Objective To analyze the innovative model and effectiveness of the four-level prevention of stroke in Nantong Medical and Prevention Collaborative Center for Cardiovascular and Cerebrovascular Disease,so as to provide new practical experience for the prevention and treatment of cerebrovascular disease.Methods In practice,Nantong city has explored the"53343"mode of collaborative treatment and prevention of cardiovascular and cerebrovascular diseases,and innovatively integrated this mode into four-level prevention to form a practice mode of zero-level guidance,first-level monitoring,second-level coordination and three-level leading.Data from the China Health Statistics Yearbook from 2011 to 2022 and the monitoring data of cardiovascular and cerebrovascular events in Nantong City on the Jiangsu Provincial Chronic Disease Management Information Platform from 2017 to 2023 were collected and processed by using Excel and SPSS 24.0,to analyze the changes of stroke surveillance data and effectiveness in Nantong City after applying the model.Results According to the monitoring data of cardiovascular and cerebrovascular events in Nantong City from the Jiangsu Provincial Chronic Disease Management Information Platform,despite the continuous increase in the number of monitored individuals over five years,the monitoring data for stroke from the Nantong Medical and Prevention Collaborative Center for Cardiovascular and Cerebrovascular Disease witnessed a decline in the number of monitored individuals for the first time in 2022.The stroke monitoring data from the same monitoring agency showed a more stable fluctuation trend compared to the number of national stroke patients discharged from 2017 to 2021.We established a coherent health service operation mechanism,cultivated 14 interdisciplinary talents,held a special continuing education class on stroke,strengthened the in-depth collaboration between clinical and public health,and provided a practical and innovative model for effective prevention and treatment of stroke.Conclusions The four-level prevention based on the medical and preventive collaboration center for cardiovascular and cerebrovascular diseases can achieve process and cycle health management,effectively slow down the upward trend of stroke,and improve the ability and level of scientific research and teaching.

Objective:To explore the latent trajectory class of perioperative pain catastrophizing in patients undergoing lumbar internal fixation surgery and analyze the influencing factors of these latent classes.Methods:A total of 180 patients who underwent lumbar internal fixation surgery at Xinxiang Central Hospital from January to December 2023 were selected using convenience sampling. The Pain Catastrophizing Scale (PCS) was used to assess pain catastrophizing at 1 day preoperatively and on postoperative days 3, 7, and 14. Latent Class Growth Modeling (LCGM) was employed to identify trajectory classes of pain catastrophizing, and Logistic regression analysis was used to examine their influencing factors.Results:A total of 177 patients completed the follow-up, with a follow-up rate of 98.33% (177/180) . The overall perioperative PCS score was (30.39±10.86) . PCS scores at 1 day preoperatively and on postoperative days 3, 7, and 14 were (37.63±6.23) , (33.27±6.00) , (28.55±9.02) , and (23.81±9.33) , respectively. The proportions of patients with PCS≥38 at the four times were 42.94% (76/177) , 23.16% (41/177) , 22.60% (40/177) , and 12.43% (22/177) , respectively. LCGM identified three latent trajectory classes of perioperative pain catastrophizing: "high-level declining group" (55.93%, 99/177) , "high-level fluctuating group" (28.81%, 51/177) , and "persistent high-level group" (15.25%, 27/177) . Logistic regression analysis showed that payment method, surgical duration, and preoperative PCS score were significant influencing factors of pain catastrophizing trajectory classes ( P<0.05) . Conclusions:Pain catastrophizing levels in patients undergoing lumbar internal fixation surgery peaked preoperatively. While most patients showed a declining trend postoperatively, a subset exhibited fluctuating or persistently high levels. Payment method, surgical duration, and preoperative pain catastrophizing levels significantly influenced the trajectory of pain catastrophizing, warranting attention from clinical nursing staff.

Objective To analyze the innovative model and effectiveness of the four-level prevention of stroke in Nantong Medical and Prevention Collaborative Center for Cardiovascular and Cerebrovascular Disease,so as to provide new practical experience for the prevention and treatment of cerebrovascular disease.Methods In practice,Nantong city has explored the"53343"mode of collaborative treatment and prevention of cardiovascular and cerebrovascular diseases,and innovatively integrated this mode into four-level prevention to form a practice mode of zero-level guidance,first-level monitoring,second-level coordination and three-level leading.Data from the China Health Statistics Yearbook from 2011 to 2022 and the monitoring data of cardiovascular and cerebrovascular events in Nantong City on the Jiangsu Provincial Chronic Disease Management Information Platform from 2017 to 2023 were collected and processed by using Excel and SPSS 24.0,to analyze the changes of stroke surveillance data and effectiveness in Nantong City after applying the model.Results According to the monitoring data of cardiovascular and cerebrovascular events in Nantong City from the Jiangsu Provincial Chronic Disease Management Information Platform,despite the continuous increase in the number of monitored individuals over five years,the monitoring data for stroke from the Nantong Medical and Prevention Collaborative Center for Cardiovascular and Cerebrovascular Disease witnessed a decline in the number of monitored individuals for the first time in 2022.The stroke monitoring data from the same monitoring agency showed a more stable fluctuation trend compared to the number of national stroke patients discharged from 2017 to 2021.We established a coherent health service operation mechanism,cultivated 14 interdisciplinary talents,held a special continuing education class on stroke,strengthened the in-depth collaboration between clinical and public health,and provided a practical and innovative model for effective prevention and treatment of stroke.Conclusions The four-level prevention based on the medical and preventive collaboration center for cardiovascular and cerebrovascular diseases can achieve process and cycle health management,effectively slow down the upward trend of stroke,and improve the ability and level of scientific research and teaching.

Objective:To explore the latent trajectory class of perioperative pain catastrophizing in patients undergoing lumbar internal fixation surgery and analyze the influencing factors of these latent classes.Methods:A total of 180 patients who underwent lumbar internal fixation surgery at Xinxiang Central Hospital from January to December 2023 were selected using convenience sampling. The Pain Catastrophizing Scale (PCS) was used to assess pain catastrophizing at 1 day preoperatively and on postoperative days 3, 7, and 14. Latent Class Growth Modeling (LCGM) was employed to identify trajectory classes of pain catastrophizing, and Logistic regression analysis was used to examine their influencing factors.Results:A total of 177 patients completed the follow-up, with a follow-up rate of 98.33% (177/180) . The overall perioperative PCS score was (30.39±10.86) . PCS scores at 1 day preoperatively and on postoperative days 3, 7, and 14 were (37.63±6.23) , (33.27±6.00) , (28.55±9.02) , and (23.81±9.33) , respectively. The proportions of patients with PCS≥38 at the four times were 42.94% (76/177) , 23.16% (41/177) , 22.60% (40/177) , and 12.43% (22/177) , respectively. LCGM identified three latent trajectory classes of perioperative pain catastrophizing: "high-level declining group" (55.93%, 99/177) , "high-level fluctuating group" (28.81%, 51/177) , and "persistent high-level group" (15.25%, 27/177) . Logistic regression analysis showed that payment method, surgical duration, and preoperative PCS score were significant influencing factors of pain catastrophizing trajectory classes ( P<0.05) . Conclusions:Pain catastrophizing levels in patients undergoing lumbar internal fixation surgery peaked preoperatively. While most patients showed a declining trend postoperatively, a subset exhibited fluctuating or persistently high levels. Payment method, surgical duration, and preoperative pain catastrophizing levels significantly influenced the trajectory of pain catastrophizing, warranting attention from clinical nursing staff.

Objective To study the method of gray-scale blood flow imaging and image processing in condition of high frequency ultrasound,and the implementation of the system.Methods On the base of research of scattered signals of red blood cells in high frequency ultrasound,20 MHz ultrasound mechanical and linear scanning probe was used to transmit a number of pulses on a scan line.Pulse-echo subtraction method was used to obtain the blood flow information.At the end,simulated blood vascular was used to conduct flow imaging,and the obtained images were analyzed.Results Experiment results showed that clear blood flow images were obtained using this system.The noise from perivascular tissue could be filtered and the signals from blood flow could be enhanced after image processing.Conclusions In the detection of superficial blood vessel,blood flow signals can be obtained even using single pulse emitting via high frequency ultrasound.The blood flow imaging system can be implemented after image processing.

Objective To evaluate the teaching activity on public health courses from clinical medical students in our university in order to provide a scientific basis for improving the curriculum design and teaching reform. Methods The “Questionnaire on Teaching Evaluation in Public Health Courses”, including teaching attitude, teaching content, teaching methods and teaching effectiveness was designed, and a general investigation was conducted among the clinical medical students of five-year program (840 students) and eight-year program (278 students) in these three aspects to under-stand students' evaluation to the course, who had finished the public health courses, including Preven-tive Medicine, Medical Statistics and Epidemiology (hereinafter referred to as: statistics, epidemiology, prevention) in Sun Yat-sen University. Statistical analysis was made using SPSS 13.0 software. Data analysis methods contain descriptive analysis, T-test, ANOVA, LSD, SNK, hierarchical logistic regres-sion analysis, etc. Results The overall score of teaching evaluation is (4.04±0.60). Differences exist between the evaluation in the five-year medical students and the eight-year medical students. The P values were 0.000 (Medical Statistics), 0.269 (Epidemiology), 0.047 (Preventive Medicine). The com-parison of scores among the four dimensions shows: Teaching effectiveness < Teaching methods β' effectiveness. Conclusions Clinical Medical students' overall evaluation on the public health courses offered by this university was good. Teaching effectiveness and teaching methods still need improvement. Teaching contents are the most influential factor of overall teaching satisfaction, followed by teaching effectiveness.

Objective To explore clinical value of serum carcinoembryonic antigen (CEA) rate in early evaluation of imaging tumor efficacy and prognosis of disease control for advanced non-small cell lung cancer (NSCLC) before and after the second course of chemotherapy, and provide the basis for clinical adjustment chemotherapy regimens.Methods Patients in the Third Affiliated Hospital of Sun Yat-sen University were randomly collected in January 2007-September 2014 during the pathological diagnosis of 130 cases for advanced NSCLC, who had an elevated serum CEA level, including pre-chemotherapy and prochemotherapy, were collected.Receiver operating characteristic (ROC) was used to evaluate efficacy of CEA change in evaluation of early disease control (DC).SPSS 18.0 was used to analyze the relationship between CEA change and prognosis.Results After two chemotherapy cycles, the area under the ROC curve was 70.6％.When the cut-point of the change rates of CEA levels was 2.05％ , the Youden index reaches the maximum.Adenocarcinoma group and squamous cell carcinoma patients after 2 courses of CEA change rate evaluation, which area under the ROC curve was 72.0％ (95％ CI :61.4％ ～ 82.5％), and 70.1％ (95％ CI:45.8％ ～94.5％).Survival was analyzed with the Kaplan-Meier method, which showed the change rates of CEA levels were all the influencing factors of progression-free survival (PFS) in patients with advanced NSCLC(P ＜ 0.05).While the change rates of CEA levels were not predictive overall survival (OS) (P =0.715).Conclusions It prompts effective chemotherapy, and patients have the extended PFS, when CEA levels before and after chemotherapy dropped to a certain degree.

Objective To study the characteristics and treatments of occlusive abdominal injuries during pregnancy. Methods The clinical data of 37 cases with occlusive abdominal injuries admitted in hospital from June 1993 to June 2003 were collected for study. Results All 37 cases received operative treatment, of which two cases complicated by enterorrhexis in the early pregnancy and one by retroperitoneal hematoma were managed using laparoscope. Laparotomy was performed in other 34 cases, of which eight received caesaren section because of placental abruption and enlarged uterus that impeded the management for intraabdominal organs. Of all, 33 cases (33/37,89%) were cured and four (4/37, 11%) died. The postoperative incidence of complications was 16% (6/37). The complications included abdominal cavity infection in two cases (5%), pulmonary infection in three (8%) and multiple organ failure in one (3%). Conclusion Besides obstetrics' diseases, we must keep alert about the injury of abdominal organs during the management of trauma. Accurate diagnosis and timely treatment will win time to save the lives of mother and infant.

A sensitive method for the determination of Cr, Mn and Cu in serum sample by flameless atomic absorption spectrophotometry is described. It requires only 0.1-0.2 ml serum sample. The method involves low temperature ashing of serum, 2-10 fold dilution with 0.01N HNO3 and injection of 20?l aliquot into graphite furnace. The known amounts of trace metals arc added to different diluted serum samples, and the recovery rates are 90-109%. The coefficients of variance for within-run and day-to-day values are 1.5-2.8% and 2.0-10.0% respectively. The serum Cr, Mn and Cu levels were determined in 79 normal subjects. 80% of the values are distributed within: 0.8-1.45 ?g/ml(Cu), 0.04-0.08 ?g/ml(Mn), 0.009-0.022 ?g/ml(Cr). It is suggested that the method described is available for a mass survey in a short time and is valualole to detect the trace metal concentation in serum in clinical laboratory.

Trace amount of molybdenum was measured by polarography in serum from 105 healthy adults and 159 patients with Keshan disease. Geometric mean molybdenum concentration in normal serum was found to be 6.2ng/ml (range: 1.5-25.0ng/ml), in serum of patients with latent and chronic type, the average level was 5.7ng/ml and 5.8ng/ml respectively (range: 1.7-33.7 ng/ml)There was no statistically significant difference between the molybdenum concentrations found in patients and healthy adults.In 80-85% samples the range of molybdenum concentration was found to be 3-11ng/ml.There was no significant difference between the molybdenum concentrations found in different age groups and sexes.