BackgroundStudies show tranexamic acid can reduce the risk of death and early neurological deterioration after intracranial haemorrhage. We aimed to assess whether tranexamic acid reduces haematoma expansion and improves outcome in intracerebral haemorrhage patients susceptible to haemorrhage expansion.MethodsWe did a prospective, double-blind, randomised, placebo-controlled trial at 10 stroke centres in China. Acute supratentorial intracerebral haemorrhage patients were eligible if they had indication of haemorrhage expansion on admission imaging (eg, spot sign, black hole sign or blend sign), and were treatable within 8 hours of symptom onset. Patients were randomly assigned (1:1) to receive either tranexamic acid or a matching placebo. The primary outcome was intracerebral haematoma growth (>33% relative or >6 mL absolute) at 24 hours. Clinical outcomes were assessed at 90 days.ResultsOf the 171 included patients, 124 (72.5%) were male, and the mean age was 55.9±11.6 years. 89 patients received tranexamic acid and 82 received placebo. The primary outcome did not differ significantly between the groups: 36 (40.4%) patients in the tranexamic acid group and 34 (41.5%) patients in the placebo group had intracranial haemorrhage growth (OR 0.96, 95% CI 0.52 to 1.77, p=0.89). The proportion of death was lower in the tranexamic acid treatment group than placebo group (8.1% vs 10.0%), but there were no significant differences in secondary outcomes including absolute intracranial haemorrhage growth, death and dependency.ConclusionsAmong patients susceptible to haemorrhage expansion treated within 8 hours of stroke onset, tranexamic acid did not significantly prevent intracerebral haemorrhage growth. Larger studies are needed to assess safety and efficacy of tranexamic acid in intracerebral haemorrhage patients.
The contamination of soil and groundwater with BTEX (benzene, toluene, ethyl benzene, and xylenes) is a common issue at petrochemical sites, posing a threat to the ecosystems and human health. The goal of this study was to evaluate the biodegradation of BTEX in the subsurface of a petrochemical site near the Yangtze River, thus providing scientific basis for bioremediation of the contaminated site. Both molecular analysis of field samples and microcosm study in the laboratory were performed for the evaluation. Soil and groundwater samples were collected from the site. Microcosms were constructed with inoculum from the soil and incubated anaerobically in the presence of nitrate, ferric oxide, manganese oxide, sulfate, and sodium bicarbonate, respectively. The initial concentration of each component of BTEX (benzene, toluene, ethyl benzene, o-xylene) was 4–5 mg/L. Actinobacteria was dominant in the highly contaminated soil, while Proteobacteria was dominant in the slightly contaminated soil and the groundwater. The relative abundances of Firmicutes, Spirochaetes, and Caldiserica were higher in the highly contaminated soil and groundwater samples compared to those in the corresponding slightly contaminated samples. The relative abundances of predicted functions, such as carbohydrate transport and metabolism, nucleotide transport and metabolism, coenzyme transport and metabolism, amino acid transport and metabolism, etc., in the highly contaminated soil and groundwater samples were higher than those in the corresponding slightly contaminated samples. In microcosms, biodegradations of BTEX occurred, and the first-order rate constants in the presence of various electron acceptors had the following order: sulfate (0.08–0.10/d) > sodium bicarbonate (0.07–0.09/d) > ferric oxide (0.04–0.06/d) > nitrate (0.03–0.05/d) > manganese oxide (0.01–0.04/d).
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