The Danshen-Gegen formula (DG) is a traditional Chinese herbal formula which has long been used to treat cardiovascular disease. DG was found to be a cardiovascular tonic in our recent research. ...However, a comprehensive investigation of the molecular mechanism of DG in cardiovascular disease has not been performed. The aim of this study was to clarify the transcriptional profiling of genes modulated by DG on postmenopausal women by using DNAmicroarray technology. We obtained 29 whole blood samples both from DG-treated and placebo-treated subjects. Blood lipid profile and intima-media thickness (IMT) were measured. Affymetrix GeneChip was used to identify differentially expressed genes (DEGs), followed by validation by the real-time PCR method. The results showed that DG-treated group has a significant improvement in IMT and lipid profile as compared to placebo-treated group. For the genomic study, the DG-treated group has a higher number of DEGs identified as compared to the placebo-treated group. Two important biological processes of “regulation of systemic arterial blood pressure by hormone” and “regulation of smooth muscle proliferation” have been identified by GePS in the DG-treated group. No significant biological process and cellular components were identified in the placebo-treated group. This genomic study on the molecular action of DG in postmenopausal women gathered sufficient molecular targets and pathways to reveal that DG could improve neointima thickening and hypertension.
Background
Compared with Caucasians, East Asians have a lower incident of back pain, lower prevalence and severity of osteoporotic vertebral fracture and lumbar spine degeneration.
Aim
This study ...compares radiographic spine degeneration features of older Chinese women (as an example of East Asians) and older Italian women (as an example of Caucasians) with a focus on the thoracic spine.
Methods
From two population-based epidemiological studies conducted in Hong Kong, China and Rome, Italy, 297 pairs (mean age: 73.6 years) age-matched older community women’s lateral spine radiographs were sampled. Existence (or absence) of seven degeneration features were assessed including: (1) hyper-kyphosis, (2) disc space narrowing (T3/T4 ~ T11/T12), (3) osteoarthritic (OA) wedging (T4 ~ T12), (4) generalised osteophyte formation (T4 ~ T12); (5) acquired short vertebrae (T4 ~ T12), (6) Schmorl node (T4 – L5), (7) disc calcification (T4–L5).
Results
Italian women were more likely to have hyper-kyphosis (53.4% vs 25.6%), disc space narrowing (34.4% vs. 17.2%), OA wedging (6.4% vs. 0.67%), Schmorl node (19.5% vs. 4.4%, all
P
< 0.001). However, there was no statistically significant difference in osteophyte formation (7.7% vs. 9.4%,
P
> 0.1) and acquired short vertebrae (8.0% vs. 10.4%,
P
> 0.1). Disc calcification was uncommon among both Chinese and Italians.
Discussion and conclusion
For the first time, this study documented a lower prevalence of a number of thoracic spine degeneration features among Chinese. This study further affirms the concept of a generally healthier spine in older Chinese relative to older Caucasians. The observed differences may reflect a foundational background influence of genetic predisposition that represents an important line of future research.
This study examined the transmission power and waveform purity of vertical (synchronous) whole-body vibrations upon its propagation in the human body among older adults.
Forty community-dwelling ...older adults participated in the study (33 women; mean age: 60.3 (SD 5.7) years). Four vibration frequencies (25, 30, 35, 40Hz), two amplitudes (0.6 and 0.9mm), and six different postures were tested. Skin-mounted tri-axial accelerometers were placed at the medial malleolus, tibial tuberosity, greater trochanter, third lumbar vertebra, and forehead. The transmissibility of vibration was computed as the ratio of the root-mean-square-acceleration at different body sites to that of the platform. Signal purity was expressed by the percentage of total transmitted power within 1Hz of the nominal frequency delivered by the platform.
Vibration frequency and amplitude were inversely associated with transmissibility in all anatomical landmarks except the medial malleolus. Amplification of signals was noted at the medial malleolus in most testing conditions. The effect of posture on whole-body vibration transmission depends on its frequency and amplitude. In general, toe-standing led to the lowest transmissibility. Single-leg standing had the highest vibration transmission to the hip, while erect standing had the highest transmissibility to the head. The purity of waveform of the vibration signals was well conserved as the vibrations were transmitted from the feet to the upper body.
Whole-body vibration transmissibility was highly influenced by signal frequency, amplitude and posture. These parameters should be carefully considered when prescribing whole-body vibration to older adults.
•Higher vibration frequency and amplitude led to lower transmissibility above knee.•Significant amplification of vibration signals was noted in the medial malleolus.•Single-leg standing led to higher transmission at the hip relative to other postures.•Signal waveform purity was well conserved during signal propagation.
Abstract only
Introduction:
Tai Chi and walking are both moderate-intensity physical activity (PA) that can be easily practiced in daily life. The purpose of this study was to better understand that ...after practicing these two types of PAs in a relative short term and keeping the stable dietary intake in this period, how much body weight would be reduced and what extent the metabolic syndrome parameters would be improved; and if a significant weight loss was observed, whether this exercise-induced weight loss had adverse effect on bone mineral density (BMD).
Methods:
Three-hundred seventy-four healthy and physically inactive adults (45.8±5.3 years) from 9 geographic areas in Hong Kong were randomized to 12 weeks training (45 minutes per day, 5 days per week) of Tai Chi (n=124) or self-paced walking (n=121), or control group (n=129) at area level. Body weight, fat and lean mass, waist circumference, blood pressure and regional BMD, as well as the fasting blood samples were obtained at the beginning and end of trial. Fasting blood glucose (FBG), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides were analyzed.
Results:
On average, Tai Chi and walking groups lost 0.50 and 0.76 kg of body weight, 0.47 and 0.59 kg of fat mass, respectively (all p<0.001). No significant changes were observed for lean mass and BMD. Two intervention groups had significant improvements in waist circumference and FBG. The between-group difference of waist circumference and FBG was -3.7 cm and -0.18 mmol/L for Tai Chi vs. control; and -4.1 cm and -0.22 mmol/L for walking vs. control (all p<0.001). No significant differences were observed regarding blood pressure, total cholesterol, HDL-C, LDL-C and triglycerides compared to control (all p>0.05). The effects on all outcomes between Tai Chi and walking were similar (all p>0.05). Among intervention groups, change in lean mass, not fat mass or total weight loss, was significantly correlated to the change in BMD.
Conclusions:
12-week Tai Chi and walking exercises can produce moderate weight loss and improve the waist circumference and FBG in middle-aged Hong Kong Chinese people, with no additional effects on BMD.
Background: Hip fracture is associated with immobility, morbidity, mortality, and high medical cost. Due to limited availability of dual-energy X-ray absorptiometry (DXA), hip fracture prediction ...models without using bone mineral density (BMD) data are essential. We aimed to develop and validate 10-year sex-specific hip fracture prediction models using electronic health records (EHR) without BMD. Methods: In this retrospective, population-based cohort study, anonymized medical records were retrieved from the Clinical Data Analysis and Reporting System for public healthcare service users in Hong Kong aged ≥60 years as of 31 December 2005. A total of 161,051 individuals (91,926 female; 69,125 male) with complete follow-up from 1 January 2006 till the study end date on 31 December 2015 were included in the derivation cohort. The sex-stratified derivation cohort was randomly divided into 80% training and 20% internal testing datasets. An independent validation cohort comprised 3046 community-dwelling participants aged ≥60 years as of 31 December 2005 from the Hong Kong Osteoporosis Study, a prospective cohort which recruited participants between 1995 and 2010. With 395 potential predictors (age, diagnosis, and drug prescription records from EHR), 10-year sex-specific hip fracture prediction models were developed using stepwise selection by logistic regression (LR) and four machine learning (ML) algorithms (gradient boosting machine, random forest, eXtreme gradient boosting, and single-layer neural networks) in the training cohort. Model performance was evaluated in both internal and independent validation cohorts. Findings: In female, the LR model had the highest AUC (0.815; 95% Confidence Interval CI: 0.805–0.825) and adequate calibration in internal validation. Reclassification metrics showed the LR model had better discrimination and classification performance than the ML algorithms. Similar performance was attained by the LR model in independent validation, with high AUC (0.841; 95% CI: 0.807–0.87) comparable to other ML algorithms. In internal validation for male, LR model had high AUC (0.818; 95% CI: 0.801–0.834) and it outperformed all ML models as indicated by reclassification metrics, with adequate calibration. In independent validation, the LR model had high AUC (0.898; 95% CI: 0.857–0.939) comparable to ML algorithms. Reclassification metrics demonstrated that LR model had the best discrimination performance. Interpretation: Even without using BMD data, the 10-year hip fracture prediction models developed by conventional LR had better discrimination performance than the models developed by ML algorithms. Upon further validation in independent cohorts, the LR models could be integrated into the routine clinical workflow, aiding the identification of people at high risk for DXA scan. Funding: Health and Medical Research Fund, Health Bureau, Hong Kong SAR Government (reference: 17181381).
This study explored how physical and psychosocial factors influenced the practice of health-promoting behaviors among elderly Chinese patients with type-2 diabetes. Individual structured interviews ...were conducted with 191 elderly Chinese attending an outpatient clinic in Hong Kong. Results showed that demographic and illness characteristics were unrelated to health practices. Participants were more likely to engage in health-promoting behaviors when they were physically well, valued their health, were confident of practicing the behaviors and viewed their illness as controllable by both doctors and themselves. The above factors exerted their respective main effects, instead of interaction effects, in predicting health practices.
Osteoporosis is a major physical health issue in healthy ageing among urban populations. However, few studies have investigated how greenspace can influence osteoporosis, especially to those who ...lived in a compact city with high-density living environment. Furthermore, no studies have investigated how “planned greenspace” and “natural greenspace” can separately influence osteoporosis among senior population. We hereby conducted an empirical study to evaluate the relationship between osteoporosis, “planned greenspace” and “natural greenspace”, based on the use of land use data derived from local geospatial information and satellite images. Our results showed that seniors who were 1) aged, 2) female, 3) less educated, 4) smokers, and 5) with chronic respiratory diseases were associated with osteoporosis. Considering factors of greenspace, a higher percentage of planned greenspace surrounding the residence may be a protective factor while natural greenspace did not influence the individuals. Specifically, a 10% increase of planned greenspace within the 600-m radius area surrounding the residence was negative associated with osteoporosis (−2.8% -5.1%, −0.5%). Based on our results, development of planned greenspace may be necessary, as compact built environment of a high-density city often resulted in a lack of planned greenspace for physical activities. Along with the World Health Organization (WHO) guidelines for an age-friendly city, our findings suggest that improving the planned greenspace in a walkable distance around one's neighboring environment is a potential strategy for prevention of osteoporosis and related physical health issues as well as for life quality improvement among the senior population.
•Association of greenspace and osteoporosis in a high-density city.•Planned space in compact environment may not have an extensive cover of greenery.•Natural greenspace in a high-density city may be inaccessible.•More planned space in compact environment may reduce osteoporosis.•Natural greenspace may be unable to reduce osteoporosis risk due to inaccessibility.
Given the increase in average lifespans in countries around the world, diseases that afflict the elderly are a major focus for scientists. Uppermost among these is dementia, a broad term which ...includes many types of cognitive decline from mild impairment to severe conditions such as
Alzheimer's disease. We lose brain volume and function as we age, and it is this atrophy of different parts of the brain that leads to loss of cognitive function. Although atrophy takes many different forms and thus results in a range of conditions, there are commonalities between each that
might be targets for treatment. One area of research is the possibility of using large doses of B vitamins to lower levels of the amino acid homocysteine, which has been linked to many conditions including cardiovascular disease and dementia. This is the focus of Professor Timothy Kwok's
ongoing research at the Chinese University of Hong Kong. Kwok is also a practising consultant geriatrician at the Prince of Wales Hospital in Hong Kong and has been inspired to pursue this field of inquiry by the need for simple and inexpensive treatments which could be made available to large
numbers of elderly patients. He says: 'A trial at the University of Oxford showed that lowering homocysteine levels led to a significant reduction in the rate of brain atrophy. However, many questions remain unanswered and our current two-year trial will hopefully give further insights into
the benefits or otherwise of vitamin B supplementation. If a causative link can be found between vitamin B supplementation and a slower rate of cognitive decline, this would be an inexpensive and safe way of treating people at the early stage of disease. In addition, these vitamins could
potentially be given as a preventative treatment in older people who are not yet showing signs of cognitive impairment. As Kwok says: 'Dementia is a major cause of dependency in old age and has a big impact on the people affected, their families and scarce medical resources. If supplementation
could prevent dementia in people with early symptoms, this simple intervention could make a huge difference to the quality of life of elderly people and reduce the burden of dementia on national health services.'
Introduction: We have developed an innovative herbal formula containing two herbs of popular use for the
supplementation of cardiovascular health. Three clinical trials, viz. on patients with ...coronary arterial
obstruction, hypertension, and post-menopausal borderline hyperlipidaemia, have been done, all showing
promising results detected in ultrasonography as diminished intima media thickness (IMT), a surrogate
marker recommended for clinical trials related to cardiovascular health. 49+49 patients with known
peripheral arterial disease (PAD) were treated with twin formula or placebo group for 24 weeks. Assessment
using ultrasonography showed thinning down of the carotid intima (2.67%) only in the treatment group.
Maximal walking distance also increased by 21.8% in the treatment group compared with 7.2% in the
placebo group (p=0.499).
Discussion: The positive results in the PAD study as well as in the other studies done previously
demonstrated the effectiveness of the twin formula in the maintenance of cardiovascular health. It is safe
and offers direct protection of the internal environment of the artery while at the same time carries the
multiple roles of anti-inflammation, anti-oxygenation and anti-fibrosis, as were shown in in vitro and animal
bioactivity studies.
Conclusion and Outlook: The twin formula offers a good example of evidence-based medicinal
supplements with specific functions. Its developmental process also offers a more comprehensive way to
test traditional wisdom and practice through pragmatic clinical trials in the attempt to properly introduce it
to modern health care practice.
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