[Objective] To evaluate the in vitro procoagulant efficacy and in vivo potential thrombogenic risk of self-prepared activated prothrombin complex concentrate (aPCC). [Methods] The preparation was administered at a dose of 0.5 IU per milliliter of plasma. For in vitro assays, the self-prepared aPCC concentrate was added to plasma spiked with factorⅧ (FⅧ) inhibitors. Calibrated automated thrombin generation (CAT), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen (Fib) quantification were performed. Normal saline and FEIBA® were set as controls to evaluate the procoagulant capacity of the self-prepared aPCC concentrate. For in vivo animal studies, the self-prepared aPCC concentrate was injected into rats via the jugular vein. A ferric chloride (FeCl3) filter paper patch was applied to induce carotid arterial thrombosis. Laser speckle blood flow imaging was used to continuously monitor thrombus formation in the rat carotid artery. Plasma samples were collected from rats for CAT, PT, APTT, TT and Fib testing, with normal saline and FEIBA® as controls to evaluate the potential thrombogenic risk of the self-prepared aPCC concentrate. [Results] Supplementation with aPCC significantly shortened APTT and PT values in inhibitor-spiked plasma (all P<0.001). There were no statistically significant differences in APTT and PT between FEIBA® and self-prepared aPCC (P>0.05). CAT results demonstrated that adding aPCC to inhibitor-containing plasma markedly increased endoge-nous thrombin potential (ETP) and peak thrombin concentration (Peak) (P<0.001), with both parameters higher than those of normal plasma (P<0.05). No significant intergroup difference in ETP was observed between self-prepared aPCC and FEIBA® (P>0.05). Carotid blood flow imaging in rats revealed that, compared with FEIBA®, thrombi induced by self-prepared aPCC were smaller and less stable, and all underwent spontaneous lysis, accompanied by better restoration of carotid blood perfusion. [Conclusion] The self-prepared aPCC restores coagulation function in inhibitor-spiked plasma to a comparable extent as FEIBA®, while exhibiting a lower thrombogenic risk.
[Objective] To assess the current status of bacterial detection capabilities in various blood collection and supply and related laboratories across China, and to identify key factors affecting the consistency of test results. [Methods] A pooled analysis was conducted on data from 21 external quality assessment (EQA) rounds for blood bacterial detection carried out by the China International Transfusion Infection Prevention and Control (CITIC) project from 2019 to 2025. The study covered three types of laboratories-blood centers, central blood stations, and commercial laboratories—across 23 provincial-level administrative regions in China. Statistics were compiled on the number of participating laboratories, and the concordance rates were calculated for different institution types, different automated blood culture systems, different bacterial concentrations, and different strains. Non-standard reporting issues were also reviewed, and statistical methods were applied for analysis. [Results] Over the seven-year period, the number of participating laboratories increased from 161 to 236, with an average annual growth rate of 6.58%, and the annual concordance rates ranged from 82.61% to 94.92%. The overall laboratory concordance rates for the three types of participating laboratories were all>89.0% (P>0.05), while commercial laboratories showed a significant year-by-year increase (70.97%-100%, P<0.05). The concordance rates of automated blood culture systems from eight manufacturers showed no significant differences (97.98%-100%, P>0.05), indicating stable performance across all devices. The overall sample concordance rate was 98.88%, with negative samples showing a lower rate than positive samples (97.97% vs 99.14%); positive sample rates increased with higher concentrations; and low-concentration Gram-negative bacterial samples had a lower concordance rate than Gram-positive ones (93.15% vs 100%). A total of 50 instances of non-standard result reporting were identified, with incorrect time units accounting for the highest proportion (52.0%). Conclusion The participation scale and overall testing proficiency of blood collection and supply and related laboratories nationwide have improved year by year, and all types of automated blood culture devices can meet the requirements for blood bacterial screening. Detection of negative and low-concentration positive samples remains a weak link in current bacterial EQA, and the standardization of laboratory data reporting requires further strengthening. [Continuous] external quality assessment, targeted training, and standardized reporting procedures can effectively enhance the homogenization level of blood bacterial testing across the country and ensure the safety of clinical transfusion.
[Objective] To explore factors associated with return intention and behavior among young lapsed blood donors from three psychological dimensions: blood donation values, moral identity and internalized responsibility, and to provide a contextualized interpretation of these psychological factors within the traditional Chinese ethical framework of “benevolence-righteousness-virtue”. [Methods] A prospective cohort study was performed among 732 young lapsed blood donors in Hangzhou, China, recruited via stratified random sampling. At baseline, participants completed measures of blood donation values, moral identity and identified regulation. Six months later, return intention was assessed among 344 participants who completed the follow-up survey, while actual return behavior was determined from blood center records for all 732 participants at baseline. Univariate and multivariate logistic regression analyses were used to analyze the predictive effects of these psychological variables on return intention and behavior. [Results] Blood donation motivations varied significantly across participants with different educational levels (P<0.05). Among the 344 participants who completed the follow-up survey, blood donation values, moral identity, and identified regulation were each significantly associated with return intention (P<0.05). These associations remained significant after adjustment for demographic factors (P<0.01). When the three psychological factors were simultaneously entered into the model, only identified regulation remained independently associated with return intention (OR=1.95, 95%CI:1.35-2.82, P<0.001). Among all 732 participants, the three psychological factors were each significantly associated with actual return behavior in univariate and adjusted analyses；however, none remained independently associated with actual return behavior when entered simultaneously into the model (all P>0.05). [Conclusion] Identified regulation may be an important psychological factor underlying the formation of return intention among young lapsed blood donors. From the perspective of the “benevolence - righteousness - virtue” ethical framework, blood donation values, identified regulation, and moral identity represent distinct dimensions of donation motivation, with the dimension of “righteousness” reflected in internalized responsibility, showing a relatively prominent role in return intention. The translation of psychological motivation into actual return behavior may additionally depend on other factors and warrants further investigation.
Objective To analyze the characteristics and key risk factors of abnormal blood disposal throughout the 2024-2025 blood collection and supply process based on nationwide multi-site monitoring data,develop a comprehensive prevention and control strategy across the entire chain,reduce preventable blood waste,and ensure clinical blood safety.Methods According to the Guidelines for Haemovigilance(T/CSBT 001-2026),we extracted 74 cases of abnormal blood disposal events reported by the China Blood Transfusion Association's Blood Safety Monitoring System from January 1 2024,to December 31 2025,and conducted descriptive statistical analysis on the distribution of events,types of deviations,root causes,and classifications of disposal manifestations.Results A total of 664 adverse events related to blood collection and supply were reported over two years,with 74 cases involving discarded abnormal blood units,accounting for 11.1%of the total.Among these,blood component preparation(40.5%)and blood collection(37.8%)remained traditional high-risk stages.The proportion of blood waste occurring during storage,distribution,and transportation increased from 7.7%in 2024 to 34.3%in 2025.Deviations from standard operating procedures(SOP)by personnel were the primary cause,ac-counting for 74.3%of cases.Discarded blood units were categorized into four types:compromised closed blood bag systems(40 cases),mainly due to inadequate heat sealing,physical damage,or dropped bags;blood out of the cold chain(12 ca-ses),primarily resulting from blood being left at work sites;imbalanced proportion of preservation solution(10 cases),mostly caused by blood collection volumes exceeding the standard capacity of blood bags;and other causes(12 cases).Conclusion Human operational errors are the core cause of abnormal blood waste.The collection and preparation stages have long been at high-risk,and the risks in the storage and transportation stages have been increasing year by year.We should focus on standardizing personnel management,improving specialized operation norms such as heat sealing,transpor-tation,and storage,establishing a full-process intelligent cold chain monitoring and multi-node visual verification mecha-nism,and systematically reducing the occurrence rate of abnormal blood waste through a closed-loop quality intervention sys-tem,thereby improving the utilization efficiency of voluntary blood donation resources.
Objective To explore the independent risk factors of allogeneic blood transfusion during perioperative peri-od of cytoreductive surgery in patients with ovarian cancer,and to construct a predictive model to facilitate clinical risk as-sessment and optimize perioperative blood management.Methods Clinical data of 156 patients who underwent cytoreduc-tive surgery for ovarian cancer in our hospital from January 2020 to December 2025 were retrospectively collected.The pa-tients were divided into transfusion group(n=51)and non-transfusion group(n=105)according to whether they received allogeneic blood transfusion during perioperative period.The 1∶1 propensity score matching(PSM)was used to correct the confounding factors.Independent sample t test or Mann-Whitney U test was used for measurement data,and chisquare test was used for enumeration data.Variables with P<0.05 in univariate analysis were included in binary logistic regression for multivariate analysis to determine independent risk factors.A nomogram model for perioperative allogeneic blood transfusion risk prediction was constructed based on independent risk factors.Bootstrap method(100 samples)was used for internal calibration verification.ROC curve was used to evaluate the discrimination efficiency,and decision curve analysis(DCA)was used to evaluate the clinical net benefit of the model.Results After propensity matching,the baseline data of the two groups were balanced and comparable.Multivariate logistic regression analysis showed that preoperative prothrombin time(PT)(OR=2.666,95%CI 1.249～5.693,P=0.011),preoperative hemoglobin(Hb)(OR=0.953,95%CI 0.923～0.984,P=0.003),intraoperative blood loss(OR=1.004,95%CI 1.001-1.006,P=0.004),preoperative anemia grade(OR=3.052,95%CI 1.007-9.252,P=0.049)were independent influencing factors of perioperative allogeneic blood transfusion.The nomogram model based on the above four factors was significant(LR χ2=58.617,P<0.001),and the internal calibration curve showed that the predicted probability of the model was in good agreement with the actual probabili-ty(mean absolute error=0.042).The area under the ROC curve(AUC)was 0.890,indicating good discrimination effi-ciency.DCA showed that the clinical net benefit of the model was better than that of the unified transfusion/non-transfusion strategy in the 0-0.45 risk threshold range.Conclusion Intraoperative blood loss,preoperative PT,preoperative Hb and preoperative anemia grade are independent risk factors for perioperative allogeneic blood transfusion in patients undergoing cytoreductive surgery for ovarian cancer.The nomogram model based on the above factors has good predictive efficacy and clinical hierarchical decision-making value,which can provide reference for clinical implementation of individualized blood management for high-risk patients and reduction of unnecessary blood transfusion rate.
[Objective] To preliminarily explore the microbiome information of apheresis platelets from healthy blood donors in Nanjing, Jiangsu, and to lay the groundwork for further studies on the microbial community composition and diversity in this region. [Methods] Thirteen fresh apheresis platelet samples (5 mL each) were collected from voluntary blood donors at the Nanjing Red Cross Blood Center. After centrifugation and removal of the supernatant, DNA was extracted from the pellet and libraries were constructed. High-throughput sequencing was performed on the Illumina NovaSeq X Plus platform, followed by in-depth bioinformatics analysis. Metagenomic analysis software, including fastp, Bowtie 2, MEGAHIT, Meta-GeneMark, DIAMOND, and Micro_NR, were used to analyze microbial abundance in the apheresis platelet samples. [Results] Using Krona for visualization of species annotation and metagenomic sequencing analysis, after removing the human genome background, a total of 71 phyla, 54 classes, 102 orders, 181 families, 421 genera, and 1 340 species of microbes were identified. Starting from relative abundance tables at different taxonomic levels, at the family level, the top 10 most abundant families were: Flavobacteriaceae; Moraxellaceae; Rhizobiaceae; Sphingomonadaceae; Comamonadaceae; Caulobacteraceae; Burkholderiaceae; Acidimicrobiaceae; Streptomycetaceae; Streptosporangiaceae. At the genus level, the top 10 most abundant genera were: Wenyingzhuangia, Acinetobacter, Aquabacterium, Rhizobium, Brevundimonas, Novosphingobium, Astrithrvirus, Unclassified Rhizobiaceae, Acidiferrimicrobium, and Limnobacter. [Conclusion] Next-generation sequencing (NGS) was used to comprehensively annotate the metagenome of apheresis platelets from voluntary blood donors in Nanjing, Jiangsu, enabling rapid acquisition of extensive microbial data. Exploratory analysis of the blood microbiome in healthy populations provides valuable guidance for developing context-specific measures to prevent platelet bacterial contamination, thereby enhancing blood safety.
[Objective] To analyze population distribution characteristics, routine blood parameters, and independent influencing factors of elevated hemoglobin in overweight red blood cell (RBC) products (suspected polycythemia), and to provide evidence for optimizing pre-donor screening and improving component quality and clinical transfusion safety. [Methods] A total of 82 overweight RBC product cases verified by the quality control department from 2021 to 2025 were retrospectively enrolled. Product information, donor demographic data and blood disposal outcomes were statistically described. Correlation analysis and multiple linear regression were performed on 55 samples with complete routine blood test data. [Results] Overweight products were mainly leukocyte-filtered suspended red blood cells (70.73%), with 2 U specifications accounting for 56.10%. Most donors were young and middle-aged males (96.34% male, 87.80% aged 18-49 years). Hb, RBC count and Hct in the overweight group were significantly higher than those in the control group (all P<0.001), with strong correlations among the three indicators. History of high-altitude exposure was an independent risk factor for elevated Hb (B=14.517, P=0.020). Higher Hb level was associated with higher discard rates of blood products for clinical use. [Conclusion] Overweight RBC products result from synchronous abnormal elevation of Hb, RBC count and Hct among donors. Young and middle-aged males and those with a history high-altitude exposure are high-risk populations. Current donor screening only sets the lower limit of Hb without unified upper limits for RBC-related parameters. Incorporating upper-limit screening for Hb/Hct and standardized inquiry for high-altitude exposure to routine pre-donation assessment may reduce overweight events of RBC products, decrease blood discard rates and enhance transfusion safety. It also offers practical in-sights for implementing the 2026 edition of the Technical Operating Procedures for Blood Stations.
[Objective] To explore the influencing factors of blood transfusion volume in obstetric patients based on the national health development strategy, and to provide evidence for clinical transfusion management and maternal and infant safety. [Methods] A total of 1 203 obstetric patients who received blood transfusion in a tertiary hospital in Beijing from 2013 to 2023 were enrolled retrospectively. Seventeen indicators including age, body mass index (BMI), hemoglobin and prothrombin time were selected as research variables. Descriptive analysis was conducted firstly. Scatter plot matrix was used to analyze the correlation between continuous variables and transfusion volume, and box plots were used to analyze the relationship between categorical variables and transfusion volume. Linear regression, logistic regression and random forest models were established for empirical analysis, and ROC curves and AUC values were compared to evaluate model performance. [Results] Descriptive analysis showed that the distribution of obstetric blood transfusion volume was right-skewed, and multiple indicators were significantly correlated with transfusion volume. Linear regression indicated that 9 variables such as age, BMI and hemoglobin had linear correlation with transfusion volume. Logistic regression confirmed that 7 variables including BMI and hemoglobin were statistically correlated with the probability of massive blood transfusion. Random forest model screened the core influencing factors, which were ranked by importance: hemoglobin, prothrombin time, hematocrit, BMI, activated partial thromboplastin time, platelet count and age. The AUC values of logistic regression and random forest were 0.78 and 0.81 respectively, and the latter had better predictive performance. [Conclusion] Prenatal anemia, coagulation disorders, advanced age, obesity, gestational hypertension, placental abnormalities and organ damage can increase the risk of massive blood transfusion in obstetric patients. The random forest model has better analytical and predictive ability in this study. The results can provide reference for accurate blood transfusion and risk prediction in obstetrics.
[Objective] To establish quality standards for pooled cryoprecipitate based on measured data, addressing the issues of wide variability in coagulation factor content attributable to individual donor differences and imprecise clinical dosing with single-bag cryoprecipitate. [Methods] A total of 120 bags of fresh frozen plasma of different ABO blood groups were enrolled. Single-bag cryoprecipitate was prepared using either the centrifugation method or the siphonage method. For each blood group and each preparation method, every five single units of the same blood group were pooled into one bag of pooled cryoprecipitate. Factor Ⅷ content, fibrinogen content, and volume were measured in source plasma, single-bag cryoprecipitate, and pooled cryoprecipitate. Recovery rates and coefficients of variation were calculated, and the effect of the pooling process on product homogeneity was analyzed. [Results] The factor Ⅷ content, fibrinogen content, and volume of pooled cryoprecipitate were significantly higher than those of single-unit cryoprecipitate and were linearly correlated with the number of units pooled. After pooling, the coefficient of variation for factor Ⅷ content decreased from 34.9%-35.2% (single units) to 18.2%-20.7% (pools), and the coefficient of variation for fibrinogen content decreased from 27.0%-28.6% to 13.1%-13.4%. The pooling procedure had no significant effect on the recovery rates of factor Ⅷ or fibrinogen (P>0.05). [Conclusion] For pooled cryoprecipitate prepared by pooling five single units, the proposed quality standards are: factor Ⅷ content≥400 IU/bag, fibrinogen content≥750 mg/bag, volume 200-250 mL/bag, and sterility test negative. These standards can provide a basis for large-scale preparation and clinical application of pooled cryoprecipitate.
Objective To analyze the structural changes in whole blood and apheresis platelet donations in Chinese So-ciety of Blood Transfusion(CSBT)sentinel units from 2021 to 2025,and to provide evidence for donor recruitment and blood service management.Methods Aggregated data reported by sentinel sites were collected and stratified according to six indicators:age,sex,donation history,donation volume,donation site,and organization mode.Pearson χ2 test,Cramer'V coefficient,Cochran-Armitage trend test and simple linear regression were adopted for analysis.Results A total of 16 256 973 whole blood donations and 1 576 546 apheresis platelet donations were included.Among whole-blood donations,the proportion of donors aged 18-22 years decreased from 27.30%to 10.60%.The proportion of male donors increased from 58.81%to 63.13%;the proportion of people aged 30 and above increased from 58.40%to 75.30%;the proportion of fixed locations rose from 28.37%to 36.57%;the proportion of social groups increased from 21.69%to 39.69%.The 400-mL do-nations decreased from 62.12%to 53.46%,while individually initiated voluntary donations remained above 50%.Aphere-sis platelet donations were predominantly from males,individuals aged 30-39 years,and repeat donors;2-treatment-unit a-pheresis platelet donations increased from 67.19%to 74.93%,and individually initiated donations accounted for 92.97%-96.02%.Statistically significant overall annual compositional differences were observed for all six indicators(all P<0.001),whereas linear trends for some sub-categories were not statistically significant.Conclusion In the participating CSBT sentinel units,among whole blood donations,the proportions of donors aged 18-22 years,university-organized group donations,and donations at blood mobiles decreased,whereas the proportions of organizational group donations and dona-tions at fixed venues increased.The apheresis platelet donation cohort is relatively mature and is evolving toward a high-effi-ciency donation model.Individual voluntary donation remains the primary organization mode for both donation types.Strate-gies such as youth donor recruitment,optimized layout of fixed donation sites,and retention of repeat donors should be strengthened to improve the resilience of blood supply.
[Objective] To explain the healthcare industry standard (WS/T 865-2025) "Basic dataset of blood collection and supply in blood establishments" from the perspectives of project initiation, purpose and significance, compilation methods, and standard content, so as to help blood establishment personnel better understand the standard and facilitate its correct implementation and enforcement. [Methods] Starting from the actual work needs of blood establishments, a technical route combining top-down and bottom-up approaches was designed. Object-oriented modeling technology was adopted to establish an information model. Datasets from existing information systems and blood information standards were collected. After comprehensive evaluation, data subsets were formed and data elements were extracted. Subsequently, the attributes of the data elements were standardized in accordance with published health information data standards. [Results] Eleven data subsets, 170 data elements, 35 allowed values of data elements, and 15 value domain code tables were established. Each subset corresponds to a business process, thus forming a complete data chain. [Conclusion] This standard provides a set of data standards for blood establishment information systems with standardized terms, clear definitions, and unambiguous semantic contexts. It enables the standardization of blood establishment business data collection and thereby lays the foundation for data sharing.
[Objective] To evaluate the operational efficiency of a single-center platelet genotype database in HLA genotype-matched platelet search and applcation, and to compare the efficiency among different matching strategies, hospitals, and between first-time versus repeat application modes. [Methods] Data on platelet genotype-based matching applications from December 1, 2025, to May 31, 2026, at our center were collected. Four time intervals were defined according to the workflow: the time from clinical hospital application to blood center receipt confirmation (Δt1); the time from blood center confirmation to completion of platelet gene database search (Δt2); the time from completion of database searching to availability of compatible platelet products (Δt3); and the time from clinical hospital application to availability of compatible platelet products (Δt4). Applications were classified as first-time or repeat based on application history, and as speed-priority matching strategy or classical matching strategy based on matching approach, with efficiency differences compared across the groups. [Results] A total of 1 051 valid matching applications were included. The median values of Δt1, Δt2, Δt3, and Δt4 were 6.2 h, 0.1 h, 0.2 h, and 11.5 h, respectively. Overall, 55.9% of genotype-based matches resulted in compatible platelets being available on the same day. The median Δt4 of the speed-priority strategy was significantly shorter than that of the classical strategy (5.2 h vs 39.6 h, P<0.001). Median Δt4 differed significantly among hospitals (P<0.001), with the shortest being 4.4 h. The median Δt4 for repeat applications was 6.9 h, significantly shorter than that for first-time applications (27.7 h, P<0.001). [Conclusion] The platelet gene database demonstrates sufficient efficiency in HLA genotype-matched platelet searching and application to meet clinical demands. Optimizing matching strategies and hospital application workflows may shorten the time for obtaining compatible platelets.
[Objective] To investigate the effects of salvianolic acid B (Sal B) on the quality of stored red blood cells (RBC) and to preliminarily explore its underlying mechanisms. [Methods] Whole blood was collected from healthy adult volunteers, and suspended RBC were prepared and stored in MAP (mannitol-adenine-phosphate) solution. The RBC suspensions were divided into a control group and a Sal B group, with the latter supplemented with Sal B at a final concentration of 10 μM. All samples were mixed and stored at 2-6℃. RBC were collected on days 0, 7, 14, 21, 28, and 35 for evaluation. RBC damage was assessed through cell counting, morphological observation, osmotic fragility test, and hemolysis rate measurement. Cytosolic ROS levels and intracellular SOD activity were measured to evaluate oxidative stress. [Results] Sal B helped maintain RBC morphology and osmotic stability, and reduced the generation of morphologically abnormal cells such as spherocytes and echinocytes. On days 28 and 35, the hemolysis rate in the Sal B group was significantly lower than that in the control group. Compared with the control group, the Sal B group exhibited decreased cytosolic ROS levels and increased intracellular SOD activity from day 14 onward. [Conclusion] Sal B alleviates RBC storage lesion by reducing oxidative stress.
[Objective] To develop an automated platelet instance segmentation method for high-throughput structured illumination microscopy (SIM) data, with the goal of improving segmentation accuracy in wide-field bright-field images. [Methods] Bright-field images were used as input to build a YOLOv11-based unified detection-and-segmentation network, trained and inferred with a standardized annotation format. The network consists of a backbone for feature extraction, an improved PAFPN neck for multi-scale feature fusion, and a joint detection/segmentation prediction head, enhancing representation of small targets and crowded scenes. Training was initialized with pretrained weights, using an input resolution of 1 024×1 024 for 200 epochs with a batch size of 4 and automatic mixed precision enabled. Pixels outside the 1st and 99th grayscale percentiles were clipped and linearly mapped to 8-bit intensity values. Data augmentation included flipping, rotation, translation, and scaling. The loss function combined binary cross-entropy loss and Dice loss. [Results] In five-fold cross-validation on the gastric cancer dataset, YOLOv11-m achieved balanced precision and recall, with an mAP50-95 of 0.848. Compared with Mask R-CNN, YOLOv8-m, YOLOv9-c, and YOLO26-m, it used a smaller model size and achieved a total processing time of 14.85 ms per image. When directly transferred to validation sets of cholangiocarcinoma, hepatocellular carcinoma, liver cirrhosis, and ovarian cancer, the model maintained stable detection and segmentation performance, indicating good generalization across data sources and imaging variations. [Conclusion] The proposed method enables high-throughput, robust platelet instance segmentation and effectively handles challenging bright-field scenarios involving small targets, dense distributions, and local overlaps. By balancing segmentation accuracy and inference efficiency, it serves as a reliable preprocessing component in automated platelet image-analysis pipelines.
[Objective] To analyze the time-related factors influencing daily blood donation attendance at fixed donation sites in Nanjing and the heterogeneity among sites, and to provide evidence for optimizing site layout and operational management. [Methods] Based on daily attendance data from 17 fixed donation sites in Nanjing for the full year of 2025, matched with contemporaneous meteorological and air quality data, a two-stage negative binomial generalized linear mixed model (NB-GLMM) was constructed. In the second stage, site-level static characteristics (number of scenic spots, daily operating hours, number of shopping malls, public transport stops, hospitals, universities, and residential buildings) were additionally incorporated. Model comparison was performed using Akaike information criterion (AIC). Significance of random effects was tested by likelihood ratio test, and site-specific random effects were extracted using empirical Bayes estimation. Robustness of the results was verified through residual diagnostics and multiple sensitivity analyses. [Results] The first-stage model showed that rainfall was associated with lower attendance (IRR=0.943, P<0.001); holidays were associated with higher attendance (IRR=1.162, P<0.001); Saturdays and Sundays showed higher attendance than Mondays, with the strongest association on Sundays (IRR=1.195, P<0.001). Temperature exhibited a non-linear relationship (linear term P=0.051, quadratic term P=0.036). The joint results of the linear and quadratic terms for temperature suggested a nonlinear relationship between attendance and temperature. After introducing static characteristics in the second stage, the number of scenic spots (IRR=1.372, P=0.008) and daily operating hours (IRR=1.823, P<0.001) were found to be positively associated with attendance, while the numbers of shopping malls, public transport stops, hospitals, universities, and residential buildings showed no significant effects. [Conclusion] Daily blood donation attendance at fixed sites in Nanjing is influenced by multiple factors including weather, day of the week, holidays, and site surroundings. Substantial heterogeneity exists among different sites; extended operating hours and more nearby scenic spots are associated with increased attendance.
[Objective] To evaluate the safety and efficacy of transfusing apheresis platelets from an anti-M-positive donor. [Methods] A retrospective analysis was conducted on two units of apheresis platelets collected from a single anti-M-positive donor at Chongqing Blood Center of the Chinese People’s Liberation Army. These platelets were transfused into two unexpected antibodies-negative patients with hematological diseases at the First Affiliated Hospital of the Army Medical University. In vitro, the quality of the anti-M-positive low-plasma apheresis platelets was analysed. In vivo, transfusion efficacy and safety was observed. [Results] Following transfusion of anti-M-positive plasma-depleted platelets, the platelet counts of the two patients increased from 13 and 5×109/L to 24 and 18×109/L, respectively. The CCI24hvalues were 7.02 and 9.10, both exceeding 4.5. The transfusions were effective, and no transfusion-related adverse reactions occurred in either patient. [Conclusion] Anti-M-positive apheresis platelets can be used clinically after plasma removal.
[Objective] To evaluate the methodological quality and reporting quality of clinical practice guidelines or expert consensus on blood transfusion and blood use (BTBU) in China (hereinafter referred to as "guidelines/consensus"), providing reference for the development and updating of future BTBU guidelines/consensus. [Methods] A systematic search was conducted in Chinese databases such as China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP Data-base, relevant guideline release platforms, and professional association websites. BTBU-related guidelines/consensus published between January 2006 and December 2025 were included. According to the inclusion and exclusion criteria, after completing literature screening and data extraction, three evaluators independently assessed the quality of the included literature using the Scientificity, Transparency, and Applicability of Guidelines Rating Tool (STAR), the Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ), and the International Practice Guideline Reporting Standards (RIGHT). [Results] A total of 29 documents were included, including 5 guidelines, 22 consensus statements, and 2 protocols. The results of the STAR assessment showed that the total score was (21.7±8.8)%. The domain score ratios for registration, research protocol, funding, working group, conflict of interest, clinical question, evidence, consensus method, recommendation, accessibility and other domains were (2.2±12.1)%, 0, (36.7±25.1)%, (18.3±7.6)%, (19.2±15.3)%, (16.6±23.1)%, (15.1±6.3)%, (9.6±21.2)%, (54.3±18.4)%, (31.7±10.4)% and (10.3±31.0)%, respectively. For the AGREE Ⅱ assessment, the methodological quality of 26 articles was rated Grade B and 3 articles Grade C. The results of the RIGHT assessment indicated that the overall reporting rate of all guidelines/consensuses was (65.3±4.0)%. [Conclusion] The methodological and reporting quality of current expert guidelines/consensus on BTBU in China still need improvement, and guidelines and consensus should be strictly formulated and standardized according to the standards of STAR, AGREE II and RIGHT.
Platelet-derived exosomes (PLT-Exos) are a subgroup of nanoscale extracellular vesicles released by platelets upon activatin. As key intercellular signaling mediators, they precisely regulate target cells through the delivery of functional molecules, exerting multiple biological effects that promote tissue repair. Accumulating evidence has demonstrated that PLT-Exos significantly facilitate the repair of various tissue injuries by modulating inflammatory responses, stimulating angiogenesis, activating key repair signaling pathways, and mediating stem cell homing. Furthermore, owing to their inherent targeting capacity and low immunogenicity, PLT-Exos have emerged as a promising platform for novel drug delivery carriers in tissue repair. This article systematically reviews the biological characteristics of PLT-Exos, their isolation and identification techniques, the underlying mechanisms of action, and recent advances in clinical application. It also addresses the current challenges in clinical translation, including standardized preparation, subpopulation heterogeneity, scalable production, and clinical implementation, aiming to provide a theoretical reference for both basic research and clinical translation of PLT-Exos in tissue repair.
[Objective] To investigate the technical considerations and clinical value of plasma exchange (PE) in the treatment of cardiohepatic syndrome (CHS). [Methods] A 76-year-old male patient with CHS was treated. The patient’s underlying conditions included valvular heart disease (severe mitral and tricuspid regurgitation), chronic heart failure (cardiac function class IV) complicated with liver failure [total bilirubin (TBIL) up to 590.6 μmol/L; alanine aminotransferase (ALT) up to 325.4 IU/L; aspartate aminotransferase (AST) up to 190.4 IU/L]. Due to poor response to conventional anti-heart failure and hepatoprotective therapy, three sessions of stepwise PE (total volume 6 400 mL) were performed. A "calcium-fluid balance-hemodynamics“ trinity monitoring system was established during treatment, comprising:1) prophylactic calcium supplementation (continuous calcium infusion at 5 mL/h initiated before PE); 2) dynamic blood gas monitoring (ionized calcium measured every 30-60 min with calcium dose adjusted accordingly); 3) individualized fluid balance setting (75%-90%); 4) standby norepinephrine (0.02-0.1 μg/kg/min). [Results] Complications such as hypocalcemia (lowest 0.83 mmol/L) and hypotension (lowest 65/38 mmHg) occurred during treatment. Hemodynamics were stabilized by adjusting calcium supplementation, regulating fluid balance, and concomitant use of vasoactive agents. After treatment, B-type natriuretic peptide (BNP) decreased by 42.0% (from 7 122.53 pg/mL to 4 128.77 pg/mL), TBIL decreased by 69.7% (from 590.6 μmol/L to 178.7 μmol/L), ALT decreased by 91.8% (from 325.4 IU/L to 26.7 IU/L), and AST decreased by 83.2% (from 190.4 IU/L to 31.9 IU/L). [Conclusion] PE based on the "calcium-fluid balance-hemodynamics" trinity monitoring system can improve cardiac and liver function in patients with CHS.
