Objective Marvelous advancements have been made in cancer therapies to improve clinical outcomes over last few years. However, therapeutic resistance has always been a major difficulty in cancer therapy, with extremely complicated mechanisms remain elusive. N6-methyladenosine (m6A) RNA modification, a hotspot in epigenetics, has gained growing attention as a potential determinant of therapeutic resistance. As the most prevalent RNA modification, m6A is involved in every links of RNA metabolism, including RNA splicing, nuclear export, translation and stability. Three kinds of regulators, methyltransferase (writer), demethylase (eraser) and RNA binding proteins (reader), together orchestrate the dynamic and reversible process of m6A modification. Herein, we primarily reviewed the regulatory mechanisms of m6A in therapeutic resistance, including chemotherapy and targeted therapy. Then we discussed the clinical potential of m6A modification to overcome resistance and optimize cancer therapy. Additionally, we proposed prospects of m6A modification for future research.

Objective To improve HLA genotyping performance in clinical laboratory,the results of National Proficiency Testing（PT）for HLA-A/B/DRB1 low-resolution genotyping were collected and summarized from 2017 to 2020. Methods HLA genotyping results from 2017~2020 PT were analyzed and different kinds of errors were described and classified,and the possible reasons were also analyzed. Results The number of participant laboratories was increasing from 78 to 96 during 2017 and 2020. 12 096 HLA alleles were returned from the participants during the 4 years and total of 127 errors（1.05%）were found. These 127 errors were classified into two major types including 13 technical errors and 114 artificial errors. The proportion of laboratory which made mistakes was 2.56％（2/78）、4.88％（4/82）、8.75％（7/80） and 3.13％（3/96）in 2017,2018,2019 and 2020,respectively. Conclusion There were above 2.5% of laboratories with errors in HLA genotyping PT surveys past four years. More attentions should be greatly paid to clinical HLA genotyping test and the procedure of reporting.

Objective To explore the effect of platelet rich plasma (PRP) on traumatic synovitis of ankle joint. Methods From January 2021 to June 2022, 45 patients with traumatic synovitis of the ankle joint who were treated in the department of orthopedics and traumatology of a tertiary hospital were included. The patients were randomly divided into the observation group (20 cases, PRP treatment) and the control group (25 cases, traditional corticosteroid treatment) according to the random number table method. The ankle joint scores and clinical effects were compared between the two groups at before, 1, 3 and 6 months after treatment. Results The Baird-Jackson score and AOFAS score were higher (P<0.05) and VAS score was lower than before treatment in both groups after 1 month of treatment (P<0.05), and the control group was better than observation group (P<0.05). After 3 months of treatment, Baird-Jackson score and AOFAS score decreased (P<0.05) and VAS score increased (P<0.05) in the control group compared with one month after treatment. Baird-Jackson score and AOFAS score increased (P<0.05) and VAS score decreased (P<0.05) in the observation group compared with one month after treatment ( P<0.05), which was better than the control group (P<0.05). Time to first improvement in the control group was more common in 24 hours after treatment, and which was more common in 2 weeks and 1 month after treatment in the observation group (P<0.05). The total effective rate of the observation group was 95%, higher than that in the control group of 68% (P<0.05). Conclusion Traditional hormone therapy is fast-acting but short-sustained and prone to recurrence. PRP has better long-term effects and can improve patients' clinical symptoms for up to 6 months, which is worthy of clinical application.

Objective To investigate the effectiveness of reagents and assays suitable for screening tests for accidental antibodies to the red blood cell blood group system in daratumumab-treated patients. Methods Red blood group antibody screening cells were treated with 0.2 mol/L dithiothreitol（DTT） and 0.01 mol/L DTT,and the plasma of 13 patients treated with darettuzumab was accidentally screened for antibodies using the treated reagent red blood cells（microcolumn gel method）. The hemolysis degree,antigenicity of blood group antigen and red blood cell count were measured after treatment. Results Both concentrations of reagent red blood cells were uniformly detected. Negative results from the unexpected antibody screening test were observed in 11 patients,and unexpected antibodies（anti-E）in 2. Hemolysis occurred in 0.2 mol/L DTT treated reagent red blood cells on the 5th day of storage at 4℃,while there was no hemolysis within 31 days after treatment with 0.01 mol/L DTT,and red blood cell count was not statistically different from that of untreated reagent cells（P=0.59,0.40,0.78,all greater than 0.05）. The agglutination intensity of erythrocytes D,Fy ^a,Fy ^b,M,N,C,c,E,e,JK ^a,JK ^b,Le ^a,Le ^b,P1 and S antigens remained unchanged, but the agglutination intensity of K and k antigens was reduced. Conclusion After 0.01 mol/L DTT treatment,RBC blood group antibody screening cells could be used to detect unexpected antibodies in the RBC blood group system of patients receiving darettuzumab treatment,effectively eliminate the interference of darettuzumab and identify alloantibodies. Moreover,long-term storage can be achieved at 4℃,which does not necessitate temporary treatment of reagent red blood cells, thus saving the test time.

Objective To observe whether neoantigen peptides sequenced from tumor patients can induce allo-donor sourced PBMC to be specific reactive T cell. Methods PBMC were separated from healthy donors' buffy coat, then monocytes were collected using adhesion method, remaining PBL was kept frozen in -80℃. GM-CSF and IL-4 were added to induce monocytes into dendritic cells every three days. At Day 7 mature dendritic cells were harvested and plated in 24 well-plates, then these plates were loaded with 16 neoantigen peptides as one peptide in each well, 13/16 peptides were designed by our team. Five hours later PBLs recovered from -80℃ were added into these plates to be co-cultured with these treated DC in ratio of 4~10∶1. No peptide wells (DC only) were negative controls, and PBL only wells were prepared for adding PHA later as positive control. IL-2 was replenished in these plates every three days. Peptides were pulsed twice more at Day 14 and Day 21 respectively. Supernatant of each well was collected at Day 22 to measure IFN-γ concentration using ELISA methods, remaining cells were analyzed using Flowcytometry to measure the percentages of CD3 ⁺IFN-γ ⁺ or CD8 ⁺IFN-γ ⁺Tcells. Results 10 of 13 peptides can induce more than 3 kinds of PBL to proliferate into reactive CD3 ⁺ or CD8 ⁺ T cells, similar increases were also found in IFN-γ concentration（r=0.66, 0.58 for CD3 ⁺, CD8 ⁺ respectively, P<0.05) in supernatant by ELISA method. Conclusions Our research data demonstrate these neoantigen peptides sequenced from tumor patients can induce allo-blood donors'PBMC proliferate to neoantigen specific reactive T cells.

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.

Objective To explore the predictive effect of early pregnancy placental growth factor （PlGF） combined with pregnancy associated protein A（PAPP-A）, mean arterial pressure（MAP）and uterine artery pulsatility index（UtPI）on preeclampsia,and to analyze the positive rate,incidence rate and efficiency of screening, so as to provide some data basis for the clinical application of preeclampsia screening in Anhui Province. Methods From 2019 to 2021, six hospitals in Anhui Province were organized to carry out a multi center research project to collect the clinical information of pregnant women who met the enrollment criteria within 11~13 ⁺⁶ gestational weeks. PlGF and PAPP-A were detected by time-resolved fluoroimmunoassay. The eclampsia risk assessment software was used to calculate the combined risk of multiple indicators in combination with maternal factors,PlGF,PAPP-A,MAP and UtPI,and to track the pregnancy development and pregnancy outcome of pregnant women. The clinical application effect of this screening model was analyzed by data statistics. Results A total of 9 400 pregnant cases were collected. There were 243 pregnant women with pregnancy related hypertension,including 128 cases of preeclampsia,6 cases of chronic hypertension with preeclampsia,101 cases of gestational hypertension,and 8 cases of pregnancy with chronic hypertension. The incidence rate of preeclampsia was about 1.43%. The cases of chronic hypertension with preeclampsia,gestational hypertension and pregnancy with chronic hypertension were excluded,and the remaining 9 285 pregnant women were included in this study. 128 cases of preeclampsia were taken as the study group,and the other 9 157 cases were taken as the control group. The results showed that PAPP-A and PlGF in the study group were lower than those in the control group （P<0.05）,and MAP and UtPI were higher than those in the control group（P<0.05）. A total of 6 139 samples with complete quadruple indicators （PlGF+PAPP-A+MAP+UtPI） were collected for separate statistical analysis. When the cut-off value was 1/137,the false positive rate of PlGF+PAPP-A+MAP+UtPI quadruple screening scheme was 15%,and the positive rates of PE<32 weeks, PE<34 weeks and PE<37 weeks were 1.16%,3.31% and 15.08% respectively,and the detection rates were 90%,80% and 63.64% respectively. Conclusion PlGF combined with PAPP-A,MAP and UtPI in early pregnancy is of high value in predicting early-onset preeclampsia.