Transfusion medicine, as a secondary discipline of clinical medicine, requires a well-established talent training system to ensure clinical blood transfusion safety and promote disciplinary development. This paper systematically compares the differences between China and the United States in areas such as disciplinary development, talent training objectives, curriculum systems, teaching models, career development and evaluation and accreditation mechanisms in transfusion medicine. Incorporating the latest policy directions proposed at the Working Conference of the Chinese Society of Blood Transfusion held in March 2025—including the transformation of transfusion departments into therapeutic platforms and the initiation of a specialized training system for transfusion physicians—and based on China's national conditions, this paper proposes optimized pathways for the talent training system in transfusion medicine, aiming to provide references for disciplinary construction and educational reform.

Platelet-rich plasma (PRP) has demonstrated substantial therapeutic efficacy in tissue repair and regenerative medicine, owing to its abundant reservoir of growth factors. However, the widespread clinical application of autologous PRP is hampered by inherent limitations, including interindividual variability, time-consuming preparation, and donor-site complications that impede its broader adoption. The establishment of a standardized allogeneic PRP (al-PRP) bank, which enables ready-to-use availability and batch-to-batch consistency, represents a pivotal innovative strategy to overcome the clinical barriers associated with autologous PRP. This review systematically elaborates the conceptual framework for constructing a standardized al-PRP bank, covering standardized manufacturing procedures and a whole-chain quality control system. Emphasis is placed on fundamental research and clinical evidence derived from human-derived al-PRP, with an in-depth discussion of its clinical value in regenerative scenarios, including osteoarthritis, chronic non-healing wounds, and tendon and ligament injuries. We analyze the regulatory landscape in China pertaining to cell-based therapies and blood products, addressing compliance pathways, technical bottlenecks, ethical considerations, and industry-wide challenges. This review aims to provide a theoretical foundation and practical reference for the clinical translation, standardized implementation, and industrial-scale development of al-PRP banks.

Individualized precision assessment of stored red blood cell (RBC) quality is a key requirement for advancing precision transfusion practices. The theoretical basis for this lies in the heterogeneity of red blood cells at the microscopic rheological, metabolic, and morphological levels, which leads to the formation and progression of storage lesions displaying "non-uniform" characteristics. Traditional quality control primarily relies on macro-indicators based on population-average storage duration, facing challenges in clinical translation including insufficient sensitivity, difficulty in identifying vulnerable subpopulations, and the need for invasive sampling. To overcome these limitations, this paper systematically reviews the latest developments in intelligent devices and artificial intelligence-assisted systems for individualized RBC quality assessment, with particular focus on microfluidic chip platforms, spatially offset Raman spectroscopy (SORS), and photoacoustic imaging technologies. Concurrently, deep learning and machine learning can perform automatic characterization and classification learning of microscopic morphological features, further establishing data-driven quality assessment frameworks. Although current challenges remain—including non-standardized clinical release criteria, insufficient biosafety assessment of nanosensing substrates, and cost-benefit imbalances—future prospects remain promising. By integrating low-cost, non-invasive point-of-care testing (POCT) with artificial intelligence, decision pathways can be established to promote the formation of intelligent, convenient, and clinically accessible quality assessment closed-loop systems. This approach will provide both theoretical foundation and practical guidance for overcoming the current bottleneck in storage lesion assessment.

Horizon Scanning (HS), a systematic management approach to identifying signals of external environmental change and supporting strategic decision-making, has been extensively applied in international healthcare settings. Currently, China's blood transfusion sector faces multiple challenges including population aging, emerging infectious disease threats, and rapid technological iteration, which urgently call for the introduction of prospective management tools to enhance strategic adaptability. Based on a systematic review of international HS practices, this study developed a "Technology-society-risk" three-dimensional analytical framework tailored to the blood transfusion services. The technology dimension focuses on how frontier technologies such as artificial intelligence, the Internet of Things, and synthetic biology are reshaping the entire blood supply chain; the society dimension analyzes shifts in donor behaviors and clinical blood utilization patterns; and the risk dimension prioritizes early warning for risks related to infectious diseases, regulatory policies, and supply chain security. Furthermore, this study, by taking into account China's specific national conditions, proposed a three-stage localized implementation pathway comprising "pilot exploration, institutional embedding, and top-level design".

Objective To investigate the therapeutic efficacy of adoptively transferred sEV in mice with collagen-induced arthritis (CIA), we isolated small extracellular vesicles (sEV) from the culture supernatant of human peripheral blood-derived induced CD8⁺Treg cells. Methods sEV were isolated via differential ultracentrifugation and characterized by nanoparticle tracking analysis, transmission electron microscopy and western blotting. CIA mice were randomly assigned into control and sEV-treated groups. After intervention, clinical arthritis scoring and histopathological examination of joint tissues were examined. Plasma levels of proinflammatory cytokines and anti-type II collagen antibodies were detected, and CD4⁺ T cell subsets in lymph nodes were quantified by flow cytometry. Results Purified sEV exhibited a typical cup-shaped morphology with an average diameter of 106.8±3.3 nm and expression of CD63 and TSG101. Compared with controls, the sEV-treated group displayed delayed disease onset, alleviated articular inflammation and reduced cartilage erosion. Consistently, plasma TNF-α, IL-6 and anti-type Ⅱ collagen antibodies were markedly reduced, while the frequencies of lymph node CD4⁺IFN-γ⁺ and CD4⁺IL-4⁺ T cells were elevated. Conclusion CD8⁺Treg-derived sEV alleviate joint inflammation in CIA mice by suppressing inflammatory cytokines and modulating CD4⁺ T cell differentiation.

Objective This study aimed to determine the quality indicators, proteomic and metabolomic profiles of washed red blood cells (WRBCs), and further evaluate their quality alterations at the end of storage via correlation analysis. Methods Suspended RBCs were categorized into two groups: the control group (Control5w), which did not undergo washing treatment, and the saline-washed group (Saline5w). Following storage at 4 ℃, samples were collected at the end of storage, and relevant quality control indicators for suspended RBCs were examined. Proteomic and metabolomic analyses were performed to assess changes in biological functions and correlations during the storage process of the two groups using bioinformatics analysis. Results After 35 days of storage at 4 ℃ in the saline group, all RBC indicators complied with national standards for the quality of WRBCs. The comprehensive integration and analysis of proteomics and metabolomics data have elucidated alterations in the protein and metabolite composition of RBCs washed with saline. This was achieved by examining the correlations among various biomolecular levels. Conclusion This study substantiates the investigation of the physiological and biochemical functions of washed RBCs through the application of advanced proteomic and metabolomic methodologies.

Objective Based on the chemical coupling method, the blood-derived human immunoglobulin-NK cell retargeting molecular conjugate was constructed and its antiviral effect was evaluated. Methods Using human immunoglobulin products with high anti-VZV antibody titers as raw materials, the conjugates of human immunoglobulin and NK cell redirection molecule (anti-CD16a scFv) with different coupling degrees, IgG×αCD16a, were prepared by Traut's reagent and Sulfo-SMCC. The conjugated products were characterized by non-reducing SDS-PAGE, and the binding ability of IgG×αCD16a to effector cells (NK cells) was determined by flow cytometry. ADCC activity was detected by LDH release assay, the release of cell killing mediators (granzyme B, perforin) and cytokines (TNF-α, IFN-γ) was detected by ELISA. The killing ability of coupled product IgG×αCD16a and unconjugated human immunoglobulin on VZV infected cells was systematically evaluated. Results The coupling rate of IgG×αCD16a can reach more than 30%. IgG×αCD16a can bind to NK cells, and the binding ratio is higher than that of unconjugated human immunoglobulin. Compared with unconjugated human immunoglobulin, IgG×αCD16a significantly enhanced the ADCC activity on VZV infected cells and the release level of cytokines (TNF-α, IFN-γ). Conclusion The molecular chemical conjugate of blood-derived human immunoglobulin -NK cell redirection based on chemical coupling can effectively improve the antiviral effect of blood-derived human immunoglobulin, and provide a new idea for the development of a new generation of highly effective anti-viral antibody drugs.

Objective The blood group-related antigen Lewis y is highly expressed in various tumors, and its humanized monoclonal antibody Hu3S193 has been applied in clinical trials as an anti-tumor drug. Previous studies have confirmed the presence of Lewis y antigen on the surface of human platelets, yet the effect of Hu3S193 on platelet function remains unclear. This study aimed to explore the regulatory effect of Hu3S193 on the in vitro functions of human platelets, providing experimental evidence for the safety and mechanism of its clinical anti-tumor application. Methods Flow cytometry was used to verify the in vitro binding ability of Hu3S193 to human platelets. The release of platelet α-granules was evaluated by detecting P-selectin expression, and the intracellular calcium concentration ([Ca²⁺]i) of platelets was measured using Fluo-3 fluorescent probe to analyze the effect of Hu3S193 on platelet activation with or without thrombin stimulation. Thromboelastography (TEG) was performed to detect platelet coagulation function, and flow adhesion assay was used to assess the adhesion ability of platelets to type Ⅰ collagen. Results In vitro experiments confirmed that Hu3S193 could specifically bind to human platelets in a concentration-dependent manner. Hu3S193 at clinical dose (5 μg/mL) and higher concentrations (10, 20 μg/mL) had no significant effect on platelet α-granule release and did not induce abnormal platelet activation. TEG detection showed that 5 μg/mL Hu3S193 had no obvious change on maximum amplitude (MA), the core index of platelet coagulation function. In the absence of thrombin stimulation, clinical-dose Hu3S193 significantly increased platelet intracellular calcium concentration and inhibited thrombin-induced calcium influx activation. Flow adhesion experiments verified that Hu3S193 inhibited the flow adhesion ability of platelets to type Ⅰ collagen in a dose-dependent manner. Conclusion Hu3S193 does not affect the basal activation and coagulation function of human platelets. but can regulate platelet intracellular calcium level and significantly inhibit platelet flow adhesion. This finding supplements a new theoretical basis for its anti-tumor mechanism and provides a reference for its clinical safe medication.

Objective This study aims to characterize high-abundance intact glycopeptides in platelets and explore the functions of major glycosylation modifications. Methods Intact glycopeptides from platelets were enriched using hydrophilic interaction liquid chromatography (HILIC) and analyzed by liquid chromatography coupled with high-resolution mass spectrometry (LC-HRMS). Results A total of 76 intact glycopeptides were identified, mapping to 35 glycosylation sites derived from 28 platelet proteins. Among these, glycosylation modifications associated with fibrin adhesion, including those on ITGB3 and THBS1, were successfully identified. Notably, the C2orf80 protein was found to carry a bisecting N-glycan modification. To date, no site-specific glycosylation on C2orf80 has been reported in the literature; existing studies have primarily focused on the expression changes of the gene encoding this protein in gliomas and psychiatric disorders, while its biological function remains poorly characterized. Conclusion This study first identified the bisecting N-glycan modification of C2orf80 in platelets, which provides a crucial theoretical and data basis for further exploration of the biological function of C2orf80.

Objective To isolate small extracellular vesicles(sEVs) derived from the supernatant of CD8⁺ regulatory T cells induced from human peripheral blood mononuclear cells (TR-sEVs), and explore their intervention effect and preliminary mechanism against transfusion-related acute lung injury (TRALI) in mouse model. Methods TR-sEVs were extracted by differential centrifugation combined with ultracentrifugation, and identified via nanoparticle tracking analysis (NTA), transmission electron microscopy (TEM), and Western blotting (WB). A mouse model was established and grouped according to the two-hit hypothesis of TRALI. Mice received an intraperitoneal injection of lipopolysaccharide (LPS) as the first insult at 0 h. After 2 h, gradient doses of TR-sEVs were administered via tail vein, and anti-mouse H-2K^d antibody was injected via the tail vein at 24 h to establish the second insult. Mouse survival time and lung wet-dry weight ratio were recorded. Hematoxylin-eosin (HE) staining and immunohistochemical staining were performed to evaluate pulmonary pathological damage and inflammatory infiltration. The level of interleukin-6 (IL-6) in bronchoalveolar lavage fluid was detected by enzyme-linked immunosorbent assay (ELISA). An LPS-induced inflammatory injury model of EA.hy926 endothelial cells was established in vitro. Quantitative real-time polymerase chain reaction (qRT-PCR) and flow cytometry were used to detect the expression of intercellular adhesion molecule-1 (ICAM-1) in endothelial cells, and the adhesion effect of Tohoku Hospital Pediatrics-1 (THP-1) monocytes to endothelial cells was further evaluated. Results TR-sEVs increased the survival rate of TRALI mice, decreased lung wet-dry weight ratio (6.21±0.15 in control group vs 4.45±0.12 in intervention group), alleviated pulmonary inflammation and reduced IL-6 level. In vitro, TR-sEVs inhibited endothelial ICAM-1 expression and weakened monocyte-endothelial adhesion. Conclusion Infusion of TR-sEVs alleviates pulmonary lesions, inflammatory cell infiltration and the release of inflammatory cytokines in mice with transfusion-related acute lung injury. Its mechanism may exert effects via downregulating ICAM-1 expression in endothelial cells and suppressing monocyte-endothelial cell adhesion.

Objective To compare the survival of Staphylococcus epidermidis in whole blood, red blood cell suspensions, and platelet concentrates, and to preliminarily investigate biofilm formation on the inner wall of blood storage bags. Methods Whole blood was collected from five healthy volunteers, and red blood cell suspensions and platelet concentrates were manually prepared. Skin flora from the antecubital region was sampled using sterile swabs, and the predominant isolate was identified as S. epidermidis. Each blood component was spiked with the bacterial suspension to a final concentration of approximately 10 CFU/mL, with sterile controls set up in parallel. Whole blood and red blood cell suspensions were stored at 4 ℃, while platelet concentrates were agitated at (22±2) ℃. Samples were taken on days 1 (within 2 h), 3, 5, 7, and 9 post-inoculation, plated on blood agar, and colonies were counted after 48 h of incubation. At the end of the experiment, crystal violet staining was used to assess biofilm formation on the inner bag surface. Results On day 1, all three groups yielded small numbers of bacteria (1~8 CFU/100 μL), with no significant difference among groups (H=1.792, P=0.436). Thereafter, the three groups showed distinctly different trends: in the whole-blood group, bacteria were progressively cleared from day 3 onward, with 4 of 5 specimens becoming sterile by day 9 and the remaining one showing only 1 CFU/100 μL. In the red blood cell suspension group, counts rose to 19 (8, 32) CFU/100 μL on day 3, but by day 9, 3 specimens were sterile. In the platelet concentrate group, massive proliferation occurred as early as day 3, with counts reaching 81 (33 300) CFU/100 μL, and all specimens became uncountable from day 7 onward. Crystal violet staining revealed purple coloration on the inner bag walls in both the whole-blood and red blood cell suspension groups, including bags that had become sterile. Conclusion Whole blood and red blood cell suspensions exhibit a certain capacity for self-clearance against S. epidermidis, whereas platelet concentrates strongly support bacterial proliferation. Bacteria may form biofilms on the inner bag surface, potentially leading to false-negative results in routine culture and detection.

Objective To evaluate the efficacy and safety of a combined "freeze-thaw, high-speed centrifugation, and EDTA" pre-treatment method in reducing non-specific high background in flow fluorometric panel reactive antibody (PRA) testing. Methods A retrospective analysis was performed on 232 PRA testing specimens clinically submitted from June 2025 to September 2025. High background was defined as the fluorescence intensity of at least one negative control bead exceeding the manufacturer's recommended range. High background Samples were sequentially treated by freeze-thaw (-30 ℃ for 12 h, thawed at 20 ℃), high-speed centrifugation (13 000×g, 15 min), and EDTA (final concentration 2.3 mmol/L, incubated for 10 min). To verify the incremental value of EDTA, a paired analysis was performed on the first 31 high-background samples using two methods: Method1 (without EDTA) and Method2 (with EDTA). The remaining 28 specimens were treated with Method2 only. Additionally, 10 normal-background specimens were selected to verify the safety of the method. Results After routine high-speed centrifugation, 173 of the 232 specimens (74.6%) had normal negative control MFI, and 59 (25.4%) still exhibited high background. After treatment with Method2 (with EDTA), 22 specimens (37.29%) achieved complete normalization, 22 (37.29%) showed partial improvement, and 15 (25.42%) showed enhanced reactivity. Paired analysis of the first 31 samples indicated that Paired comparison of the first 31 specimens showed that Method2 yielded a higher effective improvement rate (74.19%) than Method1 (64.52%), with 3 samples improvement of the classification. Furthermore, the mean fluorescence intensities (MFIs) of all quality control markers in the 10 normal-background samples showed no significant changes after treatment (P>0.05), demonstrating good safety. Conclusion The combined "freeze-thaw, high-speed centrifugation, and EDTA" pre-treatment method effectively reduces high-background in PRA testing. EDTA is a crucial step in this protocol, and the method shows no significant interference with normal-background specimens.

Objective In order to explore whether there are PF4 antibodies in patients with thrombocytopenia and affect platelet function. Methods Serum samples were randomly collected from thrombocytopenic patients referred for specialized platelet cross-matching and from healthy donors, P latelets from donors of the same blood group were randomly selected as target cells. Anti-PF4 antibodies were screened by enzyme-linked immunosorbent assay (ELISA), and positive samples were retested with heparin supplementation. Anti-PF4+ samples were further analyzed for the coexistence of other antibodies. Normal platelets treating with incubated with anti-PF4+ samples, followed by assessment of platelet function via thromboelastography (TEG) and analysis of platelet activation levels using flow cytometry. Results Among 107 patients with thrombocytopenia, 12 (11.42%) were positive for anti-PF4, including 3 showing heparin inhibition and 8 presenting with concurrent non-PF4 antibodies. TEG analysis revealed lower platelet aggregation in 1/12, mixed aggregation patterns in 2/12, and higher aggregation in 9/12. Flowcytometry demonstrated a higher proportion of CD41a+CD62p+ platelets induced by anti-PF4+ sera than that by healthy donors (23.05%±4.88% vs 14.09%±3.24%, P<0.001). Conclusion Anti-PF4 antibodies are present in a subset of thrombocytopenic patients, and exhibit significant functional heterogeneity, which may exert diverse effects on platelet transfusion outcomes.

Objective To assess the extent to which changes in age-group and collection-site composition accounted for the annual difference, we compared repeat donation outcomes among first-time whole blood donors between 2023 and 2024. Methods A retrospective annual cohort design was used to include first-time whole blood donors in 2023 and 2024. Repeat donation was defined as any subsequent donation recorded in the blood collection information system within 365 days after the first donation. The observed repeat donation rates were compared using the chi-square test, and year-specific multivariable logistic regression models were fitted to identify factors associated with repeat donation. Direct standardization was performed using the 2023 joint distribution of age group and collection-site type as the standard weights to calculate the standardized repeat donation rate for 2024. Results A total of 218 408 first-time whole blood donors were included, comprising of 113 656 donors in 2023 and 104 752 in 2024. The observed repeat donation rate decreased from 14.27% (16 214/113 656) in 2023 to 12.05% (12 622/104 752) in 2024, an absolute decrease of 2.22 percentage points (χ²=233.490, P<0.001). The standardized repeat donation rate for 2024 was 11.50%, which was 2.77 percentage points lower than the observed rate in 2023 and 0.55 percentage points lower than the observed rate in 2024. Changes in the selected age-group and collection-site composition did not explain the annual decline; the difference was mainly reflected in an overall reduction in repeat donation rates within the age-group-by-collection-site strata. In the year-specific regression models, donors giving 300 mL had higher adjusted odds of repeat donation than those giving 200 mL in 2023, but lower adjusted odds in 2024. Donors giving 400 mL still had higher adjusted odds than those giving 200 mL in 2024. In 2024, donors recruited at fixed donation sites or mobile blood-collection vehicles had lower adjusted odds of repeat donation than those recruited through workplace-based collections, and weekday-donors had lower adjusted odds than weekend-donors. Conclusion The repeat donation rate among first-time whole blood donors was lower in 2024 than in 2023. Changes in the age-group-by-collection-site composition examined in this study did not explain the annual decline. In addition to comparing observed repeat donation rates, annual monitoring should assess changes within comparable donor groups and collection settings to guide stratification of donor retention.

Objective Systematically explain the differential effects of various biological characteristics of blood donors on the incidence of febrile non-hemolytic transfusion reaction and allergic transfusion reaction in red blood cell transfusion, and clarify their independent related risk factors, so as to provide evidence-based basis for pre-risk screening and clinical accurate blood use in blood collection and supply institutions. Methods A total of 337 756 bags of red blood cell infusion records from January 2020 to December 2025 in six hemovigilance sentinel hospitals in China were included, and the information of gender, age, blood donation times and ABO blood group of the corresponding blood donors were collected. Different types of red blood cell preparations and monitoring sentinel sites were simultaneously included as confounding variables, and univariate analysis was completed by chi-square test. Independent influencing factors of two kinds of adverse reactions were screened by binary unconditional Logistic regression model. The adverse blood transfusion reactions reported by 6 hospitals participating in HV in China from January 2020 to December 2025 and all clinical red blood components were collected, and the influence of gender, age, blood donation times and ABO blood type of related blood donors on the occurrence of adverse blood transfusion reactions was analyzed. The differences of ATR and FNHTR occurred in the infusion of different red blood cell blood components. Results The total incidence of FNHTR was 0.099%, the highest was suspended red blood cells (0.420%) and the lowest was washed red blood cells (0.036%). The total incidence of ATR was 0.086%, the highest was irradiated suspended red blood cells (0.230%) and the lowest was leucocyte-depleted suspended red blood cells (0.065%). Univariate analysis showed that there were statistical differences in the incidence of FNHTR and ATR between blood types and different sentinel units, and the influence of blood donor characteristics on the incidence of FNHTR was statistically significant, but there was no statistical difference in ATR. Multivariate Logistic regression analysis showed that blood type and monitoring sentinel were independent influencing factors of FNHTR and ATR, the characteristics of blood donors were not independent influencing factors of FNHTR, and the gender of blood donors was independent influencing factor of ATR. The risk of ATR in male blood donors after red blood cell transfusion was significantly lower than that in women. Conclusion There are significant differences in the intensity and path of the biological characteristics of blood donors to the two kinds of adverse reactions, and the heterogeneity of blood product processing technology and clinical monitoring is the more critical influencing factor. In the future, an associated database of "blood donors, blood products and recipients" should be established to promote accurate blood transfusion.

Objective To characterize the potential impacts of a CD109 exon 19 deletion on human platelet antigen 15 (HPA-15) genotyping, protein structure, and its interaction with transforming growth factor-β1 (TGF-β1). Methods A platelet donor presenting with abnormal results on routine HPA screening was enrolled. HPA-related genes were performed using third-generation sequencing on the PacBio Sequel Ⅱ platform. The effects of the variant on CD109 conformation and its binding mode to TGF-β1 were evaluated through an integrated structural bioinformatics workflow, including AlphaGenome splicing effect prediction, AlphaFold3 structural modeling, PyMOL structural superposition and alignment, and HADDOCK protein-protein docking. Functional phenotyping was complemented by blood count, coagulation assays, platelet aggregation testing, and flow cytometric analysis. Results Third-generation sequencing detected a large intragenic deletion spanning CD109 exon 19, which introduces a frameshift mutation and premature stop codon, rendering conventional HPA-15 genotyping unassignable for one haplotype. AlphaGenome analysis predicted that this structural variant may destabilize local splice site recognition and give rise to aberrant transcripts. Structural modeling demonstrated that the variant did not abrogate the overall fold of CD109, but induced localized conformational remodeling and spatial rearrangement of functional domains. Molecular docking simulations revealed altered interaction patterns at the protein-protein interface, augmented conformational heterogeneity, and a potentially dysregulated binding mode between mutant CD109 and TGF-β1. No overt abnormalities were identified on routine testings, whereas flow cytometry showed discordant expression profiles of CD42a/CD42b and CD62P/PAC-1. Conclusion The CD109 exon 19 deletion is a rare structural genomic variant that disrupts routine HPA-15 genotyping. It may drive subclinical functional perturbations in platelets by altering CD109 conformation and its interaction with TGF-β1. This study demonstrates that integrating third-generation sequencing with structural bioinformatics provides a powerful approach to unraveling the functional consequences of complex platelet antigen variants.

Objective To develop a risk prediction model for vasovagal reaction (VVR) in apheresis blood donors, thereby supporting evidence-based strategies for donor safety as well as adverse event prevention and control. Methods We retrospectively enrolled 58 031 apheresis platelet donors from Ningbo Central Blood Station (2021—2025), including 155 VVR cases with a positive rate of 0.27%. Demographic characteristics, physical examination findings, hematological indices and apheresis parameters were collected. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used for feature screening, and a multivariate logistic regression model was established. The dataset was divided into training and test sets at a 7:3 ratio by stratified sampling, with five-fold cross-validation for model verification. Model performance was assessed using area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and other metrics. Results From 29 candidate variables, 21 core predictors were retained. The model achieved an AUC of 0.840 in the training set and 0.800 in the test set, with an accuracy of 72.60%, sensitivity of 68.09%, specificity of 72.61%, precision of 0.67%, and F1-score of 0.013 2. Logistic regression analysis identified apheresis volume grouping, hemoglobin level, and pulse rate as independent risk factors, whereas male sex, platelet count, history of multiple apheresis donations, and body weight were independent protective factors. Although extracorporeal circulation volume and anticoagulant dosage exhibited statistically protective effects, these were recognized as statistical artifacts arising from early termination of apheresis following VVR occurrence. Conclusion The proposed model displays good discriminative ability and stability. It could identify high-risk VVR candidates based on pre-collection baseline indicators before blood and facilitate individualized preventive interventions, supporting its clinical utility in blood donation settings.

Objective To develop a scale assessing cognition and intention regarding group voluntary blood donation, and evaluate its reliability and validity. Methods A theoretical framework was constructed based on group dynamics. Initial scale items were generated through literature review and semi-structured interviews, and then revised and optimized via a pilot test. A total of 1 052 participants were recruited from enterprises and institutions that had regularly organized group blood donation activities, and they completed the formal scale administration. Item analysis done using the total sample. Then, all participants were randomly assigned into two subsamples: Sample 1 (n1=526) for exploratory factor analysis, and Sample 2 (n2=526) for confirmatory factor analysis, as well as tests of convergent validity, discriminant validity and reliability. Results The final scale comprised 27 items loading onto six factors: social cohesion, task cohesion, self-monitoring, conformity, self-efficacy, and group blood donation intention. These six factors collectively explained 78.91% of the total variance, exhibiting good construct validity. The fit indices of the six-factor structure were as follows: χ²/df=3.65, CFI=0.911, TLI=0.899, RMSEA=0.071, SRMR=0.065. The scale also showed favorable convergent and discriminant validity. The overall Cronbach's α coefficient and the Cronbach's α coefficients for each of the six dimensions were all≥0.8, reflecting strong internal consistency reliability. Conclusion The Group Voluntary Blood Donation Cognition and Intention Scale exhibits satisfactory reliability and validity, and could be used to evaluate members' cognitive perceptions and donation intentions in the context of group blood donation.

Objective To analyze the direct antiglobulin test (DAT) positive rate, demographic distribution, characteristics of irregular antibodies, and donation frequency among voluntary whole blood donors in Nanchong City from 2011 to 2025, providing a basis for donor health management and transfusion safety. Methods A retrospective analysis was conducted on DAT-positive voluntary whole blood donors in Nanchong City from January 1, 2011 to December 31, 2025. The DAT positive rate was calculated, differences between gender and age groups were compared, The types of irregular antibodies, agglutination intensity, and donation frequency were analyzed. Results Among 316 443 whole blood donations over 15 years, 395 were DAT positive (0.125%). The positive rate in females (0.182%) was significantly higher than that in males (0.074%) (P<0.001), with the highest rate observed in females aged 40~49 (0.374%) (P<0.001). The detection rate of irregular antibodies among DAT-positive donorls was 7.087%, predominantly autoantibodies (16 cases), with no significant difference between genders (P>0.05). Agglutination intensity was mainly 2+ (42.391%) and 1+ (29.348%), with only 3 female cases showing 4+ intensity. Among DAT positive individuals, first-time donors accounted for the largest proportion (45.316%), and the positive rate decreased with increasing donation frequency. Conclusion The DAT positive rate among voluntary whole blood donors in Nanchong area is relatively low, with higher rates in 40~49 years female group. Most DAT positive cases exhibit weak to moderate agglutination intensity. The detection rate of irregular antibodies in DAT positive individuals is higher than that in the general blood donor population. DAT positive status is most common among first-time blood donors. Enhanced screening and follow-up for DAT positivity in this population are recommended to safeguard donor health and clinical blood transfusion safety.

Objective To optimize a modified trapezoidal microplate platform for high-throughput RhCE antigen screening and to delineate the phenotypic spectrum and RHCE genetic polymorphisms among blood donors in the Zigong region of China. Methods A total of 10 045 samples from voluntary blood donors collected between August and December 2025 were screened for RhCE antigens using the modified trapezoidal microplate assay. Of which 111 samples were tested in parallel with the standard tube method and Kompetitive Allele-Specific PCR (KASP) genotyping. Eighteen samples with serologically weak RhCE reactivity underwent further genotyping and long-read third-generation sequencing. Results The modified trapezoidal microplate assay demonstrated 100% concordance with both the standard tube method and KASP genotyping across the 111 validation samples. Among the 10 045 samples, 10 011 were RhD positive, accounting for 99.66%. Eight distinct RhCE phenotypes were identified, ranked by prevalence in descending order: CCDee (49.71%), CcDEe (31.93%), CcDee (8.78%), ccDEE (5.34%), ccDEe (3.06%), CCDEe (0.74%), ccDee (0.26%), and CcDEE (0.18%); no CCDEE phenotype was detected. Antigen frequencies were e (94.49%)>C (91.35%)>c (49.55%)>E (41.25%). Thirty-four donors (0.34%) were RhD negative, with ccdee (50.00%) being the predominant phenotype, followed by Ccdee (38.24%), ccdEe (5.88%), CCdee (2.94%), and CcdEe (2.94%). No CcdEE, ccdEE, CCdEe, or CCdEE phenotypes were detected. Antigen frequencies were e (100%), c (97.06%), C (44.18%), and E (8.82%). Overall, 108 samples (1.07%) showed serologically weak RhCE antigen expression. Among the 18 RhCE weak-expression samples subjected to long-read sequencing, 10 harbored mutations or recombinant alleles, including 3 putative novel structural variants. Conclusion Coupled with automated handling, the modified trapezoidal microplate assay enables rapid, accurate, and high-throughput RhCE antigen screening, with reliable detection of weak antigen expression. This approach provides a platform for characterization of RhCE variant alleles. The RhCE locus exhibits genetic diversity in the Zigong donor population. A comprehensive judgment should be made by combining multiple experimental methods to provide a basis for implementing precise RhCE-matched blood transfusion.

Objective This study is to assess associations of sex, age, and ABO blood group with platelet counts. Methods A total of 4 657 healthy donors were enrolled. ABO groups were determined serologically and platelet counts measured by automated hematology analyzer. Associations were evaluated using R software (4.4.1). Results Mean platelet count was lower in males [(243±45.3)×10⁹/L] than that in females [(259±50.2)×10⁹/L] (t=-10.15, P<0.001). Age correlated negatively with platelet count in both sexes (male: r=-0.13, female: r=-0.14; both P<0.001). Age-stratified trend analysis showed an overall decline with age; males exhibited a steady gradual decrease, while females remained relatively stable between ages 30~49. Multivariable linear regression identified sex, age, and ABO group as independent predictors; group B had lower platelet counts than group A (P<0.05). Conclusion Platelet counts are lower in males than in females. Platelet counts decline slowly with age, with a relatively stable phase in females. ABO blood group is associated with platelet count; it may be a heritable trait affecting platelet count.

Objective This study aims to conduct a genotyping analysis of the RHCE blood-group system among regular blood donors in the Shandong Peninsula using molecular biology techniques. It evaluates the reliability of predicting C/c and E/e antigen phenotypes based on two single-nucleotide polymorphisms (SNPs) in the RHCE gene, namely c.307C>T (Exon 2) and c.676C>G (Exon 5). Additionally, it analyzes the genetic characteristics of D-phenotypes and individuals with weak RhCE antigen expression using third-generation single-molecule sequencing technology, with the goal of elucidating the regional distribution patterns of the RHCE gene and its variants. Methods A total of 13 691 regular blood donors from the Shandong Peninsula were selected as study subjects. The TaqMan-MGB genotyping method, combined with an improved U-shaped microplate method, was employed for typing the C, c, E, and e antigens of the RHCE gene. The differences between the results obtained by the two methods were compared. For the four rare D-phenotypic samples and two samples with weak RhCE antigen expression identified during screening, full-length haplotype sequencing was carried out using the third-generation sequencing platform to precisely identify variant genotypes. Results Both methods were used to test 9 411 donors. Discrepancies were mainly observed in C/c antigen typing, with 74 inconsistent specimens detected. Specifically, there were 31 cases where the serological Cc phenotype matched the cc genotype, 21 cases where the serological CC phenotype matched the cc genotype, and 22 cases where the serological cc phenotype matched the Cc genotype. E/e antigen typing showed high consistency, with only three discrepancies: two cases where the serological ee phenotype matched the Ee genotype and one case where the serological EE phenotype matched the Ee genotype. Third-generation sequencing revealed that among the four rare D- phenotypic samples and two samples with weak RhCE antigen expression, four D-silent alleles (RHCE*02N.07, RHCE*02N.08, RHCE*02N.14, c.940-3C>G) and two RHCE recombinant variant genes (RHCE-D(2)-CE-D(9)-CE, RHCE-D(4-5)-CE) were identified. Conclusion The TaqMan-MGB method using a single SNP site is relatively reliable for predicting E/e antigens, but for more accurate prediction of C/c antigens, additional SNPs should be included. The improved U-shaped microplate method can be applied for RhCE typing in blood collection and supply institutions. The RHCE gene is prone to structural variations such as recombination and inversion with the RHD gene, which are difficult to accurately detect using conventional methods. Third - generation single-molecule full-length sequencing provides a reliable approach for the precise identification of RHCE variant genotypes, offering valuable data support for regional precision transfusion and blood-group genetics research.

Objective To analyze the composition and frequency distribution of mixed antibodies in the Chinese population, evaluate the feasibility of screening compatible donors for each mixed antibody combination, and propose recommendations for transfusion strategies in patients with multiple alloantibodies. Methods Data from irregular antibody-positive cases identified in our laboratory and reported in domestic literature were collected and analyzed to determine the specificity combination spectrum of mixed antibodies. Antigen frequency data of blood group systems from various regions in China were systematically retrieved and pooled using a weighted method. The expected probability of finding compatible phenotypes for each mixed antibody combination was then calculated. Two thresholds (≤1/50 and≤1/200) were set to grade the difficulty of blood matching. Results A total of 20 069 irregular antibody-positive cases were included, among which 92 distinct mixed antibody combinations were identified (677 cases, 3.37%). Mixed antibodies were predominantly composed of RhCE system antibodies combined with antibodies from other systems. Seven combinations (69 cases, 10.2% of mixed antibodies) yielded expected compatibility probabilities between 1/50 and 1/200, while another seven combinations (18 cases, 2.7%) showed probabilities<1/200. Combinations with probabilities<1/200 were difficult to secure with routine inventory alone and required reliance on rare donor repositories or frozen red blood cell reserves. Conclusion Mixed antibodies in the Chinese population exhibit a complex spectrum with RhCE antibodies as the core component coexisting with multiple antibodies from other systems. Early referral to rare donor programs is recommended for patients with multiple alloantibodies. RhCE typing could be considered as an adjunct test when constructing rare blood type repositories.

Objective To investigate the application value of chemiluminescence resonance energy transfer (CRET) technology in functional monitoring of apheresis platelets during storage, and to evaluate its feasibility for detecting platelet membrane molecules and activation-related indicators in combination with flow cytometry. Methods Apheresis platelet samples were randomly collected from 48 donors in 2026 and randomly assigned to seven storage groups according to storage duration from day 1 to day 7. Flow cytometry was used to detect CD61 expression percentage, CD61 mean fluorescence intensity (MFI), CD62P expression percentage and CD62P MFI in each group. CRET technology was used to detect CD61, basal CD62P and ADP-stimulated CD62P-related indicators, and positive expression percentage and relative light units (RLU) were recorded. Intra-assay precision of the CRET method was evaluated. Results Flow cytometric CD62P expression percentage and CD62P MFI increased with prolonged storage time (P<0.05). Basal CRET-CD62P expression percentage was significantly positively correlated with storage duration (P<0.05), and basal CRET-CD62P RLU was also significantly positively correlated with storage duration (P<0.05). After ADP stimulation, both CRET-CD62P expression percentage and RLU were significantly higher than those in the basal state (P<0.05), whereas the response reserve expressed as the difference between ADP-stimulated and basal values showed no significant correlation with storage duration (P>0.05). CRET-CD61 RLU was significantly positively correlated with flow cytometric CD61 MFI (P<0.05), while the correlation between CD61 expression percentages detected by the two methods was insufficient. Repeatability testing showed that the coefficients of variation (CVs) of low- and high-level CD61 samples were 6.25% and 3.91%, respectively, and the CVs of low- and high-level CD62P samples were 14.27% and 11.43%, respectively. Conclusion CRET technology can reflect changes in basal CD62P-related activation signals during apheresis platelet storage and can detect ADP-induced platelet activation responses. It has potential value for rapid monitoring of platelet storage quality.

Objective To analyze the reasons and influencing factors for on-site attrition among first-time prospective apheresis platelet donors, develop a retention stratification model, and evaluate the conversion effect of repeated donations within one year. Methods A total of 496 first-time prospective apheresis platelet donors at the Shoushan Blood Donation Room of our center between August 1, 2024 and January 31, 2025 were enrolled. Data on demographic characteristics, donor recruitment channels, and reasons for on-site attrition were collected. Chi-square tests and multivariable logistic regression were applied to identify predictors of donation success. A retention stratification model was constructed based on significant predictors. The situation of repeated donations within one year after the first successful donation was observed. Results The overall on-site attrition rate was 66.9% (332/496). The causes of attrition were health- and procedure-related concerns (38.2%), abnormal blood counts (26.2%), and time constraints (19.0%). Multivariate regression analysis showed that age 18-35 years (odds ratio OR=0.494, P=0.001) and self-initiated recruitment (OR=2.659, P<0.001) were independent predictors of successful donation. There was no significant difference between the organization-organized group and the peer-referral group (P=0.143). The stratified model, derived from age and recruitment channel, demonstrated attrition rates of 47.4%, 67.4%, and 83.5% for the high-, medium-, and low-potential groups, respectively. Among the 164 donors who completed their first time donation, the one-year repeat donation rate was 33.5% (55/164), translating to an overall one-year retention rate of 11.1% (55/496) across the cohort. Self-initiated recruitment was an independent predictor of repeat donation (OR=3.612, P=0.014), while age showed no predictive value (P=0.695). Conclusion Donors younger than 36 years and those recruited through self-initiated channels are associated with higher apheresis platelet donation success rates. Self-initiated recruitment also predicts the likelihood of repeat donation within one year. The retention potential stratification model provides a reference for differentiated donor interventions, which may improve conversion rates and long-term retention of apheresis platelet donors.

Objective To systematically analyze and evaluate the blood donors' real experiences with voluntary blood donation, providing a theoretical basis for the subsequent activities. Methods A qualitative systematic review was conducted by searching Web of Science, PubMed, The Cochrane Library, EmBase, CINAHL, CNKI, CBM, Wanfang, and VIP databases from inception to April 1, 2026. Study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist for qualitative research, followed by meta-analysis of the findings. Results A total of 25 articles were included, yielding 57 distinct findings categorized into 10 categories and synthesized into four integrated findings: (1) complex, intertwined physical and emotional experiences; (2) blood donation decisions influenced by multiple drivers and practical constraints; (3) interpersonal interactions and service experiences during blood donation services, and (4) the formation of sustained donation intention through perceived social support. Based on these findings, a standardized service improvement checklist incorporating specific items adapted for county- and township-level mobile blood collection. construct a standardized service improvement checklist was developed, incorporating specific items adapted for county- and township-level mobile blood collection. Conclusion Blood management authorities should enhance service quality while prioritizing emotional support and donor incentive preferences. Government departments should optimize incentive mechanisms and leverage online platforms for health education. Additionally, developing stratified nursing guidelines tailored for primary care settings will provide practical references, thereby stabilizing the donor base, boosting motivation, and promoting the high-quality, sustainable development of voluntary blood donation.

Objective To analyze the global research status, hotspots and frontier trends of severe fever with thrombocytopenia syndrome (SFTS) from 2011 to 2025, reveal the evolutionary context of knowledge in this field, and explore its significance in blood safety assurance. Methods Chinese and English literatures related to SFTS published from 2011 to 2025 were retrieved from the China National Knowledge Infrastructure (CNKI) and Web of Science (WoS) Core Collection databases. Excel was used to analyze the annual publication volume, and CiteSpace 6.3.R1 software was applied to conduct visual analysis and knowledge mapping of national/institutional cooperation networks, journal and literature co-citation networks. Results A total of 1 309 English literatures and 738 Chinese literatures were included in this study. The annual number of publications both at home and abroad showed a significant overall upward trend from 2011 to 2025, with China ranking first globally with 815 publications. Among the core publishing institutions, the top 5 in terms of publication volume and betweenness centrality were concentrated in China, Japan and South Korea. The top 5 most frequently cited literatures also showed high betweenness centrality, and the top 5 journals by citation frequency covered top general medical journals, infectious disease professional journals and open access journals. Keyword clustering and burst analysis revealed that research hotspots and directions differed between domestic and foreign studies. Conclusion Research on SFTS involves multiple fields including epidemiological investigation, etiological mechanism research, clinical treatment, and natural epidemic focus prevention and control. In the future, systematic research on the risk of bloodborne transmission can be carried out to improve the research layout in this field and enhance the comprehensive prevention and control capacity against SFTS transmission risks.

The plateau environment is characterized by hypoxia, low atmospheric pressure, low temperature and intense ultraviolet radiation. As key effector units participating in thrombosis and vascular injury repair, platelets play a critical role in hemostasis and pathological thrombosis. Aberrant platelet activation is closely associated with the development of various high-altitude disorders. Under hypobaric hypoxic conditions, platelet morphology, adhesion, aggregation and secretion are markedly altered via multiple signaling pathways, thereby inducing enhanced platelet activation.Meanwhile, combined environmental factors on the plateau further aggravate platelet dysfunction and eventually lead to plateau-related disorders. This paper systematically summarizes recent literature pertaining to the correlation between high-altitude exposure and platelet activation, with a particular focus on the underlying molecular mechanisms and the expression profiles of platelet activation markers under such conditions, Additionally, we analyze current research limitations and propose future directions, aiming to provide a basis for both clinical prevention and therapeutic strategies for plateau diseases and to support further fundamental investigations in this field.