IMPORTANCE Although the benefit of reducing blood pressure for primary and secondary prevention of stroke has been established, the effect of antihypertensive treatment in patients with acute ischemic stroke is uncertain.OBJECTIVE To evaluate whether immediate blood pressure reduction in patients with acute ischemic stroke would reduce death and major disability at 14 days or hospital discharge. DESIGN, SETTING, AND PARTICIPANTS The China Antihypertensive Trial in Acute IschemicStroke, a single-blind, blinded end-points randomized clinical trial, conducted among 4071 patients with nonthrombolysed ischemic stroke within 48 hours of onset and elevated systolic blood pressure. Patients were recruited from 26 hospitals across China between August 2009 and May 2013.INTERVENTIONS Patients (n = 2038) were randomly assigned to receive antihypertensive treatment (aimed at lowering systolic blood pressure by 10% to 25% within the first 24 hours after randomization, achieving blood pressure less than 140/90 mm Hg within 7 days, and maintaining this level during hospitalization) or to discontinue all antihypertensive medications (control) during hospitalization (n = 2033). MAIN OUTCOMES AND MEASURESPrimary outcome was a combination of death and major disability (modified Rankin Scale score Ն3) at 14 days or hospital discharge.RESULTS Mean systolic blood pressure was reduced from 166.7 mm Hg to 144.7 mm Hg (−12.7%) within 24 hours in the antihypertensive treatment group and from 165.6 mm Hg to 152.9 mm Hg (−7.2%) in the control group within 24 hours after randomization (difference, −5.5% [95% CI, −4.9 to −6.1%]; absolute difference, −9.1 mm Hg [95% CI, −10.2 to −8.1]; P < .001). Mean systolic blood pressure was 137.3 mm Hg in the antihypertensive treatment group and 146.5 mm Hg in the control group at day 7 after randomization (difference, −9.3 mm Hg [95% CI, −10.1 to −8.4]; P < .001). The primary outcome did not differ between treatment groups (683 events [antihypertensive treatment] vs 681 events [control]; odds ratio, 1.00 [95% CI, 0.88 to 1.14]; P = .98) at 14 days or hospital discharge. The secondary composite outcome of death and major disability at 3-month posttreatment follow-up did not differ between treatment groups (500 events [antihypertensive treatment] vs 502 events [control]; odds ratio, 0.99 [95% CI, 0.86 to 1.15]; P = .93).CONCLUSION AND RELEVANCE Among patients with acute ischemic stroke, blood pressure reduction with antihypertensive medications, compared with the absence of hypertensive medication, did not reduce the likelihood of death and major disability at 14 days or hospital discharge.

A multiple-input single-output cognitive radio downlink network is studied with simultaneous wireless information and power transfer. In this network, a secondary user coexists with multiple primary users and multiple energy harvesting receivers. In order to guarantee secure communication and energy harvesting, the problem of robust secure artificial noise-aided beamforming and power splitting design is investigated under imperfect channel state information (CSI). Specifically, the transmit power minimization problem and the max-min fairness energy harvesting problem are formulated for both the bounded CSI error model and the probabilistic CSI error model. These problems are non-convex and challenging to solve.A one-dimensional search algorithm is proposed to solve these problems based on S-Procedure under the bounded CSI error model and based on Bernstein-type inequalities under the probabilistic CSI error model. It is shown that the optimal robust secure beamforming can be achieved under the bounded CSI error model, whereas a suboptimal beamforming solution can be obtained under the probabilistic CSI error model. A tradeoff is elucidated between the secrecy rate of the secondary user receiver and the energy harvested by the energy harvesting receivers under a max-min fairness criterion. USA (e-mail: lee880716@gmail.com).The research was supported by the Natural Science Foundation of China (61301179, 61501356, 61501354 and 61401338) and a scholarship from China Scholarship Council. Index TermsCognitive radio, physical-layer secrecy, robust beamforming, wireless information and power transfer.

Higher serum MMP-9 levels in the acute phase of ischemic stroke were associated with increased risk of mortality and major disability, suggesting that serum MMP-9 could be an important prognostic factor for ischemic stroke.