The directed molecular evolution of enzyme in vitro can not only improve the efficiency of evolution, but also evolve enzyme according to the investigator's desire. This review summed up the feasible methods of this novel technique.

Objective: To study the extraction process of the total flavones of Pollen Typhae ( Typha angustifolia L.). Methods: The optimum extraction process was selected with the orthogonal design. The content of total flavones was determined by UV spectrophotometry. Results: The significant effects of alcohol concentration, extraction time and extraction times on the extraction of total flavones were discovered. Conclusion: The optimum extraction process was as follows: Pollen Typhae was extracted with 70% alcohol for 3 times, with the solvent volume 8, 6, 6 times amount and extraction time 60, 60, 30 minutes in turn.

[Objective]To analyze the clinical effect of intertrochanteric fractures treated with percutaneous proximal femoral nails(PFN).[Method]From January 2004 to May 2009,PFN using percutaneous technique was performed in 180 elderly patients of femoral intertrochanteric fractures(180 hips,80 males and 98 females),with mean age of 76 years(range from 57-99 years).According to Evans classification,12 cases were type Ⅰ,28 were type Ⅱ,62 were Ⅲa,20 were Ⅲb,49 were Ⅳ,9 were Ⅴ.Traction table and C-arm fluroscopic intensifier were used with close reduction and interlocking during the course of operation.[Result]One hundred and seventy two cases in 180 patients were followed up for 8 to 21 months with a mean of 13.5 months.Other 8 patients were lost to follow up after discharge.Of 172 patients followed up,166 cases' radiographs showed the callus during 6-8 weeks postoperatively,while they had a full range of hip motion as the original level.Partial weight bearing exercises were carried out since the 8th postoperative week.The time of clinical fracture healing was from 12 to 16 weeks,the rate of healing was 98.8%.In the function assessment of 172 patients the satisfactory rate reached to 87.8 percents.[Conclusion]Percutaneous proximal femoral nails is an ideal way for the treatment of intertrochanteric fractures in aged because of its simple procedure,minimal invasion,less fluoroscopy exposures,less complications,stable fixation,early fracture healing and satisfied functional outcomes.

Haizhenyuye(HY) is a nourishment made from fresh Stichopus japonicus Se-lecka and traditional Chinese medicine herbs. It can enhance hematopoiesical and immuologi-cal function, prevent and treat a decrease in the WBC Count caused by cyclophosphamide (CTX). Through prevention effect on rats by HY, we can prove that HY can increase the levels of WBC,Hb,PC,reticulocytes and improve hematopiesis. HY is a marine nourishment with great values.

Objective To dump and recover the expired data in No.1 Military Medical Project, avoiding the waste of large amount of storage space and improving the operation performance of hospital information system. Methods After clearing the backup table, the data from the original table backup was put into the backup table. The data was unloaded from the backup table to a file, and then the file was saved. The data in the original table was deleted, but it could be restored to the table when needed, and the corresponding data could be obtained through the application program. Results The storage space was enlarged after data dump. Conclusion The dump of the expired data can make data management more scientific and hospital information system run more smoothly.

The concept of EMR is described and the problems of EMR application are analyzed including restrictions on change permissions and writing time of EMR, and sounds in medical record management mechanism to ensure legality and effectiveness of record. Based on improvement of national policy, third-party management services institutions are estab- lished and related suggestions on technical and environmental support of EMR development are provided, and the future of its development in our country are expected.

Objective To evaluate the value of preoperative spiral CT (SCT) scanning in the diagnosis and staging of middle-late stage rectal carcinoma. Methods The results of SCT scanning of 34 patients with middle-late stage rectal carcinomas were compared with the pathological examination results and the findings of surgical operation. Results SCT could display the manifestations of middle-late stage rectal carcinoma, such as rectal wall thickening, local tumor mass, tumor invasion of rectal circumference, narrow rectal cava, lymph node enlarging (diameter≥10mm) and tumor distant metastasis. According to Duke's staging, the overall accuracy of SCT staging was 70.6%, and for the stages B1, B2, C, and D the sensitivity was 83.3%, 50%, 66.7%, 78.5%, and the specificity was 62.5%, 44.4%, 57.1%, 100%, respectively. According to TNM staging, the overall accuracy of SCT was 73.5%, and for the stages T2, T3, T4 the sensitivity was 85.7%, 61.5%, 78.6%, and the specificity was 54.5%, 66.7%, 100%, respectively. Conclusion Preoperative SCT could display the invasive range of middle-late stage rectal carcinoma and the tumor lymph nodes metastasis, especially distant metastasis, and had a definite diagnostic value.

Intracranial artery stenosis is one of the main causes inducing transient ischemic attack (TIA) or cerebral ischemic stroke. Being a minimally-invasive and reliably-effective technique, intracranial artery stent angioplasty has brought about a new approach for the treatment of intracranial artery stenosis , and thus provides more opportunities to the patients who are not suitable for intracranial vascular bypass surgery. However, the higher occurrence of perioperative complications caused by stent angioplasty should be seriously taken into consideration by clinical physicians. In order to reduce the occurrence of complications , in this paper the perioperative complications of stent angioplasty for intracranial artery stenosis are analyzed , and the therapeutic strategies as well as the proper approaches are discussed.

Objective To observe the influence of total glucosides of peony (TGP) combined with leflunomide on serum level of TNF-α,IL-8 in the patients with psoriatic arthritis(PsA) ,to evaluate its efficacy and safety and to preliminarily study its action mechanism .Methods The open clinical study was adopted .36 patients with PsA were treated by TGP combined with leflunomide for 12 weeks .at the same time 20 healthy control were selected .The double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) was adopted to detect the level of serum TNF-α and IL-8 before treatment and in 12 weeks after treatmention the two groups .The Psoriasis Area And Severity Index (PASI) was adopted as the main effective index and the Health Assessment Ques-tionaire(HAQ) was taken as the secondary effective index .The level of CRP ,ESR ,TNF-α,IL-8 before and after treatment were an-alysed .Results The serum TNF-α,IL-8 levels before therapy in the poriatic arthritis group were significantly higher than those in the normal control group(P<0 .05);after 12 weeks ,PASI ,HAQ ,serum TNF-αand IL-8 levels in the treatment group were signifi-cantly improved than those before treatment ,the difference had statistical significance(P<0 .01) ,and the serum TNF-α,IL-8 levels were similar to those in the healthy control group without statistical difference (P>0 .05) .Conclusion TGP combined leflunomide for treating PsA has better effect and better safety ,which could play the role by influencing serum TNF-α,IL-8 levels .

The brain—type creatine kinase isoenzyme (CK—BB)in the cerebrospinal fluid(CSF) within 24 hs following trauma was measured in 62 cases with acute head injuries by chromatography and fluorometry, and the comparative analysis was made between CSF-CK-BB activities and the outcome of the patients in 6 months after trauma according to Glasgow Outcome Scale(GOS),The results showed that the determinations of CSF-CKBB activities,in combination with Glasgow coma Scale (GCS) can be used as an early objective diagnostic index for assessing the prognosis ,and there was a reference value for improving accuracy of evaluating recovery of neurological disfunction in the patients with acute head injuries.