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.

Fetomaternal hemorrhage (FMH) is a series of reactions in which fetal red blood cells enter the maternal circulation before or during delivery, and the mother produces antibodies against fetal red blood cells, which in combination with red blood cell surface antigens cause fetal red blood cells to undergo varying degrees of hemolysis. Accurate quantification of fetalmaternal hemorrhage is crucial for the prevention of neonatal birth defects including neonatal hemolytic disease. Based on the latest relevant literature at home and abroad, this article analyzes the new and traditional detection methods for FMH, elucidates the advantages and shortcomings of various detection methods, and briefly outlines the correlation between FMH and various perinatal fetal clinical disorders, in order to provide a basis for standardization of testing techniques for fetalmaternal hemorrhage and further prevention and treatment of related diseases.

In recent years, the mechanisms of platelet aging have garnered increasing attention. With advancements in detection technologies, researchers are now able to study the age stratification of platelets in the peripheral blood of healthy individuals, revealing extensive changes at both the transcriptomic and proteomic levels during the aging process. Pathophysiological studies have further elucidated the critical role of platelets in various diseases, closely associated with age-related changes in platelets. However, the specific characteristics of platelet aging and their precise role in disease development remain to be fully elucidated. Therefore, understanding the physiological characteristics and molecular mechanisms of aging platelets under normal conditions is crucial for research. This review summarizes the transcriptomic and proteomic studies on platelet aging in physiological conditions, as well as the changes in platelet turnover in related diseases, aiming to provide a reference for exploring the relationship between platelet aging and disease development.

Smoking constitutes a significant public health concern, recognized as a leading preventable cause of mortality worldwide. Tobacco smoke carries biologically active substances and toxic compounds that affect human health, leading to shortened lifespans. Oxidative stress induced by smoking exerts negative effects on the quality of red blood cells (RBCs), primarily through membrane damage and increased levels of abnormal hemoglobin. Prolonged smoking leads to abnormalities in various RBC parameters, thereby facilitating the onset and progression of diseases. This paper provides a summary of recent research on the adverse effects of smoking on red blood cells, aiming to furnish additional theoretical groundwork for enhancing tobacco control efforts.

Objective To analyze the distribution of HLA/HPA antibody specificity and its influence on the efficacy of platelet transfusion in patients with immune platelet transfusion refractoriness（PTR）. Methods In this study, 86 patients with immune PTR were recruited, and clinical data were collected, including gender, age, height, weight, times of platelet cross-matching, diseases, as well as platelet count before and after platelet transfusion. HLA antibody specificity was determined using the microbead assay. Results Among 86 PTR patients, 72 (83.72%) had HLA antibodies alone, 8 (9.30%) had HPA antibodies alone, and 6 (6.98%) had both HLA and HPA antibodies. The most prevalent HLA alleles corresponding to HLA antibodies in different loci were A*25:01, B*15:12, C*02:02 (and C*17:01), with the positive rates of 81.48%, 87.04%, and 48.15%, while the top antigenic epitopes were 163LG, 97V, and 71ATD, with the positive rates of 87.04%, 77.78%, and 74.07%, respectively. In patients with HLA antibodies alone, cross-matched platelet transfusions showed significantly higher 24 h corrected count increment（CCI）and transfusion efficiency than randomized transfusions (P<0.01). In patients with negative cross-matching results, the intensity of HLA antibodies inversely correlated with both the 24 h CCI and the effective rate of platelet transfusion in patients receiving cross-matched platelets. Specifically, a higher the level of HLA antibodies corresponded to a lower 24 h CCI and reduced transfusion efficiency (P<0.01). Conversely, in patients with a lower level of HLA antibodies, the efficiency of platelet transfusion and 24 h CCI of cross-matched platelets were significantly higher than those of randomized platelets (P<0.05). Conclusion Our findings reveal the specificity of HLA/HPA antibodies in patients with immune PTR and their effect on platelet transfusion efficacy, which would provide guidance for donor selection in the establishment of platelet banks. Furthermore, this study could also provide a reference for selecting appropriate treatment strategies for patients with immune PTR.

Objective To investigate the clinical effect of autologous plateletpheresis (APP) transfusion in patients with acute type A aortic dissection (ATAAD). Methods The clinical data of 125 ATAAD patients admitted to our hospital from January 2020 to April 2023 were retrospectively analyzed. The patients were divided into APP group (n=59) and non-APP group (n=66) based on whether APP and transfusion performed. The levels of coagulation indexes and liver and kidney indexes were recorded at preoperative (T0), 24 h postoperative (T1), 48 h postoperative (T2), and 72 h postoperative (T3). Platelet count, the amount of allogeneic blood transfusion, duration of surgery, duration of mechanical ventilation, volume of mediastinal drainage in the postoperative period, length of stay in the ICU, hospitalization cost, and rate of postoperative complications were recorded. Results At T1-T3, PT and APTT in the APP group were significantly shorter than those in the non-APP group (P<0.05), and the level of FIB was higher than that in the non-APP group (P<0.05). The liver function parameters after operation were observed. Compared with the non-APP group, the levels of ALT and AST in the APP group were relatively lower at T1 and T2 (P<0.05); LDH was maintained at lower levels at T1, T2, and T3 (P<0.05); the levels of DBil and TBil were lower than those in the APP group at T1 (P<0.05). Postoperative renal function parameters were observed. SCr and BUN levels in the APP group were significantly lower than those in the non-APP group at T1, T2, and T3 (P<0.05). From blood protection, compared with the non-APP group, PLT in the APP group maintained a high level at T1 (P<0.05), and the amount of perioperative allogeneic red blood cells, platelets, plasma and cryoprecipitate transfusion in the APP group was relatively lower (P<0.05). The postoperative outcomes were observed. Compared with the non-APP group, duration of mechanical ventilation and length of stay in the ICU in the APP group were shorter; total hospitalization cost was lower; the volume of mediastinal drainage at 24 h after surgery was lower (P<0.05). The postoperative complications were observed. The incidence of acute kidney injury in the APP group was significantly lower than that in the non-APP group (P<0.05). Conclusion Autologous plateletpheresis and transfusion technology can effectively improve the coagulation function of ATAAD patients and have obvious effects on postoperative liver and kidney function protection and blood protection, and accelerate postoperative recovery and regression. The application of this technology is helpful to reduce the economic burden of patients and achieve good social and economic effects.

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 analyze the clinical characteristics and nucleic acid testing (NAT) to guide the interpretation of gray zone (GZ) sample results detected by chemiluminescence technology. Methods The results of patients admitted to 5 general hospitals in different regions of the country from July to December 2021 were collected for Transfusion Transmissible Infection (TTI) screening tests before surgery/transfusion. NAT detection and clinical characteristics analysis were performed on GZ samples. Results Among the 5 723 samples, 28 (0.49%) were GZ for HBV and 20 (0.35%) for HCV. NAT results showed that 15 of the 28 HBV GZ (53.5%) were NAT-positive, and their HBcAb were all positive; 13 HBV samples (46.5%) were NAT-negative, of which 4 positive for HBcAb. HBV and HCV GZ samples were found in all clinical departments. The top three departments of HBV GZ samples were orthopedics, gynecology, and urology and the largest number of false positives were gynecology and orthopedics. The top three departments for HCV GZ samples were urology, nephrology, and surgery, and all of them were false positives. 35.7% (10/28) of patients with HBV GZ samples and 40% (8/20) of patients with HCV GZ samples were diagnosed as neoplastic diseases. Conclusion Chemiluminescence methods are prone to false-positive results, so attention should be paid to retest for verification and it is not necessary to set up GZ. Gz samples can be found in some clinical departments exhibiting specific clinical distribution characteristics. NAT can improve detection sensitivity and ensure accuracy to verify GZ.

Whole blood was the earliest blood product ever used, however, with the advent of component transfusion treatments, whole blood all but disappeared from blood bank lists in the 1970 s. In recent years, based upon the successful military experience, the use of whole blood to resuscitate patients with hemorrhagic trauma has again attracted the attention of the blood transfusion circle,and it has gradually been introduced from the military field to the civilian treatment settings.Based on the guidelines for whole blood transfusion at home and abroad and related published studies, this paper reviews the classification of whole blood, history of whole blood use, whole blood storage and platelet protection, removal of whole blood white blood cells, inactivation of whole blood pathogens, and urgent problems to be solved in scientific and accurate transfusion of whole blood, and looks forward to its future development direction, providing reference for the introduction of whole blood more widely, and the development of blood transfusion medicine.

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.

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.

Aplastic anemia (AA) is a bone marrow hematopoietic failure disease. Blood component transfusion is necessary to treat anemia and maintain quality of life in AA patients. However, long-term blood transfusion easily leads to transfusion dependence, and the current blood supply is insufficient, and it is also increasingly difficult to meet the blood transfusion needs of AA patients. Therefore, it is particularly important to perform "patient blood management" (PBM) for AA, apply various non-transfusion methods to treat anemia, reduce the transfusion of allogeneic blood, and improve the quality of life of AA patients. Traditional Chinese medicine (TCM) treatment can improve the symptoms of anemia in AA patients, reduce the need for allogeneic blood transfusion, and facilitate the blood management of AA patients. This article reviews the traditional Chinese medicine and its mechanism of action in the treatment of AA, and discusses the clinical significance of traditional Chinese medicine in the blood management of AA patients.

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.

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 Through the research of many cases of mimicking antibodies, To study the characteristics of mimicking antibodies and explore the transfusion principles of mimicking antibodies. Provide effective detection methods and clinical suggestions for patients with mimicking antibodies. Methods A retrospective analysis was made on the sex, age, diagnosis and serological test of 160 cases of mimicking antibodies. Analyze the experimental data and find the relevant rules. Results The specificity of RH blood group antibodies is the most common in all mimicking antibodies. Mimicking antibodies of anti-Ce, anti-Ec and anti-D accounted for 94.48% in 160 cases. The type of CCDee is the most common type in all cases. GEL test in serum showed strong antibody reactivity (the score was 7.16). Indirect antiglobulin test in serum with tube showed strong specificity. Conclusion It is suggested that a variety of identification methods should be employed because it's difficult to identify the specificity of mimicking antibodies. The GEL test is more reactive in detecting antibodies and Indirect antiglobulin test method is more specific in distinguishing antibodies. The two methods should be combined. Blood transfusion treatment should be as far as possible to avoid mimicking antibody specificity, transfuse corresponding antigen negative of red blood cells will have obvious therapeutic effect on the patients.

To date, the proliferation of life science and medical research involving human participants in Chinese blood collection and supply institutions necessitates the eatablishemnt of medical ethics committees, which conduct ethical reviews to ensure that medical research trials adhere to ethical and legal standards, safeguarding the safety, health, privacy and other rights of study subjects. Taking the Ethics Committee of Nanjing Red Cross Blood Center as a case study, we aimed to explore the standardization process of medical ethics committees within blood collection and supply institutions by evaluating their accomplishments and shortcomings, and we sought to offer insights into the ethical considerations regarding medical device clinical trials using blood samples and donor information from these institutions, thus better protecting the rights and interests of research participants, and fostering the healthy and sustainable growth of blood transfusion medical research within the sector.