Recent studies have found that intestinal flora dysregulation may be closely related to the pathogenesis and progression of Parkinson’s disease (PD). Whether in the preclinical, early, middle and late stages of PD, the regulation of intestinal flora may bring new opportunities to the treatment of PD. The correlation between intestinal flora dysregulation and the pathogenesis of PD coincides with the theory of syndrome differentiation and treatment based on spleen by the stages of PD, which is developed by Professor CAI Gan—an inheritor of CHENG Menxue’s academic thoughts inherited from DING’s internal medicine of traditional Chinese medicine. Based on this theory, syndrome differentiation and treatment with the classical prescription revised on a small quantity based on spleen by stages of PD can achieve satisfactory results, which provides empirical evidence for the treatment of PD and other neurodegenerative diseases with the integration of traditional Chinese and western medicine.

The choice of therapies for neurological disorders is limited and the effectiveness is poor. Stem cells are a group of cells that are immortal and have unlimited renewal abilities. Stem cell transplantation is expected to be an important choice for treating neurological diseases. The types of stem cells usually used in registered clinical trials include multipotent stem cells, hematopoietic stem cells and mesenchymal stem cells, which are usually used to treat stroke, spinal cord injury, Parkinson’s disease, multiple sclerosis, neuromyelitis optica spectrum disorders, amyotrophic lateral sclerosis, brain tumors, cerebral palsy, hypoxic ischaemic encephalopathy, etc. The majority of these clinical trials are early small-scale trials and the results of completed clinical studies suggest that stem cell therapies are safe and well tolerated. However, large-scale randomized controlled clinical trials to study the effectiveness of stem cell therapies for neurological disorders are still lacking.

Objective: To evaluate the feasibility, reliability, validity and sensitivity of ALS-SSIT scale—a traditional Chinese medicine (TCM) evaluation scale for therapeutic efficacy in amyotrophic lateral sclerosis (ALS).

Methods: To summarize the experience in traditional Chinese medicine (TCM) in the treatment of ALS and consult experts’ suggestions, and then develop a scale (ALT-SSIT scale) suitable for evaluating the efficacy of TCM in the treatment of ALS. The performance of ALSSSIT scale was evaluated on the day of enrollment and after 6-month of follow-up in 160 patients with ALS who received traditional Chinese medicine treatment. The SF-36 and ALSFRS-R scales were used as references to evaluate the feasibility, reliability, validity and sensitivity of ALS-SSIT scale.

Results: The acceptance and completion rates of ALS-SSIT scale were both higher than 99%. The test-retest reliabilities of ALS-SSIT scale were 0.917 and 0.918 on the day of enrollment and after 6-month of follow-up, respectively. The content validity and sensitivity (total score, score of each field and score of each item) were higher. There was a linear correlation between ALS-SSIT scale and SF-36 and ALSFRS-R scales, which means that ALS-SSIT scale could better reflect the changes in disease condition.

Conclusion: The feasibility, reliability, validity and sensitivity of ALS-SSIT scale in evaluating the efficacy of TCM in the treatment of ALS are satisfactory, which is suitable for clinical application.

Objective: To observe the effect of indwelling scalp acupuncture combined with occupational therapy on cognitive dysfunction after stroke.

Methods: Sixty patients with cognitive dysfunction after stroke were recruited from April 2017 to December 2019 and randomly divided into study group (n = 30) and control group (n = 30). The study group received indwelling scalp acupuncture combined with occupational therapy, while the control group only received occupational therapy. The patients were all treated for four weeks. Montreal Cognitive Assessment (MoCA) Fuzhou version, Minimental State Examination (MMSE) and Modified Barthel Index were used to evaluate the cognitive function and activities of daily living before and after rehabilitation treatment.

Results: After rehabilitation, the overall score and the scores of each items in MoCA Fuzhou version of two groups were significantly higher than those before rehabilitation (P < 0.05), except for the score of memory and delayed recall ability item of the control group. After rehabilitation, the overall score and the visual space and executive function, orientation, attention, memory and delayed recall ability and calculation scores in MoCA Fuzhou version of the study group were significantly higher than those of the control group (P < 0.05). The Modified Barthel Index and the MMSE scores of the two groups after rehabilitation were significantly higher than those before rehabilitation (P < 0.05), and the degree of improvement of the Modified Barthel Index and MMSE scores of the study group was better than that of the control group (P < 0.05).

Conclusion: Indwelling scalp acupuncture combined with occupational therapy can improve the cognitive function and activities of daily living of patients with cognitive dysfunction after stroke.

Ischemic stroke accounts for 60%-80% of stroke and is an important type of stroke. Damage of blood-brain barrier is an important pathological feature of ischemic stroke. Stem cells have shown remarkable potential in the treatment of ischemic stroke. From the perspective of protecting blood-brain barrier, this paper expounds the mechanism of transplantation of bone marrow mesenchymal stem cells, endothelial progenitor cells and oligodendrocyte precursor cells in the treatment of ischemic stroke, involving immune regulation and paracrine pathway.

In November 2020, Myasthenia Gravis Foundation of America (MGFA) released International Consensus Guidance for Management of Myasthenia Gravis: 2020 Update online. In addition to retaining seven topics for myasthenia gravis, two new topics (ocular myasthenia gravis and immune checkpoint inhibitor-associated myasthenia gravis) were included in this guideline. Furthermore, the previous recommendations for thymectomy were updated, and the new recommendations were developed for the use of rituximab, eculizumab, and methotrexate in the topic of myasthenia gravis and immunosuppression therapy. This paper summarizes the updated recommendations and new contents in this guideline.

Sirtuin 5 (SIRT5) is a nicotinamide adenine dinucleotide (NAD+)-dependent desuccinylase. It is mainly located in the mitochondrial matrix and is closely related to mitochondrial metabolism and redox process. In recent years, great progress has been made on the role of SIRT5 in cardiovascular and cerebrovascular diseases, neurodegenerative diseases and tumorigenesis. This review summarizes the latest progress in desuccinylation of SIRT5 and its mechanism in nervous system diseases.