Targeting Stroke Therapeutic Window

Principal Investigators: Renyu Liu, Associate Professor of Anesthesiology and Critical Care at the Hospital of the University of Pennsylvania, Co-Director of Penn-China Anesthesia Partnership Program, Penn Medicine; Jing Zhao, Fudan University

Lead School: Perelman School of Medicine

Project Abstract

China has the largest number of stroke victims; 2 million stroke victims die each year, and stroke is the leading cause of death and disability due to significant prehospital delays. A rapid stroke recognition and response program suitable for stroke victims in China is urgently needed. “FAST” (“Face”, “Arm”, “Speech”, “Time”) educational program is effective in reducing prehospital delay in English-speaking countries. However, it cannot be directly used in China due to language barriers. To address this, we modeled Stroke 1-2-0 program based on the “FAST”. We link stroke symptoms to “1-2-0”, the medical emergency telephone number in China, and transform “1-2-0” into three stroke recognition actions, where 1 represents “First, look for an uneven face”; 2 represents “Second, examine for arm weakness”; and 0 represents “Zero (absence of) clear speech”. Immediately after the online publication of Stroke 1-2-0 in Lancet Neurology, the Chinese Stroke Association (CSA) endorsed it on World Stroke Day, Oct 29, 2016. Massive media coverage by over 50 regional and national news agencies followed. To further promote Stroke 1-2-0 in China, we are currently working closely with CSA to develop an effective plan. CSA is establishing a Stroke 1-2-0 special task force of Chinese Stroke Association lead by both Dr. Jing Zhao and Dr. Renyu Liu. Stroke 1-2-0 is now incorporated into the practice guideline for thrombolytic therapy in China by CSA to be released in 2017. A dedicated website ( and a social media WeChat public platform (Chinastroke120) were established to deliver the most up-to-date information related to Stroke 1-2-0. A Stroke 1-2-0 educational video was produced by us and released to the public domain via our website ( and many other media platforms in mid February. The total views of the video in one of the hosting websites (Tengshun) have exceeded 40 million. We are starting a national campaign in promoting stroke awareness in China through the CSA. This project will promote the stroke awareness in China through various platforms and measure the effectiveness of such promotion and the overall outcome of stroke patients. The predicted impact is that the prehospital delay will be reduced and the mortality rate will be decreased. This project also includes a small pilot project in extending therapeutic window for ischemic stroke.