Objective: To report severe hemolytic adverse reactions caused by intravenous infusion of human immunoglobulin (IVIG) in a child, and to alert clinical staff to be aware of IVIG-associated hemolytic reactions to ensure transfusion safety in pediatric populations. Methods: A retrospective analysis was conducted on a case of severe hemolytic reaction following high-dose IVIG infusion in a pediatric patient with severe pneumonia. Results: Following high-dose IVIG infusion, severe hemolytic adverse reactions developed, clinically manifesting as decreased hemoglobin, progressively elevated bilirubin and lactate dehydrogenase (LDH), and gradual hepatomegaly. IgG antibodies were detected in the patient's erythrocytes and plasma. Conclusion: When patients passively acquire IgG antibodies through IVIG infusion, timely monitoring of antibody titers in vivo is critical. For subsequent transfusions, red blood cell products that lack the corresponding antigens should be selected to mitigate hemolysis. Clinicians should remain vigilant against rare but severe hemolytic adverse reactions.

Clinical blood transfusion has long faced challenges such as blood resource shortages and blood type incompatibility. Macaques, as core animal models for preclinical trials, require precise ABO blood group typing, which is crucial for transplantation immunology, disease modeling, and xenogeneic blood transfusion research. However, identifying macaque ABO blood types presents complex challenges, including weak expression of surface antigens on erythrocytes, abnormal plasma proteins, and interference from heterophilic antibodies. This article systematically reviews the development of ABO blood group detection technologies for macaques—from early serological methods to modern molecular biology techniques and immunohistochemistry—and analyzes the applicable scenarios of each technique in transfusion medicine research. Through comparative evaluation of serology, genotyping, and emerging integrated technologies, it reveals quantitative differences in accuracy, operational complexity, and resource consumption among different methods, and elaborates on the application value of precise blood group typing in cutting-edge fields such as xenogeneic transfusion, universal red blood cell development, and cell therapy.

Objective To study the expression levels and clinical significance of histone H3 trimethylation at lysine 4(H3K4me3),histone H3 trimethylation at lysine 27(H3K27me3)and modifying enzyme in placental tissue of patients with premature rupture of membranes(PROM)with chorioamnionitis.Methods Clinical data of 95 pregnant women treated in the Xi'an Gaoxin Hospital due to PROM from June 2021 to December 2023 were retrospectively collected,and they were divided into infected group and a non-infected group according to whether they were complicated with histological chorioamnionitis(HCA).Another 30 normal pregnant women were selected as the control group.Placental tissues of all subjects were collected and H3K4me3 and H3K27me3 levels were detected,and the expression levels of H3K4me3,H3K27me3 specific methyltransferase[mixed lineage leukemia protein-1(MLL1),Zeste enhancer homolog 2(EZH2)]and demethyltransferase[lysine-specific demethylase 5B(KDM5B),Jumonji domain-containing protein 3(JMJD3)]were detected by quantitative real-time PCR(qRT-PCR).The expression differences of H3K4me3,H3K27me3 and specific modifiers among the three groups and the correlation with the histological stage of HCA were analyzed.The Receiver operating characteristic curve(ROC)was plotted,the Area under curve(AUC)value was calculated,and H3K4me3 was evaluated.Predictive value of H3K27me3 for concurrent HCA infection.Result Compared with the control group,the levels of H3K4me3(0.08%±0.02%,0.12%±0.03%vs 0.25%±0.06%),MLL1 mRNA(1.32±0.16,1.44±0.23 vs 2.02±0.31),and JMJD3 mRNA(0.78±0.13,0.91±0.15 vs 1.53±0.23)in the infected and non-infected groups were significantly decreased(t=10.939～19.062),while the levels of H3K27me39(0.23%±0.05%,0.15%±0.03%vs 0.10%±0.02%),EZH2 mRNA(1.96±0.26,1.85±0.25 vs 1.15±0.29)and KDM5B(1.46±0.15,1.35±0.18 vs 0.94±0.12)were significantly increased(t=6.077～14.974),and the levels in the infected group were lower/higher than those in the non-infected group(t=2.017～10.688),with statistically significant differences(all P<0.05).There was a significant negatively correlation between H3K4me3 and H3K27me3 levels in placenta tissue of PROM(r=-0.604,P<0.05).The levels of H3K4me3,MLL1 and JMJD3 were negatively correlated with the histological stages of HCA(r=-0.646,-0.489,-0.503,all P<0.05).The levels of H3K27me3,EZH2 and KDM5B were positively correlated with the histological stages of HCA(r=0.632,0.515,0.520,all P<0.05).The cutoffvalues of H3K4me3 and H3K27me3 were 0.10%and 0.19%,respectively.The AUC(95%CI)value of the combined prediction of PROM combined with HCA infection was 0.896(0.882～0.947),and the sensitivity and specificity were 92.14%and 86.23%respectively,which was significantly higher than the diagnosis of a single index.Conclusion The levels of H3K4me3,H3K27me3 and modifying enzymes in the placenta tissue of PROM are closely related to HCA infection and histological stage,which has high clinical prediction value for HCA infection and is expected to be a new biomarker for clinical diagnosis.

Objective:To analyze the epidemiological and clinical characteristics of respiratory pathogens in China.Methods:This study was a cross-sectional study, which encompassed 19 core units of the clinical pathogen network and established a three-tiered clinical pathogen surveillance system. Thirty respiratory samples were collected every two weeks from various units from January to December 2024, and the clinical and pathogen diagnostic information were gathered. A total of 11 864 samples were tested using this system. The tier-1 clinical pathogen surveillance system covered influenza A virus (Flu-A), influenza B virus (Flu-B), respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The tier-2 clinical pathogen surveillance system focused on 18 key respiratory pathogens. The tier-3 clinical pathogen surveillance system further clarified whether any emerging infectious diseases had occurred.Results:The tier-1 clinical pathogen surveillance system showed Flu-A predominated in December, Flu-B predominated in January, SARS-CoV-2 peaked in March and August, whereas RSV circulated sporadically throughout the year. Geographic trends were broadly consistent across the seven major regions, although Flu-A detection in December was notably higher in Northeast China (48.1%(111/231)) and East China (36.2%(148/409)), and RSV detection was concentrated in the Northwest and South China from January to March. Data from the tier-2 clinical pathogen surveillance system indicated that Streptococcus pneumoniae, Mycoplasma pneumoniae, rhinovirus, and adenovirus were detected year-round, of these, Streptococcus pneumoniae and rhinovirus showed elevated positive detection rates from August to September, while adenovirus peaked in January. Legionella pneumophila was not detected throughout the year, and other pathogens fluctuated throughout the year without a consistent pattern. The predominant etiologic agents of pediatric pneumonia were Mycoplasma pneumoniae (35.0%(105/300)), rhinovirus (25.7%(77/300)), and adenovirus (17.3%(52/300)), whereas adult pneumonia was mainly caused by Streptococcus pneumoniae (10.5%(29/277)), Staphylococcus aureus (6.9%(19/277)), Mycoplasma pneumoniae (6.9%(19/277)), and Flu-A (6.1%(17/277)). The tier-3 clinical pathogen surveillance system did not identify any emerging respiratory pathogens. Conclusion:Respiratory pathogens in China in 2024 exhibit distinct temporal and spatial distribution patterns and vary among different populations.

[Objective] To compare the characteristics of platelet-rich plasma derived exosomes (PRP-Exos) under different activation conditions and their differential effects on the proliferation capacit of human microvascular endothelial cells (HMEC-1) and human skin fibroblasts (BJ). [Methods] Ten healthy volunteers were recruited, and 10 mL of venous blood anticoagulated with EDTA-K2 was collected. PRP-Exos were prepared and extracted by the secondary centrifugation method. Transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA), and Western blotting (WB) detection techniques were used to compare the morphological characteristics, particle size distribution, concentration, and the expression of surface marker proteins of PRP-Exos. Through in vitro cell culture, the differences in morphological changes and proliferation abilities of HMEC-1 and BJ cells induced by PRP-Exos in different activator groups were compared. [Results] 1) TEM observation showed that the morphologies of PRP-Exos in different activator groups were different. 2) NTA analysis showed that compared with the particle size of (109.60±2.71) nm in the normal saline group, the particle sizes of the thrombin group [(104.93±1.55) nm] and the mixed agent group [(103.83±1.58) nm] were relatively smaller, while the particle size of the calcium gluconate group [(113.57±4.70) nm] was larger and its particle size distribution range was wider. There were statistically significant differences among different groups (F=7.019, P<0.05). The concentration of exosomes obtained in the group with the mixture of calcium gluconate and thrombin was the highest [(4.87±0.63)×10⁶ particles/mL, P<0.001]. Both the thrombin group [(2.75±0.13)×10⁶ particles/mL, P < 0.01] and the calcium gluconate group [(3.82±0.06)×10⁶ particles/mL, P<0.001] obtained higher concentrations of exosomes compared with the normal saline group. The concentration in the calcium gluconate group was slightly higher than that in the thrombin group, and there was a significant difference between the two groups (P<0.05). 3) WB analysis showed that CD41, CD81, and TSG101 were expressed on the surface of PRP-Exos, and the protein signal intensities of CD41 and TSG101 in the group with the mixture of thrombin and calcium gluconate were the strongest (P<0.001). 4) The results of in vitro cell culture showed that PRP-Exos in the group with the mixture of thrombin and calcium gluconate could significantly promote the proliferation of HMEC-1 and BJ cells (P<0.05). [Conclusion] The PRP treated with the thrombin and calcium gluconate mixture group yielded the highest concentration of exosomes; under in vitro culture conditions, PRP-Exos from this group significantly promoted the proliferation of HMEC-1 and BJ cells.

Objective To study the expression levels and clinical significance of histone H3 trimethylation at lysine 4(H3K4me3),histone H3 trimethylation at lysine 27(H3K27me3)and modifying enzyme in placental tissue of patients with premature rupture of membranes(PROM)with chorioamnionitis.Methods Clinical data of 95 pregnant women treated in the Xi'an Gaoxin Hospital due to PROM from June 2021 to December 2023 were retrospectively collected,and they were divided into infected group and a non-infected group according to whether they were complicated with histological chorioamnionitis(HCA).Another 30 normal pregnant women were selected as the control group.Placental tissues of all subjects were collected and H3K4me3 and H3K27me3 levels were detected,and the expression levels of H3K4me3,H3K27me3 specific methyltransferase[mixed lineage leukemia protein-1(MLL1),Zeste enhancer homolog 2(EZH2)]and demethyltransferase[lysine-specific demethylase 5B(KDM5B),Jumonji domain-containing protein 3(JMJD3)]were detected by quantitative real-time PCR(qRT-PCR).The expression differences of H3K4me3,H3K27me3 and specific modifiers among the three groups and the correlation with the histological stage of HCA were analyzed.The Receiver operating characteristic curve(ROC)was plotted,the Area under curve(AUC)value was calculated,and H3K4me3 was evaluated.Predictive value of H3K27me3 for concurrent HCA infection.Result Compared with the control group,the levels of H3K4me3(0.08%±0.02%,0.12%±0.03%vs 0.25%±0.06%),MLL1 mRNA(1.32±0.16,1.44±0.23 vs 2.02±0.31),and JMJD3 mRNA(0.78±0.13,0.91±0.15 vs 1.53±0.23)in the infected and non-infected groups were significantly decreased(t=10.939～19.062),while the levels of H3K27me39(0.23%±0.05%,0.15%±0.03%vs 0.10%±0.02%),EZH2 mRNA(1.96±0.26,1.85±0.25 vs 1.15±0.29)and KDM5B(1.46±0.15,1.35±0.18 vs 0.94±0.12)were significantly increased(t=6.077～14.974),and the levels in the infected group were lower/higher than those in the non-infected group(t=2.017～10.688),with statistically significant differences(all P<0.05).There was a significant negatively correlation between H3K4me3 and H3K27me3 levels in placenta tissue of PROM(r=-0.604,P<0.05).The levels of H3K4me3,MLL1 and JMJD3 were negatively correlated with the histological stages of HCA(r=-0.646,-0.489,-0.503,all P<0.05).The levels of H3K27me3,EZH2 and KDM5B were positively correlated with the histological stages of HCA(r=0.632,0.515,0.520,all P<0.05).The cutoffvalues of H3K4me3 and H3K27me3 were 0.10%and 0.19%,respectively.The AUC(95%CI)value of the combined prediction of PROM combined with HCA infection was 0.896(0.882～0.947),and the sensitivity and specificity were 92.14%and 86.23%respectively,which was significantly higher than the diagnosis of a single index.Conclusion The levels of H3K4me3,H3K27me3 and modifying enzymes in the placenta tissue of PROM are closely related to HCA infection and histological stage,which has high clinical prediction value for HCA infection and is expected to be a new biomarker for clinical diagnosis.

Objective:To analyze the epidemiological and clinical characteristics of respiratory pathogens in China.Methods:This study was a cross-sectional study, which encompassed 19 core units of the clinical pathogen network and established a three-tiered clinical pathogen surveillance system. Thirty respiratory samples were collected every two weeks from various units from January to December 2024, and the clinical and pathogen diagnostic information were gathered. A total of 11 864 samples were tested using this system. The tier-1 clinical pathogen surveillance system covered influenza A virus (Flu-A), influenza B virus (Flu-B), respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The tier-2 clinical pathogen surveillance system focused on 18 key respiratory pathogens. The tier-3 clinical pathogen surveillance system further clarified whether any emerging infectious diseases had occurred.Results:The tier-1 clinical pathogen surveillance system showed Flu-A predominated in December, Flu-B predominated in January, SARS-CoV-2 peaked in March and August, whereas RSV circulated sporadically throughout the year. Geographic trends were broadly consistent across the seven major regions, although Flu-A detection in December was notably higher in Northeast China (48.1%(111/231)) and East China (36.2%(148/409)), and RSV detection was concentrated in the Northwest and South China from January to March. Data from the tier-2 clinical pathogen surveillance system indicated that Streptococcus pneumoniae, Mycoplasma pneumoniae, rhinovirus, and adenovirus were detected year-round, of these, Streptococcus pneumoniae and rhinovirus showed elevated positive detection rates from August to September, while adenovirus peaked in January. Legionella pneumophila was not detected throughout the year, and other pathogens fluctuated throughout the year without a consistent pattern. The predominant etiologic agents of pediatric pneumonia were Mycoplasma pneumoniae (35.0%(105/300)), rhinovirus (25.7%(77/300)), and adenovirus (17.3%(52/300)), whereas adult pneumonia was mainly caused by Streptococcus pneumoniae (10.5%(29/277)), Staphylococcus aureus (6.9%(19/277)), Mycoplasma pneumoniae (6.9%(19/277)), and Flu-A (6.1%(17/277)). The tier-3 clinical pathogen surveillance system did not identify any emerging respiratory pathogens. Conclusion:Respiratory pathogens in China in 2024 exhibit distinct temporal and spatial distribution patterns and vary among different populations.

Objective:To investigate the risk factors for severe hyperbilirubinemia complicated by acute bilirubin encephalopathy (ABE), and the value of total serum bilirubin (TSB) and bilirubin (B)/albumin (A) ratio in predicting ABE.Methods:Clinical data of children with severe hyperbilirubinemia admitted to the Affiliated Hospital of Inner Mongolia Medical University, Ordos Central Hospital, People's Hospital of Inner Mongolia Autonomous Region, the Fourth Hospital of Baotou, Tongliao Hospital, Maternal and Child Health Hospital of Hohhot, the Affiliated Hospital of Chifeng University, Manzhouli People's Hospital, and Chifeng Hospital from January 1, 2020, to December 31, 2021, were retrospectively collected. The subjects were divided into ABE and non-ABE groups based on the occurrence of ABE. Multivariate logistic regression analysis was used to identify high-risk factors for ABE. Statistical analysis was performed using t-test, Wilcoxon signed-rank test, or Chi-square tests. Indicators with statistically significant differences were included in the multivariate logistic regression model, and stepwise regression was used to analyze the influencing factors of ABE. Results:(1) A total of 543 children were included in this study, accounting for 3.7% (543/14 831) of the total admissions during the same period. Among the 543 children, 81 (14.9%) had ABE, and 462 (85.1%) did not. The age at admission was (7.2±2.1) d, and the length of hospital stay was (5.2±2.2) d. The breastfeeding initiation time was 2 d (1-4 d) after birth. The peak TSB of the 543 cases was (385.98±51.22) μmol/L, and the age at peak TSB was (4.4±2.1) d. Fourteen cases (2.5%) gradually reached the peak TSB after admission [(392.01±61.24) μmol/L], while 529 cases (97.5%) had already reached the peak TSB at admission [(386.42±50.22) μmol/L]. Among the 543 cases, 356 had a clear etiology (65.6%, with 278 cases having a single cause and 78 cases having more than two causes), and 187 cases (34.4%) had an unknown etiology. (2) Compared with the non-ABE group, the breastfeeding initiation in the ABE group was later [6 h (2-6 h) vs. 2 h (1-3 h), Z=－6.87] and the length of hospital stay was longer [(6.5±1.9) d vs. (5.0±2.1) d, t=0.55]. The proportions of breastfeeding, delayed meconium passage, isoimmune hemolysis, and maternal gestational diabetes, as well as peak TSB and B/A ratio at peak TSB, were higher in the ABE group than in the non-ABE group [64.2% (52/81) vs. 36.8% (170/462), χ2=21.96; 16.0% (13/81) vs. 2.4% (11/462), χ2=27.32; 27.2% (22/81) vs. 10.6% (40/462), χ2=16.61; 24.7% (20/81) vs. 13.6% (63/462), χ2=6.50; (442±68) vs. (375±39) μmol/L, t=－8.55; (11.9±1.6) vs. (9.8±1.2), t=－11.61; all P<0.05]. The admission weight, proportion of transfer from the hospital's obstetrics department, unknown etiology, and breast milk jaundice were lower in the ABE group than in the non-ABE group [(3 098±482) vs. (3 278±493) g, t=3.04; 12.3% (10/81) vs. 42.4% (196/462), χ2=30.48; 3.7% (3/81) vs. 39.8% (184/462), χ2=39.83; 0.0% (0/81) vs. 5.8% (27/462), χ2=3.81; all P<0.05]. (3) Isoimmune hemolysis, peak TSB, and B/A ratio at peak TSB were independent risk factors for ABE [ OR(95% CI) were 2.924 (1.209-7.073), 1.006 (0.997-1.014), and 2.647 (1.841-3.805), respectively]. When the peak TSB was 380.05 μmol/L and the B/A ratio at peak TSB was 10.45, the sensitivity for predicting ABE was 0.963, the specificity was 0.789, and the area under the receiver operating characteristic curve was 0.752. Conclusions:Isoimmune hemolysis, peak TSB, and B/A ratio at peak TSB are independent risk factors for ABE. The B/A ratio at peak TSB and peak TSB can effectively predict ABE.

Objective To study the changes in serum immunoglobulin levels in children with thalassemia who undergo repeated blood transfusions and explore their correlation with delayed hemolytic transfusion reactions(DHTR).Methods Serum samples from children with thalassemia who received blood transfusion treatment from June 2022 to April 2023(ob-servation group)and healthy children who underwent physical examination(control group)in our hospital were collected.The levels of serum immunoglobulins(IgG subtype,IgM,IgA,IgE and IgD)were detected using flow cytometry CBA multi-factor quantitative detection technology,and the differences between the two groups were compared.The children were divided into 4 groups according to different transfusion numbers:≤10 numbers,11-30 numbers,31-50 numbers and＞50 numbers,and the differences between different blood transfusion numbers and serum immunoglobulin levels in each group were compared using one-way analysis of variance(ANOVA).Children with thalassemia with DHTR were in the hemolysis group,and children with thalassemia who did not experience DHTR were in the non-hemolysis group.The changes in serum immunoglobulins(IgG subtypes,IgM,IgA,IgE and IgD)between the two groups were compared to explore the correlation between serum immunoglobulins in thalassemia children with repeated transfusion and DHTR.Results The levels of IgG1,IgG3,IgG4 and IgA in the observation group were significantly higher than those in the control group,with the increase of(2.07±2.12),(0.67±2.03),(0.30±0.37)and(6.04±11.40)mg/mL,respectively,while the level of IgD in observation group was significantly lower than that in the control group,with a decrease of(0.03±0.01)mg/mL,P＜0.05.No significant difference was noticed in IgG2,IgM and IgE between the groups(P＞0.05).IgG1 and IgG4 both significantly increased with the number of blood transfusions.The IgG1 in the 4 groups increased sequentially as(0.30±0.62),(0.41±0.51)and(3.60±3.48)mg/mL,and IgG4 increased sequentially as(0.12±0.13),(0.22±0.07)and(0.21±0.38)mg/mL.IgG2,IgM and IgD showed a significant decrease,with IgG 2,IgM,and IgD in four groups decreased as(0.91±1.50),(0.14±0.10)and(0.05±0.05)mg/mL,respectively,showing significant differences with the number of blood transfusions(P＜0.05).No sig-nificant difference was found in IgG3,IgA and IgE with different number of transfusions(P＞0.05).IgG1,IgG3 and IgG4 in the hemolysis group were significantly higher than those in the non-hemolysis group,with an increase of(4.44±3.41),(0.73±1.26)and(0.52±0.40),respectively(P＜0.05).IgD in the hemolysis group was significantly lower than that in the non-hemolysis group,with a decrease of(0.00±0.06)mg/mL,P＜0.05.No significance was noticed in IgG2,IgM,IgA and IgE between the hemolysis group and the non-hemolysis group(P＞0.05).Conclusion The serum immunoglobulin levels of children with thalassemia who undergo repeated blood transfusions are abnormal.There are differences in correlation between the number of blood transfusions and serum immunoglobulin levels among children with thalassemia who undergo repeated blood transfusions.The relevant serum immunoglobulins for DHTR in children with thalassemia who undergo repeated blood transfusions are IgG1,IgG3 and IgG4.

To investigate the collective influence of sarcopenia on the extended prognosis of hospitalized elderly individuals with type 2 diabetes mellitus(T2DM).