Objectives:To develop modified prehospital stroke scales and to evaluate their predictive value for in-hospital acute large vessel occlusion (LVO) stroke.Methods:Patients admitted to Dongtai People's Hospital due to non-stroke-related diseases and activated the in-hospital stroke green channel due to suspected stroke symptoms during hospitalization from January 2015 to December 2022 were included retrospectively. According to the final imaging diagnosis, they were divided into LVO group and non-LVO group. The five prehospital stroke scales included Field Assessment Stroke Triage for Emergency Destination (FAST-ED), Rapid Arterial Occlusion Evaluation (RACE), Los Angeles Motor Scale (LAMS), Cincinnati Prehospital Stroke Severity Scale (CPSSS), and Prehospital Acute Stroke Severity Scale (PASS). Multivariate logistic regression analysis was used to determine independent predictive factors of LVO in patients with in-hospital stroke, and incorporating them into the prehospital stroke scale to develop modified scales. The receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of the modified scales. Results:A total of 174 patients with in-hospital stroke were enrolled, including 92 males (52.9%), aged 65.7±11.9 years. Fifty-four patients (31.0%) had LVO, and 59 (33.9%) had a surgical history within 3 days before the onset of stroke, mainly cardiopulmonary surgeries. Multivariate logistic regression analysis showed that atrial fibrillation (odds ratio 2.940, 95% confidence interval 1.387-6.230; P=0.005) and recent history of cardiopulmonary surgery (odds ratio 6.861, 95% confidence interval 2.437-11.315; P<0.001) were the independent predictive factors of LVO in patients with in-hospital stroke. According to the β coefficient and ROC curve, they were assigned a score of 1 and included in the prehospital stroke scale. The area under the curve of the modified scale for predicting LVO (mRACE: 0.917; mFAST-ED: 0.865; mPASS: 0.859; mCPSSS: 0.853; mLAMS: 0.907) was significantly higher than the corresponding original scale (RACE: 0.888; FAST-ED: 0.820; PASS: 0.786; CPSSS: 0.810; LAMS: 0.859) (all P<0.05). Conclusion:The modified scales based on the prehospital stroke scales can significantly improve the predictive value of in-hospital acute LVO stroke compared to the original prehospital stroke scales.

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.

An analytical method of on-line injection technique including on-line dilution and on-line preconcentration with inductively coupled plasma mass spectrometry ( ICP-MS ) was established for the determination of trace metals in seawater, such as Cr, Mo, Cu, Pb, Zn, Cd, Fe, Mn, Ni, V, Co. This method could automatically make standard curves and match matrix, and by the on-line dilution and preconcentration modes, 11 trace metals could be analyzed directly. With high-level automation, CASS-5 and NASS-6 seawater standard samples were analyzed accurately by this method. The recovery of metals in seawater sample addition was between 80% and 115%. The method quantitation limits (μg/L ) of theses metals in seawater were 0. 06(Cr), 0. 06(Mo), 0. 01(Cu), 0. 005(Pb), 0. 01(Zn), 0. 006(Cd), 0. 03 (Fe), 0. 02(Mn), 0. 01(Ni), 0. 01(V), and 0. 01 (Co), respectively. This method was applied to analyze seawater samples of various salinities in Zhejiang coast, and the analysis results were consistent with results of conventional atomic absorption method.

Objective To evaluate the effect and safety of nicorandil on Coronary Slow Flow Phenomenon (CSFP) .Methods The CSFP patients(n=60) were randomly divided into the control group treated with placebo and the treatment group treated with nicorandil .The changes of the clinical symptoms ,the frequency and duration of pectoralgia ,the six-minute walk test ,and TIMI frame counts were observed before and after treatment .Results The treatment group had a better therapeutic effect than the con-trol group(P<0 .05) .There were significant differences in the frequency and duration of pectoralgia ,the six-minute walk test ,and TIMI frame counts in treatment group before and after treatment ,which were superior to those of control group (P<0 .05 ,P<0 .01) .The blood routine examinations and hepatorenal function were within the normal range before and after treatment .Conclusion Nicorandil has better therapeutic effect and safety on CSFP .

Purpose To study the effect of China cobra venom active factor(CCVAF) from China cobra venom on endothelial cells and its mechanism.Methods MTT experiment was adopted to evaluate the effect of CCVAF on bovine arteria pulmonalis vascular endothelial cells(BAVEC).The Eosin-Coomassie brillient blue and rhodamine-phalloidin method was used for actin cytoskeleton.Flow cytometry for [Ca~(2+)]_i and spectrophotometry were used for lactate dehydrogenase(LDH) and nitrogen oxide(NO) levels in cell culture supernatant.Results CCVAF(0.625-20 μg/mL) inhibited the proliferation of BAVEC in dose-dependent manner,and IC50 of CCVAF on BAVEC was 2.45 μg/mL. After CCVAF and BAVEC coincubation, it was showed that regression of intercellular conjunctions and disorder of F-actin distribution occurred. The content of [Ca~(2+)]_i, [LDH] and [NO] increased respectively.Conclusion CCVAF can inhibit BAVEC proliferation and it maybe associated with the change of cytoskeleton and increasing of [Ca~(2+)]_i,[LDH] aod [NO].

Objective To explore the effect of the traumatic brain injury on the fracture healing and the related mechanism. Methods 64 12-week-old SD rats were randomly divided into 2 groups: The femoral fracture with a brain injury group and the femoral fracture group. The bone callus was obtained 1, 2, 3 and 4 week after operation respectively, and observed with the HE staining. The vascular endothelial growth factor (VEGF) and VEGF mRNA in the callus were detected with immunohistochemical staining and hybridization in situ. Results The formation and reforming of the callus in group with brain injury were ahead to only fracture. The percentages of the cells positive for VEGF and VEGF mRNA in the callus were more in group with brain injury than in pure fracture group at the same time point (P<0.05). Conclusion Traumatic brain injury can promote the healing of fracture, which is probably related to an increase in the expression of VEGF.

Objective To evaluate the correlation between the expression of Survivin、VEGF and MMP 2 and the prognosis of patients with hepatocellular carcinoma Methods Expressions of Survivin、 VEGF and MMP 2 were detected by immunohistochemical S P method in 67 postoperative HCC cases Twelve candidate factors associated with long term survival were analyzed by Kaplan Meier Log rank estimation A multivariative Survival analysis of these individual variables was undertaken using the cumulative survival rate by the COX proportional hazards model Results A multivariative analysis determined three independent significant factors influencing overall cumulative survival including Survivin, VEGF, liver function (Child grade) The three prognostic factors predicted an increased risk of death from HCC Conclusion Survivin, VEGF, liver function, particularly the Child Pugh classification are the most significant prognostic factors for HCC patients undergoing hepatic resection