Objective: To retrospectively analyze the clinical data of 474 newborns with hyperbilirubinemia, and to investigate the clinical characteristics of hyperbilirubinemia caused by ABO hemolytic disease of the fetus and newborn (ABO-HDFN) and factors influencing the phototherapy duration. Methods: A total of 474 neonates with hyperbilirubinemia treated in the First Hospital of Lanzhou University from January 2019 to January 2023 were enrolled. Blood type identification and the standard serological tests (direct antiglobulin test, serum free antibody test, and antibody elution test) were performed for all neonates. Baseline clinical data were collected and analyzed. According to the results of the hemolysis tests, neonates were divided into hemolytic jaundice group and non-hemolytic jaundice group. Clinical indicators, including hemoglobin levels, length of hospital stay, and phototherapy duration, were compared between the two groups. A multiple linear regression model was used to explore clinical factors influencing the duration of phototherapy. Results: Among the 474 neonates with hyperbilirubinemia, 354 were diagnosed with ABO-HDFN (hemolytic group), while 120 were without ABO-HDFN (non-hemolytic group). The incidence of ABO-HDFN in neonates with blood type A (55.93%, 198/354) was significantly higher than those with blood type B (44.07%, 156/354) (P<0.05). Furthermore, neonates born to multiparous women had a significantly higher ABO-HDFN incidence (81.56%, 146/179) than first-born neonates (70.51%, 208/295) (P<0.05). Neonates in the hemolytic group had significantly lower hemoglobin levels (170.67±21.86 g/L vs 178.99±22.05 g/L, P<0.001), lower red blood cell counts (4.66±0.63×10 /L vs 4.89±0.59×10 /L, P<0.05), and lower hematocrit (50.05±6.56% vs 52.61±6.75%, P<0.05) compared to the non-hemolytic group. Additionally, the hemolytic group had significantly longer hospital stays (6 [5, 9] days vs 6 [4, 8] days), longer phototherapy duration (62 [38, 84.25] h vs 53 [34.25, 64.77] h), and higher frequency of jaundice episodes (9 [7, 13] times vs 8 [6, 12] times] compared to the non-hemolytic group (all P<0.05). Regression analysis indicated that a positive indirect Coombs test and multiparity were independent risk factors associated with prolonged phototherapy duration (P<0.05). Conclusion: ABO incompatibility is the leading cause of hemolytic disease in neonates, particularly in cases where the mother has blood type O and the neonate has blood type A. In such cases, close monitoring of bilirubin levels is strongly recommended. Multiparous pregnancies increase the risk of alloimmune hemolysis. Therefore, neonates born to multiparous women may require more frequent bilirubin monitoring and appropriate prenatal interventions when necessary. Additionally, changes in indicators such as hemoglobin level and red blood cell count should be closely monitored as early warning indicators for hemolytic anemia and bilirubin elevation.

【Objective】 To investigate the factors affecting the length of hospitalization after the Sun's procedure in patients with type A aortic coarctation. 【Methods】 From January 2018 to June 2023, the clinical data, related laboratory indicators and perioperative blood transfusion data of patients with type A aortic dissection who underwent Sun's procedure in the First Hospital of Lanzhou University were collected. LASSO regression was used to screen the characteristics related to the length of hospital stay, and linear regression analysis was used to determine the risk factors for prolonged length of hospital stay. 【Results】 The statistical analysis of 242 patients showed that the amount of red blood cell transfusion, plasma transfusion, platelet transfusion and autologous blood transfusion were the influencing factors of the length of hospital stay in patients with type A aortic dissection after operation. The total sum of squared deviations of the linear regression equation fitting the total length of hospital stay was statistically significant (F= 10.504, P<0.001). 【Conclusion】 Perioperative red blood cell transfusion,plasma transfusion,platelet transfusion and autologous blood transfusion are risk factors for prolonged postoperative hospitalization in patients undergoing the Sun's procedure for type A aortic coarctation. Control of operation time and reduction of intraoperative blood loss may help to prevent prolonged postoperative hospital stay and other adverse conditions.

【Objective】 To investigate the serology and genotype identification method of B (A) subtype patients. 【Methods】 Test tube method (serology) was used to confirm the clinically difficult ABO blood group samples of 3 patients with ABO blood group; ABO blood group was genotyped by real-time PCR, and the ABO gene exon 1-7 was sequenced to determine the genotype. 【Results】 The forward and reverse blood typing result of three patients was B (A) subtype all with ABO genotype B/O2 and c.640A> G mutation on B allele of exon 7, which meets the characteristics of ABO * BA.04 genotype. 【Conclusion】 The combination of serological and genetic testing could identify difficult blood types such as ABO subtypes accurately and ensure the safety of clinical blood use.

Tumor associate macrophages ( TAMs) play a significant role in the interaction of tumor inflam-mative microenvironment and tumor cells .TAMs originate from monocytic precursors ,recruiting into tumor tissue by colony stimulating factor ( CSF) .This review summarized that TAMs promote tumor progression and metastasis though angiogenesis ,lymphogenesis , immunosuppression , matrix remodeling and affecting cancer stem cells .The article pointed that targeting TAMs is a new strategy for future tumor therapy .