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Additional file 3. Comparison of the predictive ability of HbA1c, FBG and the FBG/HbA1c ratio with mortality.

Additional file 1.

Additional file 1. Baseline characteristics of patients included and excluded.

Additional file 2. Logistic regression of outcomes according to FBG/HbA1c quartiles in nondiabetic patients.

Oxidized low-density lipoprotein (ox-LDL) and its receptor, lectin-like ox-LDL receptor-1 (LOX-1) are involved in the pathogenesis of atherosclerosis. Expression of LOX-1 was substantially raised in the basilar arterial wall of subarachnoid hemorrhage (SAH) rabbits. We ascertained the relationship between serum soluble LOX-1 concentrations and functional outcome after human aneurysmal SAH.We enrolled 94 aneurysmal SAH patients and 94 healthy controls. Serum soluble TOX-1 concentrations were quantified using commercial enzyme-linked immunosorbent assay kit. A poor outcome was defined as Glasgow outcome scale score of 1-3.Median values of serum soluble LOX-1 in stroke patients were significantly higher than those in controls (1.5 vs. 0.4 ng/ml, P 0.001). Thirty patients (31.9%) had a poor outcome at 6 months after stroke. Serum soluble LOX-1 was a strong predictor of poor outcome (OR 5.20, 95% CI 1.25-22.04). Serum soluble LOX-1 concentrations exhibited a significant discriminatory capability (area under curve 0.811, 95% confidence interval 0.717-0.884). The predictive powers of World Federation of Neurological Surgeons grade, Hunt-Hess grade, modified Fisher grade, and serum soluble LOX-1 concentrations were comparable (all P 0.05).Serum soluble LOX-1 appears to have the potential to become a promising prognostic predictor after human aneurysmal SAH.

Objective: To investigate the effect of metformin combined with insulin aspart on blood glucose levels and maternal and neonatal outcomes in women with gestational diabetes mellitus (GDM) accompanied by chronic hypertension (CH). Methods: A prospective study was conducted on 112 women with GDM and CH. The patients were divided into the control group and the observation group according to a random number table method, with 56 patients in each group. The control group received injections of insulin aspart based on blood pressure control, and the observation group received injections of insulin aspart combined with oral metformin based on blood pressure control. Besides, blood glucose levels, maternal pregnancy outcomes and neonatal complications before and after intervention were compared between the two groups. Results: Before intervention, there was no significant difference in blood glucose and blood pressure levels between the two groups (P > 0.05). After intervention, the observation group showed significantly decreased fasting blood glucose, 2-h postprandial plasma glucose and glycosylated hemoglobin levels than the control group (P < 0.05); the blood pressure in the observation group was significantly lower as compared with that before intervention (P < 0.05). Additionally, the incidences of adverse pregnancy outcomes (e.g., premature rupture of membranes) and neonatal jaundice and macrosomia were significantly lower in the observation group than in the control group after intervention (both P < 0.05). Conclusion: Metformin combined with insulin aspart for treating GDM and CH can effectively control blood glucose and blood pressure levels and reduce the risk of adverse perinatal and neonatal outcomes, which exerts positive effect in clinical treatment.

The marginal semi-enclosed Bohai Sea is an important ecosystem for many commercial as well as ecologically important species. At the same time, the Bohai Sea increasingly facing various anthropogenic disturbances which have been reported to affect the functioning of this ecosystem in many ways. Using Ecopath and Ecosim modeling suite (ver 6.5), this study examined the temporal changes in the ecological status of the Bohai Sea ecosystem. The present model comprises a total of 23 functional groups based on a year-round trawl survey conducted in 2016. The results of the present study showed that the mean trophic level of the commercial species as well as the overall fisheries species declined during the last few decades. The fundamental source of biomass flows within the Bohai Sea food web generated from the lower trophic levels. Primary producers (phytoplankton) and detritus contributed about 52.77% and 47.23%, respectively of the total energy flows originated from the base of the food web in 2016. Estimation of the ecological parameters during the decadal-scale suggests that the Bohai Sea ecosystem is at an immature stage. The niche overlap indices showed intermediate overlaps between prey species rather than predator species overlapping. The mixed trophic impacts indicated that the lower trophic levels had positive influences on most of the groups in the higher trophic levels, indicating the strong bottom-up ecosystem dynamics. Increased biomass of jellyfish and cephalopod had moderate adverse effects on other groups. This comparative analysis provides an important platform by increasing our understanding of the several food web properties that can be integrated within a future management plan of the Bohai Sea fisheries resources.

High on-treatment platelet reactivity (HTPR) after clopidogrel administration in patients with acute coronary syndrome (ACS) has been associated with an increased risk of adverse events. Our previous studies reported that half-dose ticagrelor provides a similar inhibitory effect on adenosine diphosphate (ADP)–induced platelet aggregation as standard-dose ticagrelor, but half-dose of ticagrelor has not been studied in Chinese ACS patients with HTPR. This study aimed to compare the antiplatelet action of half-dose ticagrelor with high-dose clopidogrel in ACS patients with HTPR. In this single-center randomized controlled trial, 80 (of 418 screened, 19.13%) ACS patients with HTPR while on clopidogrel were randomized to either half-dose ticagrelor (90 mg LD, then 45 mg twice daily) or high-dose clopidogrel (150 mg once daily). Platelet function was assessed by thromboelastography (TEG) and light transmission aggregometry (LTA), and adverse events were monitored throughout the study for 30 days. The ADP-induced platelet inhibition rate (IR) as measured by TEG was significantly higher for half-dose ticagrelor compared with high-dose clopidogrel (70.40% [61.10%–91.70%] vs. 44.25% [34.67%–79.07%], p = 0.001). The repeated HTPR rate was dramatically higher for high-dose clopidogrel compared with half-dose ticagrelor (6 of 32, 18.75% vs. 1 of 35, 2.85%; p = 0.04). No patients in either treatment group exhibited a major bleeding event or other adverse events. In ACS patients with HTPR, half-dose ticagrelor is more effective than high-dose clopidogrel in reducing platelet reactivity (NCT03062462).