Preoperative Advanced Autologous Apheresis (AAA) is a new type of preoperative autologous blood donation. In recent years, this technology has been introduced in many hospitals across the country. However, there has yet to be a consensus or technical standard for its implementation process and quality control. To address this, the Chinese Blood Transfusion Association Clinical Transfusion Management Committee organized experts from related fields nationwide to extensively and deeply discuss the technical principles, entry requirements, indications, contraindications, operational key points, adverse reaction prevention and treatment, and blood quality evaluation and disposition of preoperative Advanced Autologous Apheresis, and jointly formulated this consensus. The aim is to better manage autologous blood for patients and to provide a basis for medical staff to implement preoperative Advanced Autologous Apheresis more safely and standardized.

Cellular immunotherapies, new complementary therapies for tumor patients, are aimed at malignant tumors with low ability of autoimmune cells, including T cell-based chimeric antigen receptor T cell (CAR-T) therapy, tumor infiltrating lymphocytes (TILs) therapy, NK cell-based chimeric antigen receptor NK cell (CAR-NK) therapy, and autologous cell immunotherapy (CIK), as well as infusion therapies based on other immune cells such as mononuclear phagocytes like dendritic cells and macrophages. Among them, nature killer cells (NK cells), important to the body's natural immunity, matter greatly in anti-tumor, antiviral infection and immune regulation. Like T cells, it can be engineered to target tumor treatment, and can also be transfused with allogeneic NK cells, making up for the shortcomings of limited T cell source and allogeneic immune rejection. No evidence shows that patients tansfused with allogeneic NK cells may develop severe Graft Versus Host Disease (GVHD). NK cells not only expand the types of cells used in cellular immunotherapy, but also provide a broad application prospect for the formation of low-cost cellular immunotherapy products. However, there are still problems such as unstable quality of NK cells and lack of unified quality standards in the preparation process. Although some NK cell immunotherapy products have been approved by the Food and Drug Administration (FDA) or the National Medical Products Administration (NMPA), there is still no clear and publicly available standardized production system for NK cell immunotherapy products. Starting from the unique immunomodulatory mechanism of NK cells, this paper summarizes the therapeutic strategies applied by researchers in the treatment of malignant tumors in recent years and the latest progress of preclinical studies and clinical trials, and finally focuses on the research progress of in vitro expansion methods and maintenance of active function of NK cells, indicating that NK cells promise to be a unified quality of cellular immunotherapy products.

Plasma transfusion is clinically used to replenish clotting factors and correct coagulopathy, playing an important role in the treatment of massive hemorrhage. Universal plasma and low titer group O whole blood can improve the timeliness and accessibility of urgent transfusions in patients with major bleeding. The strategy of ABO non-identical plasma transfusion, in the form of active and passive transfusion, has been extensively adopted in clinical practice. Active transfusion mainly includes group AB and A plasma; passive transfusion, on the other hand, involves the transfusion of low titer group O whole blood and ABO non-identical platelets. However, hemolysis and circulating immune complex formation are recognized to be the risks associated with transfusion of ABO non-identical plasma. Together, the risk-benefit trade-off with transfusion of non-ABO identical plasma deserves more attention and further exploration.

Objective To investigate the antiplatelet effect of tanshinone ⅡA (Tan IIA) and its inhibition effect of the interaction between human platelets and HCT116 cells of colon cancer. Method Whole blood or platelets of healthy volunteers were treated with different concentrations of Tan ⅡA (10, 20, 40 μmol/L), and inhibition rate of platelet aggregation triggered with Adenosine diphosphate (ADP) and arachidonic acid (arachidonic acid) were detected by TEG. The expression rates of CD62P and PAC-1 in platelets were detected by flow cytometry, the adhesion test was used to detect the adhesion of platelets to HCT116 cells after Tan ⅡA treatment, and the effect of platelets on the migration ability of HCT116 cells after Tan ⅡA treatment was tested by scratch test. Results The TEG results showed that Tan ⅡA inhibited ADP and AA-induced platelet aggregation in a concentration-dependent manner (P<0.01), low concentration Tan ⅡA treatment can obtain higher ADP inhibition rate, which is (73.48±19.63) %, high concentration Tan ⅡA treatment can obtain higher AA inhibition rate, which is (78.20±18.58) %. Flow cytometry detection showed that Tan IIA inhibited thrombin or ADP-induced expression of CD62P and PAC-1 on platelet surface in a concentration-dependent manner (P<0.05). Adhesion test results confirmed that Tan ⅡA could significantly inhibit the adhesion between thrombin or ADP-activated platelets and HCT116 cells, and the inhibition ability was positively correlated with Tan ⅡA concentration. The results of scratch test showed that activated platelets could promote the migration of HCT116 cells, and treatment of platelets with low concentration (10 μmol/L) Tan ⅡA could significantly inhibit promotion of platelet to the migration of tumor cells. Conclusion Tan IIA can inhibit the interaction between platelets and tumor cells by inhibiting platelet aggregation and activation.

Objective To detect the Rh antigens C, c, E, e in hematopoietic stem cell transplantation (HSCT) patients with blood diseases and donors before and after transplantation, and analyze the time and process of the conversion of Rh blood type from recipients to donor Rh antigens C, c, E, e. Methods Anticoagulant blood samples were collected from patients and donors before and after transplantation for detection of antigen transformation by using microcolumn agglutination card, ABO and Rh antigen conversion time were analyzed and compared. Results Excluding the effects of red blood cell transfusions, the average time length of 58 HSCT patients was 57.81±8.99 days that Rh antigens C, c, E, e completely transformed from recipient to donor after transplantation. Patient age and hematological classification showed impact on the time of Rh antigens conversion, while the gender, ABO blood group compatibility, as well as transplant mode showed no influence on the Rh antigen conversion time. Donor's red blood cells appeared in some patients as early as 3rd week after transplantation, mixed chimerism of donor and patient was detected from the 4th week, and the Rh blood group antigens were found to be completely transformed from the 7th to the 10th week. In addition, both Rh and ABO blood group antigen transition time in 25 HSCT patients those Rh and ABO blood type between patients and donors were different were analyzed, and the Rh transition time was shorter than ABO, and its difference was statistically significant. Conclusion Regular typing of Rh blood group antigen is necessary for patients after HSCT transplantation, and these Rh antigens are indicators to judge transplantation treatment effect, and they also show a significance of guiding transfusion of Rh blood group compatible red blood cells in HSCT patients after transplantation.

Objective To study the inhibitory effect of ginkgolide B (GB) on platelet activation as well as on the interaction between platelets and colorectal cancer HCT-116 cells. Methods Whole blood or platelets were treated with different concentrations of GB (5, 15, 30 μmol/L). Thromboelastogram (TEG) , then platelet Adenosine diphosphate was detected . The inhibitory rate of ADP and arachidonic acid (AA) pathway was detected by flow cytometry. The effects of GB on the expression of CD62P and PAC-1 after thrombin and ADP-activated platelets were detected. The effect of GB on the cell migration of platelets and HCT-116 cells after 24 and 48 h interaction was observed by cell scratch test, and the effect of GB on the adhesion of platelets to HCT-116 cells was observed by cell adhesion test. Results (1) TEG test results showed that with the increase of GB concentration, AA inhibition rates increased significantly in dose-dependent manner (P<0.001), the difference was statistically significant compared with the control group (P<0.001); The inhibition rate of ADP in the drug group was significantly increased compared with the control group in a dose-dependent manner (P<0.001), the differences were statistically significant (P<0.001). (2) Flow cytometry showed that after thrombin and ADP activated platelets, the positive rates of CD62P and PAC-1 in the drug group decreased with the increase of drug concentration in a dose-dependent manner (P<0.001), the positive rate of PAC-1 in 5 µmol/L group with thrombin activation pathway was lower than that in control group, and the difference was not statistically significant (P<0.05), the positive rate of CD62P in 5 µmol/L group, the positive rate of PAC-1 in 5µmol/L and 15µmol/L groups of ADP-activated pathway drugs was lower than that of control group, and the difference was not statistically significant (P<0.05), and there were statistically significant differences between the remaining concentration groups and the control group (P<0.01). (3) Scratch test results showed that 24 and 48 h cell mobility in different concentration groups was lower than that in thrombin group and ADP group, respectively, and the difference was statistically significant (P<0.01), cell mobility at 24 and 48 h in 15µmol/L group was significantly lower than that in 5 µmol/L group, and the difference was statistically significant (P<0.05), the mobility of 30 µmol/L group was lower than that of 15 µmol/L group, but the difference was not statistically significant (P<0.05). (4) The adhesion test results showed that activated platelets could enhance the adhesion between them and tumor cells, but the adhesion rate of all groups in the drug group was lower than that in the positive group, and the adhesion rate decreased with the increase of drug concentration. Conclusion GB can inhibit platelet activation through AA pathway and ADP pathway, and then inhibit the adhesion of platelets to HCT-116 tumor cells and promote the migration of tumor cells.

Fibrinogen is a coagulation protein with the highest concentration in the blood circulation. During the treatment of massive traumatic hemorrhage, more and more evidence showed that fibrinogen played a key role not only as the main hemostatic component, but also as a regulator in inflammatory immunity and the anti-microbial infection. This article provides a brief overview of the multiple function of fibrinogen in the treatment of massive traumatic hemorrhage from the prospective of its influence on the early and late mortality, aiming to provide more theoretical supports to the early and sufficient fibrinogen replacement.

Objective The purpose of this study was to explore the mechanism of Sema7a protein promoting the adhesion between endothelial cells and megakaryocytes. Methods Human umbilical vascular endothelial cells (HUVECs) and megakaryocyte line MEG01 were used to simulate the adhesion of pulmonary vessels and megakaryocytes in vitro. Immunofluorescence, flow cytometry, 4D Label free and other biological techniques were used to detect the adhesion between endothelial cells and megakaryocytes, the amount of Sema7a binding to HUVECs, and the changes of protein expression and biological information in HUVECs. Immunofluorescence was used to detect the expression of intercellular cell adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) in HUVECs. Results The adhesion between MEG01 and HUVECs was promoted after Sema7a binding to HUVECs, with the MAPK signal pathway been activated, and molecules ICAM-1 and VCMA-1 of HUVECs been up-regulated. Conclusion Sema7a promoted the adhesion between megakaryocytes MEG01 and endothelial cells HUVECs by up-regulating the expression of molecules ICAM-1 and VCMA-1 in HUVECs.

Objective To compare the effect of double filtration plasmapheresis (DFPP) and plasma exchange (PE) on blood type antibody removal before ABO-incompatible kidney transplantation (ABOi-KT). Method Clinical data and antibody titers before and after each treatment of 36 recipients treated with DFPP and 27 recipients treated with PE before ABOi-KT from February 2021 to December 2023 in the First Affiliated Hospital of Zhengzhou University were collected and analysed. Results 98 and 82 times of treatment were performed in DFPP and PE group, respectively. The titers of blood type antibodies after DFPP and PE treatment were significantly lower than those before treatment (P<0.05). Both DFPP and PE showed good removal effect on high titer antibodies, and the removal effect of DFPP on IgG anti-A, IgG anti-B and IgM anti-B antibodies in group of titer ≥32 was better than that in group of titer ≤16 (P<0.05). The removal effect of PE on IgM anti-A and IgM anti-B antibodies in group of titer ≥32 was better than that in group of titer ≤16 (P<0.05). Overall, DFPP and PE showed no significant difference in the removal effect on different types of antibodies. However, both DFPP and PE showed a better removal effect on IgM antibodies in group of titer ≥32 compared with group of titer ≤16 (P<0.05), and the effect of PE was more obvious. The removal effect on anti-A antibodies in PE group was better than that in DFPP group. This advantage was mainly manifested as follows: PE had a better removal effect on IgG anti-A antibody than DFPP in group of titer ≤16 (P<0.05); PE had a better removal effect on IgM anti-A antibody than DFPP in group of titer ≥32 (P<0.05). There was no significant difference between the two methods in the removal effect on the other blood group antibodies (P>0.05). Conclusion Both DFPP and PE can significantly reduce the titer of blood type antibodies, and the two methods have a better removal effect on high titer antibodies. There was no significant difference between the two methods in the removal of antibodies of other blood groups, except that the removal efficiency of low titer IgG anti-A and high titer IgM anti-A antibodies by PE was better than that by DFPP.

Objective Exosomes, as cellular messengers circulating in bodily fluid, carry diverse bioactive chemicals. This study aimed to analyze the characteristics and variations in plasma exosomal proteins between young and middle-aged individuals, offering theoretical insights into their role in influencing bodily functions. Methods Peripheral blood samples were collected from young (age:19.33±1.16) and middle-aged (age:50.33±2.52) adults. Plasma exosomes were isolated by differential ultracentrifugation, and characterized via transmission electron microscopy, particle size analysis, and Western blot. Liquid-phase mass spectrometry analysis technology was used to detect and analyze the types and functional differences of plasma exosome proteins between the two age groups. Results The average diameter and protein concentration of plasma exosomes in young men were similar to those in middle-aged men, but the average concentration of exosomes was slightly lower in young men. Plasma exosomes from young men exhibited low CD9 levels, contrary to high CD9 levels observed in middle-aged men. A total of 110 differential proteins were identified in the plasma exosomes of both groups, with 36 proteins upregulated and 74 downregulated in young males compared to middle-aged males. GO functional analysis revealed differences in biological processes, particularly translation elongation, cellular macromolecule biosynthesis, and organic nitrogen compound biosynthesis. Molecular functions focused on translation elongation factors, copper ion binding, and nucleic acid binding. KEGG pathway analysis indicated enrichment in 13 pathways, including antigen processing, presentation, and endocytosis. Among the 21 proteins specific to young men's plasma exosomes, Drebrin-like protein (DBNL) displayed functions related to both the nervous system and the immune system. Conclusion No differences have been noted in the morphology, size, and concentration of plasma exosomes between young and middle-aged men, but there are significant differences in their surface markers and intronic proteins.

Objective To explore the underlying causes for the observed anomalies, the oxygen-carrying/releasing capacity of sensitized red blood cells (RBCs) was analyzed . Methods The sensitized red blood cells were detected through microcolumn gel cards, and an oxygen-carrying/releasing assessment device was employed to evaluate the oxygen-carrying/releasing capacity of sensitized RBCs in patients with autoimmune hemolytic anemia (AIHA) and hemolytic disease of the newborn (HDN). We constructed a transfusion-induced hemolytic reaction mouse model using plasma from healthy adults, while the control group received PBS. Record the time until exhaustion during weight-loaded swimming in mice and analyze the oxygen-carrying/releasing capacity of isolated mouse RBCs. Perform GO and KEGG enrichment analysis on differentially expressed proteins related to hemolysis and the control group using proteomics. Measure BPGM enzyme activity and 2,3-DPG levels in sensitized RBCs using ELISA. Results Compared to the corresponding control groups, the oxygen dissociation curves in AIHA, HDN, and transfusion-induced hemolytic reaction model mice exhibited a left shift and decreased P50. The weight-loaded swimming time in hemolytic model mice was significantly shortened. Proteomic screening revealed abnormalities in BPGM, with decreased BPGM enzyme activity and a decline in intracellular 2,3-DPG content. Conclusion The reduced activity of BPGM in sensitized RBCs led to a decline in their oxygen-releasing capacity.

The combined application of platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) has shown great potential in regenerative medicine, providing new therapeutic strategies and powerful tools for the treatment of various diseases and tissue regeneration. This combined application combines the abundant growth factors in PRP and the multidirectional differentiation potential of MSCs to produce a synergistic effect that accelerate tissue regeneration and repair processes. The combined application of PRP and MSCs in different medical fields, such as orthopedics, orthopedics, cardiovascular and infertility treatment, has shown a wide range of application potential. In addition, personalized medicine has been made possible to adjust the treatment plan according to the specific situation of the patient and improve the treatment effect. However, there are some risks and limitations in the process. Among them, the risks of uncontrolled differentiation, bleeding and thrombosis require to be payed specialattention. In addition, the long-term safety, persistence of effects, and standardization of treatment protocols remain uncertain and need to be verified by more large-scale studies. In summary, the combined application of PRP and MSCs brings new hope and prospects for the field of regenerative medicine, but the advantages and risks need to be carefully weighed to ensure the safety and effectiveness of treatment options.

Erythrocytes are abundant within the body and are predominantly responsible for oxygen delivery. Mature mammalian erythrocytes have no nucleus and organelles, and they possess a high surface area-to-volume ratio, making them easy to conduct modification. These characteristics make erythrocytes suitable as delivery system, and erythrocytes have been used for drug delivery. Erythrocytes also possess immune regulatory capabilities. Erythrocytes can bind to pathogens and interact with chemokines, participating in innate immunity. Senescent erythrocytes modulate the expression of surface molecules and interact with phagocytic cells in the spleen, thereby regulating the adaptive immune response, facilitating the clearance of senescent erythrocytes through non-inflammatory pathways. The advantages in delivery and immunomodulation have led to the use of erythrocyte-based carriers in novel vaccines, replacing traditional vaccine adjuvants. There are diverse methods for synthesis of erythrocyte-based carriers. These carriers have great biocompatibility and are amenable to modification, accommodating the needs of different vaccines. By design, carriers based on erythrocytes in different stages can exert different immunomodulatory functions. Carriers based on normal erythrocytes can induce immune activation, while those based on senescent erythrocytes can be used to induce immune tolerance, showing promising results in the prevention and treatment of cancer, infectious diseases and autoimmune diseases. This article reviews the biological advantages of erythrocyte as vaccine carriers, antigen-loading strategies, the immunological effects of erythrocyte-based vaccine carriers and optimization strategies, providing insights for the development of novel vaccines.

Plasma, as the common blood components, has been widely used to supplement coagulation factors, which can prevent or treat bleeding or bleeding tendency caused by coagulation factor deficiency. Although the concept of rational and scientific transfusion has been implemented for many years, the majority of plasma transfusions are still sub-optimal, and achieving optimal plasma utilization is an ongoing challenge. Based on the domestic and international blood transfusion guidelines and published relevant clinical studies, this article reviews the current status, applications and challenges of plasma transfusion, looks forward to the future development, and update and expand the existing guidelines.

Objective By comparing and analyzing the related indexes of hemolytic disease of the fetuses and newborn (HDFN) in fetuses and newborns delivered by RhD-negative pregnant women, we can provide reference and guidance for the prevention and treatment of HDFN. Method A total of 737 RhD-negative pregnant women who gave birth in our hospital from January 2018 to December 2022 were collected. The relative factors of HDFN caused by RhD blood group incompatibility and ABO blood group incompatibility, RhD-HDFN and ABO-HDFN were compared. Moreover, the differences of laboratory indexes between RhD-HDFN and ABO-HDFN and RhD-HDFN in newborns with IgG anti-D titer ≤16 and ≥32 were analyzed. Results Among 737 RhD-negative pregnant women, 88.89% (40/45) had the same or compatible ABO blood type between mother and infant, which was significantly higher than 11.11% (5/45) in mother-infant ABO blood type incompatibility. Maternal second pregnancy and above births had a 93.33% (42/45) RhD-HDFN rate which was significantly higher than the 60.66% (37/61) ABO-HDFN rate. In addition, the lowest hemoglobin value in newborns born to mothers with IgG anti-D titers ≥32 was significantly lower than that of mothers with IgG anti-D titers ≤ 16 (χ ²=5.61, P<0.05). As expected, the peak value of serum total bilirubin in newborns born to mothers with IgG anti-D titers ≥32 was higher than those with IgG anti-D titers ≤ 16 (χ ²=4.471, P<0.05). Conclusion Among RhD-negative pregnant women, those with the same or compatible ABO blood type and gravidity and parity history ≥2 are more likely to develop RhD-HDFN in their corresponding newborns and the severity of neonatal hemolysis is significantly higher in those with maternal IgG anti-D titer ≥ 32 than in those with anti-D titer ≤ 16.

Red blood cell transfusion has been widely used in trauma treatment, surgery, anemia treatment, war wound emergency treatment and other aspects, but there are still problems such as shortage of blood resources, short storage period, cross-matching before transfusion, and possible transmission of pathogens through blood. Hemoglobin-based oxygen carriers (HBOCs) are a class of soluble nano-oxygen carriers prepared by chemical modification of matrix-free hemoglobin, which can replace red blood cells to transport oxygen to organs and tissues in the body. HBOCs have the characteristics of no blood group and virus transmission risk, long storage, and instant use, so they are also known as red blood cell substitutes. This paper aims to review the research progress of HBOCs, and explore their application prospects in organ preservation, cerebral ischemia, tumor treatment and other treatments in addition to the replacement of red blood cell transfusion.