Sarcopenia, characterized by the loss of muscle mass and function, significantly impacts the quality of life in older adults and has emerged as a major global public health challenge.With the aging population, the incidence of sarcopenia continues to rise, necessitating urgent in-depth studies on effective treatments and its pathogenesis.Exosomes serve as effective carriers for intercellular substance transfer, participating in the physiological regulation and pathological changes of organic cells by transporting specific nucleic acids, proteins, and lipids.Although the potential role of exosomes in sarcopenia has been identified, the specific mechanisms remain poorly understood, and clinical applications are still in the early stages of exploration.This review outlines the role of exosomes from various sources in the communication of skeletal muscle satellite cells and their impact on the occurrence and development of sarcopenia.It also explores their potential applications as biomarkers and therapeutic strategies, providing new ideas and directions for the prevention and treatment of sarcopenia.As research progresses, exosomes are expected to lead to novel treatment options for patients with sarcopenia, ultimately improving their quality of life and health.

Based on the "Qi-blood-meridians" system， it is proposed that recurrence after radiofrequency ablation （RFA） for arrhythmia originates from damage to the heart and injury to the meridians caused by thermal burns. Disorder of qi movement， blood obstruction and heat constraint are the prerequisites for recurrence， while internal consumption of deficient qi， yin damage and scarce blood are key factors in frequent episodes. Latent pathogen of both phlegm and stasis， along with condensation of pathogenic yin， is the main cause of disease progression. Accordingly， self-made Tong Xin Beverage （通心饮） with 18 herbs is used throughout the postoperative intervention process to nourish the heart， unblock the meridians， restore vessels in balance of yin and yang. Self-made Qingxin Dingji Decoction （清心定悸汤） can be used to promote qi movement， diffuse stagnation， relieve heat and activate blood circulation so as to facilitate early recovery. Self-made Peiben Yangxin Decoction （培本养心汤） can boost qi and nourish yin， harmonize the ying （营） level and nourish blood， thereby improving long-term prognosis. In addition， Shiwei Wendan Decoction combined （十味温胆汤） with Taoren Honghua Decoction （桃仁红花煎） resolves phlegm， dissipates masses， removes stasis， and softens hardness， which can be used to prevent disease aggravation. These approaches aim to provide ideas and references for clinical practice.

Sarcopenia, characterized by the loss of muscle mass and function, significantly impacts the quality of life in older adults and has emerged as a major global public health challenge.With the aging population, the incidence of sarcopenia continues to rise, necessitating urgent in-depth studies on effective treatments and its pathogenesis.Exosomes serve as effective carriers for intercellular substance transfer, participating in the physiological regulation and pathological changes of organic cells by transporting specific nucleic acids, proteins, and lipids.Although the potential role of exosomes in sarcopenia has been identified, the specific mechanisms remain poorly understood, and clinical applications are still in the early stages of exploration.This review outlines the role of exosomes from various sources in the communication of skeletal muscle satellite cells and their impact on the occurrence and development of sarcopenia.It also explores their potential applications as biomarkers and therapeutic strategies, providing new ideas and directions for the prevention and treatment of sarcopenia.As research progresses, exosomes are expected to lead to novel treatment options for patients with sarcopenia, ultimately improving their quality of life and health.

This paper discussed the pathogenesis and treatment ideas of recurrent angina pectoris after percutaneous coronary intervention （PCI） based on qi and blood vessels. It is believed that patients after PCI often have poor qi and blood circulation and damaged vessels and collaterals as the basis， and subsequently suffer from binding of phlegm and stasis， accumulated and sticky， which further lead to the vessels congested and blocked， qi and blood declined， and the body and functions of the heart damaged. Accordingly， in terms of the treatment principles， it has been proposed to regulate qi and transport blood， unblock and nourish vessels， dissolve phlegm and dispel stasis， direct turbidity downward and unblock collaterals， supplement qi and nourish the body， unblock vessels and rejuvenate meridians， by using self-made Tiaoqi Yunxue Formula （调气运血方）， self-made Huoxue Jiangzhuo Formula （活血降浊方） and self-made Shenrong Tongmai Formula （参茸通脉方） in their modifications respectively， in order to provide reference for clinical diagnosis and treatment.

BACKGROUND:Mangiferin is a biphenylpyridone compound extracted from mango leaves,bark and roots.Previous studies have shown that mangiferin can exert anti-systemic inflammatory effects through the activation of transcription factors such as NF-κB and JAK/STAT. OBJECTIVE:To investigate the effects and mechanisms of mangiferin on proliferation,migration and inflammatory factor release of rheumatoid arthritis fibroblast-like synovial cells(RA-FLS). METHODS:RA-FLS were divided into blank group,R848(TLR7/8 agonists)stimulated group,mangiferin low-,medium-,high-dose groups(2,4 and 8 μg/mL)and positive control group(Cu-CPT8,TLR8 pathway inhibitor).The cytotoxic effect of different mass concentrations of mangiferin was detected using cell counting kit-8 method and the final cellular dosing mass concentration was screened.The proliferation ability of RA-FLS was detected by cell clone formation assay,the migration ability of RA-FLS was detected by scratch assay and Transwell migration assay,and the expression of interleukin 1β,interleukin 6 and tumor necrosis factor α mRNA in RA-FLS was detected by qRT-PCR. RESULTS AND CONCLUSION:Compared with the blank group,the viability of RA-FLS was inhibited after treatment with mangiferin at 2-10 μg/mL,but there was no significant difference among groups(P>0.05),indicating that the toxic effect on RA-FLS was minimal.Compared with the R848-stimulated group,mangiferin decreased the number of cell clones,the scratch healing rate and the number of migrating cells in all dosing groups(P<0.01);and the expression of interleukin 1β,interleukin 6 and tumor necrosis factor α mRNA was also reduced in the mangostin medium-and high-dose groups(P<0.01).Compared with the R848-stimulated group,the number of cell clones,the scratch healing rate and the number of migrating cells as well as the expression levels of interleukin 6 and tumor necrosis factor α mRNA were significantly reduced in the positive control group(P<0.05,P<0.01).But there was no significant difference in the expression level of interleukin 1β.To conclude,mangiferin may exert its anti-rheumatoid arthritis effects through the TLR7/8 signaling pathway by inhibiting RA-FLS proliferation,migration,and inflammatory factor release.

Intestinal schistosomiasis is caused by infestation with schistosome, which is easy to be confused with inflammatory bowel disease, especially Crohn′s disease or malignant tumor. Such a case that was misdiagnosed as Crohn′s disease in Zhongnan hospital is described. Schistosome eggs, granuloma and eosinophil infiltration observed in resected specimens can help reaching the correct diagnosis.

Intestinal schistosomiasis is caused by infestation with schistosome, which is easy to be confused with inflammatory bowel disease, especially Crohn′s disease or malignant tumor. Such a case that was misdiagnosed as Crohn′s disease in Zhongnan hospital is described. Schistosome eggs, granuloma and eosinophil infiltration observed in resected specimens can help reaching the correct diagnosis.

Objective To study the association between impaired fasting glucose (IFG) and cognitive impairment in community elderly residents.Methods A total of ≥60 years old 1223 people were divided into normal fasting glucose (NFG) group (n=981) and IFG group (n=242).Their baseline data were recorded,their cognitive function was assessed according to the MMSE score.Results The education level,BMI,serum FBG,TG,LDL-C levels,incidence of hypertension and hyperlipidemia were significantly higher while the serum HDL-C level was significantly lower in IFG group than in NFG group (P＜0.05,P＜0.01).The incidence of cognitive impairment was significantly higher while the score of MMSE,orientation,attention and calculation,immediate recall and language was significantly lower in IFG group than in NFG group (40.50％ vs 21.51％,24.76±5.38 vs 26.60±4.26,9.07±1.81 vs 9.48±1.15,3.39±2.00 vs 3.88±1.81,2.93±0.41 vs 2.98±0.24,6.74±1.51 vs 7.18±1.15,P＜0.01).Age,female sex,LDL-C and IFG were risk factors for cognitive impairment in the elderly (P＜0.01,P＜0.05) while the education level was a protective factor for cognitive impairment in the elderly (P=0.000).Conclusion IFG is an independent risk factor for cognitive impairment in the elderly.Early diagnosis and intervention can improve cognitive function in the elderly.

White matter lesions (WMLs) are a common neuroimaging finding.With the aging of the population and the development of imaging technology,the detection rate of WMLs in the elderly increased gradually.WMLs are closely associated with ischemic stroke.This article reviews the pathophysiological mechanism,imaging evaluation,clinical manifestation of WMLs,and its relationship with ischemic stroke as well as its prevention and treatment.

Objective To investigate the association between warfarin drug effects and vitamin K epoxide reductase complex subunit 1 (VKORC1)-1639 G/A gene polymorphisms in Han Chinese very elderly patients.Methods The subjects were elderly patients aged more than 60 years, with stable anticoagulation with warfarin and the target international normalized ratio(INR), who were hospitalized in Beijing Friendship Hospital, Capital Medical University from August 2009 to August 2016.The patients were divided into the very elderly group and aged group.The first record of warfarin dosage, the duration of achieving stable dosage (defined as the initial stage of treatment) and warfarin stable dosage were recorded.The bleeding and embolism events during early treatment were observed.After INR was at the steady state, genotyping for the VKORC1-1639 G/A alleles were tested.The effects of drugs and complications in warfarin initiation therapy were also investigated.Results A total of 322 patients were enrolled, including 300 cases of atrial fibrillation and 22 cases of pulmonary embolism.The very elderly group had 200 cases, including 110 males and 90 females;their ages ranged from 75 to 96 years, the average age was (83+7).The aged group had 122 cases, including 68 males, 54 females, their ages ranged from 60 to less than 75 years, the average age was (67±8).The VKORC1-1639 G/A genotype included 256 cases of AA type (79.5%) which contained 150 males and 106 females, and 62 cases of type AG (19.3%) which contained 26 males and 36 females.The GG type included 4 cases (1.2%), containing 2 males and 2 females.Genotype distribution accorded with the law of genetic equilibrium.There was no significant difference in VKORC1-1639 G/A genotype distribution between the aged group and the very elderly group (P>0.05).The carriers of VKORC1-1639 AG+GG genotype had a significantly higher warfarin stable dosage than those of AA genotype [(2.90±1.39)mg vs.(2.00±1.14)mg, t=5.39, P<0.01].In the same genotype, the very elderly patients had a decreased warfarin stable dosage compared with the aged patients [AA: (1.62±1.24)mg vs.(2.58±0.98)mg, t=6.68, P<0.01;AG+GG: (2.43±0.55)mg vs.(3.36±1.52)mg, t=3.97, P<0.01].The AG+GG patients have a longer time to achieve stable dosage-effect relation compared with AA genotype [(18.9±2.8)d vs.(11.2±2.5)d, t=4.28, P=0.01].Conclusions Warfarin stable dosage was related to patient age and VKORC1-1639 gene polymorphism.According to the results of VKORC1-1639 genotype testing to adjust warfarin dose maybe have some clinical significance in Han elderly patients.