Objective To investigate the changes in the expression profile of growth factors in platelet-rich plasma (PRP) under different preparation conditions, providing experimental evidence for selecting different types of PRP for different clinical treatment purposes. Methods Seven portions of PRP (30 mL each) were obtained using a blood component separator. Ten milliliters of the same PRP were randomly divided into platelet-poor plasma (PPP) control group, PRP gel supernatant group, and PRP frozen lysate group. The PRP gel group utilized bovine thrombin and 10% calcium gluconate to create a premix solution, which was then added to PRP in a 1∶9 ratio to obtain PRP supernatant. The PRP frozen lysate group went through five cycles of freezing and thawing at temperatures ranging from -20℃ to 37℃ to obtain platelet lysate. Changes in the growth factor profile in the samples were detected using Quantibody® growth factor protein chips, and differential growth factors were validated using ELISA. Results Compared to PPP, five growth factors showed increased expression in the PRP supernatant group: brain-derived neurotrophic factor (BDNF, 14.64 times), platelet-derived growth factor-AA (PDGF-AA, 4.53 times), epidermal growth factor (EGF, 4.52 times), vascular endothelial growth factor (VEGF, 3.45 times), and hepatocyte growth factor (HGF, 2.16 times). GO and KEGG analyses indicated that these factors were mainly enriched in cell migration, Ras, and PI3K-Akt signaling pathways, participating in tissue repair. In the PRP lysate group, the increased growth factors were BDNF (20.74 times), EGF (11.12 times), transforming growth factor-β1 (TGF-β1, 5.76 times), while the decreased growth factor was insulin-like growth factor-binding protein-6 (IGFBP-6, 1.46 times). These factors were primarily enriched in the MAPK signaling pathway and FoxO signaling pathway, playing anti-inflammatory roles. Conclusion Both PRP supernatant and PRP lysate can release a variety of growth factors. Growth factors produced in PRP supernatant mainly participate in wound repair and healing, while those in PRP lysate mainly contribute to tissue repair and anti-inflammatory effects. Therefore, for different clinical treatment purposes, PRP products prepared in different ways should be selected to achieve the best therapeutic outcome.

More recently, novel monoclonal antibodies targeting immune checkpoints related signaling pathways have shown promise in the field of cancer immunotherapy. Hu5F9-G4, IBI188, and Daratumumab, designed specifically to target CD47 and CD38, have demonstrated clinical efficacy in patients with lymphoma, multiple myeloma, and other malignancies. Because CD38 and CD47 molecules are expressed not only on tumor cells, but also on red blood cells, anti-CD38 or anti-CD47 antibodies are specifically bound to red blood cells in the blood of patients treated with anti-CD38 and anti-CD47 monoclonal drugs. This leads to false positives in compatibility testing, such as blood typing, cross-matching and irregular antibody screening etc., which poses a risk to transfusion safety. In this paper, the interference problems of anti-CD38 and anti-CD47 on blood transfusion compatibility testing and the existing elimination strategies are described to provide reference for minimizing the impact of anti-CD38 and anti-CD47 on blood transfusion safety.

Objective To investigate the effects of platelets with different storage days and quantities on the proliferation of liver cancer cells. Methods Twelve type O platelet braids were collected from Nanning Central Blood Station and sent to the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine. According to the storage days, they were divided into fresh PLT group and old PLT group, of which the fresh PLT group was platelets stored for 1 day. In the old PLT group, platelets stored for 4 days were used. The two groups of platelets were co-cultured with human liver cancer cell Huh-7. The confluence degree of Huh-7 cells in each group within 48 hours was observed by scratch test, and the invasion ability of Huh-7 cells in each group within 24 hours was observed by transwell test. Results The results of scratch test showed that the proliferation ability of Huh-7 cells was significantly enhanced after co-culture with platelets. When the same amount of PLT was added, old PLT could promote the proliferation of Huh-7 cells more strongly. When PLT with the same storage days was added, PLT with a higher number generally showed a relatively stronger ability to stimulate cell proliferation. The results of transwell experiment were similar to the results of scratch. When the number of PLT was the same, the number of Huh-7 cells invaded by old PLT group was more than that of fresh PLT group, and the difference was statistically significant (P<0.05). The more PLT was added into Huh-7 cells, the more invasive cells occurred in the fresh PLT group and the old PLT group, and the difference was statistically significant (P<0.05). Conclusion The ability of platelets to promote cell proliferation and invasion is positively correlated with the storage time of platelets and the number of platelets. The application rules of platelet products need to be analyzed according to the specific clinical conditions. In the treatment of patients with neoplastic diseases, the application of old platelets should be avoided as far as possible, and the transfusion of platelets should be minimized when platelets have to be used, so as to achieve the purpose of slowing down the proliferation and metastasis of tumor cells.

Objective To investigate whether free heme released in hemolysis could directly damage hepatocytes and disrupt liver function. Methods The mice model of hemolytic transfusion reaction was established, and ALT, AST and other biochemical indexes were detected to analyze the liver function. In vitro, the LO2 cells were stimulated with different concentrations of lysed supernatant of red blood cells and heme respectively. Then the levels of ALT and AST were detected to analyze the liver function. Cell viability was observed by flow cytometry, and cell morphology and skeleton structure were observed by immunofluorescence. Results Abnormal liver function was observed on the mice model of hemolytic transfusion reaction. The results of in vitro experiments showed that LO2 cell viability decreased and the proportion of dead cells increased along with the incremental concentration of free heme. The biochemical indexes such as ALT and AST were aggravated significantly. And free heme could directly destroy the cytoskeleton of LO2 cells. Conclusion Free heme can directly destroy the cell structure of hepatocytes, inhibit cell vitality, induce cell death and abnormal liver function. The degree of damage is positively correlated with the concentration of free heme.

Clinical transfusion is one of the important treatment of severe hemorrhage patients. Timeliness is a key factor of curative effect in transfusion therapy. Many complicated process and many departments are involved. Therefore, it is imperative to build a standard, reasonable and effective paperless process of clinical transfusion. The paperless process transforms the traditional paper-based documents into seamless connections between programs. It is mainly composed of three modules, information interaction, compatibility test and transfusion closed-loop. This process improves the work efficiency, reduces the error rate, saves energy and storage space. It also has realized the safety management of standardization, informationization and paperless transfusion closed-loop.

Objective To study the value of serum IgG anti-A/B titer score of pregnant women with blood type O for predicting the hemolytic disease of newborn (HDN). Methods 45 blood type O pregnant women with high IgG antibody titer were selected as the research object. The IgG titer of the mother was measured by anti-human globulin test carried out by traditional tubing test. At the same time, the score of each tube were measured according to the intensity of agglutination. To obtain the antibody titer scores of the tested samples, add up the scores of the tubes. The correlations between the IgG antibody titer score of pregnant women and the possibility of HDN of newborns were analyzed. Results Of the 45 newborns, 27 were diagnosed as HDN. With the serum antibody titer of pregnant women increasing, the prevalence of HDN shows an upward trend, but the difference between different antibody titer groups was not statistically significant. There was a statistically significant correlation between the titer score and the incidence of HDN, and the correlation coefficient was -0.665. Conclusion Compared to antibody titer, the titer score of pregnant mothers is more closely related to the incidence rate of HDN of newborn. The IgG antibody titer score of pregnant women has more clinical significance in predicting the HDN of hemolytic disease.

Objective The first case of blood stream infection with Candida auris in Tongling of Anhui province was reported, the drug resistance and source of the strain were analyzed. Methods MS and gene sequencing were used to identify the strain of Candida auris from a patient with blood infection in the intensive care unit (ICU) of a tertiary hospital in Anhui Province, China, and its resistanceto various drugs, bacterial origin and virulence were analysed. Results The drug sensitivity test showed that the fungus was resistant to azoles and polyene, but sensitive to 5-fluorocytosine.Mutations in ERG11 and CDR1 were found in the whole genome sequencing. The former mutated from tyrosine to L-Phenylalanine at position 132 and the latter mutated from glutamate to L-Aspartic Acid at position 709.No mutation was detected in ergosterol pathway related genes ERG1, ERG2, ERG6, Erg13. In addition, a phylogenetic tree drawn by comparing Internally Transcribed Spaer（ITS）sequences revealed that the strain with the closest relationship to the strains we isolated was the Indian strain. Conclusion This is the first report of blood stream infection caused by Candida auris in Anhui Province.MS and gene sequencing enable accurate identification of Candida auris. In addition, gene sequencing enables in-depth analysis of the species origin, resistance to multiple drugs, and high virulence of Candida auris.

Objective To observe the effect of mixed red blood cells with different ratios of A/O on blood type identification, and select the appropriate method to accurately determine the blood type after type A-supply to O hematopoietic stem cell transplantation. Methods Red blood cells mixed in different proportions of A/O were accurately prepared, and the blood type was identified by the test tube method of saline medium, the microcolumn gel carding method of low-ion liquid medium and flow cytometry. Results When the ratio of A cell/A cell+O red blood cell was 0.1%, small agglutination could be observed by tube method; When the proportion was 3%, type A red blood cells appeared in gel cards; At 3%~15%, the blood type card presents a double group of AB type, and the flow cytometry results can identify the positive of B type as false positive. Conclusion The test tube method combined with microscopic examination is the most accurate and sensitive method for identifying blood type; Flow cytometry can identify the false positive results of micro column gel blood type cards.

The treatment of chronic non-healing wounds remain challenging in terms of complexity. Although platelet rich plasma (PRP) therapy has been widely proven effective, the traditional method of in vitro activation of PRP leads to the rapid release of all growth factors. Due to the separation of colloid and supernatant after activation, the factor-rich supernatant is easy to flow and lose, and it is difficult to form a stable structure, which affects its therapeutic effect. To overcome this problem, researchers in recent years have explored hydrogels as carriers for PRP to improve the shortcomings of traditional PRP treatment. This article reviews the latest research on hydrogel-loaded PRP for the treatment of chronic non-healing wounds and provides a reference for optimal treatment.

Autoimmune hemolytic anemia (AIHA) is a hemolytic disease caused by its own red blood cell antibodies, which is mainly characterized by accelerated destruction of red blood cells. The diagnosis of AIHA is based on direct antiglobulin test (DAT) and hemolysis related indexes.And the treatment for AIHA based on the type and etiology includes blood transfusion,symptomatic supportive care and immunotherapy. In immunotherapy, glucocorticoids are the main first-line therapy, rituximab the second-line therapy, and splenectomy and cytotoxic immunosuppressants the third-line therapy for warm-antibody type; rituximab is the main first-line therapy, rituximab plus bendamustine the second-line therapy and complement inhibitor the third-line therapy for cold-antibody type. The current treatment regimens are not specific and poor efficacy, and there are side effects. New drugs including foctatinib , orilanolimab ( SYNT 001) , rozanolixizumab (UCB7665), nipocalimab (M281) , PI3K inhibitors, venetoclax, ofamulimab, alemtumab and daratumab are undergoing in clinical trials. In addition, traditional Chinese medicine treatment regimens may bring a new potential breakthrough point for the treatment of AIHA.

Objective To observe the effect of Daratumomab on detection of IgG anti-D antibody by polybrene test. Methods Ten plasma samples with AB RhD positive blood type and negative irregular antibody screening were selected, and each sample was divided into 3 groups by 2 mL in 3 tubes. Any substance was added in the antibody screening negative control group. IgG anti-D antibody was added in the antibody screening positive control group. Daretozumab (400 mg/20 mL) and IgG anti-D reagent were added in the experimental group. The irregular antibody screening test was performed by microcolumn gel card test and polybrene test to identify IgG anti-D antibody. Results There was significant difference between the experimental group (23.80±1.40) and the positive control group (18.80±1.40) by microcolumn gel card test (P<0.05). There was no significant difference between the experimental group (14.80±2.53) and the positive control group (14.80±2.53) by polybrene test (P>0.05). The lower limit of detection of IgG anti-D in the experimental group by polybrene test after dilution was the same result as that in the positive control group (1∶64). Conclusion Daretozumab has no effect on the detection of IgG anti D antibody by polybrene test, but has effect by the microcolumn gel card test.

Objective To analyze the quality control indexes of national clinical blood use in 2020 and provide reference for the management of clinical blood use. Methods A retrospective investigation was carried out to collect and analyze the data of blood quality control indexes of medical institutions in 2020. Results We collected 438 clinical blood quality control data, 1 673 (68.62%) of which were from tertiary hospitals, 594 (24.37%) from secondary hospital, and 171 (7.01%) from the hospitals below secondary or other ungraded ones. There were significant differences in clinical blood quality control indexes such as the number of professional and technical personnel for blood transfusion per thousand units, reported cases of adverse transfusion reactions per thousand transfusion times, average blood consumption of third and fourth level operating tables, and average blood consumption of discharged patients among hospitals at all levels (P<0.05). Except for the indoor quality control rate of transfusion compatibility test items and the autotransfusion rate of surgical patients, the other quality control index data had significant differences between regions (P<0.05). Conclusion The quality control indexes of blood for clinical use vary in different grades of hospitals and in different regions, suggesting that there is still room for improvement in the management of blood for clinical use.

Objective To analyze the specificity of HLA-I antibody in patients with platelet transfusion refractoriness. Methods Samples from 65 patients with platelet transfusion refractoriness were collected. Luminex platform was used to screen platelet-related antibodies and identify the specificity of HLA-I antibodies. The relative immunogenicity of different alleles was calculated according to the frequency of HLA-I alleles in Henan Han population reported in the laboratory and the number of positive antibodies detected in this experiment. Results HLA-I antibodies were detected in 51 of 65 samples including HLA-A antibodies and HLA-B antibodies. The antibody positive rates of A*11:01 and B*13:02 with the highest alleles frequencies of HLA-A and B loci were 0.33 and 0.65, respectively, and the relative immunogenicity was 0.113 0and0.183 8. The allele frequency of A ^*34:01 in Henan population was only 0.000 4, but the relative immunogenicity of corresponding antigen was as high as 48.795 3. Similarly, the allele frequency of B ^*44:02 is only 0.000 1, but the relative immunogenicity of its corresponding antigen is up to 127.420 4. Conclusion The characteristics of HLA-I antibodies are different in the patients with platelet transfusion refractoriness, and the immunogenicity of their corresponding antigens is different. The analysis of antibody characteristics and antigen relative immunogenicity can provide data support for the selection of appropriate donors for the patients, improve the infusion effect, and prevent the production of new antibodies.