Human umbilical cord mesenchymal stem cell （hUC-MSC） as a cell-based therapeutic strategy have demonstrated significant application potential in the field of intervention for neurodegenerative disease （NDD） due to their advantages such as self-renewal， multi-directional differentiation， and low immunogenicity. hUC-MSC effectively intervenes in the pathological features and neurological functions of various disease models such as Alzheimer disease， Parkinson’s disease， amyotrophic lateral sclerosis， and multiple sclerosis primarily through multiple mechanisms such as homing and differentiation， mediating paracrine actions and releasing exosomes， as well as immune regulation and anti-inflammation. Some clinical studies have also preliminarily verified their safety and effectiveness. Currently， its research still faces challenges such as immune rejection reactions requiring further observation， long-term safety needing evaluation， mechanisms of action not being fully elucidated， and slow progress in clinical trials. Future research needs to establish pharmaceutical standards for hUC-MSC， deepen their pharmacological mechanisms and clinical trials， ultimately providing new and effective drug treatment options for patients with NDD.

Cognitive impairment is a major public health challenge facing global aging societies， and currently lacks effective treatment measures. Herb pair， characterized by their rigorous compatibility and synergistic effects， demonstrate unique advantages in clinical practice. Acorus tatarinowii-Polygala tenuifolia is a classic herbal pair for treating cognitive impairment， widely utilized in various traditional Chinese medicine formulations， such as Kaixin san， Shenghui tang， and Yuanzhi san. This article summarizes the pharmacological mechanisms of A. tatarinowii， P. tenuifolia and their compatible compound prescriptions in ameliorating cognitive impairment. It is found that they can exert effects in ameliorating cognitive impairment through mechanisms such as reducing amyloid β-protein deposition and inhibiting excessive phosphorylation of Tau protein， suppressing inflammatory responses， alleviating oxidative stress， protecting neurons and regulating neurotransmitters， modulating the structure and function of the blood- brain barrier， and regulating autophagy. Subsequently， in-depth analysis can be conducted on the active ingredients of A. tatarinowii- P. tenuifolia herb pair that ameliorate cognitive impairment， along with the addition of relevant clinical trials for verification. This will provide theoretical foundations and research approaches for the treatment of cognitive impairment using traditional Chinese medicine.

Renal metastasis of oral adenoid cystic carcinoma is rare. A patient with bilateral renal metastasis secondary to surgery for oral adenoid cystic carcinoma was reported. The left kidney was treated with radiofrequency ablation, and the right kidney was treated with radical nephrectomy. The creatinine was 74 μmol/L at 3 months after surgery. The multidisciplinary comprehensive diagnosis and treatment model adopted in this case provided diagnosis and treatment ideas for patients with bilateral renal secondary malignant tumors.

The treatment of sacrococcygeal pilonidal disease (SPD) remains challenging due to its high recurrence rate and treatment-related complications. An ideal treatment plan for SPD should be simple to perform, reduce recurrence rates, enable patients to quickly return to normal daily activities, and be associated with a low incidence of complications. Various surgical techniques have been employed for the treatment of SPD, but discrepancies and controversies persist in current clinical practice. Non-surgical treatment is suitable for asymptomatic SPD patients. For patients in the acute abscess phase, drainage is the primary therapeutic goal, with avoidance of midline incisions. Minimally invasive procedures may be considered for patients with localized lesions after weighing the recurrence risk, aiming for faster recovery and better cosmetic outcomes. For recurrent SPD or cases with extensive lesions, excision followed by secondary healing or combined with flap techniques is required to pursue a lower recurrence risk. Based on clinical experience and literature review, this article summarizes the treatment strategies for different types of SPD, providing a reference for clinicians in formulating diagnosis and treatment plans.

Cognitive impairment(CI)is a clinical syndrome characterized by progressive decline in advanced cognitive functions such as memory,thinking,and judgment.Its etiology and pathogenesis are complex,and there is currently a lack of specific drug interventions.Metformin,as a first-line hypoglycemic drug for type 2 diabetes,not only lowers blood glucose levels but also improves CI.This article reviews and summarizes the pharmacological effects and mechanisms of metformin in improving Alzheimer's disease,diabetes cognitive impairment,cognitive impairment after chemotherapy,in order to provide novel insights and approaches for the treatment of CI-related diseases.Studies have shown that the mechanism by which MET intervenes in CI mainly includes regulating β-amyloid protein and tau protein metabolism,reducing insulin resistance,inhibiting neuroinflammation,improving synaptic plasticity,improving mitochondrial dysfunction,regulating gut microbiota and lipid metabolism,etc.Future research needs to be conducted through interdisciplinary collaboration,fully integrating multiple omics data,and combining advanced technologies to further reveal their mechanisms of effect.

The treatment of sacrococcygeal pilonidal disease (SPD) remains challenging due to its high recurrence rate and treatment-related complications. An ideal treatment plan for SPD should be simple to perform, reduce recurrence rates, enable patients to quickly return to normal daily activities, and be associated with a low incidence of complications. Various surgical techniques have been employed for the treatment of SPD, but discrepancies and controversies persist in current clinical practice. Non-surgical treatment is suitable for asymptomatic SPD patients. For patients in the acute abscess phase, drainage is the primary therapeutic goal, with avoidance of midline incisions. Minimally invasive procedures may be considered for patients with localized lesions after weighing the recurrence risk, aiming for faster recovery and better cosmetic outcomes. For recurrent SPD or cases with extensive lesions, excision followed by secondary healing or combined with flap techniques is required to pursue a lower recurrence risk. Based on clinical experience and literature review, this article summarizes the treatment strategies for different types of SPD, providing a reference for clinicians in formulating diagnosis and treatment plans.

Renal metastasis of oral adenoid cystic carcinoma is rare. A patient with bilateral renal metastasis secondary to surgery for oral adenoid cystic carcinoma was reported. The left kidney was treated with radiofrequency ablation, and the right kidney was treated with radical nephrectomy. The creatinine was 74 μmol/L at 3 months after surgery. The multidisciplinary comprehensive diagnosis and treatment model adopted in this case provided diagnosis and treatment ideas for patients with bilateral renal secondary malignant tumors.

Attention deficit hyperactivity disorder(ADHD),also known as childhood hyperactivity disorder,is a very common clinical disorder in children,which seriously affects their physical and mental health.Animal models conforming to the clinical diseases of Chinese and Western medicine are the basis for in-depth research on the pathogenesis and prevention and treatment of ADHD.Taking"Attention Deficit Hyperactivity Disorder"as the theme,this paper summarizes the modeling methods and model features of ADHD animal models in CNKI,Wanfang,Wipu,and pubmed databases in the past 20 years,evaluates their strengths and weaknesses,and analyzes the extent to which the models are in agreement with the clinical diseases of Chinese and Western medicine.The results show that there are many existing animal models of ADHD,which can be mainly divided into three kinds:spontaneous model,induced model and gene model,among which the SHR rat model has become a popular and ideal animal model because of its good surface validity,moderate price and other advantages.Currently,animal models of ADHD are dominated by disease models of Western medicine,and models that meet the characteristics of Chinese medicine clinical conditions are rare,with insufficient reflection of Chinese medicine evidence.Therefore,it is suggested that the subsequent construction of animal models of ADHD should consider adding the relevant pathogenic factors and indexes of different certificates of Chinese medicine,such as the animal's tongue,mental state,water intake and heart rate,etc.,with the aim of constructing an animal model that is more close to the clinic.

Objective:To investigate the efficacy of arthroscope-assisted reduction and anchor fixation in the treatment of old ununited fractures of the ulnar styloid process combined with triangular fibrocartilage complex (TFCC) injury.Methods:A retrospective case series study was conducted to analyze the clinical data of 30 patients with old ununited fractures of the ulnar styloid process combined with TFCC injury (with pressing pain of the ulnar wrist and decreased grip strength) admitted to Sichuan Provincial Orthopedic Hospital from June 2018 to June 2023, including 18 males and 12 females, aged 40-54 years [(47.6±5.4)years]. All the patients had Hauck type II fractures. A total number of 17 patients had fractures on the left side and 13 on the right side. Arthroscope-assisted reduction and anchor fixation of the ulnar styloid process were performed and the injured TFCC was repaired simultaneously. The visual analogue scale (VAS) scores for ulnar-sided wrist pain before surgery, at 3 and 6 months after surgery, and at the last follow-up were compared. Anteroposterior and lateral X-rays of the wrist joint were taken at 1-6 months after surgery to observe the fracture healing. The ranges of motion of wrist flexion and extension, wrist radial-ulnar deviation, and forearm rotation, Cooney wrist function scores, and grip strengths before surgery, at 3 and 6 months after surgery, and at the last follow-up were compared. The occurrence of intraoperative and postoperative complications was observed.Results:All the patients were followed up for 12-16 months [(13.5±2.3)months]. At 3, 6 months after surgery and at the last follow-up, the VAS scores for ulnar-sided wrist pain were (3.1±0.8)points, (1.4±0.8)points, and (1.2±0.5)points respectively, which were all lower than (7.1±0.8)points before surgery ( P<0.05). The VAS scores at 6 months after surgery and at the last follow-up were lower than that at 3 months after surgery ( P<0.05), while there were no significant difference between the scores at 6 months after surgery and at the last follow-up ( P>0.05). Fractures healed well in the 28 patients, with the healing time of 3-4 months [(3.0±1.3)months], while 2 patients had delayed union. There were no significant differences in the ranges of motion of wrist flexion and extension or radial-ulnar deviation before surgery, at 3 and 6 months after surgery, and at the last follow-up ( P>0.05). At 3, 6 months after surgery and at the last follow-up, the ranges of motion of forearm rotation were (149.9±10.8)°, (158.6±10.5)°, and (159.0±11.1)° respectively, which were all greater than (131.7±11.0)° before surgery. The ranges of motion of forearm rotation were greater at 6 months after surgery and at the last follow-up than that at 3 months after surgery ( P<0.05), while there were no significant difference between the angles at 6 months after surgery and at the last follow-up ( P>0.05). At 3, 6 months after surgery and at the last follow-up, the Cooney wrist function scores were (51.7±5.8)points, (74.8±6.2)points, and (84.3±6.6)points respectively, which were all higher than (39.8±6.1)points before surgery ( P<0.05), and the scores gradually increased at each time point after surgery ( P<0.05). At the last follow-up, the Cooney wrist function scores of 13 patients were evaluated as excellent, 15 good, and 2 fair, with an excellent and good rate of 93.3%. At 3, 6 months after surgery and at the last follow-up, the grip strengths of the affected side were (21.6±2.5)kg, (36.6±2.5)kg, and (45.7±5.8)kg respectively, which were all greater than (14.6±2.5)kg before surgery ( P<0.05), and the grip strengths gradually increased at each time point after surgery ( P<0.05). No bone fragment fragmentation occurred during the surgery. No internal fixation failure occurred after the surgery, and there was no secondary ulnar tissue irritation or injury to the dorsal branch of the ulnar nerve. Conclusion:Arthroscope-assisted reduction and anchor fixation in the treatment of old ununited fractures of the ulnar styloid process combined with TFCC injury has advantages of good bone and soft tissue healing, relieved wrist pain, increased grip strength, improved wrist rotation range and function, and fewer complications.

Objective To explore the clinical effect of reconstructing distal radioulnar ligament with al-lograft tendon under wrist arthroscopy in the treatment of chronic PalmerⅠD type triangular fibrocarti-lage complex injury complicated with distal radioulnar joint instability.Methods Clinical data of 15 pa-tients with chronic PalmerⅠD type triangular fibrocartilage complex injury and admitted to our hospital between January 2017 to January 2020 were retrospectively analyzed.All of them were treated with wrist arthroscopic allograft tendon reconstruction of distal radioulnar ligament.During the postoperative follow-up,the wrist range of motion and grip strength were evaluated,while the wrist pain and wrist function were assessed using the visual analogue scale(VAS)and modified Mayo score.Results All pa-tients were followed up twelve to twenty-four months,with an average of(18.15±2.20)months.The postoperative VAS score was(2.56±0.69),significantly better than the preoperative one(6.78±1.24)(P<0.05).Moreover,the postoperative ratio of grip strength between the affected and the healthy hand was(76.18±9.72)%,significantly better than that of(50.18±6.79)%(P<0.05),with increased grip strength.Meanwhile,the postoperative rotational motion of wrist joint[(151.09±12.38)°]improved significantly compared with that before operation[(142.87±10.19)°](P<0.05).According to the modi-fied Mayo score,8 cases were excellent,6 cases were good,and 1 case was fair,reaching an excel-lent and good rate of 93.33%.Conclusion Wrist arthroscopic reconstruction of distal radioulnar liga-ment with allograft tendon is effective in the treatment of chronic PalmerⅠD type triangular fibrocarti-lage complex injury with lower radioulnar joint instability,relieving pain and promoting grip strength and rotational motion.