ObjectiveTo systematically summarize the relevant pathophysiology underlying muscle fatigue in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). MethodsDatabases including PubMed, Web of Science Core Collection, Embase, Cochrane Library, EBSCO (CINAHL), CNKI, Wanfang Data and VIP Database were searched from their inception to July, 2025 for basic and clinical studies related to ME/CFS. Multidimensional evidence involving mitochondrial, neuromuscular junction dysfunction, autonomic dysregulation and immune-inflammatory responses was integrated. The role of muscles in the central-immune-metabolic-neural regulatory network and its association with clinical phenotypes were evaluated. ResultsPatients with ME/CFS commonly presented with impaired mitochondrial energy supply, oxidative stress, ion homeostasis disorders, reduced stability of neuromuscular junction transmission, insufficient central drive and postural intolerance. These abnormalities resulted in a predisposition to cross the anaerobic threshold and trigger post-exertional malaise. ConclusionMuscle pathophysiology plays a critical role in the pathogenesis and symptom persistence of ME/CFS. Rehabilitation practice should prioritize safety boundaries to avoid post-exertional malaise.

Objective:To explore the application and effect of the online teaching in the clinical nursing practice of obstetrics and gynecology during the coronavirus disease 2019 (COVID-19) epidemic.Methods:A total of 26 undergraduate nursing interns in the obstetrics and gynecology department of Xiangya Hospital of Central South University during the epidemic period were enrolled in this study. The interns accepted online practical teaching, and the teaching effect was analyzed and evaluated through the results of the exit examination and online teaching satisfaction.Results:The theoretical course scores of nursing students are all above 80 points, among which 22 (84.62%) are above 90 points. The operation scores are all above 90 (94.04±2.96) points. The results of the online teaching satisfaction survey show that, 23 (88.46%) nursing students are satisfied with the effect of their online practice.Conclusion:The online teaching mode during COVID-19 epidemic can help nursing students master the theoretical knowledge of obstetrics and gynecology, improve their clinical reasoning ability, strengthen their practical operation skills, and enhance their autonomous learning ability.

Objective: To study the effect of three different doses of propofol, midazolam and etomidate on short latency somatosensory evoked potential(SLSEP). Method:Ninety patients undergoing elective operation were randomly divided into 3 groups with 3 subgroups each,and propofol,midazolam,etomidate were administered by bolus injection at propofol 1.5,2,3mg/kg, midazolam 0.2,0.3,0.4mg/kg, etomidate 0.15,0.3,0.4mg/kg accordingly. SLSEP was recorded before,during and after injection. Result:Propofol did not significantly change the latencies of the subcortical N_(14),cortical N_(20) and central conduction time(CCT)N_(14)-N_(20),decreased the interwave amplitude N_(20)-P_(25)(P