22 research outputs found

    Methylprednisolone as Adjunct to Endovascular Thrombectomy for Large-Vessel Occlusion Stroke

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    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.InterventionsEligible 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 RegistrationChiCTR.org.cn Identifier: ChiCTR210005172

    Discriminating characters of ore-forming intrusions in the super-large Chalukou porphyry Mo deposit, NE China

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    The Chalukou porphyry Mo deposit, located in the Great Hinggan Range, is the largest Mo deposit in northeast China, although the age and genesis of the associated magmatic intrusions remain debated. Here we report zircon U–Pb ages and trace elements, whole rock geochemistry and Sr–Nd isotope data with a view to understand the relationship between the magmatism and molybdenum mineralization. Zircon U–Pb analysis yield an age of 475 Ma for rhyolite in the older strata, 168 Ma for the pre-mineralization monzogranite, and 154 Ma for the syn-mineralization granite porphyry. The granite porphyry and quartz porphyry are considered as the ore-forming intrusions. These rocks are peraluminous, alkali-calcic, and belong to high-K to shoshonitic series with a strong depletion of Eu. They also display characteristics of I-type granites. The rocks exhibit wide variations of (87Sr/86Sr)i in the range of 0.705426–0.707363, and εNd(t) of −3.7 to 0.93. Zircon REE distribution patterns show characteristics between crust and the mantle, implying magma genesis through crust-mantle interaction. The Fe2O3/FeO values (average 1) for the whole rock and EuN/EuN∗ values (average 0.45), Ce4+/Ce3+ values (average 301) for zircon grains from the granite porphyry are higher than those from other lithologies. These features suggest that the ore-forming intrusions (syn-mineralization porphyry) had higher oxygen fugacity conditions than those of the pre-mineralization and post-mineralization rocks. The Chalukou Mo deposit formed in relation to the southward subduction of the Mongol-Okhotsk Ocean. Our study suggests that the subduction-related setting, crust-mantle interaction, and the large-scale magmatic intrusion were favorable factors to generate the super-large Mo deposits in this area. Keywords: Greater Hinggan Range, Chalukou porphyry Mo deposit, Geochronology, Ore-forming intrusions, Mongolia-Okhotsk ocea
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