Effects of exergame and bicycle exercise intervention on blood pressure and executive function in older adults with hypertension: A three-group randomized controlled study.

Management of hypertension and prevention of cognitive decline are challenging public health problems. However, the effects of exergame intervention on blood pressure (BP) remain to be explored, and whether exergame intervention is an effective alternative to traditional physical exercise intervention for older adults with hypertension remains to be demonstrated. This study aimed to explore the effectiveness of moderate-intensity exergame intervention and bicycle exercise training on BP and executive function in older hypertensive patients. A total of 128 participants were randomly assigned to the exergame intervention group (n = 41), bicycle exercise intervention group (n = 44), and control group (n = 43). The intervention groups exercised for 60 min, 3 times per week, for 16 weeks, while the control group maintained their normal lifestyle. The results revealed that there were no significant differences between two intervention groups and control group in systolic BP and diastolic BP changes (ps > 0.05). Both intervention groups demonstrated significant improvements in working memory when compared with control group (exergame intervention group: -461.9 ms, p = 0.025; bicycle exercise intervention group: -470.1 ms, p = 0.021). There were no significant differences in systolic BP, diastolic BP, or working memory between the two intervention groups after 16 weeks of training (ps > 0.05). No difference in inhibition or cognitive flexibility was observed between the intervention and control groups (ps > 0.05). The current results showed that moderate-intensity exergame intervention did not produce significant benefits in reducing BP, but yielded similar beneficial effects in working memory to that of bicycle exercise intervention. More studies are needed on whether exergame intervention has the potential to be a promising supplemental therapeutic tool for older adults with hypertension.

Prevention of polycystic ovary syndrome and postmenopausal osteoporosis by inhibiting apoptosis with Shenling Baizhu powder compound.

Objective: Shenling Baizhu powder (SBP) has been shown to reverse the abnormal expression of the aromatic hydrocarbon receptor (AHR) mediated by air pollution. Our study aimed to understand the main ingredient of SBP and investigate its action mechanism in preventing polycystic ovary syndrome (POCS) and postmenopausal osteoporosis (PMO). Methods: The active ingredients of SBP with the highest binding affinity to AHR were screened using a Chinese medicine database, and their binding mechanism was simulated using molecular dynamics simulation (MDS). Rutin was utilized to treat ovarian granulosa cell lines and osteoblast cell lines. The cell lines were treated with a gradient of rutin concentration (0.01 mmol/L, 0.05 mmol/L and 0.1 mmol/L) to find the optimal drug dose. PCR was used to detect AHR and apoptosis-related proteins, and WB to detect the expression of AHR, caspase-3 and cleaved-caspase-3. Finally, the CCK-8 cell proliferation assay detected the proliferation of cells. Results: We obtained Rutin through the Chinese medicine database, and dynamics simulation determined its binding sites. Ovarian granulosa cell lines and osteoblast cell lines were treated with Rutin. RT-PCR and western blotting revealed that the expression of apoptosis-associated protein Bcl-2 was elevated, and the expression of AHR, Bax, caspase-3 and PARP were decreased. CCK-8 results showed accelerated proliferation in both cell types. Conclusion: Rutin, the main ingredient of SBP compound, works by binding to AHR, which can improve POCS and PMO by inhibiting cell apoptosis and by promoting cell proliferation.

The Effect of Exergame Training on Physical Functioning of Healthy Older Adults: A Meta-Analysis.

Exergames have attracted increasing attention from both the public and researchers. Although previous systematic reviews provided evidence that exergame training is beneficial for improving balance or mobility in older adults, multidimensional physical function measurements, including balance, upper body strength, lower body strength, aerobic endurance, and gait, might help us achieve more robust and reliable results. This meta-analysis aims to quantify the effects of exergame training on overall and specific physical function in healthy older adults. We systematically searched exergame training studies published between January 1985 and June 2021. Forty-eight studies were included in the present meta-analysis, with a total of 1099 participants included in the training group and 1098 participants in the control group. Random-effects meta-analyses found that older adults obtained a small benefit in overall physical function performance (g = 0.43, 95% confidence interval [CI] = 0.33 to 0.53), moderate benefits in balance (g = 0.59, 95% CI = 0.46 to 0.71), upper body strength (g = 0.65, 95% CI = 0.20 to 1.10), lower body strength (g = 0.51, 95% CI = 0.37 to 0.65), and aerobic endurance (g = 0.65, 95% CI = 0.44 to 0.86), a small benefit in gait (g = 0.33, 95% CI = 0.08 to 0.59), and negligible effects on upper body flexibility (g = 0.13, 95% CI = -0.06 to 0.32) and lower body flexibility (g = 0.10, 95% CI = -0.45 to 0.67) from exergame training. The mini-mental state examination score was positively associated with the overall training efficacy (ß = 0.08, P = 0.01), while body mass index and the sample size in the training group were negatively associated with the overall training efficacy (ß = -0.01, P < 0.01; ß = -0.004, P < 0.01). The current meta-analytic findings revealed that exergame training produced general benefits for overall physical function and different effects on specific physical function domains in older adults.

Effects of exergame and video game training on cognitive and physical function in older adults: A randomized controlled trial.

Few studies have simultaneously explored the training effects of exergame and video game. The purpose of this study was to investigate the effects of exergame and video game training on cognitive and physical function in healthy older adults. Eighty-four healthy older adults were randomly assigned to exergame training group, video game training group, and control group. Cognitive and physical function was measured before and after the training. Both training groups improved in verbal memory and aerobic endurance, but the training effects were greater in the exergame training group. The exergame training group also showed significant improvement in lower limb strength and balance. The current study provides evidence that exergame training, incorporating both cognitive engagement and physical activity, exerts greater benefits than cognitively engaging video game training alone. The findings shed lights into the future use of exergame in preventing cognitive and physical function decline in older adults.

Age-related impairment of navigation and strategy in virtual star maze.

BACKGROUND: Although it is well known that aging impairs navigation performance, the underlying mechanisms remain largely unknown. Egocentric strategy requires navigators to remember a series of body-turns without relying on the relationship between environmental cues. Previous study suggested that the egocentric strategy, compared with non-egocentric strategy, was relatively unimpaired during aging. In this study, we aimed to examine strategy use during virtual navigation task and the underlying cognitive supporting mechanisms in older adults. METHODS: Thirty young adults and thirty-one older adults were recruited from the local community. This study adapted star maze paradigm using non-immersive virtual environment. Participants moved freely in a star maze with adequate landmarks, and were requested to find a fixed destination. After 9 learning trials, participants were probed in the same virtual star maze but with no salient landmarks. Participants were classified as egocentric or non-egocentric strategy group according to their response in the probe trial. RESULTS: The results revealed that older adults adopting egocentric strategy completed the navigation task as accurate as young adults, whereas older adults using non-egocentric strategy completed the navigation task with more detours and lower accuracy. The relatively well-maintained egocentric strategy in older adults was related to better visuo-spatial ability. CONCLUSIONS: Visuo-spatial ability might play an important role in navigation accuracy and navigation strategy of older adults. This study demonstrated the potential value of the virtual star maze in evaluating navigation strategy and visuo-spatial ability in older adults.

Safety and Efficacy of Higher Order Multifetal Pregnancy Reduction: A Single-Center Retrospective Study.

Objective This research was aimed to study the safety and efficacy of higher order multifetal pregnancy reduction (MFPR). Study Design This was a retrospective study of patients from an academic maternity center between 2005 and 2015. We evaluated outcomes of 131 consecutive patients who underwent higher order MFPR (quadruplets and greater). MFPR was performed at 11 to 18 weeks of gestation in all cases. In total, 122 of 131 cases of higher order multiple pregnancy were reduced to twins. We discuss the perinatal outcomes of patients who underwent higher order MFPR, followed by a comparative analysis between the 122 cases of MFPR that were reduced to twins and 101 cases of nonreduced twin pregnancies. Results The study included 104 sets of quadruplets, 20 sets of quintuplets, 5 sets of sextuplets, 1 set of septuplets, and 1 set of octuplets. The perinatal outcomes of the 131 cases were as follows: pregnancy loss, preterm deliveries at 28 to 33 (+ 6/7 ) weeks, and preterm deliveries at 34 to 36 (+ 6/7 ) weeks occurred in 23.66, 9, and 37% of cases, respectively. The mean time of delivery was 36.56 ± 1.77 weeks, and mean birth weight was 2,409.90 ± 458.16 g, respectively. A total of 122 cases that were reduced to twins were compared with nonreduced twins. The pregnancy loss rate for reduced twins was significantly higher than that for nonreduced twins. The preterm labor rate, mean delivery week, mean birth weight, birth-weight discordance, incidence of gestational diabetes mellitus, and pregnancy-induced hypertension were not significantly different between the groups ( p > 0.05). Conclusion Perinatal outcomes were significantly improved by reducing the number of fetuses in higher order multifetal pregnancies. This study involved a large, diverse sample population, and the results can be used as a reference while conducting prenatal counseling.

Intrinsic Resting-State Activity in Older Adults With Video Game Experience.

Playing video games is a prevalent leisure activity in current daily life, and studies have found that video game experience has positive effects in several cognitive domains. However, few studies have examined the effect of video game experience on the amplitude of low-frequency fluctuations (ALFF) among older adults. In the current study, we compared behavioral performance in the flanker task and ALFF activities of older adults, of whom 15 were video game players (VGPs) and 18 non-video game players (NVGPs). The results showed that VGPs outperformed NVGPs in the flanker task and that VGPs showed significantly increased ALFF relative to NVGPs in the left inferior occipital gyrus, left cerebellum and left lingual gyrus. Furthermore, the ALFF in the left inferior occipital gyrus and left lingual gyrus was positively correlated with cognitive performance as measured by Mini-Mental State Examination (MMSE) scores. These results revealed that playing video games might improve behavioral performance and change intrinsic brain activity in older adults. Future video game training studies in older adults are warranted to provide more evidence of the positive effects of video game experience on behavioral and brain function.

Evidence that growth hormone can improve mitochondrial function in oocytes from aged mice.

Decline in successful conception decreases more rapidly after 38 years of age owing to follicular depletion and decreased oocyte quality. However, limited information is available regarding the underlying mechanism and the useful treatment. This study aimed to evaluate the effects of growth hormone supplementation on oocyte maturation in vivo in aged and young mice and to determine its effect on mitochondrial function. The influence of three different doses of recombinant human growth hormone (rhGH) (0.4, 0.8 and 1.6 mg/kg/day) for 8 weeks before ovarian stimulation was analyzed. Superovulated oocytes were released from the oviduct of 12-week-old and 40-week-old female C57BL/6J mice 14-16 h after administration of human chorionic gonadotropin. Ovarian follicle and morphological analysis and oocyte maturation parameters were then evaluated. This study is the first, to our knowledge, to report that medium- and high-dose rhGH significantly increases antral follicles in aged mice but anti-Müllerian hormone (AMH) levels. Furthermore, derived oocytes, MII-stage oocyte rate, ATP levels, mitochondrial membrane potential and frequencies of homogeneous mitochondrial distribution increased. In contrast, in both aged and young mice, the mtDNA copy numbers per oocyte were similar before rhGH administration, and upon saline administration, they did not differ significantly. We conclude that medium-dose rhGH supplementation before standard ovarian stimulation regimens improves oocyte quality in aged mice, probably by enhancing mitochondrial functionality.

[Protective Effect of Schisandra Extract on Embryotoxicity and Reproductive Toxicity in Early Pregnant Rats Exposed to Benzo [a] pyrene].

OBJECTIVE: To observe protective effects of Schisandra extract (SE) on embryotoxicity and reproductive toxicity of early pregnant rats exposed to Benzo[a]pyrene (Bap). METHODS: Pregnant rat model was prepared using periodic screening cage method. Totally 50 female pregnant SD rats were divided into five groups by randomized block design according to the weight, i.e., the BaP model group, the low dose SE group, the middle dose SE group, the high dose SE group, the normal control group, 10 rats in each group. Rats in the BaP model group were administered with BaP at a daily dose of 2 mg/kg by gastrogavage. Rats in low, middle, and high dose SE groups were administered by gastrogavage with BaP (at a daily dose of 2 mg/kg) plus SE at a daily dose of 40, 200, and 1 000 mg/kg, respectively. Equal volume of olive oil was administered to rats in the normal control group by gastrogavage. All medication was performed for 8 successive days. Changes of rat body weight in each period were observed. The uterus embryonic total quality and ovary quality were measured, and organ index calculated. The number of corpus luteum, the number of embryo implantation, and the number of absorbed embryo were statistically calculated respectively. The implantation rate and the absorbed embryos rate were calculated. Serum levels of human chorionic gonadotrophin ß (ß-HCG) and progesterone (PROG) were detected by ELISA. RESULTS: Compared with the normal control group, the weight of 9-day pregnant rats, the number of embryo implantation, the uterus embryonic total index, ovary index, serum levels of ß-HCG and PROG all decreased in the Bap model group with significant difference (P < 0.05, P < 0.01). Compared with the Bap model group, body weight, the uterus embryonic total index, and the PROG level increased in 3 dose SE groups (P < 0.05, P < 0.01). Ovary index and serum ß-HCG increased in middle and high dose SE groups (P < 0.05, P < 0.01). The number of implantation obviously increased in the high dose SE groups (P < 0.01). CONCLUSION: SE could reduce the embryotoxicity and reproductive toxicity of early pregnant rats exposed to Benzo[a]pyrene.

Outcome of laparoscopy-guided hysteroscopic tubal catheterization for infertility due to proximal tubal obstruction.

STUDY OBJECTIVE: To determine pregnancy outcomes after laparoscopy-guided hysteroscopic tubal catheterization and to report its role in the era of in vitro fertilization. DESIGN: Clinical cases series (Canadian Task Force classification II-3). SETTING: Reproductive surgery center. PATIENTS: Patients with unilateral or bilateral proximal tubal obstruction as the only cause of infertility were included. INTERVENTIONS: Laparoscopy-guided hysteroscopic tubal catheterization. MEASUREMENTS AND MAIN RESULTS: Only the first spontaneous conception was considered. Cumulative conception rate (CCR) was calculated using Kaplan-Meier survival analysis. Of 168 women included, 107 (63.7%) had bilateral proximal obstruction and 61 (36.3%) had unilateral obstruction. The successful recanalization rate was 54.2% per tube and 61.9% per patient. In the 93 patients in whom at least 1 fallopian tube was successfully recanalized, 40 spontaneous pregnancies (43.0%) occurred within 24 months, of which 35 (37.6%) were intrauterine pregnancies and 28 (30.1%) resulted in live births. The CCR was 37.6% at 1 year and 43.7% at 2 years. Patients with unilateral obstruction in whom cannulation was successful had the highest CCR (60.7% at 2 years). CONCLUSION: Successful tubal cannulation led to significant improvement in the pregnancy rate, which suggests that women with a proximal tubal block could be considered for laparoscopy-guided hysteroscopic cannulation, which is still a viable alternative to in vitro fertilization.

Does ambient air pollutants increase the risk of fetal loss? A case-control study.

OBJECTIVE: To examine the associations between the ambient air pollution and early fetal loss. STUDY DESIGN: A retrospective case-control study was conducted. 959 fetal losses and 959 normal intrauterine pregnancies within 14 weeks of pregnancy in 15 general or obstetrics and gynecology hospitals were selected into case and control groups, respectively. Data based on hospital records and national pollution monitor station records were collected. Logistic regression model was conducted to examine the associations between 4 ambient air pollutants (SO2, PM10, NO2 and TSP) exposures and fetal loss. RESULTS: The ratio of fetal loss to termination of pregnancy for heating months (2.28 %) was significantly (P < 0.001) higher than that for the non-heating months (1.77 %). Logistic regression suggested that fetal loss within 14 weeks was associated with higher exposure to SO2 (OR = 19.76, 95 % CI 2.34-166.71) and TSP (OR = 2.04, 95 % CI 1.01-4.13) in the first month of pregnancy. CONCLUSION: Exposure to high levels of SO2 and TSP during the first month of pregnancy was associated with an increased risk of fetal loss in early pregnancy.

[Related factors associated with pelvic adhesion and its influence on fallopian tube recanalization in infertile patients].

OBJECTIVE: To investigate factors with pelvic adhesions and the effect of different degrees pelvic adhesions on fallopian tube recanalization in infertile patients. METHODS: Total of 527 infertile patients undergoing hysteroscopy and laparoscopic surgery in Affiliated Hospital of Chinese People's Armed Police Forces Logistics College were studied retrospectively. According to the extent of pelvic adhesions, tubal umbrella adhesions and atresia, 377 cases were classified into adhesion groups, including 73 cases in grade I, 221 cases in grade II, 75 cases in grade III and 8 cases in grade IV based on adhesion score. The 150 cases with no obvious pelvic adhesion were matched as control group. Among 8 cases with grade IV ahesion were exluded from ahesion group the relationship between pelvic adhesions and related history, abdominal lesions, tubal patency and the prognosis were studied. RESULTS: (1) Related factors: the frequency of pelvic adhesion and more than 7 years of infertility of 23.9% (88/369) in adhesion group were significantly higher than 12.0% (18/150) in control groups. (2) HISTORY: compared with the control group (12.7%, 19/150; 28.7%, 43/150; 11.3%, 17/150; 12.0%, 18/150; 17.3%, 26/150), patients with pelvic adhesions present more incidence abortion (23.6%, 87/369), uterine cavity operation (38.2%, 141/369), ectopic pregnancy (20.9%, 77/369), pelvic inflammatory disease (25.5%, 94/369) and abdominopelvic surgery (31.4%, 116/369). (3) Endoscopy exploration: the incidence of hydrosalpinx (24.7%, 91/369), tube distorted (15.7%, 58/369) and salpingostomy (72.9%, 269/369) in adhesion group were higher than those in control group (2.0%, 3/150; 4.0%, 6/150; 12.0%, 18/150), but relatively lower incidence of pelvic endometriosis lesions (5.7%, 21/369) and mesosalpinx cysts (16.3%, 60/369) than those in control group (16.0%, 24/150; 30.0%, 45/150). The rate of proximal tubal recanalization (59.5%, 91/153) in adhesion group was lower than 75.4% (52/69) in control group. However, the rate of distant tubal recanalization of 84.4%, (281/333) in adhesion group and; 13/15 in control group didn't show statistical difference. (4) PROGNOSIS: the rate of ectopic pregnancy of 9.7% (29/299) in adhesion group was significantly higher than 3.1% (4/128) in control group. Among cases with grade III adhesion exhibited the highest rate of ectopic pregnancy (13.0%, 7/54; OR = 4.62, 95%CI: 1.29 - 16.50). (5) Multivariate analysis: it was found that more than two drug abortions (OR = 3.29, 95%CI: 1.34 - 8.07), pelvic and(or) abdominal surgery history (OR = 2.20, 95%CI: 1.35 - 3.57) and pelvic inflammatory disease history (OR = 1.54, 95%CI: 1.21 - 1.97) were risk factors with pelvic adhesions. CONCLUSION: More than or equal to two drug abortion history, pelvic inflammatory disease and pelvic and abdominal surgery damage were important factors for pelvic adhesions of infertility patients, which may decrease the possibility of proximal tubal recanalization and increase ectopic pregnancy risk.

[Comparative study of pregnancy outcomes between spontaneous twin pregnancies and twin pregnancies after fetal reduction in the second trimester].

OBJECTIVE: To compare the outcomes of multifetal pregnancy reduced to twins with initial twin pregnancy. METHODS: This study included all patients who had high-order multiple pregnancies from August 2007 to September 2010 (n = 567) in outpatient or inpatient of Department of Obstetrics and Gynecology, Provincial Hospital Affiliated to Shandong University. There were 478 initial twin pregnancy (non-reduced group) and 89 multifetal pregnancy reduced to twins (reduced group). All fetal reduction procedures were performed after 12 weeks gestation. The maternal ages, gestational ages at delivery, pregnancy complications, birth weight of twins and neonatal outcomes were observed in all groups. RESULTS: (1) Average maternal ages and mean gestational ages at delivery: the average maternal ages were (29.7 ± 4.5) and (29.9 ± 5.0) years for the non-reduced and reduced groups, respectively, no statistical significance (P = 0.755). The mean gestational ages at delivery in the nonreduced and reduced twins were (35.3 ± 3.9) and (34.4 ± 6.3) weeks, respectively (P < 0.01). (2) Pregnancy complications:the rate of pre-eclampsia was 8.2% (39/478) in the nonreduced group and 12.4% (11/89) in the reduced group, no statistical significance (P = 0.199). The rates of gestational diabetes mellitus were 1.7% (8/478) and 3.4% (3/89), respectively, no statistical significance (P = 0.287). (3) Neonatal outcomes: 1) the frequencies of birth weight discordances > 400 g were 28.9% for the nonreduced group and 27.0% for the reduced group, no statistical significance (P = 0.715). The frequencies of birth weight discordances > 100 g were 75.1% for the nonreduced group and 75.3% for the reduced group, no statistical significance (P = 0.972). 2) The mean birth weight of the nonreduced twin group was significantly higher than that of the reduced group [(2700 ± 468) g vs. (2352 ± 602) g, respectively, P < 0.01], there was statistical significance. The mean birth weight of gestational ages > 36(+1) weeks at delivery of the nonreduced twin group was significantly higher than that of the reduced group [(2809 ± 424) g vs. (2707 ± 506) g, respectively, P < 0.01], there is statistical significance. 3) The rate of infant mortality (gestational ages > 28 weeks at delivery) was 1.3% (1/78) for the reduced group and 2.2% (10/448) for the nonreduced group. The major morbidity rate was 3.8% (3/78) for the reduced group and 4.0% (18/448) for the nonreduced group, no statistical significance (P = 0.588, 0.943). CONCLUSIONS: Multiple pregnancies after fetal reduction were still associated with a mild increased risk when compared to initial twin pregnancies and their abortion rate is high. The gestational ages of the reduced group were affected by the initial number of fetuses, and the birth weights of reduced twins were lower than that of the nonreduced twins.