Transfusion-associated circulatory overload (TACO) is a severe transfusion complication. The Working Party on Clinical Transfusion, Chinese Society of Blood Transfusion (CSBT) organized domestic experts and scholars from disciplines including transfusion medicine, hematology, cardiology, pulmonology, and critical care medicine to formulate the Expert Consensus on the Clinical Diagnosis and Treatment of Transfusion-Associated Circulatory Overload (2026 Edition). This consensus puts forward expert recommendations on TACO-related auxiliary examinations, diagnosis and differential diagnosis, prevention, and treatment strategies, aiming to further improve the standard of TACO diagnosis and treatment in China.

This expert consensus consists of two parts: blood quality inspection and environmental hygiene quality inspection in the blood collection and supply system. The part of blood quality inspection specifies the sampling principles and frequencies for different blood products, clarifies requirements for sampling methods, specimen retention and disposal, and introduces the testing methods, quality standards, result application and analysis for each parameter of blood quality inspection. The part of environmental hygiene quality inspection classifies the environments of blood collection and supply service sites, stipulates the monitoring frequencies and quality standards for different environmental hygiene quality inspection items (including disinfection of air, object surfaces, hand hygiene, skin at puncture sites, blood storage and transportation equipment, as well as items such as high-pressure sterilization effect monitoring and sewage monitoring), clarifies the sampling quantity and requirements for different quality inspection items, and introduces pre-sampling preparation, sampling process, specific testing methods, as well as analysis and utilization of inspection results.

Mature red blood cells (RBCs), lacking nuclei and protein synthesis systems, were once considered devoid of functional RNA. However, recent studies have revealed abundant microRNAs (miRNAs) within RBCs, making their origin and function a research hotspot in hematology and molecular biology. This article reviews the paradigm shift from the "presence" to the "function" of RBC miRNAs, systematically discussing their roles in erythropoiesis, potential as disease biomarkers, mechanisms of intercellular communication, and clinical significance in transfusion medicine. RBC miRNAs are not merely "molecular archives" of erythroid differentiation but may also participate in various physiological and pathological processes through extracellular vesicle-mediated communication, such as in malaria infection, tumor microenvironment modulation, and self-regulatory feedback in erythropoiesis. Furthermore, dynamic changes in RBC miRNA profiles during blood storage provide novel molecular markers for assessing blood product quality. Future research, integrating high-throughput technologies like single-cell sequencing and spatial transcriptomics, will further unveil the translational potential of RBC miRNAs in disease diagnosis and therapy.

Objective To investigate the effects of multi-level regulatory effects within the hematopoietic system in a murine model of phenylhydrazine(PHZ)-induced chronic hemolytic anemia. Methods A chronic hemolytic anemia model was established in C57BL/6 mice using PHZ. We analyzed multiple hematopoietic parameters, including complete blood count, plasma-free hemoglobin, and flow cytometric quantification of terminal erythroid differentiation stages, hematopoietic stem cells (HSCs) , and bone marrow mesenchymal stem cells (BMSCs). Results Successful model establishment was confirmed by complete blood count and elevated free hemoglobin. Flow cytometry revealed significant increases in the proportions of proerythroblasts [(2.33±0.29)%, P<0.01] and basophilic erythroblasts [(1.04±0.23)%, P<0.05]. Additionally, the proportions of HSCs [(0.16±0.03)%, P<0.000 1] and BMSCs were significantly elevated in the bone marrow. Conclusion PHZ-induced chronic hemolytic anemia triggers multi-level regulation within the hematopoietic system, which helps maintain erythrocyte homeostasis and provides a theoretical basis for understanding the pathogenesis of hemolytic anemia.

Objective To investigate the regulatory role of protein kinase A (PKA) in the differentiation of human induced pluripotent stem cells (iPSCs) into megakaryocytes (MKs). Methods A PKA overexpression plasmid was constructed and introduced into iPSCs derived from human umbilical cord blood via a lentiviral transduction system to establish a PKA overexpression cell line. A PKA gene knockout iPSC line was generated using CRISPR/Cas9 gene-editing technology. The expression of PKA in both cell lines was verified at the protein level. In a serum-free, feeder-free "Spin-EB" culture system, three groups were established: control group (untreated group), PKA overexpression group (OV group), and PKA knockout group (KO group). On day 21 of culture, cells from each group were collected, and the expression levels of megakaryocytic lineage markers (CD41⁺) and mature megakaryocytic markers (CD41⁺CD42a⁺) were detected by flow cytometry. Results No significant difference was observed in CD41⁺ cell proportion or count between PKA OV and control groups (P>0.05); PKA OV significantly reduced the proportion and count of CD41⁺CD42a⁺ mature MKs (P<0.01; P<0.05); PKA KO markedly increased both CD41⁺ and CD41⁺CD42a⁺ cell proportions and counts (P<0.001; P<0.001; P<0.01; P<0.01). Conclusion This study successfully established PKA gene-modified iPSC lines and demonstrated the regulatory role of PKA in the differentiation of iPSCs into MKs, providing a new target for optimizing the generation of platelets from human iPSCs. PKA overexpression inhibited the differentiation of iPSCs into MKs, whereas PKA knockout significantly promoted this differentiation.

Objective To compare the viral inactivation effects of methylene blue(MB) plus light (MB/light) treatment using white light LEDs, red light LEDs, and fluorescent lamps on plasma. Methods Plasma samples were treated with methylene blue at a final concentration of 1 μM, followed by 30 minutes of irradiation using white light LEDs, red light LEDs, or fluorescent lamps. The study evaluated the impact of these treatments on coagulation factors (FIB, FⅡ, FⅤ, FⅦ, FⅧ、FⅨ, FⅩ, FⅪ, FⅫ, vWF:Ag, vWF:Ac), anticoagulant proteins (AT, PC), PT, and APTT. Additionally, the efficacy of SINDBIS virus inactivation in plasma was assessed. Results All three methylene blue photodynamic therapies significantly reduced the activity of coagulation factors and anticoagulant proteins, and prolonged coagulation times. No significant differences were found in the activity of FⅤ, FⅦ, FⅨ, FⅪ, vWF:Ac, and AT among the three light sources (P=0.115 8, 0.434 2, 0.610 8, 0.094 3, 0.137 7, 0.166 7). There were no significant differences in the changes of PT and APTT (P=0.652 6, 0.138 2). Red light LEDs treatment resulted in lower FIB, FⅧ, FⅫ, and PC levels compared to white light LED (P<0.000 1, P<0.000 1, P=0.023 2, P<0.000 1) and fluorescent lamps (P<0.000 1, P<0.000 1, P=0.003 4, P<0.000 1). Fluorescent lamps treatment resulted in higher FII levels than red light LED (P=0.012 2), and higher FX levels than both white light LEDs and red light LEDs (P=0.036 6, 0.006 8). White light LEDs treatment yielded higher vWF:Ag levels than red light LED and fluorescent lamps (P=0.014 3, 0.017 2). Following MB/light treatment with the three light sources, the Sindbis virus titer in plasma decreased by>4 LogTCID₅₀/0.1 mL. Conclusion All three MB/light treatments effectively inactivated Sindbis virus in plasma. Red light LED had the most significant effect on FIB and FⅧ activity. White light LED is the preferred light source for future plasma viral inactivation treatments.

Objective This study aimed to investigate the effects of platelet-rich plasma (PRP) on the proliferation and migration of immortalized human endometrial stromal cells (iehESCs), to determine the optimal concentration of PRP, and to identify the key gene mediating PRP-induced enhancement of cell proliferation and migration. Methods iehESCs were exposed to graded PRP concentrations. Cell proliferation and migratory capacity were assessed by CCK-8 assay and Transwell migration assay, respectively. Transcriptome profiling was performed to screen differentially expressed genes (DEGs), and the findings were validated by quantitative RT-qPCR and Western blot. Results PRP at 5% and 10% significantly enhanced both proliferation and migration of iehESCs, whereas 15% PRP showed no stimulatory effect. Transcriptomic analysis revealed 1 032 DEGs between the 5% PRP group and control group. GO and KEGG enrichment analyses highlighted 12 up-regulated and 3 down-regulated genes. Among them, CDCA8 (cell division cycle associated 8) was markedly up-regulated at both the mRNA and protein levels. Conclusion Low concentrations of PRP (5%~10%) promote iehESC proliferation and migration, whereas high concentrations (15%) are ineffective. The beneficial effects of PRP are, at least partially, mediated by up-regulation of CDCA8, which facilitates cell-cycle progression.

Objective This study aimed to systematically analyze the distribution characteristics of Rh blood group antigens in the Chinese population, including: (1) the frequency distribution of RhD/D alleles in mainland China; (2) haplotypes of the RHD and RHCE loci in Rh-positive and Rh-negative populations; and (3) mapping the geographic distribution of Rh antigens in China. Methods A cross-sectional study design was adopted, collecting literature data on Rh blood group studies in Chinese populations published both domestically and internationally from January 1981 to December 2024. A total of 24 278 938 samples were included from 31 provinces/municipalities (data from Hong Kong, Macao, and Taiwan were unavailable), including 1 435 893 cases of Rh-positive and 113 676 cases of Rh-negative typing. Gene frequencies were calculated using the Bernstein method, followed by Hardy-Weinberg equilibrium testing. Principal component analysis was used to characterize Rh antigen distribution. Data quality control involved dual-entry verification, with data from multiple literature sources in the same region being combined for calculation. Results The Rh-negative rate in the Chinese population was 4.04‰, showing significant regional variation: highest in Xinjiang Uygur Autonomous Region (9.90‰), followed by Tianjin (6.40‰), and lowest in Guangxi Zhuang Autonomous Region (1.82‰). The frequency of the D allele was 0.936 4, and that of the d allele was 0.063 6. Genotype distribution adhered to Hardy-Weinberg equilibrium (χ²=1.32, P=0.251), with an expected genotype distribution of 877 individuals with the DD genotype, 119 with the Dd genotype, and 4 with the dd genotype per 1 000 individuals. Phenotypic analysis revealed that DCCee was predominant among RhD-positive individuals (44.37%), while dccee was most common in RhD-negative individuals (56.84%), with significant haplotype distribution differences ( P<0.001). The distribution of RhCE antigens among Chinese populations also showed clear regional differences: higher Ce and lower ce in the south, higher ce and lower Ce in the northwest; Rh-negative CE antigens were rare in Guangxi and the central region had higher cE. Conclusion Based on 24 million samples, this study mapped the distribution of Rh blood group antigens across China, unveiling the genetic polymorphism of the Rh system in the Chinese population.

Objective To investigate the clinical efficacy of plasma exchange (PE) and hemodialysis (HD) in children with lupus nephritis. Methods We retrospectively analyzed 12 children with lupus nephritis who were admitted to the Department of Rheumatology and Immunology of our hospital for plasmapheresis from January 1, 2022 to August 31, 2024. The treatment is formulated according to the children's condition, gender, height, weight, hematocrit and other indicators. The levels of ANA, Anti-dsDNA antibody, hemoglobin, white blood cells, platelets, total protein, albumin, globulin, white globulin ratio and coagulation function were measured before and after PE. The changes in creatinine and urea nitrogen levels at discharge and during replacement were detected. Results The average number of plasma exchanges in 12 children was about 3, and the average total amount of replacement fluid was about 1 600 (1 200~2 200) mL, which was about 1.3±0.23 total plasma volume (TPV), and there were no statistically significant differences in Hb, PLT, PT, PTA, INR, ALB, Cr, and BUN before and after PE (P>0.05), WBC, APTT, FIB, TP, GLB, A/G ware statistically significant (P<0.05). At discharge, the creatinine of the children decreased to about 100 μmol/L, and the positive intensity of urine protein was also weakened. Conclusion PE combined with HDF can effectively improve renal function in children with lupus nephritis.

Objective To investigate the changs and characteristics of regulatory T cells (Treg), helper T cells 17 (Th17) and related cytokines in the peripheral blood of patients with immune platelet transfusion refractoriness (IPTR). Methods A case-control study was conducted involving 20 patients with IPTR, 20 patients with effective platelet transfusion and 20 healthy controls. Flow cytometry was applied to detect the proportions of Treg (CD4+CD25+Foxp3+) and Th17 (CD4+IL-17A+) cells. Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-17A (IL-17A) and transforming growth factor-β1 (TGF-β1). Results Compared with the healthy control group, the IPTR group showed a significantly decreased proportion of Treg (P<0.05), accompanied by a significantly increased proportion of Th17 cells and an elevated Th17/Treg ratio (both P<0.05). Meanwhile, the serum levels of pro-inflammatory cytokines IL-6 and IL-17A were significantly elevated (both P<0.05), while the levels of anti-inflammatory cytokines IL-10 and TGF-β1 were significantly reduced (both P<0.05). Conclusion Patients with IPTR have an imbalance in the Treg/Th17 axis and dysregulation of the pro-inflammatory and anti-inflammatory cytokine network. This finding suggests that the disruption of immune homeostasis may contribute to the pathogenesis of PTR by enhancing inflammatory responses and impairing immune tolerance.

Objective To investigate the effect of Daratumumab (DARA) treatment on transfusion compatibility testing in patients with multiple myeloma, and to eliminate interference using a modified DTT method. Methods We collected samples from 11 patients with multiple myeloma treated with DARA in our hospital, and identified the effects of DARA treatment on irregular antibody screening testing and cross matching blood tests. After reagent red cells and donor red blood cells were treated with classical DTT method and modified DTT method respectively, irregular antibody screening and cross matching test were performed by microcolumn gel method. Then we evaluated the effectiveness of blood transfusion and observed adverse reactions of blood transfusion. Results After treatment with DARA, all patients exhibited positive reactions in both irregular antibody screening and the primary cross-matching by microcolumn gel method, while negative reactions by the polybrene method. When the modified DTT method (0.02 mol/L) was used to treat reagent red cells and donor red cells, the results showed negative reactions in both tests by the microcolumn gel method, which could accurately detect anti-K antibodies.The hemoglobin levels of patients increased, and there was no significant change in serum indirect bilirubin before and after transfusion, which indicating transfusion treatment was effective. No serious adverse reactions occurred. Conclusion DARA treatment could interfere transfusion compatibility tests. Modified DTT method would be an optional method for irregular antibody screening and cross matching.

Objective This study aimed to evaluate the performance of SARS-CoV-2 antibody detection kits based on the wild-type strain and Omicron variants in people living with HIV (PLWH) who were unvaccinated and infected with the Omicron variant. Methods This study recruited 45 unvaccinated PLWH who were infected with the Omicron BA.5 variant for the first time and conducted a follow up four months later. Antibody levels were measured using eight kits targeting the wild-type strain and two kits specific to Omicron variants. Pseudovirus neutralization assays targeting the wild-type (WT), BA.4/5, and XBB.1.5 variants were used as the gold standard. Agreement of qualitative results was assessed using McNemar and Kappa tests, while quantitative correlations were analyzed using Spearman correlation analysis. Results The wild-type antibody kits showed the highest agreement with WT-neutralizing antibody (nAb) (maximum κ=0.483), but significantly lower agreement with Omicron-nAb. Quantitatively, strong correlations were observed between wild-type kits and WT-nAb (r_s=0.69~0.85), while correlations with BA.4/5 (r_s=0.40~0.57) and XBB.1.5 (r_s=0.43~0.63) -nAb were weaker. After second infection, the correlation between wild-type kits and Omicron-nAb was improved. Omicron-specific antibody kits demonstrated narrower 95% limits of agreement with Omicron-nAb neutralization assays. Conclusion In unvaccinated PLWH, antibody detection kits based on the wild-type strain showed limited effectiveness in assessing immune responses after Omicron infection. These findings support the development and application of variant-specific antibody kits for more accurate immune monitoring and evaluation.

Objective To investigate the effects of varying sodium citrate anticoagulant dosages on plasmapheresis plasma quality and donor parameters, thus establishing an evidence-based dosage regimen tailored for the Chinese plasma donor population. Methods An in vitro study was done involving 220 volunteer plasma donors, who were randomly assigned to four experimental groups. Each group received a different volume ratio of 4% sodium citrate anticoagulant to whole blood: 1∶18, 1∶20, 1∶22, and 1∶25. A control group used a standard anticoagulant-to-whole blood ratio of 1∶16. Two separate whole blood samples were collected from each donor; one was treated with the designated anticoagulant ratio while the other was treated with the control ratio (1∶16). Plasma was then isolated by centrifugation and analyzed for the following parameters: pH, conductivity, activated Partial Thromboplastin Time (APTT), prothrombin time (PT), coagulation factor Ⅷ (FⅧ) activity, coagulation factor Ⅸ (FⅨ) activity, fibrinogen (Fg) level, and total plasma protein content. Correlations between the anticoagulant dose (citrate-to-blood ratio) and each measured parameter were analyzed. Results No significant differences in pH or Fg levels were observed between any experimental group and the control group (all P>0.05). A slight decrease in conductivity (≤0.29 μs/cm) was noted in groups with an anticoagulant-to-blood ratio≤1∶25 compared to the control (1∶16). Although the mean values of plasma protein content, APTT, FⅧ activity, and FⅨ activity varied with the anticoagulant dilution ratio, all remained within their respective reference ranges. However, the mean PT fell below the reference range when the anticoagulant dilution ratio was≤1∶20. Within the tested range (1∶18 to 1∶25), the anticoagulant concentration showed no significant correlation with plasma protein content, pH, and Fg; a weak positive correlation with conductivity and APTT (r=0.264, P<0.01 and r=0.267, P<0.01, respectively); a moderate negative correlation with FⅧ and FⅨ activity (r=-0.417, P<0.01 and r=-0.358, P<0.01, respectively); and a strong positive correlation with PT (r=0.566, P<0.01). Conclusion Within the tested sodium citrate dilution ratio range of 1∶18 to 1∶25, adjustments in anticoagulant concentration had limited and manageable effects on plasma quality parameters but exerted measurable effects on donor coagulation function. These results indicate differential sensitivity of coagulation pathways to citrate anticoagulation. Considering the balance between coagulation function preservation and plasma component stability, a sodium citrate anticoagulant-to-blood ratio of 1∶20 represents a potential optimization threshold for plasmapheresis procedures. Nevertheless, the safety profile of this specific ratio, particularly concerning donor tolerance and citrate-related adverse events, requires further validation in subsequent clinical studies.

Objective To develop and a hierarchical training system based on the Miller pyramid model ifor enhancing the job competency of blood collection and supply technicians in blood stations. Methods A preliminary indicator framework was established through literature analysis and semi-structured interviews. Core indicators were identified using the Delphi method (2 rounds) with weights determined via the he analytic hierarchy process. A dynamic evaluation mechanism was introduced to optimize the training pathways. Results A hierarchical training system was finalized, comprising 4 first-level indicators, 13 second-level indicators and 53 three-level indicators. The pilot study showed that the experimental group was significantly better than the control group in theoretical assessment performance (92.3±3.1 vs. 85.6±4.2), operation compliance rate (100% vs. 83.3%) and blood donor satisfaction score (4.8±0.2 vs. 4.2±0.3) (P<0.05). Conclusion The Miller pyramid-based hierarchical training system, featuring a "theory-application-practice" ladder and dynamic assessment, can effectively improve the comprehensive competency of blood collection and supply technicians and provide a scientific basis for standardized training in blood centers.

Objective To investigate the polymorphism of the RhD gene and its molecular mechanism in RhD-negative blood donors in Kunming region, and to provide data support for establishing a regional RHD gene database for blood donors. Methods A total of 218 RHD-negative samples were enrolled from November 2023 to August 2024. RhD negativity was confirmed by the Indirect Antiglobulin Test (IAT), and the RhCE phenotypes were identified using the saline test tube method. Genomic DNA was extracted from whole blood samples. RHD genotyping was performed via PCR-SSP method /SSP fluorescent PCR dye methods. For samples with undetermined genotypes, Sanger sequencing analysis of exons 1~10 of the RHD gene was conducted. Results A total of 179 cases (82.11%) were identified as serologically confirmed RhD-negative phenotypes, among which 154 cases (86.03%) carried the RHD*01N.01 genotype (complete RHD deletion) , with the predominant phenotype being ccee (87.01%). Twenty-five cases (13.97%) harbored non-functional RHD alleles, including RHD*01N.03 (20 cases), RHD*01N.16 (3 cases), RHD*01N.05 (1 cases), and RHD*01N.59 (1 cases). The main phenotype was Ccee (64%). Thirty-nine cases (15.89%) were classified as D variants, among which 34 cases belonged to the RHD*DEL1(c.1227G>A) type, all of which expressed the c antigen (comprising 27 Ccee and 7 CCee phenotypes). Four cases were identified as weak D/partial D types, including RHD* VI.3 (2 cases), RHD*weak D Type 71 (1 cases), and RHD*weak D Type108 (1 cases). Additionally, 1 case with the RHD*01/RHD*01N.01 genotype was detected, showing inconsistency between genotype and serological phenotype. The seropositivity rate of irregular antibodies (predominantly anti-D) in female blood donors with the RHD*01N.01 genotype was 9.84%. Conclusion The RhD gene exhibits significant polymorphism among initially screened RhD-negative donors in Kunming region. The proportion of true RhD-negative donors is higher than that in some other regions. The Asian-type DEL is the predominant D variant, though its overall proportion is relatively low. This study provides theoretical and data support for precision blood transfusion in individuals with RhD-negative and D variants.

Objective To develop and validate a nomogram model for predicting the risk of postpartum hemorrhage (PPH) within 24 hours after cesarean section, thus supporting timely targeted preventive measures and preoperative blood preparation. Methods In this retrospective study, we analyzed 1 000 cesarean section cases from Yijishan Hospital of Wannan Medical College. Based on postpartum blood loss, the training cohort (n=1 000) was divided into a PPH group and a non-PPH group. An additional independent validation cohort (n=207) was collected. Independent risk factors for PPH were screened using Least Absolute Shrinkage and Selection Operator (LASSO) regression and further assessed by multivariable logistic regression analysis. A nomogram prediction model was then constructed based on the identified factors. The model's performance was evaluated via both internal and external validation, including discrimination assessed by the area under the receiver operating characteristic curve (AUC), calibration evaluated using the Hosmer-Lemeshow test, and clinical utility examined by decision curve analysis (DCA). Results (1) Multivariable logistic regression analysis identified five independent predictors of PPH after cesarean section: placental abnormalities (OR=5.75), preterm birth (OR=4.41), preeclampsia (OR=2.11), gestational diabetes mellitus (GDM) (OR=2.07) and gestational hypertension (OR=1.78) (all P<0.05). These factors were incorporated into the nomogram. (2) The nomogram demonstrated an AUC of 0.80 (95%CI: 0.80~0.85) in the training cohort, with improved performance in the validation cohort (AUC: 0.87, 95%CI: 0.81~0.93). The calibration curves showed good agreement between predicted and observed probabilities. Decision curve analysis (DCA) confirmed the model's clinical utility across a wide range of risk thresholds. Conclusion This study successfully constructed a nomogram model with good predictive performance based on five factors: placenta accreta spectrum disorders, preterm birth, preeclampsia, gestational diabetes mellitus, and gestational hypertension. This model helps identify high-risk populations for postpartum hemorrhage after cesarean section, providing a tool for clinical preoperative decision-making and blood transfusion preparedness.

Objective To compare whether there is a significant difference in disease outcomes between anemic and non-anemic patients with pulmonary tuberculosis. Methods A retrospective analysis was conducted on 253 inpatients diagnosed with pulmonary tuberculosis at our hospital from January 1 st, 2023 to December 31 st, 2023. Patients were divided into two groups based on anemia status: anemic group (n=163) and non-anemic group (n=90). Clinical characteristics were analyzed hematological indices、sputum bacterial load and imaging data were compared before and after treatment. Logistic regression analysis was used to clarify the correlation between anemia and sputum bacterial load and pulmonary pathological damage, to further explore the impact of anemia on pulmonary tuberculosis outcomes. Results The anemia rate among pulmonary tuberculosis patients in our hospital exceeds 60%, the main type of anemia is normocytic normochromic anemia. Before treatment, anemic patients with pulmonary tuberculosis showed differences in hematological indices compared to non-anemic patients, including neutrophil percentage (NEUT%)、lymphocyte percentage (LY%)、absolute neutrophil count (NEUT#)、absolute lymphocyte count (LY#)、red blood cell distribution width coefficient of variation (RDW-CV)、aspartate aminotransferase (AST)、total protein (TP)、albumin (ALB), prothrombin time (PT)、prothrombin activity (PA)、thrombin time (TT)、D-dimer (DD), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). After treatment, anemic patients still exhibited differences in LY#、LY%、monocyte percentage (MONO%)、RDW-CV、TP、ALB and ESR, indicating anemia's impact on the hematopoietic system and immune cell function. Anemic patients had poorer treatment efficacy, longer treatment duration, higher rates of pulmonary cavitation and pleural effusion, delayed cavitary closure, slow pleural effusion absorption, and increased pulmonary injury areas. Logistic regression analysis confirmed that anemia was a correlated factor for increased sputum bacterial load and aggravated pulmonary pathological damage. Conclusion Anemia negatively affects treatment outcomes in pulmonary tuberculosis patients, anemia is a risk factor for pulmonary injury. Differences in blood test indicators before and after treatment suggest poor prognosis.

Objective Investigation of clinical, serological, and genotypic characteristics and multidisciplinary tiered management strategies in a case of A₁ antigen loss resulting from passenger lymphocyte syndrome (PLS) following ABO minor-incompatible (B to A₁B) allogeneic hematopoietic stem cell transplantation (allo-HSCT), combined with literature review to provide a reference for early clinical identification and treatment. Methods The patient's ABO blood group was determined using both microcolumn gel and tube methods, with genotyping confirmed by Sanger sequencing. Hemolysis was assessed by monitoring pre- and post-transplant changes in total bilirubin, lactate dehydrogenase (LDH), hemoglobin levels, and reticulocyte percentage. Results Following transplantation, the patient exhibited progressive hemoglobin decline, elevated reticulocyte percentage, hyperbilirubinemia, and increased LDH levels—findings indicating hemolysis. Discrepancies were noted between ABO forward and reverse typing. Genetic sequencing confirmed an ABO*A1.02/ABO*B.01 genotype; however, serological testing revealed a transient loss of A₁ antigen expression. Conclusion This case report of transient A₁ antigen loss with passenger lymphocyte syndrome (PLS) following allo-HSCT demonstrates that PLS diagnosis requires the combination of ABO forward/reverse grouping discrepancy, hemolytic laboratory evidence, and recognition of PLS clinical heterogeneity, further highlighting the value of ABO blood group monitoring in multidisciplinary collaboration.

Objective By integrating serological characteristics with gene sequencing analysis, the aim is to clarify the chimeric nature of a difficult ABO blood type sample presenting mixed field agglutination and to identify its specific ABO allele combination, thereby assisting in formulating precise blood transfusion strategies. Methods Microcolumn gel immunotechnology was used for typing and irregular antibody screening, and blood typing was rechecked by the tube saline method. Polymerase chain reaction (PCR) was used to target amplify the 6th and 7th exons of the ABO gene and their flanking intron regions, and Sanger sequencing technology was used for allele typing and single nucleotide polymorphism (SNP) analysis. Results Based on the serological MFA and the sequencing results of exons 6 and 7, it is suggested that the patient may have A1/O1/O2 chimerism (chimerism ratio at the c.261delG site is 1∶5). Conclusion For samples with MAF, even if only partial genetic testing is performed, the analysis of key loci can still provide an important reference for transfusion.

Objective The serological identification of a sample with weak D phenotype were carried out, and the mutation sites were identified. Further the impact of all mutations at this site on protein structure and function as well as molecular mechanism were studied. Methods The Rh phenotype was identified by serological methods. The RHD zygosity analysis was analyzed by PCR-SSP, and the RHD exon sequence was analyzed by direct PCR sequencing. SOPMA was used for prediction of RhD structure. Constructing 3D simulated structures of proteins using AlphaFold. The protein stability was analyzed by Mupro. PROVEAN and PolyPhen-2 analysis were used to investigate the impact on protein function. Results The antibodies from different clones exhibit weak reactivity with sample red blood cells, and the Rh phenotype is ccEe; RHD gene sequencing revealed a novel mutation c.254C>A (p.Ala85Gly) in exon 2; Retrieval revealed the presence of two other base T and G mutations at position 254. Analysis and prediction suggested that the protein secondary structure did not undergo significant changes with different mutations at position 254. However, c.254C>G and c.254C>A mutations affect the stability of the protein and lead to functional impairment. Conclusion This specimen is a rare case of weak D phenotype caused by c.254C>A. Although the 254 site is located in the transmembrane region, it is a key site of the RHD gene and has four common base forms. Mutations can lead to decreased protein stability and impaired function.

Objective To investigate a case of ABO difficult blood group patient for serological and molecular biological characteristics, and provide transfusion recommendations for the clinical transfusion in the patients. Methods The ABO blood group was identified by serological method, further serological detection was conducted by absorption-elution test, and the ABO gene sequence was analyzed by gene sequencing technology. Results The patient's ABO serological test showed inconsistent in forward and reverse typing; weak A antigen was detected by absorption-elution test; gene sequencing revealed that it carried the c.374+5G>A gene mutation, and the c.374+5G>A combined with c.467C>T gene mutations were found for the first time in the ISBT database. Conclusion Gene sequencing technology helped to elucidate the molecular biological basis of difficult blood groups, and provided evidence-based significant value for transfusion safety and the implementation of precision transfusion.

Objective To explore the relationship between serum levels of peptidylarginine deiminase (PAD) 2, nuclear factor-kappa B (NF-κB), heparin binding protein (HBP) and pulmonary infections, and the diagnosis value of their combined detection for pulmonary infections. Methods From 1 January 2020 to 30 January 2025, 84 patients with pulmonary infections in our hospital were recruited, and 30 non-infected hospitalized patients were set as control group. ELISA method was used to detect serum levels of PAD2 and NF-κB, and HBP level were detected by immunofluorescence. Pearson's correlation method was used to analyze the correlation between serum PAD2, NF-κB, HBP and white blood cell count (WBC), C-reactive protein, neutrophil percentage.. Logistic regression was used to analyze the influencing factors of lung infection. ROC curve was used to evaluate the usefulness of serum PAD2, NF-κB, and HBP for diagnosis of pulmonary infections. Results The serum levels of PAD2, NF-κB, and HBP of patients in the observation group were significantly higher than those in the control group (P<0.05). The serum levels of PAD2, NF-κB, HBP significantly correlated with the levels of white blood cell count (WBC), C-reactive protein and neutrophil percentage in observation group (P<0.05). Serum PAD2, NF-κB, and HBP were risk factors for pulmonary infection (P<0.05). The areas under the curve (AUC) of ROC of PAD2, NF-κB, HBP and combination for diagnosis of pulmonary infection were 0.814, 0.787, 0.804, and 0.930 respectively, and the diagnostic efficacy of the combined test was better (Z_combination=3.226, P<0.05). Conclusion Serum levels of PAD2, NF-κB, and HBP were closely related to pulmonary infections, and correlated with the levels of infection indicators, and the combination of these three factors displays a better diagnostic value for pulmonary infection.

Ginkgolide B is a typical diterpene lactone active ingredient extracted from the traditional Chinese medicine Ginkgo biloba, which has the effect of efficiently antagonizing platelet-activating factor, and can be involved in the inhibition of platelet activation, antioxidant, anti-thrombosis, and protection of blood vessels, especially in the regulation of platelet function demonstrates a good prospect of application. Mechanistically, GB can exert its effects through multiple signaling pathways, including Ca²⁺ signaling pathway, phosphatidylinositol 3-kinase signaling axis, arachidonic acid metabolic pathway and integrin αⅡbβ3-mediated signaling pathway, so as to exert the effect of platelet function regulation.