Objective: To comprehensively evaluate the current alanine aminotransferase (ALT) screening strategies and provide a basis for their optimization. Methods: ALT test results of 21 345 blood samples were collected from 33 blood collection institutions. Multiple probability distribution functions were employed to fit the data, and the akaike information criterion (AIC) was used to determine the optimal fitting model. Based on this model, 1 million random samplings were conducted to simulate the final ALT test results of blood donors under different ALT screening strategies, eligibility criteria, and pre-donation ALT detection deviations. A decision tree was subsequently constructed for health economic analysis. Results: The log-normal distribution with a mean of 2.96 and a variance of 0.65 provided the best fit for the data. When the eligibility criteria was 50 U/L and the pre-donation detection deviation was ±20%, not conducting pre-donation testing increased blood donation by 1.14%. When the pre-donation detection deviation was ±20% and the eligibility criteria was raised from 50 U/L to 100 U/L, conducting and not conducting pre-donation testing increased blood donation by 7.59% and 6.60%, respectively. With a eligibility criteria of 50 U/L and a pre-donation detection deviation of ±20%, 1.14% of eligible blood donors would be disqualified from donating blood. Health economic analysis showed that when the eligibility criteria was adjusted to 56 U/L or higher, not conducting pre-donation ALT testing was the dominant strategy; under other conditions, conducting pre-donation testing was the dominant strategy. Conclusion: The selection of ALT testing strategies is a complex process influenced by multiple factors, and it is necessary to adopt an appropriate ALT screening strategy based on specific testing circumstances.

ObjectiveTo investigate the effect of Yunkang oral liquid on postpartum kidney deficiency in mice. MethodPostpartum mice were randomized into model and low-dose （6 mL·kg^-1）， medium-dose （9 mL·kg^-1）， and high-dose （12 mL·kg^-1） Yunkang oral liquid groups. The mouse model of postpartum kidney deficiency was established by sleep deprivation combined with forced swimming. Another 9 female ICR mice were selected as the normal control group. The mice were administrated with Yunkang oral liquid during the period of modeling. The levels of estradiol （E₂）， progesterone （P）， follicle-stimulating hormone （FSH）， and luteinizing hormone （LH） in the serum were measured by the enzyme-linked immunosorbent assay. The morphological changes of ovaries and uterus were observed by hematoxylin-eosin （HE） staining， and the expression of transforming growth factor （TGF）-β and Smad2/3 was determined by immunohistochemistry and Western blotting. ResultThe mice in the model group showed prolonged estrous cycle， reduced voluntary activity， dorsal temperature， grip strength， and bone strength， and whitening tongue coating. Compared with the model group， Yunkang oral liquid shortened the estrous cycle， increased the voluntary activity， dorsal temperature， grip strength， and bone strength， and alleviated the whitening of tongue coating. Moreover， it elevated the E₂ and P levels and lowered the FSH and LH levels in the serum， decreased ovarian follicular atresia rate， promoted uterine repair， and down-regulated the expression of TGF-β and Smad2/3 in the ovarian and uterine tissues. ConclusionYunkang oral liquid can ameliorate postpartum kidney deficiency in mice by regulating the TGF-β/Smads signaling pathway.

Objective:To investigate phenotype and function of IL-17A-expressing CD8+T cells(i.e.Tc17 cells)in early stage of acute ST-elevation myocardial infarction(STEMI).Methods:Blood leukocytes were harvested from healthy donors and STEMI patients,and Tc17 cells were recognized by flow cytometry based on expressions of CCR6,CD161,CCR5,IL-23R and RORγt.Activation status,cytokine expression profiles and proliferation of Tc17 cells were evaluated by flow cytometry.Results:CCR6+CD161+CD8+T cells,either in healthy donors or STEMI patients,highly expressed CCR5,IL-23R and RORγt.Therefore,they were identified as Tc17 cells.Compared with healthy donors,frequency of Tc17 cells in total CD8+T cells was increased in STEMI patients.Besides,phenotype of Tc17 cells in STEMI patients was more skewed towards effector memory T cells.Tc17 cells in healthy donors predominantly expressed IL-17A and IL-22,whereas Tc17 cells in STEMI patients expressed IL-10 and TGF-β in addition to IL-17A and IL-22.However,Tc17 cells,either in healthy donors or STEMI patients,did not express IFN-γ,IL-5,Foxp3,and Ki67.Conclu-sion:In early stage of STEMI,Tc17 cells up-regulate IL-10 and TGF-β expressions while producing IL-17A and IL-22,probably participate in and regulate post-STEMI acute inflammation.

【Objective】 To analyze the cost-effectiveness of ELISA grey area strategy through establishing the health economics model. 【Methods】 The serological grey area strategy evaluation model was composed of screening strategy subdecision tree, pathogen infection subdecision tree and pathogen detection subdecision tree. The key parameters in the model were obtained from literatures and research data. The cost-effectiveness of setting ELISA grey area strategy was compared by software, and multifactor sensitivity analysis was conducted. 【Results】 After setting the ELISA grey area, extra samples(5.86 cases/100 000) with serological false negativity could be detected, including HBV samples at 4.93/100 000, HCV samples at 0.27/100 000, HIV samples at 0/100 000, syphilis samples at 0.66/100 000. To yield an additional seropositive sample out of every 100 000 blood donors, blood center will afford extra 1 million yuan about. 【Conclusion】 Through this study, a cost-effectiveness evaluation model of serological detection strategy was established. Although the ELISA grey area setting can yield a small number of seropositive samples, the cost is much higher than the current affordability.

Aplastic anemia(AA) is characterized by severe pancytopenia. The clinical features of bone marrow failure syndrome are closely related to viral infection, environment toxin, genetic and acquired gene mutation. Aplastic anemia is a historic disease that often occurred in young people, which was fatal to patients. However, here are many methods can treat and cure this fatal disease. Pathological and physiological studies have important guiding significance for the treatment of aplastic anemia. The diagnosis and treatment of current situation and prospect of aplastic anemia are reviewed in this article.

Objective To analyze the impact of electronic portal imagingdevice (EPID) position error on three-dimensional dose verification of volumetric modulated arc therapy (VMAT).Metbods Five Suremark SL-20 lead points were fixed on Elekta tray,and EPID images were collected in 0-360° rotation,one image per 5°.The position error relative to the accelerator was analyzed via Matlab.Then the images position error was corrected according to the analysis,and the 3D dose was reconstructed with the corrected images.The dose distributions of double arcs,clockwise arc(arc 1),and counterclockwise arc (arc 2) of 16 nasopharyngeal carcinoma patients' VMAT plan were evaluated by γ analysis,and the results of before and after position error correction were compared.Results Compared to 0° gantry angle,the error of source to the image distance (SID) was maximum (1.20 cm) when the gantry angle was 180°.On account of the SID change,the maximum error along the up-down (y) direction in the iso-center planar was 2.28 mm and the left-right (x) direction error was within ± O.5 mm.The 3D γ analyses of 16 nasopharyngeal carcinoma in VMAT plans were obviously increased after the position error along y was corrected.The double arcs,arc1 and arc 2 were increased by (4.12 ±1.67) ％ (t =-9.86,P＜ 0.05),(3.47±1.64) ％ (t=-8.46,P＜ 0.05) and (5.08±1.30) ％ (t=-15.63,P＜ 0.05) in 5％/3 mm standard,respectively.However,in 3％/3 mm standard,γ value of the double arcs,arc 1 and arc2 were increased by (7.63 ±2.24) ％ (t =-13.63,P＜ 0.05),(6.03 ±2.07) ％ (t =-11.66,P＜ 0.05),(9.17 ±2.23) ％ (t =-16.41,P＜ 0.05),respectively.Since the EPID position error along x was corrected after y,the 3D γ analysis of reconstruction dose indicated that the average of the 5％/3 mm and 3％/3 mm γ value were increased by 0.23％ and 0.24％,respectively.Conclusions EPID motion error along the gantry to table direction of the accelerator can't be ignored.When reconstruct dose based on EPID,a modification should be made for rebuilding more accurate patients' 3D dose distribution.

Objective To establish and confirm the hepatitis B surface antigen(HBsAg) enzyme linked immunosorbent assay(ELISA) high specificity S/CO limit as blood donor deferral criterion.Methods A total of 783 HBsAg ELISA reactive and 588 non-reactive samples were collected, and confirmed by HBsAg electrochemiluminescence detection and neutralization test.Receiver operating characteristic curve (ROC curve) was used to evaluate the S/CO limit under 95% and 99% specificity.Another 124 HBsAg ELSIA reactive samples were tested for five kinds of hepatitis B virus(HBV) markers by using electrochemiluminescence detection to verify the blood donor deferral limit.The blood donor deferral limits of 3 laboratories, using the same reagents, were compared.Results The 95% specificity S/CO limit of two reagents were 0.24 and 0.65, the 99% specificity S/CO limit of two reagents were 3.89 and 3.62.The 99% specificity S/CO limit was set as the blood donor deferral criterion.Verify test indicated that the samples, with S/CO higher than the blood donor reentry limit of reagent 1 and 2, were all from HBV infected donor.The 99% specificity S/CO limits of reagent 1 in the other three laboratories were 3.77, 3.60 and 13.42 respectively.And the 99% specificity S/CO limits of reagent 2 in the other three laboratories were 27.73, 31.75 and 1.17.Conclusion The blood donor deferral limit of HBsAg ELISA could identify the true positive blood donor, and reduce the number of blood donor, entering the reentry process.It might not suit to adopt a unified donor deferral limit in different laboratories, even using the same reagents.

Objective To estimate and optimize the dosage regimen of vancomycin and linezolid for treatment in different Gram-positive cocci infections. Methods The pharmacokinetic data of vancomycin and linezolid were collected, and the pharmacodynamics in vitro of these drugs for staphylococcus epidermidis, staphylococcus aureus, enterococcus faecalis and enterococcus faecium were analysed. The cumulative response fraction (CFR) was evaluated in different dosage regimens of two drugs against four types of bacteria. Results The regimen of 3 500 mg/d vancomycin was recommended for patients with staphylococcus epidermidis infection. The regimen of 2 500 mg/d vancomycin was recommended for patients with staphylococcus aureus infection. The regimens of 3 000 mg/d vancomycin and 400 mg linezolid given 2 times/day were recommended for patients with enterococcus faecalis infection. The regimens of 2 500 mg/d vancomycin and 400 mg linezolid given 2 times/day were recommended for patients with enterococcus faecium infection. Conclusion In application of vancomycin and linezolid for treatment of Gram-positive cocci infections, different dosage regimens should be used in different types of infections.

Objective To compare the early diagnostic value of between transabdominal color Doppler ultra-sound(TACDS)and transvaginal color Doppler ultrasound(TVCDS)in tubal pregnancy.Methods Clinical data of 112 cases which were diagnosis of tubal pregnancy by operation and postoperative pathologic examination were retro-spectively ananlyzed.The accuracy of clinical diagnosis of tubal ectopic pregnancy were compared between TACDS group and TVCDS group.Results 75 cases and 108 cases were diagnosed of tubal pregnancy in TACDS group and TVCDS group,respectively.The diagnostic accuracy were 66.96% and 96.43%,respectively.There was evident difference between the TACDS group and TVCDS group(χ2 =32.511 8,P =0.000).Conclusion Compared with TACDS,TVCDS has high accurate for early diagnosis of tubal pregnancy,which can provide characteristic images and objective basis for the diagnosis and treatment of tubal ectopic pregnancy.

OBJECTIVETo obtain streptavidin-tagged human granulocyte-macrophage colony-stimulating factor (SA/hGM-CSF) fusion protein and evaluate its bioactivity .

METHODSPET24a-6His-SA-L-hGM-CSF and PET24a-hGM-CSF-L-SA-6His plasmids were constructed and expressed in Rosetta (DE3) host bacteria to generate the fusion proteins. The two fusion proteins were refolded by gradient dialysis after Ni-NTA affinity chromatography and finally purified using DEAE-sepharose FF anion exchange chromatography. MTT method was used to evaluate the effect of SA/hGM-CSF fusion proteins in inducing the proliferation of human erythroleukemia cells (TF-1). The efficiency of the fusion proteins for surface modification of biotinylated MB49 tumor cells was evaluated by flow cytometry.

RESULTSThe recombinant fusion proteins SA-hGM-CSF and hGM-CSF-SA were highly expressed in Rosetta (DE3) at about 20% of the total bacterial proteins, with a purity of about 96% after purification. The two fusion proteins exhibited bifunctional activities, namely the pro-proliferation effect on human erythroleukemia cells (TF-1) and SA-mediated high-affinity binding to biotinylated cell surfaces (with an anchoring modified rate of about 99%).

CONCLUSIONSA/hGM-CSF bi-fusion proteins obtained in this study lays the groundwork for the development of cancer cell vaccines with surface modification by hGM-CSF.

Biomarkers ; Cancer Vaccines ; biosynthesis ; Cell Line, Tumor ; Diterpenes ; pharmacology ; Escherichia coli ; metabolism ; Granulocyte-Macrophage Colony-Stimulating Factor ; biosynthesis ; Humans ; Membrane Fusion Proteins ; biosynthesis ; Plasmids ; Streptavidin ; chemistry