In vitro erythrocyte manufacturing technology offers a novel solution for transfusion therapy, ensuring sustainable blood supply, reducing dependence on donors, and minimizing the risk of infectious disease transmission. This review summarizes recent advancements in in vitro erythrocyte production, including techniques for generating red blood cells (RBC) from various cell sources, with a focus on the cultivation and development of immortalized erythroid cell lines. The importance of enhancing enucleation efficiency and ensuring the safety of immortalized erythroid cells is emphasized. Additionally, the potential and challenges in clinical translation are discussed, aiming to provide new insights for future sustainable RBC supply and therapeutic applications.

【Objective】 To explore the effect of recovery autologous blood transfusion combined with bilateral internal iliac artery presetting in high-risk patients with hemorrhage during cesarean section. 【Methods】 A total of 162 high-risk patients with hemorrhage who underwent cesarean section from January 2021 to May 2023 in our hospital were prospectively selected and divided into in Groups A, B, and C with 54 cases in each group according to the indications for the method of transfusion. Group A received allogeneic blood transfusion, Group B received autologous blood transfusion, Group C received autologous blood transfusion combined with bilateral internal iliac artery balloon presetting. 【Results】 Intraoperative blood loss (mL) (1 600 vs 1 500 vs 800), postoperative hospital stay(d) (7 vs 7 vs 6) and operative time(min) (107 vs 104.50 vs 77) in group C were all lower than those in group A and B (P<0.05), with no difference between group A and B (P>0.05); The autologous blood transfusion volume(mL) in group C was lower than that in group B (525.5 vs 261, P<0.05). The proportion of allogeneic erythrocytes in group C was lower than that in group A (22.22% vs 100.00%, P<0.016 7). The proportion of plasma in group C was lower than that in groups A and B (18.50% vs 66.70%/18.50% vs 44.40%, P<0.016 7). The incidence of coagulating dysfunction in group C was lower than that in group A (7.41% vs 25.93%, P<0.016 7). The incidence of hysterectomy in group C was lower than that in group A (1.85% vs 16.67%, P<0.016 7), and there was no difference between group A and B (16.67% vs 11.11%, P>0.016 7). 【Conclusion】 Recovery autologous blood transfusion combined with bilateral internal iliac artery balloon presetting in cesarean section for high-risk patients with hemorrhage achieved ideal effects, which can significantly reduce intraoperative blood loss, intraoperative autologous blood transfusion, allogeneic red blood cells and plasma transfusion, as well as the operation time and postoperative hospital stay. In addition, it can improve the coagulation function and hysterectomy, which is conducive to ensuring the safety of maternal and promoting early rehabilitation, and preserving the fertility of patients to a certain extent, which is worthy of further clinical promotion.

Objective:To investigate feasibility, efficiency and safety of kissing pancreatojejunostomy after pancreatoduodenectomy.Methods:From Jan 2006 to Sep 2020, the clinical data of 267 patients undergoing pancreatoduodenectomy and kissing pancreatojejunostomy were retrospectively analyzed.Results:Grade B postoperative pancreatic fistula (POPF) occurred in 6.37%, Grade C POPF in 2.25% of patients. There was no mortality within 30 days postoperatively as to pancreatic fistula, by cut-off of pancreatic duct diameter at 3mm, there was no significant difference between two subgroups (15/140 vs. 8/127, P=0.20). also, when grouped by texture of the pancreas, no there was significant difference (20/194 vs. 3/73, P=0.11). Conclusions:Kissing pancreatojejunostomy is feasible and easy to perform. It also does not increase the POPF rate when applied to the pancreatojejunostomy with thin pancreatic duct and soft texture.

With the constant increase in the awareness of primary biliary cholangitis (PBC) and the continuous improvement in related diagnostic methods in the past two decades, the incidence and prevalence rates of PBC tend to increase and PBC is now the most common autoimmune liver disease worldwide. A series of family-based studies in the early stage have shown that PBC has strong genetic tendency, and subsequent genomic analyses have been performed for PBC in different populations and have obtained a large amount of genetic data. Future genetic studies of PBC will focus on translating these results into clinical practice.

Objective:To assess the value of nalbuphine intravenously injected before epidural labor analgesia in inhibiting uterine contraction pain in primiparae.Methods:A total of 140 expectant primiparae who were suitable and willing to receive epidural labor analgesia with a singleton fetus in vertex presentation, aged 20-40 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅱ, with their cervical dilation of 2-3 cm, were divided into nalbuphine group (N group) and routine control group (C group), with 70 cases in each group.Group N received intravenous injection of nalbuphine 0.1 mg/kg (in normal saline 5 ml) at 10 min before epidural puncture, while group C received intravenous injection of the equal volume of normal saline at 10 min before epidural puncture.The epidural puncture-related items including the intensity of pain (Numeric Rating Scale [NRS] scores) and degree of sedation-agitation (Riker sedation agitation scores) during uterine contraction, duration of epidural procedure, parturients′ satisfaction with epidural puncture, successful epidural catheterization at first attempt and complications (nerve paraesthesia and inadvertent intravascular punctures) were recorded.Results:Compared with group C, the NRS scores and Riker scores for uterine contraction pain were significantly decreased during epidural procedure ( P<0.05), with NRS score <6 and Riker sedation agitation scores of 4, the duration of epidural puncture was shortened, the success rate of epidural puncture at first attempt was increased(51%/70%), and the incidence of nerve paraesthesia and inadvertent intravascular puncture was decreased(17%/6%, 14%/4%), and the parturients′ satisfaction with epidural puncture was increased in group N ( P<0.05). Conclusions:Nalbuphine 0.1 mg/kg intravenously injected before epidural labor analgesia can safely and effectively reduce uterine contraction pain without limb agitation, which is helpful in implementating epidural puncture in primiparae.

Objective:To explore the effect of enhanced recovery after surgery (ERAS) nursing in patients with chronic sinusitis during the perioperative period.Methods:From July 2019 to January 2021, 106 patients with chronic sinusitis admitted to the Otolaryngology and Head and Neck Surgery, Beijing Tongren Hospital Affiliated to Capital Medical University were selected by convenience sampling as the research object. According to the random number table method, the patients were divided into the control group (52 cases) and the observation group (54 cases) . The control group was given routine nursing, and the observation group was given ERAS nursing on this basis. The preoperative discomfort (thirst and hunger) scores, postoperative discomfort (shoulder, neck and low back discomfort) incidence, perioperative anxiety, comfort, and discharge satisfaction were compared between the two groups.Results:The preoperative thirst and hunger scores of the observation group were lower than those of the control group, and the differences were statistically significant ( P<0.05) . The postoperative incidence of shoulder, neck and low back discomfort, and discharge anxiety scores of the observation group were lower than those of the control group, and the scores of comfort and discharge satisfaction were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Perioperative ERAS nursing in patients with chronic sinusitis can reduce preoperative thirst, hunger and postoperative discomfort in the shoulder, neck, and lower back, improve patients' perioperative anxiety, comfort and discharge satisfaction, and promote patients' rapid recovery.

Objective:To carry out genetic analysis for a family with a fetus manifesting micrognathia and a previous history for fetal micromandibular deformity.Methods:Systematic ultrasound examination was carried out for the fetus, and the prenatal and postnatal phenotype of the first fetus were retrospectively analyzed. The fetus and his parents were subjected to whole exome sequencing (WES) to identify potential pathogenic variants. Candidate variants were verified by Sanger sequencing.Results:Fetal ultrasound has indicated micrognathia. The first fetus was found to have micrognathia by prenatal ultrasonography and have featured macrosomia and dyspnea due to with tongue retraction, high palatal arch and small mandibular deformity. WES revealed that the fetus has a harbored a c. 3G>C (p.Met1? ) variant of the COL2A1 gene, which was inherited from the father who had myopia and retinal detachment. Conclusion:Stickler syndrome is mainly characterized prenatally by micrognathia, in addition with a variety of postnatal anomalies. The c. 3G>C (p.Met1? ) variant probably underlay the Stickler syndrome in this pedigree.

Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.

Objective:To detect the potential biomarkers in the serum of adolescents with depressive disorder and provide the basis for clinical diagnosis of depression.Methods:A total of 45 adolescents with depression who met the inclusion criteria and 47 healthy controls (HC group) were screened.Patients with depression were treated with sertraline (100 mg/d) for 4 weeks.The patients before sertraline treatment were called DN-MDD group and then were called DT-MDD group after sertraline treatmant.Hamilton Depression Scale (HAMD) was used to evaluate the efficacy of the two groups before and after treatment.The serum was collected for UPLC-MS/MS to determine the changes in profiles of endogenous metabolites.And the software of SPSS 21.0, XCMS and Analyst 3.0 were used to analyze the data.The reliability and feasibility of clinical diagnosis were further analyzed by ROC via GraphPad 8.0.Results:After 4 weeks of sertraline treatment, the patients' HAMD score decreased (before: 19.71±1.72, after: 15.36±1.91) and the effective rate reached 51% ( P<0.01). Multivariate statistical analysis showed that HC group and DN-MDD group and DT-MDD group had significant differences in metabolic profile.Compared with healthy controls, 11 different metabolites were found in the plasma of DN-MDD group including glycerate, adenosine, creatine and so on.After treatment, concentrations of glucose, glutamate, aspartate, sucrose, creatine, pyruvate and adenosine were significant changes in serum of adolescent depression patients.Area under ROC curve of glucose and glutamic acid were >0.9, and the AUC of aspartic acid, sucrose, creatine, pyruvate and adenosine were >0.7, suggesting that these 7 metabolites had different degrees of diagnostic ability. Conclusion:There are different metabolic profiles between adolescents with or without depression, and the antidepressant sertraline is helpful to maintain the level of substance metabolism which can be used as one of the treatment methods for adolescent depression.Our research may support the new strategy for clinical diagnosis and treatment of adolescent depression.

There is an imbalance between the supply and demand of functional red blood cells (RBCs) in clinical appli-cations. This imbalance can be addressed by regenerating RBCs using several in vitro methods. Induced pluripotent stem cells (iPSCs) can handle the low supply of cord blood and the ethical issues in embryonic stem cell research, and provide a promising strategy to eliminate immune rejection. However, no complete single-cell level differentiation pathway exists for the iPSC-derived erythroid differentiation system. In this study, we used iPSC line BC1 to establish a RBC regeneration system. The 10X Genomics single-cell transcriptome platform was used to map the cell lineage and differentiation trajectory on day 14 of the regeneration system. We observed that iPSC differentiation was not synchronized during embryoid body (EB) culture. The cells (on day 14) mainly consisted of mesodermal and various blood cells, similar to the yolk sac hematopoiesis. We identified six cell classifications and characterized the regulatory transcription factor (TF) networks and cell–cell contacts underlying the system. iPSCs undergo two transformations during the differentiation trajectory, accompanied by the dynamic expression of cell adhesion molecules and estrogen-responsive genes. We iden-tified erythroid cells at different stages, such as burst-forming unit erythroid (BFU-E) and orthochromatic erythroblast (ortho-E) cells, and found that the regulation of TFs (e.g., TFDP1 and FOXO3) is erythroid-stage specific. Immune erythroid cells were identified in our system. This study provides systematic theoretical guidance for optimizing the iPSC-derived erythroid differentiation system, and this system is a useful model for simulating in vivo hematopoietic develo-pment and differentiation.