Quality Evaluation Of Suspended Red Blood Cells Stored In Special Environment

Background:The western plateau and the southeast coast are two important national strategic directions of China and have great economic and strategic value.Under the background of the development of the western region,the Qinghai-Tibet tourism,the construction of the southern island reef and the escort of the Gulf of Aden,the people who went to the above-mentioned areas became increasingly dense,which brought severe challenges to local medical and health conditions.Injured people who are seriously ill with blood,need blood guarantee during treatment;if the blood is not adequately supplied,it will often threaten the lives of the wounded.However,the medical resources in the sea and plateau areas,especially the blood reserves,are limited,and cannot guarantee a large amount of blood supplement during emergencies.Therefore,it is necessary to mobilize blood from land?plain?areas to the sea and the special areas of the plateau for storage.China's“Quality Requirements for Whole Blood and Component Blood”?GB18469-2012?clearly defined the preservation conditions of whole blood or component blood,that is,a standard atmospheric pressure,constant temperature,and standing.However,under the special circumstances of the sea and the plateau,these conditions cannot be guaranteed.This also means a comprehensive evaluation of blood quality after transport to the sea and plateau.However,there are still no specific conclusions about the blood quality of these special areas;the evaluation strategy is still the focus of debate in the industry and needs to be further resolved.During the preservation process,red blood cells will undergo a series of changes over time,eventually leading to death and disintegration.Specifically,the cells include a double-concave disk shape,a cell membrane rupture,a content flow out,hemolysis,and the like.These structural changes can be reflected by currently accepted indicators such as hemolysis rate,hemoglobin content,hematocrit,and the like.These classic indicators are also the main content of the aforementioned blood preservation standards in China.In addition to these,lactic acid accumulation,adenosine triphosphate?ATP?and 2,3-diphosphoglycerate?2,3-diphosphoglycerate,2,3-DPG?occur in the cells while structural changes in red blood cells occur,even before structural changes.A series of events in which the concentration is reduced by changes in energy metabolism.Therefore,we carry out research from the two perspectives of structure and energy metabolism,which will be beneficial to comprehensively evaluate the quality changes of stored red blood cells in special environments at sea and plateau.However,studies on the preservation of red blood cell evaluation in special areas,especially the lack of energy metabolism-based research,still need to be explored in depth.Extracellular flow analysis?XF?is an energy detection technique that performs high-throughput multi-index dynamics on cells at the living cell level.In red blood cells,XF technology can calculate the basic glycolysis,glucose reactivity and glycolysis by reflecting the extracellular acidification rate?ECAR?.An indicator of the level of glycolysis.However,there is currently no research on the application of XF technology to store red blood cell energy metabolism in special environments.Objective:In this study,the selected suspension red blood cells?the most widely used component blood at home and abroad?were selected as the main research objects,and the suspended red blood cells collected from the plain?land?were transported to the plateau areas?Lhasa,Linzhi?and the sea ships?Bohai Bay,Pacific?,using structural and energy metabolism detection methods,aimed at?1?Systematically evaluate the quality of suspended red blood cells after plateau/sea storage and transportation;?2?Defining the feasibility of energy research strategies in evaluating the quality of suspended red blood cells after plateau/sea storage and transportation.Methods:1.Quality evaluation of blood storage and transportation at seawe placed land-collected suspended red blood cells on land-based blood banks and ships at 4°C in the background of terrestrial blood supply to the sea.The navigation route of the ship at sea is divided into the navigation around the Bohai Bay and the Pacific Rim:20 days in the Bohai Bay,the mission is over,samples of the maritime navigation group and the onshore blood bank are collected for testing;the Pacific Rim route is divided into the South Pacific Navigation?zone B?and the Central Pacific Rim?zone C?sailed for 14 days and 16 days respectively,and the mission was completed.Samples of each group were collected.Test as follows:?1?Using automatic blood analyzer to measure the red blood cell count,hematocrit,hemoglobin content and other indicators of each group of samples.?2?Using the kit to detect the free hemoglobin content of each group of samples,combined with hemoglobin content and hematocrit,calculate the hemolysis rate of each group according to the formula.?3?The energy metabolism changes of each group of suspended red blood cell samples were detected by XF.According to the ECAR of red blood cells,three indicators of basic glycolysis,glucose reactivity and glycolysis ability were calculated.?4?The ATP content of each sample was detected using a kit.2.Quality evaluation of blood stored in the plateauwe used the plain blood supply plateau as the background,and stored the suspended red blood cells collected in Beijing in the plain area?Beijing?and the plateau blood bank?Lhasa and Linzhi?at 4?.Samples stored in various places were collected at the end of the suspension red blood cell storage period?35 days and 42 days?and tested as follows:?1?Using automatic blood analyzer to measure the red blood cell count,hematocrit,hemoglobin content and other indicators of each group of samples.?2?The free hemoglobin content of each sample was detected by Triton^TM/NaOH method,and the hemolysis rate was calculated according to the formula.?3?The ECAR value of red blood cells in each group of samples was detected by extracellular flow analysis technology,and three indicators of glycolysis,glucose reactivity and glycolysis ability were calculated to reflect the level of red blood cell glycolysis.?4?The ATP content of each sample was detected by colorimetric fluorescence method.Result:1.Quality evaluation of blood storage and transportation at sea?1?In the Bohai Sea navigation,there is no significant change in the basic glycolysis,glucose reactivity and glycolysis capacity of suspended red blood cells stored on ships compared with suspended red blood cells stored in the land blood bank;There were no significant changes in blood quality evaluation indicators such as hemolysis rate,hemoglobin content,hematocrit,cell viability,and number of red blood cells.Compared with the control group?freshly suspended red blood cells?,the glucose reactivity of the suspended red blood cells stored in the onshore blood bank and the suspended red blood cells stored on the ship was reduced,and the basic glycolysis and glycolysis ability and the above blood quality indicators were not obvious Variety.?2?In the Pacific Rim,compared with the positive control group?freshly suspended red blood cells?,there was no significant change in hemolysis rate,hemoglobin content,hematocrit,cell viability and red blood cell count of suspended red blood cells in the South Pacific Navigation?zone B?and the Central Pacific Navigation Group?zone C?.In terms of energy metabolism,the basal glycolysis and glucose reactivity of suspended blood cells in zone B were reduced,and the glycolysis ability was not significantly changed.The three indicators of basal glycolysis,glucose reactivity and glycolysis of red blood cells were all reduced in zone C.Compared with the negative control group?expired suspended red blood cells?,the hemoglobin content,hematocrit,cell viability and red blood cell count of the suspended red blood cells in the zone B and zone C were increased;there was no difference in the energy metabolism index of the suspended red blood cells in the zone B.The basic glycolysis and glycolysis ability of the suspended red blood cells in the zone C was reduced.2.Quality evaluation of blood stored in the plateau?1?Compared with the suspended red blood cells stored in Beijing,there was no significant difference in basic glycolysis,glucose reactivity,glycolysis and ATP content between Lhasa stored red blood cells at the end of storage?35 days and 42 days?;There were no significant differences in blood quality evaluation indexes such as hemolysis rate,hemoglobin content,hematocrit,red blood cell survival rate,and cell number,and the hemolysis rate was less than 0.8%,and the hemoglobin content was?20g/200mL,which was in line with national blood quality standards.?2?Compared with the suspended red blood cells stored in Beijing,there was no significant difference in basic glycolysis,glucose reactivity,glycolysis and ATP content between between Linzhi stored red blood cells at the end of storage?35 days and 42days?;There were no significant differences in blood quality indicators such as hemolysis rate,hemoglobin content,hematocrit,red blood cell survival rate,and cell number,and they met the national blood quality standards.Conclusion:In this study,the quality of suspension red blood cells in special storage?marine and plateau?was evaluated by structural and energy metabolism research methods.?1?Different sea conditions have significant effects on the quality of suspended red blood cells.?2?Within a certain altitude range,the altitude has no significant effect on the quality of suspended red blood cells.This study provides a new idea for the evaluation of stored blood quality in special environments?sea and plateau?,which is a comprehensive and accurate analysis of blood quality changes from the perspective of structure and energy metabolism.Energy metabolism reflects the intracellular changes before erythrocyte disintegration and death,and is a“predictive indicator”;structural changes reflect the“immediate”state of red blood cells,which is a“reality indicator”.Both are indispensable,and joint research will greatly enrich the connotation of red blood cell quality evaluation,which has important theoretical and practical significance.