Objective To investigate the perioperative risk factors associated with prognoses of patients with acute ischemic stroke accepted mechanical thrombectomy under general anesthesia.Methods The clinical data of 108 patients with acute ischemic stroke,admitted to and accepted mechanical thrombectomy under general anesthesia in our hospital from January l,2016 to October 31,2018,were collected.According to modified Rankin scale (mRS) scores 90 d after surgery,patients were divided into good prognosis group (mRS scores ≤2) and poor prognosis group (mRS scores ≥3).Univariate analysis was used to compare the general data (age,gender,body mass index,and underlying diseases) and perioperative conditions (immediate heart rate,systolic and diastolic blood pressures immediately after admission,operative time,and anesthesia time) between the two groups of patients.Multivariate Logistic regression analysis was used to identify the perioperative risk factors influencing the prognoses of patients with acute ischemic stroke accepted mechanical thrombectomy.Results Among the 108 patients,65 had good prognosis and 43 had poor prognosis.Univariate analysis showed that there was no significant difference in general data between the two groups (P＞0.05),but there were significant differences in heart rate immediately after admission,National Institutes of Health Stroke Scale (NIHSS) scores immediately after admission and 3 d after operation,maximum hemoglobin and blood glucose values from immediately after admission to 3rd d of operation,and thrombolysis in myocardial infarction (TIMI) blood flow classification (P＜0.05).Multivariate Logistic regression analysis showed that heartrate immediately after admission (OR=1.035,95％CI:1.002-1.067,P=0.037) and NIHSS scores 3 d after operation (OR=1.153,95％CI:1.016-1.272,P=0.030) were the perioperative risk factors influencing the prognoses of patients with acute ischemic stroke accepted mechanical thrombectomy.Conclusion For patients with acute ischemic stroke who have rapid heart rate immediately after admission and high NIHSS scores 3 d after mechanical thrombectomy,possibility of poor prognosis should be noticed.

Objective : To investigate the effect and mechanism of celecoxib on retinal vascular endothelial growth factor(VEGF) in rats with diabetic retinopathy. Methods : Forty - five SD rats were divided into normal control group (NC) , diabetic retinopathy group (DR) , celecoxib intervention diabetic retinopathy group ( DR + C) . The diabetic model was established by intraperitoneal injection of 1% STZ. After one month , celecoxib (50 mg/kg) was given intragastric administration (1/day) in the DR + C group. Two months later, serum total cholesterol (TC) and insulin were detected. The histopathological changes of the retina were observed. The expression of junctional adhesion molecule⁃like protein (JAML) , VEGF and their signal pathway proteins and the distributions of interleukin⁃10 (IL⁃10) , vascular cell adhesion molecules⁃1(VCAM⁃1) were detected by Western blot. HUVEC cells were divided into normal glucose group (NG) , high glucose group (HG) and high glucose plus celecoxib group (HG + C) to detect the expression of the above proteins. Results : Compared with DR , retina in DR + C group was thinner. The retina in the DR + C group was thicker than that in the NC group. The levels of retinal JAML ,phosphatidylinositol kinase3(PI3K), phosphorylphosphatidylinositol kinase3(P⁃PI3K) , hypoxia⁃inducible factor1 ⁃α (HIF1 ⁃α ) , and VEGF in DR + C group were lower than those in DR group ,while higher than those in NC group. The expression of retinal IL⁃10 and VCAM⁃1 decreased . The content of TC in DR + C and DR group was higher than those in NC group (P < 0. 01) , while the content of insulin in DR + C and DR group was lower than thlse in NC group (P < 0. 001) . Compared with HG group , the expressions of JAML , PI3K , P ⁃PI3K , HIF1 ⁃α , VEGF in HG + C group decreased , but was higher than those in NG group. There was no significant difference in PI3K among the three groups. Conclusion Celecoxib can decrease the expression of VEGF , IL⁃10 , VCAM⁃1 in retina of DR rats , which may be related to the PI3K/HIF1 ⁃α signaling pathway mediated by JAML.

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.