In May 2025, the Association for the Advancement of Blood and Biotherapies (AABB) and the International Collaboration for Transfusion Medicine Guidelines (ICTMG) jointly released the updated Guidelines for Platelet Transfusion. Based on 21 Randomized Clinical Trials (RCTs) and 13 high-quality observational studies, the guideline adopted the Grading of Recommendations Assessment Development and Evaluation (GRADE) system for evidence analysis, and established the "restrictive platelet transfusion strategy" as the core, aiming to promote the standardization and homogenization of global platelet transfusion practices. The guideline has a wide scope of application, covering different populations such as adults, children, and neonates, including patients with hematological diseases, stem cell transplant recipients, perioperative patients, dengue fever patients, and those undergoing invasive procedures. It sets minimal important differences (MIDs) thresholds for three key outcomes—mortality (2%), grade 2-4 bleeding (20%), and grade 3-4 bleeding (5%)—for evidence certainty grading. In terms of key recommendations, it clarifies strong recommendations with high/moderate certainty of evidence (e.g., transfusion for patients with non-bleeding thrombocytopenia undergoing chemotherapy or allogeneic stem cell transplantation when platelet count<10×10 ⁹/L; transfusion for neonates with consumptive thrombocytopenia without severe bleeding when count<25×10 ⁹/L; no transfusion for dengue fever patients without major bleeding, etc.) and conditional recommendations with low/very low certainty of evidence (e.g., conditional non-recommendation of prophylactic transfusion for adult patients undergoing autologous stem cell transplantation; conditional transfusion for adult patients undergoing central venous catheterization when count<10×10 ⁹/L, etc.). Meanwhile, it elaborates on common platelet transfusion reactions and their risks, such as allergic reactions, febrile reactions, and transfusion-related acute lung injury (TRALI). By lowering transfusion thresholds and refining risk stratification, the guideline can reduce unnecessary transfusions and related adverse reactions, and alleviate the shortage of platelet resources. In the future, it is necessary to further supplement evidence-based evidence in fields such as cardiopulmonary bypass and interventional radiology, and explore technologies like in vitro induced differentiation of platelets and universal engineered platelets to optimize transfusion practices.

Aging is a multifactorial, system-wide process of functional decline and is a major risk factor for various chronic diseases, including cancer, diabetes, cardiovascular diseases, and neurodegenerative disorders. In recent years, the use of blood and blood-derived products as potential anti-aging therapies has attracted considerable attention. Studies suggest that growth factors, cytokines, and small-molecule metabolites in young blood components exhibit significant tissue repair and anti-aging effects, promoting neurogenesis, enhancing cellular regeneration, and regulating metabolic homeostasis, thereby improving health in older individuals. Young plasma has been found to reverse neurological decline, improve cardiovascular function, reduce liver fibrosis, and enhance kidney function, showing anti-aging potential across various organs. Current clinical trials of young plasma focus on neurodegenerative diseases such as Alzheimer's and Parkinson's, demonstrating safety and good tolerance in small-scale studies. However, the long-term efficacy and safety of this therapy remain to be validated, and ethical and resource considerations require careful evaluation. This review summarizes research progress on blood and blood-derived products as anti-aging therapies, with a focus on their regenerative effects on the nervous, cardiovascular, hepatic, and renal systems/organs, and consolidates findings from related clinical trials to support further clinical applications in anti-aging interventions.

Objective To establish a human induced pluripotent stem cells (iPSCs) line with doxycycline-inducible, stable over-expression of human telomerase reverse transcriptase (hTERT) and investigate how hTERT affects iPSC differentiation into megakaryocytes (MKs), as well as their proliferative capacity. Methods A doxycycline-inducible dual-vector encoding hTERT was transfected into human iPSCs. Stable clones were obtained via puromycin selection and single-colony expansion, and hTERT induction was verified by fluorescence microscopy, RT-qPCR, and Western blot. IPSCs differentiation into megakaryocytes was triggered by the spin-EB method; Flow cytometry, cell counting and microscopy were employed to assess the differentiation efficiency and proliferative capacity of hTERT-iPSCs, while ultrastructure, morphology and functional maturity of the generated megakaryocytes were evaluated by transmission electron microscopy, Wright-Giemsa staining and immunofluorescence. Results We successfully established a Dox-inducible hTERT-iPSC stable line. After Dox induction in vitro, the GFP positivity rate, hTERT mRNA ( P<0.05), and protein expression of hTERT-iPSCs were significantly upregulated. The cells differentiated from hTERT-iPSCs could be continuously cultured for up to 35 days, but the GFP positivity rate decreased in a time-dependent manner. Advancing the timing of Dox induction to day 8 of in vitro differentiation significantly promoted cell proliferation ( P<0.001) and maintained hTERT expression ( P<0.01). Morphological and functional assessments revealed no significant differences in the size, typical organelles, or platelet-like particle release of megakaryocytes generated from hTERT-iPSCs. Conclusion hTERT promotes the megakaryocytic differentiation of iPSCs in vitro. Initiating Dox induction on day 8 of differentiation effectively enhances the long-term proliferation of iPSC-derived megakaryocytes while maintaining their mature morphological characteristics and functions. This strategy provides a robust and scalable platform for in vitro production of megakaryocytes and platelets.

As an essential substance for maintaining life activities and metabolic processes, oxygen plays an irreplaceable role in regulating physiological homeostasis and treating disease. The clinical field currently faces severe challenges such as blood supply shortages and transfusion-related infection risks, prompting researchers to develop safe and efficient artificial oxygen carriers (AOCs) as red blood cell substitutes. Hemoglobin-based oxygen carriers (HBOCs) have gained significant attention in this context due to their oxygen-carrying capacity being similar to that of natural red blood cells. This makes them a key area of research in the development of alternative transfusion therapies. However, traditional HBOCs present challenges for clinical use due to their vasoconstrictive activity, oxidative stress toxicity, and short circulatory half-life. Advances in nanotechnology have enabled researchers to develop a new generation of HBOC nanomaterial systems using innovative strategies such as haemoglobin nano-encapsulation, surface functionalisation modification, and biomolecular conjugation. These novel carriers significantly overcome the limitations of traditional HBOCs and have promising applications in fields such as trauma emergency care, treatment of ischaemic diseases, and tumour oxygenation regulation. This paper provides a comprehensive review of research progress on HBOCs and nanomaterial-based HBOCs, analysing their advantages and challenges for future clinical applications.

Pre-clinical blood transfusion testing in medical institutions is the most crucial inspection link in the clinical blood transfusion process. High-quality clinical pre-transfusion detection techniques and capabilities can minimize the risk of adverse reactions to blood transfusion to the greatest extent. Since the test results before clinical blood transfusion are the definitive diagnosis for the recipient (patient), whether the safety and effectiveness of blood transfusion can be ensured often depends on the accuracy and timeliness of the test results. Therefore, in order to ensure the safety and effectiveness of clinical blood transfusion, and to safeguard people's health and social stability, the expert consensus group has gathered experts and scholars in the field of clinical blood transfusion medicine and related disciplines in China. They have combined national laws and regulations, standardized documents, national health standards related to blood transfusion, and research results related to clinical blood transfusion to formulate this expert consensus. The aim is to further standardize the use of key equipment and reagents for pre-transfusion testing in the blood transfusion department (blood bank), as well as the detection capabilities of personnel.

Objective To investigate the mechanism by which free heme released from stored red blood cells exacerbates the inflammatory response through endoplasmic reticulum stress (ERS)-induced neutrophil extracellular trap formation (NETosis) in a mouse model of trauma-hemorrhagic shock, and further to assess the intervention effect of ERS inhibition on NETosis and the expression of related signaling pathway proteins. Methods This study employed a trauma-hemorrhagic shock mouse model with experimental groups including sham operation group, fresh red blood cell suspension resuscitation group, storage-damaged red blood cell resuscitation group, and free heme+ERS inhibition group, with 10 mice in each group. Body temperature, blood pressure, and pathological tissues were evaluated in each group, and the proportions of neutrophil elastase (NE) positive cells and myeloperoxidase (MPO) positive cells in peripheral blood were detected. Western Blot was used to detect the protein expression levels of protein kinase R-like endoplasmic reticulum kinase (PERK), eukaryotic translation initiation factor 2α (eIF2α), and activating transcription factor 4 (ATF4). Enzyme-linked immunosorbent assay (ELISA) was used to detect plasma free heme, MPO-DNA complexes, and inflammatory cytokines interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) concentrations. PicoGreen fluorescent dye method was used to determine extracellular DNA levels. Results Compared with the sham surgery group, mice in the stored damaged red blood cell resuscitation group showed significantly decreased body temperature and blood pressure ( P<0.01), significantly increased expression levels of ERS-related proteins PERK, eIF2α and ATF4 (all P<0.01), elevated concentrations of inflammatory factors IL-1β, TNF-α and IL-6 in serum and increased plasma free heme levels (all P<0.01), significantly increased proportions of NE and MPO positive cells in peripheral blood ( P<0.01), and significantly elevated MPO-DNA complex and extracellular DNA levels ( P<0.01). Compared with the stored damaged red blood cell resuscitation group, mice in the fresh red blood cell suspension resuscitation group and the free heme+ERS inhibition group showed significantly increased body temperature and blood pressure ( P<0.05), significantly decreased expression levels of ERS-related proteins PERK, eIF2α and ATF4 (all P<0.01), reduced concentrations of inflammatory factors IL-1β, TNF-α and IL-6 in serum and decreased plasma free heme levels (all P<0.01), significantly reduced proportions of NE and MPO positive cells in peripheral blood ( P<0.01), and significantly decreased MPO-DNA complex and extracellular DNA levels ( P<0.01). Compared with the fresh red blood cell suspension resuscitation group, there were no significant differences in body temperature and blood pressure, expression levels of ERS-related proteins PERK, eIF2α and ATF4, concentrations of inflammatory factors IL-1β, TNF-α and IL-6 in serum and plasma free heme levels, proportions of NE and MPO positive cells in peripheral blood, and MPO-DNA complex and extracellular DNA levels in the free heme+ERS inhibition group mice. Pathological examination showed that organ inflammation and cell apoptosis were significant in the stored damaged red blood cell resuscitation group, while they were relatively mild in other groups. Conclusion Free heme released from red blood cell storage lesions plays a crucial role in trauma-hemorrhagic shock by significantly exacerbating NETosis and inflammatory responses through the induction of ERS. ERS intervention can effectively block this effect of free heme, reducing NETosis, decreasing levels of inflammatory factors IL-1β, TNF-α, and IL-6, as well as free heme levels, and inhibiting the activation of the PERK/eIF2α/ATF4 signaling pathway. This provides important experimental evidence and potential new strategies for targeting the free heme-ERS-NETosis axis in the treatment of inflammatory injury in trauma-hemorrhagic shock.

Clinical blood transfusion, as a vital medical intervention for patient treatment, carries inherent risks. Therefore, implementing systematic quality management of blood transfusion is crucial to ensuring transfusion safety. Investigations reveal that some medical institutions still suffer from overly complex and inefficient blood transfusion quality management systems, while a few institutions with relatively low blood usage lack or have incomplete quality management systems. In response, the Yangtze River Delta Integration Clinical Transfusion Quality Control and Management Consortium, Shanghai Clinical Transfusion Quality Control Center, Blood Transfusion Professional Committee of Shanghai Association of Social Medical Institutions, Blood Transfusion Branch of Shanghai Medical Association, and Blood Transfusion Physician Branch of Shanghai Medical Doctor Association organized a group of renowned domestic experts in transfusion medicine. Based on evidence-based medicine methods, they developed the Expert Consensus on Checklist-based Quality Management for the Entire Clinical Blood Transfusion Process. Centered on the transfusion workflow, this consensus defines 38 specific tasks across four dimensions: process, task, personnel, and requirements. It covers key stages including transfusion indication assessment, transfusion request and approval, blood transfusion compatibility testing, blood release, blood transfusion administration, and post-transfusion management, with clear definitions of responsible personnel and requirements for each task. Previously, this consensus has been registered on an international practice guideline platform (Registration Number: PREPARE-2025CN735). The consensus aims to use a checklist model to clarify the key steps and quality control points at each stage of clinical blood transfusion. It provides standardized, refined, and actionable guidance for medical institutions to standardize technical operations, reduce human errors, minimize transfusion risks, and systematically ensure clinical transfusion safety.

The Rh blood group system is one of the most clinically significant blood group systems. Incompatibility in this system can lead to alloimmunization, resulting in severe adverse reactions such as hemolytic transfusion reactions in patients and hemolytic disease of the fetus and newborn (HDFN), which threaten patient lives. Recent cutting-edge research on RHD and RHCE variants has yielded significant progress, providing not only an impetus for innovating transfusion protocols but also novel strategies for the management of blood resources. This article reviews the latest advances in the distribution of Rh antigens, their molecular basis, clinical applications, and associated technological innovations, with the aim of optimizing transfusion strategies to enhance safety and efficacy.

Objective To understand the distribution of RhD, C, c, E and e antigens among Chinese people in China, and to explore the genetic relationships of Rh blood type distribution across different regions and ethnic groups. Methods Data on the distribution of RhD, C, c, E, and e antigens from 1 048 519 Chinese individuals across 34 provinces, municipalities directly under the Central Government, and autonomous regions were collected for population genetic analysis. The maximum likelihood method was used to calculate the Rh gene frequency and haplotype frequency. The reliability of the data was evaluated by the Hardy-Weinberg equilibrium fit test. Results The distribution of Rh blood type in 34 provinces, municipalities and autonomous regions and 16 ethnic groups in China was consistent with Hardy-Weinberg equilibrium. The allele frequencies of RHD and RHCE, as well as the Rh haplotype frequencies, were associated with the subjects' place of origin. Among northerners and southerners, the RhD-positive rates were 99.55% and 99.61% respectively, and the RhD-negative rates were 0.45% and 0.39% respectively. The frequencies of DCe haplotype with Asian characteristics were 0.625 9 and 0.683 5, and the frequencies of the RHCE*Ce allele were 0.641 6 and 0.701 4, respectively. Conclusion The data analyzed in this report were collected nationwide using uniform standards, with over one million subjects examined. The derived data obtained through analysis can be used as control data for various regions in China and used in disease association studies, anthropological studies, and transfusion medicine research.

Blood group gene polymorphism holds significant importance in the fields of genetic research, clinical blood transfusion, and transplant immunology, as it determines the polymorphism of blood group antigens. In recent years, third-generation sequencing (TGS) technology, also known as single-molecule sequencing, has emerged as a research hotspot in the precision medicine genetic testing industry, opening a new door for the entire field of genetics. Research findings on blood group genes based on TGS technology have been successively published, continuously expanding the application boundaries of this technology in blood group polymorphism analysis. This review summarizes the latest advancements in TGS technology for studying blood group gene polymorphism and its applications in clinical transfusion medicine.

Tissue regeneration is a central objective in the field of regenerative medicine and is currently confronted with pivotal bottlenecks such as low survival of transplanted cells, limited functionality, and an imbalanced microenvironment. The combination of platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) offers a new strategy to address these challenges through multi-pathway synergism that optimizes the microenvironment. The growth factors abundant in PRP can significantly enhance MSC survival and function, exhibiting synergistic effects in the repair of various tissue injuries. This article systematically elaborates on the molecular mechanisms by which PRP regulates MSC function, the research progress of the combined therapy in animal models, and the current status of clinical application, with the aim of providing novel theoretical foundations and practical directions for tissue-regenerative treatment.

Occult hepatitis B virus infection (OBI), characterized by extremely low viral loads and the persistent latency of intrahepatic cccDNA, poses a profound challenge to global public health security. Its prevention and control have long been constrained by the sensitivity limitations of conventional diagnostic methods, highlighting the urgent need for technological breakthroughs. Emerging detection technologies are driving progress from multiple perspectives: droplet digital PCR enables ultra-sensitive quantification through micro-compartmentalized amplification; CRISPR-Cas systems coupled with isothermal amplification are advancing the development of point-of-care diagnostics; third-generation sequencing technologies open new dimensions for viral genome analysis; and nanomaterial-mediated signal amplification mechanisms are reshaping screening models at the primary-care level. This review summarizes recent advances in OBI diagnostic technologies, provides a comprehensive analysis of their advantages, limitations, and transfusion-related applications, and offers recommendations to support improved OBI risk control in blood transfusion and the development of novel diagnostic strategies tailored to China's national context.

Objective To investigate the molecular mechanism by which methyltransferase-like 3 (METTL3) promotes megakaryocyte differentiation via m ⁶A modification-mediated regulation of integrin β3 (ITGB3) expression. Methods Human megakaryoblastic leukemia cells (MEG-01) treated with 20 nM phorbol myristate acetate (PMA) were used to establish a differentiation model. Baseline METTL3 expression in MEG-01 cells and hematopoietic stem cell (HSC) differentiation models was detected by Western blot (WB) and quantitative real-time PCR (RT-qPCR). Subsequently, lentivirus-mediated shRNA (sh METTL3) was used to transfect the MEG-01 megakaryocytic cell line. Knockdown efficiency was detected by WB and RT-qPCR. The expression levels of megakaryocytic surface differentiation markers CD41a and CD61 were measured by flow cytometry. Transcriptome sequencing was applied to identify downstream targets of METTL3, and their expression levels were validated by RT-qPCR and WB. Furthermore, in METTL3-overexpressing cells, the expression levels of METTL3 were detected by RT-qPCR and WB, and CD41a and CD61 were analyzed by flow cytometry. Additionally, METTL3 was re-expressed in METTL3-silenced MEG-01 cells, and its expression was assessed by RT-qPCR and WB, while the levels of CD41a and CD61 were detected by flow cytometry. Finally, bioinformatic prediction (SRAMP) was employed to identify potential m ⁶A modification sites on ITGB3 mRNA, and m ⁶A-RIP combined with Me-PCR was performed to examine the enrichment of m ⁶A signals. Results METTL3 was expressed at mRNA and protein levels in MEG-01 cells and HSC-derived megakaryocytes.shMETTL3 significantly reduced METTL3 mRNA and protein ( P<0.001). shMETTL3 decreased CD41a and CD61 surface expression versus the Scramble control ( P<0.001). Transcriptomics identified ITGB3 (encoding CD61) as a key target; its mRNA and protein decreased in shMETTL3 cells ( P<0.05). METTL3-OE upregulated CD41a and CD61; METTL3 rescue restored their expression ( P<0.01). m ⁶A-RIP/Me-PCR confirmed: (1) Higher m ⁶A enrichment on ITGB3 versus GAPDH mRNA ( P<0.001); (2) Reduced m ⁶A modification on ITGB3 in shMETTL3 cells ( P<0.001). Conclusion Downregulation of the RNA methyltransferase METTL3 reduces m ⁶A modification on ITGB3 mRNA, thereby suppressing ITGB3 expression and impairing megakaryocyte differentiation and platelet production.

Objective To analyze the prevalence of human cytomegalovirus (CMV) infection markers among voluntary blood donors in China and to provide a basis for evaluating the necessity of CMV screening and formulating relevant strategies. Methods A systematic search was conducted in eight databases including CNKI, Wanfang Medical, VIP, CBM, PubMed, Embase, Web of Science, and Medline from inception to March 2024. Literature meeting the inclusion criteria was selected, and meta-analysis was performed using StataMP 17.0 software. Results Thirty-two studies were included, with sample sizes of 30 388 for CMV-IgG, 27 273 for CMV-IgM, and 12 934 for CMV-DNA. The pooled prevalence rates of CMV-IgG, CMV-IgM, CMV-DNA, and CMV-(IgG+IgM) were 88% [95% CI (81%, 94%)], 3% [95% CI (2%, 5%)], 6% [95% CI (3%, 9%)], and 1% [95% CI (1%, 2%)], respectively. Subgroup analysis showed that in southern China, the pooled prevalence rates of CMV-IgG, CMV-IgM, and CMV-DNA were 91% [95% CI (84%, 96%)], 4% [95% CI (2%, 7%)], and 3% [95% CI (1%, 6%)], respectively; in northern China, they were 83% [95% CI (72%, 94%)], 2% [95% CI (1%, 3%)], and 4% [95% CI (1%, 10%)], respectively. The pooled prevalence rates of CMV-IgG and CMV-IgM detected by ELISA were 85% [95% CI (69%, 96%)] and 3% [95% CI (2%, 5%)], respectively, while those detected by other methods were 88% [95% CI (87%, 89%)] and 3% [95% CI (2%, 4%)], respectively. Conclusion The prevalence of CMV infection is high among voluntary blood donors in China, with notable regional variations. Strengthening CMV screening is essential to prevent TT-CMV.

Platelet products are crucial components in clinical blood transfusion. However, their storage under conventional conditions (22±2) ℃ is prone to bacterial contamination, which poses a risk of sepsis and constitutes one of the core challenges to blood transfusion safety. This review aims to summarize the research progress of bacterial detection technologies for platelets. First, the article analyzes the advantages and disadvantages of traditional detection methods represented by automated microbial culture systems, as well as the performance merits and demerits of various emerging technologies, including nucleic acid amplification technology, immunoassay, flow cytometry, mass spectrometry, metagenomics, surface-enhanced Raman spectroscopy, and nanobiosensors. Subsequently, it elaborates on the core challenges currently faced and provides an outlook on future development trends.Ultimately, this review intends to offer a scientific basis for establishing a more comprehensive quality and safety assurance system for platelets.

The ABO blood group system is a crucial component of blood transfusion. Attenuation or absence of ABO antigens on red blood cells is occasionally observed, posing significant challenges to blood group determination. The occurrence of such phenomena may be associated with physiological, genetic, or pathological factors. The underlying causes and mechanisms of weakened or absent ABO antigens are highly complex; recent studies have primarily focused on variations within the ABO gene coding region, promoter region, untranslated regions at the 5' and 3' ends, as well as intronic regions. This article provides an analytical summary of the potential causes and mechanisms underlying the attenuation or absence of ABO blood group antigens, offering a theoretical basis for accurate identification of complex blood groups, enriching the research on ABO blood group variants in the Chinese population, and ensuring the safety and effectiveness of clinical transfusion practice.

Dry eye disease (DED) is a multifactorial mediated keratoconjunctivitis sicca, whose main clinical symptoms are dry eyes, blurred vision, burning sensation, etc., if not treated in time, it can lead to vision loss, and in severe cases, be accompanied by severe pain or even blindness, which seriously impacts patients. Blood-derived eye drops are derived from blood and contain a variety of bioactive factors, mimicking the biological activity of natural tears, which can lubricate the surface of the eyeball, promote corneal epithelial repair, and improve ocular surface inflammation, and are used to treat eye diseases caused by various causes. Existing clinical studies have shown that the use of blood-derived eye drops can effectively treat dry eye syndrome by reducing corneal epithelial damage, promoting corneal nerve and cell repair, and increasing tear secretion and goblet cell activity. This paper systematically searched the databases of PubMed, CNKI and Wanfang Data, and the search time period was from the establishment of the database to July 2025. Keywords such as "dry eye syndrome", "blood-derived eye drops", "autologous serum", and "platelet-rich plasma" were used to search in Chinese and English. Published clinical studies (e.g, randomised controlled trials, case series) were included, excluding animal trials, reviews, conference abstracts, and non-monotherapy studies. By conducting a summary analysis of the search results, it aims to provide a scientific reference for its clinical application.

Sonoclot coagulation and platelet function analysis plays a role in the clinical application of multiple fields. By synthesizing recent literature, this article expounds on the research progress of Sonoclot in coagulation function monitoring of patients with different diseases and efficacy evaluation of coagulation drugs. It discusses the application advantages and limitations of Sonoclot, looks forward to future research directions, and provides new ideas for clinical diagnosis and treatment.

With the application of advanced weapons, the traumatic condition in modern warfare has become severe and complex. Acute hemorrhagic shock is the leading cause of death among patients. Early fluid resuscitation is of great significance for improving the survival rate. Liquid plasma (LP) has the characteristics of simple preparation process, short blood transfusion preparation time, and low dependence on cold chain during transportation and storage, which is conducive to ensuring timely and effective fluid resuscitation for patients within the golden time of rescue. Different from the frozen plasma and freeze-dried plasma, LP has unique characteristics and its own advantages that are suitable for the treatment of war wounds, providing a prerequisite for it to be part of the blood support system. This article compares the characteristics of LP and other plasma products, and analyzes its advantages and disadvantages, application status and prospects as emergency resuscitation fluid for war wounds, providing information for its further application and development in the military field.

Objective To explore association between serum aldehydes and red blood cell count and hemoglobin concentration in the real world. Methods The associations between serum aldehydes and anemia in US adults from the National Health and Nutrition Examination Survey were analyzed. Results Isopentanaldehyde was the primary contributor to the association between aldehyde exposure and anemia with the highest posterior inclusion probability value of 0.872. In addition, differential associations between isopentanaldehyde and anemia were identified in men and women. The isopentanaldehyde Q4 concentration exhibited a positive association with the anemia T2 group in the male population, while the isopentanaldehyde Q4 concentration manifested negative correlations with both the anemia T1 and T3 groups in the female population. Furthermore, each 1 ng/mL increment in isopentanaldehyde was associated with a 2.55 g/L increase in hemoglobin in females ( P=0.006) and a 0.114×10 ¹²/L decrease in RBC count in males ( P=0.002). Conclusion Serum isopentanaldehyde are related to anemia in adults in the real word and the association appeared difference between male and female groups. For cases with basically normal hemoglobin concentrations but presenting with unexplained anemia symptoms, isopentanaldehyde may become a pontential biomarker to assist evaluating disease status.