Transcutaneous vagus nerve stimulation (tVNS) is an emerging non-invasive technique designed to stimulate branches of the vagus nerve distributed over the body surface. Studies suggest a correlation between the brain-gut-microbiota (BGM) axis and the pathogenesis of Alzheimer’s disease (AD). The BGM axis represents a complex bidirectional communication system, with the vagus nerve being a crucial component. Therefore, non-invasive electrical stimulation of the vagus nerve might have the potential to modify—most of the time probably in a non-physiological way—the signal transmission within the BGM axis, potentially influencing the progression or symptoms of AD. This review explores the interaction between percutaneous vagus nerve stimulation and the BGM axis, emphasizing its potential effects on AD. It examines various aspects, such as specific brain regions, gut microbiota composition, maintenance of intestinal environmental homeostasis, inflammatory responses, brain plasticity, and hypothalamic–pituitary–adrenal (HPA) axis regulation. The review suggests that tVNS could serve as an effective strategy to modulate the BGM axis and potentially intervene in the progression or treatment of Alzheimer’s disease in the future.

BackgroundRepetitive transcranial magnetic stimulation (rTMS), as an emerging non-invasive neuromodulation technique, is now widely employed in rehabilitation therapy. The purpose of this paper is to comprehensively summarize existing evidence regarding rTMS intervention for lower limb motor function in patients at different stages of stroke.MethodsA systematic search was conducted to identify randomized controlled trials (RCTs) assessing the efficacy of rTMS for treating lower limb motor dysfunction after stroke. Multiple databases, including China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP Database, PubMed, Embase, Web of Science, and Cochrane Library, were searched. The search period extended from the inception of the libraries to June 2024. Literature information was extracted, and methodological quality was evaluated using the risk of bias assessment tool in the Cochrane Handbook. Meta-analysis was performed using Stata 17.0 software.ResultsOverall, 49 appropriate studies (including 3,558 stroke subjects) were found. Meta-analysis results demonstrated that rTMS effectively improved lower limb motor function across all stages of stroke. The intervention was particularly more effective in patients in the subacute stage than in the acute or chronic stages. Subgroup analysis revealed that, for acute-stage patients, low-frequency stimulation targeting the M1 or DLPFC brain regions on the unaffected side with 20–40 sessions significantly improved FMA-LE scores. In subacute-phase patients, low-frequency stimulation targeting the M1 brain regions on the unaffected side with 18 sessions significantly improved FMA-LE scores. The results demonstrated that HF-rTMS was more effective than LF-rTMS in improving walking speed, with the greatest efficacy observed at 20 sessions. While for enhancing gait balance in stroke patients, LF-rTMS with the best therapeutic effect was observed at a frequency of 20–40 treatments.ConclusionThis study demonstrates the efficacy of rTMS in improving lower limb motor function, balance, and walking speed in stroke patients at various stages. The findings provide a valuable reference for the development of optimized rTMS treatment plans in clinical practice.Systematic review registration: PROSPERO: CRD42023466094.

阿尔茨海默病(AD)是严重的神经退行性疾病之一.近年来研究发现,脑-肠-微生物轴(BGMA)与神经退行性病变的病理生理相关,而针刺可显著改善AD患者的认知行为和日常生活能力.对近年有关BGMA相关研究及针刺治疗AD机制进行综述,发现针刺能够通过调控肠道微生物群、迷走神经、下丘脑-垂体-肾上腺轴(HPA轴)及神经-免疫过程影响BGMA系统中的信息交流,从而治疗AD.因此,针刺调节BGMA可以在未来成为预防和治疗AD的潜在手段.

The common peroneal nerve is the second most vulnerable nerve after the radial nerve in mononeuropathies and its injury is the most common nerve injury of the lower extremity, which will severely compromise quality of patients′ life.The common clinical manifestations include foot drop, foot varus, " threshold gait" , even function loses of foot or sensory disturbances in calf and foot.Professor Yu Tao specializes on using Yin and Yang acupuncture in the treatment of neurological related diseases, and one of such case which uses a combination of yin and yang acupuncture and modern rehabilitation techniques to treat common peroneal nerve injury is discussed.The treatment is based on the " paralysis" , and is aimed at harmonizing qi and blood, draining the meridians and balancing yin and yang. Combining the meridian system of traditional Chinese medicine with the neuroanatomical system of modern medicine, the muscle strength and muscle tension are dynamically adjusted through the different dynamics of Yin and Yang meridian selection and manipulation, so as to restore the motor and sensory function of the limbs.The clinical results are remarkable with muscle strength but not tension increased.

郁证患者逐年增加,且与不寐、心悸、怔忡等诸多身心疾病交织错杂,诊断率低,治疗率差.王新志教授十分重视郁证的临床识别和诊治,注重郁证与气血的关系,提倡从气血辨治郁证,指出"久郁要勿忘逐瘀、敢于逐瘀",创新性提出运用经方、气血辨证和脏腑辨证相结合综合论治郁证的思想.在郁证的识别诊断、辨证论治方面积累了大量经验,取得了良好的临床疗效,形成了诸多值得借鉴的学术思想.