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The mitochondrial ultrastructure was damaged under hypoxia conditions, indicating the breakdown of cellular bioenergetics, which affected the metabolism in TCA cycle ( Glucose 6-phosphate from glycolysis enters the PPP to produce ribose 5-phosphate and nicotinamide adenine dinucleotide phosphate, which drive anabolic metabolism and biomass production ( Pyruvate can be converted into lactate, which is significantly elevated in RA ( AA can be released from membrane phospholipids under hypoxia and inflammatory activation