Objective To explore the effect of collateral status on prognosis in elderly patients with acute ischemic stroke due to large vessel occlusion(AIS-LVO)after Solitaire stent retriever in combination with the intracranial support catheter aspiration for mechanical thrombectomy(SWIM),and construct a prediction model for prognosis.Methods A retrospective analysis was performed on 240 elderly AIS-LVO patients who underwent SWIM technique in our hospital be-tween February 2019 and February 2024.According to gender,age,occlusion sites and TOAST classifications,they were divided into a modeling group(180 cases)and a verification group(60 cases)in a ratio of 3∶1.Based on the results of modified Rankin scale(mRS)at 3 months after surgery,the patients in the modeling group were further divided into good prognosis subgroup(mRS score:0-2,97 cases)and poor prognosis subgroup(mRS score:3-6,83 cases).Multivari-ate logistic regression analysis was applied to evaluate the relationship between preoperative col-lateral circulation status and prognosis and to identify the influencing factors for prognosis.Then a prediction model for prognosis was constructed,and its performance was evaluated by ROC curve analysis.Results In the modeling group at 3 months of follow-up,the poor prognosis subgroup had significantly larger proportions of posterior circulation occlusion,cardiogenic embolism,ASITN/SIR grades 3-4 and hemorrhage transformation,higher NIHSS score at admission and longer interval from onset to vascular recanalization,while lower ASPECTS score at admission when compared with the good prognosis subgroup(P＜0.01).Multivariate logistic regression analysis showed that occlusion site,TOAST classification,NIHSS score at admission,interval from onset to vascular recanalization and hemorrhage transformation were independent risk fac-tors for poor prognosis,while ASPECTS score at admission and collateral circulation were protec-tive factors of good prognosis in the elderly AIS-LVO patients after SWIM technique(P＜0.01).Hosmer-Lemeshow test showed that the regression equation obtained goodness of fit in the mod-eling group(P=0.435).ROC curve analysis revealed that the AUC,sensitivity and specificity of then constructed prediction model for poor prognosis was 0.855[95％CI(0.797-0.913)],81.93％and 79.38％,respectively.The model was further verified in the data of the verification group(34 cases in good prognosis and 26 cases with poor prognosis),the AUC value,sensitivity and speci-ficity was 0.839[95％CI(0.732-0.947)],84.62％and 79.41％,respectively.Conclusion Our pre-diction model constructed based on screened risk factors for poor prognosis has good validity in patients with AIS-LVO after SWIM technique,which can identify the patients at high risk for poor prognosis.

Objective To explore the effect of collateral status on prognosis in elderly patients with acute ischemic stroke due to large vessel occlusion(AIS-LVO)after Solitaire stent retriever in combination with the intracranial support catheter aspiration for mechanical thrombectomy(SWIM),and construct a prediction model for prognosis.Methods A retrospective analysis was performed on 240 elderly AIS-LVO patients who underwent SWIM technique in our hospital be-tween February 2019 and February 2024.According to gender,age,occlusion sites and TOAST classifications,they were divided into a modeling group(180 cases)and a verification group(60 cases)in a ratio of 3∶1.Based on the results of modified Rankin scale(mRS)at 3 months after surgery,the patients in the modeling group were further divided into good prognosis subgroup(mRS score:0-2,97 cases)and poor prognosis subgroup(mRS score:3-6,83 cases).Multivari-ate logistic regression analysis was applied to evaluate the relationship between preoperative col-lateral circulation status and prognosis and to identify the influencing factors for prognosis.Then a prediction model for prognosis was constructed,and its performance was evaluated by ROC curve analysis.Results In the modeling group at 3 months of follow-up,the poor prognosis subgroup had significantly larger proportions of posterior circulation occlusion,cardiogenic embolism,ASITN/SIR grades 3-4 and hemorrhage transformation,higher NIHSS score at admission and longer interval from onset to vascular recanalization,while lower ASPECTS score at admission when compared with the good prognosis subgroup(P＜0.01).Multivariate logistic regression analysis showed that occlusion site,TOAST classification,NIHSS score at admission,interval from onset to vascular recanalization and hemorrhage transformation were independent risk fac-tors for poor prognosis,while ASPECTS score at admission and collateral circulation were protec-tive factors of good prognosis in the elderly AIS-LVO patients after SWIM technique(P＜0.01).Hosmer-Lemeshow test showed that the regression equation obtained goodness of fit in the mod-eling group(P=0.435).ROC curve analysis revealed that the AUC,sensitivity and specificity of then constructed prediction model for poor prognosis was 0.855[95％CI(0.797-0.913)],81.93％and 79.38％,respectively.The model was further verified in the data of the verification group(34 cases in good prognosis and 26 cases with poor prognosis),the AUC value,sensitivity and speci-ficity was 0.839[95％CI(0.732-0.947)],84.62％and 79.41％,respectively.Conclusion Our pre-diction model constructed based on screened risk factors for poor prognosis has good validity in patients with AIS-LVO after SWIM technique,which can identify the patients at high risk for poor prognosis.

Objective:Through the establishment and application of the biosafety autopsy pathology platform in Huoshenshan Hospital, the feasibility and application effect of the biosafety autopsy pathology platform were analyzed.Methods:The feasibility and application effect of the biosafety autopsy pathology platform were analyzed by layout design, instruments and equipment preparation, testing methods examination, and effect evaluation.Results:A total number of 26 cases of systematic autopsy and 8 cases of minimally invasive autopsy (puncture) were performed on the biosafety autopsy pathology platform, and no one was infected. Some pathology original findings were identified, including COVID-19 and pathological characteristics of identification, SARS respiratory failure mechanism and treatment significance, systemic distribution and spreading mechanism of the new coronavirus, the " storm" of inflammation pathological basis, some tumor markers rise in pulmonary pathological cell source and the overcast with fibrosis characteristics, such findings play important roles in the clinical diagnosis and treatment of COVID-19.Conclusions:The study of autopsy pathology is of great significance for the prevention and control of emerging infectious disease, which calls for early intervention. To promote the standard construction of biosafety autopsy platform is the key to the pathological study of emerging infectious diseases. Pathological research and clinical diagnosis and treatment should be combined to inform each other.

The afferent connections to the nucleus amygdaloideus centralis and nucleusamygdaloideus medialis in 42 albino rats were examined by means of retrogradetransport method of horseradish peroxidase(HRP).The microinjection syringe needle or microelectrophoretic pipette was insertedstereotaxically from vertical or oblipue approaches.The injections of HRP weregiven in the central and medial nuclei of the amygdaloid complex.The results were as follows:Following the injections of HRP into the nucleus amygdaloideus centralis,label-ed cells were always found in prepiriform cortex,periamygdaloid cortex,entorhinalcortex,ventral part the caudoputamen and globus pallidus,nucleus lateralis hy-pothalami,nucleus parafascicularis,corporis geniculati medialis,nucleus raphe dosalis,nucleus parabrachialis,locus coeruleus and zona reticulate substantia nigra.While HRP was injected into the nucleus amygdaloideus medialis,the labeledcells were always found in bed nucleus of stria terminalis,nucleus ventromedialis(hypothalami)and substantia nigra pars compacta.As the injections were given from lateral oblique approaches,labeled cells werenot found in the neo-cortex.There were no labeled cells demonstrated in the nuc-leus solitarius.In the above-mentioned areas nucleus ventromedialis(hypothalami),nucleusparabrachialis and locus coeruleus were often labeled bilaterally while others,ipsila-terally.