Objective To explore the influencing factors of poor prognosis after successful recanalization of symptomatic acute internal carotid artery occlusion(AICAO)by applying endovascular therapy(EVT)technology.Methods We made a retrospective analysis of the clinical and imaging data of 62 symptomatic AICAO patients.After collateral evaluation and recanalization therapy,we obtained flat CT and DSA images,together with the findings of the collateral circulation assessment.At 24.0±6.0 hours after surgery,head plain CT scans were reexamined,and at 14 days after surgery or at discharge,neurological function was assessed using the NIHSS scale.Using the modified Rankin scale,we assessed neurological function and prognosis over a 90-day period.Results Each of the 62 patients had a TICI grade of 2b or 3 and was successfully recanalized.On average,it took 124.36±66.31 minutes from puncture to recanalization.Two instances involved iatrogenic dissection,while twelve cases had intraoperative distal thrombus escape episodes.Of all the patients,32 ones(51.6％)had a fair prognosis,whereas 30 patients(48.4％)had a bad prognosis.The two patient groups differed significantly in the ASPECT score,preoperative NIHSS score,intraoperative balloon catheter usage,postoperative 24 hour and 14 days NIHSS score,postoperative 14 days neurological function,and all-cause mortality within 90 days(all P＜0.05).The best intervention threshold for preoperative NIHSS score was 11.5 points,and both the preoperative NIHSS score and intraoperative BGC utilization were independent predictors influencing poor outcome.Conclusion The preoperative NIHSS score and intraoperative BGC usage are independent predictors of 90-day poor prognosis in AICAO patients with symptomatic AICAO who underwent successful recanalization via endovascular therapy.

Objective To explore the influencing factors of poor prognosis after successful recanalization of symptomatic acute internal carotid artery occlusion(AICAO)by applying endovascular therapy(EVT)technology.Methods We made a retrospective analysis of the clinical and imaging data of 62 symptomatic AICAO patients.After collateral evaluation and recanalization therapy,we obtained flat CT and DSA images,together with the findings of the collateral circulation assessment.At 24.0±6.0 hours after surgery,head plain CT scans were reexamined,and at 14 days after surgery or at discharge,neurological function was assessed using the NIHSS scale.Using the modified Rankin scale,we assessed neurological function and prognosis over a 90-day period.Results Each of the 62 patients had a TICI grade of 2b or 3 and was successfully recanalized.On average,it took 124.36±66.31 minutes from puncture to recanalization.Two instances involved iatrogenic dissection,while twelve cases had intraoperative distal thrombus escape episodes.Of all the patients,32 ones(51.6％)had a fair prognosis,whereas 30 patients(48.4％)had a bad prognosis.The two patient groups differed significantly in the ASPECT score,preoperative NIHSS score,intraoperative balloon catheter usage,postoperative 24 hour and 14 days NIHSS score,postoperative 14 days neurological function,and all-cause mortality within 90 days(all P＜0.05).The best intervention threshold for preoperative NIHSS score was 11.5 points,and both the preoperative NIHSS score and intraoperative BGC utilization were independent predictors influencing poor outcome.Conclusion The preoperative NIHSS score and intraoperative BGC usage are independent predictors of 90-day poor prognosis in AICAO patients with symptomatic AICAO who underwent successful recanalization via endovascular therapy.

Objective To investigate the clinical influencing factors for the occurrence of intracranial hemorrhage(ICH)in the elderly patients with massive ischemic stroke after endovascular therapy(EVT).Methods A retrospective study was conducted on 103 elderly hospitalized patients who underwent EVT due to anterior circulation acute arterial occlusion in our department from March 2021 to December 2023.All of them were diagnosed with massive ischemic stroke before treat-ment.Multivariate logistic regression analysis was used to identify the influencing factors for ICH after EVT treatment.Then based on the obtained factors,a nomogram model was constructed,and its performance efficiency was evaluated.Results After EVT treatment,95 patients had success-ful vascular recanalization,26(25.24％)experienced ICH,10 had symptomatic cerebral hemor-rhage,and 32(31.07％)obtained good functional outcomes after 90 d of follow-up.Multivariate logistic regression analysis that history of alcohol consumption(OR=3.795,95％CI:1.381-10.427,P=0.010),coronary heart disease(OR=2.969,95％CI:1.094-8.059,P=0.033)and bridging thrombolysis(OR=0.284,95％CI:0.091-0.884,P=0.030)were independently influen-cing factors for ICH occurrence in acute ischemic stroke patients after EVT.Our nomogram model based on these three factors had an AUC value of 0.759(95％CI:0.662-0.856).Conclusion Alcohol consumption,bridging thrombolysis,and history of coronary heart disease can predict adverse outcomes in elderly patients with massive ischemic stroke after EVT.

Objective To investigate the clinical influencing factors for the occurrence of intracranial hemorrhage(ICH)in the elderly patients with massive ischemic stroke after endovascular therapy(EVT).Methods A retrospective study was conducted on 103 elderly hospitalized patients who underwent EVT due to anterior circulation acute arterial occlusion in our department from March 2021 to December 2023.All of them were diagnosed with massive ischemic stroke before treat-ment.Multivariate logistic regression analysis was used to identify the influencing factors for ICH after EVT treatment.Then based on the obtained factors,a nomogram model was constructed,and its performance efficiency was evaluated.Results After EVT treatment,95 patients had success-ful vascular recanalization,26(25.24％)experienced ICH,10 had symptomatic cerebral hemor-rhage,and 32(31.07％)obtained good functional outcomes after 90 d of follow-up.Multivariate logistic regression analysis that history of alcohol consumption(OR=3.795,95％CI:1.381-10.427,P=0.010),coronary heart disease(OR=2.969,95％CI:1.094-8.059,P=0.033)and bridging thrombolysis(OR=0.284,95％CI:0.091-0.884,P=0.030)were independently influen-cing factors for ICH occurrence in acute ischemic stroke patients after EVT.Our nomogram model based on these three factors had an AUC value of 0.759(95％CI:0.662-0.856).Conclusion Alcohol consumption,bridging thrombolysis,and history of coronary heart disease can predict adverse outcomes in elderly patients with massive ischemic stroke after EVT.

Objective　To evaluate the status and prognosis of multimodal neuroimaging screening before endovascular therapy in patients with symptomatic intracranial atherosclerotic disease(sICAD) in the real world.Methods　Patients with sICAD,who were hospitalized in our hospital from January 2016 to May 2019,were enrolled in the study retrospectively.The admission criteria was:proximal lesions of anterior circulation artery,stenosis rate ≥70%,baseline NIHSS score ≤20,standard medical therapy within 2 weeks after the onset or angioplasty within 3 months after the onset.The application of multimodal neuroimaging technology before endovascular therapy in the real world was studied,the gap between the current situation and the guidelines of endovascular therapy screening was analyzed.The clinical prognosis of DWI combined with traditional angiographic screening in patients with watershed infarction was evaluated.The clinical and safety outcomes of the patients were followed up and compared with those of the patients treated with standard drugs.Results　In this study,all patients received structural imaging examinations such as NCCT/DWI/FLAIR and vascular imaging examinations such as TCD/MRA;Only 5.3% of the 38 endovascular patients received perfusion imaging such as ASL or CTP before surgery.Compared with patients in the standard medical therapy group,the recurrence rate of stroke in the endovascular therapy group were significantly reduced at 6 months and 1 year (P=0.045;P=0.011),and there was no significant difference in intracranial hemorrhage and all-cause mortality between the two groups (P>0.05).Among the watershed infarcts selected by DWI,the 1-year recurrence rate in the endovascular therapy group was significantly lower than that in the standard medical treatment group (P=0.035).The recurrence rate of patients with non-watershed infarcts treated with the two methods was similar (P>0.05).Conclusion　The preoperative evaluation of cerebral perfusion in patients with endovascular therapy is not optimal;DWI combined with traditional angiographic examination can clarify the watershed infarct and local cerebral perfusion,and replace perfusion imaging as an indication screening method for endovascular therapy.

Objective: To understand status of amphetaminetype stimulants (ATS) use among residents aged 15-64 in a border city of Yunnan province. Methods: Using the stratified cluster random sampling method, a total of 3 130 residents were recruited through both anonymous questionnaire and interview, regarding their health-related behaviour and ATS use. Results: Among 3 130 residents aged 15-64 years in this city, the overall prevalence rates of ATS use were 4.0% (126/3 130) in the lifetime and 2.6% (82/3 130) in the past one year, while the prevalence of ATS use disorder in the past year was 2.3% (73/3 130). The prevalence rates of lifetime ATS use and in the past year were 7.5% (108/1 443) and 5.1% (73/1 443) in the high epidemic area, 7.3% (122/1 682) and 4.8%(80/1 682) in males, 5.2% (118/2 260) and 3.4% (77/2 260) in 18-45 age group, 4.6%(63/1 361) and 3.4% (46/1 361) in the ones having had elementary school education, 10.3% (50/487) and 8.6% (42/487) in unmarried group, 17.1% (19/111) and 12.6% (14/111) in either divorced, widowed or separated group, 4.8% (108/2 256) and 3.2% (72/2 256) in the farmers group, 6.0% (99/1 643) and 4.4% (73/1 643) in the non-religious groups (neither Buddhism nor Christianity), 15.2% (97/639) and 11.9% (76/639) in groups with negative hobbies which were 1.3% (29/2 314) and 0.3%(6/2 314) higher than the ones with positive hobbies, 8.5% (84/992) and 6.3% (62/992) in the ones negatively managing the stress which were 2.0% (42/2 138) and 0.9% (20/2 138) higher than the ones that treating the stress in a positive way. Conclusions The prevalence rates of ATS use and ATS use disorder in the past one year appeared high among those residents aged 15-64 years in the border city of Yunnan province. Prevention and intervention programs should be carried out for the target groups as soon as possible.