OBJECTIVE: To investigate the selections of radionucide and vehicle and the indications, contraindications, complications and cautions of radiation synovectomy in clinical applications; meanwhile, to provide valuable references for clinical application of radiation synovectomy.DATA SOURCES: Of 277 articles which have the word "radiation synovectomy" or "radiosynovectomy" were searched out from PubMed database without limitations.STUDY SELECTION: All the titles and most abstracts of the articles were reviewed. A total of 58 articles were selected by the standard of having close relations with radionucide, vehicle and radiation synovectomy. Then the full texts were searched in other available databases, especially in "OVID" and "ScienceDirect".DATA EXTRACTION: The last articles and articles published in authority journals were chosen for further read, and 41 articles were obtained.DATA SYNTHESIS: Recently, the hot topic of radionucide is detailed as follows: Firstly, selection of vehicle. Till now, silicate, citrate, Ca oxalate, ferric hydroxide macroaggregate (FHMA), hydroxyapatite (HA), polylactic acid (PLA), sulfur colloids, microspheres, etc. Have been the most widely used vehicles. The usage of a good vehicle is to control the size and stability of the radiopharmaceutical, and decrease its leakage from the joint. Secondly, it should contain radiopharmaceuticals of nuclein and vehicle. An ideal radiolabeled radiopharmaceutical for radiation synovectomy should meet the following requirements: ① it should be sufficiently small to be phagocytized, but not so small that it might leak from the joint before being phagocytized, the appropriate size range is usually considered to be from 2 to 10 μm; ② the binding between the radionuclide and the vehicle should be irreversible throughout the course of the radiotherapy, which, in turn, is determined by the physical half-life of the radionuclide; ③ the radiolabeled particles should be distributed homogeneously in the joint without initiating an inflammatory response; ④ the half-life of the vehicle should be longer than that of the nuclide it combines,and the vehicle should be biodegradable, so that it can be eliminated out of the body after therapy; ⑤ good stability and low cost are also very important features. Thirdly, Radiation synovectomy is an effective method to treat chronic arthritis.CONCLUSION: With careful nuclide and indication selection and correct operation, radiation synovectomy is a clinically useful, safe, and cost-effective outpatient procedure in the treatment for many kinds of joint disease.

Objective: To observe the clinical effect of depakine (sodium valproate) in the treatment of childhood epilepsy.　Methods:78 epileptic children were treated with either godilum valproate sustained-release tablets or syrups according to their ages, the control degree of the seizures were observed and reexamination of liver function and blood routine were carried at periodically.　Results: Of the 78 cases, 58 cases (74.4 percent) were completely controlled, 10 cases (12.8 percent) significantly improved, 5 cases (6.4 percent) improved, 5 cases (6.4 percent) remained the same. The total effective rate was 93.6 percent.　Conclusion: Depakine is a new broad-spectrum, easily used anti-epliepsy drug. Its efficacy is significant and there are different dosage forms to be selected and no significant adverse reactions. So depakine is the first selection in treating childhood epilepsy and suited for clinical application.

Objective To investigate the clinical efficacy and safety of decompression in the treatment of large jaw cystic lesions.Methods 42 patients suffered from large jaw cystic lesions were randomly divided into two groups,21 patients in the control group performed the traditional curettage surgery;21 patients in the experiment group performed the decompression surgery.The intraoperative blood loss,operative time,the incidence rate of postoperative pain and postoperative infection,follow-up recurrence rate were compared between the two groups.Results The intraoperative blood loss,operative time,postoperative pain and postoperative infection rates of the experiment group were significantly better than the control group,the differences between two groups were significant(P ＜ 0.05).The recurrence rate of the control group and the experiment group was 24.0％,4.8％.The recurrence rate of the experiment group was significantly lower than the control group (P ＜ 0.05).Conclusion Compared to the traditional curettage surgery,decompression surgery can reduce blood loss,shorter operative time,reduce postoperative infection,reduce the risk of recurrence,then improve the clinical efficacy.

Objective To investigate the feasibility and clinical results under laparoscopic resection of colorectal cancer.Methods Clinical data of 17 colorectal cancer patients with laparoscopic resection from October 2009 to September 2011 were analyzed.Results There were 16 cases of successful completion of laparoscopic surgery,conversion to open surgery in 1 case.Postoperative of incomplete intestinal obstruction and rectal vaginal fistula are each 1 case.Oncology did not occur metastasis through puncture holes in postoperative follow-up up to 2 years.Conclusion Laparoscopic resection of colorectal cancer should be widely applied,and it had more advantages such as less trauma,safety,recover quickly,consistent with the effect of laparotomy.

Objective:To investigate the perioperative issues on the elderly patients undergoing total knee arthroplasty.Methods:Seventy nine knees from 62 patients ≥75 years of age received total knee arthroplasty from September 2000 to January 2006,the operative result and perioperative complications were reported.Results:Sixty one cases were followed up for 28 months(ranging from 6 to 58 months),according to the hospital for special surgery(HSS) knee rating scale,the HSS scores were improved after the operation from 27.18?7.01 preoperatively to 76.24?6.08 postoperatively(P

Objective To explore the levels of IL-1β,IL-6 and tumor necrosis factor α (TNF α) in serum and cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage and their relationship with systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS).Methods The levels of interleukin-1β(IL-1β),interleukin-6(IL-6),and TNF α in serum and cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage were measured with enzyme-linked immunosorbent assay (ELISA).Results The levels of IL-1β,IL-6,and TNFα in serum and cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage were significantly higher than those of control group (P ＜ 0.05),but the increased time of these cytokines was different.Three cytokines in serum and the cerebrospinal fluid levels of IL-1β and IL-6 but not TNFα were significantly related to SIRS and MODS.Condusions The increased cytokine levels in serum and cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage may be related to SIRS and MODS,and the measurement of IL-1β,IL-6,and TNFαin serum,and IL-1β and IL-6 in cerebrospinal fluid of patients with spontaneous subarachnoid hemorrhage can be useful to predict and treat SIRS and MODS.

Objective To investigate the result of arthroscopic surgery in the treatment of sinus tarsi syndrome. Methods The study involved 15 patients (6 males and 9 females) with sinus tarsi syndrome admitted to First Hospital of Nanjing from July 2006 to May 2008. The age of the patients ranged from 23 to 63 years ( average 46.3 years). All the patients had one side involvement, including 10 patients with left side involvement and five with right side involvement. All the operations were performed under the tourniquet control and the patients were placed at the lateral decubitus position. The lateral, anterolateral and posterolateral portals were applied intraoperatively and the medial portal was applied when necessary. Visual analogue scale (VAS) and American orthopedic foot and ankle scale (AOFAS) ankle-hindfoot scale were used for follow-up evaluation. Results More than two lesions were found under arthroscope in all patients. The lesions included scar tissue hypertrophy and inflammation in the sinus tarsal canal, soft tissue impingement in the subtalar joint, synovitis, partial tears of subtalar capsule, interosseous talocalcaneal ligament or cervical ligament, cartilage injury and subtalar degeneration. All patients were followed up for 19-35 months (mean 26. 1 months). At the final follow-up, the VAS score was improved from preoperative 7.6 points ( range 6-9 points) to postoperative 2.5 points (range 1-4 points) (P＜0.01 ), and the AOFAS score improved from preoperative 41. 9 points (range 20-67 points) to postoperative 83. 1 points ( range 70-100 points) ( P ＜ 0. 01 ). The excellence rate of the AOFAS score reached 73% at the final follow-up. Conclusion For patients with sinus tarsi syndrome after a failed conservative treatment, arthroscopic surgery should be performed as soon as possible and the clinical result is satisfactory.

Objective: To analyze the effects of technetium99 conjugated with methylene diphosphonate(99Tc-MDP) on adjuvant arthritis in rats.Methods: Thirty SD rats were randomly and equally divided into a normal control group an adjuvant arthritis control group and a 99Tc-MDP treatment group.Intraperitoneal injection of 99Tc-MDP(2.5?10-3?g/kg) was given to the rats in the treatment group on the tenth day and repeated every other day after arthritis induction.The left-right diameter of the left hind ankle,arthritic index,serum TNF and IL-1? levels,articular radionuclide imaging and histopathological changes were observed.Results: Compared with the adjuvant arthritis group,the diameter of the left hind ankle,arthritic index,the serum TNF and IL-1? levels and the T/NT value were decreased in the treatment group,and histopathology showed less synovium hyperplasia and fewer infiltration of inflammatory cells in the group treated with 99Tc-MDP intraperitoneal injection than in the adjuvant arthritis control group.Conclusion: 99Tc-MDP intraperitoneal injection is effective for adjuvant arthritis in rats.

Objective To investigate the prevalence and risk factors of metabolic syndrome (MS) in residents in Pudong New District of Shanghai. MethodsA total of 5 584 residents aged 20-80 years were randomly selected from Pudong New District of Shanghai through multistage sampling and interviewed from April to July of 2008. Metabolic syndrome was defined according to three diagnostic criteria for MS, issued by the modified National Cholesterol Education Program Adult Treatment Panel Ⅲ criteria ( NCEP-ATP Ⅲ ), International Diabetes Federation (IDF), and Chinese Diabetes Society (CDS). ResultsThe crude prevalences of MS in the adult population in Pudong New District were 18.2％ and 13.1％ standardized ( male 19. 1％, female 17.4％, the age-standardized 15.6％ and 13.2％ ) with CDS criterion, 31.8％ and 24.4％ standardized ( male 28.4％ ,female 35.1％ ,the agestandardized 22. 7％ and 25.0％ ) with NCEP-ATP Ⅲ criterion, and 21.7％ and 17.0％ standardized ( male 15.9％ ,female 26.7％, the age-standardized 13.8％ and 19.2％ ) with IDF criterion. The age-specific prevalence of MS increased according to three diagnostic criteria, and the age-adjusted prevalence was higher in males than females in junior age groups and higher in females than males in senior ones. Significant differences were present among region, education, marriage status, smoking, work intensity, recreation, and physical activity according to some diagnostic criteria. ConclusionsSubstantial proportions of adults in Pudong New District of Shanghai suffer from metabolic syndrome, and there exists a tendency for young people involved. MS has become a noteworthy public health problem. It suggests that community-integrated control strategy of MS should be made a priority.

Objective Investigate and intervene the psychological health state of clinical trainees in the hospital of Yuxi City, in order to explore the method to improve the psychological health and clinical quality of teaching. Methods From 2009 to 2013, clinical trainees were investigated by SCL-90. Intervention for interns included holding psychological health lectures and making psychological counseling for the serious interns. At the same time, the teachers were trained to carry out two-way intervention between the teachers and clinic interns and to improve clinical interns' psychological health. Results Before the intervention,among 216 interns,34 (15.74%) showed positive. Except fear factor, other factors were significantly different than national norms ( <0.05). After the intervention, among 149 interns, 20 ( 13.42%) showed positive. Obsessive-compulsive symptom, depression,anxiety,hostility, spirit factors and the mean scores were all lower than before ( <0.05),similar to the national norm.Conclusion Clinical trainees have prominent psychological problems. Teaching hospitals should pay more attention to psychological health of them. Intervention is necessary and effective in improving psychological health and quality of teaching.