China Society for Human Rights Studies, I would like to extend my warm greetings to the launch of your Human Rights magazine. Enjoying human rights fully is a lofty goal long pursued after by human race. Over the year...China Society for Human Rights Studies, I would like to extend my warm greetings to the launch of your Human Rights magazine. Enjoying human rights fully is a lofty goal long pursued after by human race. Over the years when they carried out revolution, construction and reforms, the Chinese people have struggled indomitably and strived incessantly to achieve this goal. Progress made in this regard has caught worldwide attention. When struggling for, safeguarding, promoting and developing human rights, the Chinese people have always combined the universality prin-展开更多
In order to study the response law of vortex-induced vibration(VIV)of marine risers under the combined action of roughness and interference effects,and to reveal the coupling mechanism of roughness and interference ef...In order to study the response law of vortex-induced vibration(VIV)of marine risers under the combined action of roughness and interference effects,and to reveal the coupling mechanism of roughness and interference effects on the riser,a VIV experiment of rough risers in tandem arrangement was conducted in a wave−current combined flume.The experiment characterized the risers’roughness by arranging different specifications of attachments on the surface of the risers.Three rough risers with different roughness and smooth risers were arranged in tandem arrangement,with the rough risers arranged downstream.The experimental results indicate that the suppression of the attachments on the downstream risers’vibration are more significant both in the CF and IL directions as the reduced velocity increases.For the downstream riser,the amplitude response of rough riser is more significantly weakened compared with the smooth one at high reduced velocity.For the upstream risers,changes in the roughness and spacing ratio have an impact on their‘lock-in’region.When the roughness of downstream risers is relatively large(0.1300)and the spacing between risers is small(S/D=4.0),the reduced velocity range of‘lock-in’region in the CF direction of upstream risers is obviously expanded,and the displacement in the‘lock-in’region is severer.展开更多
A vortex-induced vibration(VIV)experiment of rough risers with coupling interference effect under a side-by-side arrangement was carried out in a wave-current combined flume.The roughness of the riser was characterize...A vortex-induced vibration(VIV)experiment of rough risers with coupling interference effect under a side-by-side arrangement was carried out in a wave-current combined flume.The roughness of the riser was characterized by arranging different specifications of surface attachments on the surface of the riser.Rough risers with three different roughnesses were arranged side by side with smooth risers to explore the VIV response of the riser under the combined action of roughness and interference effect,and to reveal the coupling mechanism between roughness and interference effect.The experimental results show that,compared with that of a smooth riser,the VIV of a rough riser under the coupling interference effect has a wider"lock-in"region,and the displacement decreases more significantly at a high reduced velocity,which is more likely to excite higher-order modes and frequency responses.In addition,the displacement response and frequency response of the smooth riser are not significantly affected by wake interference from the rough riser,which is caused by the decrease of the wake region due to the delay of the boundary layer separation point of the rough riser.展开更多
China’s Grain to Green Program(GTGP),which is one of the largest payments for ecosystem services(PES)in the world,has made significant ecological improvements to the environment.However,current understanding of its o...China’s Grain to Green Program(GTGP),which is one of the largest payments for ecosystem services(PES)in the world,has made significant ecological improvements to the environment.However,current understanding of its outcomes on the social-ecological system(SES)remains limited.Therefore,taking the South China Karst as an example,a SES resilience evaluation index system was constructed followed by an exploratory spatial analysis,root mean square error,and Self-Organizing Feature Map to clarify the spatiotemporal changes and relationship of SES resilience,achieve the zoning of SES resilience and provide restoration measures.The results showed an upward trend in social resilience from 2000 to 2020,especially its subsystem of social development.Regional ecological resilience was stable,owing to a slightly declined ecosystem services and increased landscape pattern.Spatially,nearly half of the counties exhibited a distribution mismatch in SES resilience.There was an obvious inverted U-shaped relationship of SES resilience,indicating a clear threshold effect,and the constraint relation-ship of SES resilience eased over time,demonstrating the effectiveness of the ecological restoration program.GTGP played a positive role in reducing regional SES trade-off,but this positive effect was limited,reflecting the limitations of overemphasizing the conversion from farmland to forest and grassland.Regional SES resilience can be divided into four clusters,which were the key optimization zone for social system,the SES resilience safety zone,the key restoration zone for SES resilience,and the key optimization zone for ecological system.Adaptive adjustments for the GTGP in these zones should be taken to achieve maximum SES benefits in the future.展开更多
BACKGROUND Surgical resection remains the primary treatment for hepatic malignancies,and intraoperative bleeding is associated with a significantly increased risk of death.Therefore,accurate prediction of intraoperati...BACKGROUND Surgical resection remains the primary treatment for hepatic malignancies,and intraoperative bleeding is associated with a significantly increased risk of death.Therefore,accurate prediction of intraoperative bleeding risk in patients with hepatic malignancies is essential to preventing bleeding in advance and providing safer and more effective treatment.AIM To develop a predictive model for intraoperative bleeding in primary hepatic malignancy patients for improving surgical planning and outcomes.METHODS The retrospective analysis enrolled patients diagnosed with primary hepatic malignancies who underwent surgery at the Hepatobiliary Surgery Department of the Fourth Hospital of Hebei Medical University between 2010 and 2020.Logistic regression analysis was performed to identify potential risk factors for intraoperative bleeding.A prediction model was developed using Python programming language,and its accuracy was evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Among 406 primary liver cancer patients,16.0%(65/406)suffered massive intraoperative bleeding.Logistic regression analysis identified four variables as associated with intraoperative bleeding in these patients:ascites[odds ratio(OR):22.839;P<0.05],history of alcohol consumption(OR:2.950;P<0.015),TNM staging(OR:2.441;P<0.001),and albumin-bilirubin score(OR:2.361;P<0.001).These variables were used to construct the prediction model.The 406 patients were randomly assigned to a training set(70%)and a prediction set(30%).The area under the ROC curve values for the model’s ability to predict intraoperative bleeding were 0.844 in the training set and 0.80 in the prediction set.CONCLUSION The developed and validated model predicts significant intraoperative blood loss in primary hepatic malignancies using four preoperative clinical factors by considering four preoperative clinical factors:ascites,history of alcohol consumption,TNM staging,and albumin-bilirubin score.Consequently,this model holds promise for enhancing individualised surgical planning.展开更多
Bulk graphene nanofilms feature fast electronic and phonon transport in combination with strong light-matter interaction and thus have great potential for versatile applications,spanning from photonic,electronic,and o...Bulk graphene nanofilms feature fast electronic and phonon transport in combination with strong light-matter interaction and thus have great potential for versatile applications,spanning from photonic,electronic,and optoelectronic devices to charge-stripping and electromagnetic shielding,etc.However,large-area flexible close-stacked graphene nanofilms with a wide thickness range have yet to be reported.Here,we report a polyacrylonitrile-assisted’substrate replacement’strategy to fabricate large-area free-standing graphene oxide/polyacrylonitrile nanofilms(lateral size~20 cm).Linear polyacrylonitrile chains-derived nanochannels promote the escape of gases and enable macro-assembled graphene nanofilms(nMAGs)of 50-600 nm thickness following heat treatment at 3,000℃.The uniform nMAGs exhibit 802-1,540 cm^(2)V-1s-1carrier mobility,4.3-4.7 ps carrier lifetime,and>1,581 W m^(-1)K^(-1)thermal conductivity(n MAG-assembled 10μm-thick films,mMAGs).nMAGs are highly flexible and show no structure damage even after 1.0×10^(5)cycles of folding-unfolding.Furthermore,n MAGs broaden the detection region of graphene/silicon heterojunction from near-infrared to mid-infrared and demonstrate higher absolute electromagnetic interference(EMI)shielding effectiveness than state-of-the-art EMI materials of the same thickness.These results are expected to lead to the broad applications of such bulk nanofilms,especially as micro/nanoelectronic and optoelectronic platforms.展开更多
AIM:To evaluate and compare the anatomical and functional outcomes and negative effects of the three anti-vascular endothelial growth factor(VEGF)drugs in the treatment of macular edema(ME)due to retinal vein occlusio...AIM:To evaluate and compare the anatomical and functional outcomes and negative effects of the three anti-vascular endothelial growth factor(VEGF)drugs in the treatment of macular edema(ME)due to retinal vein occlusion(RVO)based on the evidence pooled from current clinical trials and observational studies.METHODS:A systematic literature search was conducted on nine online databases from inception until April 30,2022.The main endpoints were best corrected visual acuity(BCVA),central macular thickness(CMT),and adverse events(AEs).Cumulative Meta-analysis was conducted to synthesize the outcomes of the drugs.The retrieved data were analyzed using Stata software(version 12.0).RESULTS:A total of 20 studies comprising 1674 eyes met the inclusion criteria to the Meta-analysis.It was observed that conbercept and aflibercept had better visual acuity effects compared with ranibizumab at 1mo[weight mean difference(WMD)=-0.03,P=0.001;WMD=-0.05,P=0.019],but the effects were not different from that of ranibizumab at 6mo.Moreover,there was not statistically significant dif ference in the propor tion of patients gaining≥15 letters at 12-24mo between aflibercept and ranibizumab[odds ratio(OR)=1.16,P=0.427].Conbercept had higher mean CMT change effects at 1mo(WMD=-14.43,P=0.014)and 6mo(WMD=-35.63,P≤0.001)compared with ranibizumab.Meanwhile,the mean CMT change effects at 1mo(WMD=-10.14,P=0.170),6mo(WMD=-26.98,P=0.140)and 12-24mo(WMD=-12.34,P=0.071)were comparable among the groups.Similarly,AEs were not significantly different among the treatments(OR=0.75,P=0.305;OR=1.04,P=0.89).The stability of effect size of mean BCVA and CMT improved with the increase in sample size.Aflibercept and conbercept required fewer injections compared with ranibizumab.CONCLUSION:This is the first study to evaluate the efficacy and AEs of intravitreal administration of conbercept,ranibizumab,and aflibercept in the treatment of RVOME.Intravitreal aflibercept or conbercept results in better mean change in vision and CMT reduction compared with ranibizumab.Conbercept can be considered to be a promising and innovative drug with good anti-VEGF effects.展开更多
Objective There is a large population of patients classified as complex higher-risk and indicated patients(CHIPs)in China with a poor prognosis.The treatment of these patients is complex and challenging,especially whe...Objective There is a large population of patients classified as complex higher-risk and indicated patients(CHIPs)in China with a poor prognosis.The treatment of these patients is complex and challenging,especially when acute cardiac events occur,such as acute coronary syndrome(ACS)or heart failure.Pharmacotherapy and some mechanical circulatory support(MCS)therapeutic devices can provide stable hemodynamic support for CHIPs-percutaneous coronary intervention(PCI).LDL-C is an important pathogenic factor in atherosclerosis,and the target of blood lipid control.Recent studies have revealed that lipoprotein(a)[Lp(a)],which is formed when a covalent bond between apolipoprotein(a)and apolipoprotein B-100 is made,produces an LDL-like particle.This particle is an independent risk factor for the development of atherosclerosis,and is closely correlated to stent thrombosis and restenosis.Furthermore,this requires active intervention.PCSK9 inhibitors have been used in lipid-lowering treatment,and preventing atherosclerosis.The present study explores the efficacy of PCSK9 inhibitors in CHIPs-ACS,and the association between the change in Lp(a)and survival after 2 years of follow-up.Methods The present real-world,prospective control study enrolled 321 CHIPs-ACS who underwent emergency PCI from August 2019 to November 2020,and these patients were followed up for 2 years.These patients were divided into two groups:PCSK9 group(n=161)given the combined PCSK9 inhibitor(140 mg of evolocumab every 2 weeks)and statins-based therapy,and SOC group(n=160)treated with statin-based lipid-lowering therapy alone.Then,the change in lipid index was measured,and the cardiovascular(CV)event recurrence rate was evaluated after one month and 2 years.Afterwards,the contribution of serum lipid parameters,especially the Lp(a)alteration,in patients with earlier initiation of the PCSK9 inhibitor to the CV outcome was analyzed.Results The LDL-C level was significantly reduced in both groups:52.3%in the PCSK9 group and 32.3%(P<0.001)in the SOC group.It is noteworthy that the Lp(a)level decreased by 13.2%in the PCSK9 group,but increased by 30.3%in the SOC group(P<0.001).Furthermore,the number of CV events was not significantly different between the PCSK9 and SOC groups after the 2-year follow-up period.In the PCSK9 group,the Lp(a)reduction was associated with the baseline Lp(a)levels of the patients(r2=−0.315,P<0.001).Moreover,the decrease in Lp(a)contributed to the decline in CV events in patients who received ACS CHIPs-PCI,and the decrease in Lp(a)level was independent of the LDL-C level reduction.Conclusion The early initiation of PCSK9 inhibitors can significantly reduce the LDL-C and Lp(a)levels in ACS CHIPs-PCI.However,further studies are needed to confirm whether PCSK9 inhibitors can reduce the incidence of CV disease in CHIPs.展开更多
文摘China Society for Human Rights Studies, I would like to extend my warm greetings to the launch of your Human Rights magazine. Enjoying human rights fully is a lofty goal long pursued after by human race. Over the years when they carried out revolution, construction and reforms, the Chinese people have struggled indomitably and strived incessantly to achieve this goal. Progress made in this regard has caught worldwide attention. When struggling for, safeguarding, promoting and developing human rights, the Chinese people have always combined the universality prin-
基金supported by the Natural Science Foundation of Shandong Province(Grant Nos.ZR2023ME040 and ZR2022QE118)the Key Technology Research and Development Program of Shandong Province(Grant No.2023CXGC010316)the Natural Science Foundation of Qingdao(Grant No.23-2-1-207-zyyd-jch),and the National Natural Science Foundation of China(Grant No.51709161).
文摘In order to study the response law of vortex-induced vibration(VIV)of marine risers under the combined action of roughness and interference effects,and to reveal the coupling mechanism of roughness and interference effects on the riser,a VIV experiment of rough risers in tandem arrangement was conducted in a wave−current combined flume.The experiment characterized the risers’roughness by arranging different specifications of attachments on the surface of the risers.Three rough risers with different roughness and smooth risers were arranged in tandem arrangement,with the rough risers arranged downstream.The experimental results indicate that the suppression of the attachments on the downstream risers’vibration are more significant both in the CF and IL directions as the reduced velocity increases.For the downstream riser,the amplitude response of rough riser is more significantly weakened compared with the smooth one at high reduced velocity.For the upstream risers,changes in the roughness and spacing ratio have an impact on their‘lock-in’region.When the roughness of downstream risers is relatively large(0.1300)and the spacing between risers is small(S/D=4.0),the reduced velocity range of‘lock-in’region in the CF direction of upstream risers is obviously expanded,and the displacement in the‘lock-in’region is severer.
基金financially supported by the Natural Science Foundation of Shandong Province(Grant Nos.ZR2023ME040 and ZR2022QE118)the Key Technology Research and Development Program of Shandong Province(Grant No.2023CXGC010316)+1 种基金the Natural Science Foundation of Qingdao(Grant No.23-2-1-207-zyyd-jch)the Introduction and Education Plan for Young Innovative talents in Colleges and Universities of Shandong Province(Marine Civil Engineering Materials and Structure Innovation Research Team).
文摘A vortex-induced vibration(VIV)experiment of rough risers with coupling interference effect under a side-by-side arrangement was carried out in a wave-current combined flume.The roughness of the riser was characterized by arranging different specifications of surface attachments on the surface of the riser.Rough risers with three different roughnesses were arranged side by side with smooth risers to explore the VIV response of the riser under the combined action of roughness and interference effect,and to reveal the coupling mechanism between roughness and interference effect.The experimental results show that,compared with that of a smooth riser,the VIV of a rough riser under the coupling interference effect has a wider"lock-in"region,and the displacement decreases more significantly at a high reduced velocity,which is more likely to excite higher-order modes and frequency responses.In addition,the displacement response and frequency response of the smooth riser are not significantly affected by wake interference from the rough riser,which is caused by the decrease of the wake region due to the delay of the boundary layer separation point of the rough riser.
基金the National Key Research and Development Program of China(Grant No.2022YFF1300701)National Natural Science Foundation of China(Grant No.42001090).
文摘China’s Grain to Green Program(GTGP),which is one of the largest payments for ecosystem services(PES)in the world,has made significant ecological improvements to the environment.However,current understanding of its outcomes on the social-ecological system(SES)remains limited.Therefore,taking the South China Karst as an example,a SES resilience evaluation index system was constructed followed by an exploratory spatial analysis,root mean square error,and Self-Organizing Feature Map to clarify the spatiotemporal changes and relationship of SES resilience,achieve the zoning of SES resilience and provide restoration measures.The results showed an upward trend in social resilience from 2000 to 2020,especially its subsystem of social development.Regional ecological resilience was stable,owing to a slightly declined ecosystem services and increased landscape pattern.Spatially,nearly half of the counties exhibited a distribution mismatch in SES resilience.There was an obvious inverted U-shaped relationship of SES resilience,indicating a clear threshold effect,and the constraint relation-ship of SES resilience eased over time,demonstrating the effectiveness of the ecological restoration program.GTGP played a positive role in reducing regional SES trade-off,but this positive effect was limited,reflecting the limitations of overemphasizing the conversion from farmland to forest and grassland.Regional SES resilience can be divided into four clusters,which were the key optimization zone for social system,the SES resilience safety zone,the key restoration zone for SES resilience,and the key optimization zone for ecological system.Adaptive adjustments for the GTGP in these zones should be taken to achieve maximum SES benefits in the future.
文摘BACKGROUND Surgical resection remains the primary treatment for hepatic malignancies,and intraoperative bleeding is associated with a significantly increased risk of death.Therefore,accurate prediction of intraoperative bleeding risk in patients with hepatic malignancies is essential to preventing bleeding in advance and providing safer and more effective treatment.AIM To develop a predictive model for intraoperative bleeding in primary hepatic malignancy patients for improving surgical planning and outcomes.METHODS The retrospective analysis enrolled patients diagnosed with primary hepatic malignancies who underwent surgery at the Hepatobiliary Surgery Department of the Fourth Hospital of Hebei Medical University between 2010 and 2020.Logistic regression analysis was performed to identify potential risk factors for intraoperative bleeding.A prediction model was developed using Python programming language,and its accuracy was evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Among 406 primary liver cancer patients,16.0%(65/406)suffered massive intraoperative bleeding.Logistic regression analysis identified four variables as associated with intraoperative bleeding in these patients:ascites[odds ratio(OR):22.839;P<0.05],history of alcohol consumption(OR:2.950;P<0.015),TNM staging(OR:2.441;P<0.001),and albumin-bilirubin score(OR:2.361;P<0.001).These variables were used to construct the prediction model.The 406 patients were randomly assigned to a training set(70%)and a prediction set(30%).The area under the ROC curve values for the model’s ability to predict intraoperative bleeding were 0.844 in the training set and 0.80 in the prediction set.CONCLUSION The developed and validated model predicts significant intraoperative blood loss in primary hepatic malignancies using four preoperative clinical factors by considering four preoperative clinical factors:ascites,history of alcohol consumption,TNM staging,and albumin-bilirubin score.Consequently,this model holds promise for enhancing individualised surgical planning.
基金supported by the National Natural Science Foundation of China(No.52090030)the China Postdoctoral Science Foundation(2022T150558,2020M681819)+1 种基金the Fundamental Research Funds for the Central Universities(No.2021FZZX001-17)the Postdoctoral Research Program of Zhejiang Province(ZJ2021145).
文摘Bulk graphene nanofilms feature fast electronic and phonon transport in combination with strong light-matter interaction and thus have great potential for versatile applications,spanning from photonic,electronic,and optoelectronic devices to charge-stripping and electromagnetic shielding,etc.However,large-area flexible close-stacked graphene nanofilms with a wide thickness range have yet to be reported.Here,we report a polyacrylonitrile-assisted’substrate replacement’strategy to fabricate large-area free-standing graphene oxide/polyacrylonitrile nanofilms(lateral size~20 cm).Linear polyacrylonitrile chains-derived nanochannels promote the escape of gases and enable macro-assembled graphene nanofilms(nMAGs)of 50-600 nm thickness following heat treatment at 3,000℃.The uniform nMAGs exhibit 802-1,540 cm^(2)V-1s-1carrier mobility,4.3-4.7 ps carrier lifetime,and>1,581 W m^(-1)K^(-1)thermal conductivity(n MAG-assembled 10μm-thick films,mMAGs).nMAGs are highly flexible and show no structure damage even after 1.0×10^(5)cycles of folding-unfolding.Furthermore,n MAGs broaden the detection region of graphene/silicon heterojunction from near-infrared to mid-infrared and demonstrate higher absolute electromagnetic interference(EMI)shielding effectiveness than state-of-the-art EMI materials of the same thickness.These results are expected to lead to the broad applications of such bulk nanofilms,especially as micro/nanoelectronic and optoelectronic platforms.
基金Supported by the Natural Science Foundation of Hainan Province(No.821QN1005)Hainan Provincial Health Commission Project(No.21A200067)Hainan Provincial Classification of Project(No.ZDYF2020110)。
文摘AIM:To evaluate and compare the anatomical and functional outcomes and negative effects of the three anti-vascular endothelial growth factor(VEGF)drugs in the treatment of macular edema(ME)due to retinal vein occlusion(RVO)based on the evidence pooled from current clinical trials and observational studies.METHODS:A systematic literature search was conducted on nine online databases from inception until April 30,2022.The main endpoints were best corrected visual acuity(BCVA),central macular thickness(CMT),and adverse events(AEs).Cumulative Meta-analysis was conducted to synthesize the outcomes of the drugs.The retrieved data were analyzed using Stata software(version 12.0).RESULTS:A total of 20 studies comprising 1674 eyes met the inclusion criteria to the Meta-analysis.It was observed that conbercept and aflibercept had better visual acuity effects compared with ranibizumab at 1mo[weight mean difference(WMD)=-0.03,P=0.001;WMD=-0.05,P=0.019],but the effects were not different from that of ranibizumab at 6mo.Moreover,there was not statistically significant dif ference in the propor tion of patients gaining≥15 letters at 12-24mo between aflibercept and ranibizumab[odds ratio(OR)=1.16,P=0.427].Conbercept had higher mean CMT change effects at 1mo(WMD=-14.43,P=0.014)and 6mo(WMD=-35.63,P≤0.001)compared with ranibizumab.Meanwhile,the mean CMT change effects at 1mo(WMD=-10.14,P=0.170),6mo(WMD=-26.98,P=0.140)and 12-24mo(WMD=-12.34,P=0.071)were comparable among the groups.Similarly,AEs were not significantly different among the treatments(OR=0.75,P=0.305;OR=1.04,P=0.89).The stability of effect size of mean BCVA and CMT improved with the increase in sample size.Aflibercept and conbercept required fewer injections compared with ranibizumab.CONCLUSION:This is the first study to evaluate the efficacy and AEs of intravitreal administration of conbercept,ranibizumab,and aflibercept in the treatment of RVOME.Intravitreal aflibercept or conbercept results in better mean change in vision and CMT reduction compared with ranibizumab.Conbercept can be considered to be a promising and innovative drug with good anti-VEGF effects.
基金the Translational Medicine and Interdisciplinary Research Joint Fund of Zhongnan Hospital of Wuhan University(No.ZNLH-201907)the Hubei Province Health and Family Planning Scientific Research Project(No.WJ2019Q041)the Chinese Academy of Medical Science Innovation Fund for Medical Sciences(No.2021-I2M-1-009).
文摘Objective There is a large population of patients classified as complex higher-risk and indicated patients(CHIPs)in China with a poor prognosis.The treatment of these patients is complex and challenging,especially when acute cardiac events occur,such as acute coronary syndrome(ACS)or heart failure.Pharmacotherapy and some mechanical circulatory support(MCS)therapeutic devices can provide stable hemodynamic support for CHIPs-percutaneous coronary intervention(PCI).LDL-C is an important pathogenic factor in atherosclerosis,and the target of blood lipid control.Recent studies have revealed that lipoprotein(a)[Lp(a)],which is formed when a covalent bond between apolipoprotein(a)and apolipoprotein B-100 is made,produces an LDL-like particle.This particle is an independent risk factor for the development of atherosclerosis,and is closely correlated to stent thrombosis and restenosis.Furthermore,this requires active intervention.PCSK9 inhibitors have been used in lipid-lowering treatment,and preventing atherosclerosis.The present study explores the efficacy of PCSK9 inhibitors in CHIPs-ACS,and the association between the change in Lp(a)and survival after 2 years of follow-up.Methods The present real-world,prospective control study enrolled 321 CHIPs-ACS who underwent emergency PCI from August 2019 to November 2020,and these patients were followed up for 2 years.These patients were divided into two groups:PCSK9 group(n=161)given the combined PCSK9 inhibitor(140 mg of evolocumab every 2 weeks)and statins-based therapy,and SOC group(n=160)treated with statin-based lipid-lowering therapy alone.Then,the change in lipid index was measured,and the cardiovascular(CV)event recurrence rate was evaluated after one month and 2 years.Afterwards,the contribution of serum lipid parameters,especially the Lp(a)alteration,in patients with earlier initiation of the PCSK9 inhibitor to the CV outcome was analyzed.Results The LDL-C level was significantly reduced in both groups:52.3%in the PCSK9 group and 32.3%(P<0.001)in the SOC group.It is noteworthy that the Lp(a)level decreased by 13.2%in the PCSK9 group,but increased by 30.3%in the SOC group(P<0.001).Furthermore,the number of CV events was not significantly different between the PCSK9 and SOC groups after the 2-year follow-up period.In the PCSK9 group,the Lp(a)reduction was associated with the baseline Lp(a)levels of the patients(r2=−0.315,P<0.001).Moreover,the decrease in Lp(a)contributed to the decline in CV events in patients who received ACS CHIPs-PCI,and the decrease in Lp(a)level was independent of the LDL-C level reduction.Conclusion The early initiation of PCSK9 inhibitors can significantly reduce the LDL-C and Lp(a)levels in ACS CHIPs-PCI.However,further studies are needed to confirm whether PCSK9 inhibitors can reduce the incidence of CV disease in CHIPs.
