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Neurally Adjusted Ventilatory Assist (NAVA) is a new ventilator mode, which collects the electrical activity of diaphragm (EAdi) and provides proportional pressure. The relationship between intra-abdominal hypertension (IAH) and EAdi still needs to be elucidated. The aim of our study was to investigate the effect of EAdi on IAH and to assess whether NAVA is a suitable ventilation mode for patients with IAH.The patients were divided into non-IAH-NAVA (NIAH-NAVA) group (10 cases), IAH-NAVA group (10 cases), and IAH-PSV group (10 cases). The asynchrony index was also recorded for 30 minutes after enrollment. After 24 hours, the intra-abdominal pressure (IAP), EAdi, NAVA level, positive end-expiratory pressure (PEEP), static lung compliance (CSt), plateau pressure (Pplat), airway pressure (Paw), driving pressure (Pdriv), respiratory rate (RR), tidal volume (VTi), pH, PaO2, PaCO2, and oxygenation index (OI) values were monitored. We also recorded the duration of mechanical ventilation and the length of ICU stay. Patients with IAH had lower EAdi values, and there was a negative correlation between them. In patients with IAH, the NAVA level values were higher, the CSt value was lower, and the Pplat, Paw, PEEP and Pdriv values were increased. Compared with the PSV group, the CSt value was increased and the Pplat, Paw, PEEP and Pdriv values were reduced in the NAVA group. RR value was higher in patients with IAH, while VTi value was reduced. In the NAVA group, the asynchrony index was lower than that in the PSV group. In patients with IAH, the duration of mechanical ventilation in the NAVA group was shorter than that time in the PSV group, however, the length of ICU stay had no differences between the two groups. Our study found a negative correlation between IAP and EAdi. the NAVA level values were higher, the CSt value was lower, and the Pplat, Paw, PEEP and Pdriv values were increased in patients with IAH.However, NAVA could be used to improve respiratory mechanics and reduce the duration of mechanical ventilation in patients with IAH, also improve the asynchrony. Trial registration: Registered in Clinical Trials under number ChiCTR1900022218 and approved by the Ethics Committee of The First' People’s Hospital of Lianyungang, protocol number ky20180520001.

Background Anthocyanins contribute to coloration and antioxidation effects in different plant tissues. MYB transcription factors have been demonstrated to be a key regulator for anthocyanin synthesis in many plants. However, little information was available about the MYB genes in the halophyte species Eutrema salsugineum. Result Here we report the identification of an important anthocyanin biosynthesis regulator EsMYB90 from Eutrema salsugineum, which is a halophyte tolerant to multiple abiotic stresses. Our phylogenetic and localization analyses supported that EsMYB90 is an R2R3 type of MYB transcription factor. Ectopic expression of EsMYB90 in tobacco and Arabidopsis enhanced pigmentation and anthocyanin accumulation in various organs. The transcriptome analysis revealed that 42 genes upregulated by EsMYB90 in 35S:EsMYB90 tobacco transgenic plants are required for anthocyanin biosynthesis. Moreover, our qRT-PCR results showed that EsMYB90 promoted expression of early (PAL, CHS, and CHI) and late (DFR, ANS, and UFGT) anthocyanin biosynthesis genes in stems, leaves, and flowers of 35S:EsMYB90 tobacco transgenic plants. Conclusions Our results indicated that EsMYB90 is a MYB transcription factor, which regulates anthocyanin biosynthesis genes to control anthocyanin biosynthesis. Our work provides a new tool to enhance anthocyanin production in various plants.

To evaluate the value of lung ultrasound score (LUS) on predicting weaning outcome in patients with intro-abdominal infection (IAI) undergoing mechanical ventilation.Patients with IAI undergoing mechanical ventilation admitted to Research Institute of General Surgery of East War Zone Hospital and intensive care unit (ICU) of the First People's Hospital of Lianyungang from January to December in 2018 were included. The patients who satisfied weaning criteria were enrolled in the weaning process, which included spontaneous breathing trial (SBT) and extubation. They were divided into SBT success group and SBT failure group according to whether passed 120-minute SBT or not. LUS scores before and after SBT were compared between the two groups. The patients in the SBT success group were extubated, and they were divided into successful extubation group and failed extubation group for sub-group analysis according to whether re-intubation was needed in 48 hours after extubation. LUS score before extubation (at the end of SBT) and 48 hours after extubation (48 hours after extubation in the successful extubation group or before re-intubation in the failed extubation group) were compared. The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of LUS score before SBT for SBT failure and LUS score before extubation for the failure.A total of 76 patients with IAI undergoing mechanical ventilation were included. Twenty-three patients had duration of mechanical ventilation less than 48 hours, severe chronic obstructive pulmonary disease (COPD), tracheotomy or automatic discharge were excluded, and 53 patients were enrolled. SBT was failed in 9 patients, and successfully performed in 44 patients, of whom 23 patients with successful extubation, and 21 with failed extubation. The LUS scores before and after SBT in the SBT failure group were significantly higher than those in the SBT success group (before SBT: 13.22±1.99 vs. 10.79±1.64, t = -3.911, P = 0.000; after SBT: 19.00±1.12 vs. 13.41±1.86, t = -8.665, P = 0.000). ROC curve analysis showed that the area under ROC curve (AUC) of LUS score before SBT for predicting SBT failure was 0.82 [95% confidence interval (95%CI) was 0.67-0.98, P = 0.002]. When the optimum cut-off value was 12.5, the sensitivity was 66.7%, and the specificity was 84.1%. Sub-group analysis showed that the LUS scores before and after extubation in the failed extubation group were significantly higher than those in the successful extubation group (before extubation: 14.19±1.60 vs. 12.69±1.81, t = -2.881, P = 0.006; after extubation: 16.42±1.59 vs. 12.78±1.54, t = -7.710, P = 0.000). ROC curve analysis showed that the AUC of LUS score before extubation for predicting the failure was 0.81 (95%CI was 0.69-0.92, P = 0.000). When the optimum cut-off value was 13.5, the sensitivity was 80.0%, and the specificity was 65.2%.LUS score can effectively predict SBT outcome, risk of re-intubation after extubation in patients with IAI undergoing mechanical ventilation.

Background: Multidrug-resistant (MDR) bloodstream infection (BSI) by Gram-negative bacteria (GNB) is an important cause of mortality in the intensive care unit (ICU). The purpose of this study was to compare the clinical characteristics of some GNB BSIs and to analyze their drug resistance, with an emphasis on the analysis of prognostic risk factors related to MDR-Acinetobacter baumannii (A. baumannii) BSI.Methods: A retrospective study was conducted in the ICU of lianyungang hospital in China. Patients with BSIs due to MDR-A. baumannii, MDR-Klebsiella pneumoniae (K. pneumoniae), MDR-Pseudomonas aeruginosa (P. aeruginosa) and MDR-Escherichia coli (E. coli) were included.Results: The overall drug resistance rate to imipenem of A. baumannii and K. pneumoniae was significantly higher than that of P. aeruginosa and E. coli (95.8% and 75.5% vs 44.6% and 9.2% respectively). The mortality rates were 71.9%, 63.3%, 41.5% and 38.1%, respectively. The multivariate analysis of MDR-A. baumannii BSI, APACHE II score, hormone use, development of septic shock were associated with the 30-day mortality, while high albumin level with survival.Conclusion: The treatment of MDR-A. baumannii and MDR-K. pneumoniae infection resulted difficult due to their high drug resistance rate. However, the understanding of the clinical characteristics of different BSIs might be helpful to predict, to some extent, the pathogenic bacteria involved so as to proceed with an early sensitive antibiotic treatment. The high mortality rate due to BSI MDR-A. baumannii might be correlated with APACHE II score, nutritional status, and hormone therapy, while septic shock was a warning sign of poor prognosis.

To analyze the effect of interposed abdominal pulling-pressing cardiopulmonary resuscitation (IAPP-CPR) and standard cardiopulmonary resuscitation (S-CPR) on hemodynamics and oxygen metabolism in patients with cardiac arrest, and to evaluate the treatment effect of IAPP-CPR.The patients with cardiac arrest, cardiac arrest time less than 30 minutes, and with S-CPR indications admitted to intensive care unit (ICU) of the First People's Hospital of Lianyungang from January 2017 to January 2019 were enrolled. The patients were divided into IAPP-CPR group and S-CPR group according to whether the patients had IAPP-CPR indication or not. The patients in the S-CPR group were operated according to the 2015 American Heart Association (AHA) CPR guidelines; and the patients in the IAPP-CPR group received the IAPP-CPR on the basis of the S-CRP. During the relaxation period, the patients were subjected to abdominal lifting and compressing with amplitude of 4-5 cm, frequency of 100-120 times/min, and the time ratio of lifting to compressing was 1:1. Hemodynamic changes during resuscitation were recorded in the two groups. Hemodynamics, oxygen metabolism, arterial blood gas analysis and prognostic indicators were recorded at 30 minutes after successful resuscitation.During the study period, 77 patients were selected, 24 patients were excluded from giving up treatment and quitting, 53 patients were enrolled in the analysis finally, with 28 patients in the S-CPR group and 25 in the IAPP-CPR group. (1) The heart rate (HR), mean arterial pressure (MAP) and coronary perfusion pressure (CPP) showed an upward trend during resuscitation, and a more significant increase was shown in the IAPP-CPR group. (2) Hemodynamics after successful resuscitation: there were 16 patients with successful resuscitation in the IAPP-CPR group and 13 in the S-CPR group. The MAP, CPP, global ejection fraction (GEF) and stroke volume (SV) of patients with successful resuscitation at 30 minutes after resuscitation in the IAPP-CPR group were significantly higher than those in the S-CPR group [MAP mmHg (1 mmHg = 0.133 kPa): 52.88±3.11 vs. 39.39±4.62, CPP (mmHg): 36.56±6.89 vs. 29.61±6.92, GEF: 0.217±0.036 vs. 0.178±0.027, SV (mL): 38.43±5.25 vs. 32.92±8.28, all P0.05], but there was no significant difference in central venous pressure (CVP) or HR between the two groups. (3) Oxygen metabolism after successful resuscitation: the cardiac output (CO), arterial oxygen content (CaOIAPP-CPR can produce better hemodynamic effect during and after resuscitation than S-CPR, and oxygen metabolism and arterial blood gas analysis parameters at 30 minutes after resuscitation were better than S-CPR, with higher ROSC rate, CPR successful rate and 28-day survival rate, and no significant difference in complications between the two resuscitation methods.

Additional file 9. Sequences of the primers used in the study.

Additional file 1. Fig. 1. Molecular identification of EsMYB90 transgenic tobacco and Arabidopsis plants. Fig. 2. Pathways of the most enriched KEGG DEGs in RNA-Seq of EsMYB90 transgenic tobacco. Fig. 3. Sequence alignment analysis of the EsMYB90 and other EsMYB proteins in E.salsugineum.

CH4 emissions could vary with biotic and abiotic factors at different time scales. However, little is known about temporal dynamics of CH4 flux and its controls in coastal marshes. In this study, CH4 flux was continuously measured with the eddy covariance technique for 2 years in a subtropical salt marsh in eastern China. Wavelet analysis was applied to explore the multi-scale variations of CH4 flux and its controls. Additionally, partial wavelet coherence was used to disentangle confounding effects of measured variables. No consistent diurnal pattern was found in CH4 fluxes. However, the hot-moments of CH4 flux were observed after nighttime high tide on days near the spring tide. Periodic dynamics were also observed at multi-day, semilunar and seasonal scales. Tide height in summer had a negative effect on CH4 flux at the semilunar scale. Air temperature explained most variations in CH4 fluxes at the multi-day scale but CH4 flux was mainly controlled by PAR and GEP at the seasonal scale. Air temperature explained 48% and 56% of annual variations in CH4 fluxes in 2011 and 2012, respectively. In total, the salt marsh acted as a CH4 source (17.6 ± 3.0 g C–CH4 m−2 year−1), which was higher than most studies report for inland wetlands. Our results show that CH4 fluxes exhibit multiple periodicities and its controls vary with time scale; moreover, CH4 flux is strongly modified by tide. This study emphasizes the importance of ecosystem-specific measurements of CH4 fluxes, and more work is needed to estimate regional CH4 budgets.

Flavonoids are representative secondary metabolites with different metabolic functions in plants. Previous study found that ectopic expression of EsMYB90 from Eutremasalsugineum could strongly increase anthocyanin content in transgenic tobacco via regulating the expression of anthocyanin biosynthesis genes. In the present research, metabolome analysis showed that there existed 130 significantly differential metabolites, of which 23 metabolites enhanced more than 1000 times in EsMYB90 transgenic tobacco leaves relative to the control, and the top 10 of the increased metabolites included caffeic acid, cyanidin O-syringic acid, myricetin and naringin. A total of 50 markedly differential flavonoids including flavones (14), flavonols (13), flavone C-glycosides (9), flavanones (7), catechin derivatives (5), anthocyanins (1) and isoflavone (1) were identified, of which 46 metabolites were at a significantly enhanced level. Integrated analysis of metabolome and transcriptome revealed that ectopic expression of EsMYB90 in transgenic tobacco leaves is highly associated with the prominent up-regulation of 16 flavonoid metabolites and the corresponding 42 flavonoid biosynthesis structure genes in phenylpropanoid/flavonoid pathways. Dual luciferase assay documented that EsMYB90 strongly activated the transcription of NtANS and NtDFR genes via improving their promoter activity in transiently expressed tobacco leaves, suggesting that EsMYB90 functions as a key regulator on anthocyanin and flavonoid biosynthesis. Taken together, the crucial regulatory role of EsMYB90 on enhancing many flavonoid metabolite levels is clearly demonstrated via modulating flavonoid biosynthesis gene expression in the leaves of transgenic tobacco, which extends our understanding of the regulating mechanism of MYB transcription factor in the phenylpropanoid/flavonoid pathways and provides a new clue and tool for further investigation and genetic engineering of flavonoid metabolism in plants.

We study the Cauchy problem of the nonlinear stochastic fractional heat equation ∂ t u = − ν 2 ( − ∂ x x ) α 2 u + σ ( u ) W ˙ ( t , x ) on real line R driven by space-time white noise with bounded initial data. We analyze the large- | x | fixed- t behavior of the solution u t ( x ) for Lipschitz continuous function σ : R → R under three cases. (1) σ is bounded below away from 0. (2) σ is uniformly bounded away from 0 and ∞ . (3) σ ( x ) = c x (the parabolic Anderson model). From the sensitivity to the initial data of stochastic fractional heat equation, we describe that the solution to the Cauchy problem of stochastic fractional heat equation exhibits chaotic behavior at fixed time before the onset of intermittency.

A functionalized glass sensor (G-P) was prepared for detecting nitroaromatic compounds (NACs) by chemically immobilizing a conjugated polymer P on the surface of a glass slide. The monolayer film sensor had several advantages: the signal amplification effect of conjugated polymers, no leakage of sensing materials in solution, and good permeability for the analytes. Fluorescence quenching studies demonstrated that the sensor was highly sensitive to NACs. When the DNT concentration was 1.03 × 10–7 mol/L, the quenching efficiency (1–I/I 0) of G-P reached 52.8%. Moreover, the excellent properties of reversibility, selectivity and sensitivity indicated the glass G-P might be a promising sensor in the field of explosives detection.

To investigate the application of peripheral perfusion index (PPI) in early diagnosis and goal-directed therapy of septic shock, and to provide reference for the early clinical diagnosis and treatment of septic shock.A prospective single-blind randomized controlled trial (RCT) was conducted. Adult patients with sepsis admitted to emergency medical department and intensive care unit (ICU) of the First People's Hospital of Lianyungang City in Jiangsu Province from January 2013 to December 2016 were enrolled. The patients were randomly divided into two groups (n = 46). The PPI group was defined using PPI1.4 as diagnosis of septic shock standard, and PPI2 as treatment guide target. Control group was defined according to the traditional diagnostic criteria of shock which systolic blood pressure was less than 90 mmHg (1 mmHg = 0.133 kPa) or systolic blood pressure value decrease40 mmHg baseline and bundle treatment was performed. The volume of fluid resuscitation, organ dysfunction, the sequential organ failure score (SOFA), acute physiology and chronic health evaluation II (APACHE II) score, continuous renal replacement therapy (CRRT) time, mechanical ventilation (MV) time, the length of ICU stay and 28-day mortality were observed.There were 39 and 27 septic shock patients in PPI group and control group respectively. The diagnostic criteria of traditional septic shock with blood pressure as "gold standard", the sensitivity of PPI1.4 for septic shock was 94.3%, the specificity was 28.2%, the authenticity was 66.3%, the positive predictive value was 64.1%, the negative predictive value was 78.6%, the positive likelihood ratio was 1.31, the negative likelihood ratio was 0.18. The per capita fluid replacement within 24 hours in the PPI group was significantly higher than that in the control group (mL: 4 601±1 250 vs. 3 458±1 006, P0.01), but there was no significant difference in the per capita volume of the patients diagnosed as septic shock (mL: 4 596±1 320 vs. 4 205±1 058, P0.05). Compared with the control group, the PPI group treated patients within 48 hours with less vascular active drugs (cases: 6 vs. 15), APACHE II and SOFA score were lower (48 hours: APACHE II was 10.2±2.1 vs. 12.0±3.2; 72 hours: SOFA was 5.1±1.8 vs. 6.0±2.1, APACHE II was 8.9±1.8 vs. 9.8±2.2), the period of CRRT and the length of ICU stay were shorter [the period of CRRT (days): 3.0±0.9 vs. 3.6±1.4, the length of ICU stay (days): 5.2±2.1 vs. 6.3±2.9), the difference was statistically significant (all P0.05). There was no significant difference in the liver and kidney function index, arterial blood lactic acid (Lac), MV time (days: 3.3±1.4 vs. 3.5±1.2) and 28-day mortality (15.22% vs. 19.57%) between two groups (all P0.05).The inadequacy of microcirculatory perfusion by oximetry-derived PPI is more sensitive to the diagnosis of septic shock than hypotension of systemic circulation. With PPI guiding the fluid resuscitation of septic shock patients, vasopressors can be withdrawn earlier and the duration of the CRRT and ICU can be decreased.

To investigate the efficacy and safety of second-generation tyrosine kinase inhibitors (TK-II) combined with allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of high-risk Philadelphia chromosome positive (Ph⁺) leukemia.The clinical data of 17 cases of high-risk Ph⁺ leukemia patients underwent allo-HSCT were retrospectively analyzed, including 1 case in accelerated phase and 7 cases in blast crises of chronic myeloid leukemia, and 9 cases of Ph⁺ acute lymphoblastic leukemia. Nilotinib or Dasatinib were administered before and (or) after allo-HSCT in all patients.All patients successfully engrafted. Median times to neutrophil and platelet recovery were 12 days (range 10-14) and 15 days (range 11- 23), respectively. Acute GVHD developed in 7 patients: 6 patients had grade 1 to 2 and 1 patient grade 3. Chronic GVHD developed in 6 patients, all were limited and no lethal GVHD occurred. At a median follow-up of 17(range 3-60) months, 11(64.7%) patients survived disease free, 6 patients relapsed and 5 died.TK-II combined with allo-HSCT effectively improved the remission rate of high-risk Ph⁺ leukemia and reduced recurrence after allo-HSCT, which represented an important improvement in the treatment of patients with high-risk Ph+ leukemia.

Objective To investigate the effect of hematopoietic stem cell transplantation in the treatment of T cell lymphoma. Methods The clinical data of 98 patients with T cell lymphoma (T-NHL) treated by hematopoietic stem cell transplantation from June 2001 to December 2015 in our center were retrospectively analyzed. Results (1) 98 T-NHL patients, 62 males and 36 females, aged 7-64 years (median age 27 years). Disease subtypes: 30 cases of T-cell lymphoblastic lymphoma, 24 cases of NK / T cell lymphoma, 22 cases of peripheral T-cell lymphoma (PTCL, NOS), 19 cases of variable large cell lymphoma (ALCL), and 3 cases of subcutaneous panniculitic T cell lymphoma. Transplantation type: 55 cases of autologous transplantation, 43 cases of allogeneic transplantation. The follow-up was ended in April 2016, the duration of following-up ranged from 2 to 178 months (median follow-up time was 20 months). (2) 55/98 patients with autologous hematopoietic stem cell transplantation (auto-HSCT), 31 males and 24 females, aged 7-64 years (median age 27 years). Disease subtypes: 19 cases of anaplastic large cell lymphoma (ALCL) , 15 cases of NK / T cell lymphoma, 13 cases of peripheral T-cell lymphoma (PTCL, NOS), 5 cases of T cell lymphoblastic lymphoma, and 3 cases of subcutaneous panniculitic T cell lymphoma. The 3 year overall survival (OS) and disease-free survival (EFS) were 79.6% and 58.4%, respectively. (3) 43/98 patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT), 31 males and 12 females, aged 8-52 years (median age 27 years). Disease subtypes: 25 cases of T lymphoblastic lymphoma, 9 cases of NK / T cell lymphoma, and 9 cases of peripheral T cell lymphoma (PTCL, NOS). Transplant subtypes: 23 cases of haploidentical transplantation, 12 cases of HLA-identical sibling donor transplantation, 6 cases of HLA-identical unrelated donor transplantation, and 2 cases of umbilical cord blood transplantation. The 3 year EFS and OS of allo-HSCT were 58.3% and 56.7%, respectively. (4) 38/55 patients with CR1 status before auto-SCT, 3 year OS and EFS were 82.8% and 60.7% respectively. 17/55 patients with non-CR1 status before auto-HSCT, 3 year OS and EFS were 57.2% and 47.8%. Compared with non-CR1 group, the OS and PFS of CR1 group were better, but failed to show significant statistical difference (p>0.05), which may be related to the less number of cases and sub types of the two groups do not match the correlation. (5) 31/98 cases were young and high-risk patients (age < 60 years, IPI score ≥3).16/31 cases treated with allo-HSCT, the 3 year OS and EFS were 73.1% and 70.5%. 15/31 cases treated with auto-HSCT, the 3 year OS and EFS were 48.4% and 27.8%. The OS and EFS of the two groups were significantly different (P=0.001). Conclusion Hematopoietic stem cell transplantation can improve the efficacy of T cell lymphoma. Auto-HSCT in first complete remission (CR1) enables T-NHL patients with greater benefit. Allo-HSCT can cure some T-NHL patients, which can be considered for the treatment of young and high-risk T-NHL patients. Disclosures No relevant conflicts of interest to declare.

Objective: Preliminary study the expression and clinical significance of TIM3 on peripheral blood NK cells in patients with acute myeloid leukemia (AML). Methods: We investigated the expression characteristics of TIM3 on the peripheral blood NK cells of newly diagnosed AML patients and its clinical significance. Peripheral blood was obtained from 50 patients with newly diagnosed AML before intervention, with peripheral blood from 30 cases of healthy volunteers collected as normal control. Expression levels of TIM3 on the peripheral blood NK cells and subsets were assayed with flow cytometry. Then the expression of gamma interferon in Tim3+CD56+NK cells and Tim3-CD56+NK cells were analyzed by intracellular immunofluorescence labeling and flow cytometry. Results: Compared with the normal control, in the newly diagnosed AML patients, the NK cells percentage and the proportion of CD56dimNK/CD56+NK reduced, while the proportion of CD56brightNK/CD56+NK increased significantly, and the proportions of Tim3+CD56+NK/CD56+NK and Tim3+CD56dimNK/CD56dimNK decreased significantly. However, in AML patients with complete remission after chemotherapy, the proportion of peripheral blood NK cells and cell subsets recovered. Furthermore, compared with Tim3-CD56+NK cells, IFN-γsecretion level of Tim3+CD56+NK cells in the newly diagnosed AML patients is increased significantly. Conclusion: The dynamic expression of TIM3 on NK cell and its cell subsets before and after chemotherapy in AML patients suggest that Tim3 and NK cells may play an important role in the occurrence and development of AML. Disclosures No relevant conflicts of interest to declare.

Objective: To investigatethe expression and the role of Tim3 and PD-1 on T cells of peripheral blood in patients with acute myeloid leukemia(AML). Consistently discuss the clinical significance of Tim3 and PD-1 co-expression on these cells and the mechanism of Tim3-mediated immune escape. Methods: Collectedclinical data of 36 patients who had been diagnosed with AML by bone marrow MICM classification, and then gathered their heparin anticoagulation peripheral blood before any treatment. The heparin anticoagulation peripheral blood from 20 healthy volunteers was gathered as normal control. We used the methods of immune fluorescence labeling and flow cytometry to detect expression of Tim3 on T cells. Then detected co-expression of Tim3 and PD-1 on T cells, consistently with IFN-γ secreting level on T cells. Results: 1.The proportions of CD4+ T cells and CD8+ T cells on lymphocytes in AML patients were (15.28±10.99)% and (9.19±7.54)% respectively, which were significantly lower than the proportion of normal controls [(31.12±2.22)% and (21.59±4.22)% respectively] (P Conclusion: 1.The high expression of Tim3 on peripheral blood T cells in AML patients mediate T cell exhaustion/dysfunction, which can be an important mechanism of immune escape in leukemia. 2.PD-1 and Tim3 co-expression On CD4+ T cells and CD8+ T cells in AML patients which were dificient in there ability to produce IFN-γ. Further investigations are needed to explore the correlation of co-expression PD1 and Tim3 with process of AML, thus probably making Tim3 become another new immunotherapy target. Disclosures No relevant conflicts of interest to declare.