Objective To evaluate the therapeutic efficacy of Shexiang Baoxin Pill combined with exercise in heart failure patients with preserved ejection fraction (HFpEF). Methods Sixty patients with HFpEF were randomly divided into group A ( n =20), receiving Shexiang Baoxin Pill combined with home-based exercise training based on conventional drugs for 12 weeks; group B ( n =20), receiving conventional drugs combined with home-based exercise training for 12 weeks; and group C ( n =20), receiving conventional drug treatment only. Peak oxygen uptake (peakVO 2 ), anaerobic threshold (AT), 6-min walking test (6MWT), Pittsburgh Sleep Quality Index (PSQI), and SF-36 questionnaire (SF-36) results before and after treatment were compared among groups. Results After the 12-week intervention, patients in group C showed significant declines in peakVO 2 , AT, 6MWT, PSQI, and SF-36 compared with pre-treatment ( P <0.01), while groups A and B both showed significant improvements in peakVO 2 , AT, 6MWT, PSQI, and SF-36 results compared with pre-treatment ( P <0.01). Compared with group C, patients in groups A and B showed significant improvements in peakVO 2 , AT, 6MWT, PSQI, and SF-36 ( P <0.01). In addition, patients in group A showed more significant improvements in physical function, role-physical, vitality, and mental health scores on the SF-36 questionnaire, and PSQI scores than those in group B ( P <0.01). Conclusions Exercise training improved exercise tolerance, sleep quality and quality of life (QoL) in patients with HFpEF. Notably, Shexiang Baoxin Pill played an active role in sleep quality and QoL of patients with HFpEF. (The trial was registered in the Chinese Clinical Trial Registry (No. ChiCTR2100054322))

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There is limited information regarding the reference values for cardiopulmonary exercise testing (CPX) variables in patients with primary hypertension. Our aim was to provide such values. In this single-center, retrospective study, we included 635 patients (male, 53.7%; mean ± standard deviation age, 62.1 ± 12.6 years) who completed maximal ramp incremental CPX using cycle ergometry at the Rui An Hospital of Traditional Chinese Medicine from August 1, 2018, to December 31, 2021. The patients were classified into two groups based on pulse pressure (PP): (1) patients with a low PP !60 mmHg (n = 324) and ( 2) patients with a high PP > 60 mmHg (n = 311). Stepwise linear regression was used to fit the equations of the key CPX variables. CPX was self-interrupted owing to fatigue by 64.5% (low PP) and 72.0% (high PP) of patients (χ 2 analysis, P = 0.05). The anaerobic threshold (AT) could not be determined in 3.7% and 7.7%, respectively (χ 2 analysis, P = 0.038). Peak oxygen consumption (VO2), carbon dioxide production, ventilation/minute, work rate, and VO2 at the AT were associated with age, weight, and sex. Moreover, a high PP was associated with impaired anaerobic exercise ability, as indicated by the reduced peak VO2, peak VE, and absolute peak work rate. Compared with prior research of a healthy population, patients with primary hypertension in this study exhibited impaired cardiopulmonary ability both at rest and during exercise, especially in the high PP group. The reference values and predictive equations for CPX variables provide a framework for interpreting the response to maximal ramp incremental cycle ergometry among older Chinese patients with primary hypertension.

It has been reported that, in submarine landslides down a slope, only a small part of the landslide momentum was transferred to the tsunami while most was lost in the further propagation over the flat bed. The high momentum of landslides off a slope meant a long run-out and a great impact on underwater infrastructure. Nevertheless, little attention has been paid to the variation of momentum of deformable submarine landslides off a slope, i.e. the loss of momentum when the slides flow away from the slope over a flat bottom. In this paper, the translational momentum of deformable submarine granular landslides running down a non-erodible inclined bed is investigated with a two-phase smoothed particle hydrodynamics model. After flowing down the slope, the transport rate and flux of the landslide translational momentum along the propagation over the flat bottom are examined. The effects of physical variables of the slide, particularly the grain size, the initial compaction and the front intrusion angle on the variation of the translational momentum, are explored. Accordingly, scaling relations of the spatial-temporal maximum transport rate and flux of the landslide translational momentum, as well as those of the slide final run-out and the generated leading wave height, are proposed. These scaling relations, although based on numerical data of small-scale granular landslides, demonstrate a preliminary attempt to develop practical expressions in the framework of momentum for estimating the run-out of real submarine landslides and the impact on underwater infrastructure.