The official implementation of the Regulations on Clinical Research and Translation of New Biomedical Technologies (State Council Decree No.818, hereinafter referred to as the "Regulations") marks a new stage of legal governance, standardization, and whole-chain regulation for emerging biomedical fields such as cell and gene therapy (CGT) in China, exerting a profound impact on the development of transfusion medicine as a discipline. Within the framework of the core regulatory systems established by the Regulations, and drawing upon the extensive experience of transfusion medicine in comprehensive quality control, cell processing and handling, ethical compliance, and clinical translation, this study systematically elucidates the intrinsic alignment between transfusion medicine and CGT with respect to technical workflows, quality control rationale, and management systems. It further clarifies the discipline-specific advantages of the department of transfusion medicine to proactively undertake CGT engagement, while analyzing current shortcomings and transformational bottlenecks. By leveraging the existing institutional framework, the department of transfusion medicine is well positioned to evolve into a core platform for whole-process quality control and a pivotal hub for in-hospital clinical translation of CGT. However, this transformation must concurrently address multiple challenges, including heightened compliance responsibilities, lagging technical infrastructure, a shortage of interdisciplinary talent, and increasingly stringent standards for clinical research and translation. The Regulations provide a legal basis and policy support for the department of transfusion medicine to transcend its traditional, singular function of blood safety assurance and establish a synergistic development model integrating blood safety and cell therapy. Therefore, the department of transfusion medicine should proactively align with regulatory requirements, refine whole-process compliance systems, upgrade technical platforms, and cultivate interdisciplinary professionals to achieve high-quality transformative development as a core supporting discipline for biotherapy.

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 correlation between the expression levels of breast cancer metastasis-like transcriptional repressor (BRMS1L), keratin 19 (KRT19), microRNA-101 (miR-101) in surgical resection specimens and postoperative recurrence and metastasis of differentiated thyroid cancer (DTC) .Methods:A total of 186 DTC patients were selected in Shanxi Province Cancer Hospital from Jan. 2021 to Jan. 2023. Their recurrence and metastasis status were assessed in 2 years after surgery, and they were categorized into the recurrence and metastasis group and the non-recurrence and metastasis group. The clinical data of the two groups, as well as the expression levels of BRMS1L, KRT19, and miR-101 in the surgical resection specimens, were compared. Logistic regression analysis was used to investigate the relationship between BRMS1L, KRT19, miR-101 in the surgical resection specimens and postoperative recurrence and metastasis of DTC. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were used to evaluate the predictive value of BRMS1L, KRT19, and miR-101 in the surgical resection specimens for postoperative recurrence and metastasis of DTC, as well as their gain value in constructing predictive models.Results:Among 186 DTC patients were followed up for 2 years postoperatively, 4 were lost to follow-up. Of these, 137 did not experience recurrence or metastasis, while 45 did, resulting in a recurrence and metastasis rate of 24.73% (45/182). The tumor diameter, proportion of stage Ⅲ-Ⅳ, proportion of multiple lesions, and proportion of lymph node metastasis in the recurrent and metastatic group were all higher than those in the non-recurrent and non-metastatic group, while the proportion of postoperative 131I therapy was lower ( P<0.001, P=0.002, P=0.008, P<0.001). The KRT19 mRNA level in the recurrent and metastatic group was higher than that in the non-recurrent and non-metastatic group, while the BRMS1L mRNA and miR-101 levels were lower (both P<0.001). Logistic regression analysis showed that, before and after adjusting for other factors, BRMS1L, KRT19, and miR-101 were independent factors influencing postoperative recurrence and metastasis of DTC (both P<0.001). ROC curves showed that the AUCs of BRMS1L, KRT19, and miR-101 for predicting recurrent metastasis after DTC were 0.776, 0.802, 0.812, with sensitivities of 84.44%, 73.33%, and 84.44%, and specificities of 62.04%, 72.26%, and 79.56%; the R language package was used to construct a conventional prediction model consisting of clinical factors such as tumor diameter, clinical stage, lesion type, lymph node metastasis, and postoperative 131I treatment, and a new prediction model consisting of tumor diameter, clinical stage, lesion type, lymph node metastasis, postoperative 131I treatment, BRMS1L, KRT19, and miR-101. The test results indicated that both prediction models exhibited good fit ( P>0.05). The ROC curve analysis revealed that the AUCs for predicting postoperative recurrence and metastasis in DTC were 0.928 and 0.854 for the new and conventional prediction models, respectively. The sensitivity was 91.11% and 80.00%, and the specificity was 83.94% and 78.83%, respectively. The predictive value of the new prediction model was significantly better than that of the conventional prediction model ( Z=2.011, P=0.044) . Conclusions:The expression levels of BRMS1L, KRT19, and miR-101 in surgically resected specimens are closely correlated with postoperative recurrence and metastasis of DTC, serving as independent influencing factors with good predictive value. Furthermore, they exhibit significant gain value in constructing predictive models.

Objective:To investigate the correlation between the expression levels of breast cancer metastasis-like transcriptional repressor (BRMS1L), keratin 19 (KRT19), microRNA-101 (miR-101) in surgical resection specimens and postoperative recurrence and metastasis of differentiated thyroid cancer (DTC) .Methods:A total of 186 DTC patients were selected in Shanxi Province Cancer Hospital from Jan. 2021 to Jan. 2023. Their recurrence and metastasis status were assessed in 2 years after surgery, and they were categorized into the recurrence and metastasis group and the non-recurrence and metastasis group. The clinical data of the two groups, as well as the expression levels of BRMS1L, KRT19, and miR-101 in the surgical resection specimens, were compared. Logistic regression analysis was used to investigate the relationship between BRMS1L, KRT19, miR-101 in the surgical resection specimens and postoperative recurrence and metastasis of DTC. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were used to evaluate the predictive value of BRMS1L, KRT19, and miR-101 in the surgical resection specimens for postoperative recurrence and metastasis of DTC, as well as their gain value in constructing predictive models.Results:Among 186 DTC patients were followed up for 2 years postoperatively, 4 were lost to follow-up. Of these, 137 did not experience recurrence or metastasis, while 45 did, resulting in a recurrence and metastasis rate of 24.73% (45/182). The tumor diameter, proportion of stage Ⅲ-Ⅳ, proportion of multiple lesions, and proportion of lymph node metastasis in the recurrent and metastatic group were all higher than those in the non-recurrent and non-metastatic group, while the proportion of postoperative 131I therapy was lower ( P<0.001, P=0.002, P=0.008, P<0.001). The KRT19 mRNA level in the recurrent and metastatic group was higher than that in the non-recurrent and non-metastatic group, while the BRMS1L mRNA and miR-101 levels were lower (both P<0.001). Logistic regression analysis showed that, before and after adjusting for other factors, BRMS1L, KRT19, and miR-101 were independent factors influencing postoperative recurrence and metastasis of DTC (both P<0.001). ROC curves showed that the AUCs of BRMS1L, KRT19, and miR-101 for predicting recurrent metastasis after DTC were 0.776, 0.802, 0.812, with sensitivities of 84.44%, 73.33%, and 84.44%, and specificities of 62.04%, 72.26%, and 79.56%; the R language package was used to construct a conventional prediction model consisting of clinical factors such as tumor diameter, clinical stage, lesion type, lymph node metastasis, and postoperative 131I treatment, and a new prediction model consisting of tumor diameter, clinical stage, lesion type, lymph node metastasis, postoperative 131I treatment, BRMS1L, KRT19, and miR-101. The test results indicated that both prediction models exhibited good fit ( P>0.05). The ROC curve analysis revealed that the AUCs for predicting postoperative recurrence and metastasis in DTC were 0.928 and 0.854 for the new and conventional prediction models, respectively. The sensitivity was 91.11% and 80.00%, and the specificity was 83.94% and 78.83%, respectively. The predictive value of the new prediction model was significantly better than that of the conventional prediction model ( Z=2.011, P=0.044) . Conclusions:The expression levels of BRMS1L, KRT19, and miR-101 in surgically resected specimens are closely correlated with postoperative recurrence and metastasis of DTC, serving as independent influencing factors with good predictive value. Furthermore, they exhibit significant gain value in constructing predictive models.

Kleine-Levin Syndrome(KLS)is a rare neurological disease characterized by recurrent episodes of hypersomnia, hyperphagia, hypersexuality, and cognitive and behavioral abnormalities, with complete functional recovery between episodes. Its pathogenesis remains unclear. We report a 33-year-old female with a 17-year clinical course, characterized mainly by recurrent hypersomnia. During episodes, the patient exhibited prominent anorexia, irritability, derealization, and disorientation, followed by brief periods of excitement after episode resolution. Inter-episode periods were entirely normal. Long-term polysomnography monitoring was conducted for a total of 7 792 minutes. Unlike the typical hyperphagia commonly observed in KLS, this case was marked by prominent anorexia, underscoring the clinical heterogeneity of KLS.This report adds to the limited documentation of rare cases in China.

Flow diverter (FD) devices have gradually become the mainstream approach for interventional treatment of intracranial aneurysms. In-stent stenosis (ISS) is a common complication after FD implantation, which can lead to ischemic events and affect the prognosis of patients. Current studies have shown that ISS occurrence is closely related to hemodynamic changes. From the perspective of hemodynamics, this article reviews the research progress of mechanisms, evaluation methods and treatments of ISS after FD implantation, in order to provide reference for clinical practice.

Knee osteoarthritis (KOA) is a prevalent degenerative joint disease characterized by synovial inflammation, cartilage loss. Often manifesting as joint pain and limited mobility, it severely affects the quality of life of patients. Traditional treatment methods such as pharmacological injections and surgical interventions primarily aim to alleviate symptoms but have limited effects on cartilage repair. Human umbilical cord mesenchymal stem cells (hUC-MSCs), due to their anti-inflammatory and chondrogenic capabilities, is considered a new hope for the treatment of KOA. This article synthesizes the latest research findings from both domestic and international sources to discuss the theoretical basis for the clinical application of hUC-MSCs in treating KOA, clinical study design, and efficacy evaluation. It also addresses the challenges in the clinical application of hUC-MSCs and explores future directions, in the hope of providing feasible theoretical support for the treatment of KOA with hUC-MSCs.

[Objective] To explore the strategy of blood management in patients with massive transfusion in the frigid plateau region. [Methods] The treatment process of a patient with liver rupture in the frigid plateau region was analyzed, and the blood management strategy of the frigid plateau region was discussed in combination with the difficulties of blood transfusion and literature review. [Results] The preoperative complete blood count (CBC) test results of the patient were as follows: RBC 3.14×10¹²/L, Hb 10⁶ g/L, HCT 30.40%, PLT 115.00×10⁹/L; coagulation function: PT 18.9 s, FiB 1.31 g/L, DD > 6 μg/mL, FDP 25.86 μg/mL; ultrasound examination and imaging manifestations suggested liver contusion and laceration / intraparenchymal hematoma, splenic contusion and laceration, and massive blood accumulation in the abdominal cavity; it was estimated that the patient's blood loss was ≥ 2 000 mL, and massive blood transfusion was required during the operation; red blood cell components were timely transfused during the operation, and the blood component transfusion was guided according to the patient's CBC and coagulation function test results, providing strong support and guarantee for the successful treatment of the patient. The patient recovered well after the operation, and the CBC test results were as follows: RBC 4.32×10¹²/L, Hb 144 g/L, HCT 39.50%, PLT 329.00×10⁹/L; coagulation function: APTT 29.3 s, PT 12.1 s, FiB 2.728 g/L, DD>6 μg/mL, FDP 25.86 μg/mL. The patient was discharged after 20 days, and regular follow-up reexamination showed no abnormal results. [Conclusion] Individualized blood management strategy should comprehensively consider the patient’s clinical symptoms, the degree of hemoglobin decline, dynamic coagulation test results and existing treatment conditions. Efficient and reasonable patient blood management strategies can effectively improve the clinical outcomes of massive transfusion patients in the frigid plateau region.

In recent years, growing interest has been directed toward the application of platelet derivatives in regenerative medicine, cell therapy and targeted drug delivery. This article analyzes the basis and classification of platelet derivatives, discusses their clinical applications, and addresses main challenges such as the quantification and standardization of preparation process— particularly when used as individualized biologics, as well as the uncertainty and lack of comparability across experimental results. Countermeasures and improvements are provided, suggesting that standardized and normative management may offer new opportunities for the clinical use of platelet derivatives.

Circulating tumor cells (CTCs) have the ability to sow tumors and can be found in the peripheral blood of patients with precancerous lesions and healthy people. However, CTCs are not currently screened in the donors blood. A large number of allogeneic blood transfusions occurred worldwide each year, and allogeneic blood transfusions expose recipients to the risk of transmission and affect tumors associated with donor CTCs. Although leukocyte filtration can not completely remove tumor cells in the blood, it can effectively reduce the number of white blood cells in the blood and reduce their proliferation ability. Blood irradiation can effectively destroy the DNA of CTCs in the blood, and inhibit the occurrence and metastasis of tumors caused by the infusion of allogeneic blood containing CTCs. Therefore, we should pay attention to the potential risk of CTCs on clinical transfusion, and strengthen the preclinical treatment of blood to avoid donor-related tumor infection in blood recipients due to clinical transfusion.