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
Complex higher-risk and indicated patients (CHIPs) refers to patients with severe coronary artery disease (CAD) needing revascularization. However, these patients are at an increased risk for this procedure.[1] The CH...Complex higher-risk and indicated patients (CHIPs) refers to patients with severe coronary artery disease (CAD) needing revascularization. However, these patients are at an increased risk for this procedure.[1] The CHIP population is attracting much interest in the field of interventional cardiology, since it was introduced in 2016 by Kirtane et al,[1] and the optimal treatment strategies for this population were fiercely discussed in almost every interventional forum at home and abroad. First of all, a comprehensive risk assessment must be conducted to determine which patients with CAD should undergo revascularization based on clinical presentation, functional tests, and anatomic characteristics. Percutaneous coronary intervention (PCI) might be a beneficial option when complete revascularization can be achieved, especially for patients are either inoperable or at higher surgical risk.[2,3] To treat these high-risk patients safely and effectively with PCI, well-trained interventionalists exhibiting both technical and cognitive skills are needed.展开更多
Quantification of complicated surface morphology of soil crack is a prerequisite and key to soil crack study. This paper takes soil crack quads in Yuanmou arid-hot valley region as examples, selecting several morpholo...Quantification of complicated surface morphology of soil crack is a prerequisite and key to soil crack study. This paper takes soil crack quads in Yuanmou arid-hot valley region as examples, selecting several morphological indicators, and analyzes the soil crack＇s morphological features under various development degrees. By statistic analysis, three quantitative indicators for surface morphology are selected, namely soil crack area density, area weighted mean fractal dimension and connectivity index R, which can not only express the development intensity of soil cracks, but also effectively describe its morphological complexity and connectivity. The research results set a good base for the establishment of soil crack assessment system in Yuanmou arid-hot valley region.展开更多
Performance indicators play some important roles in enterprise operation.Both researchers and managers have recently pointed out that the identification of correlation between different performance indicators may lead...Performance indicators play some important roles in enterprise operation.Both researchers and managers have recently pointed out that the identification of correlation between different performance indicators may lead to a better understanding of business.However,it is becoming more and more difficult to measure and analyze these indicators since the fast growing number of performance indicators and the complex relationships between them.The existing categories failed to reflect these changes in an adequate way,and the quantitative analysis methods for identifying the characters of those performance indicators are still worthy of investigation.The main objective of this paper is to propose a practical methodology for managing and analyzing performance indicators in enterprises,which focuses on building up a performance indicator system and discovering the characters of those performance indicators by applying complex network methods.The empirical results of a telecommunication enterprise show that the proposed method can be effective in understanding the correlations between performance indicators.展开更多
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.
文摘Complex higher-risk and indicated patients (CHIPs) refers to patients with severe coronary artery disease (CAD) needing revascularization. However, these patients are at an increased risk for this procedure.[1] The CHIP population is attracting much interest in the field of interventional cardiology, since it was introduced in 2016 by Kirtane et al,[1] and the optimal treatment strategies for this population were fiercely discussed in almost every interventional forum at home and abroad. First of all, a comprehensive risk assessment must be conducted to determine which patients with CAD should undergo revascularization based on clinical presentation, functional tests, and anatomic characteristics. Percutaneous coronary intervention (PCI) might be a beneficial option when complete revascularization can be achieved, especially for patients are either inoperable or at higher surgical risk.[2,3] To treat these high-risk patients safely and effectively with PCI, well-trained interventionalists exhibiting both technical and cognitive skills are needed.
基金the National Natural Science Foundation of China (30470297)the National Key Technologies Research and Development Program in the Eleventh Five-Year Plan of China (2006BAC01A11)the Youth Foundation of Institute of Mountain Hazards and Environment of Chinese Academy of Sciences
文摘Quantification of complicated surface morphology of soil crack is a prerequisite and key to soil crack study. This paper takes soil crack quads in Yuanmou arid-hot valley region as examples, selecting several morphological indicators, and analyzes the soil crack＇s morphological features under various development degrees. By statistic analysis, three quantitative indicators for surface morphology are selected, namely soil crack area density, area weighted mean fractal dimension and connectivity index R, which can not only express the development intensity of soil cracks, but also effectively describe its morphological complexity and connectivity. The research results set a good base for the establishment of soil crack assessment system in Yuanmou arid-hot valley region.
基金This work was partially supported by the Project of National Natural Science Foundation for Distinguished Young Scholars under Grants No.70901009,No.71202155，the Youth Research and Innovation Program in Beijing University of Posts and Telecommunications，the National Basic Research Program of China under Grant No.2012CB315805
文摘Performance indicators play some important roles in enterprise operation.Both researchers and managers have recently pointed out that the identification of correlation between different performance indicators may lead to a better understanding of business.However,it is becoming more and more difficult to measure and analyze these indicators since the fast growing number of performance indicators and the complex relationships between them.The existing categories failed to reflect these changes in an adequate way,and the quantitative analysis methods for identifying the characters of those performance indicators are still worthy of investigation.The main objective of this paper is to propose a practical methodology for managing and analyzing performance indicators in enterprises,which focuses on building up a performance indicator system and discovering the characters of those performance indicators by applying complex network methods.The empirical results of a telecommunication enterprise show that the proposed method can be effective in understanding the correlations between performance indicators.
