YKL-40 (human cartilage glycoprotein 39) is a newly discovered inflammatory cytokine, which belongs to the member of 18 glycosyl hydrolase of mammal family. Previous studies have indicated that YKL-40 is associated with the acute or chronic inflammatory diseases and tumors. Studies in recent years have suggested that YKL-40 may be involved in the occurrence and development of atherosclerotic plaques, and it is correlated with the plaque instability. The physiological function and the mechanisms of YKL-40 are not fully understood. It may have the roes of promoting vascular smooth muscle migration and proliferation, promoting cell adhesion and proliferation, as well as regulating extracellular matrix remodeling The detection of YKL-40 may have some significance in the aided diagnosis, predicting prognosis, prevention of cardiocerebrovascular diseases, and even the establishment of new therapeutic strategies.

Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) can be induced in ischemia and other pathological states and mediate neuronal apoptosis after cerebral ischemia.Understanding the upregulation mechanism of TRAIL in ischemic brain tissue is promising to develop new treatment for stroke.

Objective To compare inhibitory effects among extract of Radix tripterygii wilfordii (RTW),dexamethasone and diclofenac sodium on nitric oxide (NO) production and inducible isoform of nitric oxide synthase (iNOS) activity in chondrocytes of patient with rheumatoid arthritis,and to explore cartilage protection of three kinds of medicines in the treatment of rheumatoid arthritis (RA).Methods Chondrocytes from the resected knee joint cartilage of patients with RA were isolated and cultured.The chondrocytes were stimulated by IL 1,and at the same time the cells were treated with RTW,dexamethasone and diclofenac sodium in different concentration overnight.Supernatants were collected to detect the content of NO with Griess reagent.Chondrocytes were collected to examine the iNOS activity by detecting the conversion of L 14 C arginine into L 14 C citruline.The total RNA of chondrocytes was extracted and the iNOS mRNA was examined by Northern blot.Results RTW inhibited NO production and iNOS activity in different concentration (2,4,8 and 16 mg/L).The maximal inhibitory rates were 81 1% and 84 3% respectively.Such inhibitory effects were dosage dependent.Corresponding to NO and iNOS,RTW inhibited the expression of iNOS mRNA induced by IL 1 in chondrocytes.Dexamethasone inhibited NO production,iNOS activity and iNOS mRNA expression significantly,the maximal inhibitory rate around 50%,but not dosage dependent.Diclofenac sodium only had 12 9% inhibitory effect.Conclusion RTW and dexamethasone both inhibited NO production by chondrocytes,but inhibitory effect of dexamethasone was limited.Diclofenac sodium only had weak inhibitory effect.

Direct oral anticoagulants,include direct thrombin inhibitor and direct factor Xa inhibitor.As the pharmacokinetics and pharmacodynamics of these drugs are known,their plasma concentration is not food-effective,and theoretically it is not necessary to monitor routinely.However, clinical practice in recent years has shown that anticoagulant effect of DOACs is required to evaluate in patients with thrombosis, major bleeding, emergency surgery, hepatic/renal dysfunction and other special situations.Recent studies have shown that routine coagulation assays such as activated partial thromboplastin time(APTT) and thrombin time(TT) can be used as laboratory screening tests for direct thrombin inhibitor dabigatran and prothrombin time(PT) can be used as laboratory screening test for direct factor Xa inhibitor rivaroxaban.DOAC′s quantitative measurements include dilute thrombin time(dTT),hemoclot thrombin inhibitor (HTI),ecarin clotting time (ECT) and ecarin chromogenic assay (ECA) for direct thrombin inhibitor and anti-FXa assay(rivaroxaban calibration) for rivaroxaban.Laboratories should establish their own monitoring range when performing these assays.

Manual microscopic differential of white blood cell has been challenged by multiparameter flow cytometry,using monoclonal antibodies to define the different leukocyte types.Compared with manual differential,flow cytometry method is more sensitive,specific,objective and has good repeatability.Recent studies demonstrated flow cytometric differential correlates well with manual microscopic method and has good clinical performance for blast and immature granulocyte.Meanwhile more leukocyte populations can be identified with flow cytometric method,such as lymphocyte subset and CD 16 + monocyte,thus helping in monitoring blast in acute leukemia,B lymphocyte proliferative disorder differential diagnosis and minimal residual disease.With the development and improvement of flow cytometric differential,it might be a candidate reference method of leukocyte differential,gradually applied in the routine work.

Objective To investigate the effects of environmental enrichment (EE) on the neurological functions in patients with stroke. Methods From May, 2013 to November, 2015, 76 patients with stroke were selected and randomly divided into control group (n=39) and EE group (n=37). Both groups received routine therapy and the EE group received EE in addition. They were assessed with simplified Fugl-Meyer Assessment (FMA), Montreal Cognitive Assessment (MoCA) and modified Barthel Index (MBI) before and after treatment. Re-sults The scores of FMA, MoCA and MBI increased in both groups after treatment (t>2.339, P<0.05), and the scores of MoCA and MBI in-creased more in the EE group than in the control group (t>2.187, P<0.05). Conclusion EE could promote the recovery of cognitive function and activities of daily living in patients with stroke.

Objective Using chemically synthesized small interfering RNA (siRNA) transfected HepG2.2.15 cells to construct a cell model in interfering hepatitis B virus (HBV) X gene, studying the inhibi-tion of HBV replication and antigen expression in vitro. Methods After transfection of HepG2.2.15 cell for 24 h, 48 h, 72 h, detecting the cell supernatant of HBsAg and HBeAg by chemiluminescence immunoassay, the cell supernatant HBxAg protein by ELISA , the HBx mRNA relative expression of transfected cell was detected by fluorescence quantitative polymerase chain reaction (PCR), the ability of cell proliferation was detected by CCK-8 assay. Results After HBx-siRNA transfected HepG2.2.15 cells, cell proliferation ability was inhibited. The cell of HBx mRNA and the cell supernatant of HBxAg expression decreased (P < 0.05); at the same time it in-hibited the expression of HBsAg and HBeAg. The suppressed peak and the inhibition rate were 66% and 58%respectively at 72 h. The fluorescence quantitative PCR confirmed that expression of HBV DNA in the super-natant was decreased. Conclusion The HepG2.2.15 cell interference model of HBV X gene has been success-fully constructed, which has an effect of inhibiting proliferation of HepG2.2.15 cells and replication and expres-sion of HBV gene in vitro.

Objective To study the influence of the angle of multileaf collimator leaves on segments (control point for sliding windows) number and monitor units in intensity-modulated radiotherapy (IMRT) plan optimization.Methods 10 cases undergone IMRT with rectangle target volume were choosed,2 plan were designed with step and shot technique and sliding windows technique for running direction of collimator with target long axis vertical and parallel respectively,compared the plans with similar optimization parameters for different angle of the collimator.Results The number of segments and monitor units increased by 52.8％ and 49.6％ more than longitudinal direction of leaf collimator with static IMRT respectively,there appeared significant difference (P =0.000) ; and the number of segments and monitor units increased by 58.2％ and 61.9％ more than longitudinal direction of leaf collimator with dynamic IMRT respectively,there appeared significant difference (P =0.000).Conclusions For the optimization of IMRT based on multileaf collimator,the direction of collimator perpendicular to the target long axis,there could be obviously decrease the number of monitor units,shorten the treatment time,improve the treatment efficiency with similar dose distribution.

Objective To investigate the clinical features of paroxysmal kinesigenic dyskinesia (PKD) and the mutation features of its pathogenic gene proline-rich transmenbrane protein 2 (PRRT2). Method The clinical manifestations and genetic tests of one case of PKD were retrospectively analyzed, and the related literatures were reviewed. Results A 10 year and 9 month male patient was recruited. The age of dyskinesias onset was 7 year and 6 month. The descriptions of the attacks were abnormal involuntary movements which were induced by sudden voluntary movements and presented with dystonia. The frequency of the attacks was three to ifve times per day with the duration lasting ten to twenty seconds, and there is no loss of consciousness. Treatment with oxcarbazepine is effective. A heterozygous mutation in PRRT2 gene, c.649_650insC (p. 217fs224X), was found by genetic testing, and the mutation was inherited from the patient’s mother who showed no symptom of PKD. Conclusion The onset age of PKD could be in the childhood and adolescence. The attack is provoked by sudden movements and the duration time is short. Treatment with antiepileptic drug is effective. The test of PRRT2 gene may help diagnosis. Mutation c.649_650insC is the hotspot mutation of the gene.

Objective To establish a coupled model combining the rat brain nuclei microelectrode recordings and the behavioristics for rehabilitation experiment. Methods The modified indwelling tube connection fixed device was put inside the rats' back, and the microprobes were implanted into related neural nucleus. A signal connection was made between self-administration system and electrophysiological data acquisition system. The rat was addicted after training by self-administration system. The related cerebral nucleus electrophysiological sig-nals were recorded in different states of addiction. Results and Conclusion The modified indwelling tube connection fixed device has a bet-ter quality for reducing the phenomenon of leak. The signal was well in the combination of two different systems. The signals for the rat's ac-tion and neural electrical were recorded in the same time.