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1.
Nature ; 623(7988): 724-731, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37938779

RESUMO

Nanomaterials must be systematically designed to be technologically viable1-5. Driven by optimizing intermolecular interactions, current designs are too rigid to plug in new chemical functionalities and cannot mitigate condition differences during integration6,7. Despite extensive optimization of building blocks and treatments, accessing nanostructures with the required feature sizes and chemistries is difficult. Programming their growth across the nano-to-macro hierarchy also remains challenging, if not impossible8-13. To address these limitations, we should shift to entropy-driven assemblies to gain design flexibility, as seen in high-entropy alloys, and program nanomaterial growth to kinetically match target feature sizes to the mobility of the system during processing14-17. Here, following a micro-then-nano growth sequence in ternary composite blends composed of block-copolymer-based supramolecules, small molecules and nanoparticles, we successfully fabricate high-performance barrier materials composed of more than 200 stacked nanosheets (125 nm sheet thickness) with a defect density less than 0.056 µm-2 and about 98% efficiency in controlling the defect type. Contrary to common perception, polymer-chain entanglements are advantageous to realize long-range order, accelerate the fabrication process (<30 min) and satisfy specific requirements to advance multilayered film technology3,4,18. This study showcases the feasibility, necessity and unlimited opportunities to transform laboratory nanoscience into nanotechnology through systems engineering of self-assembly.

2.
J Chem Phys ; 160(9)2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38445839

RESUMO

A method for characterizing the topological fluctuations in liquids is proposed. This approach exploits the concept of the weighted gyration tensor of a collection of particles and permits the definition of a local configurational unit (LCU). The first principal axis of the gyration tensor serves as the director of the LCU, which can be tracked and analyzed by molecular dynamics simulations. Analysis of moderately supercooled Kob-Andersen mixtures suggests that orientational relaxation of the LCU closely follows viscoelastic relaxation and exhibits a two-stage behavior. The slow relaxing component of the LCU corresponds to the structural, Maxwellian mechanical relaxation. Additionally, it is found that the mean curvature of the LCUs is approximately zero at the Maxwell relaxation time with the Gaussian curvature being negative. This observation implies that structural relaxation occurs when the configurationally stable and destabilized regions interpenetrate each other in a bicontinuous manner. Finally, the mean and Gaussian curvatures of the LCUs can serve as reduced variables for the shear stress correlation, providing a compelling proof of the close connection between viscoelastic relaxation and topological fluctuations in glass-forming liquids.

3.
Int J Urol ; 30(11): 991-999, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37431969

RESUMO

OBJECTIVES: Real-world uptake of treatment intensification (TI) with novel hormonal agents (NHA) or chemotherapy as treatment of metastatic prostate cancer remains low outside of trial settings. We aim to report the prescription patterns and treatment outcomes of de novo metastatic hormone-sensitive prostate cancer (mHSPC) in a tertiary institution. METHODS: This is a retrospective cohort study using real-world data from a prospectively maintained prostate cancer registry. We selected patients newly diagnosed with mHSPC from January 2016 to December 2020. Clinicopathological parameters were recorded to determine their impact on prescription patterns. RESULTS: In total, 585 patients with metastatic prostate cancer were identified. Prescription of NHA increased from 10.5% (2016) to 50.4% (2020), but that of chemotherapy declined. Factors associated with TI were (1) baseline health status: Charlson Comorbidity Index 0-2, ECOG 0-1, age ≤ 65, (2) disease burden: PSA (>400, CHAARTED high volume disease, p = 0.004), development of systemic complications and (3) physician factor: primary physician being uro-oncologist and medical oncologist versus general urologist. Patients with TI had a longer mean time to castration-resistant prostate cancer (45.0 vs. 32.5 months, HR 0.567, 95% CI: 0.441-0.730, p < 0.001) and overall survival (55.3 vs. 46.8 months, HR 0.612, 95% CI, 0.447-0.837, p = 0.001). CONCLUSION: This study demonstrated the trend of treatment prescription of mHSPC and factors contributing to the use of TI. TI improved mean time to CRPC and OS.


Assuntos
Neoplasias de Próstata Resistentes à Castração , Neoplasias da Próstata , Masculino , Humanos , Estudos Retrospectivos , Neoplasias de Próstata Resistentes à Castração/patologia , Neoplasias da Próstata/tratamento farmacológico , Resultado do Tratamento , Próstata/patologia , Sistema de Registros , Antagonistas de Androgênios/uso terapêutico
4.
Phys Chem Chem Phys ; 24(28): 16988-16996, 2022 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-35665787

RESUMO

We have investigated the molecular exchange of sodium dodecyl sulfate (SDS) micelles in aqueous solution by time-resolved small angle neutron scattering (TR-SANS) measurements as a function of the surfactant and salt concentration. Starting with deuterated (d-SDS) and protonated (h-SDS) SDS micelles, surfactant exchange across the micelles leads to a randomized distribution of d-SDS and h-SDS within each micelle. By employing the contrast matching technique, we have studied this randomization process which is a direct measure of the molecular exchange of this system. Our results show that the randomization of the pure h-SDS and d-SDS micelles occurs in two steps: first, an almost instantaneous drop in the scattering intensity is observed where ∼80% of the micelles are randomized (contrast matched). After this, micelle randomization progresses slowly spanning over ∼100 hours. Importantly, we show that the kinetics in the second step are dominated by the formation of domains rich in either h-SDS, d-SDS and randomized (50 : 50 h-SDS : d-SDS). The slow exchange step is modeled via a phenomenological approach by drawing analogy to the Langmuir adsorption theory. Finally, the effects of the surfactant and salt concentrations on the instantaneous, and the time dependent randomization of SDS micelles are discussed.

5.
Phys Chem Chem Phys ; 24(13): 8015-8021, 2022 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-35315475

RESUMO

The distribution and diffusion of water molecules are playing important roles in determining self-assembly and transport properties of polymeric systems. Small-angle neutron scattering (SANS) experiments and molecular dynamics (MD) simulation have been applied to understand the distribution of water molecules and their dynamics in the lamellar membrane formed by Pluronic L62 block copolymers. Penetration of water molecules into the polyethylene oxide (PEO) layers of the membranes has been estimated using scattering length density (SLD) profiles obtained from SANS measurements, which agree well with the molecular distribution observed from MD simulations. The water diffusion coefficient at different regions of the lamellar membrane was further investigated using MD simulation. The diffusion characteristic shows a transition from normal to anomalous diffusion as the position of the water molecule changes from the bulk to PEO and to the polypropylene oxide (PPO) layer. We find that water molecules within the PEO or PPO layers follow subdiffusive dynamics, which can be interpreted by the model of fractional Brownian motion.

6.
J Chem Phys ; 156(13): 131101, 2022 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-35395880

RESUMO

We outline a machine learning strategy for quantitively determining the conformation of AB-type diblock copolymers with excluded volume effects using small angle scattering. Complemented by computer simulations, a correlation matrix connecting conformations of different copolymers according to their scattering features is established on the mathematical framework of a Gaussian process, a multivariate extension of the familiar univariate Gaussian distribution. We show that the relevant conformational characteristics of copolymers can be probabilistically inferred from their coherent scattering cross sections without any restriction imposed by model assumptions. This work not only facilitates the quantitative structural analysis of copolymer solutions but also provides the reliable benchmarking for the related theoretical development of scattering functions.

7.
Int J Urol ; 29(12): 1488-1496, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36070249

RESUMO

OBJECTIVES: To identify predictive factors for the development of sepsis/septic shock postdecompression of calculi-related ureteric obstruction using the Sequential Organ Failure Assessment (SOFA) score and to compare clinical outcomes and odd risk ratios of patients developing sepsis/septic shock following the insertion of percutaneous nephrostomy (PCN) versus insertion of retrograde ureteral stenting (RUS). METHODS: Clinico-epidemiological data of patients who underwent PCN and/or RUS in two institutions for calculi-related ureteric obstruction were retrospectively collected from January 2014 to December 2020. RESULTS: 537 patients (244 patients in PCN group, 293 patients in RUS group) from both institutions were eligible for analysis based on inclusion and exclusion criteria. Patients with PCN were generally older, had poorer Eastern Cooperative Oncology Group status, and larger obstructive ureteral calculi compared to patients with RUS. Patients with PCN had longer durations of fever, the persistence of elevated total white cell and creatinine, and longer hospitalization stays compared with patients who had undergone RUS. RUS up-front has more unsuccessful interventions compared with PCN. There were no significant differences in the change in SOFA score postintervention between the two interventions. In multivariate analysis, the higher temperature just prior to the intervention (adjusted odds ratio [OR]: 2.039, p = 0.003) and Cardiovascular SOFA score of 1 (adjusted OR:4.037, p = 0.012) were significant independent prognostic factors for the development of septic shock postdecompression of ureteral obstruction. CONCLUSIONS: Our study reveals that both interventions have similar overall risk of urosepsis, septic shock and mortality rate. Despite a marginally higher risk of failure, RUS should be considered in patients with lower procedural risk. Patients going for PCN should be counseled for a longer stay. Post-HDU/-ICU monitoring, inotrope support postdecompression should be considered for patients with elevated temperature within 1 h preintervention and cardiovascular SOFA score of 1.


Assuntos
Sepse , Choque Séptico , Cálculos Ureterais , Obstrução Ureteral , Humanos , Descompressão , Prognóstico , Estudos Retrospectivos , Sepse/etiologia , Choque Séptico/etiologia , Obstrução Ureteral/etiologia , Obstrução Ureteral/cirurgia
8.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 44(3): 377-383, 2022 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-35791932

RESUMO

Objective To investigate the effect of dual-specificity phosphatase 1/optical atrophy 1 (DUSP1/OPA1) signaling pathway on vascular smooth muscle cell (VSMC) calcification.Methods An in vitro model of VSMC calcification was induced by exposure to ß-glycerophosphate and calcium chloride.VSMC calcification was assessed by Alizarin Red S staining and calcium content by ELISA.Apoptosis was detected by TUNEL.Western blotting was employed to determine the protein levels of DUSP1,OPA1,Runt-related transcription factor 2 (Runx-2),bone morphogenetic protein 2 (BMP-2),and cysteinyl aspartate-specific proteinase-3 (Caspase-3).The effects of DUSP1 overexpression and OPA1 knockdown on cell calcification were investigated.Results Calcium chloride and ß-glycerolphosphate induced VSMC calcification and down-regulated the expression levels of DUSP1 (t=11.951,P<0.001) and OPA1 (t=8.487,P<0.001).DUSP1 overexpression promoted OPA1 expression (t=-8.921,P<0.001),attenuated VSMC calcification,reduced calcium content and apoptosis rate,and down-regulated the expression of Runx-2,BMP-2,and active Caspase-3 (all P<0.001).OPA1 knockdown increased calcium content and apoptosis rate,up-regulated the expression of Runx-2,BMP-2,and active Caspase-3,and promoted VSMC calcification (all P<0.001).Conclusion DUSP1 may inhibit the VSMC calcification through the OPA1 signaling pathway.


Assuntos
Calcinose , Músculo Liso Vascular , Atrofia/metabolismo , Atrofia/patologia , Cálcio/metabolismo , Cloreto de Cálcio/metabolismo , Caspase 3/metabolismo , Fosfatases de Especificidade Dupla/metabolismo , Humanos , Músculo Liso Vascular/metabolismo , Músculo Liso Vascular/patologia
9.
Phys Chem Chem Phys ; 23(7): 4120-4132, 2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-33592085

RESUMO

We outline a nonparametric inversion strategy for determining the orientation distribution function (ODF) of sheared interacting rods using small-angle scattering techniques. With the presence of direct inter-rod interaction and fluid mechanical forces, the scattering spectra are no longer characterized by the azimuthal symmetry in the coordinates defined by the principal directions of simple shear conditions, which severely compounds the reconstruction of ODFs based on currently available methods developed for dilute systems. Using a real spherical harmonic expansion scheme, the real-space ODFs are uniquely determined from the anisotropic scattering spectra and their numerical accuracy is verified computationally. Our method can be generalized to extract ODFs of uniaxially anisotropic objects under different flow conditions in a properly transformed reference frame with suitable basis vectors.

10.
Phys Chem Chem Phys ; 22(22): 12524-12531, 2020 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-32452477

RESUMO

We investigate the phase behaviours of Pluronic L62 in aqueous solution in the presence of aerosol-OT (AOT) molecules by small angle neutron scattering (SANS). The presence of AOT significantly changes the micellization phenomenon of L62 micelles in aqueous solution, including their critical micelle temperature (CMT), global size, and asphericity. The origin of these observations is attributed to the complexation between the neutral L62 surfactants and the ionic AOT molecules, which additionally provides charge to the mixed micelles: we analyse the data and extract meaningful information using the Ornstein-Zernike integral formalism. As a result, we observe that the co-micellization of L62 and AOT is very stable across a wide temperature range.

11.
J Chem Phys ; 153(18): 184902, 2020 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-33187411

RESUMO

Self-assembly of amphiphilic polymers in water is of fundamental and practical importance. Significant amounts of free unimers and associated micellar aggregates often coexist over a wide range of phase regions. The thermodynamic and kinetic properties of the microphase separation are closely related to the relative population density of unimers and micelles. Although the scattering technique has been employed to identify the structure of micellar aggregates as well as their time-evolution, the determination of the population ratio of micelles to unimers remains a challenging problem due to their difference in scattering power. Here, using small-angle neutron scattering (SANS), we present a comprehensive structural study of amphiphilic n-dodecyl-PNIPAm polymers, which shows a bimodal size distribution in water. By adjusting the deuterium/hydrogen ratio of water, the intra-micellar polymer and water distributions are obtained from the SANS spectra. The micellar size and number density are further determined, and the population densities of micelles and unimers are calculated to quantitatively address the degree of micellization at different temperatures. Our method can be used to provide an in-depth insight into the solution properties of microphase separation, which are present in many amphiphilic systems.

12.
Sensors (Basel) ; 20(6)2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32178311

RESUMO

The traditional method of using electric field sensors to realize early warning of electric power safety distance cannot measure the distance of dangerous sources. Therefore, aiming at the electric field with a frequency of 50 to 60Hz (AC electric field), a new method for localization of aerial AC target by the capacitive one-dimensional spherical electric field sensor circular array is studied. This method can directly calculate the distance, elevation, and azimuth of the detector from the dangerous source. By combining the measurement principle of the spherical electric field sensor and the plane circular array theory, a mathematical model for the localization of aerial targets in an AC electric field is established. An error model was established using Gaussian noise and the effects of different layout parameters on the localization error were simulated. Based on mutual interference between sensors, minimum induced charge, and localization error, an optimal model for sensor layout was established, and it was solved by using genetic algorithms. The optimization results show that when the number of sensors is 4, the array radius is 20 cm, and the sensor radius is 1.5 cm, the ranging error is 8.4%. The detector was developed based on the layout parameters obtained from the optimization results, and the localization method was experimentally verified at 10 and 35 kV alarm distances. The experimental results show that when the detector is located at 10 kV alarm distance, the distance error is 0.18 m, the elevation error is 6.8°, and the azimuth error is 4.57°, and when it is located at 35 kV alarm distance, the distance error is 0.2 m, the elevation error is 4.8°, and the azimuth error is 5.14°, which meets the safety distance warning requirements of 10 and 35 kV voltage levels.

13.
Sensors (Basel) ; 20(17)2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32825769

RESUMO

The fabrication and characterization of a magnetic micro sensor (MMS) with two magnetic field effect transistors (MAGFETs) based on the commercial complementary metal oxide semiconductor (CMOS) process are investigated. The magnetic micro sensor is a three-axis sensing type. The structure of the magnetic microsensor is composed of an x/y-MAGFET and a z-MAGFET. The x/y-MAGFET is employed to sense the magnetic field (MF) in the x- and y-axis, and the z-MAGFET is used to detect the MF in the z-axis. To increase the sensitivity of the magnetic microsensor, gates are introduced into the two MAGFETs. The sensing current of the MAGFET enhances when a bias voltage is applied to the gates. The finite element method software Sentaurus TCAD was used to analyze the MMS's performance. Experiments show that the MMS has a sensitivity of 182 mV/T in the x-axis MF and a sensitivity of 180 mV/T in the y-axis MF. The sensitivity of the MMS is 27.8 mV/T in the z-axis MF.

14.
Phys Chem Chem Phys ; 21(33): 18346-18351, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31397831

RESUMO

Surfactants are amphiphilic molecules that spontaneously self-assemble in aqueous solution into various ordered and disordered phases. Under certain conditions, one-dimensional structures in the form of long, flexible wormlike micelles can develop. Cetyltrimethylammonium bromide (CTAB) is one of the most widely studied surfactants, and in the presence of sodium salicylate (NaSal), wormlike micelles can form at very dilute concentrations of surfactant. We carry out a systematic study of the structures of CTAB/NaSal over a surfactant concentration range of 2.5-15 mM and at salt-to-surfactant molar ratios of 0.5-10. Using small-angle neutron scattering (SANS), we qualitatively and quantitatively characterize the equilibrium structures of CTAB/NaSal, mapping the phase behavior of CTAB/NaSal at low concentrations within the region of phase space where nascent wormlike micelles transition into long and entangled structures. Complementary rheological assessments not only demonstrate the significant influence of the inter-micellar Coulombic interaction on the micellar structure but also suggest the potential existence of a hierarchical structure which is beyond the accessibility of the SANS technique.

15.
Phys Chem Chem Phys ; 21(15): 7745-7749, 2019 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-30839968

RESUMO

Using small-angle neutron scattering, we conducted a detailed conformational study of poly(3-alkylthiophene) solutions in deuterated dichlorobenzene. The focus was placed on addressing the influence of the spatial arrangement of side chain constituents on backbone conformation. We demonstrate that by introducing a branch point in the side chain, side chain steric interactions may promote torsional motion between backbone units, resulting in greater chain flexibility. Our findings highlight the key role of topological isomerism in determining the chain rigidity and throw new light on the debate about the effective approaches for optimizing the electronic properties of conducting polymers via side chain engineering.

16.
Sensors (Basel) ; 20(1)2019 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-31906202

RESUMO

Disconnect switch and circuit breakers operations in gas insulated switchgear (GIS) systems may produce very fast transient overvoltage (VFTO). Detecting VFTO is the first step for researchers to reduce the damage to other equipment of the substation caused by VFTO. Most of the existing sensors used for VFTO are generally bulky, complex to install, and require modification of the GIS structure. In this paper, a miniaturized measurement system that uses capacitive voltage divider and differentiating-integrating circuit is proposed. A special sensor structure and optimized differentiating-integrating circuit components arrangement were designed to increase the bandwidth of the measurement system. The frequency-domain, time-domain and voltage divide calibration experiment was performed, and a comparison experiment with an internal VFTO sensor was conducted. The measurement system was applied in the 500 kV GIS substation, and the VFTO measurement under specific conditions was carried out. The measured time domain and frequency domain waveforms conformed to the definition of standard VFTO according to IEC 60,071. It was found that the proposed measurement system meets VFTO measurement requirements and can be applied to actual VFTO measurements.

17.
Phys Rev Lett ; 121(11): 117801, 2018 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-30265084

RESUMO

Drawing an analogy to the paradigm of quasielastic neutron scattering, we present a general approach for quantitatively investigating the spatiotemporal dependence of structural anisotropy relaxation in deformed polymers by using small-angle neutron scattering. Experiments and nonequilibrium molecular dynamics simulations on polymer melts over a wide range of molecular weights reveal that their conformational relaxation at relatively high momentum transfer Q and short time can be described by a simple scaling law, with the relaxation rate proportional to Q. This peculiar scaling behavior, which cannot be derived from the classical Rouse and tube models, is indicative of a surprisingly weak direct influence of entanglement on the microscopic mechanism of single-chain anisotropy relaxation.

18.
Phys Chem Chem Phys ; 21(1): 38-45, 2018 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-30283930

RESUMO

The flow of colloidal suspensions is ubiquitous in nature and industry. Colloidal suspensions exhibit a wide range of rheological behavior, which should be closely related to the microscopic structure of the systems. With in situ small-angle neutron scattering complemented by rheological measurements, we investigated the deformation behavior of a charge-stabilized colloidal glass at particle level undergoing steady shear. A short-lived, localized elastic response at particle level, termed as the transient elasticity zone (TEZ), was identified from the neutron spectra. The existence of the TEZ, which could be promoted by the electrostatic interparticle potential, is a signature of deformation heterogeneity: the body of fluids under shear behaves like an elastic solid within the spatial range of the TEZ but like fluid outside the TEZ. The size of the TEZ shrinks as the shear rate increases in the shear thinning region, which shows that the shear thinning is accompanied by a diminishing deformation heterogeneity. More interestingly, the TEZ is found to be the structural unit that provides the resistance to the imposed shear, as evidenced by the quantitative agreement between the local elastic stress sustained by the TEZ and the macroscopic stress from rheological measurements at low and moderate shear rates. Our findings provide an understanding on the nonlinear rheology of interacting colloidal glasses from a micro-mechanical view.

19.
Cardiovasc Diabetol ; 16(1): 72, 2017 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-28587613

RESUMO

BACKGROUND: Dipeptidyl peptidase-4 (DPP4) regulates blood glucose levels and inflammation, and it is also implicated in the pathophysiological process of myocardial infarction (MI). Plasma DPP4 activity (DPP4a) may provide prognostic information regarding outcomes for ST-segment elevation MI (STEMI) patients. METHODS: Blood samples were obtained from 625 consecutively admitted, percutaneous coronary intervention-treated STEMI patients with a mean age of 57 years old. DPP4a was quantified using enzymatic assays. RESULTS: The median follow-up period was 30 months. Multivariate Cox-regression analyses (adjusted for confounding variables) showed that a 1 U/L increase of DPP4a did not associate with risks of major adverse cardiac or cerebrovascular events (MACCE), cardiovascular mortality, MI, heart failure readmission, stroke, non-cardiovascular mortality and repeated revascularization. However, in a subset of 149 diabetic STEMI patients, DPP4a associated with an increased risk of MACCE (HR 1.16; 95% CI 1.04-1.30; p = 0.01). CONCLUSIONS: DPP4a did not associate with cardiovascular events and non-cardiovascular mortality in non-diabetic STEMI patients. However, DPP4a may be associated with future MACCE in diabetic STEMI patients. Trial registration NCT03046576, registered on 5 February, 2017, retrospectively registered.


Assuntos
Dipeptidil Peptidase 4/sangue , Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST/sangue , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Distribuição de Qui-Quadrado , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/mortalidade , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/mortalidade , Valor Preditivo dos Testes , Modelos de Riscos Proporcionais , Fatores de Risco , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Infarto do Miocárdio com Supradesnível do Segmento ST/mortalidade , Fatores de Tempo , Resultado do Tratamento
20.
Cardiology ; 136(4): 252-257, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27846629

RESUMO

BACKGROUND: The drug-eluting balloon (DEB) is a promising tool to prevent restenosis after coronary angioplasty. However, data on the outcomes of DEB in de novo lesions are scarce. Vessel recoil and constrictive remodeling are the dominant causes of restenosis after angioplasty. The use of cutting balloons (CB) may effectively reduce elastic recoil after balloon dilation. In this study, we evaluate the efficacy and safety of DEB in treating de novo coronary artery lesions, using a predilation strategy with cutting balloon (CB) dilation before DEB angioplasty. METHODS/DESIGN: We present the design of a prospective, single-center, open-label, randomized, 2-arm clinical trial aiming to assess whether or not the strategy of CB dilation before DEB angioplasty reduces the primary end point of late lumen loss (LLL) compared with drug-eluting stent (DES) implantation alone for de novo coronary artery lesions. A total of 120 patients will be randomly enrolled into the DEB or DES group (1:1 ratio). The primary end point is insegment LLL at 12 months as measured by optical coherence tomography (OCT). Secondary end points include procedural success, such as angiographic success and device success, and clinical outcomes including all-cause death, myocardial infarction, target vessel revascularization, target lesion revascularization, and stent thrombosis. DISCUSSION: The study will evaluate the clinical efficacy, angiographic outcomes, and safety of DEB after CB dilation compared with DES for the treatment of de novo coronary artery lesions guided by OCT.


Assuntos
Síndrome Coronariana Aguda/terapia , Angioplastia Coronária com Balão , Stents Farmacológicos , Síndrome Coronariana Aguda/complicações , Causas de Morte , China , Angiografia Coronária , Humanos , Infarto do Miocárdio/etiologia , Estudos Prospectivos , Desenho de Prótese , Projetos de Pesquisa , Trombose/etiologia , Tomografia de Coerência Óptica , Resultado do Tratamento
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