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This is especially common in long-standing diabetes with nerve damage, making regular monitoring important even without obvious symptoms

This damage leads to increased membrane permeability, intracellular calcium overload, mitochondrial dysfunction, and ultimately, nerve cell death ( 1.2 Induction of nerve cell apoptosis: Oxidative stress can activate intracellular apoptosis signaling pathways, such as mitochondrial pathway, death receptor pathway, etc., leading to nerve cell apoptosis ( 1.3 Promote inflammatory response: Oxidative stress can activate inflammatory cells and trigger the release of inflammatory factors, such as TNF- and IL-1, thereby exacerbating the inflammatory response following nerve injury (40)

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For example, chiral chromatography with a suitable organic solvent, such as ethanol/acetonitrile and Chiralpak AD packing, 20 micron can also be utilized to effect separation of the enantiomers

However, some studies have reported contrasting results (260)