The World Health Organization (WHO) released the “Global report on hypertension” on September 19, 2023. This report systematically summarizes the prevalence, mortality, diagnosis and treatment of hypertension in various countries, and elucidates the current situation of hypertension management, and gives a series of suggestions on how to manage hypertension, providing new thinking and inspiration for countries to optimize hypertension management. Through the summary of relevant studies and reports, this paper further reviews the present situation, early identification and management of hypertension.

OBJECTIVE To assess the efficacy of bioabsorbable steroid-releasing sinus stents for improving surgical outcomes and subjective symptoms when placed in the bilateral frontal sinus opening(FSO)following full functional endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyps(CRSwNP).METHODS CRSwNP patients who had under full functional endoscopic sinus surgery with complete data of nasal endoscopy and sinus computed tomography data were identified and included in the study.The patients were divided into a control group consisting of patients receiving only full functional endoscopic sinus surgery(n=92)and a stent group consisting of patients receiving full functional endoscopic sinus surgery combined with placement of steroid implants in both FSO(n=38).The visual analogue scale(VAS)subjective symptom scores and surgical outcomes were compared preoperatively,and on postoperative day(PD30 and PD90)between the two groups.RESULTS Compared to baseline,the overall symptom VAS scores of patients after operation decreased significantly in both groups(P<0.05),and the degree of improvement of overall symptoms in the stent group was significantly better than in the control group(P<0.05).On PD30,the proportion of patients requiring postoperative interventions for bilateral FSO was reduced by 42.3%in the stent group,and was significantly lower than in the control group(P<0.05).Compared to the control group,the proportion of patients needing postoperative intervention in both ethmoid sinus on the stent group decreased by 17.7%(P>0.05).The results at PD90 were consistent with those at PD30.CONCLUSION Full functional endoscopic sinus surgery in combination with bilateral frontal sinus stent implantation is better than full functional endoscopic sinus surgery alone.

Organ transplantation is the optimal treatment for end-stage organ failure. Nevertheless, organ shortage is a global problem, which limits further development of organ transplantation. Recent research shows that genetically modified pig may become a realistic alternative source of clinical organ transplantation donor. Xenotransplantation may serve as one of the effective measures to resolve the problem of organ shortage. Since 2021, 2 cases of living xenotransplantation and 6 cases of xenotransplantation in brain death recipients have been performed worldwide, and phase Ⅰ clinical trial of xenotransplantation has been launched, and the results have exceeded expectations. Therefore, in this article, recent clinical trial results of xenotransplantation in living and brain death recipients were retrospectively analyzed, and scientific, technical and ethical issues related to clinical research of xenotransplantation were illustrated, hoping to provide reference for clinical research of xenotransplantation in China and promote the development of xenotransplantation in clinical practice.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the diagnostic value Tamm-Horsfall protein(THP)and osteopontin(OPN)in serum and 24-hour urine for urolithiasis.Methods A total of 101 patients with urolithiasis who underwent flexible ureteroscopy lithotripsy at the Urology Department of Civil Aviation General Hospital from April 2020 to March 2023 were included as the stone group,and 50 healthy individuals were enrolled as the control group.The samples of serum and 24-hour urine samples were collected from both the groups,and the levels of THP and OPN were measured using enzyme-linked immunosorbent assay(ELISA).Logistic regression analysis was performed to evaluate the association between each biomarker and urolithiasis,and receiver operating characteristic(ROC)curves were plotted to assess their diagnostic value.Results The stone group showed significantly lower THP levels(20.13[13.12,26.03]mg/d)and OPN levels(51.24[36.72,101.37]μg/d)in 24-hour urine,and THP levels(182.01[160.91,209.20]ng/mL)and OPN lev-els(18.76[15.72,22.48]ng/mL)in serum compared to the control group(all the P＜0.001).Binary Logistic regression analysis re-vealed that THP(OR=0.736,95％CI:0.606-0.895),OPN(OR=0.975,95％CI:0.958-0.993)and citrate(OR=0.067,95％CI:0.012-0.376)in 24-hour urine,and THP(OR=0.946,95％CI:0.908-0.986)and OPN(OR=0.896,95％CI:0.803-0.999)in ser-um were the protective factors for urolithiasis,while calcium level(OR=2.125,95％CI:1.243-3.633)24-hour urine was a risk factor(all the P＜0.05).ROC curve analysis showed that the areas under the curve(AUCROC)for the individual diagnosis of urolithiasis were 0.846,0.809,0.786,0.823,0.748,and 0.755 for the above six biomarkers,respectively.The AUCROC for the combined diagnosis u-sing THP+OPN in serum,THP+OPN in 24-hour urine and all the six biomarkers were 0.882,0.920 and 0.984,respectively,indica-ting better diagnostic performance.Conclusion The combined detection of the THP and OPN levels in serum and 24-hour urine may have good diagnostic value for urolithiasis and serve as potential diagnostic biomarkers.

OBJECTIVE To explore the role and underlying mechanism of tournefolic acid B （TAB） on the improvement of glucose metabolism and renal function in diabetic nephropathy （DN） model mice. METHODS DN model mice were established by high-fat diet combined with streptozotocin， and then randomly divided into model group， positive control group （vitamin E， 20 mg/kg）， TAB low-dose， medium-dose and high-dose groups （1， 2， 4 mg/kg）， with 12 mice in each group； normal control group was given regular diet. Each group was given relevant medicine or normal saline intragastrically， once a day， for 4 consecutive weeks. The glucose metabolic function was estimated by fasting blood glucose， glucose tolerance test， insulin tolerance test and serum insulin concentration. The renal coefficients and biochemical indicators related to renal function [serum uric acid， blood urea nitrogen， creatinine levels， and ratio of urine microalbumin to creatinine] were detected in mice； the contents of biochemical indicators related to oxidative stress [superoxide dismutase （SOD）， glutathione peroxidase （GSH-Px）， malondialdehyde （MDA）， 8-hydroxydeoxyguanosine （8-OHdG）] were determined in renal tissue of mice； the pathological morphology of renal tissue was observed； the expressions of extracellular matrix （ECM） deposition related factors [transforming growth factor β1 （TGF- β1）， fibronectin （Fn）， type Ⅳ collagen （Col Ⅳ）] and protein kinase B （Akt）/nuclear factor erythroid 2-related factor 2 （Nrf2）/heme oxygenase-1 （HO-1） pathway related proteins were determined in renal tissue of mice. RESULTS Compared with normal control group， fasting blood glucose， area under glucose tolerance curve， area under insulin tolerance curve， serum insulin content， the levels of uric acid， urea nitrogen and creatinine @qq.com and ratio of urinary microalbumin to creatinine in serum， the contents of MDA and 8-OHdG and the protein expressions of TGF-β1， Fn and Col Ⅳ were increased significantly in model group （P＜0.05）， while the contents of SOD， GSH-Px and the protein expressions of p-Akt， Nrf2， HO-1 in renal tissue were decreased significantly （P＜0.05）； the significant thickening of the basement membrane， accumulation of mesangial matrix， glomerulosclerosis and interstitial fibrosis of the renal tubules were all found. Compared with model group， above indexes of mice were all reversed significantly in TAB groups （P＜0.05）， and pathological changes were alleviated in a dose-dependent manner. CONCLUSIONS TAB can improve blood glucose metabolism and kidney function and alleviate renal tubulointerstitial fibrosis in DN model mice， the mechanism of which may be associated with activating the Akt/Nrf2/HO-1 signaling pathway and suppressing ECM deposition.

Objective : To investigate the awareness of nutritional health knowledge regular unpaid blood donors in Zhoushan City, Zhejiang Province, so as to provide insights into nutrition and health education among unpaid blood donors. Methods: The regular unpaid blood donors were sampled using a convenient sampling method from Zhoushan Central Blood Station from January 1, 2021 to June 30, 2022. The nutritional health knowledge was investigated using the Chinese Nutrition Health Knowledge Questionnaire for Adults compiled by Chinese Center for Disease Control and Prevention, and the awareness and source of nutritional health knowledge was descriptively analyzed. Results: Totally 526 questionnaires were allocated, and 502 valid questionnaires were recovered, with an effective recovery rate of 95.44%. The respondents included 240 men (47.81%) and 262 women (52.19%), and included 343 individuals at ages of 18 to 44 years (68.33%), and 159 individuals at ages of 45 years and older (31.67%). The overall awareness of nutritional health knowledge was 14.54% among regular unpaid blood donors in Zhoushan City, and a higher awareness was seen among female regular unpaid blood donors (17.56%) than among males (11.25%) (P<0.05), while the awareness of nutritional health knowledge was significantly higher among respondents at ages of 18 to 44 years than among those at ages of 45 years and older (16.91% vs. 9.43%, P<0.05). The awareness of nutritional health knowledge was significantly higher among respondents with an educational level of junior college and above than among those with an educational level of high school/technical secondary school/technical school (17.24% vs. 12.22%, P<0.05), and the awareness was significantly higher among respondents with healthcare-related occupations than among those with other occupations (16.44% vs. 14.22%, P<0.05). Wechat, Weibo, Tik Tok and Kuaishou were main routes to obtain nutritional health knowledge (83.86%). Conclusions The awareness of nutritional health knowledge is low among regular unpaid blood donors in Zhoushan City. Men, middle-aged and elderly residents and residents with a low educational level are targets that should be given a high priority for nutritional health education, and new media may be fully utilized for nutritional health education.

【Objective】 To study the characteristics of voluntary apheresis platelet donors in Zhoushan Islands and its influence on the collection and supply of apheresis platelets. 【Methods】 From January 1, 2017 to December 31, 2021, 1038 eligible donors were selected out of 1151 apheresis candidates for demographic analysis, donation time analysis, blood routine test. We also investigated whether the current supply of apheresis platelet met the needs of clinical. The lapsed donors(with only one donation) were telephone interviewed to investigate the lapsing reasons. 【Results】 From 2017 to 2021, the median (M) ratio of platelet donors to the population in Zhoushan City was 0.454 ‰. And 90.18% (1038/1151) of the candidates completed donation, involving 2659 donations and 3205 U products. The per capita donation amount was (1.29±0.77) U per person, which basically met the blood demand in clinical of Zhoushan Islands. The 1038 platelet donors were 18 to 59 yeas old[M(QR) 34(16)], and 47.50% (493/1038) of them aged 31 to 45; the ratio of male to female blood donors was 2.0∶1; 70.61% (733/1038) had college education or above; ABO blood group profile was A>O>B>AB. There were several peak periods of donation during 2017~2021: the second and third quarters of 2017~2019 and the third quarter of 2020; none in 2021, as yeae 2021 was volatile. The donation proportion of the first quarter was the lowest throughout 2017~2021. In 2017 and 2018, the proportion of donors with one donation accounted for 79.79% (75/94) and 51.63% (95/184), respectively. From 2019 to 2021, the proportion of donors with twice or more donation accounted for 60.35% (137/227), 57.36% (187/326) and 53.13% (170/320) , respectively. During 5 years, 10.88% (113/1051) of the candidates failed to donate platelets, of whom 72.57% (82/113) were due to unqualified pre-donation testing. 【Conclusion】 The donation behaviors in Zhoushan have been affected by each above-mentioned demographic factors. The awareness of donation and donation services in Zhoushan have been improved as combing the special geographic condition and demographic characteristics together, and the donation units is elevating yearly which has met the clinical needs of the whole island.

Objective:To explore the status quo of support needs among the caregivers of patients with advanced breast cancer and analyze its influencing factors to provide reference for improving the quality of life of patients with advanced breast cancer and their caregivers.Methods:Totally 168 caregivers of patients with advanced breast cancer admitted at the First Affiliated Hospital of Zhengzhou University were selected by convenient sampling and investigated with the general information questionnaire and Comprehensive Needs Assessment Tool in Cancer for Caregivers (CNAT-C) . Multiple linear regression analysis was used to analyze the influencing factors.Results:The total CNAT-C score of the 168 caregivers of patients with advanced breast cancer was (96.13±8.06) . The result of multiple linear regression analysis showed that the fertility status, monthly family income, and the payment method of medical expenses were the influencing factors of the support of the caregivers of patients with advanced breast cancer ( P<0.05) . Conclusions:Nursing staff should pay attention to the support needs of caregivers of patients with advanced breast cancer and take targeted intervention measures based on their influencing factors to improve the quality of life of patients with advanced breast cancer and their caregivers.

Objective:To explore the effects of early warning nursing on preventing the incidence of venous thrombosis in patients with breast cancer after chemotherapy.Methods:Totally 103 patients with breast cancer admitted at the First Affiliated Hospital of Zhengzhou University from January to December 2018 who received routine nursing were included into the routine group, and 103 patients with breast cancer admitted at the First Affiliated Hospital of Zhengzhou University from January to December 2019 who underwent early warning nursing were included into the early warning group. The incidence of venous thrombosis 1 month after chemotherapy was compared between the two groups. Color Doppler ultrasonography was used to detect axillary blood flow before and 1 month after chemotherapy.Results:The incidence of venous thrombosis in the early warning group after chemotherapy was lower than that in the routine group, and the difference was statistically significant ( P<0.05) . The maximum blood flow rate and average blood flow rate in the armpit after chemotherapy in the early warning group were higher than those in the routine group, with statistically significant difference ( P<0.05) . Conclusions:Early warning nursing has a positive effect on the incidence of venous thrombosis in patients with breast cancer after chemotherapy, which can improve their hemagglutination.