The incidence of pediatric adenoid hypertrophy increases year by year. However, the treatment methods are limited. By now TCM treatment has showed significant clinical efficacy in treating pediatric adenoid hypertrophy. And phlegm could be one of the main pathogenic factors. By collecting relevant literature about TCM treatment for pediatric adenoid hypertrophy, this article summarized the thoughts of treating from phlegm based on the collection and analysis of classification of syndrome and treatment methods guided by the thoughts of treating from phlegm.

BACKGROUND: There are some limitations in induced differentiation of bone-marrow-derived mesenchymal stem cells (hBMSCs) and transplantation of nucleus pulposus cells (NPCs). Inhibition of autologous NPCs degeneration is expected to become an effective way for treatment of disc degeneration in the future. OBJECTIVE: To establish a layered coculture model of hBMSCs and NPCs in vitro, and to observe the effect of hBMSCs on the differentiation of NPCs. METHODS: The fourth passage of hBMSCs was divided into 2 groups. NPCs in the new-style layer culture group were incubated in Transwell cabin without arm, 0.4-μm membrane well; the proportion to BMSCs was 1: 1. NPCs in the traditional culture group were incubated in Transwell cabin with arm. NPC culture group was set. Each group was incubated for 7 days. Collagen Ⅱ was detected by immunohistochemical method. Aggrecan expression was detected by [~(35)S ]-sulfate uptake. RESULTS AND CONCLUSION: Compared with NPC culture group, collagen Ⅱ and aggrecan expression of NPCs were upregulated most evidently in new-style culture and traditional culture groups (P < 0.05, P < 0.01). The increased range of new-style culture group was greater than the traditional culture group (P < 0.05). These results suggested that coculture of BMSCs and NPCs can significantly increase NPC proliferation and specific substance expression. The surrounding of new-style culture surpassed the traditional culture.

Objective To investigate the clinical outcomes of arthroscopic decompression of spinoglenoid notch cysts and release of suprascapular nerve in treating suprascapular nerve compression syndromes via posterior portal.Methods Eleven patients from January 2010 to January 2017 with spinoglenoid notch cysts complicated suprascapular nerve compression syndromes were included.There were 7 males and 4 females with the average age of 41.5±5.3 years old (range 29-56 years) with 3 patients left side involved and 8 right side.All patients were diagnosed with MRI and EMG.The surgical procedure began with posterior capsule arthroscopic releasement from the labmm,then found the spinoglenoid notch cyst.Split of the cyst was made for internal drainage,then found the suprascapular nerve and vessel bundle for clearing the bursal tissue with probe,decompressed the suprascapular nerve finally.Mecobalamin was taken (0.5 mg,tid) until 3 months postoperatively.The patients were evaluated by functional scores from American Shoulder Elbow Surgeons (ASES) and Constant-Murley preoperatively and postoperatively.Statistical analysis was conducted by student t-test.Results All patients were followed up at 7-15 months (with an average of 10 months).The mean preoperative ASES score increased from 46.5±3.7 to 93.8±2.2 at the time of final follow-up with the significant difference (t=3.359,P＜0.05).Preoperative ASES score were good in 5 cases,fair in 4 cases and poor in 2 cases.The postoperative score were excellent in all patients.The Constant-Murley score was 47.3±4.2 preoperatively and 94.0±1.8 postoperatively with significant difference (t=4.776,P＜0.05).Preoperative score were good in 6 cases and fair in 5 cases.The postoperative score were excellent in all patients.These patients had no recurrence of cyst after surgery and returned to work.Conclusion Arthroscopic decompression of spinlglenoid notch cyst and suprascapular nerve release via posterior portal can successfully treat suprascapular nerve compression syndrome resulting in spinoglenoid notch cyst.