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Background Atrial fibrillation is the most obvious arrhythmia in medical practice. Atrial fibrillation has been listed as one of the eight fastest-growing causes of death since 1990. Epidemiological investigation shows that the highest incidence of atrial fibrillation is 9% in people over 65 years old and 17% in people over 80 years old; more than 60% of patients with hypertension will develop atrial fibrillation after the age of 60. Atrial fibrillation increases the risk of ischemic stroke, heart failure, chronic kidney disease, cognitive impairment and dementia, but it is unclear whether it increases the risk of new onset myocardial infarction. Objective To investigate whether atrial fibrillation increases the risk of new onset myocardial infarction. Methods From June 2006 to October 2007, 96 750 employees of Kailuan Group in Tangshan, Hebei Province (Kailuan population) were selected for the study, including 458 patients with atrial fibrillation (atrial fibrillation group) and 96 292 patients without atrial fibrillation (non atrial fibrillation group) . The general information of patients was recorded, including age, gender, personal history (smoking history, drinking history) , past medical history (hypertension, coronary heart disease, diabetes, dyslipidemia) , anthropometric parameters (weight, height, blood pressure, etc.) . Total cholesterol (TC) , triglyceride (TG) , high density lipoprotein cholesterol (HDL-C) , low density lipoprotein cholesterol (LDL-C) and fasting blood glucose (FPG) were collected. The patients were followed up every 2 years, respectively, that was from 2008 to 2009, 2010 to 2011, 2012 to 2013, 2014 to 2015, and 2016 to 2017. The median follow-up was 10 years, and the end point was new onset myocardial infarction. Multivariate Cox regression model was used to analyze the effect of atrial fibrillation on new onset myocardial infarction. Results (1) There were significant differences in age, body mass index (BMI) , systolic blood pressure (SBP) , LDL-C, FPG, diabetes, smoking, drinking and new onset myocardial infarction between atrial fibrillation group and non atrial fibrillation group (P

This study was aimed to investigate the combined effects of metformin hydrochloride and insulin during gestational diabetes mellitus. A total 136 patients were randomly divided into study and control group. The control group was treated with insulin only while the study group was additionally treated with metformin hydrochloride. Maternal-infant outcomes and the levels of fasting blood glucose (FBG), 2h postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), total bilirubin (TBil), uric acid (UA) and microalbunminuria (mAlb) before and after treatment were compared. In post-treatment, the levels of FBG, 2h PG and HbA1c were decreased significantly (p<0.05) in both groups compared with pre-treatment. The levels of TC, TBil, UA and mAlb in both groups were significantly improved compared with pre-treatment. Levels of TC, UA and mAlb in the study group were significantly lower while TBil level was higher than control group. Compared to the control group, the incidence of gestational hypertension and premature delivery were significantly lower in the study group. There was no significant difference in the incidence of neonatal respiratory distress. The combination of metformin hydrochloride and insulin has significant effect in the treatment of gestational diabetes mellitus.