Insomnia belongs to Chinese medicine ‘Insomnia’ category, is the clinical common disease. The author study the classical literature, combining the theory of visceral manifestation, based on ‘liver storing blood, blood shed soul’ theory, pointed out that the occurrence of the disease is closely related with the liver, the ‘liver stores blood, blood shed soul’ function can not normally play a role as the key pathogenesis. The author starts from regulating the liver, based on treatment according to syndrome differentiation, clinical classified as deficiency of yin and blood, spirit lost glory shall not sleep, liver depression and blood stasis, restless soul shall not sleep and yin blood deficiency, liver yang hyperactivity inverse, disturbed soul surprised spirit shall not sleep three kinds of disease. Used respectively on nourishing liver blood, calming the heart and tranquilizing mind; soothing the liver qi, promoting blood circulation and tranquilizing mind; purging the liver of pathogenic fire, emolliate the liver and checking exuberance of yang, relieve irritability and quiet spirit, achieved good effect, and supplemented with cases.

Objective The abnormal ankle-brachial index ( ABI) is associated with the incidence of cardiocerebral vascular diseases, but little is known about its relationship with cerebral microbleeds (CMB).This study aimed to investigate the correlation be-tween ABI≤0.9 and different distribution patterns of CMB . Methods We enrolled 187 patients with acute lacunar infarction , inclu-ding 115 non-CMB cases and 72 CMB cases (20 strictly lobar, 24 strictly deep, and 28 lobar and deep).We analyzed the differences between the two groups and the association of abnormal ABI with the occurrence and distribution of CMB by logistic regression analysis . Results ABI≤0.9 was found in 57 (30.5%) of the patients, with a significantly higher incidence rate in the CMB group than in the non-CMB group (43.1%vs 22.6%, P=0.003).The level of ABI was negatively correlated with the number of CMBs (r=-0.211, P=0.006).Multivariate logistic regression analysis after adjusted for confounders indicated that ABI ≤0.9 was significantly associated with the presence of CMB (OR=2.363;95%CI:1.181-4.729), deep CMB (OR=3.434;95%CI:1.283-9.187), and lobar and deep CMB ( OR=2.837;95%CI:1.098-7.333) in patients with ischemic cerebrovascular disease . Conclusion Decreased ABI is a risk factor of CMB, particularly deep CMB, in patients with ischemic stroke.

Objective To discuss the effects of acupuncture therapy on resting state functional magnetic resonance imaging (fMRI) in patients with ischemic stroke; To explore the central mechanism of acupuncture therapy.Methods Ten is chemic stroke patients with hemiplegia limbs and ten matched control subjects were included. Treatment group was given anti-platelet aggregation, anticoagulation, and nutrition brain cell therapy. At the same time, acupuncture therapy was given, taking Jianyu, Quchi, Shousanli, Waiguan, Hegu, Zusanli, Fenglong, Yanglingquan, Sanyinjiao, and Taichong, with even reinforcing-reducing method, and retaining the needle 30 min, manipulating needle every 10 min, once a day, 5 times a week, needle stopping for 2 d, for continuous 30 d. The health group did not undergo any treatment. BOLD-fMRI imaging technique was used, and based on RSET1.8 software, the parameters of brain activity before and after treatment were observed by amplitude of low frequency fluctuation (ALFF) method. The Results were compared with healthy group. Results Before treatment, the ALFF value of left caudate nucleus, putamen and globus pallidus in the treatment group was lower than that in the health group, and the ALFF value of bilateral precentral and postcentral gyrus, left grus frontalis superior, gyrus frontalis medius, gyrus temporalis medius and precuneus was higher than the health group (P<0.05). After treatment, the ALFF value in left caudate nucleus, putamen and globus pallidus in the treatment group was higher than that before treatment, and the ALFF value in left gyrus frontalis superior, gyrus frontalis medius and precuneus decreased than before group (P<0.05).Conclusion In the resting state of the ischemic stroke patients with hemiplegia limbs, the principal injured brain regions are caudate nucleus, putamen and globus pallidus. Acupuncture has a regulatory role for these brain areas, presumably may be the central mechanism of efficacy.

目的 运用经颅多普勒超声对高血压病患者大脑中动脉(MCA)和眼动脉(OA)血流储备及血管反应性研究,探讨其检查结果及临床意义.方法 门诊随机抽取20例原发性高血压病患者40只眼及同时期体检健康20例正常对照组40只眼,运用经颅多普勒超声检查2组患者MCA及OA的平均血流速度(Vm)、屏气后的平均血流速度(Vm')、搏动指数(PI)、屏气后的搏动指数(PI')和屏气指数(BHI)e的参数进行对比分析.结果高血压组与对照组比较:OA 的平均血流速度(Vm) 、屏气后的平均血流速度(Vm')、搏动指数(PI)、屏气指数( BHI)与对照组比较均有统计学意义(P<0.05);MCA的搏动指数(PI)、屏气后的搏动指数( PI')与对照组比较均有统计学意义(P<0.05).结论 通过对高血压患者MCA、OA的脑血管反应性检测,可以为高血压病患者早期及时提供防治依据.

目的:评价脑心疏方对脑梗死急性期患者的疗效及对FIB和血液流变学的影响。方法:选取临床患者80例,随机分为治疗组和对照组各40例。2组患者均按照急性缺血性卒中常规治疗方案给予基本治疗,对照组给予口服拜阿司匹林100mg,每晚1次;治疗组在对照组用药的基础上给予脑心疏方治疗。结果:治疗组总有效率95.00%,显著高于对照组的80.00%;治疗组较对照组更能显著降低中医症候积分及血黏度。结论:脑心疏方治疗急性期脑梗死,可显著提高疗效,减少神经功能缺损症状、体征,改善中医症候,改善血液流变学高凝状态。

Objective To investigate the risk factors for reduced renal function in patients with ischemic stroke.Methods The medical records of patients with ischemic stroke were analyzed retrospectively.They were divided into normal renal function group and reduced renal function group.Reduced renal function was defined as estimated glomerular filtration rate (eGFR) ＜60 ml/(min·1.73 m2).Multivariate logistic regression analysis was used to identify the risk factors for reduced renal function in patients with ischemic stroke.Results A total of 805 patients with ischemic stroke were enrolled in the study.8.8％ of patients had a reduced renal function.There was no significant differences in the proportion of patients with mild and moderate neurological deficit between the reduced renal function group and the normal renal function group (all P ＞ 0.05),however,the proportion of patients with severe neurological deficit was significantly higher than that in the normal renal function group (8.4％vs.2.6％,x2 =5.573,P =0.017).The proportion of small artery occlusion in the reduced renal function group was sigaificantly higher than that in the normal renal function group (66.2％ vs.46.5％,x2 =9.962,P =0.002),and the proportion of large artery atherosclerosis was significantly lower than that in the normal renal function group (19.7％ vs.43.5％,x2 =15.045,P =0.000).Multivariate logistic regression analysis indicated that old age (odds ratio [ OR] 3.301,95％ confidence interval [ CI],1.575 to 6.918; P=0.002) was the most important independent risk factor for reduced renal function,then was female (OR,2.291,95％ CI 1.355to 3.872; P=0.002) and hyperlipidemia (OR,2.527,95％ CI 1.095 to 5.831; P=0.030).Conclusions Reduced renal function in patients with ischemic stroke is strongly associated with old age,female,and hyperlipidemia.

Objective To investigate the prevalence of renal impairent and its related risk factors in patients with cerebral infarctions.Methods Totally 902 adult patients with cerebral infarctions were included in this study.Age,sex and blood pressure were recorded.Levels of hemoglobulim,serum cretinine,blood ureanitrogen,blood liqid,serum uric acid were measured.Glomerular filtration rates(GFR) were estimated by the modification of diet in renal disease study equation(MDRD).These cases were divided into three groups:normal group GFR≥90 ml·min-1·(1.73 m2)-1(A group),mild renal insufficiency group 60 ml·min-1·(1.73 m2)-1≤GFR90 ml·min-1·(1.73 m2)-1(B group)and moderate renal insufficiency group GFR60 ml·min-1·(1.73 m2)-1(C group).according to the criterion on classification of GFR in kidney disease outcome quality initiative(K/DOQI).Results The GFR levels of 50.6% of the patients were below 90 ml·min-1·(1.73 m2)-1,and 13.4% were below 60 ml·min-1(·1.73 m2)-1.The incidence rate of chronic kidney disease(CKD)was 25.1%.Elder patients had a higher prevalence than middle-aged patients 8.6%(P0.01);kidney function decline rate were higher in women than in men for both the elder and middle-aged population(P0.001).Binary logistic regression analysis showed that the risk factors for kidney function decline were age,female,smoking,diabetes,coronary atherosclerotic heart disease,hyperuricemic and lipids disorder.Conclusion The prevalence of renal impairment is high in patients with cerebral infarction,and the related risk factors include age,female,smoking,diabetes,coronary artherosclerotic heart disease,lipids disorder and hyperuricemic.