Post-stroke depression (PSD) is a complex neuropsychiatric complication driven by neuroinflammation and ferroptosis, yet effective therapies remain limited. Sinensetin (SIN), a polymethoxylated flavone derived from citrus fruits, possesses potent anti-inflammatory and antioxidant properties. However, its therapeutic efficacy and underlying mechanisms in PSD have not been explored. To investigate this, a mouse model of PSD was established by combining photothrombotic stroke with low-dose lipopolysaccharide (LPS) administration. Mice were treated with SIN (25 and 50 mg/kg) for 14 days. Depressive-like behaviors were assessed using the sucrose preference test (SPT), tail suspension test (TST), and forced swimming test (FST). Crucially, protein-level validation was performed using quantitative immunofluorescence (for glial activation) and ELISA (for serum cytokines and pathway markers), complemented by qPCR and molecular docking/dynamics (MD) simulations. SIN treatment significantly alleviated depressive-like behaviors and restored cerebral blood flow in PSD mice. Quantitative immunofluorescence and ELISA analyses revealed that SIN effectively suppressed the hyperactivation of microglia (IBA1) and astrocytes (GFAP) in the hippocampus and reduced serum concentrations of pro-inflammatory cytokines (TNF-α, IL-6, IL-1β). Mechanistically, SIN inhibited the TLR4/NF-κB signaling pathway by suppressing NF-κB nuclear translocation and concurrently activated the NRF2/GPX4 antioxidant axis, thereby mitigating lipid peroxidation and neuronal ferroptosis. Additionally, molecular docking and MD simulations predicted energetically favorable interactions between SIN and key targets (e.g., TLR4, KEAP1), providing supportive evidence for its multi-target mechanism. Our findings demonstrate that SIN exerts neuroprotective effects in PSD by dually modulating TLR4/NF-κB-mediated neuroinflammation and NRF2/GPX4-dependent ferroptosis. These results highlight SIN as a promising natural therapeutic candidate for the treatment of depression following stroke.

ETHNOPHARMACOLOGICAL RELEVANCE:Post-stroke depression (PSD) is common among stroke survivors and negatively impacts recovery. Chaihu-Shugan-San (CSS), a traditional Chinese medicine, has shown therapeutic potential for mood disorders, particularly PSD. Recent studies suggest that CSS's effects may be mediated by exosomes, but the mechanisms remain unclear. AIM OF STUDY:This study aimed to evaluate the therapeutic effects of CSS on PSD in mice and investigate the underlying mechanisms, particularly the role of exosomes. MATERIALS AND METHODS:Active compounds in CSS were identified from rat serum using liquid chromatography-mass spectrometry (LC-MS) and analyzed through network pharmacology. In vitro, an oxygen-glucose deprivation/reperfusion (OGD/R) BV2 microglia model was used to assess the effects of CSS-containing serum (CSS-S). Exosomes from OGD/R-treated BV2 microglia were isolated, labeled with PKH26, and analyzed using transmission electron microscopy (TEM) and nanoparticle tracking analysis (NTA). In vivo, a photothrombotic stroke (PT) model combined with chronic unpredictable mild stress (CUMS) was used to induce PSD in mice. Behavioral assessments and histological analysis were performed, along with immunofluorescence (IF), ELISA and q-PCR to measure key protein and miR-146 expression in the hippocampus. RESULTS:CSS treatment significantly alleviated depressive-like behaviors in the PSD mouse model. Mice treated with high-dose CSS (4.2 g/kg) exhibited increased sucrose preference, reduced immobility in the tail suspension test (TST) and forced swimming test (FST), and enhanced exploratory activity in the open field test (OFT). Histological analysis demonstrated that CSS treatment improved brain tissue integrity, alleviating neuronal damage and reducing neuroinflammation. Exosome analysis revealed that CSS increased the expression of microglia-derived exosomes in the hippocampus, which were shown to carry miR-146. Further examination of miR-146 isoforms in the hippocampal tissue revealed significant changes: miR-146b-3p and miR-146a-5p were upregulated, while miR-146a-3p and miR-146b-5p were downregulated in PSD mice. Treatment with CSS reversed the altered miRNA expression, indicating a potential mechanism for its neuroprotective effects. Additionally, CSS treatment reduced the expression of inflammatory cytokines such as S100A8, IL1β, IL6, and TNF-α, while restoring the levels of angiogenic factors VEGFC and VEGFR3. ELISA measurements showed significant decreases in cyclic AMP response element-binding protein (CREB), brain-derived neurotrophic factor (BDNF), 5-hydroxytryptamine (5-HT), dopamine (DA), and noradrenaline (NE) in PSD mice; high-dose CSS notably elevated CREB and BDNF levels and showed comparable effects to fluoxetine in restoring 5-HT and DA levels. Additionally, the calcium signaling pathway was implicated, with altered mRNA expressions of CaMKIIα, CREB, phosphorylated CREB (p-CREB), PDE4D, and BDNF, although fluoxetine demonstrated stronger modulatory effects than CSS. CONCLUSIONS:CSS alleviates PSD in mice by modulating exosome-mediated signaling, particularly through the regulation of miR-146. The treatment reversed abnormal miRNA expression, reduced neuroinflammation, and improved synaptic function. These findings highlight CSS's potential as an effective therapeutic strategy for PSD by targeting exosome-mediated neuroprotection and miR-146 regulation.

Depression is a common, serious, and recurrent mental disorder that is closely associated with decreased quality of life, increased medical morbidity, and higher mortality rates. Currently, over 300 million people worldwide are affected by depression. According to reports from the World Health Organization (WHO), psychological disorders account for 12% of the global disease burden, and 46% of all illnesses are directly related to depression. WHO experts have warned that, if this trend continues, by 2030 the number of patients with depression will exceed the total number of patients with all cardiovascular diseases, making depression the leading cause of disability worldwide. It has thus become a major global public health concern. Xuefu Zhuyu Decoction, originally recorded in Correction of Errors in Medical Classics by Qing dynasty physician Wang Qingren, is known for its functions of promoting blood circulation, removing blood stasis, regulating qi, and relieving pain. It is now widely used in clinical practice for various conditions characterized by qi stagnation and blood stasis, with notable efficacy. This paper systematically elaborates on the therapeutic effects and mechanisms of Xuefu Zhuyu Decoction in treating depression accompanied by cognitive dysfunction.

目的 探讨桃核承气汤治疗卒中后认知障碍（PSCI）的疗效以及对认知功能和血清脂联素水平的影 响。方法 选取2018—2019年南京中医药大学第二附属医院神经内科门诊就诊的PSCI患者100例。采用随机数字法将 患者分为对照组和治疗组，每组50例。对照组中因失访脱落1例，最终纳入49例；治疗组中因依从性差及失访脱落3 例，最终纳入47例。对照组患者给予抗血小板聚集、调脂、稳定斑块、控制血压及血糖等基础治疗联合多奈哌齐片； 治疗组患者在对照组基础上加用桃核承气汤治疗，两组均以4周为1个疗程，共治疗3个疗程。治疗后评定两组患者中 医证候疗效，治疗前及治疗后采用简易精神状态检查量表（MMSE）、蒙特利尔认知评估量表（MoCA）评估患者认知 功能，采用血管性痴呆中医辨证量表（SDSVD）评估患者中医症状改善情况，采用放射免疫法检测血清脂联素水平， 记录两组患者治疗期间不良反应发生情况。结果 治疗组中医证候疗效优于对照组（u=2.418，P=0.016）。治疗后， 两组MMSE、MoCA评分分别高于本组治疗前，SDSVD评分分别低于本组治疗前（P＜0.05）；治疗后，治疗组MMSE、 MoCA评分高于对照组，SDSVD评分低于对照组（P＜0.05）。治疗后，两组血清脂联素水平分别高于本组治疗前 （P＜0.05）；治疗后，治疗组血清脂联素水平高于对照组（P＜0.05）。两组患者治疗期间均未出现明显不良反应。 结论 桃核承气汤治疗PSCI患者中医证候疗效显著，可改善认知功能，上调血清脂联素水平，未见明显不良反应。

文章通过分析脑病的病因病机,依据芍药甘草汤养阴缓急的功用,灵活化裁,应用于卒中后痉挛性瘫痪、帕金森病、面(睑)肌痉挛、偏头痛、枕神经痛、不宁腿综合征等脑病的诊治,并阐述相应组方思路.

Post-stroke depression (PSD) is one of the most common neuropsychiatric consequence of stroke, affecting cognitive function, recovery of somatic function, and patient survival. The aim of this study was to evaluate whether Chaihu-Shugan-San, a traditional Chinese medicine formula used clinically to treat depression, could improve symptoms in a rat model for PSD, to investigate the potential mechanisms, and to validate the findings in an in vitro oxygen and glucose deprivation (OGD) model. Male rats were subjected to middle cerebral artery occlusion (MCAO) and to chronic unpredictable mild stress (CUMS). The rats were then allocated to experimental groups (n = 15) that were treated with Chaihu-Shugan-San, a JAK-STAT3 inhibitor, a GSK3β overexpressing virus, or an empty virus (control). The subjects allocated to each group, as well as those that received no treatment and rats that did not undergo MCAO/CUMS, were then subjected to forced swimming, tail suspension, and sugar water preference tests, and their neurological deficit score was determined. Inflammatory factor levels and the expression of proteins related to the JAK/STAT3-GSK3β/PTEN/Akt pathway were measured, and the synaptic ultrastructure was observed using transmission electron microscopy. Flow cytometry showed microglia polarization towards the M1 phenotype in an in vitro PSD model, which was reversed after treatment with a GSK3β overexpression virus, Chaihu-Shugan-San, or a JAK-STAT3 inhibitor. The results showed that Chaihu-Shugan-San has a therapeutic effect on an in vivo model for PSD and can regulate microglia polarization through the activation of the JAK/STAT3-GSK3β/PTEN/Akt pathway, suggesting that it exerts its effect via the inhibition of neuroinflammation.

目的 探讨桃核承气汤治疗卒中后认知障碍(PSCI)的疗效及其对患者认知功能和血清脂联素水平的影响.方法 选取2018—2019年于南京中医药大学第二附属医院神经内科门诊就诊的PSCI患者100例.采用随机数字表法将患者分为常规组和桃核承气汤组,每组50例.常规组中因失访脱落1例,最终纳入49例;桃核承气汤组中因依从性差及失访脱落3例,最终纳入47例.常规组患者采用抗血小板聚集、调脂稳定斑块、控制血压及血糖等基础治疗联合多奈哌齐片进行治疗;桃核承气汤组患者在常规组基础上加用桃核承气汤进行治疗,两组均以4周为1个疗程,共治疗3个疗程.治疗后评定两组患者中医证候疗效,治疗前后采用简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)评估患者认知功能,采用血管性痴呆中医辨证量表(SDSVD)评估患者中医症状改善情况,采用放射免疫法检测血清脂联素水平,记录两组患者治疗期间不良反应发生情况.结果 桃核承气汤组中医证候疗效优于常规组(u=2.418,P=0.016).治疗后,两组MMSE、MoCA评分分别高于本组治疗前,SDSVD评分分别低于本组治疗前(P<0.05);治疗后,桃核承气汤组MMSE、MoCA评分高于常规组,SDSVD评分低于常规组(P<0.05).治疗后,两组血清脂联素水平分别高于本组治疗前,且桃核承气汤组血清脂联素水平高于常规组(P<0.05).两组患者治疗期间均未出现明显不良反应.结论 桃核承气汤可有效提高PSCI患者的中医证候疗效,改善认知功能,上调血清脂联素水平,且未见明显不良反应.

目的 基于真实世界探索喜炎平注射液治疗病毒性脑炎的用药规律,为临床合理用药提供参考.方法 从中国中医科学院中医临床基础医学研究所构建的真实世界电子医疗数据库中提取喜炎平注射液治疗病毒性脑炎患者的医疗电子病历10845例,采用Tabu搜索算法及复杂网络分析,对结果进行归纳得到临床用药规律.结果 纳入使用频次大于11的合并中西药共119种,获得最优划分的35种药物子群及复杂网络图,展现了喜炎平注射液联合其他药物治疗病毒性脑炎的最佳临床合并用药特征.结论 喜炎平注射液治疗病毒性脑炎的药物治疗包括抗病毒、对症支持、合并症及后遗症治疗的方案,上述方案与病毒性脑炎的指南/专家共识推荐的治疗方案基本一致,为临床用药提供了较为合理的证据.但在抗生素使用、中医治法组合上,需根据临床实际情况进一步探讨验证.

对于中风后吞咽功能障碍,历代医家对其病因病机以及针刺治疗均有独特见解.但治疗该病时仍以近部取穴以治标为主.根据中医"治病求本"理论,对本病恢复期应当标本兼治."子母补泻"针刺法源远流长,遵循五行相生之基础理论.研究主要论述运用"子母补泻法",从调补"肝、脾、肾"三经入手治疗卒中后吞咽障碍,以期为临床治疗此病提供新的思路,并为中医传统理论提供一定的临床依据.

卒中后抑郁是发生于脑卒中后以情绪低落、兴趣减退、睡眠障碍等为主要特征的情感障碍性疾病,临床发病率高,常规抗抑郁药治疗卒中后抑郁疗效局限性较多,中医药治疗可发挥一定优势.文章通过重点阐述卒中后抑郁的现代医学认识、中医核心病机、柴胡疏肝散与重复经颅磁刺激疗法治疗本病的作用机制,总结盛蕾教授治以内调气机、外醒脑神为治疗大法,运用柴胡疏肝散加减联合重复经颅磁刺激治疗卒中后抑郁的临床经验,以期指导临床应用.

目的:评价柴胡类方治疗卒中后抑郁的临床疗效.方法:检索中国期刊全文数据库、中国生物医学文献服务系统、万方数据、维普中国科技期刊数据库、PubMed、EMbase和Cochrane Library,搜集与柴胡类方治疗卒中后抑郁相关的随机对照试验,并应用RevMan 5.4软件对相关数据进行统计学分析.结果:本研究共纳入14个随机对照试验,共676例患者.柴胡类方治疗卒中后抑郁的总有效率与抗抑郁药单药比较,差异具有统计学意义;柴胡类方治疗卒中后抑郁的汉密尔顿抑郁量表评分与抗抑郁药单药比较,差异具有统计学意义;柴胡类方治疗卒中后抑郁的神经功能缺损量表评分与抗抑郁药单药比较,差异具有统计学意义.柴胡类方治疗卒中后抑郁的不良反应较抗抑郁药单药少.结论:柴胡类方治疗卒中后抑郁相比抗抑郁单药具有较好的疗效,不良反应较少,但应继续扩大样本量以证实本研究结论.

抑郁是帕金森病常见的非运动并发症,严重影响患者的生活质量.帕金森病抑郁不仅有运动迟缓、筋脉拘急等"筋脉"为病的表现,还有情绪低落,意志行为能力低下,思维迟缓等"情志"为病的特征.帕金森病抑郁属于"筋脉病"与"情志病"的"合病".肝在体合筋,主疏泄、调畅情志,是肝藏象生理功能的主要体现;肝郁不达则情志郁结,筋脉不利.现代研究发现,肝主疏泄的功能与脑内多巴胺等单胺类神经递质相关,多巴胺分泌不足是引起帕金森病抑郁发病的重要机制之一.基于"肝主筋脉,调畅情志"的生理功能特征,我们认为"筋脉拘急,神气郁结"是帕金森病抑郁的病机;柔肝缓急,理气解郁是帕金森病抑郁的基本治则治法;提出了将理气解郁经典方越鞠丸与酸甘缓筋急的芍药甘草合用作为治疗帕金森病抑郁的基础方,为该病治疗提供新的思路.

目的 观察加减枳实大黄汤对急性缺血性脑卒中(痰热腑实证)患者的临床疗效,以及对于血同型半胱氨酸(Hcy)、血栓素B2(TXB2)和6-酮-前列腺素F1α(6-Keto-PGF1α)的影响.方法 选取患者60例按照随机数字表法分为对照组与观察组各30例,对照组采用常规治疗,观察组在此基础上给予加减枳实大黄汤治疗,疗程为14 d.比较治疗前后美国国立卫生研究院脑卒中量表(NIHSS)评分及Barthel指数(BI)量表、中医证候评分量表、Hcy、TXB2、6-Keto-PGF1α水平,并评价疗效.结果 治疗后,两组中医证候评分、NIHSS评分均显著降低,BI评分显著增加,且治疗后观察组优于对照组,差异具有统计学意义(P＜0.05).治疗后两组言语謇涩,痰多等中医证候评分均显著降低,但总体上观察组优于对照组,差异具有统计学意义(P＜0.05).治疗后两组血浆Hcy、TXB2水平显著降低,6-Keto-PGF1α含量显著增高,且观察组优于对照组,差异具有统计学意义(P＜0.05).疗效对比:观察组总有效率为90.00％,高于对照组总有效率为73.33％(P＜0.05).结论 加减枳实大黄汤可改善急性缺血性脑卒中(痰热腑实证)患者神经缺损症状,提高自主生活能力,改善近期疗效,可能与加减枳实大黄汤降低血浆中Hcy水平,抗血小板聚集,扩张血管有关.

目的:观察针灸联合氢溴酸西酞普兰片治疗卒中后抑郁(Post-Stroke Depression,PSD)的临床疗效及对睡眠结构的影响.方法:将90例缺血性PSD患者随机分为治疗组和对照组,每组45例.对照组给予口服氢溴酸西酞普兰片,治疗组在对照组基础上给予针刺治疗.分别于治疗前及2、4、8周后进行汉密尔顿抑郁量表-17(Hamilton Depression Scale,HAMD-17)评分,观察治疗8周前后多导睡眠图相关指标变化,并评估临床疗效.结果:治疗2、4、8周后,两组的HAMD-17评分均较治疗前有显著改善(P<0.01),且治疗组优于对照组(P<0.01);治疗8周后两组睡眠总时间延长、睡眠潜伏期缩短、觉醒次数减少、睡眠效率及睡眠维持率提高、快速动眼睡眠和非快速动眼睡眠(III+IV期)延长(P<0.05),非快速动眼睡眠I和非快速动眼睡眠II期无显著变化(P>0.05),且治疗组优于对照组(P<0.05).结论:针灸联合氢溴酸西酞普兰片可改善缺血性PSD患者的抑郁症状,同时可以诱导睡眠,改善睡眠节律和睡眠结构,提高睡眠质量.

Objectives: Inflammation is associated with the occurrence and prognosis of ischemic stroke. The aim of this study was to evaluate the association between inflammatory biomarkers and the short-term clinical outcomes of acute ischemic stroke (AIS) patients after intravenous thrombolysis (IVT). Materials and Methods: A total of 208 AIS patients treated with IVT were enrolled in this retrospective study. Blood tests of inflammatory biomarkers, including the leukocyte count, neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio and high-sensitivity C-reactive protein level, were conducted within 24 h after IVT. The primary outcome was decent functional recovery (DFR) [modified Rankin Scale score (mRS) of 0-2] at 3 months. The secondary outcomes included symptomatic intracranial hemorrhage and 3-month mortality. A multivariate analysis was performed to evaluate the associations between inflammatory biomarkers and 3-month clinical outcomes. Results: At 3 months follow-up, 113 (62.2%) patients achieved DFR. As compared to patients with DFR, patients without DFR had higher leukocyte counts (8.5 +/- 2.4 x 109/L versus 6.9 +/- 1.7 pound 10(9)/L, P=0.000), neutrophil counts (6.1 +/- 2.3 x 10(9)/L versus 4.6 +/- 1.7 x 10(9)/L, P=0.000) and neutrophil-to-lymphocyte ratio (4.6 +/- 2.4 versus 3.3 +/- 1.9, P=0.000). After adjusting for the stroke subtype, severity of stroke, and medical history, the leukocyte count and neutrophil count remained significantly correlated with non-DFR (adjusted odds ratio [OR] 1.488; 95% confidence interval [CI], 1.247-1.776; P=0.000 and adjusted OR 1.522; 95% CI, 1.269-1.826; P=0.000, respectively). Conclusions: This study demonstrates that increased levels of inflammatory biomarkers are independently associated with poor outcomes at 3 months in AIS patients treated with IVT.

Objective To analyze the effective components of Chinese medicine (CM) contained in Chaihu Shugan Powder (& x67f4;& x80e1;(sic)& x809d;<SIC>, CSP) in the treatment of depressive disorders and to predict its anti-depressant mechanism by network pharmacology. Methods Absorption, distribution, metabolism, excretion, and toxicity calculation method was used to screen the active components of CSP. Traditional Chinese Medicine System Pharmacological Database Analysis Platform and text mining tool (GoPuMed database) were used to predict and screen the active ingredients of CSP and anti-depressive targets. Through Genetic Association Database, Therapeutic Target Database, and PharmGkb database targets for depression were obtained. Cytoscape3.2.1 software was used to establish a network map of the active ingredients-targets of CSP, and to analyze gene function and metabolic pathways through Database for Annotation, Visualization and Integrated Discovery and the Omicshare database. Results The 121 active ingredients and 15 depression-related targets which were screened from the database can exert antidepressant effects by improving the neural plasticity, growth, transfer condition and gene expression of neuronal cell, and the raise of the expression of gap junction protein. The 15 targets passed 14 metabolic pathways, mainly involved in the regulation of neurotransmitters (5-hydroxytryptamine, dopamine and epinephrine), inflammatory mediator regulation of TRP channels, calcium signaling pathway, cyclic adenosine monophosphate signaling pathway and neuroactive ligand-receptor interaction and other signal channels to exert anti-depressant effects. Conclusion This article reveals the possible mechanism of CSP in the treatment of depression through network pharmacology research, and lays a foundation for further target studies.

BACKGROUND AND PURPOSE:Symptomatic intracranial hemorrhage (sICH), potentially associated with poor prognosis, is a major complication of endovascular thrombectomy (EVT) for ischemic stroke patients. We aimed to develop and validate a risk model for predicting sICH after EVT in Chinese patients due to large-artery occlusions in the anterior circulation. METHODS:The derivation cohort recruited patients with EVT from the Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke Registry in China. sICH was diagnosed according to the Heidelberg Bleeding Classification within 24 hours of EVT. Stepwise logistic regression was performed to derive the predictive model. The discrimination and calibration of the risk model were assessed using the C index and the calibration plot. An additional cohort of 503 patients from 2 stroke centers was prospectively enrolled to validate the new model. RESULTS:We enrolled 629 patients who underwent EVT as the derivation cohort, among whom 87 developed sICH (13.8%). In the multivariate adjustment, Alberta Stroke Program Early CT Score (odds ratio [OR], 0.85; P=0.005), baseline glucose (OR, 1.13; P=0.001), poor collateral circulation (OR, 3.06; P=0.001), passes with retriever (OR, 1.52; P=0.001), and onset-to-groin puncture time (OR, 1.79; P=0.024) were independent factors of sICH and were incorporated as the Alberta Stroke Program Early CT Score, Baseline Glucose, Poor Collateral Circulation, Passes With Retriever, and Onset-to-Groin Puncture Time (ASIAN) score. The ASIAN score demonstrated good discrimination in the derivation cohort (C index, 0.771 [95% CI, 0.716-0.826]), as well as the validation cohort (C index, 0.758 [95% CI, 0.691-0.825]). CONCLUSIONS:The ASIAN score reliably predicts the risk of sICH in Chinese ischemic stroke patients treated by EVT.

收集1例神经元核内包涵体病(NIID)可疑病例的病史及体格检查资料,并行头颅磁共振成像(MRI)、脑电图、实验室检查、量表评定等检查,因患者家属拒绝未能行皮肤病理活检.患者头痛,反应迟钝,理解力、定时定向能力减退;头颅磁共振弥散加权成像(DWI)有特征性的"绸缎征"——皮髓交界区高信号,T2、液体衰减反转恢复(FLAIR)显示白质内高信号.心电图未见明显异常,结果说明,临床具有中枢、外周神经系统疾病症状和体征,影像学皮髓质交界处持续性DWI高信号,T2、FLAIR序列出现以额叶为主的脑白质高信号者应高度怀疑神经元核内包涵体病,可结合皮肤病理活检确诊.

Background The trajectory of ischemic stroke patients attributable to large vessel occlusion is fundamentally altered by endovascular thrombectomy. This study aimed to develop a nomogram for predicting 3‐month mortality risk in patients with ischemic stroke attributed to artery occlusion in anterior circulation who received successful endovascular thrombectomy treatment. Methods and Results Patients with successful endovascular thrombectomy (modified Thrombolysis in Cerebral Infarction IIb or III) were enrolled from a multicenter registry as the training cohort. Step‐wise logistic regression with Akaike information criterion was utilized to establish the best‐fit nomogram. The discriminative value of the nomogram was tested by concordance index. An additional 224 patients from 2 comprehensive stroke centers were prospectively recruited as the test cohort for validating the new nomogram. Altogether, 417 patients were enrolled in the training cohort. Age (odds ratio [OR], 1.07; 95% CI, 1.03−1.10), poor pretreatment collateral status (OR, 2.13; 95% CI, 1.18−3.85), baseline blood glucose level (OR, 1.12; 95% CI, 1.04−1.21), symptomatic intracranial hemorrhage (OR, 9.51; 95% CI, 4.54−19.92), and baseline National Institutes of Health Stroke Scale score (OR, 1.08; 95% CI, 1.03−1.12) were associated with mortality and were incorporated in the nomogram. The c‐index of the nomogram was 0.835 (95% CI, 0.785–0.885) in the training cohort and 0.758 (95% CI, 0.667–0.849) in the test cohort. Conclusions The nomogram, composed of age, pretreatment collateral status, baseline blood glucose level, symptomatic intracranial hemorrhage, and baseline National Institutes of Health Stroke Scale score, may predict risk of mortality in patients with ischemic stroke and treated successfully with endovascular thrombectomy.

目的:观察调肝安神方治疗失眠症肝郁血瘀证患者的临床疗效及对匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)评分的影响.方法:选取南京中医药大学第二附属医院神经内科失眠专病门诊患者96例,采用随机数字表法随机分为2组.对照组48例,给予艾司唑仑1～2 mg睡前口服;治疗组48例,在对照组基础上加用调肝安神方治疗.比较2组中医证侯疗效及PSQI分值的变化.结果:治疗组临床痊愈9例,显效16例,有效18例,无效5例,愈显率65.8％,总有效率89.6％;对照组临床痊愈3例,显效10例,有效19例,无效16例,愈显率34.2％,总有效率66.7％.治疗组临床愈显率及总有效率均明显高于对照组(均P<0.05).治疗后,对照组睡眠质量、入睡时间、睡眠时间、睡眠效率PSQI因子积分及总积分均较治疗前明显下降(均P<0.05);治疗组睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能PSQI各因子积分及总积分均较治疗前明显下降(均P<0.01),且均显著低于对照组(均P<0.05).结论:调肝安神方治疗失眠症肝郁血瘀证患者疗效确切,能显著延长总睡眠时间,增加睡眠深度,减轻睡眠障碍,缓解日间功能,改善睡眠质量,显著提高睡眠效率,值得临床进一步研究.