Ketone bodies, as terminal products of hepatic fatty acid β-oxidation, serve not only as crucial mediators in maintaining energy homeostasis but also as pleiotropic signaling molecules that participate in physiological and pathological processes through epigenetic modifications and immune regulatory networks. As the metabolic hub of the organism, the liver maintains the dynamic equilibrium of ketone body production and metabolism through sophisticated regulatory mechanisms.Emerging evidence indicates that dysregulated ketone body metabolism significantly correlates with the pathological progression of various hepatic disorders, including alcoholic liver disease(ALD), acute liver failure, and non-alcoholic fatty liver disease(NAFLD). This review systematically elucidates the regulatory mechanisms of ketone body metabolism in liver diseases,with particular emphasis on its dual role in cytoprotection and pathological injury manifestation during different disease stages.Furthermore, we critically evaluate the translational potential and clinical applicability of targeting ketone metabolism as a novel therapeutic strategy based on current research advancements.

Sepsis is a clinical syndrome characterized by systemic inflammation, microcirculation disturbance, and capillary leakage caused by infection with microorganisms. Most patients may have anasarca. Based on Zhang Zhongjing' s theory of "Qi, blood, and water phase", and in combination with the clinical practice of sepsis, the author proposes a combined traditional Chinese and Western medicine diagnosis and treatment approach for sepsis. That is, pathogen infection conforms to the pathogenesis of heat-toxin invasion, the immunosuppression is in line with the deficiency of Qi, and the imbalance of early inflammatory response and metabolic disorder conform to the pathogenesis of Qi transformation and Qi movement disorder in the Qi phase. Microcirculation disorders and capillary leakage are in line with the pathogenesis of blood stasis in the blood phase, while fluid overload is in line with the pathogenesis of water and dampness flooding in water phase. Sepsis is a critical illness, often characterized by the coexistence of Qi, blood and water phase.According to the severity of the syndrome of Qi,blood and water phase in patients with sepsis, the regulation of Qi, blood and water should be given in a coordinated manner to facilitate the recovery of the disease.

In recent years, mental illnesses such as depression have received significant attention. Long-term depression can lead to insomnia, while insomnia can also exacerbate depression. These two conditions interact as both cause and effect, increasing the risk of comorbid disorders. Besides affecting patients' daily lives, this also poses challenges for clinical healthcare professionals. Modern medicine has found that the brain-gut axis is associated with the occurrence and progression of depression and insomnia, which aligns with the traditional Chinese medicine theory that the brain and gastrointestinal tract are interconnected. Furthermore, TCM views the human body as an integrated whole composed of internal organs connected by meridians. There exists a corresponding physiological relationship between the human brain and intestines, providing a theoretical basis for combined brain-intestine treatment. In this context, this article takes the regulation of the human brain-gut axis by traditional Chinese medicine as a starting point and reviews TCM approaches and related literature for treating depression with insomnia, aiming to provide more references for the role of "brain and intestine combined treatment" in TCM management of depression with insomnia.