Based on clinical features of refractory diseases and clinical practice experience for many years,the author expounded the therapeutic strategies from establishing individualized system of differentiation treatment,treatment strategies of refractory diseases,and the key for medication,and emphasized individual concerned therapy,separating primary and secondary treatment and grasping the physiological state to treat pathological changes.Thus complicated and changeable diseases can be treated clinically.

Objective To evaluate the performance of enzyme linked immunosorbent assay(ELISA)reagent kit of hepatitis B surface antigen(HBsAg)with Clinical and Laboratory Standards Institute(CLSI)document EP12-A2,and to compare two different manufacturer kits′performance.Methods According to CLSI document EP12-A2,to evaluate the performance of two different manufacturers′HBsAg ELISA kits.Results The positive rates both were ≥95% by using the kits of two manufacturers to detect the same sample with 120%of the critical concentration.The negative rates were both ≥95%by using the kits of two manufactur-ers to detect the same sample with 80% of the critical concentration.The intra assay coefficients of variation were ≤15%,and the interassay coefficients of variation were ≤20%.The sensitivities of two manufacturers′kits were respectively 94.2%(95%CI:84.3%-98.0%)and 92.3%(95%CI:81.8%-97.0%),and the specificities were 98.0%(95%CI:89.5%-99.6%)and 100.0%(95%CI:92.8%-100.0%).The 95%interval of sensitivity of two manufacturers′s kits was 5.46%-10.19%,and which of specificity of two manufacturers′s kits was -2.00%-5.32%.Conclusion The kits of two manufacturers can provide stable re-sults of HBsAg detection with concentrations ±20% outside the critical concentrations at the cutoff point with high sensitivity and specificity.Both of the kits have no significant differences in sensitivity and specificity.

[Objective]For more pertinently opening medical students mental health education course.[Methods]Through the issuance of 500 copies of ques-tionnaires, the current medical kind of col ege students' psychological health education curriculum requirements and attitude is researched. [Result] The medical specialty of college students ' psychological health status, with a certain degree of self adjustment ability, as wel as improvements to the curriculum and teaching methods are expected. [Conclusion]Recommended that through played curriculum, scientific curriculum, to strengthen the course construc-tion of improvements in areas such as mental health course.

BACKGROUND: Intra-articular fractures of the proximal tibia are complex periarticular fractures, for which, the best implant is the focus of clinical attention.
OBJECTIVE: To explore the application methods and therapeutic effects of different implants in the internal fixation of intra-articular fractures of the proximal tibia in order to choose the appropriate implants.
METHODS:From April 2006 to May 2012, 41 patients with intra-articular fractures of the proximal tibia combined with ligament tissue injury were selected at the Second Department of Orthopedics, the 401st PLA, who had received different implant internal fixations. According to the Schatzker classification, there were 18 cases of type IV, 12 of type V, and 11 of type VI. Bone defect also be bone;simultaneously or two rows ligament tissue repair observed fracture healing and functional recovery. Bone grafting was given in patients with bone defects, and ligament tissue repair was done simultaneously or at the second stage. Fracture healing and functional recovery were observed. Hospital of Chinese
RESULTS AND CONCLUSION:Al the 41 patients were fol owed up for 6-36 months. Bristol scores in al the patients were 32-50, with a mean score of 46. Excellent was in 20 cases, good in 13 cases, and fair in eight cases. The excellent-good rate was 80%. Implants were removed in 29 of 41 cases within 12-28 months after treatment. Treatment methods are selected based on the type of fractures. Good reduction and stable internal fixation are necessary. Less Invasive Stabilization System can provide the maximal stability and lead to lowest probability of axial and lateral fracture deviation and the lowest incidence of complications, which is the best choice.

Proteomics can explore the occurrence,development of diseases from the protein level.There is important significance for us to analyse the occurrence and development mechanism of the congenital malformation disease,the diagnosis of early embryo,prevention and intervention of birth defects of the occurrence of diseases using the method of proteomics research.This paper focuses on the latest progress in research of proteomics and its application in screening for congenital malformation diseases.

Microorganisms can affect the development of body immune system.Intestinal flora regulate immune function by promoting the intestinal immune system development,inducing T cell differentiation to avoid or reduce the incidence of immune-related diseases.Allergic diseases are related with the body's immune system hypoplasia and imperfect immune regulation mechanism.The immune system can be affected by intestinal flora,and the distribution of flora in the body between children with allergies and healthy children are significantly different,indicating that the occurrence of allergic diseases are associated with intestinal microflora.Studies have reported probiotic are helpful to the prevention and treatment of allergic disease,providing a new way for the prevention and treatment of allergic diseases.

Objective To observe the curative effect of Zhengqingfengtongning release tablets and lumbroki-nase enteric -coated capsules and losartan potassium tablets joint for the treatment of chronic nephritis proteinuria, and explore its mechanism.Methods 42 patients with chronic nephritis were randomly divided into two groups. 20 cases in the control group were given losartan potassium tablets,50mg,1 ~2 times a day.22 cases in the treatment group received Zhengqingfengtongning release tablets 120mg,2 times a day,lumbrokinase enteric -coated capsules 600 000u,3 times a day on the basis of the control group.The 24h urine protein,liver and kidney function before and after the treatment were observed.Results 20 days after treatment,24h urinary protein in the treatment group decreased 57.08%,which in the control group decreased 41.59%,the difference was statistically significant (t =2.39,P <0.05).30 days after treatment,24h urinary protein in the treatment group decreased 81.28%,which in the control group decreased 52.34%,the difference was statistically significant (t =3.65,P <0.01 ).Renal function change had no significant difference between the two groups.Conclusion Zhengqingfengtongning release tablets and lumbrokinase enteric -coated capsules combined with losartan potassium tablets in the treatment of chronic nephritis proteinuria work fast,and has good curative effect,less side effects,and is worth to recommend.

Objective To investigate the effect of electroacupuncture plus functional exercise in patients with olecranon comminuted fracture.Method Seventy-sevenpatients with olecranon comminuted fracture were enrolled as the subjects and allocated, using a random numbertable, to a control group (38cases) and a treatment group (39 cases).The control group received routine rehabilitation such as postoperative functional exercise and the treatment group, electroacupuncture in addition.Inthe two groups of patients, the pain score was recorded at one,sevenand fourteen days after the surgery; elbow joint activity was examined at two days and two months after the surgery; the elbow function score was recorded at six months after the surgery.Result There was no statistically significant difference in the pain score between the twogroupsat one day after the surgery (P>0.05).Thepain score was lower in the treatment group than in the control group atsevenand fourteen days after the surgery (P<0.05).There was no statistically significant difference in elbow jointactivity between the two groupsat two days after the surgery (P>0.05). Elbow joint activity was larger in the treatment group than in the control group at two months after the surgery (P<0.05).The elbow HSS score was higher in the treatment group than in the control group at six months after the surgery (P<0.05).Conclusion Electroacupuncture plus functional exercise can effectively decrease the pain score and increase elbow joint activity and the elbow function score in patients with olecranon comminuted fracture.It has greater value in clinical application.

No significant difference in peak amplitude, duration, latency and wave integral between A-DRP and CDP-P_1 was electrophysiologically observed in control and capsaicin-treated adult rats which had been injected at birth with capsaicin(50mg/kg,s.c.), when the sural nerves were stimulated. However, the most of C-DRP and CDP-P_2 lack. These were consistent with the changs of peripheral action potentials. The above results suggest that PAD on myelinated primary afferent fibres produced by incoming volleys in the larger afferent is not affected by a lifelong loss of Group Ⅳ afferent, but the afferent responses of amall fibres disapear.

OBJECTIVE:To establish the quality criteria for Xiaoyan tablets. METHODS: Herba Taraxaci and Herba Violae in the formula were identified qualitatively by TLC and the content of Baicalin was determined by HPLC on Zorbax SB-C18(250 mm?4.6 mm,5 ?m) column with mobile phase consisted of acetonitrile-0.4%H3PO4(24∶76) at a flow rate of 1.0 mL?min-1. The detection wavelength was set at 280 nm and the column temperature was set at room temperature. RESULTS: Herba Taraxaci and Herba Violae could be detected by TLC. The linear range of Baicalin was 0.08～2.49 ?g(r=0.999 9). The average recovery rate was 100.24%(RSD=1.52%,n=6).CONCLUSION: The establish criteria are suitable for the quality control of Xiaoyan tablets.