Objective:To investigate the effects of using a high monounsaturated fatty acid (MUFA) and low carbohydrate formula on blood glucose levels and diarrhea treatment effects in critically ill neurological patients.Methods:A self-controlled before-and-after study design was employed, with 13 patients admitted to the neurology intensive care unit (ICU) of the First Affiliated Hospital of Sun Yat-sen University from November to December 2023, who were treated with a high MUFA and low carbohydrate formula [Glucerna enteral nutrition (EN) preparation]. Changes in blood glucose parameters within 7 days before and after the use of Glucerna EN preparation were analyzed, including standard deviation ( SD) of blood glucose, mean blood glucose (MG), median blood glucose, mean amplitude of glycemic excursions (MAGE), largest amplitude of glycemic excursions (LAGE), coefficient of variation ( CV) of blood glucose, the incidence of hyperglycemia (> 7.8 mmol/L) and severe hyperglycemia (> 13.9 mmol/L), and daily insulin dose. Changes in total protein (TP), albumin (ALB), hemoglobin (Hb), C-reactive protein (CRP), and white blood cell count (WBC) were observed before and after intervention. Improvement in diarrhea symptoms, Hart diarrhea score, Bristol Stool classification score, and incontinence dermatitis classification were also analyzed before and after the use of Glucerna EN preparation. Results:A total of 13 critically ill neurological patients were enrolled, among whom 9 patients had a history of hyperglycemia and 8 patients had diarrhea symptoms. After intervention with Glucerna, the patients' SD of blood glucose, MG, median blood glucose, MAGE, LAGE, CV of blood glucose, incidence of hyperglycemia, incidence of severe hyperglycemia, and daily insulin dose were all lower than those before the intervention [ SD of blood glucose (mmol/L): 1.83±1.11 vs. 2.10±1.13, MG (mmol/L): 8.87±2.03 vs. 9.75±1.37, median blood glucose (mmol/L): 9.12±1.67 vs. 10.17±0.48, MAGE (mmol/L): 0.66±0.31 vs. 0.78±0.32, LAGE (mmol/L): 4.95±3.64 vs. 5.58±3.10, CV of blood glucose: 16.00% (11.00%, 28.50%) vs. 18.00% (12.50%, 27.50%), hyperglycemia incidence: 47.31% vs. 74.66%, severe hyperglycemia incidence: 6.08% vs. 6.71%, daily insulin dose (U): 5.25 (0.00, 32.59) vs. 20.76 (0.00, 66.88)], with a significant decrease in daily insulin dose after the intervention ( P < 0.05); TP, ALB, Hb, CRP and WBC showed no significant changes before and after the intervention with Glucerna EN preparation. The improvement time of diarrhea symptoms after intervention was (3.50±1.41) days, and the Hart diarrhea score on the seventh day after intervention (4.88±3.48 vs. 10.00±3.38) and the Bristol Stool classification score on the third and seventh days after intervention (5.87±0.35, 5.50±0.53 vs. 6.50±0.53) were significantly lower than before the intervention (all P < 0.05). Before the intervention with Glucerna EN preparation, the classification of incontinence dermatitis was mainly classified as Grade 2 severity (71.43%); after the intervention, it significantly improved by the seventh day, with Grade 1 being the main classification (57.14%). Conclusion:The high MUFA and low carbohydrate formula has a positive effect on blood glucose control and diarrhea treatment in critically ill neurological patients.

Multiple sclerosis (MS) is an autoimmune disease characterized by central nervous system white matter inflammatory demyelination. Most MS starts with clinically isolated syndrome (CIS). This article summarizes the identification and management of CIS converted to MS, which helps clinicians identify prognosis risk factors as soon as possible, and evaluate the disease comprehensively, initiate the disease modified therapy promptly and accurately, so that to delay the progression of the disease.

Diabetes retinopathy （DR） is an important cause that threatens the visual health of adults. There are some treatment methods of western medicine with definite efficacy， such as anti-vascular endothelial growth factor and laser photocoagulation， but they have many adverse reactions such as intraocular infection and visual field damage. Traditional Chinese medicine （TCM） therapies are safe and effective， which can complement western medicine. Phosphatidylinositol3-kinase （PI3K）/protein kinase B （Akt） signaling pathway regulates a range of processes including glucose metabolism， cell proliferation， and cell transcription and apoptosis， which is closely related to the occurrence and development of DR. Numerous studies have shown that TCM monomers can participate in maintaining the integrity of blood-retinal barrier and inhibiting retinal neovascularization and neurodegeneration in many aspects such as inhibiting oxidative stress and alleviating inflammatory reaction by regulating the PI3K/Akt pathway， so as to delay the progress of DR. Therefore， this study reviewed PI3K/Akt pathway and its relationship with DR， as well as the TCM monomers in interfering with DR based on PI3K/Akt pathway to provide some ideas for the prevention and treatment of DR in integrated TCM and western medicine.

Objective:To establish the reference values of stimulation single fiber electromyography (SFEMG) in orbicularis oculi, and to explore its sensitivity in repetitive nerve stimulation (RNS) negative ocular myasthenia gravis (OMG) patients, and the relationship between jitter and various clinical parameters.Methods:Thirty-two healthy volunteers were included to establish the reference value of normal controls from January 2019 to December 2019. From December 2019 to January 2023, 36 OMG patients with negative RNS were collected. Quantitative MG score (QMGS) was performed, neostigmine test and antibody titers as well as thymus CT results were recorded. One side of the orbicularis oculi muscle was tested with a disposable concentric needle electrode in stimulation SFEMG, and the mean consecutive difference (MCD) value was calculated, which was compared with the average MCD value and upper limit of individual values in normal controls to evaluate whether the jitter was abnormal. Spearman correlation analysis of abnormal mean MCD values with QMGS and antibody titer was conducted.Results:Among the 32 healthy volunteers, there were 13 males and 19 females, the age was (46.8 ±18.7) years, and the MCD was (19.0 ±4.4) μs. The upper limit of the reference value was 27.7 μs for average MCD, and 37.4 μs for 10% individual values. Among 36 OMG patients negative at RNS tests, 20 were male and 16 were female, with a age of (37.2 ±17.0) years. The MCD was (29.9 ±14.7) μs, and Jitter was abnormal in 29 patients (81%). Among them, 20 (20/25) patients were antibody positive, 6 (6/26) patients had thymic hyperplasia, and 7 (7/26) patients had thymoma. The QMGS was 3(2, 4). There were 7 patients (19%) with normal jitter, whose QMGS was 3(2, 4). Among the patients with normal Jitter, 5 (5/5) patients were antibody positive, 2 (2/6) patients had thymic hyperplasia. There was no statistically significant difference in clinical indicators between the two groups of patients with abnormal or normal jitter. There was no significant correlation in antibody titer or QMGS with abnormal mean MCD value. Conclusions:The upper limit of the mean MCD value in the normal controls is 27.7 μs. The upper limit of a single value is 37.4 μs. Its sensitivity for OMG patients with RNS negative is 81%, and the abnormal mean MCD value does not show a significant correlation with various clinical indicators. Abnormal jitter indicates dysfunction of neuromuscular junction transmission, which is an important neuroelectrophysiological indicator for MG patients and is suitable for RNS negative patients. Orbicularis oculi muscle stimulation SFEMG provides a reliable and sensitive electrophysiological means for functional evaluation of neuromuscular junction.

Diabetic nephropathy （DN） has become one of the main causes of end-stage renal disease，and its pathogenesis is still unclear. Currently，it is believed to be closely related to kidney injury mediated by various factors such as autophagy disorder under the condition of high glucose，oxidative stress and inflammation. Mammalian target of rapamycin （mTOR） signaling pathway is crucial for protein synthesis and autophagy regulation，which plays an important role in the occurrence and development of DN. In recent years，the research on the prevention and treatment of DN with traditional Chinese medicine （TCM） has made important progress. Plenty of evidence has shown that the active ingredients of TCM can enhance autophagy，improve oxidative stress and inflammation，inhibit cell apoptosis and abnormal proliferation by regulating mTOR signaling pathway，so as to relieve pathological changes in the kidney such as podocyte injury，glomerular basement membrane thickening，mesangial tissue abnormalities and renal tubule dysfunction，thereby reducing proteinuria and improving renal function. All of the above are of great significance for delaying the progression of DN. This article systematically summarizes the research progress of saponins，flavonoids，polyphenols，alkaloids， terpenoids and other active ingredients of TCM intervening in DN through mTOR signaling pathway，in order to provide some reference for further basic research and the development of new drugs.

Obesity type 2 diabetes mellitus （T2DM） strengthens insulin resistance （IR） and metabolic abnormalities and significantly increases the risk of heart disease， cancer， and other diseases， and it is characterized by IR and malnutrition. As a metabolic regulation center， adenosine phosphate activated protein kinase （AMPK） mainly responds to the changes in intracellular serine/threonine kinase adenosine monophosphate （AMP） levels. After its activation， AMPK converts the cell metabolism mode from synthesis to decomposition to improve energy metabolism and acts on pathological conditions such as inflammation， ischemia， obesity， and aging. In recent years， a large number of studies have found that AMPK is an important target for the treatment of obesity T2DM. Traditional Chinese medicine（TCM） monomers/extracts and TCM formulas mainly affect the mammalian target of rapamycin （mTOR）， recombinant sirtuin 1 （SIRT1）， nuclear factor erythroid 2-related factor 2 （Nrf2）， nuclear factor kappa-B （NF-κB）， and other key signaling factors by regulating the AMPK signaling pathway， so as to achieve a variety of effects such as regulating metabolism and autophagy， reducing oxidative stress and inflammatory response， and treating obesity T2DM. It also has advantages such as multiple targets， comprehensiveness， and low toxicity. The regulation of the AMPK pathway by TCM in the prevention and treatment of obesity T2DM has become an important research direction at the present and in the future， but there is no systematic summary and induction in this field. Therefore， this article attempts to summarize the composition and regulatory mechanisms of the AMPK signaling pathway in affecting obesity. It provides a review of the current research status of TCM in regulating the AMPK signaling pathway for the prevention and treatment of obesity T2DM， so as to provide a reference for the diagnosis and treatment of obesity T2DM in TCM and the development of new drugs.

At present, effective reconstruction of the integrity and functionality of damaged skin tissue remains an important medical problem in the field of wound repair. In recent years, the rapid development of nanozymes and tissue engineering scaffolds in the field of regenerative medicine has made it possible to develop new skin wound repair materials. Based on the process of skin wound repair and regeneration, this review briefly describes the nanozymes and its catalytic mechanism. At the same time, the common tissue engineering scaffolds loaded with nanozymes and their manufacturing strategies are introduced, the application of tissue engineering scaffolds loaded with nanozymes during the stages of anti-bacteria and anti-inflammation in the process of wound repair is summarized, and their future development direction is discussed.

Glucocorticoid pulse therapy is an important means to induce remission of neuroimmune diseases in acute attack stage. However, the specific programs of glucocorticoid pulse therapy in domestic hospitals are not standardized and unified at present. Here, glucocorticoid pulse therapy in acute attack of neuroimmune diseases in national and international guidelines in last decade are reviewed and summarized. Glucocorticoid pulse therapy follows the principle of large dosage and short course of treatment, and intravenous methylprednisolone 1 000 mg/d for three days to five days is the most common regimen. According to the characteristics of diseases, the dosage reduction regimens are different. Standardized glucocorticoid pulse therapy can not only maximize its curative effects, but also minimize its side effects, which deserves the attention of clinicians.

Objective : To study the distribution range of the color values of the upper anterior teeth of Uygur youth in the Kashi area of XinJiang as a reference for clinical applications. Methods: Based on the International Commission on Illumination (CIE) L*a*b* color system, the colorimetric values of the anterior teeth of 212 Uygur youths in Xinjiang, Kashi, were analyzed by digital camera colorimetry. There were 105 males and 107 females. The length of the neck to the cutting end of the tooth was measured, and the tooth was evenly divided into thirds. To determine the chromaticity values of the incisors, lateral incisors, cuspids, and middle teeth, 1/3 of the cervical, middle and incisal regions and 9 test areas were measured. Results : The color of the cervical, middle and incisal regions of the same tooth position in Uygur youth in the Kashi area showed the following trends: L* value: middle regions > cervical regions > incisal regions; a* value: cervical regions > incisal regions > middle regions; b* value: cervical regions > middle regions > incisal regions, and the differences were statistically significant (P < 0.05). The value of L* gradually decreased, and the value of a* gradually increased (P < 0.05). There were no significant differences in the a* value of male and female maxillary anterior teeth (P > 0.05). However, there was a significant difference in the b* value between the middle teeth and the incisors, the middle and the incisal regions of the upper maxillary incisors, and the cutting end of the upper maxillary incisors (P < 0.05). Conclusions There was a significant difference in the color of the cervical, middle and incisal of the same tooth. The upper jaw gradually reduced from the incisors to the sharp teeth, and the color gradually became reddish. The maxillary central incisor was brighter in males than in females, and the middle and incisal regions of the maxillary front teeth were more yellow than in males than in females.

Objective: To investigate the epidemiological characteristics of allergic rhinitis (AR) in Ningxia and to analyze its related factors. Methods: From March to September of 2013, a multi-stage and cluster sampling method was used to investigate the diagnosis and treatment of AR in Ningxia Area (3 years and above). Guidelines for diagnosis and treatment of allergic rhinitis (2009, Wuyishan) was used as the basis for the diagnosis of adult AR, while Guidelines for diagnosis and treatment of pediatric allergic rhinitis (2010, Chongqing) was used as the basis for children. SPSS 16.0 software was used to complete the statistical analysis. Results: The total number of questionnaires was 6 000, and the number of effective questionnaire was 5 236, the recovery rate was 87.27%. With 684 cases diagnosed of AR, the prevalence of AR in Ningxia was 13.06% (684/5 236), including 13.40% (325/2 425) of males, 12.77% (359/2 811) of females. The difference was not statistically significant (χ²=0.456, P>0.05). There was significant difference in the prevalence between Hui and Han [14.35% (452/3 150) vs 11.12% (232/2 086), χ²=11.51, P<0.05]. According to ARIA criteria, persistent AR was 27.63% (189/684), intermittent AR was 72.37% (495/684). The month with highest incidence of AR in Ningxia Area was September, accounting for 71.78% (491/684). The prevalence of urban population was 14.54%, with the prevalence of rural population was 11.90%, and the difference was significant between urban and rural residents (χ²=7.90, P<0.05). The age group with highest prevalence rate was 21~30 years old. The main inhalation allergens were mugwort (68.42%), weeds (58.48%) and ragweed (55.56%). The main dietary allergens were wheat flour (14.33%), peanut (13.74%) and walnut kernel (11.99%). The most common complication was allergic conjunctivitis [82.02% (561/684)]. Conclusion The epidemiology of AR in Ningxia Area is preliminarily understood, which will provide the epidemiological evidence for the prevention and treatment of AR and the formulation of public health policy.