 25.6±3.7y, height 175.6±7.0cm, body weight 74.7±12.8kg, fat-free mass (FFM) 64.9±9.3kg). The subjects were classified into three groups according to their FFM. There was a significant difference in BMR/FFM between S-group (less than 0.5SD of average FFM) and L-group (more than 0.5SD). The parcentage of RM to body weight in S-group was significantly higher than in L-group. In conclusion, high basal metabolic rate/fat-free mass ratio in Japanese elite male athletes can be attributed to body composition.

We analyzed the relation between subjective fatigue by hard exercise and stress hormone and cytokine data. The subjects are eight healthy men who had exercise experience. In this experiment, hard exercise was carried out in the first place. After two-hour rest, a performance test was carried out. The blood test was conducted 4 times (before exercise, after exercise, rest, and a performance test). Subjective fatigue was indicated using visual analogue scale (VAS). After the hard exercise and performance test, VAS increased and showed the significant difference. Lactic acid, adrenaline, noradrenaline, growth hormone, IL-6, and IL-8 increased after each exercise and showed the significant difference. Subjective fatigue and the value of lactic acid, and IL-6 showed significant positive correlations. These results suggest that lactic acid, and IL-6 may become an index of fatigue in this exertion model.

The aim of the present study was to examine the validation of prediction equation of basal metabolic rate (BMR) in Japanese female athletes. The study population consisted of 122 Japanese female athletes (age 20.2 ± 1.3 years, height 162.5 ± 6.3 cm, body weight (BW) 57.4 ± 7.7 kg, and fat-free mass (FFM) 45.5 ± 5.1 kg). Body composition was estimated by using air displacement plethysmography (BOD POD System). BMR was measured by indirect calorimetry using dougras bag tequnique, and predicted BMR was calculated from different equations based on FFM. When compared with measured BMR, predicted BMR from the equation of Taguchi et al. (BMR (kcal/day)= 26.9×FFM (kg)+ 36) and equation of Owen et al. were not significantly different. Whereas, predicted values from equation of Japan Institute of Sports Sciences, National Institute of Health and Nutrition and Cunningham were significantly different from measured value. Estimation error and Total error were smaller in equation of Taguchi et al. and Owen et al., however, equation of Owen et al. had a larger estimation error in the subjects who was small body size (less than 42kg) or large body size(more than 69kg). Furthermore, newer equation of Taguchi et al. (BMR=27.5×FFM+5) was developed from the pool data (n=205) in the present study. Standard error of estimation (SEE) of this equation was smaller than the equation of Taguchi et al., and systematic error was hardly observed.In conclusion, the newer equation of Taguchi et al. developed from measured BMR of Japanese female athletes was useful to predict BMR.

Background: Although previous reports have shown a lower proportion of the ACTN3 XX genotype (R577X nonsense polymorphism) in sprint/power athletes compared with controls, possibly attributed to the importance of skeletal muscle function associated with alpha-actinin-3 deficiency, the findings on association between endurance athlete status and R577X genotype are equivocal. Purpose: The present study was undertaken to examine association of ACTN3 R577X genotype with elite Japanese endurance athlete status. Subjects and Methods: Subjects comprised 79 elite Japanese endurance runners (E) who participated in competition at national level and 96 Japanese controls (C). We divided endurance runners into two groups, i.e., 42 national level runners (E-N) and 37 international level runners (E-I) who had represented Japan in international competition. R577X genotype (rs1815739) was analyzed by direct sequencing. Frequency differences of polymorphisms between athletes and controls were examined by Chi-square tests. Result: The R allele frequency tended to be higher in E group than in C group (P=0.066). When we divided E into two groups, the R allele frequency in E-I group was significantly higher than that in C group (P=0.046); whereas there were no significant differences between E-N and C groups (p=0.316). Then, the three genetic models were tested. In the additive genetic model (RR>RX>XX), there were significantly differences between E-I and C (P=0.038), but not the dominant (RR vs. RX+XX) and the recessive (RR+RX vs. XX) genetic models. Conclusion: R allele of the R577X genotype in the ACTN3 gene was associated with elite Japanese endurance athlete status.

Background: Exercise training induces various adaptations in skeletal muscles. However, the mechanisms remain unclear. Purpose: Therefore, we conducted 2D-DIGE proteomic analysis, which has not yet been used for elucidating adaptations of skeletal muscle after low-intensity exercise training (LIT). Methods: For five days, rats performed LIT, which consisted of two 3-h swimming exercise with45-m rest between the exercise bouts. 2D-DIGE analysis was conducted on epitrochlearis muscles excised eighteen hours after the final training exercise. Results: Proteomic profiling revealed that, out of 681 detected and matched spots, 22 proteins exhibited changed expression by LIT compared with sedentary rats. All proteins were identified by MALDI-TOF/MS. Conclusion: The proteomic 2D-DIGE analysis following LIT identified expressions of skeletal muscle proteins, includingATPsynα, UQCRC1, dihydrolipoamide dehydrogenase, dihydrolipoamide acetyltransferase, that were not previously reported to change their expressions after exercise-training.

PORPOSE: This study aimed to investigate the relation between cardiorespiratory fitness(CRF) and physical activity, especially vigorous physical activity, in Japanese middle-aged and elderly men.METHODS: Eighty-five men aged 30-69 years participated in this study. CRF was assessed by measuring the maximal oxygen uptake based on weight (VO₂max/wt) in an incremental test on a bicycle ergometer. METs·h/week was measured as the parameter of physical activity by using accelerometers. We defined the amount of physical activity higher than 3 METs as “Physical activity ; PA”in this study. Then, PA was divided into “Moderate physical activity ; MPA”(higher than 3 METs and below 6 METs)and “Vigorous physical activity ; VPA”(higher than 6 METs).RESULTS : CRF was positively correlated with PA(r=0.318, P<0.01), MPA(r=0.230, P<0.05), and VPA(r=0.301, P<0.01) and negatively correlated with age(r=-0.607, P<0.001), BMI(r=-0.369, P<0.01), and waist circumference(WC)(r=-0.486, P<0.001). After adjusting for age and WC, the multiple regression analysis revealed that PA was positively correlated with CRF(P<0.01). VPA was positively correlated with CRF(P<0.05) after adjusting for age, WC, and MPA. MPA was not correlated with CRF in the case of adjusting for age and WC.CONCLUSION : This study suggested that physical activity higher than 3 METs was positively associated with cardiorespiratory fitness independently of age and waist circumference, and particularly vigorous physical activity may contribute to increased cardiorespiratory fitness in middle-aged and elderly men. Thus physically active life with maintenance of adequate waist circumference may help to prevent age-related decline in cardiorespiratory fitness.

The purpose of this study was to develop prediction models of sarcopenia in 1,894 Japanese men and women aged 18-85 years. Reference values for sarcopenia (skeletal muscle index, SMI; appendicular muscle mass/height², kg/m²) in each sex were defined as values two standard deviations (2SD) below the gender-specific means of this study reference data for young adults aged 18-40 years. Reference values for predisposition to sarcopenia (PSa) in each gender were also defined as values one standard deviations (1SD) below. The subjects aged 41 years or older were randomly separated into 2 groups, a model development group and a validation group. Appendicular muscle mass was measured by DXA. The reference values of sarcopenia were 6.87 kg/m² and 5.46 kg/m², and those of PSa were 7.77 kg/m² and 6.12 kg/m². The subjects with sarcopenia and PSa aged 41 years or older were 1.7% and 28.8% in men and 2.7% and 20.7% in women. The whole body bone mineral density of PSa was significantly lower than in normal subjects. The handgrip strength of PSa was significantly lower than in normal subjects. Stepwise regression analysis indicated that the body mass index (BMI), waist circumference and age were independently associated with SMI in men; and BMI, handgrip strength and waist circumference were independently associated with SMI in women. The SMI prediction equations were applied to the validation group, and strong correlations were also observed between the DXA-measured and predicted SMI in men and women. This study proposed the reference values of sarcopenia in Japanese men and women. The prediction models of SMI using anthropometric measurement are valid for alternative DXA-measured SMI in Japanese adults.