Epimedium sagittatum is a perennial herb of Berberidaceae. Its leaves have a long history of medicinal use in China. This plant is widely used as a Chinese traditional medicine，with the main functions of tonifying kidney Yang，strengthening bones and muscles，and dispelling wind and dampness. It can be used for treating kidney Yang deficiency，impotence，spermatorrhea，flaccidity of bones and muscles，rheumatic arthralgia，numbness，and spasms. The chemical constituents of this plant include flavonoids，polysaccharides，lignans，and alkaloids. Flavonoids are the main active ingredients. These compounds show a wide range of biological activities，including cartilage repair，anti-aging，anti-fatigue，cough-relieving，blood glucose-lowering，and anti-tumor effects. Modern pharmacological research has shown that E. sagittatum has definite pharmacological effects on the reproductive system，respiratory system，nervous system，cardiovascular system，skeletal system，etc. It has remarkable effects of helping pregnancy，resisting osteoporosis，controlling diabetes，improving immunity，and inhibiting tumor. Under the background of advocating one health and Chinese medicine，E. sagittatum is widely used in health care products，serving as the main raw material of various products. It has great market potential and is a Chinese medicinal herb with great clinical application and research value. This paper reviews the main chemical constituents and pharmacological effects of E. sagittatum based on domestic and foreign reports， providing a theoretical basis for further study on E. sagittatum and its safe clinical application.

Epimedium sagittatum is a perennial herb of Berberidaceae. Its leaves have a long history of medicinal use in China. This plant is widely used as a Chinese traditional medicine，with the main functions of tonifying kidney Yang，strengthening bones and muscles，and dispelling wind and dampness. It can be used for treating kidney Yang deficiency，impotence，spermatorrhea，flaccidity of bones and muscles，rheumatic arthralgia，numbness，and spasms. The chemical constituents of this plant include flavonoids，polysaccharides，lignans，and alkaloids. Flavonoids are the main active ingredients. These compounds show a wide range of biological activities，including cartilage repair，anti-aging，anti-fatigue，cough-relieving，blood glucose-lowering，and anti-tumor effects. Modern pharmacological research has shown that E. sagittatum has definite pharmacological effects on the reproductive system，respiratory system，nervous system，cardiovascular system，skeletal system，etc. It has remarkable effects of helping pregnancy，resisting osteoporosis，controlling diabetes，improving immunity，and inhibiting tumor. Under the background of advocating one health and Chinese medicine，E. sagittatum is widely used in health care products，serving as the main raw material of various products. It has great market potential and is a Chinese medicinal herb with great clinical application and research value. This paper reviews the main chemical constituents and pharmacological effects of E. sagittatum based on domestic and foreign reports， providing a theoretical basis for further study on E. sagittatum and its safe clinical application.

Objective:To explore the role adaptation experience of informal caregivers of elderly patients with swallowing disorders, providing reference for developing caregiver support programs.Methods:This study was a qualitative study. Purposive sampling method was used to select informal caregivers of elderly patients with swallowing disorders admitted to West China Hospital of Sichuan University and Chengdu Second People's Hospital from July to October 2023 for semi-structured interviews. Analyze the data and extract themes using Colaizzi's 7-step analysis method.Results:From the caregiving experience, two main themes and nine subthemes were identified: poor adaptation to multiple roles (insufficient role adaptation resources, disrupted physiological rhythms, prominent negative emotions, limited social participation, heavy economic burden) ; role activation (emotion and responsibility, external support system assistance, internal self-efficacy enhancement, self-healing) .Conclusions:Medical staff should optimize training for informal caregivers of elderly patients with swallowing disorders, enhancing their knowledge and skills to alleviate poor role adaptation experiences and improve the quality of care.

Objective:The development and application of end-of-life patient decision aids for elderly were systematically reviewed and analyzed in order to supply guidance for the design of localized patient decision aids in China.Methods:Using the Scoping Review Guidelines as a methodological framework, a systematic search was conducted across databases including China National Knowledge Infrastructure, Wanfang, China Biology Medicine, PubMed, Web of Science, Embase, Cochrane Library, CINAHL, and BIOSIS. The search period covered from the inception of these databases to October 31, 2023. Two professionally trained researchers were responsible for screening, extracting, and organizing the retrieved literature.Results:A total of 5 studies on decision aids were included. These primarily employed paper graphics, interactive web pages, or multimedia slides as formats. The content encompassed various aspects such as palliative care options along with their pros and cons, assisting patients in clarifying their personal values, encouraging patients to document their decision-making preferences, and initiating end-of-life conversations with family members. Age-friendly design strategies were adopted in 4 studies; efficacy was validated in 3 studies, and in two of these studies, significant improvements were observed in engagement of patients (or substitute decision-makers) in ACP and the consistency of decision preferences (both P< 0.05). Conclusions:End-of-life decision aids for elderly patients can improve decision-making outcomes to some extent, however, the form and quality standards of them need to be improved, and their long-term effect needs further research and verification. It is recommended that in the future, the needs for end-of-life decision-making should be properly assessed based on the health literacy level, and high-quality localized end-of-life decision aids should be developed and popularized.

Objective:The development and application of end-of-life patient decision aids for elderly were systematically reviewed and analyzed in order to supply guidance for the design of localized patient decision aids in China.Methods:Using the Scoping Review Guidelines as a methodological framework, a systematic search was conducted across databases including China National Knowledge Infrastructure, Wanfang, China Biology Medicine, PubMed, Web of Science, Embase, Cochrane Library, CINAHL, and BIOSIS. The search period covered from the inception of these databases to October 31, 2023. Two professionally trained researchers were responsible for screening, extracting, and organizing the retrieved literature.Results:A total of 5 studies on decision aids were included. These primarily employed paper graphics, interactive web pages, or multimedia slides as formats. The content encompassed various aspects such as palliative care options along with their pros and cons, assisting patients in clarifying their personal values, encouraging patients to document their decision-making preferences, and initiating end-of-life conversations with family members. Age-friendly design strategies were adopted in 4 studies; efficacy was validated in 3 studies, and in two of these studies, significant improvements were observed in engagement of patients (or substitute decision-makers) in ACP and the consistency of decision preferences (both P< 0.05). Conclusions:End-of-life decision aids for elderly patients can improve decision-making outcomes to some extent, however, the form and quality standards of them need to be improved, and their long-term effect needs further research and verification. It is recommended that in the future, the needs for end-of-life decision-making should be properly assessed based on the health literacy level, and high-quality localized end-of-life decision aids should be developed and popularized.

Objective:To explore the role adaptation experience of informal caregivers of elderly patients with swallowing disorders, providing reference for developing caregiver support programs.Methods:This study was a qualitative study. Purposive sampling method was used to select informal caregivers of elderly patients with swallowing disorders admitted to West China Hospital of Sichuan University and Chengdu Second People's Hospital from July to October 2023 for semi-structured interviews. Analyze the data and extract themes using Colaizzi's 7-step analysis method.Results:From the caregiving experience, two main themes and nine subthemes were identified: poor adaptation to multiple roles (insufficient role adaptation resources, disrupted physiological rhythms, prominent negative emotions, limited social participation, heavy economic burden) ; role activation (emotion and responsibility, external support system assistance, internal self-efficacy enhancement, self-healing) .Conclusions:Medical staff should optimize training for informal caregivers of elderly patients with swallowing disorders, enhancing their knowledge and skills to alleviate poor role adaptation experiences and improve the quality of care.

Exosomes are lipid bilayer structures containing various bioactive molecules that can be secreted by almost all cells.However,exosomes released by different types of cells perform differ-ent biological functions,and have been confirmed to participate in physiological processes such as immune response,antigen presentation,cell migration and differentiation,and hair growth through ligand receptor binding.Recent research reports have shown that exosomes can also be secreted from the fetus and placenta,playing an important role in embryo implantation and development,as well as in the treatment of animal pregnancy diseases.In order to offer recommendations for endan-gered and unique economic animals in the diagnosis and treatment of pregnancy and pregnancy-re-lated illnesses,this paper reviewed the most recent developments and innovative theories about the use of extracellular vesicles in pregnancy.

With the accelerating of aging population in China, the long-term care demand of the elderly is increasing. In recent years, extended reality technology has shown great development potential in assisting elderly chronic nursing, rehabilitation nursing, psychological nursing, palliative care, nursing personnel training. This paper reviews the application status of extended reality technology in geriatric care at home and abroad, and puts forward the problems and countermeasures of extended reality technology applied in geriatric care, so as to provide reference for promoting the application of extended reality technology in geriatric care.

Objective:To develop an in vitro neuroinflammation model by establishing a microglia-neuron co-culture system. Methods:Mouse microglia (BV-2), motor neurons (NSC34) and hippocampal neurons (HT-22) were selected.This experiment was performed in two parts.Experiment Ⅰ BV-2 microglia were stimulated with different concentrations of lipopolysaccharide (LPS, 10, 100, 500 and 1 000 ng/ml). Microglia culture supernatant(Conditioned Medium) was extracted and two types of neurons were cultured separately.The concentration of LPS that resulted in a significant 50% decrease in neuronal viability was selected using the CCK-8 method for establishment of the Transwell co-culture system.Experiment Ⅱ Microglia were cultured in the upper chamber of Transwell, and neurons were seeded in the lower chamber.Microglia were divided into 2 groups ( n=12 each) using the random number table method: control group and LPS group.In control group and LPS group, microglia were cultured for 6 h with cell culture medium and LPS, respectively, then the medium was replaced with fresh medium, microglia were continuously incubated for 12 h, and then the cells in the upper and lower chambers were combined.The cells were incubated using the BV-2-NSC34 Transwell co-culture system for 12 h and using the BV-2-HT-22 Transwell co-culture system for 24 h. The concentrations of interleukin-1beta (IL-1β) and IL-18 in neuronal culture supernatant were measured by enzyme-linked immunosorbent assay, the apoptotic rate of neurons was determined by flow cytometry, the expression of Bcl-2 and Bax mRNA in neurons was detected by quantitative real-time polymerase chain reaction, and the expression of cleaved caspase-3, Bcl-2 and Bax in neurons was detected by Western blot. Results:Experiment Ⅰ LPS concentration for stimulation was 10 ng/ml in BV-2-NSC34 Transwell co-culture system and 1, 000 ng/ml in BV-2-HT-22 Transwell co-culture system.Experiment Ⅱ Compared with control group, the concentrations of IL-1β and IL-18 and apoptotic rate of neurons were significantly increased, Bax protein and mRNA expression was up-regulated, Bcl-2 protein and mRNA expression was down-regulated, and cleaved caspase-3 expression was up-regulated in LPS group ( P<0.05 or 0.01). Conclusions:The microglia-neuron co-culture system is successfully established by the conditioned medium technique and Transwell co-culture system, which provides an experimental protocol for establishment of neuroinflammation models associated with postoperative cognitive dysfunction.

Objective:To observe the efficacy of transurethral electrocoagulation combined with hyperbaric oxygen in the treatment of hemorrhagic radiation cystitis.Methods:A total of 76 patients with hemorrhagic radiation cystitis admitted to Heji Hospital Affiliated to Changzhi Medical College of Shanxi Province from June 2014 to April 2020 were selected as research subjects and randomly divided into control group ( n=38) and combination group ( n=38). The patients in the control group were treated with transurethral electrocoagulation, and the patients in the combination group were treated with hyperbaric oxygen on the basis of the treatments in the control group. The clinical efficacies of the two groups were compared. The urodynamic indexes were evaluated by urethral syndrome score (USS), overactive bladder symptom score (OABSS), interstitial cystitis symptom score (ICSI), and visual analogue scale (VAS) for pain. Results:After treatment, the total clinical effective rate of the combination group (94.74%, 36/38) was significantly higher than that of the control group (81.58%, 31/38), with statistically significant difference ( P<0.05). Compared with those before treatment, in both groups, the bladder capacity and micturition volume increased significantly, while maximum micturition pressure decreased significantly; all showing statistically significant differences ( P<0.05). Moreover, the improvements of bladder capacity, micturition volume, and maximum micturition pressure in the combination group were greater than those in the control group, among which the improvement of micturition volume in the combination group had statistically significant difference from that of the control group ( P<0.05). The USS score, the frequency of urination, and the occurrence of urgent urination and urinary incontinence in both groups decreased compared with those before treatment, all showing statistically significant differences; moreover, the combination group had better improvements in USS score, the frequency of urination, and the occurrence of urgent urination and urinary incontinence than the control group, among which the USS score, the frequency of urination, and the occurrence of urinary incontinence in the combination group had statistically significant differences from those in the control group ( P<0.05). After treatment, the ICSI and VAS scores in both groups decreased, and the two scores in the combination group were significantly lower than those in the control group, with statistically significant differences ( P<0.05). Conclusion:Hyperbaric oxygen combined with transurethral electrocoagulation has a significant effect on hemorrhagic radiation cystitis, which can effectively improve the urodynamic properties of patients, reduce USS, OABSS, ICSI, and VAS scores, and promote the prognosis.