The transient period of 7 years which is regulated in 2004/24/EC Director is due to 2011. This paper discussed the changing of traditional herbal drug regulation, the increasing of herbal monographs and lists, extending the scope of the simplified registration procedure in European Union. The purpose was to promote traditional Chinese medicine to enter the market.

Objective To compare the clinical outcomes of different drains in total knee arthroplasty.Methods Fifty-five patients,who had accepted primary unilateral total knee arthroplasty from October 2010 to November 2012,were included in the comparative study.Based on different drainage ways,25 patients were arranged into autotransfusion drain group,18 into routine drain group,and 12 into delayed drain group.Same operative procedure and postoperative care were provided to all patients.The total amount of postoperative drainage (including intraoperative blood loss),information of allogenic blood transfusion,body temperatures of patients on postoperative 1st,3rd,7th day,pre-and post-operative hemoglobin level,and postoperative swelling,wound healing quality and range of motion were recorded and compared.Results The amount of drainage was significantly more in autotransfusion drain group (799.2±196.7ml)than those in other two groups (381.7±129.2 ml in delayed drain group and 666.1±155.0ml in routine drain group).The postoperative hemoglobin level in delayed drain group (91.50±7.92 g/L)was similar to that in autotransfusion group (91.96±9.57 g/L),while significantly higher than that in routine drain group (81.33±9.86 g/L).The highest body temperature of patients in autotransfusion drain group was higher than those in other two groups.Allogenic blood transfusion was performed in 8 patients (44.4％) in routine drain group,4 patients (16.0％) in autotransfusion drain group and 2 patients (16.7％) in delayed drain group.There were no differences between groups in swelling,wound healing quality,and range of motion.Conclusion Delayed release of drain in total knee arthroplasty could reduce blood loss,chances of allogenic blood transfusion and postoperative fever,and extra cost,which can bring more benefits to patients.

Objective To explore the effects of adriamycin-loaded immuno-nanoparticles on multidrug resistance (MDR) of hepatoma cell line SMMC-7721/ADM. Methods The cytotoxicity of the adriamycin-loaded immuno-nanoparticles on the bepatoma cell line SMMC-7721/ADM in vitro and the tumor cell-binding ability of adriamycin-loaded immuno-nanoparticles were detected. Results The effect of the cytotoxicity of adriamycin-loaded immuno-nanoparticles on the hepatoma cell line SMMC-7721/ADM was significantly better than that of adriamycin-loaded nanoparticles. Adriamycin-loaded immuno-nanoparticles had the specific binding ability with the hepatoma cell line SMMC-7721/ADM. Conclusions Adriamycin-loaded immuno-nanoparticles can overcome the MDR of the tumor in vitro. The mechanism may be that immuno-nanoparticles could adhere to the tumor cell membrane, and the release of the loaded adriamycin creates a high local concentration in the extracellular medium. The increased concentration gradient improves the diffusion of adriamycin from the extracellular medium to the intracellular medium.

Objective To analyze the risk factors for healthcare-associated pneumonia (HAP) in patients with orthopedic injury,provide the basis for making prevention and control measures.Methods HAP occurred in patients with orthopedic injury and admitted to the department of orthopedics of a hospital from June 2011 to May 2015 were investigated retrospectively,risk factors were analyzed by univariate and multivariate logistic regression methods.Results A total of 2 578 patients with orthopedic injury were investigated,92 patients developed HAI,incidence of HAP was 3.57％.107 strains of pathogens were detected,the major were Klebsiella pneumoniae (n =22,20.56％),Escherichia coli (n =14,13.08％),and Acinetobacter baumannii (n =13,12.15％).Risk factors for HAP in patients with orthopedic injury were length of hospital stay≥15 days,smoking history≥3 years,bedridden ≥7 days,associated with underlying diseases,complications,indwelling catheter≥7 days,surgical operation,mechanical ventilation,admitted to intensive care unit,open injury,blood sugar≥11 mmol/L,plasma albumin＜30 g/ L,hemoglobin concentration＜90 g/L,and use of glucocorticoid≥4 days (all P＜0.05).Multivariate logistic regression analysis showed that smoking,bedridden,surgery,mechanical ventilation,glucocorticoid use,and anaemia were independent risk factors for HAP in patients with orthopedic injury.Conclusion The occurrence of HAP in patients with orthopedic injury is related with multiple factors,the major are surgical operation,mechanical ventilation,glucocorticoid use,long term smoking,bedridden,and anaemia.

Objective To calibrate and assess the dose distribution of 125 I seed brachytherapy. Methods Twenty 125 I seeds, each with activity of 12.2 MBq, were implanted on the circumference of a circle 15mm across in a phantom. Into a designed prostate model, 70 125 I seeds were implanted in four planes. The absorbed dose rate of the target volume was monitored by Farmar 2570 dosimeter and thermoluminescence dosimeters (TLD) with the isodose curves drawn on Kodak films. Results The central dose rates of the circular target volume assessed by Farmar 2570 and TLD were 8.4, 7.9 cGy/h in the phantom and 12.0, 11.1 cGy/h in the prostate model. For the target volume of the prostate model, the total absorbed dose was 24?219 cGy. The dose rate 4 cm from the prostate cancer as shown by the isodose curves was only 10% of the central dose rate. Conclusion The central dose rate of target volume measured by the two methods are similar.

Objective To study effects of multimodal analgesia on postoperative delirium (POD)in elder patients with hip fracture.Methods One hundred and eight elder patients with hip fractures were gathered in a prospective study.Fifty-nine cases were included in the group of multimodal analgesia (25 males,34 females),with an average age of 72.91±5.42 years,and 35 were treated with hip replacements,the other 24 were internal fixations.Forty-nine cases were in the group of conventional analgesia (22 males,27 females),with an average age of 72.14±4.93 years,29 were treated with hip replacements,20 were internal fixations.Assessments of delirium were based on confusion assessment method.Local infiltrated anesthesia,patient control intravenous analgesia,and intravenous nonsteroid anti-inflammatory drug were applied in the group of multimodal analgesia.For the other group,morphine would be given only when patient complained pain or there was POD.Postoperatively,visual analogue scale (VAS),onset of delirium,other correlative data were recorded by an independent researcher.All patients underwent POD were managed with intensive pain management,and then reevaluated.Results VAS in multimodal analgesia group [Day1:2.10±1.43(resting),4.74±1.45 (active) and Day 3:1.01±0.92 (resting),3.31±1.36 (active)] were significandy lower than that in the other group [Day1:4.67±1.33 (resting),7.44±1.59 (active)and Day 3:2.24±1.39 (resting),5.06±1.46 (active)].PODs were detected in 15 (30.6％) in group of conventional analgesia; while in group of multimodal analgesia,there were 7 (11.9％).All POD were given intensive pain managements by injection of 10 mg morphine and achieved relief of deliriums.Conclusion Postoperative multimodal analgesia may reduce the incidence of POD.First aid of intensive pain management may help to control POD.

OBJECTIVETo compare shear bond strength (SBS) between two types of silicone soft liner and polymethyl methacrylate (PMMA) under the condition of heat curing and room temperature curing.

METHODSA total of 48 PMMA specimens (50 mm x 10 mm x 3 mm) were made by water-bath heating method, and randomly divided into four groups. By using Ufi Gel P (UGP) as soft liner material, group A1 was prepared under heat curing, and group A2 was prepared under room temperature curing. To form the other two groups, Silagum-Comfort (SLC) as soft-liner material was used. Group B1 was prepared under heat curing, and group B2 was prepared under room temperature curing. Shear bond strength (SBS) was tested by using the electronic universal testing machine. The adhesives layer and surface of silastic and PMMA were observed by optical microscope and scanning electron microscopy (SEM).

RESULTSThe SBS of groups A1, A2, B1, B2 were (2.39 +/- 0.24), (1.74 +/- 0.27), (3.09 +/- 0.26), and (2.21 +/- 0.29) MPa, respectively. Significant differences were found between A1 and A2, B1 and B2, A1 and B1, and A2 and B2 (P < 0.05). Optical microscope showed numerous bubbles in the cured UGP, and no air bubbles in the SLC. The surface of PMMA was rough. SEM images showed that each group had continual consistent adhesive interface and a whisker hump on the adhesive layer of A2 and B2.

CONCLUSIONThe SBS ofUGP, SLC, and PMMA achieved minimum clinical standard of 0.44 MPa. The SBS of UGP and PMMA were higher than that of SLC and PMMA. The polymerization method of heat curing was higher than room temperature curing.

94 cases with 148 abutments treated by all-ceramic restoration in premaxillary teeth region were randomly divided into 4 groups, and the impressions were prepared by one-step method,double curettage method,double polish method and double microfilm method respec-tively using 3M ESPE Vinyl polysiloxane as impression material.The cervical margin precision of the impressions was compared.Four kinds of impression method can produce qualified impression.Double polish method is easy to teach and learn.

Objective:To evaluate the cytotoxicity of colorized zirconia ceramics.Methods:Zirconia ceramic 3Y-TZP blocks were colorized by NH4 VO3 ,FeCl3 ,Co(NO3 )3 ,Ni(NO3 )3 and MoCl3 respectively.The cytotoxicity of colorized zirconia to L-929 cells was examined by immersion method and MTT assay.Results:During 3 days culture,L929 cells in all groups showed similar prolifera-tion and normal morphology.The toxicity gradation of all groups was 0 -I.Conclusion:Zirconia ceramics colorized with the 5 kinds of colorants has no cytotoxicity.