Objective To prepare and identify the monoclonal antibody (mAb) specific to epithelial cell adhesion molecule (EpCAM) and explore the function of the mAb.Methods The EpCAM antigen expressed by the prokaryotic expression systems was used to immunize the BALB/c mice,and then the splenic cells from the mice were fused with the Sp2/0 cells to produce hybridomas secreting specific mAb.The positive clones were screened by the ELISA.The western blot analysis was used to identify the reactivity of the mAb to the antigen.Then the immunohistochemistry staining was used to detect EpCAM expression in the 3 primary colorectal carcinoma tissues.Results Three mAb specific to EpCAM were obtained by ELISA tests.Western blot results indicated that these three kinds of antibodies could react to the EpCAM antigen,but no response to the GST tag.Immunohistochemical staining results identified that these mAb could give positive signals to the primary colorectal carcinoma tissues from patients.Conclusion Three mAb specific to EpCAM are obtained and identified,which contributes to the diagnosis and therapy of the carcinoma in the future.

Objective To study the related factors of no or weak immune response after inoculation of hepatitis B vaccine .Meth‐ods 120casesofadultreceivedinoculationofhepatitisBvaccineinourhospitalwereenrolled,including60casesofnoweakre‐sponse and 60 cases of normal response ,they were divided into non response group and response group .Related factors of no or weakimmuneresponsewereanalyzed.Results (1)singlefactoranalysis:Therewerestatisticalsignificanceofage,gender,BMI, smoking history ,HBV potential infection ,CD4+ T cells and CD8+ T cell content ,IFN‐γand IL‐2 content between two groups ;(2) logistic regression analysis :old age ,male ,smoking history ,high values of BMI ,HPV latent infection ,low content of CD4+ T cells and IFN‐γand IL‐2 ,high content of CD8+ cells were risk factors of no or weak immune response after inoculation of hepatitis B vaccine .Conclusion No or weak immune response after inoculation of hepatitis B vaccine is affected by gender ,age ,smoking ,obesi‐ty ,potential infection of HPV and immune function ,and necessary measure should be taken .

Objective To explore the baggy eyelids anaplasty through posterior orbital septum fat displacement. Methods Orbital septum and posterior orbital septum fat were exposed through palpebral margin incision, internal orbital septum fat was released and sutured with arcuate expansion of capsulopalpebral fascia at the middle lower eyelid, which was taken as the function of tighting the flaccid lower eyelid at transverse direction. On such a basis, the muscle and skin were repaired and so did orbital septum and baggy eyelids.Results Ofthe 38 patients with this operation, baggy eyelids anaplasty was performed with satisfactory results.Conclusion The method of baggy eyelids plasty through posterior orbital septum fat displacement could reduce hemorrhage, prevent enophthalmos and decrease baggy eye palindromia, with better long-term effects.

Objective To observe the effect of Wenxiao Decoction in treating the patients with carotid atherosclerostic (CAS) plaque and assess the safety. Methods Sixty patients with CAS plaque were randomly allocated to treatment group (33 cases) and control group (27 cases). The control group was given routine therapy, and the treatment group was given Wenxiao Decoction additionally. And they were further divided into half-year treatment group and half-year control group, 1-year treatment group and 1-year control group. Carotid artery color Doppler ultrasound and hepatorenal function were examined before and after treatment. Results Compared with the control groups after therapy, the average numbers of plaques, maximal plaque thickness, Crouse plaque integral were decreased both in 1-year and half-year treatment groups (P<0.05, P<0.01). The plaque stability of 1-year treatment group was better than that of half-year treatment group. The average numbers of plaques, plaques size and Crouse plaque integral increased in control groups after routine therapy (P<0.05, P<0.01). Bilateral common carotid artery diameter, intima-medial thickness (IMT) and hepatorenal function had no statistical difference between before and after treatment both in treatment and control groups (P>0.05). Conclusion Wenxiao Decoction is effective and safe in treatment of CAS plaque, and plaque stability is more obvious with the extension of treatment time.

Objective To investigate the clinical characteristics and related risk factors of infarction secondary to severe traumatic brain injury.Methods 480 traumatic brain injury patients were chosen.Depending on the occurrence of cerebral infarction,patients were divided into TCI groups and non-TCI group,clinical symptoms and signs of TCI group were observed,and its related risk factors was analyzed.Results In 480 cases patients,there were 30 cases of patients with traumatic brain injury secondary to cerebral infarction,the rate was 6.25%.Clinical manifestations included unilateral limb motor and sensory dysfunction,visual dysfunction,language dysfunction,dizziness,headache.10 cases Prognosis were good,6 cases were mild disability,3 cases were severe disability,1 case was plant survival,10 patients died.Univariate analysis showed that the rates of aged ≥50 years,GCS score ＜ 8 points,hernia,hypotension,subarachnoid hemorrhage,large doses of non-dehydrating agent in the TCI group were higher than those of non-TCI group,the differences were statistically significant (x2 =12.311 3,14.725 4,19.867 8,5.296 9,9.242 6,11.713 6,all P ＜ 0.05).Logistic multivariate analysis showed that age ≥50 years,GCS score ＜ 8 points,hernia,cerebral hypotension were important risk factors.Conclusion Brain injury patients with cerebral infarction secondary to clinical manifestations have some characteristics.Age ≥50 years,GCS score ＜ 8 points,hernia,hypotension are important risk factors.

With the development of virtual reality, augmented reality, and mixed reality technology, their application in medical education has become increasingly widespread. With the advantages of virtuality-reality combination, real-time interaction and exact registration, mixed reality technology is expected to improve the drawbacks of traditional medical education, and exerts great potential in virtual classroom, virtual laboratory, anatomy teaching, medical operation training, surgery simulation, and telemedicine education. This article mainly introduces the applications of mixed reality technology in medical education in recent years, and hopes to provide a reference for the integration of mixed reality technology into the field of education.

Objective To investigate the efficiency of 16S rRNA Real-time reverse transcription PCR technique in the diagnosis of periprosthetic joint infection,and compare its sensitivity and specificity with conventional culture.Methods There were 43 revision cases from July 2013 to December 2015.Synovial fluid collected by puncture preoperatively,tissues from five different parts around the prosthesis collected intra-operatively were cultured by blood plate and BacT/Alert FN respectively.The 16S rRNA in interface membrane was detected by real-time reverse transcription PCR as a marker to diagnose PJI.At the same time,the synovial fluid was routinely bacterial cultured.We compared the sensitivity and specificity of two methods.Results There are 22 THAs and 21 TKAs respectively in 43 cases,23 cases diagnosed prosthetic joint infection and 20 cases diagnosed non prosthetic joint infection.The sensitivity of 16S rRNA Real-time reverse transcription PCR is higher than the conventional bacterial culture (78.2％ vs.47.8％).There was no difference in the specificity and PPV and NPV.For PCR in prosthetic joint infection group,Staphylococcus epidermidis in 5 cases,Staphylococcus aureus in 3 cases,streptococcus in 4 cases,E.coli in 2 cases,Staphylococcus lugdunensis,Pseudomonas aeruginosa,Staphylococcus haemolyticus and Mycoplasma in 1 case respectively.For culture in prosthetic joint infection group,Staphylococcus epidermidis in 5 cases,Staphylococcus aureus in 2 cases,Staphylococcus lugdunensis,Pseudomonas aeruginosa,Staphylococcus haemolyticus and E.coli in 1 case respectively.For non prosthetic joint infection group,PCR and culture are all negative.Conclusion The sensitivity of 16S rRNA Real-time reverse transcription PCR is higher than the conventional bacterial culture.

Objective To evaluate the role of hypoxia inducible factor?1α ( HIF?1α) in reduction of apoptosis in cortical neurons of rats by sevoflurane preconditioning and the relationship with Slit2∕Robo signaling pathway. Methods Primary cortical neurons obtained from neonatal Sprague?Dawley rats were seeded in 6?well (2 ml∕well) or 96?well plates (100 μl∕well) at a density of 1×106∕ml, and randomly divided into 4 groups ( n=24 each ) using a random number table: control group ( C group ) , anoxia?reoxygenation ( A∕R ) group, sevoflurane preconditioning group ( SP group ) and HIF?1α inhibitor 2?methoxyestradiol group ( H group ) . The neurons were subjected to O2?glucose deprivation for 90 min followed by restoration of O2?glucose supply for 24 h. In group SP, the neurons were exposed to 2%sevoflurane for 2 h followed by 5 min washout with phosphate buffered saline for 3 times, and then sevoflurane preconditioning was performed immediately. In group H, sevoflurane preconditioning was performed with 5μmol∕L 2?methoxyestradiol at 72 h of incubation. The apoptosis in neurons was assessed using AnnexinⅤ?FITC∕PI assay, and apoptosis rate ( AR) was calculated. The amount of lactic dehydrogenase ( LDH) released was measured using colorimetric method. The expression of Slit2, Robo1 and Robo4 mRNA and protein was detected by fluorescent quantitative real?time polymerase chain reaction or Western blot. Results Compared with group C, the amount of LDH released and AR were significantly increased, Silt2 and Robo1 mRNA and protein expression was up?regulated, and no significant change was found in Robo4 mRNA and protein expression in A∕R group. Compared with group A∕R, the amount of LDH released and AR were significantly decreased in SP and H groups, and Silt2 and Robo1 mRNA and protein expression was up?regulated, and no significant change was found in Robo4 mRNA and protein expression in SP group. Compared with group SP, the amount of LDH released and AR were significantly increased, and Silt2 and Robo1 mRNA and protein expression was down?regulated in H group. Conclusion HIF?1α mediates reduction of apoptosis in cortical neurons of rats by sevoflurane preconditioning, and the mechanism is associated with Slit2∕Robo1 signaling pathway, but not with Slit2∕Robo4 signaling pathway.

Objective To evaluate the role of hypoxia inducible factor-1α (HIF-1α) in reduction of apoptosis in cortical neurons of rats by sevoflurane preconditioning.Methods Primary cortical neurons obtained from neonatal Sprague-Dawley rats were seeded in 6-well plates (2 ml/well),and randomly divided into 4 groups (n =15 each) using a random number table:control group (C group),anoxiareoxygenation (A/R) group,sevoflurane preconditioning group (SP group) and HIF-1α inhibitor 2-methoxyestradiol group (H group).The neurons were subjected to O2-glucose deprivation for 90 min followed by restoration of O2-glucose supply for 24 h.In group SP,the neurons were exposed to 2.0％ sevoflurane for 2 h followed by 5 min washout for 3 times,and then sevoflurane preconditioning was performed immediately.In group H,sevoflurane preconditioning was performed at 72 h of incubation with 5 μmol/L 2-methoxyestradiol.The apoptosis in neurons was assessed using Annexin V-FITC/PI assay,and apoptosis rate was calculated.The expression of Bid,Bim,Puma and activated caspase-3 in neurons was detected by Western blot.Results Compared with group C,apoptosis rate was significantly increased,and the expression of Bid,Bim,Puma and activated caspase-3 was up-regulated in group A/R.Compared with group A/R,apoptosis rate was significantly decreased,and the expression of Bid,Bim,Puma and activated caspase-3 was down-regulated in group SP.Compared with group SP,apoptosis rate was significantly increased,and the expression of Bid,Bim,Puma and activated caspase-3 was up-regulated in group H.Conclusion HIF-1α mediates reduction of apoptosis in rat neurons by sevoflurane preconditioning,and down-regulated expression of Bid,Bim,and Puma is involved in the mechanism.

Objective To explore the influence factors of poor myocardial perfusion in patients with ST-segment elevation myocardial infarction( STEMI) after primary percutaneous coronary intervention(PCI). Methods One hundred and forty-three patients with first STEMI who were on admission from April 2010 to May 2014 and underwent primary PCI within 12 hours were enrolled as our subjects. According to the sum-ST-segment resolution(sumSTR)and TIMI myocardial perfusion grade(TMP)after primary PCI,all patients were divided into well myocardial perfusion group( sumSTR ≥ 50% or TMP 2 - 3 grade)and poor myocardial perfusion group(sumSTR < 50% and TMP 0 - 1 grade). The influence factors between two groups were collected and analyzed,including sex,age,pain to balloon time,blood pressure on admission,left ventricular ejection fraction,leucocyte count,neutrophil ratio(NR),high-sensitivity C-reactive protein(hs-CRP),blood lipid,and the history of hypertension,diabetes mellitus. Results The leucocytes count,NR,hs-CRP in patients of poor myocardial perfusion group were(11. 60 ± 3. 57)× 109 / L,0. 84 ± 0. 06 and 9. 80 ± 11. 37 mg/ L,higher than those in well myocardial perfusion group((9. 51 ± 2. 59)× 109 / L,0. 77 ± 0. 11 and(3. 83 ± 5. 58)mg/ L),and the differences were significant(t = 3. 497,P = 0. 001;t = 3. 390,P = 0. 001;t = 3. 973,P < 0. 001). Multiple linear regression analysis showed that neutrophil ratio was independent risk factor of sumSTR in STEMI patient after primary PCI(P = 0. 000). Conclusion The increase of leucocyte count,NR and hs-CRP are related to the poor myocardial perfusion after primary PCI. The increase of neutrophil ratio is an independent risk factor of poor myocardial perfusion.