Objective:To discuss the effect of CD40 ligand(CD40L)on the biological behavior of the human monocytic leukemia THP-1 cells through long non-coding RNA(lncRNA)linc00239,and to clarify its potential mechanism.Methods:The linc00239 over-expression vector(pcDNA-linc00239)and interference vector(sh-linc00239)were constructed and transfected into the THP-1 cells.Real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the transfection efficiency.The THP-1 cells were divided into control group,vector group,pcDNA-linc00239 group,sh-linc00239 group,vector+CD40L group,pcDNA-linc00239+CD40L group,and sh-linc00239+CD40L group.RT-qPCR method was used to detect the expression levels of linc00239 in the cells in various groups;CCK-8 assay was used to detect the proliferation activities of the cells in various groups;flow cytometry was used to detect the percentages of the cells at different cell cycles and the apoptotic rates of the cells in various groups;RT-qPCR and Western blotting methods were used to to detect the expression levels of B-cell lymphoma-2(Bcl-2)and Bcl-2-associated X protein(Bax)mRNA and proteins in the cells in various groups;Western blotting method was used to detect the expression levels of protein kinase B(AKT)and phosphorylated AKT(p-AKT)proteins in the cells in various groups,and the ratio of p-AKT/AKT was calculated.Results:Compared with vector group,the proliferation activity of the cells and the percentage of the cells at G2 phase in pcDNA-linc00239 group were significantly increased(P<0.05 or P<0.01),the expression levels of linc00239,Bcl-2 mRNA and protein,and the ratio of p-AKT/AKT were significantly increased(P<0.05 or P<0.01),the percentage of the cells at G1 phase,apoptotic rate,and expression levels of Bax mRNA and protein in the cells were significantly decreased(P<0.05);compared with vector group,the proliferation activity of the cells and percentage of the cells at G2 phase,expression levels of linc00239,Bcl-2 mRNA and protein,and ratio of p-AKT/AKT in the cells in sh-linc00239 group and vector+CD40L group were significantly decreased(P<0.05 or P<0.01),while the percentage of the cells at G1 phase,apoptotic rate,and the expression levels of Bax mRNA and protein in the cells were significantly increased(P<0.05 or P<0.01);compared with pcDNA-linc00239 group,the proliferation activity of the cells and percentage of cells at G2 phase in pcDNA-linc00239+CD40L group were significantly decreased(P<0.05 or P<0.01),the expression levels of linc00239,Bcl-2 mRNA and protein,and ratio of p-AKT/AKT were significantly decreased(P<0.05 or P<0.01),while the percentage of cells at G1 phase,apoptotic rate,and the expression levels of Bax mRNA and protein were significantly increased(P<0.05 or P<0.01);compared with sh-linc00239 group,the proliferation activity of the cells and percentage of cells at G2 phase in sh-linc00239+CD40L group were significantly decreased(P<0.05 or P<0.01),the expression levels of linc00239,Bcl-2 mRNA and protein,and ratio of p-AKT/AKT were significantly decreased(P<0.05 or P<0.01),and the percentage of the cells at G1 phase,apoptotic rate,and expression levels of Bax mRNA and protein were significantly increased(P<0.05 or P<0.01).Conclusion:CD40L can inhibit the proliferation and cell cycle progression of the THP-1 cells through linc00239 and induce the apoptosis.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Acute myeloid leukemia (AML) is the most common type of leukemia at present. Although clinical treatment has a certain effect on this disease, most patients still die of relapse or its treatment related diseases. Nowadays, chimeric antigen receptor (CAR) T cells therapy technology has developed rapidly, and has become a hot topic in tumor immunotherapy. The high expression of CD123 in AML cells, low expression or non expression in normal hematopoietic stem cells and tissues, make more and more researchers focus on the technology of CD123+cell immunotherapy. Some studies have confirmed that CD123 CAR-T cells have a certain effect on AML, which provides a new way for clinical treatment of relapsed or refractory AML. This review summarizes the structure, production and delivery methods of CD123 CAR-T cells, and the current research status and shortcomings of CD123 CAR-T cells.

Objective To explore the relationship between the respiratory disturbance index (RDI) detected by cardiopulmonary coupling (CPC) and all parameters of polysomnography (PSG), and to analyze the correlation of the two different analytical techniques for the interpretation of sleep breathing events.Methods In this case-control study, the patients′ CPC and PSG were simultaneously recorded at the Sleep Clinic at Changzheng Hospital from Janunary 2016 to December 2016.Effective recordings were obtained from 292 patients (male/female: 173/119).According to PSG, these patients were divided into two groups: obstructive sleep apnea hyponea syndrome (OSAHS) group (n=173, aged (50.1±13.3) years) and non-OSAHS group (n=119, aged (50.5±11.7) years).All the PSG parameters and the RDI detected by CPC were compared between the two groups.Pearson correlation was used to analyze the relationship between the CPC-RDI and polysomnography parameters, and Bland-Altman chart was used to test the correlation of the two methods.The receiver operator characteristic curve was used to research the value of CPC-RDI in diagnosis of OSAHS.Results The OSAHS group showed higher levels of total sleep time (TST, (445.94±82.64) min), apnea times ((108.16±35.70)/h), hypopnea rate ((55.62±17.44)/h), apnea hyponea index (AHI, (22.78±20.73)/h), Epworth Sleeping Scale (ESS) scores ((11.21±5.30) scores), CPC-RDI ((32.98±22.19)/h) compared with the non-OSAHS group ((417.21±96.10) min,t=2.730;(7.89±5.41)/h,t=30.384;(11.05±2.23)/h, t=27.709;(5.51±3.11)/h,t=9.014;(7.61±2.29)scores,t=6.973;(11.16±8.63)/h,t=10.205, all P<0.01), and a significant decrease in N1 latency ((14.79±9.29) min vs (18.18±8.98)min, t=-3.106), N3% ((6.53±4.95)% vs(8.83±7.29)%,t=-3.212) and the lowest oxygen saturation (SaO2;(77.91±12.21)% vs(92.72±5.17)%, t=-12.479, all P<0.05 respectively).Pearson correlation analysis indicated that RDI was positively correlated with TST, N2 sleeping time, N3 sleeping time, AHI, microarousals index, leg movements index, and ESS scores (P<0.01 respectively).Remarkably, the correlation between CPC-RDI and PSG-AHI was excellent (r=0.801, P<0.01), and CPC-RDI was negatively correlated with lowest SaO2 (r=-0.765, P<0.01).Bland-Altman showed that the points in the limits of agreement accounted for more than 95% of all points.If CPC-RDI is higher than 18.95, the subjects were more likely with OSAHS.The sensitivity was 62.9% and the specificity was 88.7%.In addition, the enhanced low-frequency coupling parameters in the CPC analysis technique can clearly analyze the central respiratory rhythm disturbance.Conclusions CPC technology is an effective assessment technology to diagnose sleep-disordered breathing, and correlates well with AHI detected by traditional PSG.It shows the advantage of screening for central sleep apnea.

Objective To investigate the characteristics of HRV parameters in different posture of patients with positional obstructive sleep apnea syndrome (POSAS) and the relationship between apnea hypopnea index (AHI),minimum oxygen saturation (LSaO2) and HRV parameters.Methods A case-control study was conducted to compare the characteristics of heart rate variability between supine and lateral positions in POSAS patients.Results Compared with lateral position,POSAS group showed higher levels of heart rate variability indexes (P ＜ 0.05).Pearson correlation analysis indicated that AHI was positively correlated with SDNN、SDANN、ULF、LF/HF (P ＜ 0.05 or P ＜ 0.01).Remarkably,the correlation between AHI and LF/HF was excellent (r =0.437,P ＜ 0.01),and negatively correlated with HF(r =-0.306,P ＜ 0.05).Similarly,LSaO2 was negatively correlated with LF/HF.Conclusion The sleep-disordered breathing in supine position of POSAS patients is significantly heavier than that in lateral decubitus position.

Objective To investigate the characteristics of HRV parameters in different posture of patients with positional obstructive sleep apnea syndrome (POSAS) and the relationship between apnea hypopnea index (AHI),minimum oxygen saturation (LSaO2) and HRV parameters.Methods A case-control study was conducted to compare the characteristics of heart rate variability between supine and lateral positions in POSAS patients.Results Compared with lateral position,POSAS group showed higher levels of heart rate variability indexes (P ＜ 0.05).Pearson correlation analysis indicated that AHI was positively correlated with SDNN、SDANN、ULF、LF/HF (P ＜ 0.05 or P ＜ 0.01).Remarkably,the correlation between AHI and LF/HF was excellent (r =0.437,P ＜ 0.01),and negatively correlated with HF(r =-0.306,P ＜ 0.05).Similarly,LSaO2 was negatively correlated with LF/HF.Conclusion The sleep-disordered breathing in supine position of POSAS patients is significantly heavier than that in lateral decubitus position.

Objective To verify the performance of the ABI ViiA 7 Taqman HBV-DNA detecting system for confirming its sta-bility,accuracy and reliability.Methods According to the evaluation protocols of Clinical and Laboratory Standards Institute (CLSI),the performance of ABI ViiA 7 Taqman HBV-DNA detecting system was assessed in the aspects of precision,accuracy,lin-earity and comparability;the quantitative detection limit validation experiments was performed by diluting specimen until quantita-tive detection limit is lower than the lower limit of detection,and the detection results were compared with the quality target re-quirements and the analysis capability declared by manufacturers.Results The CV in within-run precision of this detection system was 1.485%,1.990% and 0.932% respectively;the total CV was 1.876%,3.361% and 1.891%,respectively;the maximum devia-tion of accuracy was -6.8%;the linear correlation coefficient was 0.998 3;the regression equation was Y =0.974 8X +0.050 7. The linear range was 1.00E2 - 2.00E8;the quantitative detection limit was 100 IU/mL;the comparability of ABIViiA7 and ABI7500:P =0.115,r2 =0.994,the linear regression equation was Y =0.987 2X +0.051 7.Conclusion The ABI ViiA 7 Taqman HBV-DNA detection system has excellent precision,accuracy,sensitivity and linearity and has a good correlation with ABI7500, which can be used for the detection of clinical specimens.

Objective To investigate the effects of Rhizoma Alismatis extracts on oxidative stress induced by cerebral ischemia-reperfusion injury in rats,and to explore its protective mechanism in cerebral ischemia-reperfusion injury.Methods A total of 60 male SD rats were randomly divided into sham operation group,model group,Alisma orientalis group and Nimodipine positive control group (n=15,each).Cerebral ischemia-reperfusion injury model was prepared by suture method after 14 days of intragastric administration.After 24 hours,scores of neurological dysfunction,the infarct size,the water content of the brain,the malondialdehyde (MDA),superoxide dismutase (SOD),nitric oxide (NO) levels in serum and brain tissues,and the activity of inducible NO synthase (iNOS)were detected.Results As compared with the model group,Alisma orientalis group showed that the scores of neurological dysfunction,cerebral water content,cerebral infarction size,contents of MDA and NO,and the activity of iNOS were significantly reduced,and the activity of SOD was significantly increased in respectively [(2.21 ± 0.38) vs.(2.78 ± 0.43),(81.18 ± 2.09)％ vs.(88.33±4.15)％,(0.26±0.07) ％ vs.(0.35±0.04)％,(5.92±1.64) μmol/L vs.(8.21±1.47)μmol/L,(115.48±18.65) mU/L vs.(75.52±20.78) mU/L,(28.23±4.32) μmol/L vs.(41.73±3.85) μmol/L,(15.31±1.68) mU/L vs.(23.49±3.53) mU/L,(5.41±0.68) μmol/L vs.(7.58±1.49) μmol/L,(168.57±10.65) mU/L vs.(150.11±13.62) mU/L,(14.37±0.77) μmol/L vs.(22.08±1.57) μmol/L,(9.83±0.75) mU/L vs.(13.28±1.84) mU/L,respectively,all P＜0.05]Conclusions Alisma orientalis extract has the protective effect on focal cerebral ischemia reperfusion injury,and the mechanism may be related to antioxidant and scavenging free radicals.

Objective To explore clinical application of neotype controllability artificial nephrohydrosis in percutaneous nephrolithoto-my. Methods 400 patients with renal lithiasis or superior segment ureter lithiasis in our hospital were divided into group A and group B. 200 cases of group A received neotype controllability artifiicial nephrohydrosis;200 cases of group B received conventional artificial nephro-hydrosis. The puncture duration, amount of bleeding and times of puncture of the two groups were compared. Results 195 cases in Group A were developed renal tract for PCNL effectively,157 cases were developed renal tract for PCNL effectively in Group B. The puncture duration, amount of bleeding and times of puncture of group A and group B were respectively (1. 8 ± 0. 7) vs. (2. 5 ± 1. 2) min,(112. 7 ± 51. 0) vs. (270. 2 ± 89. 3) mL,(1. 1 ± 0. 2) vs. (1. 8 ± 0. 7) times. The differences were significant. Conclusion Neotype controllability artificial nephrohydrosis can develop renal tract for PCNL effectively.

Objective To evaluate the anesthetic efficacy of etomidate target-controlled infusion (TCI) in combination with remifentanil in patients undergoing gynecological laparoscopy.Methods Sixty ASA physical status Ⅰ or Ⅱ patients,aged 25-56 yr,with body mass index 18-27 kg/m2,undergoing elective gynecological lapa-roscopy,were equally and randomly divided into 2 groups:propofol TCI combined with remifentanil group (group PR) and etomidate TCI combined with remifentanil group (group ER).Anesthesia was induced with iv injection ofmidazolam 0.1 mg/kg,fentanyl 4 μg/kg and cisatracurium 0.15 mg/kg in both groups,and with TCI of propofolwith the target effect-site concentration (Ce) of 2.5 μg/ml in group PR or with TCI of etomidate (Ce 0.8 μg/ml) ingroup ER.The patients were mechanically ventilated after endotracheal intubation.Anesthesia was maintained withTCI of propofol (Ce 2.0-2.5 μg/ml) in group PR or with etomidate (Ce 0.5-0.7 μg/ml) in group ER,and with ivinfusion of remifentanil 0.1-0.2 μg· kg-1 · min-1 and intermittent iv boluses of cisatracurium 5 mg.BIS value was maintained at 40-60.Before anesthesia (baseline,T0),at the end of operation (T1),and at 24 and 48 h after operation (T2-3),venous blood samples were collected for determination of serum cortisol and aldosterone concentrations by radioimmunoassay.The emergence time,extubation time and requirement for vasoactive agents during operation were recorded.The development of injection pain and muscle twitch during induction of anesthesia,intraoperative awareness,and post-operative agitation,nausea and vomiting were also recorded.Results Compared with the baseline value at T0,the serum cortisol concentration was significantly decreased at T1 in group ER (P ＜0.05),while no significant change was found in serum aldosterone concentrations at each time point in the two groups (P ＞ 0.05).Compared with group PR,the requirement for vasoactive agents and incidence of injection pain were significantly decreased,and the incidence of muscle twitch was increased (P ＜ 0.05),and no significant change was found in the emergence time,extubation time,and incidences of post-operative agitation,nausea and vomiting in group ER (P ＞ 0.05).Conclusion Compared with propofol TCI in combination with remifentanil,etomidate TCI combined with remifentanil is helpful in maintaining the hemodynamics stable and exerts transient inhibition of adrenocortical function with less injection pain in patients undergoing gynecological laparoscopy.