Effects of Modern Online and Traditional Offline Exercise Programs on the Frailty,Physical function,Emotional,and Social Support on Chinese Community-Dwelling Frail Older Adults:A Randomized Clinical Trail

Objective:The aim of this study were to explore the effects of 12-week modern online and traditional offline exercise programs on physical function,frailty status,emotional,and social support of pre-frail older adults.Methods:The traditional offline exercise programs were offered at a local community center,and the modern online programs were done partly at home and partly modern online.Sixty older adults were randomly allocated into the traditional offline group(n=30;66.96±4.43 years)and the modern online+traditional offline groups(n=30;65.85±5.61 years).The exercise programs for both groups included strength,balance,and gait exercises and were done twice/week for 60 min/session.We recorded the study parameters(demographic features,frailty,and physical function)at the baseline as well as at the end of the exercise program.Results:Maximum subjects observed a reversal of the pre-frail status with an increase in physical function and a decrease in fat mass in both groups;however,the CB group showed a relatively significant improvement in physical function.Conclusion:The modern online+traditional offline exercise programs were not only effective in improving the physical condition,but also enhanced psychological status,social support,and adherence.Thus,based on these results,modern online+traditional offline exercise programs were preferable for improving the overall health of pre-frail older adults.

Shenmai Injection Improves Hypertensive Heart Failure by Inhibiting Myocardial Fibrosis via TGF-β1/Smad Pathway Regulation

Objective: To study effects of Shenmai Injection on hypertensive heart failure and its mechanism for inhibiting myocardial fibrosis. Methods: Salt-sensitive(Dahl/SS) rats were fed with normal diet(0.3% Na Cl) and the high-salt diet(8% Na Cl) to observe the changes in blood pressure and heart function, as the control group and the model group. Salt-insensitive rats(SS-13BN) were fed with the high-salt diet(8% Na Cl) as the negative control group. After modeling, the model rats were randomly divided into heart failure(HF) group, Shenmai Injection(SMI) group and pirfenidone(PFD) group by a random number table, with 6 rats in each group. They were given sterilized water, SMI and pirfenidone, respectively. Blood pressure, cardiac function, fibrosis and related molecular expression were detected by sphygmomanometer, echocardiogram, enzyme linked immunosorbent assay(ELISA),hematoxylin-eosin staining, Masson staining, immunofluorescence and qPCR analysis. Results: After high-salt feeding, compared with the control and negative control group, in the model group the blood pressure increased significantly, the left ventricular ejection fraction(LVEF) and left ventricular fraction shortening(LVFS) were significantly reduced, and the serum NT-pro BNP concentration increased significantly(all P<0.05);furthermore,the arrangement of myocardial cells was disordered, the edema was severe, and the degree of myocardial fibrosis was also significantly increased(P<0.05);the protein and m RNA expressions of collagen type Ⅰ(Col Ⅰ) were up-regulated(P<0.05), and the mRNA expressions of transforming growth factor β1(TGF-β1), Smad2 and Smad3 were significantly up-regulated(P<0.05). Compared with HF group, after intervention of Shenmai Injection, LVEF and LVFS increased, myocardial morphology was improved, collagen volume fraction decreased significantly(P<0.05), and the mRNA expressions of Col Ⅰ, TGF-β1, Smad2 and Smad3, as well as Col Ⅰprotein expression, were all significantly down-regulated(all P<0.05). Conclusion: Myocardial fibrosis is the main pathological manifestation of hypertensive heart failure, and Shenmai Injection could inhibit myocardial fibrosis and effectively improve heart failure by regulating TGF-β1/Smad signaling pathway.