1.Perioperative immune dynamics and clinical outcomes in patients undergoing on-pump cardiac surgery
Zhiyuan CHENG ; Xinyi LIAO ; Juan WU ; Ping YANG ; Tingting WANG ; Qinjuan WU ; Wentong MENG ; Zongcheng TANG ; Jiayi SUN ; Jia TAN ; Jing LIN ; Dan LUO ; Hao WANG ; Chaonan LIU ; Jiyue XIONG ; Liqin LING ; Jing ZHOU ; Lei DU
Chinese Journal of Blood Transfusion 2026;39(1):31-43
Objective: To characterize perioperative dynamic changes in immune-cell phenotypes and inflammatory cytokines in patients undergoing CPB (cardiopulmonary bypass) cardiac surgery, and to explore their associations with postoperative outcomes. Methods: In this prospective cohort study, 120 adult patients who underwent elective cardiac surgery under CPB at West China Hospital from May 2022 to March 2023 were enrolled. Perioperative immune-cell phenotypes and concentrations of 40 inflammation-related cytokines were measured. The primary outcomes were the sequential organ failure assessment (SOFA) score at 24 h after surgery and ΔSOFA (the peak SOFA score within 48 h after surgery minus the preoperative SOFA score). Secondary outcomes included major adverse cardiovascular events (MACE), acute kidney injury (AKI), respiratory failure, severe liver injury, and infection. Results: The mean age of enrolled patients was 57±10 years. Of these, 52% (62/120) were male and 90% (108/120) underwent valve surgery. During the rewarming to the end of CPB, neutrophil counts rapidly increased (7.39×10
/L vs preoperative 3.07×10
/L, P<0.001), with significant upregulation of CD11b (7.30×10
/L vs preoperative 3.05×10
/L, P<0.001) and CD54 (7.15×10
/L vs preoperative 2.99×10
/L, P<0.001). Lymphocyte counts increased at the end of CPB (1.75×10
/L vs preoperative 1.12×10
/L, P<0.001) but decreased significantly at 24 h after surgery (0.59×10
/L vs preoperative 1.12×10
/L, P<0.001). Plasma analysis showed that multiple pro-inflammatory cytokines increased during CPB and remained elevated up to 24 h after surgery; five chemokines and the anti-inflammatory cytokine IL-10 peaked at the end of CPB. The SOFA score increased from 1 (1, 2) preoperatively to 7 (5, 10) at 24 h after surgery, with a ΔSOFA of 6 (4, 8). Within 30 days after surgery, 48 patients (40.0%) developed AKI, 17 (14.2%) developed infection, 4 (3.3%) developed severe liver injury, 3 (2.5%) developed respiratory failure, and 3 (2.5%) experienced MACE. During the 2-year follow-up, 8 patients (6.7%) experienced MACE and 5 (4.2%) died. Conclusion: Multi-organ dysfunction is common after cardiac surgery under CPB (median ΔSOFA, 6), accompanied by perioperative activation of multiple immune-cell subsets and upregulation of pro-inflammatory, anti-inflammatory, and chemotactic mediators. This study provides data-driven evidence and research clues for further investigation of the associations between CPB-related immune perturbations and postoperative organ dysfunction and clinical outcomes.
2.A retrospective cohort analysis on the association between blood donation intervals and adverse reactions to blood donation in Shenzhen, China
Li NING ; Yanyan ZHANG ; Jinfeng ZENG ; Jingya HUANG ; Liqin HUANG ; Xuqun WU ; Litao WU
Chinese Journal of Blood Transfusion 2026;39(3):346-352
Objective: To statistically analyze the association between blood donation intervals and the incidence of adverse reactions to blood donation based on blood donor data from Shenzhen. Methods: Basic data and records of adverse reactions to blood donation among voluntary whole blood donors in Shenzhen from January 2017 to June 2025 were extracted. A total of 795 404 whole blood donations were recorded, including 502 743 from males and 292 661 from females, with 1 088 and 751 cases of adverse reactions, respectively. Analyses were performed using R software, including restricted cubic spline (RCS), binary logistic regression, and generalized estimating equations (GEE) to evaluate the correlation between donation intervals and adverse reactions. Results: A total of 1 839 cases of adverse reactions were recorded, accounting for 0.23% of the total donations. Both binary logistic regression analysis and the generalized estimating equations (GEE) model showed that there was no significant difference in the incidence of adverse reactions between male and female donors with an interval of ≥6 months compared to those with an interval of ≥3 months but<6 months. Furthermore, using the 3-5 month interval group as the reference, the analysis indicated that the incidence of adverse reactions significantly increased in males with a 9-12 month interval, while no statistically significant differences were observed across any of the female subgroups. Conclusion: There was no significant correlation between adverse reactions to blood donation and the donation interval. Compared with a donation interval of ≥6 months, an interval of<6 months does not lead to an increase in the incidence of adverse reactions among male or female donors. The findings of this study may help enhance the willingness of blood donors to participate.
3.A retrospective cohort analysis on the association between blood donor age and adverse reactions to blood donation in Shenzhen
Litao WU ; Yanyan ZHANG ; Jinfeng ZENG ; Jingya HUANG ; Liqin HUANG ; Xuqun WU ; Li NING
Chinese Journal of Blood Transfusion 2026;39(3):353-359
Objective: To statistically analyze the association between blood donor age and the incidence of adverse reactions based on whole blood donor data from Shenzhen. Methods: Data on basic characteristics and records of adverse donation reactions among voluntary whole blood donors in Shenzhen from January 2017 to June 2025 were extracted. A total of 795 404 whole blood donations were recorded, including 502 743 from males and 292 661 from females, with 1 088 and 751 cases of adverse reactions, respectively. Analyses were performed using R software, including restricted cubic spline (RCS) analysis, binary logistic regression, and generalized estimating equations (GEE) to evaluate the correlation between donor age and adverse reactions. Results: A total of 1 839 cases of adverse reactions were recorded, accounting for 0.23% of the total donations. Both binary logistic regression and GEE model revealed that, compared with the≤55 years age group, the incidence of adverse reactions was reduced in both male and female donors in the >55 years age group, with the difference being statistically significant in males. Using the <23 years age group as a reference, the incidence of adverse reactions significantly decreased in both male and female donors across the 23-30, 31-40, 41-50, and 51-60 age groups, with the differences being statistically significant. Conclusion: There is a negative correlation between the rate of adverse donation reactions and age, with the incidence of such reactions among whole blood donors over 55 years old being no higher than that among donors aged 55 years or younger. These findings carry positive significance for safeguarding the donation rights of older donors and meeting clinical blood demand.
4.An exploratory study on the quality analysis and thin layer identification of Baohe Pills in 33 batches
Na WANG ; Lixia HAO ; Qianqian CHEN ; Liqin WU ; Yana ZHAO
Drug Standards of China 2025;26(4):439-443
objective:Thirty-three batches of Baohe Pill were subjected to quality analysis and exploratory study based on the test results.Methods:According to the methods in Chinese Pharmacopoeia,2020 Edition,Part Ⅰ and Ⅳ,the full-item chemical tests were conducted on Baohe Pill,and the exploratory study on the identification(2)method of Baohe Pill was conducted based on the method of Forsythia identification(2)in Chinese Pharmaco-poeia,2020 Edition,Part Ⅰ.Results:All the tested items in the 33 batches of samples were qualified,and the exploratory study on Baohe Pill based on the Forsythia herb also yielded satisfactory results.Conclusion:The qual-ity of Baohe Pill produced by various manufacturers can meet the requirements of Chinese Pharmacopoeia,ensuring the safe and effective use of drugs by the people.Through more extensive and thorough investigation,it is proposed to explore whether the identification(2)method of Baohe Pill in Chinese Pharmacopoeia needs to be optimized.
5.An exploratory study on the quality analysis and thin layer identification of Baohe Pills in 33 batches
Na WANG ; Lixia HAO ; Qianqian CHEN ; Liqin WU ; Yana ZHAO
Drug Standards of China 2025;26(4):439-443
objective:Thirty-three batches of Baohe Pill were subjected to quality analysis and exploratory study based on the test results.Methods:According to the methods in Chinese Pharmacopoeia,2020 Edition,Part Ⅰ and Ⅳ,the full-item chemical tests were conducted on Baohe Pill,and the exploratory study on the identification(2)method of Baohe Pill was conducted based on the method of Forsythia identification(2)in Chinese Pharmaco-poeia,2020 Edition,Part Ⅰ.Results:All the tested items in the 33 batches of samples were qualified,and the exploratory study on Baohe Pill based on the Forsythia herb also yielded satisfactory results.Conclusion:The qual-ity of Baohe Pill produced by various manufacturers can meet the requirements of Chinese Pharmacopoeia,ensuring the safe and effective use of drugs by the people.Through more extensive and thorough investigation,it is proposed to explore whether the identification(2)method of Baohe Pill in Chinese Pharmacopoeia needs to be optimized.
6.Performance evaluation of AI-enabled blood cell morphology system for peripheral blood smear and application in grading screening network of primary medical care system
Xiaobing SUN ; Gusheng TANG ; Kaiying YUAN ; Duanqin DIAO ; Jun HU ; Xiaoyuan SHI ; Hao YUAN ; Anmei WANG ; Yan FANG ; Liqin JIANG ; Xueliang QIN ; Chun XU ; Qi HOU ; Jiong WU
Chinese Journal of Clinical Laboratory Science 2025;43(4):246-252
Objective To evaluate the recognition capability of AI-enabled Cellsee CS-BM1 automatic cell morphology analyzer for pe-ripheral blood smears and its roles in assisting manual classification,and explore the application value of AI system in the diagnosis network of tiered primary medical units.Methods The blood samples which triggered the re-examination rules were collected from six primary medical units,including the Laboratory Department of Shanghai Jiahui International Hospital,and so on,from March to No-vember 2023.The smears of peripheral blood were prepared and AI analyzer was used for pre-classification to evaluate its recognition performance in identifying the samples with abnormal WBC and RBC.The sensitivity,specificity,and accuracy of WBC classification by six junior and intermediate technicians,both with and without AI assistance,were analyzed.Additionally,the roles of the AI system in tiered diagnosis of primary medical units were also evaluated.Results The sensitivity,specificity,and accuracy of AI system in recognizing malignant primitive cells were 92.86%,95.16%,and 95.10%,respectively.The sensitivities of AI system in recognizing immature granulocytes,reactive lymphocytes,and nucleated RBCs were all greater than 90%.The sensitivity of AI system in identif-ying abnormal morphology of RBCs reached 99.59%,along with rapid quantitative analysis for various anomalous types of RBCs.In AI-assisted mode,the sensitivity of recognition for all cell types was improved to varying degrees by junior and intermediate technicians,and the sensitivity for recognizing malignant primitive cells,reactive lymphocytes,and immature granulocytes increased to 58.24%,53.39%,and 62.37%for junior technicians,and to 92.06%,83.24%,and 83.12%for intermediate technicians,respectively.The improvements for junior technicians were particularly significant,with increases of 12.46%,10.61%,and 3.71%for each cell type,respectively.Both groups achieved higher specificity and accuracy.Through AI pre-classification and manual review,a variety of pe-ripheral blood cell-related diseases were accurately diagnosed in the tiered healthcare practice of primary medical units,including 339 cases(11.13%)of red blood cell diseases,5 cases(0.16%)of platelet diseases,2 343 cases(76.90%)of infection-related disea-ses,and 28 cases(0.92%)of malignant hematological diseases.In addition,332 cases(10.90%)which lacked an obvious related cause or required further examinations were identified as well.Conclusion AI pre-classification has demonstrated strong cell recogni-tion capabilities and may assist technicians in improving the sensitivity,specificity,and accuracy of blood cell classification.AI could en-hance the disease-screening capabilities in the tiered diagnosis network of primary medical units,presenting a broad application prospect.
7.Performance evaluation of AI-enabled blood cell morphology system for peripheral blood smear and application in grading screening network of primary medical care system
Xiaobing SUN ; Gusheng TANG ; Kaiying YUAN ; Duanqin DIAO ; Jun HU ; Xiaoyuan SHI ; Hao YUAN ; Anmei WANG ; Yan FANG ; Liqin JIANG ; Xueliang QIN ; Chun XU ; Qi HOU ; Jiong WU
Chinese Journal of Clinical Laboratory Science 2025;43(4):246-252
Objective To evaluate the recognition capability of AI-enabled Cellsee CS-BM1 automatic cell morphology analyzer for pe-ripheral blood smears and its roles in assisting manual classification,and explore the application value of AI system in the diagnosis network of tiered primary medical units.Methods The blood samples which triggered the re-examination rules were collected from six primary medical units,including the Laboratory Department of Shanghai Jiahui International Hospital,and so on,from March to No-vember 2023.The smears of peripheral blood were prepared and AI analyzer was used for pre-classification to evaluate its recognition performance in identifying the samples with abnormal WBC and RBC.The sensitivity,specificity,and accuracy of WBC classification by six junior and intermediate technicians,both with and without AI assistance,were analyzed.Additionally,the roles of the AI system in tiered diagnosis of primary medical units were also evaluated.Results The sensitivity,specificity,and accuracy of AI system in recognizing malignant primitive cells were 92.86%,95.16%,and 95.10%,respectively.The sensitivities of AI system in recognizing immature granulocytes,reactive lymphocytes,and nucleated RBCs were all greater than 90%.The sensitivity of AI system in identif-ying abnormal morphology of RBCs reached 99.59%,along with rapid quantitative analysis for various anomalous types of RBCs.In AI-assisted mode,the sensitivity of recognition for all cell types was improved to varying degrees by junior and intermediate technicians,and the sensitivity for recognizing malignant primitive cells,reactive lymphocytes,and immature granulocytes increased to 58.24%,53.39%,and 62.37%for junior technicians,and to 92.06%,83.24%,and 83.12%for intermediate technicians,respectively.The improvements for junior technicians were particularly significant,with increases of 12.46%,10.61%,and 3.71%for each cell type,respectively.Both groups achieved higher specificity and accuracy.Through AI pre-classification and manual review,a variety of pe-ripheral blood cell-related diseases were accurately diagnosed in the tiered healthcare practice of primary medical units,including 339 cases(11.13%)of red blood cell diseases,5 cases(0.16%)of platelet diseases,2 343 cases(76.90%)of infection-related disea-ses,and 28 cases(0.92%)of malignant hematological diseases.In addition,332 cases(10.90%)which lacked an obvious related cause or required further examinations were identified as well.Conclusion AI pre-classification has demonstrated strong cell recogni-tion capabilities and may assist technicians in improving the sensitivity,specificity,and accuracy of blood cell classification.AI could en-hance the disease-screening capabilities in the tiered diagnosis network of primary medical units,presenting a broad application prospect.
8.Cost-utility analysis of HIV screening in blood donors using a decision-tree Markov model
Liqin HUANG ; Lilin WANG ; Linfen WU ; Jiahui ZUO ; Jinfeng ZENG
Chinese Journal of Blood Transfusion 2025;38(7):958-963
Objective: To develop a comprehensive health economics evaluation model for HIV blood screening using Markov modeling, so as to evaluate the quality-of-life adjustment years (QALYs) gained by transfusion recipients after implementation of blood HIV screening. Methods: Shenzhen Blood Center was selected as the validation case for model development. Based on historical HIV screening data of Shenzhen Blood Center and published literature, the health economics evaluation of donor HIV screening was performed using cost-utility analysis. The single factor sensitivity analysis was performed on parameters in the model. Results: 3.09 QALYs were gained for each transfusion recipient prevented from HIV infection. During 2020-2023, donor HIV screening at Shenzhen Blood Center saved 506.76 QALYs, and each QALY saved 182 900 yuan. Conclusion: From the perspective of long-term benefit of transfusion recipients, HIV screening of blood donors demonstrates high health and economic value.
9.Cost-utility analysis of HIV screening in blood donors using a decision-tree Markov model
Liqin HUANG ; Lilin WANG ; Linfen WU ; Jiahui ZUO ; Jinfeng ZENG
Chinese Journal of Blood Transfusion 2025;38(7):958-963
Objective: To develop a comprehensive health economics evaluation model for HIV blood screening using Markov modeling, so as to evaluate the quality-of-life adjustment years (QALYs) gained by transfusion recipients after implementation of blood HIV screening. Methods: Shenzhen Blood Center was selected as the validation case for model development. Based on historical HIV screening data of Shenzhen Blood Center and published literature, the health economics evaluation of donor HIV screening was performed using cost-utility analysis. The single factor sensitivity analysis was performed on parameters in the model. Results: 3.09 QALYs were gained for each transfusion recipient prevented from HIV infection. During 2020-2023, donor HIV screening at Shenzhen Blood Center saved 506.76 QALYs, and each QALY saved 182 900 yuan. Conclusion: From the perspective of long-term benefit of transfusion recipients, HIV screening of blood donors demonstrates high health and economic value.
10.Analysis of abnormal ALT in blood donors in five Zang autonomous prefectures of Qinghai Province, China: characteristics and screening strategies
Yingnan DANG ; ; Rong TANG ; Liqin HUANG ; Hailin WU ; Tingting CHEN ; Shengju LI ; Yanli SUN ; Xin ZHENG ; Yanxia LI ; Xianlin YE ; Jinfeng ZENG
Chinese Journal of Blood Transfusion 2025;38(4):502-507
[Objective] To investigate the factors associated with alanine aminotransferase (ALT) abnormalities in multi-ethnic blood donors across five Zang autonomous prefectures in the plateau regions of Qinghai Province, and to provide evidence for ensuring blood safety and formulating screening strategies. [Methods] A retrospective analysis was performed on the ALT abnormal test results of blood donors in the Zang autonomous prefectures of Qinghai from 2022 to 2024. The correlations between ALT levels and factors including gender, age, altitude, and infectious markers were investigated. [Results] The overall ALT unqualified rate among blood donors in this region was 9.01%. Significant differences in ALT levels were observed across genders and age groups (P<0.05). Variations in ALT abnormality rates were also noted among different plateau regions (P<0.05). Overall, ALT values exhibited an increasing trend with rising altitude. The average ALT unqualified rates were 11.19% in Zang donors, 7.96% in Han donors, and 4.79% in donors from other ethnic groups (P<0.05). No statistically significant association was observed between ALT abnormality and the presence of HBV/HCV infectious markers (P>0.05). [Conclusion] In the plateau areas of Qinghai, multi-ethnic blood donors have a relatively high ALT levels and ALT unqualified rates, showing distinct regional characteristics. ALT elevation in voluntary blood donors is related to non-pathological factors such as gender, age, and dietary habits, but not to infectious indicators.

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