With the development of endoscopic techniques in recent years,therapeutic endoscopic retrograde cholangiopancreatography has replaced surgery as the first approach to the extraction of common bile duct stones.Endoscopic sphincterotomy and endoscopic papillary bal-loon dilation have become established endoscopic techniques for stone removal.However,it remains a challenge for endoscopists to remove large common bile duct stones.Emerging endoscopic modalities,such as endoscopic papillary large balloon dilation and cholangioscopy-guided laser or electrohydraulic lithotripsy,have been shown to be safe and effective for management of large common bile duct stones.This paper reviews recent advances in the endoscopic management of large common bile duct stones.

Totally 20 children with cerebral palsy of spastic type, aged 1.5-5.0 years, who were treated in Department of Children Nerve Rehabilitation, Nanhai Maternity and Kid Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine, were selected from March to December 2005. Of them, 11 cases were moderate degree of cerebral palsy and 9 cases were severe. The diagnostic criterion of cerebral palsy referred to the diagnostic criterion established at the Countrywide Special Topic Proseminar of Cerebral Palsy in 2004. The method to diagnose cerebral palsy of spastic type referred to the method of Cerebral Palsy Academy of United States in 1956. Cerebral palsy was clinically characterized by the very brisk reflex of extending. The degree was graded by mild, moderate and severe according to the paralyzed part, mental development, speech development, activity of daily living and complication. The children were promoted to stand and walk by themselves mainly with standing promoting training and with restraining method as complement. The course of treatment was 6 months. The curative effect was evaluated by the abducent angle of the hip joint, the angle of popliteal fossa, the dorsiflexion angle of ankle, and the forth item of gross motor function measure, which were measured before and after the treatment. Theresult showed that the range of motion of 20 children was improved. The score of gross motor function measure of standing item improved evidently. A total of 8 cases had significant effect and 12 cases had valid effect. The total effective rate was 100%.

Objective To investigate the clinical efficacy of fire needling plus moxibustion in treating prurigo nodularis. Methods Ninety patients with prurigo nodularis were randomly allocated to treatment and control groups, 45 cases. The treatment group received fire needling plus moxibustion and the control group, external application of halometasone ointment. Skin lesions and pruritus were scored in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Results There were statistically significant pre-/post-treatment differences in the skin lesion score and the pruritus score in the two groups (P<0.01,P<0.05). There were statistically significant post-treatment differences in the skin lesion score and the pruritus score between the treatment and control groups (P<0.01). The total efficacy rate was 81.8% in the treatment group and 60.5% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Fire needling plus moxibustion is an effective way to treat prurigo nodularis.

The serum samples and corresponding cervical swabs were collected fi'om 50 women with genital warts from Tianjin city,China.The neutralizing antibodies against HPV-16,-18,-58,-45,-6 and-11 in serum samples were tested by using pseudovirus-based neutralization assays and HPV DNAs in cervical swabs were also tested by using a typing kit that can detect 21 types of HPV.The results revealed that 36%(18/50)of sera were positive for type-specific neutralizing antibodies with a titer range of 160-2560,of which 22%(11/50),12%(6/50),10%(5/50),4%(2/50),4%(2/50)and 2%(1/50)were against HPVs-6,-16,-18,-58,.45 and-11,respectively.Additionally,60%(30/50)of samples were HPV DNA-positive,in which the most common types detected were HPV-68(18%),HPV-16(14%),HPV-58(12%),HPV-33(8%)and HPV-6,HPV-11,HPV-18 and HPV-52(6% each).The concordance between HPV DNA and corresponding neutralizing antibodies was 56%(28/50)with a significant difference(P＜0.05).The full-length sequences of five HPV types(HPV-42,-52,-53,-58 and-68)were determined and exhibited 98%-100% identities with their reported genomes.The present data may have utility for investigating the natural history of HPV infection and promote the development of HPV vaccines.

AIM　To investigate the chemical constituents from the rhizomes of Cimicifuga acerina (Sieb. et Zucc.) Tanaka. METHODS　Column chromatgraphy (including silica gel and ODS) together with HPLC was used to separate the chemical constituents whose structures were determined by FAB-MS, NMR (1D and 2D) and hydrolysis methods. RESULTS　Five cycloartane triterpenoids were isolated and identified as: (22R)-22-hydroxycimigenol (I), (22R)-22-hydroxy-24-O-acetylhydroshengmanol 3-O-β-D-xylopyranoside (II), dahurinol (III), 24-epi-24-O-acetyl-7,8-didehydroshengmanol 3-O-β-D-xylopyranoside (IV), 25-O-acetyl-7,8-didehydrocimigenol 3-O-β-D-xylopyranoside (V). CONCLUSION　Compound I is a new natural product, compound II is a new compound and compounds IV and V were isolated from this plant for the first time.

Objective To explore the imaging differential diagnosis of vascular malformations and intermediary character hemangiomas.Methods The roentgenographic,CT and MRI findings of vascular malformations and intermediary character hemangiomas in 58 cases were analysed retrospectively.Results In 42 cases with vascular malformations,the lesions were irregular with definite margins,and 5 cases showed the bone compressed adjacent to the lesions.31 patients studied with MRI ,3 cases appeared as hyperintensity(equal to fat) and 28 cases appeared as mixed hyperintensity(higher than that of fat) on T2WI,20 cases showed circular markedly vessel-like hyperintensity on T2WI .In 16 cases with intermediary character hemangiomas,7 cases showed circular soft tissue masses,the masses were lobulated in 8 cases and "crab nail" in 1 case,5 cases showed edema of around the tumors and occupying effect on CT and MRI,3 cases showed bone corroded adjacent to the lesions,2 cases showed bony destruction.Of the 11 patients studied with MRI,the lesions showed hyperintensity on T2WI.Conclusion The imaging findings of vascular malformations and intermediary character hemangiomas are different.

Objective: To investigate the clinical efficacies of fire acupuncture in treat various types of acne. Methods: An open test was designed. One thousand and eighty-six patients who visited for clinical service were collected as a sample. Results: The cure and marked effective rate was 78.5% for lung heat type, 80.8% for heat toxin type, 77.4% for disharmony of the Thoroughfare and Conception Vessels type and 80.1% for blood stasis and phlegm accumulation type. Statistical analysis showed no significant differences in therapeutic effect between different types (P>0.05). Conclusion: Fire acupuncture has an exact therapeutic effect on various types of acne without toxic side effects.

Background Trachoma is a serious blinding eye disease.At present,the incidence rate of trachoma in China has been greatly reduced with the unremitting efforts of World Health Orgnization (WHO) and Chinese government.However,in some economically underdeveloped areas,there is still active trachoma.Ohjective This study aimed to survey the prevalence of children's active trachoma in rural area of Naxi district and Jiangyang district of Luzhou city and assess the prevention and treatment outcome of trachoma during 10 years.Methods A cross-sectional study was performed in Naxi district and Jiangyang district of Luzhou city,the economic underdeveloping and water-starved regions in the year 2000.The active trachoma was screened in 214 school-age children with the male 113 and female 101 based on simplified trachoma grading system and trachoma rapid assessment survey standards and requirements of WHO.The symptoms of active trachoma were divided into trachomatous follicular (TF),trachomatous inflammation intense (TI),trachomatous scarring (TS),trachoma trichiasis (TT) and corneal opacities (CO).The epidemiological survey was re-assessed in 100 school-age children (with the male 58 and female 42) in these regions in the year 2013 to evaluate the prevalence change of children active trachoma during 10 years.Results In the year 2000,214 children were screened in 4 villages of Naxi district and Jiangyang district,and the prevalence rate of TF was 49.07％ (105/214) in the year 2000.The prevalence rate of TF was 49.05％ (52/106) in the Naxi district and 49.07％ (53/108) in the Jiangyang district,showing no significant difference between them (x2 =0.01,P =0.99).In the 100 school-age children who received survey in Naxi district and Jiangyang district in the year 2013,no TF,TF,TI,TS,TT and CO was found,showing no active trachoma.Conclusions The active trachoma has been controlled in rural areas of Luzhou city following the prevention and treatment of trachoma and the improvement of economic status in past decade.

Objective:To evaluate value of neuronavigator-assisted microsurgery of glioma located in cerebral functional areas.Methods:Patients with glioma located in cerebral functional areas were underwent operation in Xiangya Hospital.Of 64 patients,34 patients were performed neuronavigator-assisted microsurgery,and 30 were underwent routine surgical operation.Results:The neuronavigator-assisted microsurgery group showed high complete resection rate with low neurological deficit and cerebral edema compared with the routine surgical group (P＜0.05).Conclusion:Neuronavigator-assisted microsurgery is effective and characterized by accurate location,personalized operative incision design,and higher rate of tumor resection.

OBJECTIVE:To study the protective effects of Li medicine Chushi qufeng decoction on arthritis model rats. METH-ODS:60 rats were randomly divided into normal group,model group,positive group and Chushi qufeng decoction high-dose,me-dium-dose and low-dose groups [45.9,22.95,11.48 g(crude drug)/kg]. Except for normal group,those groups were given chicken type Ⅱ collagen to induce arthritis model. After modeling,normal group and model group were given normal saline intragastrical-ly,once a day,for consecutive 12 d;Chushi qufeng decoction groups were given relevant medicine intragastrically;positive group was given leflunomide 4.5 mg/kg on 1st-3rd day and 1.8 mg/kg on 4th-12th day. The degree of joint lesion in rats were scored. The degree of joint swelling was determined as well as the serum levels of TNF-α,IL-1β and type Ⅱ collagen antibody. RESULTS:Compared with normal group,arthritis index,degree of joint swelling,the serum levels of TNF-α,IL-1βand typeⅡcollagen anti-body increased significantly in model group (P<0.01). Compared with model group,pathological score of positive group and Chushi qufeng decoction high-dose group decreased significantly,and serum levels of TNF-α,IL-1β and type Ⅱ collagen antibody decreased significantly in treatment groups(P<0.05 or P<0.01). CONCLUSIONS:Li medicine Chushi qufeng decoction has cer-tain protective effect on arthritis model rats induced by chicken typeⅡcollagen.