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JAMA ; 331(10): 840-849, 2024 03 12.
Artigo em Inglês | MEDLINE | ID: mdl-38329440


Importance: It is uncertain whether intravenous methylprednisolone improves outcomes for patients with acute ischemic stroke due to large-vessel occlusion (LVO) undergoing endovascular thrombectomy. Objective: To assess the efficacy and adverse events of adjunctive intravenous low-dose methylprednisolone to endovascular thrombectomy for acute ischemic stroke secondary to LVO. Design, Setting, and Participants: This investigator-initiated, randomized, double-blind, placebo-controlled trial was implemented at 82 hospitals in China, enrolling 1680 patients with stroke and proximal intracranial LVO presenting within 24 hours of time last known to be well. Recruitment took place between February 9, 2022, and June 30, 2023, with a final follow-up on September 30, 2023. Interventions: Eligible patients were randomly assigned to intravenous methylprednisolone (n = 839) at 2 mg/kg/d or placebo (n = 841) for 3 days adjunctive to endovascular thrombectomy. Main Outcomes and Measures: The primary efficacy outcome was disability level at 90 days as measured by the overall distribution of the modified Rankin Scale scores (range, 0 [no symptoms] to 6 [death]). The primary safety outcomes included mortality at 90 days and the incidence of symptomatic intracranial hemorrhage within 48 hours. Results: Among 1680 patients randomized (median age, 69 years; 727 female [43.3%]), 1673 (99.6%) completed the trial. The median 90-day modified Rankin Scale score was 3 (IQR, 1-5) in the methylprednisolone group vs 3 (IQR, 1-6) in the placebo group (adjusted generalized odds ratio for a lower level of disability, 1.10 [95% CI, 0.96-1.25]; P = .17). In the methylprednisolone group, there was a lower mortality rate (23.2% vs 28.5%; adjusted risk ratio, 0.84 [95% CI, 0.71-0.98]; P = .03) and a lower rate of symptomatic intracranial hemorrhage (8.6% vs 11.7%; adjusted risk ratio, 0.74 [95% CI, 0.55-0.99]; P = .04) compared with placebo. Conclusions and Relevance: Among patients with acute ischemic stroke due to LVO undergoing endovascular thrombectomy, adjunctive methylprednisolone added to endovascular thrombectomy did not significantly improve the degree of overall disability. Trial Registration: Identifier: ChiCTR2100051729.

AVC Isquêmico , Acidente Vascular Cerebral , Feminino , Humanos , Idoso , Método Duplo-Cego , Trombectomia/efeitos adversos , Hemorragias Intracranianas , Metilprednisolona/efeitos adversos
Anal Chem ; 95(2): 1123-1131, 2023 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-36524836


Carcinoembryonic antigen (CEA) is a biomarker that is highly expressed in cancer patients. Label-free, highly sensitive, and specific detection of CEA biomarkers can therefore greatly aid in the early detection and screening of cancer. This study presents a toroidal metamaterial biosensor integrated with functionalized gold nanoparticles (AuNPs) that demonstrated highly sensitive and specific detection of CEA using terahertz (THz) time-domain spectroscopy. In the biosensor, a closed-loop magnetic field formed an electrical confinement, resulting in a high sensitivity (287.8 GHz/RIU) and an ultrahigh quality factor (15.04). In addition, the integrated AuNPs with high refractive indices significantly enhanced the sensing performance of the biosensor. To explore the quantitative and qualitative detection of CEA, CEA biomarkers with various concentrations and four types of proteins were measured by the designed biosensor, achieving a limit of detection of 0.17 ng and high specificity. Even more significant, the proposed AuNP-integrated THz toroidal metamaterial biosensor demonstrates exceptional potential for use in technologies for cancer diagnosis and monitoring.

Técnicas Biossensoriais , Nanopartículas Metálicas , Neoplasias , Humanos , Antígeno Carcinoembrionário , Ouro/química , Nanopartículas Metálicas/química , Técnicas Biossensoriais/métodos , Limite de Detecção
Langmuir ; 27(2): 815-9, 2011 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-21171645


We describe a novel route for the conversion of hexagonal Sb(2)Te(3) nanoplates into nanorings driven by growth temperature in a simple solvothermal process. The transmission electron microscopy was employed to investigate systemically the morphology, size, crystallinity, and microstructure of the as-prepared products. The experiments indicated that the growth temperature had a great effect on the morphology of antimony telluride nanostructures. When the experiments were conducted at 200 °C, the hexagonal antimony telluride nanoplates were obtained. However, if the experiments were carried out at higher temperature of 230 °C, the hexagonal antimony telluride nanorings were achieved by dissolution of the inner part with a higher density of defects of the hexagonal nanoplates for the first time. A possible formation mechanism was proposed on the basis of experimental results and analysis. This work may open a new rational route for the synthesis of the hexagonal antimony telluride nanorings, which may have scientific and technological applications in various functional devices.