Autologous apheresis red blood cell technology is an important means for developing autologous blood resources in elective surgical patients. It has been applied in clinical practice in China for more than ten years and is widely used in major elective surgeries, providing effective support for alleviating blood supply difficulties in special patient populations. However, there is currently no unified standard in China regarding key quality indicators for autologous apheresis red blood cells. To address this, we assembled experts in the fields of transfusion medicine, including clinical transfusion, blood collection and supply, basic transfusion research, as well as laboratory medicine, anesthesiology, and hematology, to develop the "Chinese Expert Consensus on Quality Evaluation Indicators for Autologous Apheresis Red Blood Cells" using a three-round consensus formation method based on expert consultation combined with the Delphi method and the RAND/UCLA Appropriateness Methods (RAM) for quantitative assessment. This consensus preliminarily establishes a set of quality evaluation standards for assessing the blood quality of autologous apheresis red blood cells, including key evaluation indicators, threshold ranges, monitoring stratification, and testing frequency. It provides a unified basis for blood transfusion departments in medical institutions at various levels to evaluate the quality of autologous apheresis red blood cells, and facilitates the homogenized management of such products across different institutions.
Cell and gene therapy (CGT) in China has evolved into a parallel framework encompassing approved commercial products, registered clinical trials, investigator-initiated trials, hospital GMP platforms, and preparations developed within hospitals. Because CGT relies on living cellular products, quality risks extend across the entire process from collection and manufacturing to storage, infusion, and follow-up. International practice demonstrates that transfusion medicine contributes meaningfully to cellular collection, identity verification, cold chain management, clinical release, and adverse event monitoring. Within Chinese hospitals, a stable quality linkage mechanism between cell manufacturing and clinical administration is currently lacking, and institutional responsibility for in-hospital CGT oversight remains undefined. Transfusion medicine departments possess mature expertise in cell preservation, apheresis technology, cold chain management, and transfusion risk control—capabilities that align closely with in-hospital CGT quality management requirements. This article proposes an in-hospital CGT quality control framework supported by transfusion medicine departments, offering a reference model for the standardized implementation of somatic cell therapy, stem cell therapy, and exosome therapies.
Human leukocyte antigen (HLA) genotyping testing is a mandatory pre-transplantation procedure for organ transplantation and hematopoietic stem cell transplantation. The test results directly guide donor selection, design of immunosuppressive regimens, and post-transplant rejection monitoring. Therefore, to ensure the safety, efficacy, and quality control of HLA genotyping detection reagents registered for market authorization, the Center for Medical Device Evaluation of the National Medical Products Administration (NMPA) has recently released the Guidance for the Registration Review of Human Leukocyte Antigen (HLA) Genotyping Detection Reagents. To facilitate a better understanding of this guidance among relevant individuals, this article interprets the specific requirements for registration applications and technical reviews. These requirements cover intended use, methodology, sample types, accuracy, precision, limit of detection, performance indicators in Product Technical Requirements, and manufacturer's reference materials settings for such products.
This study explores the application and potential impact of Digital Twin technology in transfusion medicine. Through a systematic review of relevant literature, we first outline the fundamental concepts and evolution of Digital Twin technology. We then conduct an in-depth analysis of its extinct advantages in optimizing blood collection and supply processes, enhancing transfusion procedures, and improving transfusion safety. Special emphasis is placed on its role in data governance and intelligent management within blood services. Additionallly, we examine the challenges related to data security, privacy protection, regulatory compliance, and medical ethics that arise with the implemention of this technology. Our findings indicate that while Digital Twin technology holds significant promise for transfusion medicine, several practical issues remain to be addressed. Future efforts should aim to effectively harness Digital Twin frameworks to foster innovation, ultimately providing evidence-based operational solutions and technical guidance for blood services while advancing transfusion safety.
This paper focuses on the management of medical waste in blood collection and supply institutions, aiming to transcend one-way description and provide a reference with both theoretical depth and practical foresight for advancing industry management standards. By integrating practical data with domestic and international literature and policies, it systematically analyzes the deep-seated challenges faced by blood stations in areas such as regulatory coherence, oversight mechanisms, personnel awareness, and technological application. Building on this foundation, it proposes the establishment of a comprehensive governance system encompassing the refinement of regulations and standards, intelligent closed-loop process management, multi-stakeholder collaborative oversight, and professional capacity building. The paper emphasizes that medical waste governance in blood stations must be positioned within the overarching strategies of "zero-waste cities" and the circular economy, leveraging technological innovation and management reform to achieve a transformation from passive disposal to proactive resource management.
Objective Bioinformatic analyses have identified aberrant overexpression of E3 ubiquitin ligase Mindbomb 2 (MIB2) in papillary thyroid carcinoma (PTC), implicating it as a key driver of PTC tumorigenesis. This study characterizes the functional impacts of MIB2 silencing on proliferation, apoptosis, invasion, and migration in the PTC-derived TPC-1 cell line. Methods MIB2-silenced TPC-1 cell lines were generated via RNA interference (RNAi). Cells were divided into control (TPC-1) and MIB2-silenced (TPC-1-MIB2 RNAi) groups. Cell proliferative capacity was quantified using Cell Counting Kit-8 (CCK-8) and colony formation assays. Invasive and migratory potentials were evaluated via Transwell invasion and wound healing assays, respectively. Flow cytometry was performed to assess cell cycle distribution and apoptotic rates. Results Compared with control cells, TPC-1-MIB2 RNAi group exhibited significantly attenuated proliferation kinetics and reduced colony formation efficiency, consistent with robust suppression of PTC cell proliferation following MIB2 knockdown (P<0.05). Flow cytometric profiling revealed prominent G0/G1 phase cell cycle arrest in TPC-1-MIB2 RNAi group, coupled with a marked elevation in apoptotic rate compared with control cells, indicative of enhanced PTC cell apoptosis mediated by MIB2 silencing (P<0.05). Transwell invasion and wound healing assays demonstrated that TPC-1-MIB2 RNAi cells markedly impaired the invasive and migratory capacities of TPC-1 cells, as evidenced by reduced transmembrane invasion and significantly delayed wound closure compared to TPC-1 group (P<0.05). Conclusion MIB2 silencing exerts potent tumor-suppressive effects in PTC cells through inhibition of proliferation, invasion, and migration, alongside concomitant promotion of apoptosis. These findings identify MIB2 as a promising candidate therapeutic target for papillary thyroid carcinoma.
Objective To optimize a four-stage induction system for the in vitro directed differentiation of CD34+ stem cells from umbilical cord blood into functional red blood cells (RBCs), and to systematically characterize cell proliferation, morphological changes, surface marker expression, and hemoglobin synthesis under this system, providing an experimental basis for improving in vitro RBC preparation technology. Methods Umbilical cord blood was collected from 6 healthy newborns. Mononuclear cells were isolated by density gradient centrifugation, and CD34+ stem cells were selected using immunomagnetic beads. A 28-day four-stage induction differentiation system was established, with precise regulation of the combination and concentration of specific inducing factors at each stage. Cell counts were performed at different time points, morphology was assessed by Wright-Giemsa staining, erythroid surface markers (CD45, CD71, CD235a) were analyzed via flow cytometry, color changes of cell pellets were observed, and hemoglobin content was measured using a hemoglobin test kit. The differentiation process was systematically analyzed. Results Cells continuously proliferated throughout the differentiation process, reaching a peak at day 14. Morphologically, cells gradually progressed from primitive progenitors to erythroid cells, with enucleated or nuclear-shifted cells of similar size to mature RBCs observed at day 28. Surface marker expression showed a typical trajectory of erythroid differentiation: CD45 progressively decreased (28-day positivity rate 24.93%), CD71 peaked at day 14 (84%) and then decreased, and CD235a steadily increased (28-day positivity 71.64%). Red pigmentation appeared in cell pellets at day 21, and deepened at day 28, with a hemoglobin content of 70.7 g/L. Conclusion The optimized induction system efficiently directs CD34+umbilical cord blood stem cells towards erythroid differentiation and functional hemoglobin production through precise stage-specific factor regulation. This study could provide specific schemes and experimental data to support the advancement of in vitro RBC generation systems.
Objective To investigate the associations of preoperative anemia correction strategy and hemoglobin (Hb) correction magnitude with the risk of all-cause mortality within 30 days following discharge in anemic patients undergoing cardiac valve surgery. Methods We retrospectively analyzed the clinical data of 369 adult patients with anemia defined according to the World Health Organization criteria who underwent primary cardiac valve surgery under cardiopulmonary bypass at Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University between January 2020 and December 2022. Patients were categorized according to preoperative anemia correction strategy and Hb correction magnitude. Propensity score matching (PSM) was used to balance baseline characteristics. Univariate and multivariate Logistic regression analyses were performed to evaluate risk factors for 30-day all-cause mortality after discharge. According to the Hb correction value, patients were classified into four groups:<-10, -10 to <0, 0 to <15, and≥15 g/L, and the association between different correction magnitudes and mortality was assessed. Results After PSM, the transfusion correction group showed a trend toward a higher risk of 30-day all-cause mortality than the pharmacological correction group. The difference was not statistically significant, although a potential clinically relevant trend was observed (aOR=3.038, 95%CI 0.909~10.152, P=0.071). After stratification by Hb correction value, the 30-day all-cause mortality rates in the four groups were 21.7%, 4.5%, 11.7%, and 33.3%, respectively; and the difference was statistically significant (P=0.04). The mortality risk tended to show a U-shaped distribution with the change in correction amplitude. In addition, age was an independent risk factor for 30-day all-cause mortality after discharge (aOR=1.097, 95%CI: 1.042~1.155, P<0.001). Conclusion The correction strategy and correction amplitude of preoperative anemia may be associated with short-term prognosis in patients undergoing heart valve surgery. In perioperative patient blood management, pharmacological correction based on etiology may be a preferable option, and close attention should be paid to the magnitude of Hb change to avoid the potential adverse prognosis associated with under-correction or over-correction.
Objective To study the probability of drug-dependent red blood cell antibodies produced in patients using piperacillin-tazobactam , related influencing factors and the impact on patients. Methods A total of 168 newly admitted patients who were treated with piperacillin-tazobactam for the first time from June 2020 to September 2023 were selected. Direct antiglobulin test (DAT), irregular antibody screening and piperacillin antibody detection were performed to test blood samples from patients treated with piperacillin-tazobactam after 7th day or before, and the ratio of lymphocytes in blood cells was analyzed. Results On the 7th day after medication, DAT was positive in 28 cases (16.7%) and piperacillin antibody was positive in 15 cases (8.9%). Among them, 3 cases (20%) were DAT positive, and 7 cases (46.7%) had antibody titer≥2+. The lymphocyte ratio of piperacillin antibody positive patients (42.3%±27.3%) was significantly higher than that of piperacillin antibody negative patients (26.4%±19.7%), and the difference was statistically significant (P<0.05). Conclusion The incidence of drug-dependent red blood cell antibody was 8.9% after using piperacillin-tazobactam. There is a significant correlation between the production of piperacillin antibody and the lymphocyte ratio of patients.
Objective To evaluate the capacity of freeze-dried platelet-rich plasma (FD-PRP) to stimulate the proliferation and migration of human dermal fibroblasts. Methods Freshly isolated PRP was lyophilized to generate FD-PRP. Cell proliferation was quantified using the CCK-8 assay; directional migration was monitored via scratch-wound assays; and the secretion of type Ⅰ collagen and elastin was measured by ELISA. Results Compared to untreated controls, FD-PRP significantly enhanced fibroblast proliferation and increased the secretion of type Ⅰ collagen and elastin (P<0.05). These effects were statistically comparable to those induced by fresh PRP (P>0.05). Scratch-wound assays further revealed that both FD-PRP and fresh PRP markedly enhanced cell migration into the denuded area compared with the controls. Conclusion FD-PRP induces the proliferation and migration of adult dermal fibroblasts and also enhances the secretion of type Ⅰ collagen and elastin. These findings lay a solid experimental foundation for the potential clinical application of FD-PRP in the future treatment of various wound types.
Objective To investigate the influence of reagent-dependent antibodies on blood transfusion compatibility testing and to explore potential resolution strategies. Methods Five difficult suspected reagent-dependent antibody generated patient samples referred by clinical hospitals were analyzed. ABO blood grouping, antibody screening, antibody identification and crossmatching were performed using the in vitro anti-human globulin method and the anti-human globulin card method. Results Sample 1 had antibodies against the red blood cell suspension medium, Sample 2 exhibited reagent antibodies against the anti-typing cell suspension medium, Sample 3 displayed reagent antibodies against the enhancer medium Liss, and Sample 4 also had reagent antibodies against the enhancer medium Liss, both showing similar anti-C and anti-e specificityies. Samples 5 had antibodies against the albus reagent. Conclusion By conducting a comprehensive analysis and comparing the different results obtained from different reagents, reaction media, and detection methods for the same patient sample, the specific reagent-denpendent antibody can be accurately identified.
Objective This study aimed to investigate the effects of treating red blood cells (RBCs) with four different proteinaases on the detection of anti-E and anti-c antibodies, and to compare the sensitivity among three detection methods. The goal is to provide a scientific basis for selecting the optimal enzyme treatment detection protocol in clinical practice. Methods Five RBC samples with different Rh phenotypes (3 cases of CcEe, 1 case of Ccee, and 1 case of CCEe) were selected. RBCs were treated using a two-step enzyme method with chymotrypsin, trypsin, pronase, and papain. Prior to enzyme treatment, antibody titers for anti-E and anti-c were determined by the Microcolumn Gel Test (MGT), the polybreneethylene Glycol-enhanced Microcolumn Gel Test (PEG-MGT), and the Polybrene method. Following enzyme treatment, the MGT method was used uniformly for antibody detection. Cells with CcEe and CCEe phenotypes were tested for anti-E; cells with CcEe and Ccee phenotypes were tested for anti-c. Analyses were performed on: differences among the three pre-treatment methods; differences among the four enzyme treatment groups; and different titers between post-enzyme treatment and pre-enzyme treatment. Results Anti-E results: Anti-E: Before enzyme treatment, a significant difference in detected titers was found between the PEG-MGT and MGT method (P<0.05). After treatment with the four enzymes, a significant difference in titer was observed between chymotrypsin and pronase (P<0.05). When comparing the titers of MGT after enzyme treatment with those before treatment, significant differences were observed between the pronase and MGT groups, as well as between the papain and MGT groups (P<0.05). Anti-c results: Before enzyme treatment, a significant difference in detected titers was found between the Polybrene and MGT methods (P<0.05). After treatment with the four enzymes, a significant difference in titer was observed between chymotrypsin and papain (P<0.05). When comparing post-enzyme treatment MGT titers with pre-enzyme treatment titers, significant differences were found between the MGT method and the trypsin, pronase, and papain groups (P<0.05). Conclusion Before enzyme treatment, the optimal method for detecting anti-E is PEG-MGT, while the optimal method for detecting anti-c is the Polybrene method. After enzyme treatment, the pronase-MGT combination is the best solution for detecting anti-E, whereas the papain-MGT combination serves as the optimal method for detecting anti-c. Enzyme treatment techniques and PEG can significantly enhance the detection sensitivity of specific antibodies, serving as an important supplement to conventional detection methods.
Objective To establish a novel flow cytometry-based method for quantifying residual RhD antigen on red blood cells (RBCs) in apheresis platelets, aims to assess the immunogenic risk of anti-D immunization in RhD-negative patients who receive RhD-positive platelet transfusion. Methods The method quantified residual RBCs based on anti-D antibody consumption. Simulated samples were prepared by serial dilution of RhD-positive RBCs, then incubated with a low-titer anti-D antibody. After anti-D absorption, the remaining free anti-D was quantitative detected by flow cytometry to generate a standard curve, which correlating antibody test value with RBC count. This method was applied to 30 donor apheresis platelet samples. Results The measurable range of the novel method is 2×108 to 1.25×1010 RBCs/U. In 12 of the 30 tested samples, the RBC levels were below the limit of detection. In the remaining 18 quantifiable samples, 4 samples contained residual RBC counts>1×109 RBCs/U, 3 samples contained 5×108 to 1×109 RBCs/U, and 11 samples contained 2×108 to 5×108 RBCs/U.All samples met the national standard requirements (<8×109 RBCs/U), while the residual RBC levels were significantly higher than prior reports. Conclusion The novel flow cytometric method offers enhanced sensitivity and accuracy for detecting residual RhD-positive RBCs in platelet products. There is a risk of anti-D alloimmunization in non-DEL RhD-negative patients receiving repeated transfusions of RhD-positive platelet products in a short term.
Objective To investigate the iron reserve levels and red blood cell-related parameters in apheresis platelet donors in Jinan, and provide a basis for improving donor health management. Methods This cross-sectional study enrolled voluntary apheresis platelet donors at our center from July 2023 to July 2024. Donors were stratified by sex, donation frequency, and donation interval. Serum ferritin (SF), blood cell counts (Hb, MCV, MCH, and MCHC) were measured. Iron deficiency rate and its influencing factors were analyzed. Results In male donors, SF levels decreased with higher annual donation frequency and shorter donation intervals, while the low SF rate increased accordingly. Compared with the control group, donors with≥7 annual donations and those with donation intervals≤45 days showed statistically significant differences (P<0.05). In female donors, SF levels also tended to decrease and low SF rate increased with more donations, but only the group with≥7 annual donations showed a statistically significant difference compared with the control group (P<0.05). Certain indicators among Hb, MCV, MCH, and MCHC showed statistical differences across male donors with different donation frequencies and intervals, while no significant differences were observed in female donors. However, median values of all groups remained within normal reference ranges. Multiple linear regression analysis showed that SF levels were positively correlated with age (r=0.076,P<0.05), body mass index (r=0.205, P<0.05), and Hb (r=0.124, P<0.05), and negatively correlated with donation frequency (1~6 times: r=-0.151, P<0.05; 7~12 times: r=-0.316, P<0.05; 13~18 times: r=-0.381, P<0.05; 19~24 times: r=-0.364,P<0.05). Additionally, SF was negatively correlated with female sex (r=-0.156, P<0.05). Conclusion Iron reserves in male apheresis platelet donors decrease significantly with higher donation frequency and shorter donation intervals. The current Hb-based screening criterion is insufficient for early detection of iron deficiency. Although a similar trend was observed in female donors, some differences did not reach statistical significance, requiring further validation with larger sample sizes. Diversified studies are warranted on the iron nutritional status of apheresis platelet donors using novel technologies, thus establishing a dynamic SF monitoring model, and individualizing iron supplementation guidance to safeguard donor health.
Objective To evaluate the susceptibility of alanine aminotransferase (ALT) and enzyme-linked immunosorbent assay (ELISA) employed in blood screening laboratories for hemolysis and lipemia samples, and to establish assay-specific interference thresholds for these variables. Methods Hemolysis samples with gradient hemoglobin (Hb) concentrations (0, 1, 2, 4, 5, 7.5 and 10 g/L) and lipemia samples with gradient triglyceride (TG) concentrations (0, 0.63, 1.27, 2.54, 5.08 and 10.15 mmol/L) were prepared. Interference effects were evaluated using three methods: gradient dilution linear regression, pre- and post-centrifugation bias analysis for ALT, (an absolute bias of ≤7.5% considered acceptable), and reactivity consistency testing for ELISA(maintaining an original reactivity/non-reactivity status). Based on these results, visual color charts for hemolysis and lipemia were developed. Results ALT demonstrated acceptable performance up to the highest tested triglyceride (TG) level (10.15 mmol/L), as evidenced by a linear regression slope of b=1, intercept a≈0, and absolute bias≤7.5%. ALT was also robust against hemolysis up to Hb=4 g/L (absolute bias≤7.5%). Among ELISA items, anti-HCV (sandwich method) and P24 antigen detected by HIV Ag/Ab reagent (4th generation) showed false negatives when TG=5.08 mmol/L. 3rd-generation and 4th-generation HIV Ag/Ab antibodies testing showed false negatives when Hb 4 g/L, while HBsAg testing showed false positives when Hb≥5 g/L. Considering these results of all items, the maximum acceptable interference thresholds were established as Hb 2 g/L and TG 2.54 mmol/L. Conclusion Hemolysis and lipemia significantly interfere with blood screening assay. Establishing unified, clinically relevant interference thresholds is essential to ensure result reliability and transfusion safety.
Objective To investigate the factors influencing vasovagal reactions (VVR) in whole blood donors, and to develop and validate a risk prediction model. This aim is to provide blood bank medical staff with a quantitative tool for VVR prediction, enabling early identification and precise intervention for high-risk individuals, thereby ensuring blood donation safety. Methods A total of 101 187 donation records from whole blood donors at the Guizhou Blood Center between January and December 2024 were included, encompassing demographic characteristics (gender, age, weight, ethnicity, etc.) and donation records (donation history, pre-donation pulse, blood pressure, planned collection volume, etc.). The data were randomly split into a training set (n=70 698, 70%) and a validation set (n=30 489, 30%). Univariate analysis and logistic regression were used to identify independent risk factors for VVR, and a prediction model was developed and presented as a nomogram. Model performance was evaluated using ROC curves and calibration curves to assess discriminative ability and prediction accuracy respectively. Results The results of logistic regression analysis showed that gender, age, body weight, education level, pre-collection volume, and blood donation history were independent influencing factors for vasovagal reactions during whole blood donation (P<0.05). The model exhibited good discrimination in the training set, with an area under the curve (AUC) of 0.764 (95%CI: 0.750-0.777). The optimal risk threshold determined based on the Youden index was 0.014, at which the sensitivity was 76.5% and the specificity was 64.1%. In the independent validation set, the model maintained robust performance, with an AUC of 0.772 (95%CI: 0.751-0.792), and at the same threshold, the sensitivity and specificity were 78.4% and 65.1%, respectively, confirming its generalizability. Calibration: The calibration curve showed that the predicted probabilities of the model were highly consistent with the actual occurrence rate. Quantitative analysis further confirmed that the expected calibration errors (ECE) of the training set and validation set were as low as 0 and 0.000 1, respectively, indicating that the model has excellent calibration accuracy. The model demonstrated characteristics of high sensitivity (78.4%), high negative predictive value (99.6%), and low positive predictive value (2.9%). Conclusion The risk prediction model for vasovagal responses in whole blood donation constructed in this study can reliably identify low-risk individuals for safe diversion and provides a scientific basis for blood station medical staff to develop personalized preventive measures.
Objective To investigate the serological and molecular biological characteristics of two ABO subtypes, ABO*A3.07/B.01 and ABO*BEL.03/O.01.01, analyze associated alterations in protein structure, and validate the accuracy of predicted protein structures using RamAchandran plots. Methods Blood samples from two donors were initially screened using serological techniques and detection of blood group substances in saliva. Genotyping was performed using fluorescent quantitative polymerase chain reaction (PCR), followed by sequencing of all exons of the ABO gene. Three-dimensional protein structure models were generated using AlphaFold 3.0. Comparative structural analysis was conducted using PyMOL software, and model reliability was assessed via RamAchandran plot evaluation. Results Donor 1: Serological forward typing showed weak agglutination with anti-A and no agglutination with anti-A1. Genotyping identified the subtype as ABO*A3.07/B.01. Sequence analysis identified two specific mutations, c.467C>T and c.745C>T compared to the standard sequence, resulting in amino acid changes p.Pro156Leu and p.Arg249Trp, respectively. Structural modeling indicated a reduction in hydrogen bonding following the substitution at position 249. Donor 2: Forward typing appeared as type O, while reverse typing showed weak agglutination with B cells. Genotyping identified the subtype as ABO*BEL.03/O.01. Direct sequencing detected a single mutation at c.502C>T, resulting in amino acid change p.Arg168Trp. Structural modeling indicated a reduction in hydrogen bonding following the substitution at position 168. Ramachandran plot validation confirmed the high quality of the predicted protein structure models for both subtypes. Conclusion Molecular analysis confirmed the two rare ABO subtypes as ABO*A3.07/B.01 and ABO*BEL.03/O.01.01, which were the first reported cases of blood donor population in Jinan region.
Objective To analyze the prevalence of HIV infection among Chinese college student blood donors, providing evidence for blood bank to formulate appropriate blood screening strategies for college students. Methods Relevant studies published were searched through databases including CNKI, Wanfang, PubMed, and Embase. Data were extracted and subjected to meta-analysis using R software. Results A total of 16 studies were eligible with a cumulative sample size of 914 193 donors and 93 HIV-positive cases. The pooled HIV prevalence among Chinese college student blood donors was 0.007% (95%CI: 0.005%~0.009%). Subgroup analysis revealed statistically significant differences by gender and sample size (P<0.05), but not by region, study period, or detection method (P>0.05). Conclusion The HIV positive rate among Chinese college student blood donors has maintained stable low, with a significantly higher prevalence in males than in females. The potential residual risk of transfusion-transmitted HIV cannot be overlooked.
Objective To evaluate the efficacy and safety of unrelated umbilical cord blood transplantation (UCBT) in the treatment of adult patients with hematological malignancies who have a high body weight. Methods A retrospective analysis was conducted on the clinical outcomes of 121 adult patients with hematological malignancies. All patients had a high body weight (≥70 kg) and underwent single-unit UCBT at a single center between January 2018 and September 2024. Results Compared with the low body weight group (<70 kg), the total number of nucleated cells infused was significantly lower in the high body weight group (P<0.01). However, the incidence of pre-engraftment syndrome was significantly higher in the high body weight group [80.83% vs. 69.42% (P<0.01)]. There were no significant differences between the two groups in terms of other post-transplant complications or survival outcomes. Conclusion UCBT is a safe and effective treatment option for adult patients with hematological malignancies who have a high body weight.
Objective To identify the specificity, immunoglobulin subclass and titer of an anti-K antibody detected in a patient with a positive irregular antibody screen, and to analyze potential etiological factors contributing to its formation. Methods ABO blood grouping and Rh phenotyping were performed using standard serological methods. Irregular antibody screening and identification were carried out by normal saline (NS) tube test and microcolumn gel test (MGT). Crossmatching was conducted using NS, MGT, and manual polybrene test (MPT). The serum was treated with 2-mercaptoethanol (2-ME) to determine the immunoglobulin class and titer of the antibody. Results The irregular antibody screen was positive, and the antibody was specifically identified as anti-K. It was characterized as a mixed IgM and IgG isotypes, with an IgM titer of 2 and an IgG titer of 256. Conclusion Utilization of suitable laboratory techniques allows for the accurate detection of IgM+IgG anti-K antibodies, providing a guarantee for safe clinical transfusion.
Objective For samples in the Rh blood group system that are found to contain antibodies with both anti-D and anti-C properties, further antibody identification should be performed to clarify their specificity, especially to exclude or confirm the presence of anti-G antibodies, and scientific and reasonable blood transfusion strategies should be explored in combination with clinical practice. Methods Identification of ABO and Rh blood types,unexpected antibody screening and identification, using CCdee and ccDEE cells as absorbent cells, A two - step absorption - elution test was adopted to separate and identify antibody specificity, and antibody titer was determined simultaneously. Results Anti-G, anti-D, and anti-C were detected in both patients, anti-E was additionally identified in patient 1, blood products with Rh phenotype ccdee and ABO compatibility were selected for cross-matching, and the cross-matching results were compatible. Conclusion For antibodies presenting with an anti-D + C serological reactivity profile, the presence of anti-G antibodies should be highly vigilant, as such antibodies often occur in combination with anti-D and anti-C. It is recommended that when transfusing blood to RhD-negative patients, blood products matched for both ABO and Rh system phenotypes (including C, c, D, E and e antigens) should be used whenever feasible, so as to reduce the risk of alloantibody production and ensure transfusion safety.
Human serum albumin (HSA), the most abundant circulating protein in human plasma, is exclusively synthesized by hepatic parenchymal cells. HSA undergoes a broad spectrum of enzymatic and non-enzymatic post-translational modifications (PTMs), which induce substantive conformational alterations to the protein backbone. The physiological functions of HSA include maintenance of plasma colloid osmotic pressure, ligand binding and transport, endogenous antioxidant activity, anti-inflammatory effects, etc. Critically, the biological functions of HSA are intrinsically coupled to its three-dimensional conformational state. Across a wide range of pathological conditions, disease-driven perturbations to HSA structure compromise its biological functionality, which in turn modifies disease trajectory and modulates the therapeutic efficacy of clinical interventions. Currently, plasma-derived HSA (pdHSA), purified from the plasma of healthy human donors, is ubiquitously administered in the clinical management of diverse critically ill patient populations. With recent transformative advances in biopharmaceutical technology, recombinant HSA (rHSA) has been successfully translated into clinical practice, with demonstrable differences in structural properties, biological functionality, and safety profiles relative to pdHSA. This review synthesizes the core PTMs and functional regulatory mechanisms of HSA, delineates disease-associated alterations in HSA structure and function across multiple pathological states, and directly compares the structural and functional similarities and differences between pdHSA and rHSA. Collectively, this article provides a comprehensive, integrated framework for understanding HSA biology, establishing a foundational theoretical basis for the innovative clinical application of HSA-based therapeutics and the advancement of precision medicine practice.
Eosinophils are a subset of immune cells with low abundance in humans but play critical roles in immune regulation and inflammation, traditionally associated with allergic diseases and parasitic infections. Recent studies have increasingly clarified their mechanisms in mediating damage repair within distinct tissue microenvironments. The regulatory roles of eosinophils in tumor microenvironment and tissue damage repair have emerged as cutting-edge research areas. This review systematically summarizes the functional contributions of eosinophils in multiple tissue injuries and their underlying mechanisms, aiming to provide novel theoretical basis and insights for early screening, treatment, and prevention of related diseases.
Red blood cell (RBC) transfusion remains a cornerstone of therapy for the management of anemia and hemorrhagic shock. However, during ex vivo storage, RBCs undergo progressive biochemical and metabolic alterations, a phenomenon termed "storage lesion". Such lesions can impair oxygen-carrying capacity, increase hemolysis risk, and exacerbate oxidative stress, thereby exerting adverse effects on patients' clinical outcomes. In recent years, the impact of storage lesion has attracted growing attention, particularly with respect to adverse events associated with blood transfusion. Although the clinical prognosis of transfusing stored, damaged RBCs remains controversial, accumulating evidence indicates that RBCs with longer storage time are associated with adverse clinical outcomes, including an increased risk of infection, organ dysfunction, and higher mortality rates. Therefore, in the context of tight blood supply, the rational management of RBCs storage time and research on new technologies to preserve RBC viability have become crucial. In the future, efforts should focus on elucidating the mechanisms underlying RBC storage lesion, optimizing transfusion plan, and expanding blood supply to ensure the safety of patients and the efficacy of transfusion therapy.
