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.

Rectal prolapse is a rare disease, has been attracting many surgeons to study it.Surgical treatment of rectal prolapse is currently more than 50 kinds, most of which are modifications of several basic modes treatment, depending on the doctor' s grasp on the patient anatomy.Currently comprehensive treatment of a variety of therapies is a more ideal way for the treatment of rectal prolapse.

Objective To assess the efficacy of surgical treatment and the prognostic factors predicting survival for patients with local recurrence of rectal cancer. Methods The clinical data of 43 rectal cancer patients who received reoperation at Beijing Cancer Hospital from November 1998 to April 2005 were retrospectively analyzed. The postoperative 5-year survival, incidence of complications, perioperative mortality were calculated. Postoperative survival was analyzed by Kaplan-Meier method and prognostic factors by univariate analysis and Cox proportional hazard regression model. Results Of all patients, 35 underwent radical resection, 8 underwent palliative resection or colostomy. The incidence of complications, perioperative mortality and postoperative 5-year survival were 26% (11/43), 2% (1/43) and 9% (4/43), respectively. Patients who received radical resec-tion, with primary tumor of TNM Ⅱ stage, with normal level of carcinoembryonic antigen, and with the time of recurrence within postoperative 24 months had better prognosis (χ~2 = 21.30, 14.17, 5.93, 5.53, P < 0.05). Modality of reoperation and TNM staging of primary tumor were the independent factors influcing the prognosis (χ~2 = 8.89, 6.96, P < 0.05). Conclusion Radical resection for patients with postoperative local recurrence of rectal cancer results in a favorable prognosis.

Objective An innovation of operative procedure with biological repair of ligaments for the treatment of acromioclavicular dislocation. Methods Based on the anatomy, physiology, and biomechanics, the operation was designed for restoring the stability of a completely dislocated acromioclavicular joint. Through bone holes drilled along the direction of coracoclavicular ligament fibers, the synthetic absorbable suture was used to rebuild the coracoclavicular ligament for vertical stability of the joint, and then a double loop suture was performed to rebuild acromioclavicular ligament and the capsule for horizontal stability. This biomechanical repair was simple, rapid procedure, and of less tissue trauma. The acromioclavicular joint was steadily fixed without any metallic imbedding, nor interference with joint surface. Results With 1－ 2.5 years follow up, 11 patients recovered with good healing, normal range of shoulder joint motion, and stable fixation. There was no need for secondary procedure to remove the sutures. The curative results of all patients were A degree based on the Karlsson s evaluation. There was no any complication. Conclusion The synthetic absorbable suture could be used with satisfaction for the repair of acromioclavicular dislocation. Compared with routine fixation with metallic material, the new kind of biofixation was not only effective, but also avoided the need of a second procedure for suture removal.

Objective To observe the clinical curative effect of Danhong injection combined with atorvastatin calcium in the treatment of lacunar cerebral infarction of the elderly.. Methods 125 elderly patients with lacunar cerebral infarction were randomly recruited into two groups, a control group(n=60 cases) was treated with atorvastatin calcium on the basis of conventional symptomatic treatment, and an observation group (n=65 cases) was treated with Danhong injection combined with atorvastatin calcium on the basis of conventional symptomatic treatment, the courses of two groups were 14 d. The clinical curative effect, the degree of nerve function defect score, the changes of hemorheology of two groups before and after the treatment were compared. Results The total effective rate of the observation group(89.2%)was significantly higher than that of the control group(71.7%)(P<0.05). The degree of nerve function defect score(16.24±4.63)of observation group after treatment improved significantly better than that of control group(22.17±7.38), P<0.05, and the whole blood viscosity(high), whole blood viscosity(low), plasma viscosity and fibrinogen [(3.62±0.64)mPa?s,(8.07±2.45)mPa?s, (1.61±0.30)mPa?s, (2.76±0.28)g/L]decreased significantly than that of the control group[(4.73±0.85)mPa?s, (9.86±3.26)mPa?s, (2.05±0.33)mPa?s,(3.94±0.35)g/L], P<0.05. Conclusion The treatment of Danhong injection combined with atorvastatin calcium for elderly lacunar cerebral infarction had a good therapeutic effect. It could improve nerve function defect degree and blood rheology indexes.

Objective To investigate the medication advancement of gastrointestinal polyposis in patients with Peutz-Jeghers syndrome(PJS).Methods Literatures about the medication advancement on gastrointestinal polyposis of PJS were reviewed and analyzed.The recent development of targeting drugs,especially the data of cyclooxygenase-2 selective inhibitors and rapamycin,were emphatically summarized.Results With the deep investigation of PJS and application of selective drugs,the medication of gastrointestinal polyposis in cases of PJS has got more advancement.The extensive use of synthetic cyclooxygenase-2 inhibitors and rapamycin in clinic developed a new way to treat gastrointestinal polyposis of PJS.Conclusion The cyclooxygenase-2 selective inhibitors and rapamycin have the following features: noninvasive,high selectivity and good curative effects.They have splendid prospects in the clinical treatment of gastrointestinal polyposis in patients with PJS and are bring the treatment of gastrointestinal polyposis in cases of PJS into a targeting therapy phase.

OBJECTIVE To investigate spectrum distribution of pathogens in patients with artificial airway and analyze their associated factors.METHODS The clinical data of 27 patients with tracheal intubation or tracheotomy from Mar 2005 to Mar 2006 were analyzed retrospectively.RESULTS Twenty seven patients were diagnosed as pneumonia.A total of 384 isolates of pathogens were collected from 258 sputum culture.The most were Gram-negative bacilli(293 isolates),and then were Gram-positive cocci and fungi.The four most pathogens were Pseudomonas aeruginosa,Stenotrophomonas maltophilia,meticillin-resistant Staphylococcus aureus(MRSA) and Acinetobacter baumannii.More multiple drug resistant(MDR) pathogens were detected in patients two weeks after intubation or tracheotomy than that after one week,and it was the same with sensitive rates to antibiotics of G-bacilli.CONCLUSIONS Patients with artificial airways have a higher morbidity of MDR pathogens and longer retention time of artificial airway can increase infection of MDR pathogens of lower respiratory tract.

Matrix metalloproteinases(MMP) are a family of Zn~(2+)-dependent endopeptidases capable of cleaving components of extracellular matrix(ECM).MMP-1 was the first vertebrate collagenase purified as a protein and cloned as a cDNA,and is considered the prototype for all the interstitial collagenases.It is synthesized as a zymogen.Its N-terminal residues are removed by proteolysis and it shares with other MMPs a catalytic domain and a carboxy terminal domain with the sequence similar to hemopexin.(MMP-1) should be considered as a multifunctional molecule since it participates not only in the turnover of collagen fibrils in the extracellular space but also in the cleavage of a number of nonmatrix substrates and cell surface molecules,suggesting an important role in the regulation of cellular behaviour.Furthermore,an extensive body of evidence indicates that MMP-1 plays an important role in diverse physiologic processes such as growth,tissue morphogenesis,and wound repair.Likewise,it seems to be implicated in a variety of human diseases including atherosclerosis,rheumatoid arthritis,pulmonary emphysema,and fibrotic disorders,suggesting that its inhibition or stimulation may open therapeutic avenues.

The study includes 2 experiments. Experiment 1: 24 male weanling Wistar rats were divided into 3 groups, with 8 rats in each group:zinc-deficient group (ZD), pair-fed group (PF), zinc-sufficient group (ZS). The experiment term was 30 days, and the items observed were feed intake, body weight, serum zinc, tibia zinc, serum vitamin A and liver vitamin A. The results showed that Zn-deficient rats could not mobilize liver vitamin A into their blood normally. Experiment 2; 40 male weanling Wistar rats were raised with Zn-deficient feed for 30 days, then they were divided into 4 groups randomly, keeping 7 rats in each group:Zn-deficient group (ZD), Zn-treatment group I(ZT1), Zn-treatment group II(ZT2), Zn-treatment group III(ZT3), their daily Zn dosages were 0.63 umol, 1,89 umol, 3.80 umol respectively. The treatment lasted for 6 days. The results demonstrated that serum zinc and vitamin A concentrations of the 3 Zn-treated groups were much higher than that of ZD group. In contrast, their liver vitamin A concentrations were much lower than that of ZD group.

Captopril (CPT, 40, 80mg/kg, ig) enhanced serum superoxide dismutaseactivity, and suppressed luminal-dependent chemiluminescence of peritoneal macrophagesin mice. CPT (160mg/kg, ig) had a suppressive action on lipid peroxidation of mice. Theseresults suggested that CPT had antioxygen free radical effect or anti-lipid peroxidationeffects. CPT at 25 ?g/ml concentration suppressed ConA-induced prolifeation of mousesplenic T lymphocytes in vitro, which suggested that CPT had a suppressive effct on Tlymphocyte function.