Objective To observe the efficacy of folic acid combined with mecobalamine for the treatment of vascular mild cogni-tive impairment (VMCI) in patients with cerebral small vessel disease (SVD) and hyperhomocysteinemia(Hcy) .Methods A total of 84 VMCI patients with cerebral small vessel disease and Hcy were randomly divided into combination group and control group . Two groups received conventional therapy for 6 months .Besides ,the combination group received folic acid combined with mecobal-amin .The level of plasma Hcy and ADAS-cog score were observed before and after 3 months and 6 months treatment .Results Af-ter treatment ,plasma Hcy significantly lower in the combination group (P<0 .01) ,whereas it did not show any improvement in the control group .ADAS-cog scores in combination group decreased compared with that of before treatment ,but there was no statisti-cally significant difference after 3 months treatment(P>0 .05) .However ,after 6 months treatment ,the ADAS-cog scores decreased obviously than that in the before treatment group (P<0 .05) .ADAS-cog scores in control group increased compared with before treatment ,but there was no statistically significant difference in after treatment (P>0 .05) .After 3 months treatment ,there was no significant difference on ADAS-cog score between combination group and control group (P>0 .05) ,however ,there had significant difference between the two groups after 6 months treatment(P<0 .05) .Conclusion The level of plasma Hcy could be reduced by adding folic acid and mecobalamin .Treatment of hyperhomocysteinemia may delay the progression of vascular cognitive impairment w hich caused by cerebral small vessel disease .

Objective:To investigate the relationship between non-alcoholic fatty liver disease(NAFLD) and hepatic fibrosis and skeletal muscle mass in patients with type 2 diabetes mellitus(T2DM).Methods:A total of 685 T2DM patients diagnosed at the Endocrinology department of Lanzhou University First Hospital, from April 2022 to May 2023, were divided into NAFLD and Non-NAFLD groups, and the NAFLD group was further categorized into fibrosis and non-fibrosis based on aspartate aminotransferase(AST) /alanine aminotransferase(ALT) level. The differences in appendicular skeletal muscle mass(ASM), appendicular skeletal muscle mass index(ASMI), and the prevalence of muscle mass loss were compared across groups. The correlations between ASMI and NAFLD, as well as liver fibrosis were analyzed by binary logistic regression.Results:Among male T2DM patients, those with NAFLD had lower ASMI levels and a higher prevalence of muscle mass reduction compared to non-NAFLD group. Among female T2DM patients, those with NAFLD had lower levels of ASM and ASMI, and a higher prevalence of muscle mass reduction compared to non-NAFLD group. ASMI levels in both male and female T2DM patients were independently negatively correlated with NAFLD risk( OR=-0.696, 95% CI 0.579-0.837; OR=-0.757, 95% CI 0.629-0.911). In NAFLD patients, ASM and ASMI levels were lower in those with liver fibrosis compared to those without fibrosis; however, the prevalence of muscle mass reduction did not differ significantly. Among male NAFLD patients, ASMI levels were independently negatively correlated with the risk of liver fibrosis( OR=-0.726, 95% CI 0.537-0.983), while no correlation was found in female patients. Conclusion:Reduced muscle mass is independently associated with the risk of NAFLD in both male and female T2DM patients. In males, reduced muscle mass is also independently related to the risk of liver fibrosis.