Objective: To review the current development of artificial intelligence (AI) technology in the field of transfusion medicine. Methods: A systematic search was conducted in the Clarivate Web of Science Database from inception to December 2024 for literature related to AI and transfusion. A total of 4 775 publications were identified. Based on inclusion and exclusion criteria, 133 original studies were ultimately included and analyzed using a narrative synthesis approach. Results: Research on AI in transfusion has surged since 2020 (accounting for 77% of all publications), with China ranking second globally in publication volume. Among the included studies, 69.2% focused on predicting individual transfusion needs, followed by inventory management (8.3%), diagnosis and prediction of adverse transfusion reactions (6.0%), factors influencing transfusion outcomes (5.3%), blood group identification (5.3%), blood quality testing (4.5%), and precise blood volume measurement (1.5%). Additionally, 4.5% of the studies were published in journals with an impact factor greater than 10; 19.5% developed software or applications; 31.5% were multi-center studies; 48.1% utilized decision tree methods, while 31.5% employed neural network approaches; and 14.2% conducted external validation of the algorithms. Conclusion: AI demonstrates significant potential in transfusion risk prediction, decision support, and blood management. However, challenges remain, including limited model generalizability, insufficient algorithm interpretability, and barriers to clinical translation. The deep integration of AI with transfusion medicine will accelerate the advent of precision transfusion era, maximizing blood resource utilization, reducing waste, and ensuring transfusion safety.

Objective:To establish a rapid and precise dose measurement method with EBT4 film and ensure its measurement accuracy to be within the required range through strict operational procedures for the purpose of addressing the two essential issues of poor measurement accuracy and timeliness of EBT film under FLASH conditions.Methods:After storing under different humidity conditions for a certain period of time, the film was exposed to radiation for analyzing the influence of air humidity on the intrinsic performance of EBT film. By means of repeated scanning operations and the film angle rotation, the influences of repeated scanning and film placement angle were analuzed. Parabolic correction method was used to reduce the spatial position influence during the scanning process. By analying the relationship between net optical density (netOD) and absorbed dose through the comparison of three fitting method, the optimal fitting curve was selected. After irradiation of the same batch of films for 5 min and 24 h, the film doses were calibrated and then compared with ionization chamber-measured result. The rapid and precise film dosimetry method was used to measure both the percentage depth dose from X-rays at ultra-high dose rate and the dose distribution at a depth of 2 cm in water.Results:Air humidity had the greatest influence on the intrinsic performance of EBT film (approximately 20%). The average deviation of repeated scans is within 0.5%. The angle at which the film is placed significantly affected the readouts of the film with the maximum influence approximately 70%. The net optical density combined with polynomial fitting can control the fitting residuals of 1-16 Gy within 3%. The change rate of light channels at 5 min already mostly met the requirements of the rapid mode (< 0.5%). Compared with the measurement result obtained using the reference ionization chamber, the deviations of the 5 min or 24 h dose calibration curves were all within 2%.Conclusions:The EBT4 film can be employed as a precise dosimeter to quickly measure the FLASH radiation dose. Rapid and precise FLASH dose measurements can meet the stringent requirements of both preclinical and clinical FLASH research.

Epicutaneo-cava catheters(ECC)placement plays an important role in fluid management,drug therapy and nutritional support in very low birth weight infants(VLBWI).This study reviews the selection of ECC catheters,preparation for ECC catheterization,catheterization procedures,catheter positioning and tracking,and revelations and recommendations in light of the clinical needs of VLBWI,with the aim of optimizing the clinical management of VLBWI,increasing the success rate of ECC catheterization in NICUs,decreasing the risk of complications,improving the prognosis of the children,and enhancing the quality of their clinical care.

Objective To explore the clinical infection distribution and antifungal resistance characteristics of the Stephanoascusciferrii(S.ciferrii)complex.Methods Clinical fungal culture and isolation data from Nanjing Drum Tower Hospital from 2012 to 2023 were retrospectively analyzed.The annual isolation quantity,proportion,and distribution of infection sites of S.ciferrii were statistically analyzed.The minimum inhibitory concentrations(MICs)of isolated strains against common antifungal agents were detected by ATB Fungus 3 fungal susceptibility test kit,and their resistance was analyzed.Results From 2012 to 2023,a total of 26 602 fungal strains were isola-ted in this hospital,including 79 strains of the S.ciferrii complex.Compared with 2012-2017,the isolation rate of S.ciferrii complex increased from 2018 to 2023(0.06％vs 0.43％,P＜0.001).There were 69 cases of super-ficial infection,including infection of ear canal(n=67)and skin(n=2).92.75％(n=64)of the patients were im-munocompetent individuals.There were 10 cases of invasive infection,including infection of urinary tract(n=5),respiratory tract(n=2),biliary tract(n=1),pacemaker pouch(n=1),and vagina(n=1).70.00％of the pa-tients had other underlying diseases,including 3 cases of immunosuppressed patients who died due to combined in-fection with the S.ciferrii complex.The MICs detection results showed that the MIC50 and MIC90 of fluconazole were 32 μg/mL and 128 μg/mL,respectively;the MIC50 and MIC90 of amphotericin B were 0.5 μg/mL and 2 μg/mL,respectively.Conclusion S.ciferrii complex mainly causes ear canal infection and has the dual pathogenic ability to cause superficial and invasive infection.The isolated strains showed higher MIC values for fluconazole and lower MIC values for amphotericin B.The mortality is high in immunosuppressed patients combined with invasive infec-tion caused by S.ciferrii.

Objective To explore the clinical infection distribution and antifungal resistance characteristics of the Stephanoascusciferrii(S.ciferrii)complex.Methods Clinical fungal culture and isolation data from Nanjing Drum Tower Hospital from 2012 to 2023 were retrospectively analyzed.The annual isolation quantity,proportion,and distribution of infection sites of S.ciferrii were statistically analyzed.The minimum inhibitory concentrations(MICs)of isolated strains against common antifungal agents were detected by ATB Fungus 3 fungal susceptibility test kit,and their resistance was analyzed.Results From 2012 to 2023,a total of 26 602 fungal strains were isola-ted in this hospital,including 79 strains of the S.ciferrii complex.Compared with 2012-2017,the isolation rate of S.ciferrii complex increased from 2018 to 2023(0.06％vs 0.43％,P＜0.001).There were 69 cases of super-ficial infection,including infection of ear canal(n=67)and skin(n=2).92.75％(n=64)of the patients were im-munocompetent individuals.There were 10 cases of invasive infection,including infection of urinary tract(n=5),respiratory tract(n=2),biliary tract(n=1),pacemaker pouch(n=1),and vagina(n=1).70.00％of the pa-tients had other underlying diseases,including 3 cases of immunosuppressed patients who died due to combined in-fection with the S.ciferrii complex.The MICs detection results showed that the MIC50 and MIC90 of fluconazole were 32 μg/mL and 128 μg/mL,respectively;the MIC50 and MIC90 of amphotericin B were 0.5 μg/mL and 2 μg/mL,respectively.Conclusion S.ciferrii complex mainly causes ear canal infection and has the dual pathogenic ability to cause superficial and invasive infection.The isolated strains showed higher MIC values for fluconazole and lower MIC values for amphotericin B.The mortality is high in immunosuppressed patients combined with invasive infec-tion caused by S.ciferrii.

Objective:To establish a rapid and precise dose measurement method with EBT4 film and ensure its measurement accuracy to be within the required range through strict operational procedures for the purpose of addressing the two essential issues of poor measurement accuracy and timeliness of EBT film under FLASH conditions.Methods:After storing under different humidity conditions for a certain period of time, the film was exposed to radiation for analyzing the influence of air humidity on the intrinsic performance of EBT film. By means of repeated scanning operations and the film angle rotation, the influences of repeated scanning and film placement angle were analuzed. Parabolic correction method was used to reduce the spatial position influence during the scanning process. By analying the relationship between net optical density (netOD) and absorbed dose through the comparison of three fitting method, the optimal fitting curve was selected. After irradiation of the same batch of films for 5 min and 24 h, the film doses were calibrated and then compared with ionization chamber-measured result. The rapid and precise film dosimetry method was used to measure both the percentage depth dose from X-rays at ultra-high dose rate and the dose distribution at a depth of 2 cm in water.Results:Air humidity had the greatest influence on the intrinsic performance of EBT film (approximately 20%). The average deviation of repeated scans is within 0.5%. The angle at which the film is placed significantly affected the readouts of the film with the maximum influence approximately 70%. The net optical density combined with polynomial fitting can control the fitting residuals of 1-16 Gy within 3%. The change rate of light channels at 5 min already mostly met the requirements of the rapid mode (< 0.5%). Compared with the measurement result obtained using the reference ionization chamber, the deviations of the 5 min or 24 h dose calibration curves were all within 2%.Conclusions:The EBT4 film can be employed as a precise dosimeter to quickly measure the FLASH radiation dose. Rapid and precise FLASH dose measurements can meet the stringent requirements of both preclinical and clinical FLASH research.

Epicutaneo-cava catheters(ECC)placement plays an important role in fluid management,drug therapy and nutritional support in very low birth weight infants(VLBWI).This study reviews the selection of ECC catheters,preparation for ECC catheterization,catheterization procedures,catheter positioning and tracking,and revelations and recommendations in light of the clinical needs of VLBWI,with the aim of optimizing the clinical management of VLBWI,increasing the success rate of ECC catheterization in NICUs,decreasing the risk of complications,improving the prognosis of the children,and enhancing the quality of their clinical care.

Objective:To investigate the prognostic value of enteroscopic grading for the prognostic assessment of patients with malignant hematological diseases who developed intestinal acute graft-versus-host disease (IT-aGVHD) after unrelated cord blood transplantation (UCBT) .Methods:Fifty patients with IT-aGVHD who developed hormone resistance after UCBT from June 2016 to June 2023 at Anhui Provincial Hospital were collected to compare the effective and survival rates of IT-aGVHD treatment in the group with milder enteroscopic mucosal injury (27 cases, enteroscopic grading of Ⅰ and Ⅱ) and the group with more severe injury (23 cases, enteroscopic grading of Ⅲ and Ⅳ) and to retrospectively analyze the factors affecting patients’ prognosis.Results:Patients in the mild and severe groups had an effective rate of 92.6% and 47.8% at 28 days after colonoscopy ( P<0.001), 81.5% and 39.1% at 56 days after colonoscopy ( P=0.002), with optimal effective rate of 92.6% and 65.2% ( P=0.040), respectively, and the differences were statistically significant. The multifactorial analysis found that enteroscopic grading was an independent risk factor affecting the effective rate of IT-aGVHD treatment. The overall survival rate at 2 years after colonoscopy was 70.4% (95% CI 52.0% -88.8% ) and 34.8% (95% CI 14.8% -54.8% ) for patients in the mild and severe groups, respectively, and the difference was statistically significant ( P=0.003). Multifactorial analysis revealed that enteroscopic grading, cytomegalovirus infection status, second-line treatment regimen, and patients’ age were independent risk factors for survival. Conclusion:The treatment efficacy and prognosis of patients in the group with less severe enteroscopic injury (grades Ⅰ and Ⅱ) were better than those in the group with more severe injury (grades Ⅲ and Ⅳ) .

OBJECTIVE Aims to investigate the expression changes of immunoregulatory cytokines in peripheral blood and local lesions of patients with juvenile onset recurrent respiratory papillomatosis(JORRP),and analyze their correlation with the severity of JORRP.METHODS Peripheral blood samples were collected from JORRP patients,along with peripheral blood samples from healthy children matched for gender and age as the control group.Papillomas of JORRP patients were collected,and the epithelial tissue from the palatine tonsils of patients undergoing tonsillectomy served as a control.ELISA was used to detect cytokine concentrations in plasma samples.The tissue samples were detected by mRNAseq and verified by RT-PCR.Furthermore,the correlation between cytokine expression levels and disease severity was analyzed.RESULTS The concentration of interleukin-10(IL-10)in the plasma of JORRP patients was significantly higher than that in the healthy control group(P<0.05),and it was negatively correlated with the age of onset(r=-0.3307,P<0.05).At the level of mRNA,the relative quantity of IL-10 in papillomas was significantly higher in the aggressive group compared to the non-aggressive group(P>0.05).Additionally,the concentration of TGF-β in plasma of JORRP patients was positively correlated with the number of surgeries(r=0.5144,P<0.05),and the concentration of TGF-β in the aggressive group was significantly higher than that in the non-aggressive group(P<0.05).The TGF-β mRNA expression level was significantly higher in the papillomas of JORRP patients compared to the control(P<0.001).CONCLUSION Inhibitory immunoregulatory cytokines IL-10 and TGF-β are overexpressed in JORRP patients and positively correlated with disease severity.

Objective:To measure the beam stability of the electron FLASH radiotherapy accelerator developed by the Institute of Applied Electronics of Chinese Academy of Engineering Physics and to evaluate the performance of scintillator, fast current sensor (FCT) and graphite under the electron FLASH beam.Methods:Each continuous beam exit deviation and each pulse deviation at the electron FLASH radiotherapy accelerator in the same working state were measured. The correlation among three monitors and the measured dose of the accelerator at different electron beam energy (controlled by changing the charging voltage) and different beam pulse numbers were compared, which were validated by a Monte Carlo simulation procedure.Results:At the first high pressure, the first 10 scintillators and FCT signals were relatively large, approximately 2% deviation compared with the average value of 400 pulses. Among 40 beam outflows, the deviation between each pulse was within ±5%. In the accelerator steady state, each beam outflow deviation was within ±1%. Both simulated and measured values showed that the monitor could not be used for dose monitoring at different electron beam energy. However, when the energy was the same, only the number of beam pulses was changed, and linear relationship was observed between the number of the three monitors and the dose measured by the film (all R 2 > 0.999). Conclusions:The beam deviation of each beam outflow of this electron FLASH accelerator is within ±1%. Under the stability of the accelerator beam, the scintillator, FCT and graphite can meet the dose monitoring of the target area, which can provide reference for dose monitoring for subsequent biological experiments.