Enterprise and competent department in China start to explore evaluation method and technique,as revaluation of Chinese patent medicine has been paid high attention in recent years.However,many problems of Chinese patent medicine standard itself commonly have been neglected in the revaluation of curative effect.This review comprehensively analyzed problems have to be faced in the revaluation of the curative effect of Chinese patent medicine,such as excessive broad expressions of function and indication,obscure definition of indication,identification between function and indication,correspondence of diseases and syndromes between Chinese and western medicine,feasibility of clinical trials,with the provision of general methods and solutions.

The perivascular space is formed by the pia mater around the blood vessels and participates in the fluid exchange and waste clearance in the brain. The enlarged perivascular space (EPVS) indicates the disorder of brain clearance mechanism, which is closely related to the occurrence and development of a variety of clinical diseases. In recent years, there are a lot of studies on the pathogenesis and influencing factors of EPVS. This article reviews its anatomy, neuroimaging, pathogenesis, and risk factors.

A large number of studies have shown that the elevated lipoprotein (a) is a risk factor for ischemic stroke, but the specific mechanism is still unclear. Therefore, this article reviews the role of elevated lipoprotein (a) in ischemic stroke, its mechanism, and intervention measures.

Post-stroke cognitive impairment (PSCI) directly affects the outcome of patients with stroke. Enlarged perivascular spaces (EPVS) suggest the impairment of brain clearance mechanism and may affect cognitive function. More and more studies have confirmed that the presence of EPVS will aggravate PSCI. This article reviews the relationship between EPVS and PSCI.

Objective To evaluate the role of aquaporin 1(AQPI)expression in the cartiopulmonary bypass(CPB)-induced lung injury in dogs.Methods Twenty-four healthy dogs,weighing 15-20 kg,were randomly divided into 4 group(n =6 each):control group(group C),acetazolamide Ⅰ group(group A Ⅰ),acetazolamide Ⅱ group(group A Ⅱ),and acetazolarnide Ⅲ group(group AⅢ).Lung injury was produced by CPB.The traditional priming solution was infused in group C.Priming solutions containing acetaaolamide 20,40 and 60 mg/kgwere infused in groups A Ⅰ,A Ⅱ and A Ⅲ respectively.Blood samples were collected from the femoral artery before mechanical ventilation,at the end of CPB and at 1 h after end of CPB(T1-3)for arterial blood gas analysis.Respiration index(RI)and oxygenation index(OI)were calculated.The lung specimens were oblained for determination of AQPI mRNA and protein expression(by RT-PCR and Western blot)and for microscopic examination.The pathological changes of the lung were scored.Results Compared with group C,P(A-a)O2,RI and the pathological score were significantly increased at T2.3,OI was significantly decreased at T2.3,and AQP1 protein expression was down-regulated at T2.3 in groups A Ⅰ,A Ⅱ and AⅢ,and AQP1 mRNA expression was down-regulated at T2.3 in groups AⅡ and AⅢ(P＜0.05).Compared with group A Ⅰ,P(A-a)O2,RI and the pathological score were significantly increased at T2.3,OI was significantly decreased at T2.3,and AQP1 protein expression was down-regulated at T2.3 in groups A Ⅱ and AⅢ,and AQP1 mRNA expression was down-regulated at T2.3 ingroup A Ⅲ(P ＜ 0.05).Compared with group A Ⅱ,RI and the pathological score were significantly increased at T2.3,and AQP1 protein expression was down-regulated at T2.3 in group A Ⅲ(P ＜ 0.05).Conclutsion Down-regulation of AQPI expression is involved in the CPB-induced lung injury in dogs.

Objective To evaluate the clinical value and efficacy of prophylactic pancreatic duct stenting for biliary-type stenosis of Oddi sphincter with difficulty cannulation.Methods The present study was a retrospective study of 63 patients with biliary-type stenosis of Oddi sphincter and difficult cannulation.The stent group consisted 30 patients who underwent prophylactic pancreatic duct stenting from February 2010 to February 2011 and the control group included 33 patients who underwent only ERCP without prophylactic pancreatic duct stenting from January 2009 to January 2010.The incidence of postoperative pancreatitis were compared between the two groups.Results The incidence of postoperative pancreatitis of the control group was significantly higher than that of the stent group (P ＜ 0.05).Conclusion For patients with definite diagnosis of biliary-type stenosis of Oddi sphincter and difficult cannulation,prophylactic pancreatic duct stent placement is safe and effective.

Objective To evaluate the effects of modified ultrafiltration on the expression of aquaporin 1 (AQP1) in cardiopulmonary bypass (CPB)-induced lung injury in dogs.Methods Eighteen healthy adult dogs of either sex,weighing 15-20 kg,were randomly divided into 3 groups (n =6 each):control group (group C),group CPB and modified ultrafiltration group (group MUF).The dogs were anesthetized with intraperitoneal 2.5％pentobarbital 25 mg/kg.Thoracotomy was performed in all the three groups and in addition lung injury was produced by CPB in CPB and MUF groups.In group MUF,modified ultrafiltration was performed at 10-15 min after termination of CPB.Arterial blood samples were collected before mechanical ventilation (T1),at end of CPB (T2),and at 1 h after termination of CPB (T3) to calculate respiration index (RI) and oxygenation index (OI).The lungs were removed for microscopic examination of pathologic changes in lung tissues under light microscope and for detection of AQP1 mRNA expression by real-time PCR.Results RI and OI were significantly higher and AQP1 mRNA expression was lower at T2 and T3 than at T1 in CPB and MUF groups (P ＜ 0.05).Compared with group C,RI was significantly increased and AQP1 mRNA expression was down-regulated at T2,3 in CPB and MUF groups,and OI at T2.3 in CPB group and at T2 in MUF group was decreased (P ＜ 0.05).Compared with group CBP,RI was significantly decreased,OI was increased and AQP1 mRNA expression was up-regulated at T3 in group MUF (P ＜ 0.05).Conclusion Modified ultrafiltration can reduce CPB-induced lung injury in dogs and upregulation of AQP1 may be involved in the mechanism.

Objective:To explore the correlation between enlarged perivascular spaces and other imaging markers of cerebrovascular disease in patients with ischemic stroke.Methods:Totally 287 patients with ischemic stroke hospitalized in neurology department from January 2018 to January 2019 were selected. According to the severity of EPVS in different parts of the brain, the correlations between the severity of EPVS in different parts of the brain and cerebral microbleeds (CMBs), white matter hyperintensity (WMH), lacunar infarcts (LIs) were analyzed. SPSS 22.0 software was used for analysis. Chi-square test, independent sample t-test, rank-sum test and non parametric Mann-Whitney U test were used for group comparison, and Logistic regression analysis was used for multivariate analysis. Results:EPVS was common and severe in patients with ischemic stroke. Periventricular white matter hyperintensity(PWMH)( β=1.604, P<0.001, OR=4.971, 95% CI=2.015-12.263), CMBs ( β=1.224, P=0.018, OR=3.339, 95% CI=1.232-9.383) and LIs ( β=0.626, P=0.047, OR=1.871, 95% CI=1.009-3.470) were independent risk factors for BG-EPVS. PWMH ( r=0.614), DWMH ( r=0.622), LIs ( r=0.532) were positively correlated with the severity of BG-EPVS (all P<0.01). Conclusion:The imaging makers of CSVD are related to BG-EPVS, which can affect the severity of brain BG-EPVS in patients with ischemic stroke.

Objective: To investigate the effects of orthokeratology lenses and frame glasses on anisometropia in children with low myopia in one eye. Methods: Between January 2017 and January 2018, 120 children of primary and secondary school age with myopic anisometropia low myopia in one eye presenting to the Second People s Hospital of Yunnan Province were selected as research objects,with average refractive error of(-1.00,-2.50)D in one eye and(-0.50,0.50)D in another eye. Participants were divided into an experimental group and a control group (60 cases per group), according to a random number grouping method. The control group were given frame glasses, while the experimental group were given orthokeratology lenses. A prospective study was conducted to compare and analyze the lengths of the posterior eye axis (AL) and spherical equivalent (SE), measured at different time intervals between the two groups. Results: There were some initial differences in AL and SE between the two groups before the experiment began; however, this difference was not statistically significant (P>0.05). After 12 months, participants myopic eyes given the orthokeratology lenses had shorter AL[(24.91±0.11)mm] compared to the control group[(25.02±0.09)mm],participants health eyes had longer AL[(24.58±0.24)mm] compared to the control group[(24.20±0.13)mm]. One month after the subjects stopped wearing plastic mirrors,participants myopic eyes had higher SE[(-2.22±0.78)D] compared to the control group[(-2.64±0.21)D],and had lower that in the control group[(-0.96±0.84)(-0.37±0.54)D](t=4.02，-4.58，P<0.05). Conclusion In children with low myopia in one eye, compared with wearers of frame glasses, wearing corneal shape lenses can effectively restrain AL extend and control the progression of eye myopia. At the same time, wearing corneal shape lenses can promote contralateral healthy eye axial extension and an increase in diopter, reduce the anisometropia value, solve the problems of a binocular visual axis development imbalance, and promote coordinated eye development.

Objective: To study the biomechanical property and histocompatibility of acellular porcine fascia so as to supply a new substitute material for tissue repair. Methods: Samples of normal porcine fascia, acellular porcine fascia and normal human fascia were prepared for histological and biomechanical examination. Xenogeneic fresh porcine fascia, acellular porcine fascia and allogeneic rabbit fascia were implanted into the back of rabbit. Tissues were taken for HE staining and histocompatibility test. Results: Histological examination showed that the cellular components which elicit immune rejections had been removed in the acellular porcine fasciam, with the complete extracellular matrix reserved. Arrangement of collagen fiber was loose in the acellular porcine fascia. The biomechanical performance test of the three samples showed that there was no significant difference in the extreme tensile strength (4.47±0.54) MPa, (4.49±0.91) MPa, (4.79±1.35) MPa for acellular porcine fascia, normal porcine fascia and normal human fascia respecively, P>0.05). There was no significant difference between acellular porcine fascia extracellular matrix and porcine fascia with the cell in breaking elongation (501.83%±52.01%, 661.17%±200.28%, P>0.05). However, there was a significant difference in the breaking elongation between human fascia (98.08%±26.02%)and the other 2 kinds of porcine fascia (P<0.01). Histocompatibility test showed the local reactions of the acellular porcine fascia group were weaker than the normal porcine fascia group. Conclusions With sound preparativemethod, the acellular porcine fascia has good biomechanical property and histocompatibility and may serve as a good alternative material for tissue repair.