Clinical blood transfusion, as a vital medical intervention for patient treatment, carries inherent risks. Therefore, implementing systematic quality management of blood transfusion is crucial to ensuring transfusion safety. Investigations reveal that some medical institutions still suffer from overly complex and inefficient blood transfusion quality management systems, while a few institutions with relatively low blood usage lack or have incomplete quality management systems. In response, the Yangtze River Delta Integration Clinical Transfusion Quality Control and Management Consortium, Shanghai Clinical Transfusion Quality Control Center, Blood Transfusion Professional Committee of Shanghai Association of Social Medical Institutions, Blood Transfusion Branch of Shanghai Medical Association, and Blood Transfusion Physician Branch of Shanghai Medical Doctor Association organized a group of renowned domestic experts in transfusion medicine. Based on evidence-based medicine methods, they developed the Expert Consensus on Checklist-based Quality Management for the Entire Clinical Blood Transfusion Process. Centered on the transfusion workflow, this consensus defines 38 specific tasks across four dimensions: process, task, personnel, and requirements. It covers key stages including transfusion indication assessment, transfusion request and approval, blood transfusion compatibility testing, blood release, blood transfusion administration, and post-transfusion management, with clear definitions of responsible personnel and requirements for each task. Previously, this consensus has been registered on an international practice guideline platform (Registration Number: PREPARE-2025CN735). The consensus aims to use a checklist model to clarify the key steps and quality control points at each stage of clinical blood transfusion. It provides standardized, refined, and actionable guidance for medical institutions to standardize technical operations, reduce human errors, minimize transfusion risks, and systematically ensure clinical transfusion safety.

The distribution of RhCE antigens in the Chinese populations differs from that in Caucasians and Africans, and genetic differences are also observed between northern and southern Chinese. The probability of RhCE antigen mismatch (23.6% to 26.31%) in Chinese transfusion patients is significantly higher than that of RhD antigen mismatch (0.39% to 0.45%), leading to a high incidence of RhCE alloantibodies in transfusion-related cases. Clinical transfusion studies indicate that RhCE antigen matching can reduce the risk of alloimmunization. This consensus proposes a RhCE antigen matching strategy for Chinese transfusion patients based on Landsteiner's rule and the distribution characteristics of RhCE antigens in the Chinese population.

Voluntary blood donation serves as a crucial pillar of the public health system. Currently, China's voluntary blood donation undertaking faces dual challenges of trust crisis under pandemic impacts and utilitarian-oriented advocacy, where fluctuating donor numbers and declining public trust form a vicious cycle. International practical experience demonstrates that cultivating social altruism through cultural immersion and intergenerational education mechanisms can effectively enhance the sustainability of blood donation behaviors. With growing medical demands and heightened public health awareness, there is an urgent need to re-examine the deep structural contradictions within the voluntary blood donation ecosystem. This study systematically analyzes the trust crisis triggered by instrumental advocacy under special circumstances from the perspective of the original public welfare attributes of blood donation, combining cross-national case comparisons and empirical data analysis to propose pathways for reconstructing the public welfare ecology. The research reveals that building a sense of responsibility for the community of shared life requires breakthroughs in three key dimensions: establishing a culturally embedded intergenerational value cultivation system, creating a fully transparent institutional trust mechanism, and developing intelligent blood donation service technologies. Theoretically, it demonstrates that the paradigm shift from interest-driven to value-identified donation behavior essentially represents a collective action upgrade through the reconstruction of social psychological contracts. Practically, it verifies that blockchain-integrated traceability systems can significantly enhance donor engagement, while culturally embedded advocacy strategies effectively improve long-term donor retention rates. Fundamentally, resolving post-pandemic challenges in voluntary blood donation lies in constructing a four-in-one public welfare ecology that integrates government guidance, social collaboration, value recognition, and technological support. This approach not only aligns with the Healthy China strategic orientation but also provides innovative paradigms for global blood safety governance.

From the perspective of sociological field theory, this article systematically examines the evolutionary logic and internal driving forces underlying both global and China's voluntary blood donation systems. Blood donation and transfusion are conceptualized as a dynamic "organizational field" comprising multiple actors, including blood establishments, medical institutions, the state, international organizations, donors, and recipients. The article delves into the operation of various forms of "capital" (institutional, organizational, symbolic) and the formation of "habitus" within this field, beyond merely describing its structure. The prevailing "rules of the game", power dynamics, and institutional logics within this field profoundly shape patterns and levels of blood donation behavior. Technological advancements, wartime demands, and blood contamination crises serve as pivotal events that catalyze structural transformations within the blood donation field. As a powerful actor, the state plays a critical role in shaping and regulating the field through legislative frameworks and public policies. Blood supply management constitutes a cornerstone of public health security and national security, with voluntary non-remunerated blood donation widely recognized as the internationally endorsed best practice. Nevertheless, the global blood donation system continues to confront multifaceted challenges, including population aging, shifting social attitudes, and disparities in regional development. To date, only a limited number of countries have achieved fully voluntary and non-remunerated blood donation systems. Incorporating empirical data from China's national blood donation reports, this article reveals new challenges such as declining donation rates in the post-pandemic era and significant regional disparities. Future research and policy efforts should move beyond individual-level psychological analyses of donor motivation and instead emphasize broader socio-political contexts and institutional embeddedness. In response to emerging challenges, China should strategically leverage its institutional strengths, particularly organized mobilization models such as group-based blood donation campaigns. This model is not merely a transition to the Western individual-based model but offers an important alternative for global blood safety governance. Through innovative approaches, such as constructing a multi-tiered symbolic capital system, cultivating donation habitus among youth, and optimizing data-sharing and coordination mechanisms, it is essential to reconstruct social trust and foster a sustainable blood donation culture within the evolving organizational field, thereby ensuring the long-term safety, stability, and national security of the national blood supply system.

Objective To elucidate the mechanisms of platelet antibody production, analyze their distribution across diverse populations, investigate associations with primary diseases and laboratory parameters, and assess their impact on test outcomes—with the ultimate goal of providing evidence-based recommendations for optimizing platelet antibody detection protocols and transfusion strategies. Methods A total of 29 782 patients were enrolled in this study, who had undergone platelet antibody testing at Zhujiang Hospital of Southern Medical University between March 2023 and April 2025. Platelet antibodies were detected using the solid-phase agglutination assay. We analyzed the relationships between platelet antibody production, demographic distribution, disease spectrum, and relevant laboratory indicators. Results Among the 29 782 hospitalized patients (15 353 males and 14 429 females), 864 cases tested positive for platelet antibodies, resulting in an overall positivity rate of 2.90%. Notably, the positivity rate was significantly higher in females than in males (3.37% vs. 2.46%, P<0.05). Females with a history of pregnancy had a higher positivity rate than those without (3.39% vs. 3.07%, P<0.05). Patients with a history of blood transfusions exhibited a higher positivity rate than those without (4.91% vs. 2.40%, P<0.05). Significant differences in positivity rates were observed across disease categories: immune system diseases had the highest rate, followed by hematologic diseases, with obstetric conditions ranking third (P<0.05). The distribution of different types of pregnancy complications also varied significantly with platelet antibody positivity (P<0.05). The results of total white blood cell (WBC) count, platelet (PLT) count, prothrombin time (PT) and hematocrit (Hct) in patients with positive platelet antibody were significantly different from those in negative patients (P<0.05). Female sex, history of pregnancy (in females), history of blood transfusion, low PLT, and low Hct were identified as independent risk factors for platelet antibody positivity. Conclusion Patients with a history of blood transfusion, pregnancy (particularly females), and female patients showed a relatively higher platelet antibody positivity rate. Immune system disorders and hematologic diseases demonstrated markedly higher platelet antibody positivity rates compared to other disease categories. Positivity rates also increased in patients with pregnancy complications. Platelet antibody positivity was closely associated with sex, pregnancy history, transfusion history, PLT and Hct, while also showing some correlation with WBC and PT.These findings enable more precise identification of high-risk populations and optimization of transfusion strategies.

Objective The aim of this study is to explore the accuracy of the non-invasive hemoglobin (SpHb) detection device in high-altitude hypoxic environments and its consistency with results obtained by minimally invasive hemoglobin (POCT-Hb) detection, as well as to analyze the influencing factors affecting the performance of the non-invasive hemoglobin detection device. Methods A total of 528 healthy volunteers from plain areas were recruited, and their Hb concentrations were measured using the domestic MHS28 non-invasive hemoglobin detection device and an automatic hematology analyzer for comparative analysis. Additionally, 36 healthy volunteers residing at high-altitude were divided into two groups based on their duration of stay at high altitudes. In the hypoxic environment at an altitude of 3 700 meters, Hb concentrations were detected using the US-made Masimo RAD-57 and domestic MHS28 non-invasive hemoglobin detection devices. The detection success rates of the two devices were compared, and the accuracy and consistency of SpHb results were evaluated against those obtained from the minimally invasive hemoglobin analyzer. Additionally, influencing factors of non-invasive hemoglobin detection device were analyzed. Results In plain regions, non-invasive hemoglobin (SpHb) and invasive hemoglobin (tHb) measurements were (126.00±29.14) g/L and (126.06±21.68) g/L, respectively, with no statistically significant difference (P>0.05), demonstrating good agreement between two methods. Moreover, a significant correlation was observed (R=0.816, P<0.001). In high-altitude regions, the non-invasive MHS28-SpHb detection device success rate (100%) was significantly higher than that of Masimo-SpHb (P<0.01). Compared to POCT-Hb, Masimo-SpHb showed marginally better accuracy (73.68% of measurements within ±10% deviation) than MHS28-SpHb (64.89%) across all high-altitude measurements, though without statistical significance (P>0.05). After acclimatization to the plateau, the proportion of MHS28-SpHb was 88.46%, slightly higher than that of Masimo-SpHb (61.11%), without statistical significance (P>0.05). Conversely, upon rapid entry into the plateau, the Masimo-SpHb detection device exhibited better accuracy (85.0%) than the MHS28-SpHb (55.88%) (P<0.05). The Hb values measured by MHS28-SpHb, Masimo-SpHb, and POCT-Hb were (159.66±15.92) g/L, (151.84±13.21) g/L, and (158.13±17.80) g/L, respectively. Statistical analysis revealed no significant difference between MHS28-SpHb and POCT-Hb (P>0.05), whereas Masimo-SpHb differed significantly from POCT-Hb (P<0.01). Pearson correlation analysis demonstrated strong correlations between MHS28-SpHb (R=0.669) and Masimo-SpHb (R=0.674) with POCT-Hb (P<0.001). Both non-invasive and minimally invasive hemoglobin detection devices demonstrate good consistency. Multivariate linear regression identified SpO2 as positively correlated with MHS28-SpHb bias (P<0.05). Conclusion Both in plain and high-altitude regions, the domestic non-invasive MHS28-SpHb exhibits high detection success rates and good accuracy, instrong consistency with venous invasive tHb and minimally invasive POCT-Hb, supporting its utility as a reliable tool for hemoglobin detection device.

Objective To investigate the association between the longer red blood cell (RBC) storage duration and postoperative pneumonia (POP) in pediatric patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Methods A retrospective analysis of 444 children with congenital heart disease who underwent CPB cardiac surgery at our hospital from January 2022 to July 2024 was performed, and they were divided into fresh RBC group (storage duration≤14 d, n=214) and the older RBC group (storage duration with 14~35 d, n=230). The incidence and pathogen distribution of POP were compared between two groups. Results Among 444 enrolled patients, 35 developed POP (7.89%). In the fresh RBC group, 11 of 214 patients (5.14%) developed POP, compared to 24 of 230 patients (10.43%) in the older RBC group. Statistical analysis revealed a significantly higher incidence of POP in patients receiving older RBC versus fresh RBC (χ²=4.242, P=0.039). Pathogen distribution in POP cases of the new RBC group was Gram-negative bacteria (n=6), Gram-positive bacteria (n=3) and others (n=2). Pathogen distribution in POP cases of the older RBC blood group was Gram-negative bacteria (n=13), Gram-positive bacteria (n=5) and others (n=6). There was no significant difference in pathogen spectrum between two groups (P=0.907). Conclusion Prolonged storage duration of priming RBCs may increase the risk of POP in children undergoing CPB cardiac surgery without altering the pathogenic bacterial spectrum.

Objective The aim of this study is to investigate the effects of ABO blood group and allergy on the susceptibility, disease activity, and related laboratory indicators of Crohn's disease (CD). Methods A total of 207 patients with CD were enrolled in the study. They were grouped by ABO blood group and allergy status, and differences in disease susceptibility, disease activity, and multiple laboratory indicators were compared among different groups. The laboratory indicators included: inflammatory indicators (CRP, ESR, FC, N, L, M, E, B, PLT, NLR, MLR, PLR), nutritional metabolism indicators (ALB, CAR, RBC, Hb), and coagulation indicators (FIB). Results 1.The distribution proportion of blood type AB among patients with CD was significantly higher than that in the general population of Jiangsu region (P<0.012 5). 2. ABO blood group had an impact on specific inflammatory indicators in CD patients: the erythrocyte sedimentation rate (ESR) of patients with blood type O was significantly lower than that of patients with blood type AB (P<0.05), and the faecal calprotectin (FC) level of patients with blood type A was significantly higher than that of patients with blood type B (P<0.05). type A was significantly higher than that of patients with blood type B (P<0.05). 3. Compared with the remission period, the levels of RBC, Hb, ALB, and L in CD active patients were significantly reduced, while the levels of CRP, CAR, N, M, PLT, NLR, MLR, PLR, FC, ESR, and FIB were significantly increased (P<0.05). 4. There was an interaction between ABO blood group and allergy: the RBC and Hb levels in the allergic subgroup of blood type B, as well as the M, MLR, ESR, and FIB levels in the allergic subgroup of blood type A, were significantly lower than those in the non-allergic subgroup of the same blood type; whereas the N and NLR levels in the allergic subgroup of blood type O were significantly higher than those in the non-allergic subgroup of the same blood type. Conclusion ABO blood group is not only associated with the susceptibility to CD but also affects the levels of certain inflammatory indicators. Although allergy does not independently influence the disease activity of CD, it can act as an effect modifier of blood group: it may exert a potential anti-inflammatory effect in CD patients with blood type A, while likely playing a pro-inflammatory role in CD patients with blood type B or O. As a genetic susceptibility marker, the ABO blood group may interact with environmental factors to be involved in the pathogenesis of CD and the shaping of its clinical phenotypes. This finding provides a potential basis for conducting precise prevention and control as well as individualized diagnosis and treatment. In the future, further exploration can be carried out on the customization of blood type-based individualized diagnosis and treatment strategies.

Objective To evaluate the red blood cell stability and microbiological safety of umbilical cord blood (UCB) stored in citrate phosphate dextrose adenine-1 (CPDA-1) anticoagulant preservative solution at 2~6 ℃ for up to 35 days, providing experimental evidence for its use in predeposit autologous transfusion during neonatal cardiac surgery and other clinical scenarios. Methods Within an integrated prenatal-postnatal diagnosis and treatment model for congenital heart disease, UCB samples were collected from 60 neonates prenatally diagnosed with CHD. The samples were randomly divided into five groups. After storage for 7, 14, 21, 28, and 35 days, routine blood counts, electrolytes, free hemoglobin, hemolysis rate, and microbial contamination were measured. Results There were no significant baseline differences among groups before storage. During storage, red blood cell count, hemoglobin, hematocrit, platelet count, and sodium and calcium ion concentrations showed no significant changes. Potassium, free hemoglobin, and hemolysis rate all increased significantly with prolonged storage time (P<0.05). Post-hoc analysis revealed that potassium level rose steadily from day 7 onwards, while free hemoglobin and hemolysis rate increased significantly after 21 days of storage. Bacterial contamination with Escherichia coli occurred in 1 case (1.7%) among all samples. Conclusion Under standardized collection and storage protocols, UCB stored in CPDA-1 anticoagulant preservative solution for up to 35 days showed progressive potassium accumulation and hemolysis, yet key quality indicators remained within acceptable ranges and microbiological safety was controllable. This study supports that UCB represents a safe and feasible autologous blood source for neonates, particularly those with congenital heart disease requiring time-limited surgery.

Objective The hypoxic environment of plateau regions significantly affects the quality of stored red blood cells (RBCs), and conventional assessment methods are inadequate for rapid, accurate, and dynamic quality monitoring. This study developed a deep learning-based image recognition model for evaluating red blood cells (RBCs) storage leisions, systematically compared the morphological evolution of RBCs under different storage conditions (normoxia versus hypoxia), and explored its potential application in transfusion support at high altitude. Methods RBC units stored under normoxic (21% O2) or hypoxic (8% O2) conditions were collected together with units obtained from Beijing (≈500 m) and Lhasa (≈3 600 m). RBC images were acquired every week to construct a time-series dataset. A nine-class RBC morphological recognition model was established based on the YOLOV5s algorithm and the morphological index (MI) and smooth disc cell percentage (SDC%) were introduced as quality assessment parameters to compare the progression of storage leisions in RBCs under different storage conditions and from different geographic origins. Results In the normoxic storage group, MI began to decline significantly from week 3 onward; by week 5, MI had decreased by 21.08% and SDC% by 31.33%. In contrast, the hypoxic storage group showed declines of only 13.40% in MI and 20% in SDC%, with statistically significant differences between groups (P<0.01). RBCs stored at high altitude exhibited significantly slower morphological deterioration than those stored in the plains from week 2 onward. At week 5, MI in the plateau group was 83.96%, significantly higher than 76.61% in the plains group, suggesting that the hypoxic environment at high altitude helps preserve stored RBC morphology. Conclusion This study achieved a dynamic, deep learning-based assessment of storage lesions in plateau RBCs. The proposed MI and SDC% metrics enable quantitative evaluation of RBC morphological deterioration at high altitude and offer advantages including high throughput, noninvasiveness, and transferability. This model provides intelligent technical support for rapid quality testing of blood products in plateau regions.

Objective To explore the effects of high-frequency plateletpheresis on bone metabolism markers and bone mineral density (BMD) in donors. Methods (1) Twenty-one donors were enrolled and completed 30 plateletpheresis procedures within a 2-year timeframe. Specimens were collected at the 1 st, 10th, 20th, and 30th donations, with sampling time points including pre-donation, during donation, 1 hour post-donation, and 24 hours post-donation. (2) Fifty donors with ≥10 plateletpheresis sessions and over 70 cumulative apheresis procedures, together with 50 whole blood donors in the past two years, were recruited. Specimens were collected prior to donation to detect baseline levels of calcium (Ca), intact parathyroid hormone (iPTH), osteocalcin (OST/OC), C-terminal telopeptide of type I collagen (CTX-Ⅰ, β-crosslaps), and 25-hydroxyvitamin D [25-(OH)D]. The OST/CTX-Ⅰ ratio was calculated to evaluate the dominant direction of bone turnover. (3) Twenty-six donors with ≥10 plateletpheresis sessions and more than 80 cumulative apheresis procedures, as well as 24 healthy physical examination participants, underwent BMD measurement. BMD was assessed by dual-energy X-ray absorptiometry (DXA) at the lumbar spine and hip joints. Results (1) Significant differences in Ca levels in 30 plateletpheresis donors were noted among different donation frequencies and sampling time points. The levels of iPTH, OST, CTX-Ⅰ, OST/CTX-Ⅰ ratio, and 25-(OH)D differed significantly across various sampling time points (P<0.05). A negative correlation was found between Ca and iPTH, while positive correlations existed between iPTH and OST, and between OST and CTX-Ⅰ (all P<0.05). (2) Donors with over 70 cumulative apheresis procedures (≥10 times annually) had lower baseline serum Ca levels and higher OST and CTX-Ⅰ levels compared with blood donors (P<0.05). (3) Donors with over 80 cumulative apheresis procedures (≥10 times annually) showed lower lumbar spine BMD than the healthy non-donors (P<0.05), whereas no statistically significant difference in hip BMD was detected between the two groups (P>0.05). Conclusion High-frequency plateletpheresis can alter bone metabolism and BMD, accelerate bone metabolism, and render bone formation the dominant process during donation. As the total number and frequency of donations rise, it is essential to strengthen targeted guidance and health education for donors, and intensify monitoring (e.g., detection of bone metabolism markers, BMD) to better protect donor safety.

Objective To evaluate the consistency of results among three hepatitis B virus (HBV) nucleic acid-amplification testing (NAT) for blood donor screening and identify the influencing factors. Methods A total of 241 527 voluntary blood donation specimens negative for HBV by enzyme-linked immunosorbent assay (ELISA) were subjected to NAT. One hundred and twenty-five NAT-reactive specimens were selected for retesting using the three NAT systems, and hepatitis B core antibody (anti-HBc) detection was performed. The reactive detection rate of each system, cross-reactive detection rate across multiple systems, Cohen's Kappa coefficient analysis, and anti-HBc results were analyzed to evaluate differences in HBV detection. Results The reactive detection rates of systems A, B, and C were 96.78%, 48.24%, and 44.44% respectively. The Kappa coefficients ranged from 0.58 to 0.65, indicating moderate to substantial consistency. Among specimens reactive to system A, the reactive detection rate in system B was higher than that in system C. The positive rate of anti-HBc detection was 73.6% (92/125). Among transient NAT-reactive specimens, the positive rate of anti-HBc was 58%. Conclusion NAT can effectively reduce the risk of HBV transmission via blood transfusion, but no single NAT can completely eliminate this infection risk. Particularly in the screening of transient NAT-reactive specimens, combining multi-system NAT with anti-HBc testing can further reduce the risk of transfusion-transmitted HBV infection.

Objective Improving the disparities in quality management of blood banks, achieving homogeneous and high-quality collaborative development of the Yangtze River Delta blood station quality system through management mechanism innovation, and providing references for industry advancement. Methods Since 2021, the "Four Unities" joint internal audit model, which includes "Unified training", "Unified review standards", "Unified audit methods" and "Unified result judgment", has been implemented. This model now covers 4 blood centers and 21 central blood banks, and continuous improvement is achieved by categorizing, comparing, and analyzing terms of nonconformity. Results In 2021, 2023 and 2024, 188 terms of nonconformity were identified: 69 at blood centers and 119 at central blood banks. According to "Quality Management Standards for Blood Banks", these non-conformities mainly involve "Safety and Hygiene" (29 items, 15.43%), "Equipment"(23 items, 12.23%), "Records" (22 items, 11.70%) and "Blood Testing" (22 items, 11.70%). According to the classification and analysis of unqualified reasons, there were 23 items of systematic nonconformity (12.23%), 48 items of implementation nonconformity (25.53%) and 117 items of effectiveness nonconformity (62.23%), which caused by the non-conformity between the operating procedures and the quality manual, the failure to implement the requirements and the existence of differences or incorrect records in the operation. Conclusion The implementation of joint internal audits for blood banks in the Yangtze River Delta region through the "Four Unifications" model in quality homogenization provides practical examples and reference models for improving cross-regional blood quality management systems and exploring collaborative approaches for public health management across regions.

Objective To analyze the types and frequencies of B(A) subtype alleles in the Dalian area, and to perform spatial structure prediction and molecular dynamics simulation of transferase using computational tools. Methods Initially, 18 samples exhibiting serological characteristics of the B(A) subtype were screened by serological methods. The full-length ABO gene and its flanking regulatory regions were then sequenced using PacBio third-generation technology. Finally, computer software was used to predict the spatial structure of the transferase and conduct molecular dynamics simulations. Results Among 18 B(A) samples detected, only 1 carried the BA.02 allele, 13 contained the BA.04 allele, and 4 had a novel BA.NEW (c.797T>C) allele not yet included in the ISBT database. The frequencies of the B(A) subtype alleles in the Dalian area were as follows: BA.02-2.94%, BA.04-38.24%, and BA.NEW-8.82%. The BA.04 allele was dominant, while the BA.02 allele was relatively rare. Molecular dynamics simulations of wild-type B transferase and BA.NEW encoded B(A)-c.797C transferase in a "closed" conformation suggested that amino acid substitutions at position 266 could induce changes in the surrounding spatial conformation, affecting enzyme function and activity. Additionally, molecular dynamics simulations further indicated that the binding between B(A)-c.797C transferase and ligand became unstable. Conclusion Three alleles in the B(A) subtype were identified in the Dalian area, i.e. BA.02, BA.04, and BA.NEW, with BA.04 being significantly more prevalent than BA.02. The newly discovered BA.NEW allele enriches the genetic diversity of the ABO blood group system. Molecular dynamics simulations revealed that the ligand binding of the B(A)-c.797C transferase encoded by BA.NEW is unstable.

Objective To compare the application effects of PCR-SBT and TaqMan probe method in genotyping of HLA-E gene rs76971248 (promoter region NT-26) and rs1264457 (exon 3 NT+756), and to analyze the differences in the frequency distribution of the two SNP loci and their corresponding genotypes among healthy blood donors, hematological tumor patients, and solid tumor patients. Methods Whole blood samples were collected from 208 healthy blood donors, 111 hematological tumor patients and 100 solid tumor patients at Shenzhen Blood Center. DNA was extracted using a fully automatic nucleic acid extractor. Genotyping of the two SNP loci of HLA-E gene was performed by PCR-SBT and TaqMan probe method, respectively. Chi-square test was used to analyze the frequencies of SNP loci and genotypes among different populations using SPSS software. Results The genotyping results of the two methods were completely consistent, but the TaqMan probe method was less time-consuming to operate and did not require post-product purification and sequencing steps, making it more suitable for large-scale population genotyping. The frequency results of the two SNP loci among different populations showed that compared with healthy blood donors, the frequency of rs76971248 T in hematological tumor patients was significantly lower (P<0.05, OR=0.39), while there was no statistical difference in solid tumor patients (P>0.05).Regarding genotypes, the frequencies of rs76971248 G/G genotype and rs1264457 G/G genotype in hematological tumor patients were both significantly higher than those in healthy blood donors (P<0.05, OR=2.43; P<0.05, OR=1.98), whereas the frequencies of rs76971248 G/T genotype and rs1264457 A/G genotype were significantly lower than those in healthy blood donors (P<0.05, OR=0.40; P<0.05, OR=0.54). There were no statistical difference in the above genotype frequencies between solid tumor patients and healthy blood donors (P>0.05). Conclusion The TaqMan probe method has greater efficiency advantage in the rapid genotyping of HLA-E gene SNP and can be used as a preferred technology for large-scale tumor susceptibility screening. The rs76971248 T allele is a protective locus for hematological tumors, and the rs76971248 G/G genotype and rs1264457 G/G genotype are susceptible genotypes for hematological tumors.

Objective To investigate the true positive rate of hepatitis B surface antigen (HBsAg) enzyme-linked immunosorbent assay (ELISA) samples within the gray zone, and to propose a standardized strategy for processing such results in blood banks and transfusion services nationwide. Methods A retrospective analysis of HBsAg ELISA gray zone samples from the past 5 years was conducted. For samples from the past 6 months, supplementary testing was done using two additional HBsAg ELISA reagents, anti-HBc ELISA, anti-HBs ELISA, and quantitative nucleic acid testing. In cases with limited plasma volume, the extracted plasma volume for nucleic acid testing was increased. Results The gray zone rates of four HBsAg ELISA reagents were compared. Reagent 3 exhibited a significantly higher gray zone rate (1.56‰) than the others. Intermittent significant differences were noted in performance between different laboratory equipment and reagent batch numbers. Additionally, donor-specific factors and specimen characteristics were correlated with the gray area results. The positivity rate of nucleic acid in HBsAg gray zone samples was significantly higher than the total positivity rate of nucleic acid in routine ELISA-negative samples, with 10% of gray zone samples showing positive anti-HBc nucleic acid results. Quantitative viral nucleic acid testing revealed viral loads exceeding the minimum detection limit for hepatitis B virus in blood screening reagents. For 7 plasma bag samples with positive anti-HBc but negative results in routine nucleic acid screening, additional nucleic acid testing by increasing plasma volume showed all results to be negative. Conclusion Blood banks and transfusion services can eliminate the HBsAg ELISA gray zone on the premise of using nucleic acid detection systems with high sensitivity. Alternatively, incorporating anti-HBc testing for HBsAg gray zone samples may serve as an effective strategy to rule out false reactivity, thereby supporting the conservation of valuable blood resources.

Objective To investigate the serological characteristics and clinical significance of hemolytic disease of newborn (HDN) caused by the anti-Mur antibody. Methods ABO and Rh blood group typing were done on blood samples from one neonate and their parents. Antibody screening and identification were performed on the blood samples of the neonate and the mother. The neonate's blood sample were subjected to direct antiglobulin test (DAT), serum antibody identification, and elution antibody identification. PCR-SSP was used for MUR gene detection in the blood samples from the neonate and parents. Results The blood types of the neonate, mother, and father were A DCCee Mur+, A DCCee Mur-, and A DCCee Mur+, respectively. IgM-Mur and IgG-Mur antibodies were detected in the mother's serum, while IgG-Mur antibody was found in both the neonate's serum and the elution. The IgG-Mur titers in the mother's serum, the neonate's serum, and the elution were 128, 32, and 64. The neonate's DAT, serum antibody screen, and elution screen were all positive. Jaundice occurred in the infant shortly after birth, with the bilirubin level peaking at 221.9 μmol/L, and the jaundice gradually subsided following treatment with phototherapy and intravenous administration of human immunoglobulin. Conclusion In cases of hemolytic disease of newborn test, if antibody screening is negative for both the mother and the neonate, but the neonate's DAT is positive and there are clinical signs of hemolysis, the possibility of low-frequency antibodies, such as anti-Mur, should be considered. Laboratories are encouraged to use panel cells containing rare antigens for antibody identification and combine molecular typing technology to prevent missed diagnoses and ensure the safety of both mother and neonate.

Objective To investigate the molecular mechanism and transfusion strategy of a RhDCCee phenotype patient with cold antibody and anti-e like antibody. Methods The blood type and irregular antibody specificity were identified by serological methods such as test tube method, microcolumn gel card method and absorption diffusion test. The blood type genes were systematically analyzed by PCR-SSP, fluorescent PCR, Sanger sequencing and third-generation sequencing. SWISS-MODEL was used to compare and analyze protein models carrying common and mutant alleles. Results ABO and Rh phenotypes were type B and RhDCCee. The irregular antibodies were positive and specific antibodies were cold antibodies and anti-e. The PCR SSP and fluorescence PCR results were both Ce/Ce. Sanger sequencing revealed the presence of c.375C>G and c.827C>A mutations. Third-generation sequencing showed that exon 2-3 were very low in sequencing depth and there might be structural variation. The SWISS-MODEL suggested that the above mutations may lead to abnormal expression of the e antigen. The patient was infused ccEE phenotype red blood cells. Conclusion Cold antibody combined with anti-e like antibody jointly interfere with blood typing and cross matching. RHCE gene c.375C>G, c.827C>A combined with structural variations in Exon2-3 lead to abnormal expression of e antigen.

Objective To construct a core competence evaluation index system suitable for nurses in blood bank in China, and to provide a comprehensive, systematic, and quantifiable reference for evaluating the core competence of blood bank nurses. Methods The content of the index system was constructed based on literature analysis, group discussions, and the Delphi expert consultation method. Results The response rate of the two rounds of expert consultation was 100%, with authority coefficients of 0.93 and 0.92 respectively, and the Kendall's coefficient of concordance ranged from 0.17 to 0.23 (P<0.05). Finally, an evaluation system was established, which included 5 first-level indicators, 20 second-level indicators, and 115 third-level indicators. After the implementation of the nurses' core competence evaluation system, the scores of nurses' theoretical and operational assessments, as well as the scores of quality indicators for nursing care of adverse reactions to blood donation, all showed a significant increase (P=0.002, 0.001). Conclusion The index system constructed in this study has been verified by rigorous methodological approaches and has achieved a high degree of expert consensus. It can provide a scientific basis for the qualification certification, hierarchical training, performance appraisal, and human resource management of blood bank nurses.

Immune thrombocytopenia (ITP) is an acquired autoimmune disorder characterized by peripheral thrombocytopenia and a bleeding tendency. Its pathogenesis is mainly attributed to autoantibody-mediated platelet destruction and suppression of megakaryocyte function. Recent studies have further highlighted the contribution of platelet desialylation to antibody-mediated platelet clearance. As an important pathological indicator, platelet antibody testing plays an increasingly critical role in the auxiliary diagnosis and differential diagnosis of ITP, as well as in evaluating disease activity, monitoring treatment response, and guiding transfusion or pregnancy management. This review systematically reviews the principles and analytical performance of commonly used platelet antibody detection methods, including the monoclonal antibody immobilization of platelet antigens (MAIPA) assay, enzyme-linked immunosorbent assay (ELISA), flow cytometry, and bead-based immunoassays. We also discuss the clinical relevance of platelet antibody profiles in relation to disease phenotype and therapeutic outcomes, together with recent advances in the understanding of platelet desialylation. These findings provide a foundation for further research and may contribute to improving diagnostic strategies and clinical management in ITP.

The CD36 antigen is widely present on the surface of platelets, monocytes and other cells. However, some individuals in the population show a deficiency of the CD36 antigen. These individuals may produce anti-CD36 antibodies after exposure to immune stimuli such as blood transfusion and pregnancy. Patients carrying this antibody may experience complications related to blood transfusion, such as platelet transfusion refractoriness, alloimmune thrombocytopenia in the fetus and neonate, and post-transfusion purpura, if they receive blood products positive for the CD36 antigen again. This poses a threat to the safety of clinical blood transfusion. This article will review the molecular basis of CD36 antigen deficiency and its correlation with platelet transfusion refractoriness, alloimmune thrombocytopenia in the fetus and neonate, and transfusion-related acute lung injury.

Sepsis is an organ dysfunction syndrome caused by a dysregulated host response to infection, and immunothrombosis is one of its core pathological mechanisms. In recent years, platelet-neutrophil interactions have attracted increasing attention as a key link bridging inflammation and coagulation imbalance. Although research in this area is steadily advancing, there is still a lack of systematic summaries regarding its regulatory mechanisms, clinical evaluation value, and targeted interventions. This review focuses on platelet-neutrophil complexes (PNCs) and neutrophil extracellular traps (NETs), summarizing current progress in their biomaker significance, roles in pathogenesis, activation of regulatory pathways, and potential targeted interventions in sepsis. It also highlights their application prospects in disease assessment and individualized treatment, while addressing the exisiting challenges in mechanistic integration, detection methodologies, and clinical transformation. The aim is to provide theoretical support and research directions for further elucidating the mechanisms of immunothrombosis in sepsis and developing precision treatment strategies.

Platelet is one of the important components involved in the hemostatic process of the body, and chemotherapy-induced thrombocytopenia is one of the common side effects in the treatment of tumor patients. If PLT count cannot be recovered to 100×109/L, the next chemotherapy course often has to be interrupted, which seriously affects the therapeutic benefit. When the more severe grade 3~4 thrombocytopenia occurs, patients are at risk of severe bleeding, even life-threatening. Transfusion of apheresis platelets, human recombinant interleukin-11, and thrombopoietin have been widely used in the treatment of chemotherapy-induced thrombocytopenia, but the effectiveness of these strategies is not effective due to the patients' own underlying conditions. In this article, we review the latest clinical status, mechanism, and therapeutic benefits of chemotherapy-induced thrombocytopenia in recent years, we hope to explore more updated prevention and treatment techniques and measures.

Cryopreservation of red blood cells is a key technology to ensure the safety of clinical blood and emergency response to public health incidents. Glycerol-based protectants can achieve long-term storage, but their promotion and application in China and emerging (developing) low-income regions are limited due to the complex washing process caused by high osmotic pressure, the low number of red blood cells preserved per unit volume, and relatively serious damage to cell functions. In recent years, the cross-integration of materials science, nanotechnology, and synthetic biology has provided new ideas for the advancement of red blood cell cryopreservation technology: wash-free non-glycerol protectants function through molecular interface engineering (such as trehalose-chitosan nanofiber scaffolds, polyvinylpyrrolidone gradient systems); physicochemical protective nanocomposites (such as mesoporous silica, temperature-responsive hydrogels) have also shown good prospects. This article collates the results of multiple clinical studies and conducts a multi-dimensional comprehensive consideration of the development of cryogenic technology from the three perspectives of technology, economy, and policy. Through innovative formula design, the new wash-free red blood cell protectants not only ensure the cryoprotective effect and the quality of red blood cells after thawing but also completely eliminate or greatly simplify the tedious washing steps after thawing, enabling rapid thawing and immediate use of frozen red blood cells, thus transforming frozen red blood cells from "refrigerator reserves" to "first-aid kit reserves". However, issues such as the biocompatibility and safety of nanomaterials, the lack of an efficient, low-cost, high-throughput protectant screening system, and insufficient energy consumption of freezing equipment under low-temperature conditions remain the biggest obstacles to the breakthrough and clinical promotion of red blood cell preservation technology. In the future, it is necessary to strengthen interdisciplinary collaborative research and development to promote the development of in vitro red blood cell preservation technology towards multi-functional control and low-cost application.