Objective To determine the effectiveness of ETCD ( endoscopic transpapillary cyst drainage) in treatmen! of pancreatic pseudocysts. Methods Twenty-six patients with pancreatic pesudocysts were selected. They are presented some indications for treatment and the pesudocyst were ranged in size from 1.5 to 15 cm. Of 23 cases 38 sessions of ETCD were performed. In two of thirty-eight cases the cyst bulges were invisible in the stomach or duodenum due to its compression. In one case ETCD was employed after percutaneous drainage of the pseudocyst, the other one was treated after combination therapy of plastic stent ing because of jaundice. Results Improvement of abdominal pain, changes in appetite, body weight and fat in stool were recorded in follow-ups of 60 ~ 850 days. There was only one asymptomatic recurrence. One case was complicated with pancreatic abscess. There was no mortality related to the procedure. Surgical intervention became necessary in three cases because of inadequate drainage or complication. Conclusion ETCD treatment of symptomatic pancreatic pseudocysts with ductal communication, the transpapillary pancreatic duct stenting is a safe, effective modality and should be considered as the first line therapy; on the other hand for those pancreatic pseudocyst without communication to the main pancreatic duct it is not effective.

Objective To evaluate a new type of bone graft material made by combining bFGF,BMP with AACB in the clinic repair of ANFH(avascular necrosis of the femoral head)in animal experiments.Methods The combined material of bFGF/BMP/AACB was made and then this composite was transplanted to the models of canine femoral head defects and necrosis established by liquid nitrogen freezing,The specimens were harvested respectively at the end of three,six and 12 weeks after operation.A series of examinations were carried out to evaluate the repair results,including gross observation,radiography,histology,image pattern analy sis,blood vessel immuhistochemical staining,EDAX(energy dispersion analysis X-ray),and mechanical measurement.Results All the animals had no toxic or inflammatory reactions.Little new bone formed in group A(control group)by the end of 12 weeks.Group B(AACB group)was better than group A,and group C(BMP/AACB group)better than group B in osteogenesis.All the results showed that group D(bFGF/BMP/AACB group)was much superior to groups A,B and C in angiogenesis and osteogenesis at all intervals,and even better than group E(bone autograft group)by the end of three weeks and six weeks.By the end of 12 weeks,bone repairing and remodeling effects in group D were as good as in group E.Conclusions Since the bFGF/BMP/AACB compsite has great potential for enhacing revascularization and osteogenesis in repairing the defect and necrosis model of canine femoral head,it can be used as a substitute bone graft material for clinical patients with ANFH.

The Chinese acupuncture doesn't only belong to China but rather to the world.The boom of overseas acupuncture education and scientific research as well as the satisfactory working environment compels us to reflect the Chinese traditional medicine education in our country.Especially in higher education specialty courses of acupuncture should not be subdivided;meanwhile,much attention should be paid to elementary education of western medicine.

BACKGROUND:Clinical y, bone marrow mesenchymal stem cel s combined with artificial bones for early osteonecrosis of the femoral head have a wonderful outcome.
OBJECTIVE:To review the biological properties of bone marrow mesenchymal stem cel s and to summarize the application progress of bone marrow mesenchymal stem cel s combined with different artificial bones in the treatment of early osteonecrosis of the femoral head.
METHODS:PubMed (2003-2013), FMJS (2003-2013), Wanfang (2005-2013), CNKI (2005-2013) and CBM (2005-2013) databases were retrieved by computer using the keywords of“bone marrow mesenchymal stem cel s;artificial bone;osteonecrosis of the femoral head”in Chinese and English.
RESULTS AND CONCLUSION:It wil lower the pressure of the femoral head, accelerate repair of the blood capil ary, improve the blood supply, osteoblast proliferation and differentiation, and thus delay or even prevent artificial joint replacement after osteonecrosis of the femoral head by applying bone marrow mesenchymal stem cel s combined with different artificial bones, such as corl ine hydroxyapatite, calcium hydroxylaptite, biological ceramics and calcium sulfate bones. But now, there are stil a lot of problems which need to be solved, including pathological mechanism underlying bone marrow mesenchymal stem cel s for treatment of osteonecrosis of the femoral head, obvious difference between the quantity and quality of seed cel s because of individual difference, different sites and culture techniques. So, artificial bone materials are under review, and large-sample randomized control trials are required. Its long-term outcomes also lack for fol ow-up observation, as wel as there is no a unified quantitative standard for the appropriate selection of indication, curative effect evaluation and the awareness of the operation.

Objective To investigate the efficacy and safety of ERCP for biliary stricture with duct stone after liver transplantation.Methods Clinical data of 60 patients undergoing ERCP for biliary stricture with duct stone after liver transplantation between January 2013 and June 2014 were retrospectively analyzed.Results ERCP was successfully performed 78 times in 60 patients.Bile duct stenosis was cured in 24 cases (40％),improvement was observed in 27 cases (45％) and was not obvious in 9 cases (15％).Bile duct stones were successfully removed in 39 patients (65％).Incidence of post-ERCP complications was 13％ (8/60),including mild pancreatitis in 1 case,hyperamylasemia in 5 cases,biliary tract infection in 2 cases,which were all resolved after conservative treatment.Conclusion ERCP is a safe and effective treatment for biliary stricture with duct stone following liver transplantation.

Objective To study the immunological pathogenesis of gluteal muscle contracture. Methods In 43 children with gluteal muscle contracture and 22 normal control cases, peripheral blood T-lymphocytes, B-lymphocyte and its subset were analyzed with flow cytometry. Results The percent of CD4+, B-lymphocyte and CD4+/CD8+ in children with gluteal muscle contracture were all significantly higher than those in the control(P0.05). Conclusion There is disorder of immunological regulation in children with gluteal muscle contracture. Immunologic factors may play an important role in the pathogenesis of gluteal muscle contracture.

BACKGROUND:Single scaffold materials have some shortcomings to some extent or in different ranges. Therefore, new composite materials are developed in recent year, which are compounded by two or more materials with complementary characteristics in a certain manner or ratio.
OBJECTIVE:To investigate the histocompatibility and osteogenic induction of geneX artificial bone combined with bone marrow mesenchymal stem cel s and transforming growth factor beta 2 (TGF-β2).
METHODS:Injectable geneX was co-cultured with bone marrow mesenchymal stem cel s for 5 days, and under the electron microscope, the histocompatibility of the artificial bone was observed. Passage 3 rabbit bone marrow mesenchymal stem cel s were divided into three groups:simple cel group cultured with osteogenic medium, cel scaffold group cultured with geneX+osteogenic medium, combined group cultured with geneX+TGF-β2+osteogenic medium. After 7, 14, 21 days, cel morphology, alkaline phosphatase activity detection, MTT detection, methyl thymol blue detection and alizarin red staining were performed.
RESULTS AND CONCLUSION:After osteogenic induction, bone marrow mesenchymal stem cel s were fibroblast-like cel s and adhered to the surface of geneX bone with strong secretion of extracel ular matrix. Cel proliferation and osteogenic activity in the combined group were stronger than those in the simple cel and cel scaffold groups (P<0.05). The alkaline phosphatase activity was also higher in the combined group than the other two groups. These findings indicate that the geneX/bone marrow mesenchymal stem cel s/TGF-β2 composite has good histocompatibility and pro-osteogenic differentiation ability.

Objective To study on the metal clip installation to avoid post-operative bleeding in pa- tients accepted papilla sphinctecotomy.Methods One hundred and eighty five patients who accepted ERCP +EST were divided into two groups:Group 1 was given routine regimen alone(N=95),group 2,given routine regimen and metal clip to prevent post-operative bleeding.Results The postoperative bleeding hap- pened in 3(3.2%)cases of Group 1 and none in Group 2,there is significant difference between these two groups(P＜0.05).The breeding cases in group 1 were controlled by metal clip under endoscopy successful- ly.Conclusion Preventive usage of metal clip was significantly decreased the incidence of post-operative bleeding in EST patients.

The TCM acupuncture education for foreign students is complicated and technical work.The writer discusses the modern teaching methods recently to aim directly at the problems in the traditional teaching methods in foreign students education,analyzes and compares the connotation and teaching mode of these teaching methods,and at last puts forward that we should choose correct teaching method according to the actuality to improve the teaching quality for foreign students in TCM acupuncture.

Objective To evaluate the efficacy and safety of fully covered self-expandable metal stents (FCSEMS) implanted by endoscopic retrograde cholangiopancreatography (ERCP) for patients with benign biliary stricture (BBS).Methods The clinical data of 38 patients with BBS underwent ERCP and FCSEMS placement between January 2012 and January 2016 were retrospectively recorded.Success rate of BBS,adverse events related to ERCP and stricture recurrence were analyzed.Results A total of 38 patients underwent FCSEMS placement with a mean time of stent in dwelling for 8 months (range:3-13months).During follow-up after the stent was removed,death of 1 patient after liver transplantation was due to unrelated cause.The mean follow-up time was 13 months (range:2-52 months) for other patients.Stricture recurrence occurred in 6 patients,including 2 cases of gallstone-related biliary strictures,1 case of chronic pancreatitis-related biliary strictures,2 cases of liver transplantation-related biliary strictures,and 1 case of post surgical-related biliary strictures.Stricture resolution occurred in 31 cases with 83.8％ (31/37) success rate,including 90.0％ (18/20) gallstone-related biliary strictures,75.0％ (3/4) chronic pancreatitis-related biliary strictures,80.0％ (8/10) liver transplantation-related biliary strictures,and 66.7％ (2/3)post surgical-related biliary strictures.The incidence of post-ERCP complications was 21.1％ (8/38),including mild pancreatitis in 5 case,hyperamylasemia in 2 cases,cholangitis in 1 case.All patients were cured by conservative treatment.Conclusion FCSEMS are effective and safe for BBS.Further studies are needed to assess the indwelling time of FCSEMS,whether FCSEMS are superior to multiple plastic stents and the different efficacy of FCSEMS for BBS caused by different etiology.