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在冠狀病毒爆發期間應該並且如何進行鍛煉？Should, and how can, exercise be done during a coronavirus outbreak? An interview with Dr. Jeffrey A. Woods

在冠狀病毒爆發期間應該並且如何進行鍛煉？ Jeffrey A. Woods博士訪談

Weimo Zhu

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The 2019 novel coronavirus (2019-nCoV) crisis is now present in China. Known also as the Wuhan coronavirus outbreak, it started in December, 2019 and has, so far, led 213 individuals died and at least 9066 infected in China by local time 17:26, January 30, 2020. It has also spread to a number of Asian countries, as well as to Canada, France, Germany, and the United States. As a result, the Chinese government has put several major cities in Hubei Province on lockdown and has thrown plans for the Lunar New Year holiday into chaos for millions of people. On January 30, 2020, the World Health Organization also declared the 2019-nCoV outbreak a global health emergency because it could spread to countries that are not prepared.

中國目前存在2019年新型冠狀病毒（2019-nCoV）危機。 它也被稱為武漢冠狀病毒爆發，始於2019年12月，截至2020年1月30日當地時間17:26，迄今為止已在中國導致213人死亡，至少9066例感染。 亞洲國家以及加拿大，法國，德國和美國。 結果，中國政府封鎖了湖北省的幾個主要城市，並將農曆新年假期的計劃推向了數百萬人的混亂狀態。 2020年1月30日，世界衛生組織還宣布將2019-nCoV暴發列為全球衛生緊急情況，因為它可能會蔓延到沒有準備好的國家。

Furthermore, to prevent the spread of the new and deadly virus, all cities in China now have shut down most public places and facilities, including parks, leaving many people with no place to exercise. As a result, people may wonder if one should exercise at all during the outbreak and if so, how? These questions made Journal of Sport and Health Science remember some well-known studies done by my colleague, Dr. Jeffrey A. Woods and his team at the University of Illinois at Urbana-Champaign (UIUC), in which they found a protective effect of exercise on mortality due to influenza in mice.

此外，為防止新的致命病毒傳播，中國所有城市現在都關閉了大多數公共場所和設施，包括公園，使許多人無處可運動。 結果，人們可能會懷疑在爆發期間是否應該完全鍛煉身體，如果這樣，該如何做？ 這些問題使《體育與健康科學雜誌》記住了我的同事Jeffrey A.Woods博士及其在伊利諾伊大學香檳分校（UIUC）所做的一些著名研究，他們發現了 運動對小鼠因流感引起的死亡率。

Dr. Woods is a Mottier Family Professor at UIUC. His research focuses on the effects of exercise on the immune system, the gut microbiome, and aging. He was among the first scholars to demonstrate that regular exercise can have an anti-inflammatory effect on the body and showed that exercise can improve the immune response to the flu vaccine in older adults. I interviewed Dr. Woods for the “Should and How” questions.

伍茲博士是UIUC( 伊利諾大學厄巴納-香檳分校University of Illinois Urbana-Champaign)的Mottier教授。 他的研究重點在於運動對免疫系統，腸道微生物組和衰老的影響。 他是最早證明經常運動對身體具有抗炎作用的學者之一，並表明運動可以改善老年人對流感疫苗的免疫反應。 我採訪了伍茲博士有關“應該怎樣做”的問題。

Zhu: Would you please tell the readers of Journal of Sport and Health Science a little bit about yourself, for example, where did you receive your training and what made you interested in exercise and immune function-related research?

您能否向《運動與健康科學雜誌》的讀者介紹一下您自己，例如，您在哪裡接受培訓，是什麼使您對運動和免疫功能相關研究感興趣？

Woods: I am currently an administrator and researcher at UIUC. I received my PhD from the University of South Carolina (USC) at Columbia under the direction of Drs. J. Mark Davis and Russ Pate. I had an interest in understanding how exercise affected the immune system because not much was known about it, so I sought out co-mentors at the nearby USC School of Medicine. There, I found Drs. Eugene Mayer and Abdul Ghaffar, who took me on as an additional mentee to learn about the immune system and how to study it. In the 1980s, exercise immunology was a very new subfield for exercise science. As time evolved, it has been satisfying to see how important the immune system is to the normal tissue and organ functioning and pathophysiology and how it plays a role in exercise adaptation in muscle and other tissues.

伍茲：我目前是UIUC的管理員和研究員。 我在哥倫比亞大學南加州大學（USC）博士的指導下獲得博士學位。 J.馬克·戴維斯（Mark Davis）和拉斯·佩特（Russ Pate）。 我對了解運動對免疫系統的影響很感興趣，因為對此知之甚少，所以我在附近的南加州大學醫學院尋找了導師。 在那裡，我找到了博士。 尤金·梅耶（Eugene Mayer）和阿卜杜勒·加法爾（Abdul Ghaffar），他是我的額外實習生，以了解免疫系統及其研究方法。 在1980年代，運動免疫學是運動科學的一個非常新的領域。 隨著時間的流逝，看到免疫系統對正常組織和器官功能以及病理生理的重要性，以及它如何在肌肉和其他組織的運動適應中發揮作用，一直令人感到滿意。

Zhu: Please tell us about your well-known “exercise and flu” studies,1,2 including the purposes of the studies, research design, and major findings.

朱：請介紹一下您著名的“運動與流感”研究1,2，包括研究目的，研究設計和主要發現。

Woods: Back in the 2000s, we performed a series of studies in mice and people to understand how individual bouts of exercise and exercise training affect influenza infection and vaccination, respectively. In our animal studies, we found that moderate endurance exercise (30 min/day) could protect mice from death due to influenza. Mice that exercised for longer durations (∼2.5 h/day) exhibited an increase in some illness symptoms, but there was no statistically significant difference in mortality when compared to sedentary mice. We concluded that moderate exercise could be beneficial and that prolonged exercise could be detrimental to influenza-infected mice. For obvious reasons, we have not performed this experiment in people.

We also did a large study to determine whether 10 months of regular endurance exercise could improve influenza vaccination responses in older adults, a group that is at risk for infectious disease due to immunosenescence. We found that regular, moderate cardiovascular exercise could extend the protective effect of the annual influenza vaccination so that it maintained protective levels of antibodies throughout the entire influenza season (i.e., into March and April in the northern hemisphere). We concluded that regular moderate endurance exercise might be one way to boost the protective effect of annual influenza vaccination. It is very important for all people to receive the annual influenza vaccine.

伍茲：早在2000年，我們在小鼠和人類中進行了一系列研究，以了解個體運動和運動訓練分別如何影響流感感染和疫苗接種。在我們的動物研究中，我們發現適度的耐力運動（每天30分鐘）可以保護小鼠免於死於流感。運動時間更長（〜2.5小時/天）的小鼠表現出某些疾病症狀的增加，但與久坐小鼠相比，死亡率沒有統計學上的顯著差異。我們得出的結論是，適度運動可能有益，長時間運動可能會對感染流感的小鼠有害。出於明顯的原因，我們尚未在人中進行此實驗。

我們還進行了一項大型研究，以確定10個月的定期耐力鍛煉是否可以改善老年人的流感疫苗接種反應，該人群由於免疫衰老而有傳染病的風險。我們發現，定期進行適度的心血管運動可以延長年度流感疫苗的保護作用，從而在整個流感季節（即北半球的3月和4月）保持抗體的保護水平。我們得出的結論是，定期進行適度的耐力鍛煉可能是增強年度流感疫苗接種保護作用的一種方法。對所有人來說，每年接種流感疫苗非常重要。

Both influenza and coronaviruses cause respiratory tract infection that can lead to morbidity and mortality, especially in those who are immunocompromised or who have no existing immunity to the viruses. Indeed, while the 2019-nCoV should not be taken lightly, influenza is a much bigger problem, but because it is relatively common and has been around for a long time, it does not receive the attention that new viral outbreaks do. The 2019-nCoV is scary because it is new and we do not know a lot about it yet. New viruses are always scary because we have little to no protective immunity against them and we do not have vaccines. There is work going on to understand and develop preventive strategies to deal with this 2019-nCoV threat. However, universal precautions to limit its spread are very important right now until a new vaccine or another strategy is available.

流行性感冒和冠狀病毒都會引起呼吸道感染，從而導致發病和死亡，特別是在免疫力低下或對病毒沒有免疫力的人中。 確實，雖然不應該掉以輕心地看待2019-nCoV，但流感是一個更大的問題，但是由於它相對普遍並且已經存在很長時間了，因此它並沒有引起新的病毒爆發的注意。 2019-nCoV令人恐懼，因為它是新的，我們對此還不了解。 新病毒總是令人恐懼，因為我們對它們幾乎沒有保護性免疫力，也沒有疫苗。 目前正在進行的工作是理解和製定預防策略以應對這種2019-nCoV威脅。 但是，在獲得新疫苗或其他策略之前，限制其擴散的普遍預防措施非常重要。

Zhu: Based on your earlier studies, as well as the progresses made in exercise and immunization over the past 15 years, should people exercise during a coronavirus outbreak? If so, what are the guidelines?

朱：根據您的早期研究以及過去15年在運動和免疫方面取得的進展，人們是否應該在冠狀病毒爆發期間進行運動？ 如果是這樣，指導方針是什麼？

Woods: It is safe to exercise during the coronavirus outbreak. One should not limit the multitude of health benefits that exercise provides us on a daily basis just because there is a new virus in our environment. However, there may be some additional precautions to reduce your risk of infection. If you are a “social exerciser”, you might want to limit your exposure to exercise partners who have exhibited signs and symptoms of illness. The problem, though, is that infected people may be infectious before they exhibit symptoms. In some instances, wearing a mask while exercising may be a way to reduce your exposure. It is very important to make sure that if you are exercising on equipment in fitness facilities or gymnasiums that you make sure to disinfect the equipment before and after you use it. When done exercising, the most effective way to clean hands is to wet them with clean water, then apply soap and scrub for at least 20 s, before rinsing and drying with a clean towel. Hand sanitizers with at least 60% alcohol content may also be used, but the U.S. Centers for Disease Control and Prevention warns they are not effective against all germs. This strategy should be used at all times, not just because there is an acute viral outbreak. Avoiding touching your face and neck with your hands is also advised if you cannot disinfect them until a later time.

At this stage, we know the virus is transmitted through airborne droplets and direct contact with infected people. Coronaviruses are primarily spread through close contact with another individual, in particular through coughing and sneezing on somebody else who is within a range of about 3 to 6 feet from that person. We do not know how long the virus remains viable on objects.

伍茲：在冠狀病毒爆發期間進行鍛煉是安全的。人們不應該僅僅因為我們的環境中存在一種新病毒就限制運動每天為我們帶來的眾多健康益處。但是，可能還有一些其他預防措施可降低感染風險。如果您是“社交運動者”，則可能需要限制接觸那些有疾病跡象和症狀的運動夥伴。然而，問題在於感染者在表現出症狀之前可能具有傳染性。在某些情況下，運動時戴口罩可能是減少暴露的一種方法。確保在健身設施或體育館中的設備上鍛煉時，務必確保在使用前後對設備進行消毒。做完運動後，最有效的清潔方法是用清水弄濕雙手，然後用肥皂擦洗至少20 s，然後用乾淨的毛巾沖洗並乾燥。也可以使用酒精含量至少為60％的洗手液，但美國疾病控制和預防中心警告說，它們對所有細菌均無效。應始終使用此策略，而不僅是因為存在急性病毒爆發。如果不能等到以後再消毒，還建議避免用手觸摸臉部和頸部。

在此階段，我們知道病毒是通過空氣中的飛沫傳播並與感染者直接接觸。冠狀病毒主要通過與另一個人的密切接觸而傳播，特別是通過咳嗽和打噴嚏在距離該人約3至6英尺範圍內的其他人上進行。我們不知道該病毒可在物體上存活多長時間。

Zhu: Will the guidelines apply to previously sedentary individuals?

朱：指導原則是否適用於以前久坐的人？

Woods: It is safe for sedentary individuals to exercise or to start an exercise program. Physician consultation and approval may be needed for people with disease, comorbidity, orthopedic problems, or advanced age. As above, there are prudent precautions that can be taken to limit infectious disease spread. Anything that increases your probability of coming into contact with an infected person, or that compromises your immune system, increases your risk of infection. If you are sedentary, it may be a good idea not to overdo it. Research suggests that unaccustomed strenuous or prolonged exercise might reduce the function of your immune system defenses. As such, avoiding long and stressful exercise sessions that you are unaccustomed to might be a good idea.

伍茲：久坐的人進行鍛煉或開始鍛煉計劃是安全的。 患有疾病，合併症，骨科疾病或高齡人士可能需要醫生諮詢和批准。 如上所述，可以採取謹慎的預防措施來限制傳染病的傳播。 任何增加您與被感染者接觸的可能性或損害您的免疫系統的事物，都會增加您感染的風險。 如果久坐不動，最好不要過度使用。 研究表明，不習慣的劇烈運動或長時間運動可能會降低免疫系統防禦功能。 因此，避免您不習慣的長時間緊張運動是一個好主意。

Zhu: What about the people who already got infected by flu, severe acute respiratory syndrome (SARS), or the current 2019-nCoV in China? Should they still do exercises?

朱：那已經感染了流感，嚴重急性呼吸系統綜合症（SARS）或當前中國2019-nCoV的人呢？ 他們還應該繼續鍛煉嗎？

Woods: Typically, one can exercise moderately with mild upper respiratory tract symptoms (e.g., runny nose, sinus congestion, mild sore throat). However, I would recommend against exercising if you are experiencing any of these symptoms: severe sore throat, body aches, shortness of breath, general fatigue, chest cough, or fever. You should also seek medical care if you are experiencing those symptoms. Typically, recovery from respiratory viral infections takes 2–3 weeks, which corresponds with the time it takes your immune system to generate cytotoxic T cells necessary to clear the virus from infected cells. After this period, when symptoms are gone, it is safe to begin exercising regularly, but you may want to take it slow at first.

伍茲（Woods）：通常，人們可以進行中等程度的鍛煉，出現輕度的上呼吸道症狀（例如流鼻涕，鼻竇充血，輕度喉嚨痛）。 但是，如果您遇到以下任何一種症狀，我建議您不要進行運動：嚴重的咽喉痛，身體疼痛，呼吸急促，全身疲勞，咳嗽或發燒。 如果您遇到這些症狀，也應該尋求醫療服務。 通常，從呼吸道病毒感染中恢復需要2至3週的時間，這與您的免疫系統產生清除感染細胞所需的細胞毒性T細胞所需的時間相對應。 在這段時間過後，症狀消失後，可以定期開始鍛煉是安全的，但是您可能一開始要慢慢服用。

Zhu: While many research studies examined the impact of a relatively long-term exercise intervention (8–12 weeks),3,4 others reported that even a single bout of exercise can help boost one's immune function.5 So, how quickly can one benefit from an exercise bout?

朱：許多研究研究了相對長期的運動干預（8-12週）的影響，3,4其他人報告說，即使一次運動也可以幫助增強人的免疫功能。5因此，一個人能多快 從運動中受益？

Woods: I believe that even a single exercise bout can be beneficial, but regular exercise provides a much bigger benefit. Molecular and cellular events take place within seconds to minutes following the beginning of an exercise bout or period of physical activity. This is why there is so much work right now examining sitting time and how often physical activity should be interspersed with inactivity to promote health. The historic thinking has been that exercise promotes a fight or flight stress response that mobilizes immune cells to get ready for impending infectious or noninfectious challenges accompanied by physical activity. This makes sense from an evolutionary perspective where physical activity might lead to injury or harm.

伍茲：我相信，即使是單次運動也能帶來好處，但定期運動會帶來更大的好處。 分子和細胞事件發生在運動開始或身體活動一段時間後的幾秒到幾分鐘內。 這就是為什麼現在要進行大量工作來檢查就座時間以及多長時間進行一次體育鍛煉和不運動來促進健康的原因。 歷史上的思想是，運動促進戰鬥或逃避壓力反應，從而動員免疫細胞為即將發生的傳染性或非傳染性挑戰以及身體活動做好準備。 從身體活動可能導致傷害或傷害的進化角度來看，這是有道理的。

Zhu: What about intensity? It seems that most studies and reviews say that the intensity of the exercises should be kept moderate. However, Campbell and Turner have recently challenged this belief and claimed that there is no harmful effect on immune function even when a vigorous bout of exercise intervention is employed. What is your view on the appropriate intensity of exercise for improving immune function?

朱：強度呢？ 似乎大多數研究和評論都說，鍛煉的強度應保持適度。 但是，坎貝爾（Campbell）和特納（Turner）最近對這一信念提出了挑戰，並聲稱即使採用劇烈的運動干預措施也不會對免疫功能產生有害影響。 您對改善免疫功能的適當運動強度有何看法？

Woods: The report from Campbell and Turner6 focuses on highly fit individuals who compete in, and are accustomed to, long endurance, high-intensity events. While I believe there is merit in the evidence they provide to refute the conclusions for that population, studies where sedentary people are forced to exercise at high intensities for prolonged periods might paint a different picture. There are few such studies due to the ethics and safety concerns and there are many other variables that contribute to natural infections that would need to be accounted and controlled for in such studies. The best studies would be ones that control exercise and infectious disease exposure in people. These are difficult to ethically perform in people and it would be very difficult or impossible to get approved by institutional review boards. Animal models, including ours as mentioned, may provide valuable insights into this argument and there are many studies demonstrating that prolonged, unaccustomed exercise can increase infectious disease morbidity and mortality. These studies were not reconciled in the Campbell and Turner6 article. However, as with all animal models, there are limitations, such as species differences, stress associated with forced exercise, the type of pathogen, and timing of exercise in relation to infection that would need to be taken into account before a firm conclusion could be drawn.

伍茲：Campbell和Turner的報告著重於那些長期參加高強度，高強度比賽的習慣的高素質個人。儘管我認為他們提供的證據可以反駁該人群的結論，但久坐的人們被迫長時間進行高強度運動的研究可能會得出不同的結論。出於道德和安全方面的考慮，很少進行此類研究，並且還有許多其他因素會導致自然感染，因此需要在此類研究中加以考慮和控制。最好的研究應該是控制人們的運動和傳染病暴露的研究。這些在道德上很難在人們中執行，並且很難或不可能獲得機構審查委員會的批准。動物模型，包括我們提到的動物模型，可能會為這一論點提供有價值的見識，並且有許多研究表明，長期不習慣的運動會增加傳染病的發病率和死亡率。這些研究在Campbell和Turner6的文章中並不一致。但是，與所有動物模型一樣，存在局限性，例如物種差異，與強迫運動有關的壓力，病原體的類型以及與感染有關的運動時間，在得出明確結論之前，應考慮與感染有關的鍛煉時間和時間。

Zhu: While most published studies have been focused on the impact of aerobic exercise on immune function, recent research studies have found resistance training and body–mind exercise such as Tai Ji Quan, known also as Tai Chi, and yoga could also be helpful to the immune function. What is your view and recommendation on these types of exercises?

朱：雖然大多數已發表的研究都集中在有氧運動對免疫功能的影響上，但最近的研究發現阻力訓練和身體鍛煉，例如太極拳（又稱太極拳），瑜伽也可能有助於 免疫功能。 您對這些類型的練習有何看法和建議？

Woods: There have been some more recent studies aimed at determining the role of resistance training and high-intensity interval training on various immune parameters. My take of the literature is that there are still very few studies on this to make firm conclusions. We published a study in 20077 examining the influence of 5 months of Tai Ji Quan/Qigong could influence the immune response to influenza vaccination in older adults. We found significant increases in the magnitude and duration of antibody responses in Tai Ji Quan/Qigong participants when compared to controls. While I am unaware if these data have been replicated, a recent systematic review on the effects of yoga concluded that yoga might be beneficial for those suffering from diseases with an inflammatory component.8

伍茲：最近有一些研究旨在確定抵抗訓練和高強度間歇訓練對各種免疫參數的作用。 我對文獻的看法是，對此尚缺乏確定的結論的研究。 我們在2007年發表了一項研究，研究了太極拳/氣功5個月對老年人免疫接種流感疫苗的免疫反應的影響。 我們發現，與對照組相比，太極拳/氣功參與者的抗體應答幅度和持續時間顯著增加。 雖然我不知道這些數據是否已被複製，但最近對瑜伽效果的系統評價得出結論，瑜伽可能對患有炎症成分疾病的患者有益

Zhu: You have many firsts in the area of exercise and immune function. Would you please list a few top questions that the field should address so that young researchers can address some of these questions?

朱：您在運動和免疫功能方面有許多首創。 您能否列出該領域應該解決的幾個主要問題，以便年輕的研究人員可以解決其中的一些問題？

Woods: While there has been much progress in understanding the impact of exercise on our immune systems, there is still much we do not know and the challenge is that we have known about these questions for some time but limitations of human experimentation and a dearth of good animal models have hindered progress. Questions such as shown below are key questions for the field to be moving forward:

• 1.
  What are the mechanisms whereby exercise affects various aspects of immune functioning?
• 2.
  How do various acute and chronic exercise paradigms affect immune system omics measures?
• 3.
  Does exercise cause epigenetic changes in our immune systems?
• 4.
  Do exercise-induced changes in immune functioning translate into health benefits?
• 5.
  How does exercise impact the gut microbiome and gut immunity?
• 6.
  What are optimal exercise dose-responses for various disease states?
• 伍茲：雖然在了解運動對免疫系統的影響方面已經取得了很大的進步，但我們仍然不知道很多，而挑戰在於我們已經知道這些問題已有一段時間了，但是人類實驗的局限性和缺乏 好的動物模型阻礙了進步。 如下所示的問題是該領域向前發展的關鍵問題：
  
  
  1。運動影響免疫功能各個方面的機制是什麼？
  2。各種急慢性運動範例如何影響免疫系統組學措施？
  3。運動會引起我們免疫系統的表觀遺傳變化嗎？
  4。運動引起的免疫功能改變會轉化為健康益處嗎？
  5，運動如何影響腸道微生物組和腸道免疫力？
  6。各種疾病狀態的最佳運動劑量反應是什麼？

Zhu: Finally, you have been very supportive of Chinese scholars and have trained some excellent graduate students from China. You have also often reviewed the research works submitted from Chinese laboratories. Based on your observation and experience, which areas should the Chinese scholars and laboratories further improve and focus on?

朱：最後，您一直非常支持中國學者，並培訓了一些來自中國的優秀研究生。 您也經常回顧過中國實驗室提交的研究工作。 根據您的觀察和經驗，中國學者和實驗室應在哪些方面進一步改進和關注？

Woods: Yes, I get many inquiries from Chinese and other international students about potentially working in my laboratory as a pre-doctoral student. The main advice that I would give these students is to make sure that you have (a) a strong academic record that includes basic science courses (i.e., chemistry, physiology), (b) evidence of basic science wet laboratory skills, and (c) tangible research output (i.e., abstracts, publications, and presentations) in your field. I would also caution about using cold call e-mails that do not reflect careful thought and research relative to the individual you are contacting. You should read the work and understand the research interests of the professor you are contacting while also making a case that you have strong interests and skills in this area. Most of the Chinese scholars I have mentored came to me on recommendation from someone I know and trust (e.g., another U.S. or international professor or student). Thus, it is important to create a network of people in your field of interest. You can do this by interacting with people at scientific meetings. If that is not an option due to cost or circumstance, I would recommend trying to find any connection between you, your institution, or your current mentor and someone at a target institution of study. As for manuscripts coming from Chinese or international laboratories submitted to English-language journals, my recommendation would be to make sure that the manuscript has been carefully edited for spelling and grammar relative to the English language. No matter how good the science is, if the presentation is poor it will reflect poorly on the work.

伍茲：是的，我從中國和其他國際學生那裡得到了很多關於可能在我的博士前實驗室工作的諮詢。我給這些學生主要的建議是，確保您具有（a）包括基礎科學課程（即化學，生理學）在內的良好學術記錄，（b）基礎科學濕實驗室技能的證明，以及（c） ）您所在領域的有形研究成果（即摘要，出版物和演示文稿）。對於使用冷打電話的電子郵件，我也要保持謹慎，這些電子郵件不能反映出與您所聯繫的個人有關的仔細思考和研究。您應該閱讀工作並了解所聯繫教授的研究興趣，同時還要證明您在該領域具有濃厚的興趣和技能。我所指導的大多數中國學者都是根據我認識和信任的人（例如另一位美國或國際教授或學生）的推薦來找我的。因此，在您感興趣的領域中建立人脈網絡非常重要。您可以通過在科學會議上與人們互動來做到這一點。如果由於成本或情況導致無法選擇，我建議您嘗試在您，您的機構或當前的導師與目標學習機構的某人之間找到任何联系。至於來自中國或國際實驗室提交給英語期刊的稿件，我的建議是確保對稿件進行認真編輯，以使其相對於英語拼寫和語法。無論科學水平如何，如果演講表現不佳，都會對作品產生不良影響。

Articles from Journal of Sport and Health Science are provided here courtesy of Shanghai University of Sport

上海體育大學提供《體育與健康科學》雜誌的文章

一日飢餓秘密獲得諾貝爾獎

@ You are not alone.

You are not alone.