With the rapid development of transfusion medicine, it was urgently needed for lots of professionals with highly educated transfusion medicine. However, the formal education of transfusion medicine started late in China, and the number of postgraduate students in transfusion medicine was inadequate. At present, there were no uniform systems about transfusion medicine education in many aspects yet, such as education Objectives, training system and career planning, etc. These drawbacks imposed negative impacts on the postgraduate education and training system of transfusion medicine. We reviewed and compared the situation of transfusion education and the system of postgraduate training between China and developed nations. And we explored the model of postgraduate education about transfusion medicine.

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.

Objective To investigate the expression of LncRNAs ABHD11-AS1 in ovarian cancer cell and oviductal epithelial cell and explore the effect of LncRNAs ABHD11-AS1 on ovarian cancer cell proliferation. Methods The level of LncRNAs ABHD11-AS1 and miR-133a was detected by Real-time PCR, and interaction between them was confirmed by Dual- Luciferase reporter assay (DR). Cells were transfected with NC siRNA, ABHD11-AS1 as well as siRNA NC mimic, miR-133a mimic and NC inhibitor and miR-133a inhibitor, respectively, and the proliferation was detected by Cell Counting Kit-8 (CCK-8) assay. Real-time PCR and western blotting were performed to detect the EGFR expression. Results Downregulation of lncRNAs ABHD11-AS1 could significantly inhibit the proliferation of ovarian cancer cells. Moreover, lncRNAs ABHD11-AS1 was negatively correlated with the expression of miR-133a. DR results showed that luciferase activity was significantly reduced in cells transfected with miR-133a mimic and wild-type ABHD11-AS1 fragments; and the level of miR-133a was lower in ovarian cancer cell compared to oviductal epithelial cells. Transfection of miR-133a mimic significantly upregulated miR-133a expression in both of these cells and inhibited their proliferation and EGFR expression. In addition, downregulating miR-133a significantly promoted the proliferation of ovarian cancer cells and increased the EGFR expression, while downregulating LncRNAs ABHD11-AS1 significantly decreased the EGFR expression. Conclusion LncRNAs ABHD11-AS1 promoted the malignant behaviors of ovarian cancer by targeting miR-133a to upregulate its downstream target gene EGFR.

Objective To discuss the auxiliary diagnostic value of and clinical applicability of Capillary centrifugation in high-risk pregnant women with massive fetomaternal hemorrhage（FMH）caused by maternal-fetal blood type inconsistency. Methods Twenty-five pregnant women in the second- and third-trimester pregnancy suspected of massive FMH caused by maternal-fetal blood type inconsistency were enrolled. The results of flow cytometry were used as the gold standard to evaluate the diagnostic performance of capillary centrifugation. Results In the 25 pregnant women, 15 cases were confirmed by flow cytometry to have undergone massive FMH, and 11 of them were successfully separated by Capillary centrifugation. The sensitivity, specificity, positive predictive value and coincidence rate of Capillary centrifugation for the diagnosis of massive FMH were 73.3%, 60%, 73.3% and 68%, respectively. Conclusion Capillary centrifugation has auxiliary experimental diagnostic value for massive FMH with maternal-fetal blood group incompatibility because it is simple and easy to operate.

Objective To analyze the efficacy of transfusion in patients with mismatched red blood cells caused by auto-antibodies, thus providing evidence for clinical safety and rational transfusion. Methods The clinical records and blood transfusion data of 35 patients with incompatible transfusion due to positive autoantibodies from May 2021 to June 2022 in our hospital were collected and statistically analyzed. Results A total of 60 transfusion applications had been made by 35 patients, 4 of which were rejected. Among 56 incompatible transfusions, 52 (92.9%) were found to be effective. There was no significant increase in TBIL after transfusion. No significant difference was observed in efficacy between transfusion of washed erythrocytes and that of non-washed erythrocytes (P>0.05). All patients had no transfusion reactions. Conclusion In case positive autoantibodies lead to blood mismatch, transfusion of ABO and Rh homologous red blood cells is safe and effective, whose primary agglutination strength is not higher than that of self-agglutination. It is advisable for blood transfusion departments to enhance doctor-patient communication to avert medical accidents; simultaneously, efforts should be made for more studies to prevent autoantibodies from affecting pre-transfusion tests.

Objective To explore the effects of intraoperative massive transfusion on laboratory indexes and clinical outcomes for children with the intracranial space-occupying lesion (SOL). Methods A total of 56 children with intracranial SOL were enrollled from January 2021 to December 2021 in the Beijing Children's Hospital. All of them underwent craniotomy for removal of intracranial occupancy. The children were divided into massive transfusion (MT) group (n=27) and non-massive transfusion (NMT) group (n=29) according to intraoperative blood transfusion. The indexes (blood routine, coagulation function, some biochemical indicators) and clinical outcomes were analyzed. Results After transfusion, children in NMT group had prolonged PT, decreased K⁺ and Ca²⁺ concentration, increased Cl^- and Na⁺ concentration, and blood glucose after transfusion (P<0.05), while children in MT group had reduced PLT, prolonged PT, decreased FIB, K⁺, and Ca²⁺ concentration, and increased Cl^-, Na⁺ concentration, and blood glucose (P<0.05). The changes in laboratory indexes before and after transfusion showed that ΔPLT, ΔK⁺, ΔNa⁺, ΔGLU, and ΔFIB were more significant in MT group compared with NMT group (P<0.05). Meanwhile, compared to NMT group, intensive care unit (ICU) length of stay and total length of stay were significantly longer in MT group. The incidence of postoperative hypokalemia [74.1% (20/27) vs. 27.6% (8/29)], hypernatremia [22.2% (6/27) vs. 3.4% (1/29)], and infection [48.1% (13/27) vs. 13.8% (4/29)] in MT group was significantly higher than that of NMT group (P<0.05). Conclusion Intraoperative massive transfusion in SOL children may affect the coagulation function, biochemical parameters, and immune function.

Objective To provide guidelines for safe exchange transfusion and subsequent transfusion treatment, we compared three groups of laboratory indexes before and after exchange transfusion, i.e. ABO blood type incompatibility, Rh blood type incompatibility and unexplained neonatal hyperbilirubinemia. Methods Thirty-five cases of newborns undergoing exchange transfusion in our hospital from January 2017 to December 2021 were selected, and the laboratory indexes including hemoglobin and serum total bilirubin were analyzed before and after exchange transfusion. Results Before exchange transfusion, the hemoglobin and serum total bilirubin levels in the Rh blood type incompatibility group were lower than those of the unexplained hyperbilirubinemia group. However, 24 h or 48 h after exchange transfusion, the serum total bilirubin level was higher in the Rh blood type incompatibility group than in the ABO blood type incompatibility group and the unexplained jaundice group.There were significant differences in hemoglobin and serum total bilirubin among different types of neonatal hyperbilirubinemia posttransfusion （P<0.05）. Conclusion The pathogenesis of hyperbilirubinemia and the posttransfusion levels of hemoglobin and total bilirubin seem to vary with different types of neonates with this disease.

Objective To study clinical applications of direct antiglobulin test (DAT) and ratio of total bilirubin to albumin (B/A) in newborns with severe hyperbilirubinemia resulting from ABO hemolytic disease of the newborn (ABO-HDN). Methods The neonates diagnosed with ABO-HDN in Wuhan Children's Hospital from June 2020 to December 2021 were grouped into the high-risk group and the low-risk group based on the peak value of total bilirubin of individuals. The correlations of DAT and B/A with severe hyperbilirubinemia caused by ABO-HDN were singly or conjointly analyzed between groups. Results Among 270 patients, 69 were confirmed positive in the DAT assay. The optimum cutoff values of receiver operating characteristic curve (ROC) for correlations of DAT and B/A with severe hyperbilirubinemia caused by ABO-HDN were±and 8.84. Binary logistic regression analysis showed that the peak values of total bilirubin (OR 0.970; 95% CI 0.962~0.987), B/A (OR 6.152; 95% CI 3.593~10.535), DAT(±) (OR 0.106; 95% CI 0.018~0.646), DAT (1+) (OR 0.280; 95% CI 0.116~0.674), and DAT (2+) (OR 0.152; 95% CI 0.049~0.472) were significantly and independently correlated with the severity of hyperbilirubinemia (P<0.05). Areas under the curve (AUC) of ROC for correlations of DAT, B/A and both of them with severe hyperbilirubinemia were 0.621, 0.740 and 0.750, respectively. Conclusion DAT or B/A seems to be a competent predictor of severe hyperbilirubinemia caused by ABO-HDN, which could be enhanced when the two indicators are combined.

Objective We studied the mental health status of blood transfusion practitioners in medical institutions to find out the possible causes of mental health problems and to deal with or adjust their mental state. Methods A total of 454 volunteers applied WeChat applet scan code, and filled in the SCL-90 symptom self-assessment scale. Of which 266 were engaged in blood transfusion group and 279 were engaged in non-blood transfusion group based on different professions. We analyzed the total mean scores of SCL-90 symptom self-rating scale and 10-dimension factor scores between the blood transfusion group and the general population (Chinese conventional model values). We analyzed the 10-dimensional factors including gender, age, hospital level, professional and technical title level, and work location, compared with non-transfusion group. Results There was no significant difference between the blood transfusion practitioners and the Chinese conventional pattern values (P>0.05), except for the interpersonal sensitivity and paranoia factor scores. The scores of other factors were significantly higher than those of the Chinese conventional model, with statistically significant differences (P<0.05). The total symptom index of obsessive-compulsive item reached the highest level of 1.94, followed by depression item with 1.70. Both were higher than the non-transfusion professional group. In addition,The level of three medical institutions were significantly higher than the level of two and below medical institutions in the mental health problems of blood transfusion professionals (P<0.05).The mental health problems of transfusion professionals were more significantly than those of non-transfusion professionals in the level of three medical institutions(P<0.05). Conclusion Blood transfusion practitioners have certain mental health problems. Psychological counseling should be carried out in time. Guaranteeing their health psychology could fundamentally ensure the safety of clinical blood transfusion, so as to better escort the lives of patients.

Objective In this paper, we analyzed the changes of related indexes of platelet and white blood cell in the blood routine of male apheresis platelet donors with different total times of platelet donation, then evaluated the effect of donation times on the peripheral hematology related indicators. Methods 448 voluntary male blood donors were enrolled, who had successfully donated platelet in our blood center from April 23 2020 to April 23 2021(the total number of blood donations were one time, ten times, multiple times of ten, and more than one hundred times respectively, among which, the apheresis platelet donors with a total number of donations more than ten times donate platelet at least 8 times a year,) the changes of the following indicators in the peripheral blood of the donors before the last platelet donation were compareed, including PLT, PDW, MPV, P-LCR, PCT, WBC, NEUT#, LYMPH#, MONO#, EO# and BASO#. Results Compared with first-time male apheresis platelet donors, there were significant differences in WBC, PLT, PCT, NEUT# and LYMPH# among apheresis platelet donors with more than hundreds total blood donations (P<0.01). Although the WBC, PCT and NEUT were significant between the two groups#, the median of these three indicators were still within the range of normal reference values, and PLT was within the normal range required for the blood testing (≥150×10⁹/L and <450×10⁹/L). The incidence of LYMPH # lower than the normal reference value was 86.21% in male pheresis platelet donors who donated blood more than 100 times, while that was 6.37% in those who donated platelet for the first time, and there was a significant difference between the above two groups. The more blood donations, the lower the overall level of LYMPH # of platelet donors. Among the platelet donors who donated blood 20 and 30 times, the proportion of LYMPH # lower than the normal reference value accounted for 46.38%, and with the increase of platelet donation times, the proportion of that gradually increased. Conclusion The results indicated multiple pheresis platelet donation would lead to platelet donors' LYMPH # levels lower than the normal reference value, and blood collection and supply institutions should pay attention to this phenomenon in the recruitment of apheresis platelet dononrs.

Objective To investigate the diagnostic value and clinical significance of plasma heparin-binding protein (HBP) in patients with rheumatoid arthritis (RA) complicated by bacterial infection. Methods A total of 122 RA patients, 23 patients with simple bacterial infection, and 60 healthy people who underwent physical examination during the same period were included as the research subjects, including 42 patients with RA complicated with bacterial infection, 39 patients in the active RA group, and 41 patients in the RA remission group. The concentration of HBP in venous blood was measured by transmission immunoturbidimetric assay, and its correlation with white blood cells (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) was evaluated. The Kruskal-Wallis H test was used for comparison between different groups, and Spearman for continuous variable correlation analysis; and then the receiver operating characteristic (ROC) curve was drawn to evaluate the sensitivity and specificity of HBP in the differential diagnosis of RA patients with bacterial infection. Results The HBP in the group of RA complicated with bacterial infection was 63.3 (36.83~123) ng/mL, higher than 17 (14~21.6) ng/mL (P<0.01) in the active RA group, 8.3 (6.65~9.6) ng/mL (P<0.01) in the RA remission group, and 7.4 (5.63~8.8) ng/mL (P<0.01) in the healthy control group,compared with 68.70 (42.10~100.60) ng/mL in the simple bacterial infection group, there was no significant difference (P>0.05). The active RA group had higher HBP than the RA remission group (P<0.01) and the healthy control group (P<0.01), there being no statistical difference between the RA remission group and the healthy control group (P>0.05). The level of HBP in the group of RA complicated with bacterial infection was positively correlated with CRP (r=0.332, P<0.05), and the level of HBP in active RA group was positively correlated with CRP and disease activity (DAS28) (r=0.582, P<0.01; r=0.461, P<0.05), with no correlation in the levels of HBP and WBC and ESR between the two groups (P>0.05). The ROC curve showed that when the HBP level was 24.55 ng/mL, it was the best threshold for diagnosing bacterial infection in RA patients, with a sensitivity of 92.9% and a specificity of 84.6%. Conclusion HBP could be a sensitive and specific index for the differential diagnosis of RA complicated with bacterial infection and at the active stage.

Objective To determine serum interleukin (IL)-10 and thymidine kinase 1 (TK1) levels in children with acute lymphoblastic leukemia (ALL), and analyze the relationship between the two and risk stratification in ALL children. Methods A total of 100 ALL children admitted at hospital from May 2018 to May 2021 were selected. All pediatric patients were evaluated for risk stratification, and we investigated the baseline data. Serum IL-10, TK1, as well as other laboratory indexes were detected. The expression of serum IL-10 and TK1, and the relationship between the two levels and risk stratification were performed. Results ALL children were evaluated for risk stratification, of which 24 cases had standard-risk, 50 cases had medium-risk and 26 cases had high-risk, accounting for 24.00%, 50.00% and 26.00% respectively. There was no statistically significant difference between the three groups of baseline data (P>0.05). The levels of IL-10, TK1 and white blood cell (WBC) count in high-risk group were higher than those in standard-risk group and medium-risk group, and there was a statistically significant differences between the two groups(P<0.05). Using Kendall's tau-b, we found positive correlation between serum IL-10, TK1 and WBC count were associated with risk stratification in ALL children (r>0, P<0.05). Multivariate Logistic regression analysis revealed that when serum IL-10, TK1 and WBC counts decreased, the probability of risk stratification in ALL children was 7.128 times, 13.572 times and 1.665 times, respectively, compared with high-risk group (P<0.05). Conclusions erum IL-10 and TK1 are abnormally expressed in ALL children and are positively correlated with risk stratification.

Objective To investigate the expressions of programmed death-1 （PD-1） and programmed death ligand-1 （PD-L1） in peripheral blood T lymphocytes of patients with autoimmune hepatitis and their correlation with liver function indexes. Methods 131 patients with autoimmune hepatitis admitted in our hospital from January 2016 to July 2021 were selected as the disease group,and the 112 healthy people were selected as the control group at the same period according to the matching principle,another 93 cases of hepatic hemangioma patients with matched clinical data were taken as the hepatic hemangioma group. The expression levels of PD-1 and PD-L1 in peripheral blood CD4⁺ and CD8⁺ T lymphocytes were detected and compared. The expressions of PD-1 and PD-L1 in T lymphocytes of patients with different stages of disease in the disease group were compared,and the liver function related indexes [Total bilirubin （TBIL）,direct bilirubin（DBIL）,indirect bilirubin （IBIL）,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,total protein（TP）, albumin（ALB）,gamma glutamyltranspeptidase（GGT）,alkaline phosphatase（ALP）] among the disease group, hepatic hemangioma group and the control group were compared. In addition, the relationships between the expressions of PD-1 and PD-L1 in peripheral blood T lymphocytes and the liver function related indexes in patients with autoimmune hepatitis were analyzed by the Pearson correlation analysis method, and the expressions of PD-1 and PD-L1 in peripheral blood T lymphocytes of patients with different Child-Pugh grades of liver function were compared. Results The expression rates of PD-1 and PD-L1 in peripheral blood CD4⁺ and CD8⁺ T lymphocytes in the disease group were significantly higher than those in the hepatic hemangioma group and control group（P<0.05）,but there was no significant difference between the hepatic hemangioma group and the control group（P>0.05）. The expression rates of PD-1 and PD-L1 in peripheral blood CD4⁺ and CD8⁺ T lymphocytes increased gradually in patients with mild,moderate and severe autoimmune hepatitis,and the differences were statistically significant（P<0.05）. The levels of serum TBIL,DBIL,IBIL,ALT,AST, GGT and ALP in the disease group were significantly higher than those in the hepatic hemangioma group and control group （P<0.05）,but the levels of TP and ALB in the disease group were lower than those in the hepatic hemangioma group and control group（P<0.05）. There was no significant difference in the levels of liver function related indexes between the hepatic hemangioma group and the control group（P>0.05）. Pearson correlation analysis showed that the expression rates of PD-1 and PD-L1 in peripheral blood CD4⁺ and CD8⁺ T lymphocytes of the disease group patients were significantly positively correlated with the levels of TBIL,DBIL,IBIL,ALT,AST,GGT and ALP（P<0.05）,but they were negatively correlated with the levels of TP and ALB（P<0.05）. The expression rates of PD-1 and PD-L1in peripheral blood CD4⁺ and CD8⁺ T lymphocytes increased successively in Child-Pugh grade A,B and C of liver function in patients with autoimmune hepatitis,and the differences were statistically significant（P<0.05）. Conclusion The PD-1 and PD-L1 are highly expressed in peripheral blood T lymphocytes of patients with autoimmune hepatitis,and they are closely related to the severity of the disease and liver function, which are important for clinical diagnosis and treatment.

Objective To explore the related markers of diabetic retinopathy (DR) and analyze the expression and clinical value of circulating miR-3197 and miR-2116-5p in patients with type 2 diabetic retinopathy with blood glucose control. Methods 72 patients with type 2 diabetes (T2DM) who were diagnosed with diabetic retinopathy (DR) in our hospital from July 2018 to March 2020 were selected as the research objects, and 72 patients with T2DM who did not suffer from DR during the same period were selected as control group. To compare the general information of the two groups of patients, the μParaflo™ MicroRNA microarray method was used to detect the miRNA expression levels of the two groups of patients, and verified by transcription quantitative PCR (RT-qPCR) technology. Spearman method and Pearson method were used to analyze the correlation between miR-3197 and miR-2116-5p in the serum of DR patients with DR and various biochemical indicators, and to analyze the circulating microRNAs by receiver operating characteristic curve (ROC). The diagnostic sensitivity and specificity of miR-3197 and miR-2116-5p single test and two combined tests for DR, to evaluate the diagnostic value. Results The GA, FPG, UACR, and HbA1c indicators of the DR group were higher than those of the non-DR group, and the difference was statistically significant (P<0.05). There was no significant difference between the groups in age, BMI, diabetes course, TC, Cr, HDL, LDL, TG and BUN (P>0.05). A total of 73 miRNAs were differentially expressed in DR cases through μParaflo™ MicroRNA microarray. Among them, the levels of miR-3197 and miR-2116-5p in DR patients were significantly higher than those in non-DR patients, and the results were verified by RT-qPCR analysis. The serum levels of miR-3197 and miR-2116-5p in the DR group were positively correlated with DR, GA, FPG, UACR, and HbA1c, respectively (all P<0.001). ROC curve analysis was used to evaluate circulating miR-3197 and miR-2116--5p. The AUCs of miR-3197 and miR-2116-5p were 0.903 and 0.875, respectively, and the AUC of miR-3197 and miR-2116-5p combined detection was 0.976, which was significantly greater than the single detection. Conclusion Circulating miR-3197 and miR-2116-5p are significantly up-regulated in DR patients, which are closely related to the severity of DR and a variety of DR related indicators, and may participate in the occurrence and development of DR. the combined detection of them has higher diagnostic value for DR and has a very promising application prospect in clinical treatment.