Effectiveness of traditional chinese medicine (TCM) exercise therapy intervention on the cognitive function in the elderly: A systematic review and meta-analysis.

OBJECTIVES: There exists a deficiency in a distinct understanding of the intervention effects of Traditional Chinese Medicine (TCM) exercise therapies (Tai Chi, Yi Jin Jing, Ba Duan Jin, Liu Zi Jue, Qigong, Wu Qin Xi etc.) on cognitive function and its moderating variables in the elderly. This study aims to systematically evaluate the effects of TCM exercise therapies on the cognitive function of the elderly and further propose the best exercise intervention programme to delay the cognitive decline of the elderly. METHODS: PubMed, EBSCO host, Web of Science, EMbase, China National Knowledge Infrastructure and Wan Fang databases were searched for the effects of TCM exercise therapies on the cognitive function in older adults until July 2022. A meta-analysis of the included literature was performed using Stata 12.0 software, with a subgroup analysis of seven moderating variables: subject type, intervention content, intervention duration, intervention frequency, intervention period, study type and sample size. A random effects model was used to combine the overall effect sizes and to test for heterogeneity and publication bias across studies. RESULTS: A total of 20 publications with 1975 subjects were included. The TCM exercise therapies delayed cognitive decline in older adults (d = 0.83; 95 % CI [0.62-1.04]; P < 0.001). Subgroup analysis found that intervention content, intervention duration, intervention frequency, and intervention period were significant moderating variables influencing the effectiveness of the intervention. Among them, the Ba Duan Jin intervention (d = 0.85; 95 % CI [0.65-1.06]; P < 0.001), the duration of each exercise session of 60 min or more (d = 0.86; 95 % CI [0.71-1.00]; P < 0.001), the frequency of exercise of more than 5 times per week (d = 0.80; 95 % CI [0.64-0.96]; P < 0.001) and exercise cycles of 6-9 months (d = 0.96; 95 % CI [0.80-1.12]; P < 0.001) produced the largest effect sizes. CONCLUSION: TCM exercise therapies can effectively improve the cognitive function of the elderly. The best effect on the cognitive function of the elderly was achieved by choosing Ba Duan Jin and exercising at least five times a week for at least 60 min each time for a total of 6-9 months. The effect size of the TCM exercise therapy interventions on the cognitive function in older adults may be overestimated because of publication bias. In addition, large-sample, multicenter, high-quality randomised controlled trials should be conducted to validate this result.

The effect of exercise training intervention for patients with abdominal aortic aneurysm on cardiovascular and cardiorespiratory variables: an updated meta-analysis of randomized controlled trials.

OBJECTIVE: The purpose of this meta-analysis was to evaluate the effect of exercise training intervention in patients with abdominal aortic aneurysm (AAA). METHODS: Eight randomized controlled trials (RCTs) that recruited 588 AAA patients were extracted using 4 databases (PubMed, Embase, Wanfang Data, and Cochrane Library). Physiological and biochemistry parameters that included in this study are high-sensitivity C-reactive protein (hs-CRP), respiratory peak oxygen uptake rate (VO2peak), triglyceride (TG), total cholesterol (TC), anaerobic threshold (AT), the diameter of AAA, high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), and matrix metalloproteinase-9 (MMP-9). Standard mean difference (SMD) was used to assess the between group effect. RESULTS: This meta-analysis was synthesized with findings from RCTs and found that hs-CRP (SMD, - 0.56 mg/dL; 95% CI: - 0.90 to 0.22; P = 0.001), VO2peak (SMD, 0.4 mL/kg/min; 95% CI, 0.21 to 0.60; P < 0.001), TG (SMD, - 0.39 mg/dL; 95% CI: - 0.02 to 0.77; P = 0.04), and AT (SMD, 0.75 mL/kg/min; 95% CI, 0.54 to 0.96; P < 0.001) were significantly improved in the exercise groups, while the size of AAA (SMD, - 0.15; 95% CI: - 0.36 to 0.06; P = 0.15), TC (SMD, 0.16 mg/dL; 95% CI: - 0.10 to 0.42; P = 0.23), HDL/LDL ratio (SMD, - 0.06; 95% CI: - 0.32 to 0.20; P = 0.64), HDL (SMD, - 0.09; 95% CI: - 0.39 to 0.20; P = 0.54), LDL (SMD, 0.08; 95% CI: - 0.21 to 0.38; P = 0.59), and MMP-9 (SMD, - 0.23 mg/dL; 95% CI: - 0.53 to 0.06; P = 0.12) did not differ in the exercise groups compared with the controls. CONCLUSION: Exercise intervention improved some of the CVD risk factors but not all, hs-CRP, VO2peak and AT were significantly improved after exercise intervention, while, changes of MMP-9, the size of AAA, and the overall lipids profile were not. Exercise intervention provides an additional solution for improving cardiorespiratory capacity and health status among AAA patients, and might lead to a delay of AAA progression.

The Biomechanical Screening Game between Visitor Power and Staminode Operative Strength of Delphinium caeruleum (Ranunculaceae).

During the evolution of angiosperm flowers, some floral traits may undergo certain changes in order to participate in screening. The stamens and pistils of Delphinium caeruleum are covered by two "door-like" staminodes, the evolutionary function of which, however, is quite unknown. In this study, we investigated whether D. caeruleum staminodes acted as visitor filters by assessing the respective strengths of staminodes and visitor insects (six bee species). We measured the operative strength required to open the staminodes and the strength that insects were capable of exerting using a biological tension sensor. Furthermore, we compared the strength required to open staminodes at different phases of the flowering period (male and female phases) and the strength of different visitors (visitors and non-visitors of D. caeruleum). The results showed that the strength needed to open staminodes in the male phase was significantly higher than that in the female phase. There was no significant difference between the strength exerted by visitors and required by staminodes of D. caeruleum in the male phase, but the visitor strength was significantly higher than that required to open staminodes in the female phase flowers. The strength of non-visitors was significantly lower than that required to open staminodes in the male phase. Furthermore, there was a significant positive association between the strength and the body weight of the bees. These results highlighted the observation that only strong visitors could press the two staminodes to access the sex organs and achieve successful pollination. Furthermore, these results revealed the function of pollinator screening by the staminodes of D. caeruleum. The biomechanical approach to the study of flowers allowed us to address relevant ecological and evolutionary questions of the plant-pollinator interaction and explore the functional modules within the flower structure in other plant species.

A Decrease in the Staminode-Mediated Visitor Screening Mechanism in Response to Nectar Robbers Positively Affects Reproduction in Delphinium caeruleum Jacq. ex Camb. (Ranunculaceae).

Nectar-robbing insects, which are frequently described as cheaters in plant-pollinator mutualisms, may affect plant reproductive fitness by obtaining nectar rewards without providing pollination services. The negative effects of nectar robbing on plant reproductive success have been widely reported, but the reasons for possible positive effects demand further investigation. The goal of the study was to evaluate the effects of nectar robbing on the reproductive success of Delphinium caeruleum. Two staminodes cover the stamens and pistils in the flowers of D. caeruleum, forming a "double door" type of structure that compels pollinators to physically manipulate the staminodes to access the sex organs. In order to explore whether the operative strength required to open the staminodes is affected by actions associated with nectar robbing, we set up five different treatment groups: no nectar robbing, natural nectar robbing, artificial nectar robbing, hole making, and nectar removal. A biological tension sensor was used to measure the operative strength required to open the staminodes in the flowers. We also assessed the effect of nectar robbing on the flower-visiting behavior of pollinators and the effect of nectar robbing on reproductive fitness by the flower. The results showed that the operative strength needed to open staminodes was reduced by nectar robbers but not by artificial nectar robbing, hole making, or nectar removal. The flowers' continuous visitation rate and visitation frequency by pollinators decreased significantly in robbed flowers. Both the pollen export and pollen deposition in naturally robbed flowers were significantly higher than those in nonrobbed flowers. Our results demonstrate that nectar robbers play an indirect positive role in the reproductive fitness of D. caeruleum flowers by reducing the operative strength of staminodes to promote pollen transfer. The reduction in operative strength of staminodes might be an adaptive mechanism that responds to nectar robbing.

Why flowers close at noon? A case study of an alpine species Gentianopsis paludosa (Gentianaceae).

Repeatable floral closure with diurnal rhythms, that is, flower opening in the morning and closing in the evening, was widely reported. However, the rhythm of flower opening in the morning but closing in the midday received much less attention. Gentianopsis paludosa, Gentianaceae, has an obvious petal movement rhythm opening in the morning and closing at noon at northeast of the Qinghai-Tibetan Plateau. In this study, we examined the effects of temperature (T), relative humidity (RH), and illumination intensity (II) on G. paludosa's flower closure. Furthermore, we monitored the environmental changes inside and outside of the flowers, aiming to test the effect of floral closure on the stability of microenvironment inside the flower. Finally, we artificially interrupted temporal petal closure and investigated its effects on reproductive fitness. The results showed that high/low temperature contributed more to the flower closure than low RH, while illumination intensity had no significant effect on it. The medium temperature, relative humidity and illumination intensity (environmental conditions at 10:00) did not delay flower closure when flowers at pre-closing period or stimulate reopen when flowers full closed. Floral closure provided a stable temperature condition and a higher RH condition inside the flower. Meanwhile, compulsive opening and delayed closure of flowers decreased the seed-set ratio while no effect was found when flowers were forced to close. We conclude that endogenous rhythm regulates floral closure. The rhythm of petal movement providing a stable microenvironment for G. paludosa, increasing the seed production and saving energy from flower opening maintenance, which might be an adaptive strategy to against unfavorable environmental conditions.

Range expansion decreases the reproductive fitness of Gentiana officinalis (Gentianaceae).

Plants living at the edge of their range boundary tend to suffer an overall decline in their fitness, including growth and reproduction. However, the reproductive performance of plants in artificially expanded habitats is rarely investigated, although this type of study would provide a better understanding of range limitations and improved conservation of ex situ plants. In the current study, we transplanted a narrowly dispersed species of Gentiana officinalis H. Smith (Gentianaceae) from its natural area of distribution to two different elevations and natural elevation to comprehensively study its pollination biology, including flowering phenology and duration, floral display, reproductive allocation, pollinator activity, and seed production. The findings indicated that the starting point and endpoint of the flowering phenology of G. officinalis were earlier at the low elevation, but the peak flowering periods did not differ significantly between any of the experimental plots. When transplanted, the flowering duration, especially the female phase, was reduced; the floral display, including spray numbers, flower numbers, and flower size (length and width), decreased, especially at high elevations. Moreover, the pollen numbers and pollen-ovule ratio were decreased at both high and low elevations, although the ovule numbers showed no change, and aboveground reproductive allocation was decreased. Furthermore, pollinator richness and activity were significantly decreased, and the seed-set ratio decreased under both natural conditions and with supplemental pollination. Finally, more severe pollen limitation was found in transplanted individuals. These results indicated an overall decrease in reproductive fitness in plants living outside their original area of distribution when the geographical range of G. officinalis was expanded.

The effects of exercise on body composition of prostate cancer patients receiving androgen deprivation therapy: An update systematic review and meta-analysis.

Androgen deprivation therapy is a common treatment for prostate cancer. However, this therapy is associated with various adverse effects, such as increased body fat and decreased bone mineral density. Exercise may be useful for ameliorating these adverse effects, although it is not completely effective. This review aimed to clarify how exercise interventions influenced body composition and bone mineral density and to explore the most effective exercise program among prostate cancer patients who received androgen deprivation therapy. We searched the PubMed, EMBASE, Web of Science, EBSCO, and Cochrane Library databases for reports of randomised controlled trials that were published until October 2021. All studies involved prostate cancer patients who received androgen deprivation therapy and completed aerobic exercise, resistance exercise, and/or impact exercise training. Outcomes were defined as lean body mass, body fat mass, body fat rate, regional and whole-body bone mineral density. Thirteen reports regarding 12 randomised clinical trials (715 participants) were included. Relative to the control group, exercise intervention provided a higher lean body mass (mean difference: 0.88, 95% confidence interval: 0.40 to 1.36, P<0.01), a lower body fat mass (mean difference: -0.60, 95% confidence interval: -1.10 to -0.10, P<0.05), and a lower body fat rate (mean difference: -0.93, 95% confidence interval: -1.39 to -0.47, P<0.01). Subgroup analyses revealed greater efficacy for exercise duration of ≥6 months (vs. <6 months) and exercise immediately after the therapy (vs. delayed exercise). No significant differences were observed in the bone mineral density outcomes. Exercise can help ameliorate the adverse effects of androgen deprivation therapy in body composition, with combination exercises including resistance exercise, 8-12 repetition maximum of resistance exercise intensity, prolonged exercise duration, and performing exercise immediately after therapy providing better amelioration. And the combination of resistance and impact exercise appears to be the best mode for improving the bone mineral density.