Background: Sarcopenia and frailty are both age‐related declines in functional reserve that are linked to adverse health outcomes. It is critical to know about the outcomes of a combination of these conditions. The study aimed to investigate the effects of sarcopenia and frailty on postoperative recovery in elderly patients and to explore risk factors.Methods: This prospective cohort study was conducted among 608 patients aged ≥60 years, American Society of Anesthesiologists I‐III, who were scheduled to undergo thoracic (non‐cardiac) and abdominal surgery from 1 March 2022 to 31 October 2022 at the Affiliated Hospital of Xuzhou Medical University. Frailty was measured by the 28‐item frailty index, and sarcopenia was assessed sarcopenia was assessed by skeletal muscle index in computed tomographic scan, handgrip strength and 6‐m walk. Participants were classified as follows: Group A: both sarcopenia and frailty; Group B: sarcopenia only; Group C: frailty only; and Group D: neither frailty nor sarcopenia. The primary outcome was 90‐day morbidity. Multivariable logistic regression model was used to estimate the association between sarcopenia, frailty and 90‐day morbidity.Results: The median (interquartile range) age of participants was 68 (64–72) years, and 62.7% were men. The prevalence rates of sarcopenia and frailty were 32.8% and 47.6%, respectively. The 90‐day morbidity in Group A was 58.5%, in Group B was 46.2%, in Group C was 42.0% and in Group D was 28.8%, and the difference was significant (P < 0.001). In the multivariable analysis, both sarcopenia and frailty [odds ratio (OR), 2.21; 95% confidence interval (CI), 1.26–3.89], sarcopenia only (OR, 1.84; 95% CI, 1.01–3.36), frailty only (OR, 1.77; 95% CI, 1.03–3.03), women (OR, 0.67; 95% CI, 0.45–0.99), body mass index (OR, 0.94; 95% CI, 0.88–0.99), pre‐operative albumin (OR, 0.96; 95% CI, 0.91–1.00) and operative stress score (OSS) [OSS 3 (OR, 2.09; 95% CI, 1.21–3.67); OSS 4–5 (OR, 3.81; 95% CI, 2.31–6.42)] were independently associated with 90‐day morbidity. In the multivariable analysis with inverse probability weighting adjusted cohort, sarcopenia and frailty were also significantly associated with 90‐day morbidity.Conclusions: Sarcopenia and frailty were associated with higher risks of postoperative 90‐day morbidity in elderly patients alone and in combination. Sex, body mass index, pre‐operative albumin and operative stress were also independent factors for postoperative morbidity within 90 days.

Background: Whole body vibration (WBV) is currently increasing in popularity as a treatment modality for musculoskeletal disorders and improving health-related quality of life. Recent research has shown that WBV can reduce low back pain and improve the functional abilities for patients, however, optimal frequency and duration of vibration for therapeutic use is unclear. This review was conducted to summarize and determine the efficacy of whole body vibration therapy on individuals with non-specific low back pain (NLBP) and evaluated methodological quality of the included studies.Methods: Online literature searches through the Web of Science, PubMed, Cochrane Library databases, PEDro, Ovid, EBSCO (Medline) and Scopus were conducted up to December 2019. Randomized controlled trials investigating the effect of WBV on pain intensity and/or functional ability in individuals with non-specific low back pain (NLBP) were included. Details of the sample characteristics, treatment of the comparison group, WBV parameters and outcome measures were recorded, and methodological quality appraised using the PEDro scale.Results: 7 published RCTs (418 patients) were included in the systematic review. Due to heterogeneity in vibration parameters and prescriptions, and small number of studies, no meta-analysis was performed. Four out of the six included studies using pain as an outcome measure showed that WBV had a beneficial effect on pain compared with the control group, whereas only two trials were considered to be of high methodological quality. Among the six studies which measured functional ability, three studies with good quality reported significant between-group differences in favor of WBV.Conclusions: There is limited evidence suggests that WBV is beneficial for NLBP when compared with other forms of interventions (stability training, classic physiotherapy, routine daily activity). Due to the small sample sizes and statistical heterogeneity, we still cannot draw conclusions that WBV is an effective intervention. Further high-quality studies are needed before clinical recommendations can be provided to support its use in a general population with NLBP and to explore the optimal treatment protocol.Trial registration: PROSPERO registration number:CRD42017074775.

The harpin protein Hpa1 has various beneficial effects in plants, such as promoting plant growth and inducing pathogen resistance. Our previous study found that Hpa1 could significantly alleviate the mosaic symptoms of tobacco mosaic virus (TMV) in Pinellia ternata, indicating that Hpa1 can effectively stimulate resistance. Here, the potential mechanism of disease resistance and field applicability of Hpa1 against TMV in P. ternata were further investigated. The results showed that 15 µg ml⁻¹Hpa1 had stronger antiviral activity than the control, and its protective effect was better than its curative effect. Furthermore, Hpa1 could significantly induce an increase in defense-related enzyme activity, including polyphenol oxidase, peroxidase, catalase, and superoxide dismutase, as well as increase the expression of disease resistance-related genes (PR1, PR3, PR5, and PDF1.2). Concurrently, Hpa1 significantly increased the content of some disease resistance-related substances, including hydrogen peroxide, phenolics, and callose, whereas the content of malondialdehyde was reduced. In addition, field application analysis demonstrated that Hpa1 could effectively elicit a defense response against TMV in P. ternata. Our findings propose a mechanism by which Hpa1 can prevent TMV infection in Pinellia by inducing systemic resistance, thereby providing an environmentally friendly approach for the use of Hpa1 in large-scale applications to improve TMV resistance in Pinellia.

Objectives: To investigate effects of short-chain fatty acids (SCFAs) on expressions and functions of intestinal cytochrome P4503A (Cyp3a) and P-glycoprotein (P-gp). To develop a semi-physiologically based pharmacokinetic (semi-PBPK) model for assessing their contributions. Methods: Verapamil pharmacokinetics was investigated following oral administration to rats receiving water containing 150 mm SCFAs for 3 weeks. Cyp3a activities in intestinal and liver mircosomes were assessed by norverapamil formation. In-situ single-pass perfusion was used to evaluate intestinal transport of verapamil and P-gp function. Functions and expressions of Cyp3a and P-gp were measured in mouse primary enterocytes following 48-h exposure to SCFAs. Contributions of intestinal P-gp and Cyp3a to verapamil pharmacokinetics were assessed using a semi-PBPK model. Key findings: Short-chain fatty acids significantly increased oral plasma exposures of verapamil and norverapamil. SCFAs upregulated Cyp3a activity and expression, but downregulated P-gp function and expression in rat intestine, which were repeated in mouse primary enterocytes. PBPK simulation demonstrated contribution of intestinal Cyp3a to oral plasma verapamil exposure was minor, and the increased oral plasma verapamil exposure was mainly attributed to downregulation of intestinal P-gp. Conclusions: Short-chain fatty acids oppositely regulated functions and expressions of intestinal Cyp3a and P-gp. The downregulation of P-gp mainly contributed to the increased oral plasma verapamil exposure by SCFAs.

The beneficial effects of Tai Chi on the cardiovascular risk profile and the migraine trigger factors among female migraineurs remain unknown. This study aimed to evaluate the effectiveness of a 12-week Tai Chi training on blood pressure (BP) and migraine-related trigger factors, including stress, fatigue, and sleep quality among Chinese women with episodic migraine. In this study, eligible Hong Kong Chinese women aged 18–65 years were randomly assigned to the Tai Chi group adopting a modified 33-short form of Yang style Tai Chi training for 12 weeks, followed by additional 12 weeks of self-practice or the waiting list control group that maintained the usual lifestyle for 24 weeks. The primary outcome was the changes in BP from the baseline to 12 and 24 weeks. The secondary outcomes included the stress level, fatigue, and sleep quality measured by the perceived stress scale (PSS), the numeric rating scale-fatigue (NRS-fatigue), and the Pittsburgh sleep quality index (PSQI), respectively. Significant between-group differences were found in systolic BP (−6.8 mmHg at 24 weeks, $P=0.02$ ), and a decreasing trend was significant across baseline, 12 weeks, and 24 weeks between groups ( $P<0.05$ ). The 12-week Tai Chi training significantly reduced the BP level and moderately improved stress level, fatigue status, and sleep quality among Chinese women with episodic migraine. Therefore, Tai Chi could be considered a promising mind-body exercise with good feasibility for migraineurs in the future. This trial is registered with registration number NCT03015753.

Background/Objectives: Dyslipidemia is a well-established risk factor for cardiovascular disease (CVD). However, among available drug treatments, only those targeted at lowering LDL-C and consequently TC have demonstrated efficacy in preventing CVD. This is to say that the benefit for those with isolated high TG or low HDL-C is limited. The objective of this study is to examine the overlapping pattern of the four dyslipidemia components in US adult populations, which is important for quantifying the proportion of those who are less likely to benefit from lipid-lowering drugs and for a more precise use of the drug. Methods: A total of 7822 participants aged over 20 with abnormalities in any of the four lipid parameters, excluding those on lipid-lowering medications, were included from the National Health and Nutrition Examination Survey (NHANES) cycles spanning 1999–2000 through 2017–2018. The proportions of different combinations of them were calculated and presented using area-proportional Euler plots. Results: High TC, high LDL-C, high TG, and low HDL-C were seen in 32.8% (95% CI: 31.3%–34.2%), 28.1% (95% CI: 26.6%–29.6%), 26.7% (95% CI: 25.4%–28.0%), and 65.9% (95% CI: 64.0%–67.7%) of the people with dyslipidemia, respectively. The proportions of dyslipidemia cases attributable to “high LDL-C or high TC” (irrespective of HDL-C and TG levels), “normal LDL-C, normal TC, but high TG” (irrespective of HDL-C level), and “normal LDL-C, normal TC, normal TG, but low HDL-C” (i.e., isolated low HDL-C) accounted for 37.5% (95% CI: 35.9%–39.1%), 18.3% (95% CI: 17.2%–19.4%), and 44.2% (95% CI: 42.5%–46.0%), respectively. Conclusions: Some two-thirds of those with dyslipidemia had low HDL-C or high TG but normal LDL-C and normal TC. As these people are less likely to benefit from currently available drug treatments in terms of CVD prevention, it is important to identify other effective strategies or interventions targeted at them in order to achieve more precise and cost-effective management of dyslipidemia.