Association between metabolic syndrome severity score and cardiovascular disease: results from a longitudinal cohort study on Chinese adults.

Objective: This study aimed to quantify the severity of metabolic syndrome(MetS) and investigate its association with cardiovascular disease(CVD) risk on Chinese adults. Methods: 13,500 participants from the Zhejiang Adult Chronic Disease Study were followed up between 2010 and 2021. A continuous MetS severity score derived from the five components of MetS was used to quantify MetS severity, and the association between MetS severity and the risk of incident CVD was assessed using Cox proportional hazard and restricted cubic spline regression. Results: Both the presence and severity of MetS were strongly associated with CVD risk. MetS was related to an increased risk of CVD (hazard ratio(HR):1.700, 95% confidence interval(CI): 1.380-2.094). Compared with the hazard ratio for CVD in the lowest quartile of the MetS severity score, that in the second, third, and highest quartiles were 1.812 (1.329-2.470), 1.746 (1.265-2.410), and 2.817 (2.015-3.938), respectively. A linear and positive dose-response relationship was observed between the MetS severity and CVD risk (P for non-linearity = 0.437). Similar results were found in various sensitivity analyses. Conclusion: The MetS severity score was significantly associated with CVD risk. Assessing MetS severity and further ensuring intervention measures according to the different severities of MetS may be more useful in preventing CVD.

[Influencing mechanism of stand age to the accumulation of microbial residue carbon in the Pinus masso-niana plantations]. / 林龄对马尾松人工林微生物残体碳积累的影响机制.

Clarifying the accumulation pattern of soil microbial residue carbon and its contribution to soil organic carbon (SOC) across stand age is helpful to understand the mechanism underlying soil carbon cycling. In this study, we analyzed the differences of amino sugar content, physicochemical properties and microbial composition in surface soil (0-10 cm) in young (6 a), middle-aged (13 a), near-mature (29 a), mature (38 a) and over-mature (57 a) Pinus massoniana plantations of subtropical China, quantified the microbial residue carbon content and its contribution to SOC, and discussed the mechanism. The results showed that SOC, total nitrogen, amorphous iron oxide and leucine aminopeptidase contents in the middle-aged plantation were significantly lower than those in the mature plantation. Soil pH and fungal/bacteria in young plantation were significantly higher than those in other age groups. Across the stand age gradient, the ranges of microbial, fungal and bacterial residue carbon were 7.52-14.63, 4.03-8.00 and 3.48-6.63 g·kg-1, respectively. The contents of all the residue carbon were significantly higher in the mature plantation than that of the middle-aged plantation, which were positively affected by soil total nitrogen content. The contribution of microbial, fungal, and bacterial residue carbon to SOC was 59.7%-72.3%, 33.4%-45.6%, and 24.3%-30.8%, respectively. The contribution of fungal residue carbon to SOC in young plantation was significantly higher than that in other age groups, and the contribution of bacterial residue carbon to SOC in middle-aged plantation was significantly higher than that in young and near-mature plantations, both of which were affected by soil inorganic nitrogen. Fungal residue carbon content was 1.2-1.7 times as that of bacterial residue carbon content, and dominated for the accumulation of microbial residue carbon. Results of the partial least squares model showed that stand age, soil environmental factors (such as leucine aminopeptidase, amorphous iron oxide, pH, and total nitrogen), bacterial residue carbon, fungal residue carbon and the contribution of bacterial residue carbon to SOC had total effects on the contribution of fungal residue carbon to SOC (-0.37, -1.16, 0.90, 1.09, and 0.83, respectively). In conclusion, stand age promoted the accumulation of microbial residue carbon but did not increase its contribution to SOC.

Enhanced Selective Hydrogenation of Cinnamaldehyde to Cinnamyl Alcohol over Silica-Coated Pt-CoxOy Hybrid Nanoparticles.

Selective hydrogenation of cinnamaldehyde (CAL) to cinnamyl alcohol (COL) is difficult due to the intrinsic difficulty with thermodynamically easier hydrogenation of C═C bonds. In this work, Pt-CoxOy hybrid nanoparticles encapsulated in mesoporous silica nanospheres (Pt-CoxOy@mSiO2) were synthesized by a sol-gel method, which showed greatly improved COL selectivity for hydrogenation of CAL. At 80 °C and 1.0 MPa of H2, Pt-CoxOy@mSiO2 achieved a CAL conversion of 98.7% with a COL selectivity of 93.5%. In contrast, Pt@mSiO2 yields 3-phenylpropanol (HCOL) as the major product with HCOL selectivity of 67.2%, while PtCo@mSiO2 yields 3-phenylpropionaldehyde with selectivity of 51.8% under the same conditions. The enhanced catalytic performance of Pt-CoxOy@mSiO2 for hydrogenation of CAL to COL is ascribed to the Pt surface electron deficiency induced by metal-oxide interaction, and the protection of active NPs by silica shells results in good catalytic stability.

Whole fresh fruit intake and risk of incident diabetes in different glycemic stages: a nationwide prospective cohort investigation.

PURPOSE: Fruit intake is beneficial to several chronic diseases, but controversial in diabetes. We aimed to investigate prospectively the associations of whole fresh fruit intake with risk of incident type 2 diabetes (T2D) in subjects with different glucose regulation capacities. METHODS: The present study included 79,922 non-diabetic participants aged ≥ 40 years from an ongoing nationwide prospective cohort in China. Baseline fruit intake information was collected by a validated food frequency questionnaire. Plasma HbA1c, fasting and 2 h post-loading glucose levels were measured at both baseline and follow-up examinations. Cox proportional hazards models were used to calculate hazard ratio (HR) and 95% confidence intervals (CI) for incident diabetes among participants with normal glucose tolerance (NGT) and prediabetes, after adjusted for multiple confounders. Restricted cubic spline analysis was applied for dose-response relation. RESULTS: During a median 3.8-year follow-up, 5886 (7.36%) participants developed diabetes. Overall, we identified a linear and dose-dependent inverse association between dietary whole fresh fruit intake and risk of incident T2D. Each 100 g/d higher fruit intake was associated with 2.8% lower risk of diabetes (HR 0.972, 95%CI [0.949-0.996], P = 0.0217), majorly benefiting NGT subjects with 15.2% lower risk (HR 0.848, 95%CI [0.766-0.940], P = 0.0017), while not significant in prediabetes (HR 0.981, 95%CI 0.957-4.005, P = 0.1268). Similarly, the inverse association was present in normoglycemia individuals with a 48.6% lower risk of diabetes when consuming fruits > 7 times/week comparing to those < 1 time/week (HR 0.514, 95% CI [0.368-0.948]), but not in prediabetes (HR 0.883, 95% CI [0.762-1.023]). CONCLUSION: These findings suggest that higher frequency and amount of fresh fruit intake may protect against incident T2D, especially in NGT, but not in prediabetes, highlighting the dietary recommendation of higher fresh fruit consumption to prevent T2D in normoglycemia population.

Novel evidence for the prognostic impact of ß-blockers in solid cancer patients receiving immune checkpoint inhibitors.

OBJECTIVE: Cancer immunotherapy based on immune checkpoint inhibitors (ICIs) has made encouraging achievements in both clinical trials and real-world studies. The ß-blockers, as common concomitant medications in clinical practice, have been suggested to exert anti-cancer effects in various human malignancies. This study aimed to clarify the prognostic impact of ß-blockers in solid cancer patients receiving ICI therapy. METHOD: A systematic literature review and meta-analysis was firstly performed based on databases including PubMed, Cochrane Library, Web of Science, Embase, and Clinicaltrials.gov before August 1th 2022. The association of ß-blocker use with overall survival (OS) or progression-free survival (PFS) was determined using the hazard ratios (HRs) coupled with 95% confidence intervals (CIs). Then, a retrospective study enrolling 194 patients was performed to validate the results of the meta-analysis. RESULTS: A total of 11 studies enrolling 10,156 patients were included in the meta-analysis. The pooled analysis demonstrated ß-blocker use was not significantly correlated with either OS (HR = 0.97(0.85-1.11)) or PFS (HR = 0.98(0.90-1.06)). Similar results were also observed in the subgroup analysis stratified by cancer type, age, sample size and ICI therapy, except for the OS (HR = 0.61(0.45-0.83)) and PFS (HR = 0.65(0.44-0.96)) in the studies with sample size less than 200. The retrospective study indicated no significant correlation between ß-blocker use and the clinical outcome in the entire cohort and lung cancer subgroup. However, ß-blocker use was found to be significantly associated with better objective response to ICI-based therapy in the entire cohort (odds ratio (OR) = 0.42(0.19-0.94), p = 0.036) and lung cancer subgroup (OR = 0.25(0.08-0.83), p = 0.024). CONCLUSION: Although both our up-to-date meta-analysis and retrospective study suggested ß-blocker use has no significant impact on the overall prognosis of solid cancer patients receiving ICIs, ß-blocker use may be associated with improved anti-cancer efficacy of ICIs. Considering study limitations, more clinical validations and mechanism investigations are of great necessity for clarifying the role of ß-blockers in ICI-based therapy.

Palladium-Catalyzed Cascade Cyclization/Alkylation of Oxime Ethers: Assembly of 4-Alkylisoxazoles by "Chain-Walking" Strategy.

A reliable and efficient palladium-catalyzed cascade cyclization/alkylation of oxime ethers with unactivated alkenes is described, affording a whole variety of structurally diverse isoxazole derivatives in moderate to good yields with excellent functional group compatibility. Ionic liquid [Aeim]Br not only acts as an environmentally friendly solvent but also acts as an accelerating agent to provide excess bromine source to eliminate bromomethane from oxime ethers. More importantly, the use of "chain-walking" strategy provides a novel methodology in organic synthesis to rapid generation of molecular complexity from readily available starting materials.

A Simple Method for the Acquisition and Transmission of Brassica Yellows Virus from Transgenic Plants and Frozen Infected Leaves by Aphids.

Brassica yellows virus (BrYV) is a tentative species of the genus Polerovirus, which occurs widely, and mostly damages Brassicaceae plants in East Asia. Because BrYV cannot be transmitted mechanically, an insect-based transmission method is required for further virus research. Here, a reliable and unrestricted method is described, in which non-viruliferous aphids (Myzus persicae) acquired BrYV from transgenic Arabidopsis thaliana, harboring the full-length viral genome germinated from seeds and its frozen leaves. The aphids then transmitted the virus to healthy plants. There was no significant difference in acquisition rates between fresh and frozen infected leaves, although the transmission rate from frozen infected leaves was lower compared to fresh infected leaves. This simple novel method may be used to preserve viral inocula, evaluate host varietal resistance to BrYV, and investigate interactions among BrYV, aphids, and hosts.

[Clinical studies on acupuncture assisting in vitro fertilization-embryo transfer: a review and thoughts].

Acupuncture has a long history of application in the field of reproduction, and in the past 20 years, numerous clinical studies have been conducted to explore the value of acupuncture in assisted reproductive technology. However, due to inconsistent research findings, there are still controversies over the clinical safety and efficacy of acupuncture in assisting in vitro fertilization-embryo transfer (IVF-ET), which may be closely associated with lacking of standardized treatment regimen in clinical trials of acupuncture. For that reason, this article reviews 16 representative clinical trials of acupuncture assisting IVF-ET published worldwide in 1999-2020, summarizes the grouping design, acupuncture method (acupuncture timing, acupuncture frequency, acupoints, and acupuncture types), and pregnancy outcome (pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate, and live birth rate), and discusses several key links in clinical protocol design, so as to provide references for future clinical research.

N-methyladenosine reader YTHDF2-mediated long noncoding RNA FENDRR degradation promotes cell proliferation in endometrioid endometrial carcinoma.

Dysregulation of long noncoding RNA (LncRNA) FENDDR has been shown to be closely related to the progression of several cancers. However, its role and upstream regulatory mechanism in endometrioid endometrial carcinoma (EEC) remains unclear. This study was conducted using the cancerous tissues of EEC patients (n = 60), EEC cell lines, and a xenograft mouse model. The expression level of LncRNA FENDRR was decreased and the N-methyladenosine (m6A) methylation levels of LncRNA FENDRR was elevated in cancerous tissues of EEC patients. In vitro experiments demonstrated that YTH domain-containing 2 (YTHDF2), an m6A reader, recognized the abundance of m6A-modified LncRNA FENDRR in EEC cells and promoted its degradation. LncRNA FENDRR overexpression suppressed cell proliferation and facilitated cell apoptosis in the EEC cell line HEC-1B by reducing the protein level of SRY-related HMG box transcription factor 4 (SOX4). Interference of LncRNA FENDRR reversed the inhibitory effect of sh-YTHDF2 on cell proliferation and the promoting effect of sh-YTHDF2 on cell apoptosis in HEC-1B cells by silencing FENDRR. Finally, in vivo experiments confirmed that overexpression of LncRNA FENDRR retarded the growth of EEC cells. In conclusion, YTHDF2-mediated LncRNA FENDRR degradation promotes cell proliferation by elevating SOX4 expression in EEC.

Inverted U-Shaped Associations between Glycemic Indices and Serum Uric Acid Levels in the General Chinese Population: Findings from the China Cardiometabolic Disease and Cancer Cohort (4C) Study.

OBJECTIVE: The relationship between serum uric acid (SUA) levels and glycemic indices, including plasma glucose (FPG), 2-hour postload glucose (2h-PG), and glycated hemoglobin (HbA1c), remains inconclusive. We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population. METHODS: The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study. A total of 105,922 community-dwelling adults aged ≥ 40 years underwent the oral glucose tolerance test and uric acid assessment. The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models. RESULTS: A total of 30,941 men and 62,361 women were eligible for the current analysis. Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels, but with different inflection points in men and women. The thresholds for FPG, 2h-PG, and HbA1c for men and women were 6.5/8.0 mmol/L, 11.0/14.0 mmol/L, and 6.1/6.5, respectively (SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices). CONCLUSION: An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes, while the inflection points were reached earlier in men than in women.

The association between diabetes and thyroid cancer risk: a hospital-based case-control study in China.

BACKGROUND: Previous studies have indicated inconsistent relationships of diabetes with thyroid cancer risk, yet little is known in China. In this study, we aimed to investigate the associations between diabetes, diabetes duration and the risk of thyroid cancer in Chinese population. METHODS: A 1:1 matched case-control study was performed between 2015 and 2017 in Zhejiang Province including 2,937 thyroid cancer cases and 2,937 healthy controls. Odds ratios (ORs) with 95 % confidence intervals (CIs) for thyroid cancer were estimated in logistic regression models. Specific effects stratified by age, as well as sex, body mass index (BMI) and family history of diabetes were also examined. RESULTS: Overall, neither diabetes (OR = 0.75, 95 % CI: 0.21-2.73) nor diabetes duration (OR = 0.14, 95 % CI: 0.02-1.22 for diabetes duration ≦ 5 years; OR = 2.10, 95 % CI: 0.32-13.94 for diabetes duration > 5 years) was significantly associated with thyroid cancer. In stratified analyses, significant lower risk of thyroid cancer was observed among subjects with diabetes and shorter diabetes duration ( ≦ 5 years), but limited to those who were aged more than 40 years, female, overweight/obese and had positive family history of diabetes. CONCLUSIONS: Diabetes and shorter diabetes duration were significantly associated with decreased risk of thyroid cancer in individuals characterized by older age, female sex, higher BMI and positive family history of diabetes.

Menstrual, reproductive and hormonal factors and thyroid cancer: a hospital-based case-control study in China.

BACKGROUND: There have been considerable studies on the effects of reproductive factors on thyroid cancer risk, while findings are inconsistent. In this analysis, we aimed to investigate the associations between menstrual, reproductive and hormonal factors with thyroid cancer occurrence in a population of Chinese women. METHODS: Using data from a 1:1 matched case-control study performed between 2015 and 2017 in Zhejiang Province of China, a second analysis of 2261 pairs of female subjects was conducted. The possible effects for thyroid cancer were evaluated in logistic regression models by odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Later age at first pregnancy (for > 25 vs. ≦ 20 years, OR: 0.47, 95% CI 0.23-0.96) and longer duration of breast feeding (for 6-12 vs. ≦ 6 months, OR: 0.49, 95% CI 0.24-0.98) were significantly associated with decreased occurrence of thyroid cancer, while no trend was observed. Stratified by age at enrollment, only the association with duration of breast feeding remained significant, but limited to younger women (≦ 50 years). CONCLUSIONS: Our results suggested that women with later age at first pregnancy or longer breast feeding duration were less likely to have thyroid cancer. These findings supported an influence role of reproductive factors in thyroid cancer risk.

Sleep duration and behavioral correlates in middle and high school students: a cross-sectional study in Zhejiang province, China.

OBJECTIVE: To investigate the sleep duration and correlates from lifestyle, dietary and weight control behaviors in Chinese adolescents. METHODS: Data were from 2017 Zhejiang Youth Risk Behavior Survey. A total of 17059 adolescents were included in this study and sleep duration and other behaviors information was collected via a self-reported questionnaire. Regression coefficients (ß), calculated by multivariable linear regression, were used to assess the effects of related behaviors on sleep duration, adjusting for potential confounding factors. RESULTS: Overall, the mean sleep duration in adolescents was 7.99 h. Ever smoking, engaging in moderate physical activity and muscle strengthening activity, attending physical education classes, and watching television were significantly associated with longer sleep duration (P trend ≦0.01 for all). Adolescents with breakfast, fruits, vegetables, milk and soft drinks intake were more likely to have longer sleep duration (P trend <0.05 for all). Weight perception of overweight and weight control behaviors including exercising and eating less food, fewer calories were significantly associated with the short sleep duration (P trend <0.05 for all). CONCLUSION: Chinese adolescents slept less than the counterparts in Western countries. Various lifestyle, dietary and weight control behaviors were associated with sleep duration.

Trends in prevalence of gestational diabetes mellitus in Zhejiang Province, China, 2016-2018.

BACKGROUND: Limited population-based studies have investigated the secular trend of prevalence of gestational diabetes mellitus (GDM) in mainland China. Therefore, this study aimed to estimate the prevalence of GDM and time trends in Chinese female population. METHODS: Based on Diabetes Surveillance System of Zhejiang Province, 97,063 diagnosed GDM cases aged 20-50 years were identified from January 1, 2016 to December 31, 2018. Annual prevalence, prevalence rate ratios (PRRs) and average annual percentage change with their 95% confidence intervals (CIs) were reported. RESULTS: The age-standardized overall prevalence of GDM was reported to be 7.30% (95% CI 7.27-7.33%); 9.13% (95% CI 9.07-9.19%) in urban areas and 6.24% (95% CI 6.21-6.27%) in rural areas. Compared with 20-24 years age group, women in advanced age groups (25-50 years) were at higher risk for GDM (PRRs ranged from 1.37 to 8.95 and the 95% CIs did not include the null). Compared with rural areas, the risk for GDM was higher in urban areas (PRR: 1.69, 95% CI 1.67-1.72). The standardized annual prevalence increased from 6.02% in 2016 to 7.94% in 2018, with an average annual increase of 5.48%, and grew more rapidly in rural than urban areas (11.28% vs. 0.00%). CONCLUSIONS: This study suggested a significant increase in the prevalence of GDM among Chinese female population in Zhejiang province during 2016-2018, especially in women characterized by advanced age and rural areas.

Associations of intensity, duration, cumulative dose, and age at start of smoking, with thyroid cancer in Chinese males: A hospital-based case-control study in Zhejiang Province.

INTRODUCTION: There has been considerable research on the association between smoking status and thyroid cancer risk in males, yet the findings are inconsistent. In this study, we investigated the associations of intensity, duration, cumulative dose, and age at start of smoking, with thyroid cancer in Chinese males. METHODS: From a 1:1 matched case-control study conducted between 2015 and 2017 in Zhejiang Province, China, 676 pairs of male subjects were included in the analysis. The associations between smoking characteristics and thyroid cancer were evaluated in logistic regression models by odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Compared with never smokers, the former smokers were 0.096 times (95% CI: 0.012-0.778) less likely to have thyroid cancer. The significant inverse association was not observed in current smokers (OR=0.333; 95% CI: 0.084-1.322). Among both former and current smokers, higher smoking intensity (>10 cigarettes/day), duration (>15 years), and cumulative dose of smoking (>10 packyears) were significantly associated with reduced occurrence of thyroid cancer. CONCLUSIONS: Our findings indicate that former smoking is inversely associated with thyroid cancer occurrence in Chinese males. The reduction in the occurrence of thyroid cancer was also confirmed for both former and current smokers with higher smoking intensity, duration, and cumulative dose.

Associations between trying to control weight, weight control behaviors and current electronic cigarette usage in middle and high school students: A cross-sectional study in Zhejiang Province, China.

INTRODUCTION: Previous research has indicated that weight control behaviors are linked to cigarette smoking, whether these relationships extend to electronic cigarettes (e-cigarettes) is unknown. This study aims to examine the association between weight control behaviors and current e-cigarette usage among middle and high school students in China. METHODS: Based on the 2017 Zhejiang Youth Risk Behavior Survey, 17359 students were included and relevant data involving e-cigarette and weight control behaviors were collected via self-reported questionnaires. Logistic regression models were used to examine the associations between trying to control weight, specific weight control behaviors and current e-cigarette usage. Odds ratios (ORs) and their 95% confidence intervals (CIs) are reported. RESULTS: Of the 17359 students, 374 (2.15%) were current e-cigarette users. No significant association was observed between trying to control weight and current e-cigarette usage (OR=1.01; 95% CI: 0.81-1.28). Significant associations were found between current e-cigarette usage and unhealthy weight control behaviors of eating less food, fewer calories (OR=1.74; 95% CI: 1.33-2.27), as well as taking laxatives (OR=3.34; 95% CI: 2.11-5.27), taking diet pills (OR=2.63; 95% CI: 1.72-4.02) and going without eating for 24 hours or more (OR=2.74; 95% CI: 1.86-4.04). CONCLUSIONS: A positive association was found between unhealthy weight control behaviors and current e-cigarette usage in adolescents. Specific education programs on unhealthy weight control behaviors should be considered in adolescents.

Incidence and Time Trends of Type 2 Diabetes Mellitus among Adults in Zhejiang Province, China, 2007-2017.

AIMS: Population-based incidence data are paramount to assess the effects of prevention strategies for diabetes, yet the relevant studies in mainland China are scarce. This study is aimed at estimating the type 2 diabetes mellitus (T2DM) incidence and time trends in Chinese adults. Material and Methods. Based on the Diabetes Surveillance System of Zhejiang Province, 879,769 newly diagnosed T2DM cases were identified from January 1, 2007, to December 31, 2017. Annual incidence, incidence rate ratios (IRRs), and average annual percentage change with their 95% confidence intervals (CIs) were reported. RESULTS: The age-standardized overall incidence rate of T2DM was reported to be 281.73 (95% CI: 281.26-282.20) per 100,000 person-years, 293.19 (95% CI: 292.51-293.87) in males and 270.42 (95% CI: 269.76-271.09) in females. Compared with the ≥80 years age group, younger adults were at lower risk for T2DM (IRRs ranged from 0.035 to 0.986 and the 95% CIs did not include the null), except for the 70-79 years age group (IRR: 1.087, 95% CI: 1.077-1.097). Compared with females and rural areas, the risk for T2DM was higher in males (IRR: 1.083, 95% CI: 1.079-1.088) and urban areas (IRR: 1.005, 95% CI: 1.001-1.009), respectively. The standardized annual incidence rate increased from 164.85 in 2007 to 268.65 per 100,000 person-years in 2017, with an average annual increase of 4.01% and grew more rapidly in male, younger, and rural area populations. CONCLUSIONS: Our study suggested a significant increase in the incidence rate of T2DM among Chinese over the past decade, especially in adults characterized by male sex, younger age, and rural areas.

Risk Factors Associated with Outcomes of Recombinant Tissue Plasminogen Activator Therapy in Patients with Acute Ischemic Stroke.

Ischemic stroke is the most common type of stroke, and early interventional treatment is associated with favorable outcomes. In the guidelines, thrombolytic therapy using recombinant tissue-type plasminogen activator (rt-PA) is recommended for eligible patients with acute ischemic stroke. However, the risk of hemorrhagic complications limits the use of rt-PA, and the risk factors for poor treatment outcomes need to be identified. To identify the risk factors associated with in-hospital poor outcomes in patients treated with rt-PA, we analyzed the electronic medical records of patients who were diagnosed with acute ischemic stroke and treated for rt-PA at Chang Gung Memorial Hospitals from 2006 to 2016. In-hospital death, intensive care unit (ICU) stay, or prolonged hospitalization were defined as unfavorable treatment outcomes. Medical history variables and laboratory test results were considered variables of interest to determine risk factors. Among 643 eligible patients, 537 (83.5%) and 106 (16.5%) patients had favorable and poor outcomes, respectively. In the multivariable analysis, risk factors associated with poor outcomes were female gender, higher stroke severity index (SSI), higher serum glucose levels, lower mean corpuscular hemoglobin concentration (MCHC), lower platelet counts, and anemia. The risk factors found in this research could help us study the treatment strategy for ischemic stroke.

Association between cigarette smoking during pregnancy and gestational diabetes mellitus: a meta-analysis.

Aims: Several studies have been carried out to examine the association between cigarette smoking during pregnancy and risk of developing gestational diabetes mellitus (GDM), yet the findings are mixed. Therefore, we aimed to estimate the relationship between cigarette smoking during pregnancy and GDM risk.Material and methods: PubMed, ScienceDirect, and Cochrane Library databases were searched up to December 2017. Studies on cigarette smoking during pregnancy and GDM were retrieved. The pooled odds ratios (ORs) and their 95% confidence intervals (CIs) for highest versus lowest level of cigarette smoking were calculated using a random-effects model.Results: Compared to nonsmoking, the pooled ORs of cigarette smoking during pregnancy were 0.98 (95% CI: 0.88-1.10) for GDM. Specifically, the pooled ORs of light smoking and heavy smoking during pregnancy for GDM were 1.10 (95% CI: 0.97-1.25) and 1.02 (95% CI: 0.67-1.53), respectively.Conclusions: Our findings suggest that there is no significant association between cigarette smoking during pregnancy and risk of GDM.