BACKGROUND The efficacy and safety of proprotein convertase subtilisin/kexin type 9(PCSK-9) inhibitors were confirmed by several clinical trials, but its effectiveness in routine clinical practice in China has not bee...BACKGROUND The efficacy and safety of proprotein convertase subtilisin/kexin type 9(PCSK-9) inhibitors were confirmed by several clinical trials, but its effectiveness in routine clinical practice in China has not been evaluated. This study aims to describe the real world effectiveness of PCSK-9 inhibitors combined with statins compared with statins-based therapy among patients with very high risk of atherosclerotic cardiovascular disease(ASCVD).METHODS This is a multi-center observational study, enrolled patients from 32 hospitals who underwent percutaneous coronary intervention(PCI) from January to June in 2019. There are 453 patients treated with PCSK-9 inhibitors combined with statins in PCSK-9 inhibitor group and 2,610 patients treated with statins-based lipid lowering therapies in statins-based group. The lipid control rate and incidence of major adverse cardiovascular events(MACE) over six months were compared between two groups.A propensity score-matched(PSM) analysis was used to balance two groups on confounding factors. Survival analysis using Kaplan-Meier methods was applied for MACE.RESULTS In a total of 3,063 patients, 89.91% of patients had received moderate or high-intensity statins-based therapy before PCI, but only 9.47% of patients had low-density lipoprotein cholesterol(LDL-C) levels below 1.4 mmol/L at baseline. In the PSM selected patients, LDL-C level was reduced by 42.57% in PCSK-9 inhibitor group and 30.81%(P < 0.001) in statins-based group after six months. The proportion of LDL-C ≤ 1.0 mmol/L increased from 5.29% to 29.26% in PCSK-9 inhibitor group and 0.23% to 6.11% in statins-based group, and the proportion of LDL-C ≤ 1.4 mmol/L increased from 10.36% to 47.69% in PCSK-9 inhibitor group and 2.99% to 18.43% in statins-based group(P < 0.001 for both). There was no significant difference between PCSK-9 inhibitor and statins-based treatment in reducing the risk of MACE(hazard ratio = 2.52, 95% CI: 0.49-12.97, P = 0.250).CONCLUSIONS In the real world, PCSK-9 inhibitors combined with statins could significantly reduce LDL-C levels among patients with very high risk of ASCVD in China. The long-term clinical benefits for patients received PCSK-9 inhibitor to reduce the risk of MACE is still unclear and requires further study.展开更多
Kensuke's Kingdom is a highly readable British survival novel written by Michael Morourgo. It is not only a survival novel, but also a realistic novel for the children. By the two disparate characters, the writer ...Kensuke's Kingdom is a highly readable British survival novel written by Michael Morourgo. It is not only a survival novel, but also a realistic novel for the children. By the two disparate characters, the writer wants to discuss the effects of the war, which is the deeper meaning of this novel. Writing war and the effects of the war is a heavy but necessary topic for children's literature. Books like Kensuke's Kingdom can be woven into young readers' developing senses of themselves, extending their imaginations and helping them to understand the world from unaccustomed points of view.展开更多
The outer synchronization of irregular coupled complex networks is inves- tigated with nonidentical topological structures. The switching gain is estimated by an adaptive technique, and a sliding mode controller is de...The outer synchronization of irregular coupled complex networks is inves- tigated with nonidentical topological structures. The switching gain is estimated by an adaptive technique, and a sliding mode controller is designed to satisfy the sliding con- dition. The outer synchronization between two irregular coupled complex networks with different initial conditions is implemented via the designed controllers with the corre- sponding parameter update laws. The chaos synchronization of two small-world networks consisting of N uncertain identical Lorenz systems is achieved to demonstrate the appli- cations of the proposed approach.展开更多
Small worm effects in the harmonious unifying hybrid preferential model （HUHPM） networks are studied both numerically and analytically. The idea and method of the HUHPM is applied to three typical examples of unweig...Small worm effects in the harmonious unifying hybrid preferential model （HUHPM） networks are studied both numerically and analytically. The idea and method of the HUHPM is applied to three typical examples of unweighted BA model, weighted BBV model, and the TDE rnodel, so-called HUHPM-BA, HUHPM-BBV and HUHPM- TDE networks. Comparing the HUHPM with current typical models above, it is found that the HUHPM networks has the smallest average path length and the biggest average clustering coefficient. The results demonstrate that the HUHPM is more suitable not only for the un-iveighted models but also for the weighted models.展开更多
In the 21st century, world politics appeared to far from resolved condition in terms of power sharing among the elites, thus created separatism movements in many parts of the world. These movements caused some changes...In the 21st century, world politics appeared to far from resolved condition in terms of power sharing among the elites, thus created separatism movements in many parts of the world. These movements caused some changes in the society that is nowadays seen as a multicultural. Using World Values Survey＇s data, this study revealed that separatism would cause people to less likely agree on ethnic diversity benefit. Further, when the result is tested by elaboration model, economic condition was found as important factor on how people saw ethnic diversity benefit among the society.展开更多
In order to find out the factors which influence community participation in tourism,several effect factors are summed up through the investigation of the local residents and the analysis of the logistic regression of ...In order to find out the factors which influence community participation in tourism,several effect factors are summed up through the investigation of the local residents and the analysis of the logistic regression of the data gained from Xingwen world Geopark.Results indicated there are several main influencing factors of community participation such as the comparative benefit of tourist industry,participant residents' subjective wishes,preference consciousness of working opportunity obtainment in the tourist enterprise and participant skills.Based on above investigation data and field travel,the paper put forward several methods about how to enhance the residents' participant degree:increasing the comparative benefit of tourist industry,enhancing the attraction of tourism for boosting participant wishes,improving the preference consciousness on obtaining working opportunity in tourism industry and cultivating residents' participant skills through training.展开更多
目的基于真实世界数据(Real World Data,RWD)对注射泵的主要有效性评价功能进行研究,最大程度反映其临床实践中的真实性能表现,以建立科学有效的评价方法。方法选取本院重症医学科3种品牌(M、F、L)注射泵共计37台次作为研究对象,根据建...目的基于真实世界数据(Real World Data,RWD)对注射泵的主要有效性评价功能进行研究,最大程度反映其临床实践中的真实性能表现,以建立科学有效的评价方法。方法选取本院重症医学科3种品牌(M、F、L)注射泵共计37台次作为研究对象,根据建立的临床使用评价指标,分别在5、25和50 mL/h 3种流速下,获得注射泵出第1滴液的时间和响应时间来测试注射泵快速启动的性能差异,计算流速平均值、相对示值误差和示值重复性来测试注射泵注射精度的性能差异;分别在5、10和15 mL/h 3种流速下,获得注射泵的流速波动下限和间歇时间来测试注射泵联机中继的性能差异。结果在快速启动功能方面,设定流速越大,注射泵出第1滴液的时间和响应时间越短,且在3种流速下,M品牌注射泵出第1滴液的时间和响应时间都最短(P<0.05)。在注射精度功能方面,在3种流速下,M和L品牌的流速控制性能和示值稳定性都显著优于F品牌(P<0.05)。在联机中继功能方面,人工模拟联机中继功能导致的流速波动下限和间歇时间差异显著(P<0.05),且设定流速越大,实时流速从下降到恢复设定值需要的间歇时间就越短。另外,M品牌的自动联机中继功能可有效解决前序泵与后序泵中继过程中产生的药物流量抖动或间断,但有瞬时流速上升,相对能够保证药物流量的稳定性和连续性。结论使用正确的基于RWD的注射泵临床使用评价方法不仅能够规范临床应用行为,还能够为注射泵的评价、准入/淘汰和集中采购/价格谈判提供数据支撑。展开更多
Shanghai World Financial Center is one of the highest buildings in the world, of which cumulation of vertical deformation during construction is significant and worth investigating. A refined finite element model was ...Shanghai World Financial Center is one of the highest buildings in the world, of which cumulation of vertical deformation during construction is significant and worth investigating. A refined finite element model was developed to conduct full-process analysis of construction of super-high rise buildings like Shanghai World Financial Center, in which the discrete analysis method of time-varying structures and age-adjusted effective modulus method were both used. In the finite element analysis, the whole construction process was divided into a series of stages, each with a structural system that is a part of the whole structure and with different material parameters, geometrical parameters, loading and boundary conditions. The whole construction process of Shanghai World Financial Center in consideration of creep of concrete was simulated successfully by using the finite element model and the analytical method developed. With respect to different construction stage, the total vertical deformation, inter-floor compression deformation and the relative deformation between the outer frame and the core-wall were obtained through the analysis. The comparison between the results from the stage-wise full-process analysis of construction with and without considering the creep and the results from the conventional analysis of the whole building under the total load from all self-weight and construction applied to the structure "in one go" shows that the cumulative effect on the deformation from the construction process and the creep effect need to be considered in analyzing the deformation of Shanghai World Financial Center, and the super-high rise buildings suchlike. Finally, the simulation results correlate well with the monitoring results-a proof of the feasibility and the validity of this paper.展开更多
We discuss a new class of RSII braneworld cosmology exhibiting accelerated expansion and dominated by quintessence. It is explicitly demonstrated that the universe expansion history （transition from inflation to dece...We discuss a new class of RSII braneworld cosmology exhibiting accelerated expansion and dominated by quintessence. It is explicitly demonstrated that the universe expansion history （transition from inflation to deceleration epoch to acceleration and effective quintessence era） may naturally occur in such unified theory for some classes of inverse scalar potentials. Besides a decaying effective cosmological constant, the model incorporates an increasing black hole mass, an increasing Maxwellian electrical charge with cosmic time and a time-dependent brahe tension. The cosmological model exhibits several features of cosmological and astrophysical interest for both the early and late universe consistent with recent observations, in particular the ones concerned with the gravitational constants, black holes masses and charges and variation of the gauge coupling parameters with cosmic time. One interesting mark of the constructed model concerns the fact that a black hole mass surrounded by quintessence energy may increase with time even if the horizon disappears.展开更多
With the development of computer and network technologies, computer--assisted language teaching and learning have been changing from the presentation of single text materials and response model to the integration of o...With the development of computer and network technologies, computer--assisted language teaching and learning have been changing from the presentation of single text materials and response model to the integration of outside classroom education media combining text, graphics, images, sound, animation and network communication （CMC） technology. As an auxiliary tool of foreign language teaching, the computer plays its huge potential and promotes the completion of all kinds of language learning tasks. However, high cost and lack of technical support bringing the negative effects to the foreign language teaching is also cannot be ignored. Therefore, in the study of the historical evolvement of the CALL, to fully understand the positive and negative effects from the foreign language teaching will help make the positive effect of foreign language teaching maximized, and avoid misuse and abuse of the CALL.展开更多
基金supported by the China Cardiovascular Health Alliance-Advanced Fund (2019CCA-ACCESS-054)the Beijing Lisheng Cardiovascular Health Foundation Pilot Fund Key Projects。
文摘BACKGROUND The efficacy and safety of proprotein convertase subtilisin/kexin type 9(PCSK-9) inhibitors were confirmed by several clinical trials, but its effectiveness in routine clinical practice in China has not been evaluated. This study aims to describe the real world effectiveness of PCSK-9 inhibitors combined with statins compared with statins-based therapy among patients with very high risk of atherosclerotic cardiovascular disease(ASCVD).METHODS This is a multi-center observational study, enrolled patients from 32 hospitals who underwent percutaneous coronary intervention(PCI) from January to June in 2019. There are 453 patients treated with PCSK-9 inhibitors combined with statins in PCSK-9 inhibitor group and 2,610 patients treated with statins-based lipid lowering therapies in statins-based group. The lipid control rate and incidence of major adverse cardiovascular events(MACE) over six months were compared between two groups.A propensity score-matched(PSM) analysis was used to balance two groups on confounding factors. Survival analysis using Kaplan-Meier methods was applied for MACE.RESULTS In a total of 3,063 patients, 89.91% of patients had received moderate or high-intensity statins-based therapy before PCI, but only 9.47% of patients had low-density lipoprotein cholesterol(LDL-C) levels below 1.4 mmol/L at baseline. In the PSM selected patients, LDL-C level was reduced by 42.57% in PCSK-9 inhibitor group and 30.81%(P < 0.001) in statins-based group after six months. The proportion of LDL-C ≤ 1.0 mmol/L increased from 5.29% to 29.26% in PCSK-9 inhibitor group and 0.23% to 6.11% in statins-based group, and the proportion of LDL-C ≤ 1.4 mmol/L increased from 10.36% to 47.69% in PCSK-9 inhibitor group and 2.99% to 18.43% in statins-based group(P < 0.001 for both). There was no significant difference between PCSK-9 inhibitor and statins-based treatment in reducing the risk of MACE(hazard ratio = 2.52, 95% CI: 0.49-12.97, P = 0.250).CONCLUSIONS In the real world, PCSK-9 inhibitors combined with statins could significantly reduce LDL-C levels among patients with very high risk of ASCVD in China. The long-term clinical benefits for patients received PCSK-9 inhibitor to reduce the risk of MACE is still unclear and requires further study.
文摘Kensuke's Kingdom is a highly readable British survival novel written by Michael Morourgo. It is not only a survival novel, but also a realistic novel for the children. By the two disparate characters, the writer wants to discuss the effects of the war, which is the deeper meaning of this novel. Writing war and the effects of the war is a heavy but necessary topic for children's literature. Books like Kensuke's Kingdom can be woven into young readers' developing senses of themselves, extending their imaginations and helping them to understand the world from unaccustomed points of view.
基金Project supported by the State Key Program of the National Natural Science Foundation of China(No.11232009)the Shanghai Leading Academic Discipline Project(No.S30106)
文摘The outer synchronization of irregular coupled complex networks is inves- tigated with nonidentical topological structures. The switching gain is estimated by an adaptive technique, and a sliding mode controller is designed to satisfy the sliding con- dition. The outer synchronization between two irregular coupled complex networks with different initial conditions is implemented via the designed controllers with the corre- sponding parameter update laws. The chaos synchronization of two small-world networks consisting of N uncertain identical Lorenz systems is achieved to demonstrate the appli- cations of the proposed approach.
基金The project supported by National Natural Science Foundation of China under Grant Nos. 70431002 and 70371068
文摘Small worm effects in the harmonious unifying hybrid preferential model （HUHPM） networks are studied both numerically and analytically. The idea and method of the HUHPM is applied to three typical examples of unweighted BA model, weighted BBV model, and the TDE rnodel, so-called HUHPM-BA, HUHPM-BBV and HUHPM- TDE networks. Comparing the HUHPM with current typical models above, it is found that the HUHPM networks has the smallest average path length and the biggest average clustering coefficient. The results demonstrate that the HUHPM is more suitable not only for the un-iveighted models but also for the weighted models.
文摘In the 21st century, world politics appeared to far from resolved condition in terms of power sharing among the elites, thus created separatism movements in many parts of the world. These movements caused some changes in the society that is nowadays seen as a multicultural. Using World Values Survey＇s data, this study revealed that separatism would cause people to less likely agree on ethnic diversity benefit. Further, when the result is tested by elaboration model, economic condition was found as important factor on how people saw ethnic diversity benefit among the society.
文摘In order to find out the factors which influence community participation in tourism,several effect factors are summed up through the investigation of the local residents and the analysis of the logistic regression of the data gained from Xingwen world Geopark.Results indicated there are several main influencing factors of community participation such as the comparative benefit of tourist industry,participant residents' subjective wishes,preference consciousness of working opportunity obtainment in the tourist enterprise and participant skills.Based on above investigation data and field travel,the paper put forward several methods about how to enhance the residents' participant degree:increasing the comparative benefit of tourist industry,enhancing the attraction of tourism for boosting participant wishes,improving the preference consciousness on obtaining working opportunity in tourism industry and cultivating residents' participant skills through training.
基金Sponsored by the Technology Pillar Program During the Eleventh Five-Year Plan Period (Grant No.2006BAJ01B02)
文摘Shanghai World Financial Center is one of the highest buildings in the world, of which cumulation of vertical deformation during construction is significant and worth investigating. A refined finite element model was developed to conduct full-process analysis of construction of super-high rise buildings like Shanghai World Financial Center, in which the discrete analysis method of time-varying structures and age-adjusted effective modulus method were both used. In the finite element analysis, the whole construction process was divided into a series of stages, each with a structural system that is a part of the whole structure and with different material parameters, geometrical parameters, loading and boundary conditions. The whole construction process of Shanghai World Financial Center in consideration of creep of concrete was simulated successfully by using the finite element model and the analytical method developed. With respect to different construction stage, the total vertical deformation, inter-floor compression deformation and the relative deformation between the outer frame and the core-wall were obtained through the analysis. The comparison between the results from the stage-wise full-process analysis of construction with and without considering the creep and the results from the conventional analysis of the whole building under the total load from all self-weight and construction applied to the structure "in one go" shows that the cumulative effect on the deformation from the construction process and the creep effect need to be considered in analyzing the deformation of Shanghai World Financial Center, and the super-high rise buildings suchlike. Finally, the simulation results correlate well with the monitoring results-a proof of the feasibility and the validity of this paper.
文摘We discuss a new class of RSII braneworld cosmology exhibiting accelerated expansion and dominated by quintessence. It is explicitly demonstrated that the universe expansion history （transition from inflation to deceleration epoch to acceleration and effective quintessence era） may naturally occur in such unified theory for some classes of inverse scalar potentials. Besides a decaying effective cosmological constant, the model incorporates an increasing black hole mass, an increasing Maxwellian electrical charge with cosmic time and a time-dependent brahe tension. The cosmological model exhibits several features of cosmological and astrophysical interest for both the early and late universe consistent with recent observations, in particular the ones concerned with the gravitational constants, black holes masses and charges and variation of the gauge coupling parameters with cosmic time. One interesting mark of the constructed model concerns the fact that a black hole mass surrounded by quintessence energy may increase with time even if the horizon disappears.
文摘With the development of computer and network technologies, computer--assisted language teaching and learning have been changing from the presentation of single text materials and response model to the integration of outside classroom education media combining text, graphics, images, sound, animation and network communication （CMC） technology. As an auxiliary tool of foreign language teaching, the computer plays its huge potential and promotes the completion of all kinds of language learning tasks. However, high cost and lack of technical support bringing the negative effects to the foreign language teaching is also cannot be ignored. Therefore, in the study of the historical evolvement of the CALL, to fully understand the positive and negative effects from the foreign language teaching will help make the positive effect of foreign language teaching maximized, and avoid misuse and abuse of the CALL.
