With the continuous increase in the number of terminally ill patients， end-of-life options have become a topic of great concern in recent years. New Zealand’s End of Life Choice Act and Korea’s Act on the Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life， as representative legislations on euthanasia and death with dignity in recent years， offer valuable references for China’s legislation on end-of-life options. Compared with euthanasia， which is prone to provoke legal and moral disputes， death with dignity has a better legal and social foundation in China， and relevant international legislation at this stage is more mature and more referential. China can draw on relevant extraterritorial legislation， gradually promote the nationwide legislation on advance directives and death with dignity based on clarifying the applicable standards of death with dignity and fully respecting patients’ wishes， and explore the establishment of a set of end-of-life legal system in line with the actual situation in China.

Objective:To observe any effect of an enriched environment (EET) on cognitive functioning and sonic hedgehog (SHH) signaling in rats modeling cerebral ischemia.Methods:Sixty adult male Sprague-Dawley rats were randomly divided into a blank control group, a model group and a training group. A model of cerebral ischemia was established in the model and training groups by thread thrombus. The training group was given an EET. After 7 and 14 days, the rats′ cognition was tested using the Morris water maze and the platform jumping test. Apoptosis of brain cells in the hippocampus was detected by using TUNEL staining, and the expression of SHH, Gli2 and PTCH1 proteins in the hippocampus were measured using qRT-PCRs, western blotting and immunohistochemistry.Results:After 14 days the average escape latency in the Morris water maze test had shortened more in the training group than in the model group, while the average swimming speed, the number of platform crossings and the time spent in the quadrant had increased significantly more. They also received fewer electric shocks and spent significantly less time on the platform in the platform jumping test on average. Apoptosis in the hippocampus after 14 days was significantly less in the training group with significantly greater expression of SHH and Gli2 protein and significantly less PTCH1 protein expression.Conclusion:An EET can significantly improve cognition after cerebral ischemia, at least in rats. Its mechanism may be related to enhanced activation of the SHH signaling pathway.

Post-stroke depression (PSD) refers to a series of affective disorder syndrome characterized by low mood and lack of interest after stroke, often accompanied by physical symptoms, which is a common complication of stroke. Non-invasive brain stimulation techniques, such as repetitive transcranial magnetic stimulation and transcranial direct current stimulation have been widely used in the treatment of PSD in recent years. This article summarizes the research progress of repetitive transcranial magnetic stimulation and transcranial direct current stimulation in the treatment of PSD.

ObjectiveTo observe the effect of Digital Occupational Therapy (OT) System training under suspension on upper limb motor function after stroke. MethodsFrom February, 2021, to February, 2022, 90 stroke hemiplegic patients with upper limb motor dysfunction from the First Affiliated Hospital of Bengbu Medical College were randomly divided into routine group (n = 30), digital OT group (n = 30) and suspension group (n = 30). All the groups received routine upper limb rehabilitation, medication, and routine OT, while the digital OT group received the upper limb training of Digital OT System and the suspension group received the upper limb training of Digital OT System with the upper limb suspended. They were assessed with Fugl-Meyer Assessement-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and four weeks after treatment, while the mean electromyography (AEMG), root mean square (RMS), median frequency (MF) and mean power frequency (MPF) of the radial extensor carpi dorsi muscle during contraction were measured with surface electromyography (sEMG). ResultsThe FMA-UE score, MBI score, AEMG, RMS, MF and MPF improved after treatment in all the groups (|t| > 9.202, P < 0.001), and all the indexes were the best in the suspension group (F > 8.791, P < 0.001). ConclusionDigital OT System training under suspension can promote the recovery of upper limb motor function for stroke patients, as well as the activities of daily living and the upper limb muscle function.