Objective To develop a plateau emergency medical treatment system on the helicopter for firstaid of critical patients in the plateau at peace time and wartime.Method With the characteristics of M17B-7 helicopter considered,the components of the system were supposed to include a chest for pulmonary resuscitation and monitoring,a firstaid backpack,two thermal bags and four transport stretchers.Results The resuscitation and monitoring device was gifted with perfect ergonomic design,and the requirements for firstaid,resuscitation,rewarming and heat preservation were satisfied by the firstaid backpack and thermal bags.The system could be applied to emergency treatment of combined,multiple injuries,such as dressing,hemostasia and fixation,as well as keeping the respiratory tract unobstructed,efficient respiratory support,maintenance of vital signs and treatment of cold injury.Conclusion The plateau emergency medical treatment system on the helicopter behaves well in medical treatment and field survival ability,and thus can be allocated according to service requirements and troops' organizational system for searching and firstaid of the person in distress in the plateau.

Tobacco use is the leading preventable risk factor causing the global burden of disease and one of China's most significant public health issues. Continuous and dynamic tobacco monitoring can provide critical index data for developing tobacco control strategies and measures and evaluating the impact of tobacco control. The WHO has incorporated monitoring programs into the crucial content of tobacco control and put forward relevant compliance requirements in the Framework Convention on Tobacco Control (FCTC). The Chinese government has actively promoted tobacco control significantly since the entry into force of the FCTC in China and continuously strengthened tobacco monitoring. In 2021, China's tobacco monitoring was honored to have reached the highest level required by the WHO. This study introduces the sampling design of tobacco surveys, monitoring content, the definition of key indicators and data weighting based on a complex sampling design, analyzing the challenges facing in the current setting, and provides a reference for the understanding and utilization of the data, the comparison of the results, and the future development of tobacco monitoring. The surveys involved in this study will focus on the specialized epidemiological surveys of tobacco for adults and adolescents carried out nationwide.

Objective To evaluate the prognostic significance of the candidate selection Hangzhou criteria for liver transplantation of HCC patients undergoing hepatectomy.Methods 199 HCC patients undergoing hepatectomy between 2009 and 2011 were enrolled retrospectively.Predictors of survival were identified using the Kaplan-Meier method.The disease state was staged by the Hangzhou criteria (HC) and Milan staging systems.Calculating the area under the receiver operating characteristic (ROC) curve (AUC) evaluates the discriminatory ability for the prediction of survival of both staging system.Results Portal vein thrombosis,poor differentiation,and tumor size (＞ 8 cm) were independent risk factors for survival after hepatectomy.Milan criteria and Hangzhou criteria functioned well in predicting tumor-recurrence.For 1-year AUROC,the AUROC for Milan criteria and Hangzhou criteria are 0.602 and 0.741,respectively.For 3-year AUROC,the AUROC for Milan criteria and Hangzhou criteria are 0.643 and 0.733,respectively.Conclusions The HC were shown to be a promising survival predictor in a Chinese cohort of HCC patients after hepatectomy.

Objective:To describe the current situation on quit intention and quit attempts among current smokers aged 15 years and above in China and explore the main factors affecting their smoking cessation behaviors.Methods:The subjects were people aged 15 years and above in China. A stratified multi-phased randomized cluster sampling method was used. The survey covered 200 districts/counties in 31 provinces (autonomous regions and municipalities directly under the central government), including 19 376 people under investigation. The data were weighted with SAS 9.4 for complex sampling analysis, and the frequency and weighted component ratio were used for description. The influencing factors were studied using the Rao Scott χ2 test and unconditional multivariate logistic regression. Results:Among current smokers, 6.63% reported that they planned to quit smoking in the next month, 5.44% for men and 8.49% for women. 17.96% of the current smokers made quit attempts in the past 12 months, with 17.80% men and 22.15% women. People who smoke occasionally ( OR=3.42, 95% CI: 2.09-5.59) made quit attempts in the past ( OR=4.91, 95% CI: 0.33-0.52) and knew that smoking would lead to three diseases ( OR=2.24, 95% CI: 1.48-3.40) had higher quit intention. People who occasionally smoke ( OR=1.68, 95% CI: 1.20-2.34) received smoking cessation suggestions from medical staff ( OR=1.96, 95% CI: 1.62-2.37), were a ware of that smoking causes three diseases ( OR=1.63, 95% CI: 1.32-2.02) and had smoking prohibition regulations in indoor areas of their homes, had a higher rate of quit attempts. Conclusion:Providing effective smoking cessation intervention services and creating a supportive tobacco control environment are significant in promoting smoking cessation behavior.

Objective:To investigate the exposure to tobacco advertisements and promotions among Chinese adults aged 15 and above, identify the publicity channels and forms of tobacco advertising and promotion in 2010 and 2018, and implicate further tobacco control measures in China.Methods:A multistage, stratified, randomized cluster sampling design was used in 2010 and 2018 China Adult Tobacco Survey, with national representativeness. 13 354 and 19 376 permanent residents were selected in the 2010 and 2018 surveys. SAS 9.4 software was applied for data analysis, and all the data were weighted based on a complex sampling design. Rao Scott χ2 test was used for group comparison of a single factor. Results:In 2010 and 2018, 19.61% and 18.14% of the survey respondents did see tobacco advertising and promotion. From 2010 to 2018, there was no significant change in the situation of tobacco advertisements and promotions. Among those who had gone to a cigarette shop, the proportion of seeing tobacco advertisements increased from 29.28% in 2010 to 43.28% in 2018. Among those who had seen tobacco advertisements on TV, the rate fell from 50.93% in 2010 to 28.58% in 2018. Among those who had gone to movie theaters, the proportion of seeing tobacco advertisements increased from 2.17% in 2010 to 9.89% in 2018. Among those who had used the Internet, the proportion of seeing tobacco advertisements online rose from 19.20% in 2010 to 42.30% in 2018. In terms of tobacco promotion, the percentages of people who had seen tobacco promotions, cigarette price discounts, cigarette discount coupons, gifts, and other preferential activities in various places in the past 30 days were 4.99% vs. 9.30%, 0.78% vs. 4.09%, 0.04% vs. 0.33% and 0.98% vs. 3.33% in 2010 and 2018, respectively ( P<0.001). Conclusions:Tobacco advertising and promotion are still prevalent in China, with no significant change in 2010 and 2018. Tobacco advertising and promotion have been with the constant changes and development of media platforms. It is necessary to improve the implementation of relevant policies, comprehensively ban tobacco advertisements and promotions, and strengthen the supervision of ads and promotions.

Objective:To investigate the treatment and prognosis of acute carotid artery occlusion during perioperative period of carotid endarterectomy (CEA).Methods:The clinical data of 112 carotid artery stenosis patients who underwent CEA from January 2017 to December 2021 in Lianyungang Hospital Affiliated to Xuzhou Medical University were retrospectively analyzed. The patients were followed up at 6 to 9 months after surgery, the clinical prognosis was evaluated by Glasgow outcome score (GOS), and the head and neck CT angiography (CTA) was performed.Results:Among the 112 patients, 5 patients underwent acute carotid artery occlusion during the perioperative period, including 1 case of intraoperative acute occlusion of internal carotid artery and 1 case of intraoperative internal carotid artery combined with external carotid artery cute occlusion, both of them were re-sutured, and multi-mode monitoring showed that each carotid artery was unobstructed; 2 cases of intraoperative external carotid artery occlusion, no re-suture was performed during the operation; 1 case of intraoperative monitoring showed no obvious abnormality, and the contralateral limb hemiplegia was observed after surgery, and the muscle strength was grade 1, the carotid color Doppler ultrasound showed the occlusion of the internal carotid artery on the operation side. The CT and CTA examination showed focal infarction and common carotid artery on the operation side, and drugs and conservative treatment were given. The follow-up result: GOS 5 scores was in 4 cases, and 4 scores in 1 case; the muscle strength of hemiplegia patient recovered to grade 4; head and neck CTA examination, except for 1 case of common arterial occlusion, the other 4 cases showed no special abnormality.Conclusions:Intraoperative acute carotid artery occlusion can be detected timely by intraoperative multi-mode hemodynamic monitoring during CEA. Vascular recanalization after acute occlusion is possible by adopting active and effective treatment methods, the occurrence of postoperative ischemic stroke can be effectively prevented and the prognosis of patients can be improved.

Objective:To investigate secondhand smoke (SHS) exposure among non-current smokers aged 15 and over and its influencing factors in China in 2010 and 2018.Methods:The 2010 and 2018 China Adult Tobacco Surveys used multistage stratified cluster random sampling methods to obtain national representative samples across 31 provinces (autonomous regions and municipalities) in China. This study selected non-current smokers aged 15 and over as the research subjects to describe the general demographic characteristics, perceptions of SHS hazards, attitudes towards smoking bans in indoor areas in public places, and SHS exposure and the smoking restriction regulations in different places. The Rao-Scott χ2 test was used to compare the rates, and the unconditional logistic regression was used to analyze the influencing factors of SHS exposure. All the subjects in the analysis were weighted based on a complex sampling design. Results:Among non-current smokers aged 15 and over, from 2010 to 2018, the percentage of indoor smokers had decreased from 84.7% to 71.9%. The rates of people who saw smoking in various places declined with a statistically significant difference ( P<0.001). The exposure to SHS for females, people aged 45-64, teachers, medical staff, workers in enterprises, businesses, waiters, and people who live in rural and central areas declined. The differences were statistically significant ( P<0.05). In 2018, the percentage of SHS exposure for those who reported a comprehensive smoking ban in households or allowed smoking in certain areas was lower than for those who reported allowed or without a smoking ban. Among those aged 25-44, SHS exposure for those who reported complete smoking prohibition in workplaces was lower than those who reported allowed or without smoking prohibition ( OR=0.65, 95% CI: 0.49-0.87). The proportion of SHS exposure for those who believe that smoking should not be allowed in indoor areas of 0-5 public places is higher than that smoking should not be allowed in the indoor spaces of 8 public places ( OR=2.13, 95% CI: 1.35-3.36). Among people aged 45-64, the proportions of SHS exposure for teachers ( OR=0.37, 95% CI: 0.17-0.78) and medical staff ( OR=0.35, 95% CI: 0.16-0.76) and staff working in agriculture, forestry, animal husbandry, fishery, and water conservancy were lower than governmental staff ( OR=0.49, 95% CI: 0.29-0.84). Conclusions:Data from the decreased exposure of Chinese non-current smokers aged 15 and over to SHS suggests the initial achievement through constructing a smoke-free environment, but continued efforts are needed. It is necessary to actively advocate for smoke-free families, strengthen publicity and education on the hazards of tobacco and SHS, and improve the skills of non-smokers in rejecting SHS exposure.

Purpose To analyze the expression of TRPS1 protein in breast cancer and lung cancer and its difference,and to explore the diagnostic value of TRPS1 protein in differential diagnosis between lung metastasis from breast cancer and prima-ry lung cancer.Methods A total of 369 cases of breast canc-er,57 cases of primary lung cancer(23 cases of surgical resec-tion samples,34 cases of biopsy samples),and 35 cases of lung metastases from breast cancer(3 cases of surgical resection sam-ples,32 cases of biopsy samples)were collected.Immunohisto-chemical EnVision method was used to detect the expression of TRPS1 protein in all cases and to analyze its expression differ-ences.Results TRPS1 protein was expressed in 369 cases of breast cancer,of which 93.2％cases showed diffusely strongly positive expression(≥95％ strongly positive expression in tumor cell nucleus),6.8％ cases showed heterogeneous expres-sion of tumor cells,and the tumor types were mainly breast cancer with sweat gland differentiation and metaplastic cancer.Among 57 cases of primary lung cancer,28.1％of cases were negative for TRPS1,70.2％ of cases showed heterogeneous ex-pression,manifested as varying degrees of nuclear staining or only focal nuclear staining,and heterogeneous expression was dominant in different histological types including adenocarcino-ma,squamous cell carcinoma,and neuroendocrine carcinoma.In addition,TRPS1 was observed to be diffusely strongly positive in one(1.7％)lung adenocarcinoma biopsy sample.Among 35 cases of lung metastases from breast cancer,including surgical resection samples and biopsy samples,100％cases showed dif-fusely strongly positive expression of TRPS1.The expression of TRPS1 in lung metastasis of breast cancer and primary lung cancer was significantly different(P＜0.001).Conclusion TRPS1 protein is a highly sensitive and specific biomarker for breast cancer,but it can still be expressed in other tumors such as lung cancer,and it is also observed that TRPS1 is expressed to varying degrees in various histological types of lung cancer,which has certain diagnostic value in differentiating lung metas-tases from primary lung cancer in breast cancer,but it cannot be used as a single diagnostic marker,especially in small biopsy tissues of lung nodules.Therefore it is necessary to use multiple biomarkers to comprehensively determine the source of metasta-ses to improve the diagnostic accuracy,so as to guide follow-up clinical treatment.