The blood protective effect of autologous platelet separation in aortic dissection.

OBJECTIVE: This study aimed to retrospectively analyze the blood protective effect of autologous platelet separation in operations for acute aortic dissection. METHODS: A total of 130 patients with acute aortic dissection were enrolled into the present study. The average age of these patients was 52.962±10.5061 years old. These patients underwent the modified aortic arch replacement with the elephant trunk technique or endovascular aortic exclusion with covered stent. Among these patients, 68 patients who underwent autologous platelet separation were assigned to the platelet separation group, while the remaining patients were assigned to the control group. All operations were performed under deep hypothermic circulatory arrest. After anesthesia, 1-2 therapeutic doses of autologous platelets were isolated from patients in the platelet separation group, and these platelets were quickly infused back to these patients after heparin was neutralized by protamine at the end of the cardiopulmonary bypass. The preoperative and postoperative indexes in these two groups were compared. RESULTS: There were no statistically significant differences in age, gender, smoking history, drinking history and hypertension history between these two groups. Compared with controls, the transfusion volume of allogeneic platelets in the perioperative period significantly decreased in the platelet separation group (1.919±1.6226 vs. 0.794±1.1789, P < #x003C;< #x200A;0.05), and the use rate of allogeneic platelets also significantly decreased (74.19% vs. 45.59%, P < #x003C;< #x200A;0.05). CONCLUSION: The intraoperative auto transfusion of platelets significantly reduced the volume of allogeneic platelet transfusion after the operation for aortic dissection, which has a significant blood protective effect.

Epidemiology of Hypertension in a Typical State-Level Poverty-Stricken County in China and Evaluation of a Whole Population Health Prevention Project Intervention.

BACKGROUND: In China, there were 584 state-level, poverty-stricken counties until January 2019. The central government has invested a large amount of funds and preferential policies to alleviate poverty in these areas. The Whole Population Preventive Healthcare Pilot Project (WPPHCPP) aims to explore the use of limited funds to achieve healthy poverty alleviation through free regular physical examinations and comprehensive health management for the entire population in impoverished regions. OBJECTIVE: By demonstrating the prevalence of hypertension in populations of poverty-stricken counties in Western China and evaluating health management outcomes after implementing the WPPHCPP, we can provide a foundation for the future development and promotion of improved public health. SUBJECTS AND METHODS: Through the WPPHCPP, the entire population in the pilot area was required to undergo free physical examinations. The examinations screened for hypertension revealed the epidemiology of adult hypertension. Based on blood pressure levels and risk factor exposures, risk classifications for hypertensive patients were performed. Corresponding intervention and management strategies for different risk levels were provided by a joint management team consisting of family physicians from three different levels of local medical institutions (village, town, and county). Healthcare management outcomes including awareness, treatment, and hypertension disease rates were compared between the period before and after the intervention and management. RESULTS: By the end of 2017, among the 452,200 permanent residents in the region, 285,458 adults had completed the physical examination. The prevalence of hypertension was 18.5%, which was lower than the national average of rural areas (28.8%). The prevalence of hypertension in men (18.7%) was slightly higher than that of women (18.3%). The prevalence of hypertension increases with age; for people aged >65 years, it was 39.2%. There were 15,074 newly discovered hypertensive patients in the WPPHCPP, accounting for 29.6% of the total hypertensive population in the region. Regarding the management outcomes, the rates of management and standardized management of hypertension increased each year between 2015 and 2017. Although the rate of disease control management decreased slightly, the overall level of management remained significant. The awareness and treatment rates of hypertension also increased over the years and peaked at 95.0% and 94.9%, respectively, in 2017. The disease control rate was 45.6% in 2016, which was the highest among the years assessed. All the above parameters were better than the national average of rural areas. From 2015 to 2017, the number of people with high-risk factors for hypertension and percentage of high-risk patients decreased from 33,064 to 26,982 and 27.4% to 24.6%, respectively. The percentage of the population exposed to cigarettes and alcohol decreased from 30.6% to 27.2% and 25.1% to 22.0%, respectively. The number of deaths due to hypertensive cardiovascular or cerebrovascular diseases decreased each year and was 275 (39.55/100,000 people) in 2017, which was the lowest rate measured. The annual growth of cardiovascular or cerebrovascular diseases remained negative. CONCLUSIONS: The overall prevalence of hypertension in the studied area was lower than the national average of rural areas. The health management model of "government-led joint efforts of three levels of medical institutions (village, town, and county) with active participation of local village communities" improved the management outcomes of hypertensive patients and fulfilled the latest advocacy of the prevention and control of chronic diseases by the United Nations. This model can be considered an effective model for healthcare management practice in similar situations.

Dual-Targeting Nanoparticles: Codelivery of Curcumin and 5-Fluorouracil for Synergistic Treatment of Hepatocarcinoma.

Chemotherapy has been the standard for cancer therapy, but the nonspecific cytotoxicity of chemotherapeutic agents and drug resistance of tumor cells has limited its efficacy. However, multidrug combination therapy and targeting therapy have resulted in enhanced anticancer effects and have become increasingly important strategies in clinical applications. In this study, a biotin-/lactobionic acid-modified poly(ethylene glycol)-poly(lactic-co-glycolic acid)-poly(ethylene glycol) (BLPP) copolymer was synthesized, and curcumin- and 5-fluorouracil-loaded nanoparticles (BLPPNPs/C + F) were prepared to enhance the treatment of hepatocellular carcinoma. Blank BLPPNPs were shown to have great biocompatibility via both in vitro and in vivo studies. Good targeting of tumor cells of BLPPNPs was confirmed by flow cytometry, fluorescence microscopy, and biodistribution. The synergistic anticancer effects of BLPPNPs/C + F were demonstrated by cytotoxicity and animal studies, while western blotting was used to further verify the synergistic effect of curcumin and 5-fluorouracil. The dual-targeting and drug-loaded codelivery nanosystem demonstrated higher cellular uptake and stronger cytotoxicity for tumor cells. Therefore, these dual-targeting NPs are a promising codelivery carrier that could be made available for cellular targeting of anticancer drugs to achieve better intracellular delivery and synergistic anticancer efficacy.