Objective To explore the experience of the collection,preparation and distribution of the COVID-19 convalescent plasma（CCP）for the prevention and control of the COVID-19 pandemic. Methods A survey was conducted by answering a questionnaires on the collection,testing,preparation,distribution and quality control of CCP by 72 blood stations across the country. Results 61 blood stations implemented CCP collection and 38 blood stations sharing the data. The CCP collection was mainly based on existing blood donation facilities or temporary facilities. 30 blood stations collected 1 359.8 units（200 mL/unit）CCP. The ABO blood group A∶B∶O∶AB ratio of CCP was 2.2∶2.2∶1.8∶1.37 blood stations provided the collected CCP process methods. The preparation procedure,and the local quality control standards,CCP storage,disposal of substandard products,and clinical supply strategies have been varied due to each blood stations' own conditions. Conclusion Although the regional blood stations accomplished the CCP collection and supply based on their existence resources,it is necessary to set up unified criteria and guideline for specific collection and preparation strategies and provide the qualified CCP for clinical trial evaluation.

Objective To understand the practices of convalescent plasma of COVID-19（CCP）collection and emergency management in the blood collection and supply institutions in China,and to further improve the mechanism for convalescent plasma collection. Methods Self-made questionnaires,about three aspects including CCP collection, emergency management and clinical infusion,were sent to 72 provincial and municipal blood establishments that voluntarily participated in the knowledge exchange（KE）of mainland in China by email. Results 61 institutions carried out CCP collection work,and 42 actually responded to the questionnaire（17 blood centers and 25 central blood stations）,the effective feedback rate was 69%（42/61）. 90.5% （38/42）of institutions are led by provincial or local health administrative departments. More than 70% of institutions have carried out training on COVID-19 prevention knowledge, plasma collection and biosafety. The proportion of blood centers and central blood stations that carried out the "special testing" for COVID-19 were 47.1%（8/17）and 29.4%（5/17）respectively,as the "pre-infusion immunological test of CCP" were 16%（4/25） and 4%（1/25）. Only 35.7%（14/42）of the institutions collected CCP clinical infusion efficacy data. Conclusion The model of the health administrative department as the leading department in charge of the CCP work has basically been formed,but the responsibilities of the blood collection and supply institutions in the work of the CCP have not been unified and clarified, and a standardized information exchange mechanism for the whole-process monitoring of CCP infusion therapy and application effects has not been established.

Objective To analyze the recruitment strategy for and population characteristics of COVID-19 convalescent plasma (CCP) donors. Methods The questionnaire survey was conducted until March 1, 2021. Six contents including the recruitment of CCP donors, medical ethics compliance, standard for cured COVID-19 Patients, standard for pre-donation health consultation, and CCP donor demographics, were carried out. Results The three recruitment strategies of CCP donors from designated COVID-19 hospitals, blood center and both the two institutions accounted for 75.55%. Blood centers that collected disease course information and other general medical history accounted for 70%. Both the recruitment institutions and plasma collection institutions that were responsible for informed consent notification accounted for 68.3%. Collection institutions whose recruitment criteria met two consecutive negative COVID-19 nucleic acid test results, normal body temperature, self-isolate at home at least 14 days and normal medical imaging accounted for 41.60%. A total of 75.60% institutions have formulated health examination requirements or added additional requirements for CCP donors. Among the CCP donors, male donors accounted for 56.31%, and successful donations accounted for 74.90%. Conclusion The successful recruitment rate of CCP donors is low. It is better to recruit from designated hospitals and blood collection and supply institutions simultaneously. Informed consent and long rehabilitation time is the basis for ensuring the safety of CCP donations. Among the rehabilitated patients, men are more willing to donate CCP than women.

Objective To evaluate the performance of a self-made passive blood transfusion warmer based on the coagulation exotherm of supercooled liquid,investigate the changes in blood quality after warming,and provide data support for its practical application. Methods Whole blood and suspended red blood cells stored in 2~6 ℃ was heated by passive blood transfusion warmer,and the changes of hemolysis rate,blood routine examination,biochemical indexes, morphology,membrane damage and coagulation function were detected. Results After whole blood being warmed, the white blood cells count was slightly decreased and the K⁺ concentration and MA value were slightly increased with the differences statistically significant（P<0.05）. In the case of suspended red blood cells,lactate dehydrogenase concentration were slightly increased after being warming, and the free hemoglobin concentration and hemolysis rate were slightly increased with the differences statistically significant （P<0.05）. The rest of the indicators did not show significant change. Conclusion After being warmed with the self-made warmer,although the quality-related indicators have slight changes,they are all within normal ranges. The quality of blood completely meet the requirements of GB18469-2012 "Quality requirements for whole blood and blood components".

Objective Develop a suitable in vitro model to observe the adhesion of platelets on the vessel wall under pathological vascular conditions（including stenosis,blood flow disturbance,venous valve damage,etc.）. Methods In this study,an improved parallel flow chamber device was designed to detect the adhesion of platelets under physiological and pathological conditions with different shear rates and different vessel diameters. At the same time,the aggregation of platelets that flow through the chamber but not adhered was measured. Results Peripheral blood with fluorescently labeled platelets flows through the collagen-coated flow chamber at a normal flow rate. Platelets adhered to the tube wall can be detected in about 5~8 minutes. The maximum platelet coverage area is about 60%; the inhibitor SZ-2 can significantly inhibit platelet adhesion. The same platelet adhesion area increases in the local stenosis lumen and the lumen with blood vessel branches; the platelet aggregation rate flowing through the local stenosis lumen is significantly higher than that of the platelets flowing through the normal lumen. Conclusion The improved parallel flow chamber can simulate the blood flow state under physiological and vascular pathological conditions,and has application value for researching platelet function and monitoring the efficacy of antithrombotic reagents.

Objective To preliminarily explore the effects of different concentrations of polyamine nitric oxide donor Spermine Tetrahydrochloride on platelet activation at different time points during platelet storage and to discuss its relevant mechanism. Methods The apheresis platelets stored for 1 d,3 d,and 5 d were divided into experimental groups （groups A,B,C,D,and E） and control groups（group F）. 40 μL of 10 mmol/L,20 mmol/L,30 mmol/L,40 mmol/L,and 50 mmol/L Spermine Tetrahydrochloride were added to the experimental groups. And an equal amount of PBS solution were added to the control group. Fluorescence enzyme labeling method was used to detect the nitric oxide content of platelets,and flow cytometry was used to detect the expression of CD62p on the platelet membrane surface. Results After adding Spermine Tetrahydrochloride to apheresis platelets at different storage time points,the nitric oxide content of apheresis platelets increased,and the expression of CD62p decreased,which was statistically significant（P<0.05）; The higher concentration of Spermine Tetrahydrochloride were added,the higher nitric oxide concentration and the lower the CD62p expression in the platelets,and when the concentration of Spermine Tetrahydrochloride reach to 40 mmol/L it tends to be stable. Conclusion Spermine Tetrahydrochloride,a polyamine nitric oxide donor,can provide nitric oxide to platelets and inhibit platelet activation to a certain extent,which is related to the concentration of Spermine Tetrahydrochloride .

Objective To assess the antibacterial effect of platelet-rich fibrin（PRF）on Staphylococcus aureus and Escherichia coli mixed bacteria in vitro. Methods The antimicrobial activity of PRF was tested using Oxford cup method. PRF Gel and ampicillin were used as positive controls and sterile water was used as negative control. The diameter of the bacteriostatic zone was measured. Results The mixed bacteria formed by Staphylococcus aureus and Escherichia coli was more sensitive to PRF. The diameter of the inhibition zone using Oxford cup method was（19±0.61） mm. Compared to PRF Gel and ampicillin,there were statistically significant differences（P<0.05）. Conclusion PRF has a good antibacterial effect against mixed bacteria.

Objective To analyze factors influencing the effects of blood transfusions on hereditary refractory hemolytic anemia in children,so as to provide experimental data. Methods We retrospectively analysed the medical files for 65 children with hereditary hemolytic anemia（HHA）in our hospital from January 2015 to May 2021. Patients were divided into effective group and ineffective group based on the efficacy of blood transfusion. Univariate and multivariate logistic regression analyses were performed to evaluate the factors（including gender,age,blood type,hemoglobin before transfusion,blood composition,times,type of hemolytic anemia,splenomegaly）associated with transfusion efficacy. Results Sixty-five patients had performed blood transfusion 80 times. The univariate analysis showed that splenomegaly had a significant impact（P<0.05）. The multivariate analysis showed that splenomegaly （OR=14.759,95%CI：3.527~61.752,P<0.001） was an independent risk factor for transfusion efficacy. Conclusion Splenomegaly is a factor influencing blood transfusion in HHA children, which has reference significance for transfusion and treatment of disease.

Objective We performed the pedigree analysis of abnormal Hb Q, and report this study,so as to strengthen the attention of clinicians to Hb Q patients and other abnormal Hb gene carriers. Methods Peripheral blood samples from family member of three patients were collected for routine hematologic test,hemoglobin electrophoresis,denatured globin body（Heinzbody）test and α、β thalassemia gene detection. Results MCV,MCH of five probands and their father or mother all decreased,α genotype of four probands and their father or mother were all -α^4.2/αα.α genotype of one proband was--SEA /-α^4.2,his father or mother were --SEA/αα、-α^4.2/αα.The S zone of four probands hemoglobin electrophoresis contained（19.2-24.0）% of abnormal bands. Hb Bart's was（0.3-1.4）%, Hb A was（8.1-21.0）% and Hb F was（59.3-67.4）%. His father or mother was abnormal Hb Q1, and the content was （27.9-29.1）%. Hb A was （68.2-69.7）%, Hb A2 was（1.7-1.9）% and Hb Q2 was（0.7-0.8）%. Hb electrophoresis S zone of one proband contained 46.3% abnormal bands. Hb Bart's was 26.9%,Hb F was 25.7%,while Hb A had not been detected. Heinz body test was positive, and the detection rate was 0.5%. His father's Heinz body test was also positive.The abnormal Hb Q1 of his mother content was 28.5%. Hb A was 69.1%,Hb A2 was 1.7%,and Hb Q2 was 0.7%. Conclusion Based on the analysis of family heredity and thalassemia gene,the abnormal hemoglobin of the five probands and their parents were all Hb Q linked static type of thalassemia a^4.2 with α chain variation. The five cases of abnormal hemoglobin complex α -thalassemia have enriched the knowledge of medical workers, which is of great significance for the healthy birth and guidance of genetic counseling.

Objective To establish the surgical blood order schedule （SBOS） and explore the influencing factors of blood transfusion for orthopedic surgery patients. Methods We retrospectively enrolled 2 930 patients undergoing elective orthopaedic surgery in our hospital from January 2018 to December 2019,collected the application and actual usage of red blood cells（RBCs）,and analyzed the patients' blood transfusion rate,per capita RBCs transfusion,and whether there is a risk of major bleeding according to the type of surgery,to formulate SBOS for elective orthopaedic surgery. We used chi-square and Logistic regression methods to analyze the transfusion information and screened out the factors affecting perioperative transfusion. Results （1）The amount of RBCs application was 5 256 U by 2 930 patients of 15 surgical categories. The amount of RBCs transfusion was 538 U by 142 cases,with transfusion rate 4.85% and the per capita transfused RBCs amount was（3.93±2.63）U. The SBOS was divide into 3 categories：free Typing/Antibody-Screening （T/A-S）,only T/A-S and T/A-S with Crossmatch. （2）Multivariate Logistic regression analysis showed that the patient's age, preoperative hemoglobin level, and multiple injuries had an effect on perioperative RBCs transfusion（OR=0.145,3.058, 5.683,all P<0.05）. Conclusion The establishment of SBOS in orthopedic surgery provides a basis for better guidance of clinical blood transfusion. At the same time,the preoperative hemoglobin level,multiple injuries and age should be fully considered.

Objective To analyze the relationship between positive direct antiglobulin test （DAT） and efficacy of red blood cell（RBC） transfusion. Methods Medical records of 86 DAT-positive patients accepting RBC transfusion were retrospectively analyzed. The characters including disease type,blood count,DAT-positive type,agglutination intensity and therapeutic impact of RBC transfusion were analyzed,compared with DAT-negative group. Results The common types of diseases in DAT-positive blood transfusion patients were hematological diseases（36,43.37%）,infectious diseases（22,26.51%）,kidney diseases（7,8.43%） and other unknown causes（7,8.43%）. The values of Hb,RBC,and Hct in DAT-positive group were 5.75±3.71（g/L）,0.19±0.14（10¹²/L）,1.65±1.28（%）,whereas the values in DAT-negative group were 8.09±3.57（g/L）,0.24±0.15（10¹²/L）,2.43±1.28（%）. The values in DAT-positive group were lower than that in DAT-negative group,and there were statistically significant differences（P<0.05）. The effective rate of blood transfusion in DAT-positive group（61.48%, 83/135） was significantly lower than that in DAT-negative group（80.74%,109/135）（P<0.01）. By DAT-positive typing,the values of Hb after blood transfusion in IgG+C3d group,IgG group,and C3d group were 8.20±4.65 U,5.73±3.53 U,2.01±2.55 U,respectively. The value of Hb in C3d group was lower than that in negative group（Hb 8.09±3.57 U）,IgG+C3d group and IgG group,and the difference were statistically significant（P<0.05）. The value of Hb in IgG group was lower than that in negative group and IgG+C3d group,and the difference were statistically significant（P<0.05）. The effective rate of blood transfusion in IgG+C3d type （90.00%）>IgG group（61.34%）>C3d group（16.67%）,and the difference were statistically significant（P<0.05）. There was no statistically significant difference in efficacy of different agglutination intensities on RBC transfusion by DAT-positive typing （P>0.05）. Conclusion DAT-positive is common in patients with hematological diseases and infectious diseases. The effective rate of DAT-positive patients decreases after RBC transfusion,which may be related to DAT-positive typing. Blood transfusion indications for DAT-positive patients should be strictly controlled to ensure safe and effective blood transfusion.

Objective To investigate the levels of 7 kinds of miRNA,miRNA7（including miR-21, miR-26a, miR-27a,miR-122,miR-192,miR-223 and miR-801）in serum of patients with hepatoma. And comparing the diagnostic efficacy of miRNA7 with alpha-fetoprotein（AFP） and carcinoembryonic antigen（CEA）in early hepatoma. Methods ENCORI database included 50 normal liver tissues and 370 liver cancer tissues,and the difference of miRNA7 expression levels among different liver tissues was searched. Subsequently,32 healthy subjects were collected as the control group,70 non-cancer patients as the benign liver group, and 75 liver cancer patients as the malignant liver group. The expression levels and positive rates of miRNA7,AFP and CEA in serum of the three groups were compared, as well as the value of single detection and combined detection in the early diagnosis of liver cancer. Results ENCORI database showed that miR-21, miR-26a,miR-27a,miR-122,miR-192 and miR-223 were significantly abnormal in liver cancer tissues compared with normal liver tissues. In 177 subjects,the total relative quantitative value of serum miRNA7 Logit,AFP and CEA expression level and positive detection rate in hepatic malignant group were significantly increased,with compared to healthy control group and benign liver group, the differences were statistically significant（P<0.05）. ROC curve of liver malignant group and control group showed that the AUC value（0.97）of serum miRNA7, AFP and CEA combined detection was significantly higher than that of serum miRNA7,AFP and CEA alone,and the difference was statistically significant（P<0.05）, indicating that the combined detection of those three is beneficial to improve the diagnostic efficiency of early liver cancer. Meanwhile,the ROC curve between malignant and benign groups was analyzed,and the AUC value（0.92）of serum miRNA7,AFP and CEA combined detection was also higher than that alone. There were statistically significant differences between their combined detection with AFP and CEA alone（P<0.05）,but there were no significant difference with miRNA7 alone（P>0.05）. Conclusion Serum miRNA7 is an effective tumor marker for early diagnosis of liver cancer,and its combination with AFP,CEA can improve the clinical diagnostic efficiency of early liver cancer.

Objective To explore the predictive significance of maternal and infant factors on the total number of nucleated cells （TNC） and CD34⁺ cells in umbilical cord blood. Methods Conducting statistical analysis on the maternal age, the gestational age, the volume of umbilical cord blood, the delivery method, the gender and the blood type of neonates, and other information of the 8 267 samples collected from the Shandong cord blood hematopoietic stem cell bank. The effects of different maternal and infant factors on the number of TNC and CD34⁺ cells were studied, based on Spearman rank correlation analysis, combined with multiple linear regression. Results There was no significant correlation between the maternal age, the blood type of neonates and the quantity of TNC and CD34⁺ cells. The gender of neonates, the mode of delivery, the gestational age, and the volume of the cord blood were all significantly correlated with the quantity of TNC and CD34⁺ cells. The mode of delivery had the greatest effect on TNC, and the TNC of normal delivery is greater than that of cesarean section. The gender of neonates had the greatest effect on CD34⁺ cells, and the quantity of CD34⁺ cells in boys was bigger than in girls. Conclusion By analyzing the influence of maternal and infant factors on cord blood quality parameters and establishing a multiple linear regression model, the number of TNC and CD34⁺ cells in cord blood can be effectively predicted.

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 correlation between intestinal mucosal barrier damage index and serum Gd-IgA1 expression levels. Methods In our retrospective review from January 2019 to December 2019,45 patients with IgA nephropathy（IgAN）confirmed by renal biopsy for the first time were enrolled as the IgA nephropathy group and 25 healthy individuals in the Physical Examination Center of our hospital as the control group.The levels of inflammatory factors （TNF-α and IL-6）,intestinal mucosal barrier damage index（DAO,D-LAC,sICAM-1 and LPS）and Gd-IgA1 levels were examined in all serum samples,and the general data,renal function,24 h urine protein quantification,and IgA levels of the patients were collected for statistical analysis. Results Compared with the healthy controls,inflammatory factors, intestinal mucosal barrier damage index and Gd-IgA1 levels were significantly higher in patients with IgAN（P<0.05）,and serum Gd-IgA1 levels in IgAN were positively associated with them（P<0.05）. Conclusion The impaired intestinal mucosal barrier may be involved in the Gd-IgA1 expression, which could show promise in the diagnosis and treatment of IgAN.

Objective To evaluate the morphological effects of Platelet-rich fibrin （PRF） on wound repair of intrauterine adhesion. Methods 68 patients with intrauterine adhesions were randomly divided into PRF group and control group by 1∶1. All patients received TCRA and took endometrial tissue. PRF was injected into intrauterine immediately and 4 weeks after TCRA in PRF group,while no drug was used in control group. 8 weeks later,the two groups underwent second hysteroscopy. Endometrial morphologic changes were evaluated 8 weeks after treatment. Results In PRF group,the number of endometrial glands,Ki67,Cytokeratin 18（CK-18）,Vimentin average fluorescence intensity increased after treatment,and the proportion of fibrosis area decreased. The number of endometrial glands and average fluorescence intensity of Ki67 in PRF group were significantly higher than those in control group（P<0.05）. The proportion of fibrotic area was smaller than that of control group（P<0.01）. Conclusion PRF treatment can significantly promote wound repair after intrauterine operation.

Objective To construct and validate a nomogram for predicting the risk of anemia in patients with malignant lymphoma. Methods A total of 132 patients with malignant lymphoma who were admitted to our hospital for diagnosis and treatment from January 2016 to July 2021 were enrolled. LASSO analysis and Logistic regression analysis were used to screen independent risk factors,and R（R3.5.3） software to establish a nomogram model for predicting the risk of anemia in patients with malignant lymphoma. Results 46（34.85%）patients developed anemia. The LASSO analysis and Logistic regression analysis showed that age ≥60 years,gender,radiotherapy,serum albumin concentration <35 g/L, smoking and drinking were independent risk factors （P<0.05）. Accordingly,anomogram model was established based on these 6 independent predictors. The C-index was 0.862 （95%CI：0.829~0.895）,and the calibration curve was basically consistent with the ideal curve. The AUC was 0.845（95%CI：0.819~0.871）,and the decision curve showed that when the threshold probability was in the range of 3% to 100%,and there was a higher net benefit value. Conclusion The nomogram presents accurate and applicable prediction for the anemia risk in malignant lymphoma patients.

Objective To investigate the relationship between fusion gene expression and immunological phenotype,we carried out retrospective analysis of data from 109 B cell-malignancy cases. Methods Real-time quantitative PCR assay was used for detection of fusion genes,and immunological phenotype was analyzed by multi-parameter flow cytometry. Results Of the 109 B-ALL cases,98 patients were 1~10 years old. A total of 42 cases（38.5%） were positive for fusion gene,among which TEL/AML1 is most frequent（64.3%）; For immunophenotype,81 cases（74.3%） were type II common-B-ALL which is CD34⁺CD10⁺. Those with TEL/AML1 or BCR/ABL fusion gene were all of this type; Expression of myeloid antigen was not associated with prognosis of the disease. In contrast,different fusion gene expression was related to variable efficacy of clinical therapy. Conclusion Onset age,fusion gene and immunophenotype of acute B-ALL are related to each other. Changes of specific immune markers predict expression of fusion gene in early stage of the disease,and a characteristic fusion gene will benefit an accurate diagnosis and treatment.