Objective To know the frequency of HLA antibodies in donors in Shanghai area, to provide basic data for the research on TRALI. Methods Samples of blood donors from October 2020 to April 2021 were randomly selected to detect HLA-specific antibodies by flow cytometry and microbead method, and the incidence of HLA antibodies was statistically analyzed. Results In 9 797 serum samples of blood donors, 1 715 (17.51%) were positive for HLA antibodies, among which the frequency of HLA antibodies in males and females was 4.81% and 28.08%. Excluding the history of blood transfusion, the frequency of HLA antibodies in women with no pregnancy history and women with pregnancy history was 12.10% and 36.62%, and comparative analysis the group of once, twice and three or more times pregnancies donors population, which frequency of HLA antibodies was 29.97%, 40.70% and 44.80%. The frequency of HLA antibodies in female donors with multiple pregnancy history was significantly higher than that in single pregnancy ( P<0.05). Conclusion Consultation of pregnancy history and HLA antibodies detection of female blood donors in blood stations can prevent from the occurrence of TRALI.

Non-transfusional hemotherapy should be mainly carried out by the Transfusion Department, which basis is the apheresis technology by centrifugation. The plasmapheresis can be realized in two ways: centrifugal and membrane filtration, each of which has its own technical characteristics. Apheresis/blood purification based on centrifugation shows the advantages of higher plasma separation efficiency, shorter treatment time, less platelet loss, less destruction of red blood cells, and the use of citrate anticoagulation for non-continuous clinical treatment of critically ill patients. Secondary columns suitable for centrifugal technology can realize immunoadsorption, artificial liver support system, centrifugation-filtration plasmapheresis and inflammatory factor adsorption. Using increasingly sophisticated secondary column technology should be a useful supplement to traditional TPE.

Cell-free fetal DNA (cff-DNA) exists in the peripheral blood of pregnant women during gestation, and it carries DNA fragments with relevant genetic information of the fetus, which can be screened for fetal chromosomal and gene-related diseases. It is now widely used in non-invasive prenatal testing (NIPT) because of its low operational risk and lack of side effects. Non-invasive cff-DNA blood group testing uses molecular technology to detect the genes associated with cff-DNA blood grouping, resulting in a fetal blood group. The test can be used to detect the consistency of fetal and maternal blood groups during pregnancy and to determine the risk of hemolytic disease of the fetus and newborn (HDFN) due to blood group incompatibility.

Objective Detecting the plasma vascular cell adhesion molecule 1 (VCAM-1) level in neonates with ABO hemolytic disease (HDN), to predict the degree of endothelial damage and in vivo hemolysis in ABO-HDN children. Methods A total of 127 cases of ABO-HDN attending our hospital between June 2022 and June 2023 were retrospectively collected, and further divided into three subgroups, namelymild, moderate, and severe hyperbilirubinemia. 127 healthy newborns with matching maternal and infant blood groups were recruited as a healthy control group. 41 cases of non-hemolytic jaundice were set up as the control group. A triple hemolytic test clarified the diagnosis of ABO-HDN, and all samples were tested for blood type and irregular antibodies. Plasma VCAM-1 were determined by enzyme-linked immunosorbent assay. Results 1 There was no statistically significant difference between the ABO-HDN group and the healthy control group regarding the sex of the newborns, birth weight, blood type, mode of delivery of their mothers, and the presence or absence of preterm rupture of membranes ( P>0.05), and the neonatal gestational age, maternal age, and number of pregnancies showed significant differences between the two groups ( P<0.05). There were differences in hemoglobin (Hb), reticulocyte (Ret), indirect bilirubin (IBIL), lactate dehydrogenase (LDH), high-sensitivity C-reactive protein (hs-CRP) and plasma VCAM-1 ( P<0.05, and the levels of VCAM-1 were positively correlated with the levels of LDH, IBIL, and Ret, and negatively correlated with the levels of Hb ( P<0.05). VCAM-1 levels in the ABO-HBN group showed independent correlations with Hb, Ret, IBIL, and LDH levels ( P<0.05). Among the three subgroups, VCAM-1 levels were significantly higher in the severe hyperbilirubinemia group than in the mild and moderate hyperbilirubinemia groups ( P<0.05). Conclusion Elevated VCAM-1 in children with ABO-HDN may be associated with vascular endothelial damage and with help in assessing the severity of hemolysis in the disease.

The mammalian target of rapamycin (mTOR) is a serine/threonine protein kinase that plays an important role in regulating cell growth, proliferation.The mTOR complex regulates cell growth, proliferation, protein metabolism by phosphorylating and activating downstream substrates such as S6K1, 4E-BP, etc. The mTOR signalling pathway similarly plays an important role in the haematopoietic system, integrating multiple signals to regulate the three processes of haematopoietic stem cell quiescence, self-renewal and multidirectional differentiation.This article systematically describes how relevant signalling molecules and proteins affect the mTOR signalling pathway and further influence haematopoietic stem cell function.

Objective To provide new insights into the prevention and treatment of human cytomegalovirus (HCMV) by observing the effect of autophagy induced by oxidative stress on the proliferation of HCMV in cells. Methods Using PCR to amplify the LC3B encoding fragment, an autophagy expression vector was constructed to observe the formation of cellular autophagy. Then, HFF cells infected with HCMV (AD169) for 72 hours were collected. The levels of UL122 expression and viral particles were detected by real-time quantitative PCR. And the viral protein pp65 expression level and the proliferation of virion were detected by Western blot and TCID ₅₀, respectively. Results Autophagy detection vectors were successfully constructed, which could be used to indicate the formation of cellular autophagy. Compared with normal cultured cells, oxidative stress could induce autophagy formation, and upregulated UL122 gene expression, pp65 protein levels and viral load by this pathway. The viral titer test also showed that autophagy could promote the replication of HCMV in cells. Conclusion Oxidative stress can induce autophagy and promote the replication and proliferation of HCMV, while autophagy inhibitor 3-MA can inhibit the replication of HCMV promoted by oxidative stress. It is confirmed that autophagy is one of the mechanisms of oxidative stress promoting the replication and proliferation of HCMV.

In recent years, research on immune substances in red blood cells has shown that red blood cells are not only the main carrier of oxygen transportation, but also play a variety of immune and regulatory functions as innate immune cells. These cells are capable of recognizing and adhering to antigens, fostering phagocytosis, engaing with complement system, and eliminating circulating immune complexes. Immune substances on its surface, such as Toll-like receptor 9(TLR9), complement receptor 1 and CD58, can act as bridges to maintain the immune balance of the body. Exploring the role of red blood cells with immune characteristics and their cytokines in the development and progression of diseases has important clinical significance.

Platelets play a crucial role in a variety of physiologic and pathologic processes, especially in hemostasis and wound healing. In recent years platelet-rich plasma, platelet-rich fibrin, platelet-lysate and other platelet-derived products have become a promising treatment in regenerative medicine and have been widely applied clinically. By release a variety of growth factors, cytokines, and chemokines, platelet-derived products induce cell migration, proliferation, differentiation, and chemotaxis, stimulating mitosis in multiple cell types and neovascularization, increasing endothelial cell response to pro-angiogenic factors, and promoting fibroblast migration and proliferation. This article reviews the classification and origin of platelet-derived products, biological characteristics of the main growth factors, and their therapeutic effects in promoting the healing of various wounds, then, also analyzed the possible issues and the future development possibilities.

Objective To study the effect of platelet CD36 antigen deletion type I gene mutation on its protein structure and function, and to understand the relationship between CD36 antigen deletion type I gene mutation and protein structure and function. Methods The DNA of platelet CD36 antigen deletion type I was amplified by PCR and sequenced. The obtained DNA sequence was aligned with the wild-type sequence of the CD36 gene, the start and end points of 12 exons were confirmed, and the cDNA sequence of exon 2 to 14 was spliced. Missense and synonymous mutations in cDNA sequences were analyzed with MEGA5.04 software. Psipred, SOPMA and JPred4 were used to predict the secondary structure of the protein, SWISS-MODEL to predict the spatial structure of the amino acid chain, Mupro, SDM, CUPSAT, mSCM, DUET, Dynamut to predict the stability change of the protein before and after mutation, PROVEAN to predict the effect on protein function, PyMOL and LigPlot+ modified protein spatial structure prediction map. Results A total of 4 gene mutations E4 (275). E12 (1156). E14 (1409) C>T and E6(538) T>C base mutations were detected. All 4 mutations lead to changes in protein structure and reduced stability. 3 kinds of c.T92M, c.W180R, c.R386W mutations have adverse effects on the function, the 5LGD model and the interaction between the mutant protein's ligand receptor basically unchanged. Conclusion CD36 antigen deletion type I base mutation reduces the protein stability by changing the protein structure, among which c.T92M, c.W180R, c.R386W mutations have a negative impact on protein function.

Objective To analyze the cause and significance of minor cross-match incompatibility by using micro-column gel test (MGT), and to provide reference for clinical transfusion. Methods Samples of transfusion recipients were collected from July 2022 to July 2023 with minor cross-match incompatible while antibody screening test negative. Direct antiglobulin test (DAT) was performed, Positive samples undergoing acid elution test. Antibody screening and identification were conducted on the eluate. DAT-negative individuals underwent donor antibody screening or re-cross-matching. A part of DAT-positive transfused patients were selected as the experimental group, and patients with major and minor cross-match compatibility and negative DAT were selected by propensity score matching as the control group for comparison and evaluation of transfusion efficacy. Results Among 380 patients with major cross-match compatibility and the minor cross-match incompatibility, 372 patients were DAT positive (97.89%). Antibody test of the acid elute, 364 cases showing negative results (97.85%), 6 cases were positive (1.61%) with no pattern. Two cases showed suspected reactive patterns (0.54%), but no specific antibodies were identified. These patients exhibited a significant increase in hemoglobin after receiving red blood cell suspension transfusion ( P<0.05), with no impact on the safety and efficacy of transfusion compared to the control group. Among DAT-negative patients, 4 cases were antibody screening positive (1.05%), 1 case had gel card abnormalities (0.26%), 2 cases were due to human error (0.52%), and 1 case was a false aggregation (0.26%). Conclusion The minor cross-match incompatibility with MGT has almost no impact on the safety and efficacy of transfusion for patients, and the majority of reasons for minor cross-match incompatibility are due to DAT positivity in patients. In addition, a small number of minor cross-match incompatibility were caused by human error, false aggregation and abnormal gel cards.

Objective This survey aimed to explore the contemporary situation of transfusion therapy provided by transfusion medicine department of medical institutions in China, and to identify potential directions for its further development. Methods A self-designed questionnaire was distributed nationwide, utilizing an online survey methodology, targeting staff within transfusion medicine departments to gather insights on the current landscape of transfusion therapy. Results A total of 482 effective questionnaires were finally collected, and 68.0% (325) originated from transfusion medicine departments offering transfusion therapy. Of these departments, 57.2% (186) had been administering such treatments for over 5 years. There were 24 transfusion therapy projects, with autologous whole blood (68.6%), autologous platelet-rich plasma (55.4%), and centrifugal plasma exchange (38.5%) being the three most prevalent. While 50.5% of transfusion medicine departments conducted fewer than 50 annual treatments annually, a notable 7.1% surpassed the 1 000-treatment mark. The workforce involved in transfusion therapy comprised doctors, technicians, and nurses, with the doctor-technician combination accounting for the highest share (34.2%), but the doctor-nurse combination contributed only 7.7%. Participants highlighted the fragmentation of transfusion therapy projects across other clinical departments as the primary impediment to its further development. Conclusion Transfusion medicine departments of medical institutions are currently engaging in transfusion therapy with vigor and enthusiasm. However, the overall practice remains in an initial stage, falling short of establishing a standardized, institutionalized, and widespread transfusion therapy system.

Objective To observe the clinical efficacy and adverse reactions of CSP in patients with surgical hemorrhage. Methods A prospective, double-blind, randomized clinical trial was conducted on surgical patients with related bleeding to assess the hemostatic function of CSP compared with RTP. The primary outcomes measured were drainage volume, platelet counts, and Thrombelastography-maximum amplitude. Secondary outcomes included hospital stays, the intensive care unit stays and medical cost. Results A total of 62 patients were completed the final clinical observation. There were 31 cases in each of the CSP group and RTP group. Within 1~12 hours, 13~24 hours, 25~48 hours, and 49~72 hours after platelet transfusion, drainage volume: 8.5 mL/h vs 20.83 mL/h, 0.52 mL/h vs 5.0 mL/h, 3.5 mL/h vs 5.0 mL/h, 0.63 mL/h vs 4.1 mL/h. platelet counts: 58×10 ⁹/L vs 79×10 ⁹/L, 54×10 ⁹/L vs 77×10 ⁹/L, 63×10 ⁹/L vs 75×10 ⁹/L, 66×10 ⁹/L vs 79×10 ⁹/L. TEG-MA: 50.1 mm vs 52.0 mm, 50.1 mm vs 54.8 mm, 53.0 mm vs 56.6, 56.0 mm vs 53.2 mm. There were no overall differences between the two groups by Generalized Estimating Equations at different times ( P _Drainage=0.933, P _PLTcounts=0.473, P _TEG-MA=0.246). The secondary outcomes (hospital stays, ICU stays, medical cost, discharge outcome) were no differences between the CSP group and RTP group ( P>0.05). There were no significant differences in adverse platelet transfusion events between the groups ( P>0.05). Conclusion CSP and RTP have equivalent efficacy and safety in the treatment of surgical hemorrhage. This trial provides reliable evidence to support the clinical application of CSP.

Objective To investigate the serological characteristics and DNA sequence of patients with RhD variant. Methods The ABO and RhD blood groups of the patients to be transfused were determined using the microcolumn gel method. The specimens showing weakened or negative RhD antigen reactions were further evaluated using the saline test tube method and RhD negative confirmation test. Additionally, DNA sequence detection was performed in the identified D-variant samples. Results A total of 8 cases of D variant were detected in 726 patients with decreased RhD antigen and negative samples by RhD negative confirmation test. A total of 7 genotypes were detected by DNA sequencing in the 8 samples, include RHD*01W.72/RHD*01N.01, RHD*15/RHD*D-CE(2)-D, RHD*01EL.01/RHD*15, RHD*D-CE(3-9)-D/RHD*01N.01, RHD*15/RHD *01N.01, RHD-496G/RHD*01N.01, and RHD*01EL.01/RHD*01W.71. Two cases of RHD*15/RHD*01N.01 were of weak D type 15. 1 case of RHD*01W.72/RHD*01N.01 was weak D type 72; Two cases of RhD and RhCE gene recombination were RHD*15/RHD*D-CE(2)-D and RHD*D-CE(3-9)-D/RHD*01N.01, respectively. 1 case of RHD-496G/RHD*01N.01 with c.496C> G mutant was a new RHD mutation site, and the application for confirmation was submitted to GenBank database. Three cases had mutations in both gametic genes, of which two were new combinations: RHD*15/RHD*D-CE(2)-D and RHD*01EL.01/RHD*01W.71.RhCE phenotype was detected in 6 samples, 5 samples of which contained C antigen, accounting for 83.3%,The majority of cases were Ccee phenotype (3 cases, 50%). Conclusion Serological detection combined with DNA sequencing can help to discover phenotype and genotype characteristics of blood group, and provide reference for understanding RhD variants and clinical transfusion.

Objective To explore the value of blood examination results in diagnosing hemolytic disease of newborn in primary hospitals. Methods Neonates cases born and hospitalized in the First Affiliated Hospital of University of Science and Technology of China from August 2020 to May 2023 were collected and analyzed. All the cases were grouped by clinical diagnosis. The clinical symptoms, blood routine and biochemical examination results were analyzed. The area under the curve (AUC) was used to evaluate the diagnostic efficiency of the combination index by logistic regression. Results The statistical analysis shows that ABO incompatibility were more likely to occur in O-A setting Neonates. Compared with HDN patients, The levels of white blood cell count (WBC), platelet count (PLT), red blood cell distribution width (RDW), erythrocyte mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), blood glucose (GLU), globulin (GLO) and neonatal bilirubin (NBIL) in HDN group were significantly higher than non-HDN group. Red blood cell count (RBC), hemoglobin (HB) and Red blood cell specific volume (HCT) were significantly lower than those in the HDN group. In order to find a more convenient and efficient auxiliary diagnosis method, the blood examination was combined and the diagnosis efficiency of HDN was increased to 0.77 (0.72~0.78, P<0.05). Conclusion The combination index of blood examination results has well performance at early diagnosis of HDN. It provides a new idea for screen or/and diagnosis of hemolytic disease of newborn in primary hospitals.

Discogenic low back pain (DLBP) is the most common type of low back pain in clinical practice, which is one of the most causes of disability and loss of productivity, and has a serious impact on the daily work and life of patients. PRP (platelet-rich plasma, PRP) is derived from autologous tissue, with various bioactive factors in the closest components to the body. It does not produce any immune response, is convenient to obtain, and low cost. Recent studies have shown that it contains rich growth factors that can promote the proliferation of cells and tissues in intervertebral discs, and has a significant promoting effect on intervertebral disc regeneration. This article reviews the pathogenesis of DLBP, the principle of PRP treatment for DLBP, and the clinical application of PRP, which could provide an new idea for the clinical treatment of DLBP.

Objective To analyze the residual risk (RR) of hepatitis B virus (HBV) transmission after blood transfusion in 21 selected blood centers across China. Methods We used the unqualified rate of hepatitis B surface antigen detected by enzyme-linked immunosorbent assay (ELISA) among repeat blood donors, the proportion of ELISA-negative but HBV DNA-positive samples, and the rate of first-time blood donors reported by the national information management system. Additionally, we applied the incidence/window period model to assess the temporal trends of HBV residual risk over the study period. Results Between 2018 and 2022, the RR of of HBV among blood donors in the 21 participating blood centers were (358.36~2 816.56)/(million person·year) (10 ⁶py), (69.56~1 794.90)/10 ⁶py, (50.75~1 153.05)/10 ⁶py, (55.72~1 745.93)/10 ⁶py, and (52.27~2 133.95)/10 ⁶py. Overall, the 5-year trend in HBV residual risk across all the 21 centers did not demonstrate statistical significance ( χ ²=0.663, P=0.416). However, the trend change in 14 of these centers was found to be statistically significant ( P<0.05). Conclusion The RR of HBV differs greatly among the 21 evaluated blood centers. Given this variability, it is imperative for all regions to promptly adjust their blood screening strategies in accordance with their local laboratory capabilities, thus minimizing the RR of HBV transmission by blood transfusion and ensuring the blood safety.

The big data of unexpected red blood cell antibody and Rh blood group distribution in Chinese population shows that the proportion of anti-RhCE antibody (41.94%) is 4.7 times higher than that of anti-RhD antibody (8.93%) among unexpected antibodies in hospitalized patients. In random blood transfusion, the probability of RhCE antigen mismatch (25.16%) is 51.4 times higher than that of RhD antigen mismatch (0.49%). These data indicate that RhCE antigen mismatch is the main risk for Chinese transfusion patients, and establishing RhCE antigen matching transfusion strategies suitable for Chinese patients is crucial for transfusion safety.

Objective To analyze the risk factors of transfusion-associated circulatory overload (TACO) in hospitalized patients, construct a predictive model for TACO, and verify its predictive ability. Methods 547 hospitalization patients who underwent blood transfusion in our hospital from June 2020 to December 2023 were selected and divided into TACO group and non-TACO group based on the presence or absence of TACO. Seventeen items of data were retrospectively collected for logistic regression analysis to determine the risk factors for TACO occurrence. The model for predicting TACO was constructed based on predictive indicators, and the predictive efficacy (discrimination, consistency and clinical benefit) of the model was evaluate using ROC curves, calibration curves and decision curves. Results The incidence of TACO in 547 patients was 8.04% (44/547). There were statistical differences between the TACO group and the non-TACO group in terms of age, concomitant heart failure, reasons for blood transfusion, transfusion volume, and fluid balance ( P<0.05). Age≥65 years old ( OR=2.480), concomitant heart failure ( OR=2.716), hypovolemia ( OR=3.564), transfusion volume≥800 mL ( OR=3.371), and fluid balance ( OR=2.806) had a significant effect on the occurrence of TACO in transfusion patients. Internal validation showed that the area under the ROC curve (AUC) was 0.826 (95% CI: 0.748~0.905), the calibration curve fit was better, the goodness of fit HL test showed χ ²=7.737, P=0.356, and the net benefit rate of the model was higher when the threshold probability was 3%~78%. Conclusion A model constructed based on age, concomitant heart failure, hypovolemia, transfusion volume, and fluid balance can effectively predict the occurrence of TACO in blood transfusion patients.

Objective To compare the efficacy of fresh frozen plasma infusion and virus inactivated frozen plasma infusion on the recovery of liver function and coagulation function in patients with primary liver cancer after hepatectomy. Methods A retrospective analysis was conducted on 394 inpatients who underwent partial hepatectomy for primary liver cancer in our hospital from January 1, 2020 to December 31, 2023. Based on the types of plasma transfused, the patients were categorized into two groups: the fresh frozen plasma group ( n=128) and the virus inactivated frozen plasma group ( n=266). Baseline data of the two groups were balanced by propensity score matching (PSM), and the preoperative data of the matched patients were analyzed. Liver function indicators such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), cholinesterase (CHE), total bilirubin (TBIL), plasma total protein (TP), and albumin (ALB)after surgery and after plasma infusion, prothrombin time (PT), activated partial thromboplastin time (APTT), and prognosis (length of hospital stay, discharge assessment) were utilized to evaluate the efficacy of plasma infusion. Measurement data following a normal distribution were presented as the mean±standard deviation (), a T-test was employed for inter-group comparison, M(Q1, Q3) was adopted for inter-group comparison, U test was utilized for inter-group comparison, and a χ ² test was applied for inter-group comparison of count data. Results A total of 88 pairs of patients were included in the statistics after PSM, including fresh frozen plasma group ( n=88) and virus inactivated frozen plasma group ( n=88). Compared with the preoperative results, both groups of patients showed significant impairment in liver function and coagulation function after surgery; Plasma infusion can improve patients' liver function indicators and coagulation function; There was no significant difference in the indicators of ALT, AST, CHE, and TBIL between the fresh frozen plasma group and the virus inactivated frozen plasma group after transfusion; Through the comparison of the difference between before and after transfusion, we found that the difference in TP 5.75 (2.96, 8.15) and ALB 5.01 (3.20, 9.20) in the fresh frozen plasma group was greater than the difference in TP 1.20 (0.75, 3.12) and ALB 3.35 (0.50, 5.98) in the virus inactivated frozen plasma group ( P<0.05); After infusion of fresh frozen plasma, the APTT and PT extension time were significantly shortened. The PT difference of 3.60 (2.40, 10.10) and APTT difference of 12.00 (4.10, 18.67) in the fresh frozen plasma group before and after plasma transfusion were greater than the PT difference of 1.10 (0.10, 3.30) and APTT difference of 1.70 (0.20, 6.38) in the virus inactivated frozen plasma group before and after plasma transfusion ( P<0.05); Compared with the average hospitalization time of the virus inactivated frozen plasma group, the average hospitalization time of the fresh frozen plasma group was longer (26.07±1.92) days ( P<0.05), but there was no statistical significance between the two groups in terms of discharge evaluation ( P=0.839). Conclusion In patients with primary liver cancer who have undergone hepatectomy, the administration of fresh frozen plasma and virus inactivated frozen plasma can significantly promote the recovery of liver function; The infusion of fresh frozen plasma has no significant advantage in improving patient prognosis, but for patients with postoperative coagulopathy, the infusion of fresh frozen plasma can better improve their coagulation function and increase their protein levels.