Diabetes can significantly increase the risk of post-stroke cognitive impairment (PSCI). Previous studies have shown that diabetes can be involved in the occurrence of cognitive impairment by insulin resistance, blood-brain barrier damage, low level inflammation, β-amyloid deposition and tau phosphorylation, aggravation of ischemic brain injury and oxidative stress. In recent years, the role of diabetes in the pathophysiology of PSCI is attracting increasing attention. This article reviews the correlation between diabetes mellitus and PSCI and the possible pathophysiological mechanisms, hoping to provide reference for prevention and treatment strategies of PSCI in diabetics.

The intestinal flora and the intestinal environment in which it resides together constitute the intestinal microecosystem, it is significantly disturbed in neurocritical ill patients, as manifested by the decrease of bacterial diversity, an increase of pathogen, and the destruction of the intestinal barrier. Appropriate enteral nutrition is effective in maintaining intestinal barrier stability, regulating intestinal immune function, inhibiting intestinal inflammation, and regulating specific intestinal microbiota and intestinal function. It is important for sustaining intestinal microecological balance, reducing clinical complications in patients, and is a new target for the treatment of neurocritical ill patients. This review elaborates the alteration of intestinal microecology and treatment options recommended by current clinical guidelines in neurocritical ill patients and summarizes the research progress of the effects of enteral nutrition and several nutritional additives on intestinal flora and intestinal functions, to provide a reference for the follow-up research.

Objective To investigate the effect of intermittent fasting on metabolize and gut microbiota in obese presenium rats fed with high-fat-sugar-diet. Methods We fed the Wistar rats with high-fat and high-sugar diet to induce adiposity, and the rats for intermittent fasting were selected base on their body weight. The rats were subjected to fasting for 72 h every 2 weeks for 18 weeks. OGTT test was performed and fasting blood samples and fecal samples were collected for measurement of TC, TG, HDL-C and LDL-C and sequence analysis of fecal 16S rRNA V4 tags using Illumina. Gut microbial community structure was analyzed with QIIME and LEfSe. Results After the intervention, the body weight of the fasting rats was significantly lower than that in high-fat diet group (P<0.01). OGTT results suggested impairment of sugar tolerance in the fasting group, which showed a significantly larger AUC than compared with the high-fat diet group (P<0.05). Intermittent fasting significantly reduced blood HDL-C and LDL-C levels (P<0.05) and partially restored liver steatosis, and improved the gut microbiota by increasing the abundance of YS2, RF32 and Helicobacteraceae and reducing Lactobacillus, Roseburia, Erysipelotrichaceae and Ralstonia. Bradyrhizobiaceae was found to be positively correlated with CHOL and HDL-C, and RF39 was inversely correlated with the weight of the rats. Conclusion Intermittent fasting can decrease the body weight and blood lipid levels and restore normal gut microbiota but can cause impairment of glucose metabolism in obese presenium rats.

Objective To investigate the effect of intermittent fasting on metabolize and gut microbiota in obese presenium rats fed with high-fat-sugar-diet. Methods We fed the Wistar rats with high-fat and high-sugar diet to induce adiposity, and the rats for intermittent fasting were selected base on their body weight. The rats were subjected to fasting for 72 h every 2 weeks for 18 weeks. OGTT test was performed and fasting blood samples and fecal samples were collected for measurement of TC, TG, HDL-C and LDL-C and sequence analysis of fecal 16S rRNA V4 tags using Illumina. Gut microbial community structure was analyzed with QIIME and LEfSe. Results After the intervention, the body weight of the fasting rats was significantly lower than that in high-fat diet group (P<0.01). OGTT results suggested impairment of sugar tolerance in the fasting group, which showed a significantly larger AUC than compared with the high-fat diet group (P<0.05). Intermittent fasting significantly reduced blood HDL-C and LDL-C levels (P<0.05) and partially restored liver steatosis, and improved the gut microbiota by increasing the abundance of YS2, RF32 and Helicobacteraceae and reducing Lactobacillus, Roseburia, Erysipelotrichaceae and Ralstonia. Bradyrhizobiaceae was found to be positively correlated with CHOL and HDL-C, and RF39 was inversely correlated with the weight of the rats. Conclusion Intermittent fasting can decrease the body weight and blood lipid levels and restore normal gut microbiota but can cause impairment of glucose metabolism in obese presenium rats.