Objective To investigate whether Fuzheng Buxue dietary therapy (FZBX) counteracts chemotherapy-induced myelosuppression (CIM) by partially modulating bone marrow mesenchymal stromal cells (MSCs) function via the Notch signaling pathway. Methods Ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) was used to characterize the chemical constituents of FZBX. Rat MSCs were isolated by whole bone marrow adherence and were authenticated. MSCs were assigned to four groups: normal control, 5-fluorouracil (5-FU), FZBX-medicated serum, and 5-FU + FZBX-medicated serum. Cell viability was measured using the cell counting kit-8 (CCK-8) assay, and proliferation was evaluated by 5-ethynyl-2′-deoxyuridine (EdU) staining. Cell cycle distribution and apoptosis were analyzed using flow cytometry, followed by enzyme-linked immunosorbent assay (ELISA) quantification of hematopoietic cytokines. Whole transcriptome sequencing and the search tool for the retrieval of interacting genes/proteins (STRING) protein–protein interaction (PPI) network analysis were performed to explore the global transcriptional changes and interactions of Notch pathway-related genes. Western blot was used to assess the key proteins involved in the Notch pathway. Results UHPLC-MS/MS identified amino acid related metabolites and herbal phytochemicals as the major constituents of FZBX. 5-FU impaired MSCs function, as evidenced by cell proliferation, induction of G0/G1 phase arrest, elevation of the total apoptosis rate, disruption of hematopoietic cytokine balance, and downregulation of Notch pathway-related proteins. The FZBX-medicated serum notably enhanced the proliferative activity; in 5-FU-injured MSCs (P < .001), FZBX ameliorated 5-FU-induced G0/G1 phase arrest, reduced early and late apoptosis rates, and restored the hematopoietic cytokine balance (P < .001). Transcriptomic analysis revealed a significant upregulation of multiple Notch pathway components (P < .001), and PPI network analysis confirmed their functional interplay. Western blot further indicated that FZBX activated the Notch signaling pathway by upregulating the expression of Jagged1, Notch1, and Notch2. Conclusion The findings suggest that FZBX may protect against CIM by modulating MSCs function, at least partially via the Notch signaling pathway, and offers a promising therapeutic strategy.

The disease burden of anxiety and depression is becoming increasingly severe, and the shortage of mental health clinical resources restricts patients’ access to care services. Large language models offer a new pathway for digital psychological care, yet standardized horizontal comparisons of response efficacy among different mainstream models in anxiety and depression care consultations are lacking. A cross-sectional comparative study design was adopted. Thirty standardized open-ended questions covering six themes (Diagnosis, Symptoms, Risk factors, Assessment, Management, and Outcome) were constructed. Uniform prompts were used to batch-query five tested models and collect responses. Three evaluators implemented two rounds of blind independent scoring with a 2-week interval, quantifying scores across five dimensions (Accuracy, Integrity, Relevance, Diversity, and Interpretability). Data processing and statistical testing were conducted using ICC, Spearman correlation, Wilcoxon signed-rank test, Kendall’s W, and PCA principal component analysis. Effect sizes and degrees of freedom were reported where applicable. GPT-5.3-Codex (21.35 points) and Claude-Opus-4.6 (21.25 points) showed the highest overall scores, whereas Gemini-3-Flash showed intermediate performance. The overall between-model difference was significant, F(4, 145) = 10.251, p < 0.001, η² = 0.220 (95% CI, 0.10–0.32), indicating a large overall effect. Significant pairwise contrasts were accompanied by moderate-to-large or large effects (Cohen’s d = 0.68–1.62). Test-retest ICCs were in the moderate-to-excellent range, and Spearman correlations between the two rounds were positive across all model-rater combinations (ρ = 0.549–0.864; df = 28; all p < 0.01). Wilcoxon signed-rank tests showed no systematic retest shift (all p > 0.05; effect-size r = 0.006–0.310). Within-model inter-rater correlations were generally strong. All models scored higher descriptively on Risk factors and Symptoms items, whereas Diagnosis showed the lowest overall mean score. Claude-Opus-4.6 had the highest mean scores for Accuracy and Interpretability, GPT-5.3-Codex for Integrity, and Gemini-3-Flash for Relevance and Diversity. PC1 and PC2 cumulatively explained 64.0% of the total variance. GPT-5.3-Codex and Claude-Opus-4.6 demonstrated the highest comprehensive efficacy under the standardized simulated consultation framework. Each model showed distinct performance patterns across themes and evaluation dimensions, which may inform future model optimization and prospective validation. Further real-world evaluation is required before these findings can support scenario-specific clinical deployment.

This study aims to synthesize the perceptions and expectations of long-term caregivers regarding the use of nursing robots to inform strategies for enhancing the quality and operational efficiency of care services. Global poulation aging has exacerbated long-term caregiver burnout and critical staff shortages. Nursing robots present a potential solution to mitigate these challenges and improve care standards. We conducted a meta-synthesis of qualitative studies, searching eleven databases (PubMed, Web of Science, Embase, CINAHL, Scopus, Cochrane Library, PsycINFO, SinoMed, China National Knowledge Infrastructure, Wanfang, and Vip) from their inception through January 1, 2025, for publications in Chinese and English. The search strategy utilized a comprehensive set of terms related to four core concepts: long-term caregivers, nursing robots, long-term care settings, and perceptions/experiences. Methodological quality was assessed using the Joanna Briggs Institute's critical appraisal tools. Following a rigorous screening and data extraction process, a thematic synthesis of 26 included studies was conducted using NVivo software. The analysis yielded three analytical themes and nine sub-themes: (1) Affirmation and Acceptance, (2) Concerns and Challenges, and (3) Expectations and Requirements. Findings reveal that while most long-term caregivers are enthusiastic about nursing robots, they also express significant concerns about technical reliability, safety, and privacy. Future efforts should prioritize user-centered design, supportive policy development, and comprehensive training programs to facilitate robot adoption and enhance care quality. The protocol was registered with PROSPERO (CRD42024583919). No patient or public contribution was included in this study.

Objective To compare research hotspots and development trends regarding freezing of gait in Parkinson's disease between Chinese and English articles,thus providing reference for related studies in China. Methods The articles about freezing of gait in Parkinson's disease that were published from 2001 to 2025 was retrieved from the China National Knowledge Infrastructure,Wanfang Data,VIP,and Web of Science Core Collection.Visual analyses were conducted on the distribution of countries,authors,institutions,and keywords. Results A total of 177 Chinese articles and 1 095 English articles were included.The global annual number of published articles showed an overall upward trend with fluctuations.The articles in Chinese maintained steady growth while those in English slightly declined over the past three years.The United States led in the number of published articles,followed by China and Italy.The authors and institutions of Chinese articles exhibited greater independence than those of English articles.Current research hotspots on freezing of gait in Parkinson's disease focus on pathogenesis,assessment methods,and treatment strategies.Chinese articles emphasize clinical interventions,while English articles prioritize mechanism exploration and emerging physical therapies. Conclusions The research on freezing of gait in Parkinson's disease remains active,though differences exist in research focus between Chinese and English articles.Compared with Chinese articles,English articles reported early on freezing of gait in Parkinson's disease.In the future,China should deepen international exchanges and cooperation to actively draw on advanced findings and experience and work jointly to achieve breakthrough progress in both research and clinical practice,ultimately improving patients' quality of life.

Background Integrated care is a pivotal strategy for addressing global population aging, with its core tenet being “person-centered and demand-driven”. The Chinese government’s “14th Five-Year Plan for National Aging Development” explicitly advocates for the classified development of three types of long-term care facilities (LTCFs): subsistence security-oriented, inclusive support-oriented, and fully market-oriented. However, evidence regarding the integrated care needs of older adults across these distinct institutional models remains scarce, particularly concerning activities of daily living (ADL)-impaired older people. Objectives To investigate the integrated care needs of older people in the above three types of LTCFs and explore the influencing factors of such needs. Methods This multi-centre, cross-sectional,study included 1300 older people from LTCFs. Participants were surveyed using a general information questionnaire and an integrated care needs questionnaire. Multiple linear regression analysis was conducted to identify the factors influencing their integrated care needs. Results Older adults in LTCFs reported moderate-to-high integrated care needs (overall mean ± SD: 3.42 ± 0.62 on a 5-point scale), with the highest demand for basic nursing (3.65 ± 0.72), followed by health guidance (3.58 ± 0.76). Multiple linear regression analysis (adjusted R²=0.512, F = 70.258, p < 0.001) identified ten independent determinants:facility type (public welfare vs. private: β = 0.236, p < 0.001), primary income source,family visit frequency, ADL impairment severity (severe vs. mild: β = 0.332, p < 0.001), chronic disease burden, hospitalization frequency, polypharmacy status, sensory impairment (β = 0.275, p < 0.001), psychological state (poor vs. Good: β = 0.228, p < 0.001), and length of stay. Notably, 89.30% of residents expressed desire for facility-community collaborative care windows. Conclusion Older people in Chinese LTCFs present substantial, multidimensional integrated care needs that vary inversely with facility service capacity. ADL impairment severity, sensory deficits, and psychological distress emerged as the strongest determinants. These findings inform targeted resource allocation and the development of tiered, facility-type-specific integrated care protocols to address the “high age, disability, and chronicity” challenges in institutional aging.

Background: Frailty is a public health concern in older adults. However, associations between food intake patterns and frailty dimensions remain insufficiently understood. This study aimed to construct a network linking food intake patterns with frailty dimensions, identify nodes with high centrality and bridge nodes, and provide evidence for frailty identification and factors that may be associated with frailty in older adults. Methods: We included 14,140 older adults from the 2017-2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Food intake was assessed using a validated food frequency questionnaire, and patterns were extracted by exploratory factor analysis. Frailty was assessed using a frailty index based on 35 health-related deficits and classified into three dimensions: basic status (BS), basic ability (BA), and medical history (MH). Network analysis with a Gaussian graphical model was used to construct a partial correlation network and identify central and bridge nodes. Results: Four food intake patterns were identified: FD-1 (legumes-eggs-milk pattern), FD-2 (fruits-vegetables pattern), FD-3 (garlic-nuts-salt-preserved vegetables pattern), and FD-4 (meat-fish pattern). FD-1 and FD-2 showed high strength centrality, indicating strong connections within the network. The strongest cross-network association was negative between FD-2 and BS. FD-3 was negatively associated with BA, whereas FD-4 was weakly positively associated with MH. BA had the highest bridge strength, while FD-1 showed high bridge closeness and betweenness. Conclusions: Food intake patterns showed complex associations with frailty dimensions. FD-1, FD-2, and BA emerged as potential nodes of interest. Future studies are warranted to investigate whether dietary strategies centered on FD-1 and FD-2 are associated with preserved function and reduced frailty risk in older adults.

BackgroundSocial isolation is a prevalent issue among older people in long-term care facilities (LTCFs), with profound negative impacts on their quality of life and mental health. However, the authentic experiences and underlying mechanisms of social isolation among older people in LTCFs remain understudied. A nuanced understanding of these experiences is essential for designing targeted nursing interventions. ObjectiveThis study aimed to systematically review and synthesize qualitative evidence to explore the experiences of social isolation among older adults in LTCFs and analyze them in terms of causes, mechanisms, outcomes, and strategies. MethodsA systematic review and qualitative meta-synthesis were conducted. We searched PubMed, Web of Science, Embase, PsycInfo, Cochrane Library, CINAHL, Scopus, Chinese Biomedical Literature Database, CNKI, Wanfang Data, and Weipu (VIP) with no restriction on the start year, up to February 2025. Two reviewers (WL and ZM) independently screened studies, extracted data using a Microsoft Excel spreadsheet, and assessed study quality with the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Qualitative data synthesis was performed following Thomas and Harden’s thematic and content analysis method, including line-by-line coding of participant quotes, organizing codes into descriptive themes, and developing analytical themes. ResultsA total of 4856 papers were retrieved through systematic searches, and 14 qualitative studies met the inclusion criteria. Four overarching analytical themes were identified: (1) root cause: person-environment mismatch (encompassing 4 interrelated dimensions: imbalance between declining individual capacity and insufficient environmental support, negative self-perception paired with inadequate positive environmental feedback, personal biases conflicting with homogeneous institutional social ecology, and disrupted social roles due to rigid institutional management); (2) overt behavioral patterns: proactive isolation, defensive isolation, and adaptive isolation; (3) inner emotional experiences: feelings of confinement, sorrow, and weariness; and (4) strategies for restoring person-environment match: active engagement in interaction, rational acceptance of coexistence, and passive avoidance and withdrawal. Notably, person-environment mismatch was confirmed as the core mechanism driving the onset and persistence of social isolation in this population. ConclusionsPerson-environment mismatch is the fundamental driver of social isolation among older adults in LTCFs. Interventions should prioritize restoring person-environment alignment—including optimizing physical environments, reconstructing supportive social environments, and enhancing psychological empowerment. Future studies should focus on developing tools to quantify person-environment matching degrees in LTCFs and conduct longitudinal evaluations of targeted interventions to further reduce social isolation and promote active social participation among older people.

Background Chemotherapy-induced myelosuppression (CIM) is a common dose-limiting toxicity that compromises chemotherapy continuity and patient outcomes. In the bone marrow microenvironment, mesenchymal stromal cell-derived extracellular vesicles (MSC-EVs) act as key paracrine mediators, regulating the function of CD34+ hematopoietic stem and progenitor cells (HSPCs). Based on the traditional concept of medicine–food homology, our team has developed Fuzheng Buxue dietary therapy (FBDT) and previously demonstrated its clinical efficacy in alleviating CIM. This study investigates whether FBDT alleviates CIM by modulating MSC-EV function. Methods In vitro, the optimal conditions for 5-fluorouracil (5-FU)-induced injury and FBDT intervention were first determined. CD34+ HSPCs were co-cultured with FBDT-preconditioned MSCs (FBDT-MSCs), and the expression of surface markers CD117 and CD150 was evaluated. Subsequently, EVs were isolated from FBDT-MSCs and co-cultured with CD34+ HSPCs. HSPC viability and CD117/CD150 expression were assessed. In vivo, a 5-FU-induced CIM rat model received tail vein injections of EVs from FBDT-MSCs (FBDT-EVs). Body weight, peripheral blood parameters, and serum CD117 and SCF levels were measured. Histopathology and organ indices of spleen, thymus, and bone marrow were analyzed. Key hematopoietic regulators (CD117, SCF, CD90) in bone marrow were detected by Western blot. Finally, serum creatinine levels in rats were measured. Results Co-culture with FBDT-MSCs increased HSPC numbers but did not significantly alter the distribution of CD117/CD150-defined HSPC subpopulations. FBDT-EVs enhanced the viability of CD34+ HSPCs in the co-culture system and increased the proportion of CD117+CD150+ HSPCs. Furthermore, FBDT-EVs promoted the recovery of hematopoietic function in CIM rats, with the reversal of body weight loss and restoration of key blood cell parameters. FBDT-EVs reduced CD117 protein levels in both bone marrow tissue and serum, while upregulating the expression of SCF and CD90. Serum creatinine levels were not significantly altered, suggesting no apparent renal toxicity under the present experimental conditions. Conclusion The study identifies MSC-EVs as a potential mediator of the hematopoietic effects of FBDT and suggests that FBDT may enhance the hematopoietic reparative properties of MSC-EVs. These findings suggest that MSC-EVs may mediate, at least in part, the hematopoietic effects of FBDT and that FBDT preconditioning enhances the hematopoietic reparative potential of MSC-EVs in CIM.

This study investigated the effects of combined aerobic and resistance exercise on muscle strength, physical performance, and body composition in older adults with sarcopenia. A systematic search was conducted across PubMed, Web of Science, Embase, Scopus, The Cochrane Library, CINAHL, and SPORTDiscus for randomized controlled trials on combined exercise interventions for sarcopenia, covering studies up to January 18, 2026. Data were analyzed using Review Manager (version 5.4.1) and Stata 18.0. The search identified 24,102 records, from which 14 randomized controlled trials (involving 786 participants) met the inclusion criteria. The methodological quality of the included studies was generally high, and the independent quality assessments by two researchers showed substantial inter-rater agreement (K = 0.80). Meta-analysis showed that combined exercise can improve handgrip strength (MD = 2.68, 95

IntroductionThe early diagnosis and treatment of mild cognitive impairment (MCI) can help decelerate or even reverse the progression of dementia. Therefore, China attaches great importance to the prevention and control of MCI and has introduced a series of policies.MethodsPolicy themes were identified by pre-processing, vectorizing, and clustering relevant policy texts by using the BERTopic model, and their temporal evolution patterns were revealed through dynamic topic modeling.ResultsCentral-level policies on cognitive impairment prevention and control encompass 12 themes, which can be classified into three major categories: community prevention and early screening, multistakeholder participation in rehabilitation work, and collaborative high-risk chronic disease management. Different work priorities were observed during the initial budding (2005–2018), progressive consolidation (2019–2023), and rapid development (2024–present) stages. Policies consider comorbidity management and demonstrate simultaneous systematization and refinement, with the focus of prevention and control gradually moving forward and responsibilities becoming increasingly diversified. However, issues, such as an underdeveloped comorbidity management system, insufficient coordination between central and local authorities, poor linkage between stages, and inadequate multistakeholder collaboration, persist.Discussion and implicationsIn the future, constructing cognitive impairment prevention and control implementation pathways tailored to local resources; establishing policy transition mechanisms; improving multidepartment and multistakeholder collaboration networks; and enhancing the role of personnel in early screening, rehabilitation interventions, and comorbidity management are necessary to promote effective policy translation and implementation.

AIM:To explore the attitudes and perceptions of Chinese nurses toward robotic health education. BACKGROUND:Nurse shortages have driven the adoption of robotics in clinical health education. However, limited evidence exists on nurses' attitudes and perceptions regarding robotic health education, highlighting the need for further exploration to understand their perspectives on this technology. METHODS:A qualitative interpretive descriptive study using inductive thematic analysis. A total of 28 clinical nurses from tertiary general hospitals in China were interviewed. FINDINGS:Nurses expressed both high expectations and concerns regarding the integration of robotic health education into clinical practice. Three significant themes emerged: (1) Affirming the Future of Robotic Health Education: Coexistence of Expectations and Doubts; (2) Expectations for Robotic Empowerment in Health Education: A Gap Between Technological Aspirations and Practical Realities; and (3) Expectation for Diverse Support in Robotic Health Education: Concerns about the Technology Integration Gap. CONCLUSION:The results indicate that while nurses acknowledge the value of robotic health education, they are also concerned about the technological limitations that may compromise patient safety. Consequently, there is a strong desire for future robotic health education to be more user friendly, intelligent, humanized, and secure. Nurses are particularly eager for robotic health education, under optimal environmental support, to effectively reduce their workload rather than merely serve as a display of technology. IMPLICATIONS FOR NURSING AND NURSING POLICY:These insights reveal both the benefits and challenges of using robotic health education in clinical nursing. The findings guide the optimization of workflows for integrating robots into clinical nursing and inform future technological advancements. Further research is needed to understand the attitudes of a broader range of stakeholders.

Aim: This study aims to ascertain the range of nursing care tasks that can be performed by currently available nursing robots in general adult wards, as well as to quantify the extent to which these robots can potentially replace the nursing care workload when implemented. Background: The global shortage of nurses has emerged as a significant societal issue, and nursing robots may be a potential solution to alleviate this crisis. However, there is a dearth of empirical evidence regarding the specific tasks that nursing robots can effectively replace in general adult wards within hospitals and lacking comprehensive reports that quantify how much nursing workload can be reduced by nursing robots. Methods: This research utilizes a two-phase research design with a scoping review and cross-sectional survey, involving the searching and screening of 10 scientific databases to identify nursing robots suitable for deployment in general adult wards within hospital settings. Additionally, the study measures the 24 h nursing workload for all patients across 72 wards in six hospitals located in eastern, central, and western regions of China. Results: 199 studies were included in this scoping review. A total of 26 nursing functions that can be performed by nursing robots in general adult wards were summarized. 7073 hospitalized patients were included in this study. 26 nursing robots have the potential to substitute for 62.37% of the total nursing workload per capita. Conclusions: The use of nursing robots in general adult wards is promising. However, it is worth noting that while nursing programs with the largest share of nursing workload already have nursing robots in use, there are some robots whose development focus and direction need to be adapted to the needs of the clinical nursing workload. Implications for Nursing Management: It is imperative for nursing managers to receive training in order to increase their understanding of robotic nurses and to explore effective and optimized models for managing nursing human resources when robots and nurses collaborate. Simultaneously, the definition and development of core competencies for robotic specialized nurses need to be on the agenda.

BACKGROUND:Grasping the nuanced needs of older adults is paramount for the efficacious provision of day-care services. Our study sought to identify the demand patterns for day-care services in China and to explore the underlying factors. This study aims to offer useful evidence that can refine nursing care strategies and guide policy development within day-care settings. METHODS:We implemented a comprehensive electronic survey comprising 46 questions targeting older adults across nine day-care centers in Nanjing, China. Employing latent profile analysis (LPA), we systematically examined and categorized the demand characteristics for day-care services. This analysis was conducted using Mplus version 8.3 and SPSS version 26.0 software, ensuring a rigorous and precise methodological approach. RESULTS:Our study involved a comprehensive survey of 1016 older adults. The participants were categorized into three groups based on their demand for day-care services: high demand (n = 127), medium demand (n = 197), and low demand (n = 692). The low-demand group exhibited higher levels of social support and better activities of daily living (ADL) scores compared to their counterparts. Multivariate regression analysis indicated that older adults characterized by male gender, advanced age, higher levels of education, receipt of support from a child, presence of chronic diseases, and lower social support and ADL scores exhibited a statistically significant inclination towards moderate to high demand for day-care services (p < 0.05). CONCLUSION:The demand for day-care services for older adults in China is intricately influenced by a complex array of interrelated factors. Tailoring service offerings to meet the varied physical and emotional needs of older adults is essential, with a particular focus on health and wellness management in day-care centers.

Background:The Namaste Care program is a person-centered intervention that has been shown to improve the quality of life of people with dementia and to alleviate caregiver burden. However, its application in China remains underexplored. Given China's unique sociocultural norms, cultural adaptation is essential to ensure feasibility, acceptability, and contextual fit. Objective:The primary objective is to culturally adapt the Namaste Care Home Program to the Chinese community context. The secondary objective is to evaluate the feasibility and acceptability of the adapted program (qualitative analysis), and to explore its preliminary effects (quantitative analysis) on quality of life and related outcomes for people with dementia and their family caregivers. Methods:A 3-stage, 11-step mixed methods design is used in this study. The process includes a baseline stage for community assessment and stakeholder consultations, a formulation stage for adapting the intervention and training materials, and an execution and evaluation stage in which trained family caregivers deliver the intervention. A 1-group, pretest-posttest design will be used, with quantitative assessments at baseline (T0), immediately after intervention (T1), and at the 3-month follow-up (T2), complemented by qualitative process evaluations. Results:The study was approved in April 2025 (2025-NZY-4-01) and registered on April 18, 2025 (ChiCTR2500101042). Recruitment occurred from January to April 2025, enrolling 15 caregiver-people with dementia dyads. As of April 2025, baseline data collection is complete, and analysis is ongoing. Primary results are expected in mid-2026. Conclusions:The cultural adaptation of the Namaste Care Home Program is a critical step toward advancing person-centered, home-based dementia care in China. Findings will provide evidence on feasibility and cultural appropriateness and will inform the design of future large-scale trials to test effectiveness in cross-cultural settings.

BACKGROUND:Social isolation is a significant challenge for residents in long-term care facilities. This study investigates the risk factors and predictive indicators of social isolation in these settings, aiming to enhance social connections and improve well-being. METHODS:This was a qualitative study. In-depth semi-structured interviews were conducted with participants from 12 long-term care facilities, and the data were analyzed using NVivo 10 software. Inductive analysis was used to identify key themes, which led to the development of a social isolation risk warning model and proposed prevention strategies. RESULTS:A total of 23 participants were interviewed, including 14 managers, 4 head nurses, 2 qualified nurses, and 3 healthcare assistants. In the risk warning model, social isolation risks were categorized into three domains: (1) Social isolation risks and influencing factors: Participants described limited social relationships, restricted social participation, and emotional distress as key risks, further compounded by insufficient family and peer support and weak social interaction skills. (2) Risk consequences and early warning interventions: Social isolation was perceived to contribute to declines in mental well-being and quality of life. Participants emphasized the need for risk assessment, focusing on anxiety、depression and emotional support level. They also highlighted training/education, including theoretical study and contingency plans, and suggested preventive measures such as family members' support and organizing group activities to foster social inclusion. (3) Challenges and solutions: Participants identified concerns about caregiver quality and scarce geriatric care resources as key barriers. They suggested human resource development and national policy support to strengthen workforce capacity and institutional care services. CONCLUSIONS:Social isolation risk assessment plays a pivotal intermediate role in risk prevention. Evaluating relevant risk factors, comprehensive preventive measures could be developed and implemented to reduce the incidence of social isolation. This approach not only improves the psychological well-being of older adults but also enhances the safety and overall quality of care within long-term care facilities. CLINICAL TRIAL NUMBER:SQ2024049. Registered 15th March 2024.

Background: Radiculitis-induced pain (RIP) results from dorsal root ganglion (DRG) sensitization due to inflammation. Hypoxia-inducible factor 1-alpha (HIF-1α) is linked to inflammatory responses through metabolic changes, but its role in RIP is not well understood. Gua Sha therapy has been shown to reduce inflammation and neural damage from lumbar disc herniation (LDH). This study investigates whether HIF-1α-mediated metabolic reprogramming contributes to the pain-relieving effects of Gua Sha in RIP. Methods: Male SD rats were subjected to LDH surgery and divided into six groups: sham, model, sham Gua Sha, Gua Sha, Gua Sha + DMOG, and Gua Sha + YC-1. Gua Sha was applied 5 days postsurgery, every other day for three sessions per course, totaling three courses. Changes in paw withdrawal threshold (PWT) and latency (PWL) were monitored, along with blood flow in the rats' backs. Levels of IL-1β, TNF-α, and NF-κB were assessed in serum and DRG tissue. Pathological changes and hypoxia in DRG tissues were observed using hematoxylin-eosin staining and immunofluorescence. Western blotting and qPCR measured HIF-1α, GLUT1, PFKM, and PDK1 expression, while lactic acid and ATP levels in DRG tissue were also evaluated. Results: Gua Sha increased PWT and PWL, reduced serum and DRG inflammatory factors, improved back microcirculation, alleviated DRG hypoxia, and decreased HIF-1α and related signaling factors. It also lowered lactic acid and raised ATP levels. DMOG, a HIF-1α activator, reversed these effects. HIF-1α activation did not affect serum inflammatory factors but partially improved PWT. Inhibition of HIF-1α with YC-1 did not significantly differ from Gua Sha alone. Conclusion: HIF-1α-mediated metabolic reprogramming is a pathogenic mechanism in RIP. Gua Sha alleviates RIP by enhancing microcirculation, improving DRG hypoxia, inhibiting HIF-1α-mediated reprogramming, and reducing DRG sensitization and inflammation. This study provides insights into the mechanisms of Gua Sha's therapeutic effects in RIP.

This study aimed to systematically identify and analyze the facilitating factors and barriers affecting oral dietary intervention acceptance in adult chemotherapy patients. Electronic databases including PubMed, Embase, EBSCO, Cochrane Library, and Web of Science were searched from inception to December 31, 2024. Qualitative or mixed-methods studies in English that focused on adult patients’ perspectives on oral dietary nutritional interventions during chemotherapy. were included. The quality of the included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Data synthesis was conducted using JBI's meta-synthesis approach. The quality of the synthesized findings was evaluated using the Confidence in the Evidence from the Reviews of Qualitative Research (CERQual) method. A total of 18 studies were included in the analysis, all of which exhibited good methodological quality. Through meta-synthesis, 58 key findings were extracted and systematically categorized into ten themes, including five facilitators and five barriers to dietary nutrition interventions. Facilitators included health awareness, psychological empowerment, familial emotional obligation, dietary behavior continuity, and social support system. Barriers encompassed symptom burden and sensory dysregulation, emotional and psychosocial distress, limited nutritional literacy and information ambiguity, structural and economic constraints to food access, and role conflicts. The CERQual assessment results showed confidence levels in these synthesized findings ranged from high to low. This review highlights modifiable factors influencing adult patients’ acceptance of oral dietary nutritional interventions during chemotherapy. These insights might inform the development of targeted interventions to enhance dietary adherence and improve nutritional outcomes in this patient population.

To observe the clinical efficacy of Gua Sha therapy in treating Parkinson's disease (PD) with rapid eye movement sleep behavior disorder (RBD). A total of 52 PD patients with RBD were randomly assigned to the experimental group (n = 26) and the control group (n = 26). The control group was treated with conventional anti-PD drugs, and the experimental group was treated with Gua Sha therapy based on the control group. The RBDQ-HK, PDSS-2, MDS-UPDRSIII, HADS, and PDQ-39 scores were compared before treatment, at the end of 12 weeks of treatment, and 2 months of follow-up. Before treatment and at the end of 12 weeks of treatment, polysomnography (PSG) was performed to record related sleep parameters, and the changes in serum Lp-PLA2, IL-1β, PGE2, Glu and NT-3 were observed. After treatment, the symptoms of sleep disorder, motor function, emotional disorder, and quality of life in the experimental group were significantly improved, the levels of Lp-PLA2, IL-1β, and PGE2 were decreased, the levels of Glu and NT-3 were increased, and the curative effect was better than that in the control group (P < 0.05). No serious adverse events occurred. The efficacy of Gua Sha therapy in the treatment of PD with RBD is precise and has good safety, which is worthy of clinical application.

This study sorted out the relevant concepts and their connotations.It reviewed the application of prediction and intervention in the turnover of nurses during the transition period,so as to assist managers in grasping the timing of support for nurses during the transition period,and to provide reference for prospective nursing management.