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.

Plasma transfusion is clinically used to replenish clotting factors and correct coagulopathy, playing an important role in the treatment of massive hemorrhage. Universal plasma and low titer group O whole blood can improve the timeliness and accessibility of urgent transfusions in patients with major bleeding. The strategy of ABO non-identical plasma transfusion, in the form of active and passive transfusion, has been extensively adopted in clinical practice. Active transfusion mainly includes group AB and A plasma; passive transfusion, on the other hand, involves the transfusion of low titer group O whole blood and ABO non-identical platelets. However, hemolysis and circulating immune complex formation are recognized to be the risks associated with transfusion of ABO non-identical plasma. Together, the risk-benefit trade-off with transfusion of non-ABO identical plasma deserves more attention and further exploration.

Plasma, as the common blood components, has been widely used to supplement coagulation factors, which can prevent or treat bleeding or bleeding tendency caused by coagulation factor deficiency. Although the concept of rational and scientific transfusion has been implemented for many years, the majority of plasma transfusions are still sub-optimal, and achieving optimal plasma utilization is an ongoing challenge. Based on the domestic and international blood transfusion guidelines and published relevant clinical studies, this article reviews the current status, applications and challenges of plasma transfusion, looks forward to the future development, and update and expand the existing guidelines.

Objective To investigate the antiplatelet effect of tanshinone ⅡA (Tan IIA) and its inhibition effect of the interaction between human platelets and HCT116 cells of colon cancer. Method Whole blood or platelets of healthy volunteers were treated with different concentrations of Tan ⅡA (10, 20, 40 μmol/L), and inhibition rate of platelet aggregation triggered with Adenosine diphosphate (ADP) and arachidonic acid (arachidonic acid) were detected by TEG. The expression rates of CD62P and PAC-1 in platelets were detected by flow cytometry, the adhesion test was used to detect the adhesion of platelets to HCT116 cells after Tan ⅡA treatment, and the effect of platelets on the migration ability of HCT116 cells after Tan ⅡA treatment was tested by scratch test. Results The TEG results showed that Tan ⅡA inhibited ADP and AA-induced platelet aggregation in a concentration-dependent manner (P<0.01), low concentration Tan ⅡA treatment can obtain higher ADP inhibition rate, which is (73.48±19.63) %, high concentration Tan ⅡA treatment can obtain higher AA inhibition rate, which is (78.20±18.58) %. Flow cytometry detection showed that Tan IIA inhibited thrombin or ADP-induced expression of CD62P and PAC-1 on platelet surface in a concentration-dependent manner (P<0.05). Adhesion test results confirmed that Tan ⅡA could significantly inhibit the adhesion between thrombin or ADP-activated platelets and HCT116 cells, and the inhibition ability was positively correlated with Tan ⅡA concentration. The results of scratch test showed that activated platelets could promote the migration of HCT116 cells, and treatment of platelets with low concentration (10 μmol/L) Tan ⅡA could significantly inhibit promotion of platelet to the migration of tumor cells. Conclusion Tan IIA can inhibit the interaction between platelets and tumor cells by inhibiting platelet aggregation and activation.

Objective To assess the impacts of different concentrations of Salidroside (Sal) on the morphology, metabolism and activation of platelets during in vitro preservation. Methods We used a blood component separator to collect apheresis platelets, and evenly distributed them into five separate bags. One bag served as the control group (Group A), while the remaining four bags received varying concentrations of Sal solution, resulting in final Sal concentrations of 5 μmol/L (Group B), 25 μmol/L (Group C), 40 μmol/L (Group D), and 50 μmol/L (Group E). These platelets were then stored at room temperature (22±2) ℃ with agitation. On the 1st, 3rd, 5th, 7th, 10th, and 14th days of storage, samples were taken for platelet parameter analysis, blood gas biochemistry, thromboelastography, flow cytometry, and Elisa kit measurement of sCD40L concentration. Results 1) The platelet count of each group had no significant change with the prolongation of storage time (P>0.05). The mean platelet volume (MPV) remained stable in the first 10 days of preservation, but significantly increased at 14 days (P<0.05). The platelet volume distribution width (PDW) value showed varying degrees of change with the extension of preservation time (P<0.05). No significant differences were observed in platelet count, MPV and PDW among groups during the same preservation time. 2) Seven days after storage of monopexic platelets, all groups exhibited a significant decrease of pH value (P<0.05), a continuous rise of LAC value (P<0.05), as well as a remarkable decrease of GLU value (P<0.05). 3) There was no significant difference in the thromboelastography maximum amplitude (TEG MA) of apheresis platelets between the groups within the first 10 days of storage. However, on the 14th day, the TEG MA value was significantly lower than that of earlier time points (P<0.05). 4) During the preservation period, the expression rate of CD62P in platelets increased continuously, peaking on the 10th day (P<0.05), followed by a decrease on the 14th day (P>0.05). On the 5th and 7th day of preservation, the expression rate of CD62P significantly differed between the control group (Group A) and the experimental groups (P<0.05). 5) In the early stage of preservation, the concentration of soluble CD40 ligand (sCD40L) in all groups gradually increased, reaching a peak on the 5th day, and then gradually decreased, reaching its lowest level on the 14th day. There were significant differences compared with the 3rd and 5th day (P<0.05). However, no significant difference was noted in the expression rate of sCD40L among all groups during the same preservation time (P>0.05). Conclusion The addition of Sal to platelets does not compromise their normal function but can significantly inhibit platelet activation, which may help reduce platelet storage damage.

Objective To study the inhibitory effect of ginkgolide B (GB) on platelet activation as well as on the interaction between platelets and colorectal cancer HCT-116 cells. Methods Whole blood or platelets were treated with different concentrations of GB (5, 15, 30 μmol/L). Thromboelastogram (TEG) , then platelet Adenosine diphosphate was detected . The inhibitory rate of ADP and arachidonic acid (AA) pathway was detected by flow cytometry. The effects of GB on the expression of CD62P and PAC-1 after thrombin and ADP-activated platelets were detected. The effect of GB on the cell migration of platelets and HCT-116 cells after 24 and 48 h interaction was observed by cell scratch test, and the effect of GB on the adhesion of platelets to HCT-116 cells was observed by cell adhesion test. Results (1) TEG test results showed that with the increase of GB concentration, AA inhibition rates increased significantly in dose-dependent manner (P<0.001), the difference was statistically significant compared with the control group (P<0.001); The inhibition rate of ADP in the drug group was significantly increased compared with the control group in a dose-dependent manner (P<0.001), the differences were statistically significant (P<0.001). (2) Flow cytometry showed that after thrombin and ADP activated platelets, the positive rates of CD62P and PAC-1 in the drug group decreased with the increase of drug concentration in a dose-dependent manner (P<0.001), the positive rate of PAC-1 in 5 µmol/L group with thrombin activation pathway was lower than that in control group, and the difference was not statistically significant (P<0.05), the positive rate of CD62P in 5 µmol/L group, the positive rate of PAC-1 in 5µmol/L and 15µmol/L groups of ADP-activated pathway drugs was lower than that of control group, and the difference was not statistically significant (P<0.05), and there were statistically significant differences between the remaining concentration groups and the control group (P<0.01). (3) Scratch test results showed that 24 and 48 h cell mobility in different concentration groups was lower than that in thrombin group and ADP group, respectively, and the difference was statistically significant (P<0.01), cell mobility at 24 and 48 h in 15µmol/L group was significantly lower than that in 5 µmol/L group, and the difference was statistically significant (P<0.05), the mobility of 30 µmol/L group was lower than that of 15 µmol/L group, but the difference was not statistically significant (P<0.05). (4) The adhesion test results showed that activated platelets could enhance the adhesion between them and tumor cells, but the adhesion rate of all groups in the drug group was lower than that in the positive group, and the adhesion rate decreased with the increase of drug concentration. Conclusion GB can inhibit platelet activation through AA pathway and ADP pathway, and then inhibit the adhesion of platelets to HCT-116 tumor cells and promote the migration of tumor cells.

Objective To provide reference for subsequent experimental research and clinical application, the mechanism of Taohongsiwu decoction on platelet activation was explored by network pharmacology and molecular docking technology. Methods First,we obtained the information of the main active ingredients and their corresponding targets in Taohongsiwu decoction from TCMSP database, and the targets related to platelet activation from GeneCard, OMIM, TTD and other databases; secondly, we used the Venny diagram to match the target genes corresponding to the active ingredients in Taohongsiwu decoction to the target genes of platelet activation, and then we screened the common targets between the two. Then, using the STRING platform and Cytoscape 3.7.1 software, we mapped the intersecting gene-protein interactions (PPI) network; then, we used the Gene Annotation, Visualization and Comprehensive Discovery Database (David) database to perform gene ontology (GO) biofunctional enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses of the core targets, and then we used the Microbiology Cloud Platform to analyze the enrichment of the core targets. The enrichment results were visualized on the Microbiology Cloud Platform; finally, molecular docking of the core components and key target genes were carried out with the help of AutoDock Tools software to screen out the important components of Taohongsiwu decoction and their important targets in the process of platelet activation, which provided an important basis for the subsequent experimental validation on the inhibition of platelet activation by the core components. Results A total of 69 active ingredients and 2 175 targets of platelet activation in Taohongsiwu decoction were screened according to certain conditions, and after removing duplicates, 44 active ingredients and 154 key intersecting targets of platelet activation in Taohongsiwu decoction were obtained, and five key targets were finally obtained by using PPI network analysis and related literature, including protein kinase B1 (AKTI),prostaglandin endoperoxide synthase 1 (PTGS1/COX1). collagen type I α1 (COL1A1), collagen type III α1 (COL3A1), and phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit γ (PIK3CG/PI3K); the analysis of the GO function and KEGG pathway enrichment showed that the peach red tetrapod soup acted on platelet activated during the platelet activation, Positive regulation of endothelial cell migration, platelet aggregation, platelet α-granule lumen, integrin binding and other biological processes in the process of platelet activation, regulating platelet activation, C-type lectin receptor signaling pathway, PI3K-Akt and other signaling pathways, and thus exerting inhibitory effects on platelet activation. The results of molecular docking showed that there were molecular binding sites between the five main active ingredients of Taohongsiwu decoction and the key targets and the binding energies were strong, all of which were less than -5 kcal /mol. Conclusion This study initially revealed that the mechanism of the inhibition of platelet activation by Taohongsiwu decoction may be realized through the action of multi-targets and multi-pathways.

Objective To explore how various pressures affect the quality of red blood cells in suspension, and to offer data assistance for the creation of pressurized blood transfusion apparatus. Methods Five groups were randomly selected from the 25 bags of suspended erythrocytes, and pressures of 10, 20, 30, 40, and 50 Kpa were applied to each group respectively. The blood flow rate was recorded in real time. Before and after the pressure application, blood samples were obtained to look for changes in erythrocyte-related indices (RBC, HGB, HCT, MCV, MCH, MCHC). The content of potassium ion, indirect bilirubin, lactate dehydrogenase, and free haemoglobin in plasma were detected. The osmotic fragility was tested, and the morphology was observed. Finally, the effects of different pressures on blood quality were evaluated. Results The transfusion rate can be considerably raised by pressurization. The alterations in K⁺, IBIL, and LDH indices as well as erythrocyte-related indexes under various pressures did not show statistically significant changes. Free haemoglobin and haemolysis rate were in accordance with the national regulations. Certain heterogeneous erythrocytes with rising pressure, variations in the cytomembrane's electron density, disruption of the reticulum's structure, and reticulum inhomogeneity were seen using electron microscopy. Conclusion The brief duration pressure, within the range of 50 Kpa, does not significantly result in red blood cell destruction, and the blood quality can meet Chinese norms.

Objective To detect the Rh antigens C, c, E, e in hematopoietic stem cell transplantation (HSCT) patients with blood diseases and donors before and after transplantation, and analyze the time and process of the conversion of Rh blood type from recipients to donor Rh antigens C, c, E, e. Methods Anticoagulant blood samples were collected from patients and donors before and after transplantation for detection of antigen transformation by using microcolumn agglutination card, ABO and Rh antigen conversion time were analyzed and compared. Results Excluding the effects of red blood cell transfusions, the average time length of 58 HSCT patients was 57.81±8.99 days that Rh antigens C, c, E, e completely transformed from recipient to donor after transplantation. Patient age and hematological classification showed impact on the time of Rh antigens conversion, while the gender, ABO blood group compatibility, as well as transplant mode showed no influence on the Rh antigen conversion time. Donor's red blood cells appeared in some patients as early as 3rd week after transplantation, mixed chimerism of donor and patient was detected from the 4th week, and the Rh blood group antigens were found to be completely transformed from the 7th to the 10th week. In addition, both Rh and ABO blood group antigen transition time in 25 HSCT patients those Rh and ABO blood type between patients and donors were different were analyzed, and the Rh transition time was shorter than ABO, and its difference was statistically significant. Conclusion Regular typing of Rh blood group antigen is necessary for patients after HSCT transplantation, and these Rh antigens are indicators to judge transplantation treatment effect, and they also show a significance of guiding transfusion of Rh blood group compatible red blood cells in HSCT patients after transplantation.

Objective To discuss the feasibility of the application of capillary centrifugation technology in RhD typing in patients with mixed field reactivity. Methods The red blood cells (RBCs) of 11 patients with mixed field reactivity in RhD typing were washed for hematocrit cells. The blood cells were separated by capillary centrifugation technology and the D antigen was identified by adding anti-D reagents into the proximal and distal red blood cells. The D antigen of transfused RBCs was traced against the blood donor code. Results By capillary centrifugation, RBCs showed 1 RhD- negative, 8 RhD-positives and 2 mixed field reactivities. Conclusion Capillary centrifugation technology can effectively separate the new RBCs to identify the D antigen to provide blood transfusion safety．

Objective To study the serological characteristics and genotype of B(A) phenotype in Nanchang prefecture of Jiangxi province. Methods The phenotype of AwB or AB was collected. ABO blood typing was performed by serological method on 16 highly suspected B(A) blood samples with ABO discrepancies, and family samples from 1 proband. All samples were re-examined by serological method and were subjected to sequence analysis of exons 6 and 7. Absorption-elution tests were performed to detect the reaction of B(A) samples to human anti-A. Results All 16 samples were typed as AwB and weak anti-A was found in serum. Ten samples were genotyped as ABO*BA.04 and 6 samples were ABO*BA.02. Of the 6 samples in absorption-elution tests, 4 samples with ABO*BA.04 genotype were negative, and 2 samples with ABO*BA.02 genotype showed weakly positive with human anti-A. Pedigree study showed that the ABO*BA.04 allele inherited from the father and was passed on to the son. Conclusions The serological characteristics of B(A) phenotype are similar to AwB with ABO discrepancies, so it is recommended to identify them by molecular biological methods. Different types of B(A) individuals have different A antigens on cells and reaction ability to human anti-A.

Objective To analyze whether the supply data of component blood from 25 central blood stations in China was affected by the COVID-19 during 2017 to 2022. Methods The distribution data of red blood cell components, frozen plasma, cryoprecipitate, pathogen inactivation frozen plasma, adjusted red blood cell components, and adjusted frozen plasma from 25 central blood stations in China during 2017—2022 was collected retrospectively. Based on the outbreak time of COVID-19, the distribution data of 2017—2019 was the non-COVID-19 group (referred to as the non-COVID-19 group), and that of 2020-2022 was the COVID-19 group (referred to as the COVID-19 group). Results The distribution amount of red blood cell components increased during 2017 to 2022, namely 2022>2021>2019>2020>2018>2017. There was a decrease of 19 724.12 U from 2019 to 2020, the showing a negative annual growth rate (-1.43%)in 2020, which was significantly correlated with central blood stations (P<0.05). The distribution amount of frozen plasma increased during 2017 to 2022, namely 2022>2021>2020>2019>2018>2017, which was significantly correlated with central blood stations (P<0.05) .The distribution of cryoprecipitate basically increased during 2017 to 2022, namely 2021>2022>2020>2019>2018>2017. There was a decrease of 6 303.72 U from 2021 to 2022, showing a negative annual growth rate (-1.54%) in 2020, which was significantly correlated with central blood stations (P<0.05). The distribution amount of pathogen inactivation frozen plasma increased during 2020 to 2022; the annual growth rate was negative in 2021 and positive in 2022.The distribution amount of adjusted red blood cell components decreased, and the annual growth rate was negative ; the distribution amount of adjusted frozen plasma decreased, and the annual growth rate was negative. Conclusion There were significant regional differences in the supply of whole-blood-prepared component blood from the 25 central blood stations in China, and there were different impact degrees by the COVID-19. In general, it had the most significant impact on the supply capacity in 2020. Blood re-distribution was one of the measures to ensure blood supply during the COVID-19 epidemic.

Objective The study aimed to elucidate the prognostic value of CD36 in cancer and its relationship with immune infiltration across different cancer types.Bioinformatics methods were employed to study the expression of blood type gene CD36 in human malignant tumors and its relationship with prognosis, clinical staging, and immune infiltration. Methods UALCAN database was used to analyze the difference of CD36 protein expression between tumor tissues and normal tissues. GEPIA database was used to analyze the relationship between CD36 expression and pan-cancer stage. The SangerBox database was used to analyze the relationship between CD36 expression and the survival prognosis of pan-cancer patients, the correlation between CD36 expression and immune infiltration in pan-cancer, the correlation between CD36 expression and TMB,MSI, etc., and the String database was used to analyze the upstream and downstream proteins related to CD36. Results There was significant upregulation of the CD36 gene in 9 types of tumors (P<0.05), while significant downregulation was observed in 18 types of tumors (P<0.05). The expression levels of CD36 were closely associated with the staging and prognosis of different types of cancer patients. CD36 plays different roles in different types of tumors. The expression of CD36 in 39 cancer types was significantly positively correlated with immune infiltration (P<0.05), suggesting its important role in regulating the tumor immune environment. KEGG and GO enrichment analysis showed that candidate genes mainly participate in toll-like receptor signaling pathway, NF-κB signaling pathway, and immune response activation signaling. Conclusion CD36 exhibits expression variations in different tumors, and its expression is closely associated with the staging and prognosis of various cancer patients. Blood type CD36 gene is expected to serve as an important prognostic predictor for tumors.

Objective To identify the Bel subtype of c.586T>C mutation by third-generation technology, and analyze the serological characteristics of the Bel subtype blood group system. Methods The ABO blood type phenotyping examination relies on serological methods. In cases where there is a discrepancy between the ABO forward and reverse typing in a familial sample, the ABO gene's 6th and 7th exons are sequenced using Sanger sequencing. The full-length haplotype analysis of ABO gene was performed in 3 samples of proband and her children using the PacBio third-generation technology. Results The proband's serological phenotype is identified as the Bel subtype. Sequence analysis reveals a mutation at position c.586T>C in the 7th exon of the ABO gene. The haplotype analysis through third-generation technology confirms the proband's ABO genotypes as ABO*BEL (c.586T>C)/O01.02. As for their eldest son and daughter, their genotypes are determined as ABO*A1.02/BEL (c.586T>C) and ABO*B.01/ BEL (c.586T>C), respectively. Conclusion The c.586T>C mutation at the site is responsible for the molecular basis of the Bel phenotype in this case. PacBio third-generation technology enables accurate identification of ABO subtype haplotypes.

Cellular immunotherapies, new complementary therapies for tumor patients, are aimed at malignant tumors with low ability of autoimmune cells, including T cell-based chimeric antigen receptor T cell (CAR-T) therapy, tumor infiltrating lymphocytes (TILs) therapy, NK cell-based chimeric antigen receptor NK cell (CAR-NK) therapy, and autologous cell immunotherapy (CIK), as well as infusion therapies based on other immune cells such as mononuclear phagocytes like dendritic cells and macrophages. Among them, nature killer cells (NK cells), important to the body's natural immunity, matter greatly in anti-tumor, antiviral infection and immune regulation. Like T cells, it can be engineered to target tumor treatment, and can also be transfused with allogeneic NK cells, making up for the shortcomings of limited T cell source and allogeneic immune rejection. No evidence shows that patients tansfused with allogeneic NK cells may develop severe Graft Versus Host Disease (GVHD). NK cells not only expand the types of cells used in cellular immunotherapy, but also provide a broad application prospect for the formation of low-cost cellular immunotherapy products. However, there are still problems such as unstable quality of NK cells and lack of unified quality standards in the preparation process. Although some NK cell immunotherapy products have been approved by the Food and Drug Administration (FDA) or the National Medical Products Administration (NMPA), there is still no clear and publicly available standardized production system for NK cell immunotherapy products. Starting from the unique immunomodulatory mechanism of NK cells, this paper summarizes the therapeutic strategies applied by researchers in the treatment of malignant tumors in recent years and the latest progress of preclinical studies and clinical trials, and finally focuses on the research progress of in vitro expansion methods and maintenance of active function of NK cells, indicating that NK cells promise to be a unified quality of cellular immunotherapy products.

Fibrinogen is a coagulation protein with the highest concentration in the blood circulation. During the treatment of massive traumatic hemorrhage, more and more evidence showed that fibrinogen played a key role not only as the main hemostatic component, but also as a regulator in inflammatory immunity and the anti-microbial infection. This article provides a brief overview of the multiple function of fibrinogen in the treatment of massive traumatic hemorrhage from the prospective of its influence on the early and late mortality, aiming to provide more theoretical supports to the early and sufficient fibrinogen replacement.

Red blood cell transfusion has been widely used in trauma treatment, surgery, anemia treatment, war wound emergency treatment and other aspects, but there are still problems such as shortage of blood resources, short storage period, cross-matching before transfusion, and possible transmission of pathogens through blood. Hemoglobin-based oxygen carriers (HBOCs) are a class of soluble nano-oxygen carriers prepared by chemical modification of matrix-free hemoglobin, which can replace red blood cells to transport oxygen to organs and tissues in the body. HBOCs have the characteristics of no blood group and virus transmission risk, long storage, and instant use, so they are also known as red blood cell substitutes. This paper aims to review the research progress of HBOCs, and explore their application prospects in organ preservation, cerebral ischemia, tumor treatment and other treatments in addition to the replacement of red blood cell transfusion.