Effect of Body Mass Index on the Associations between Parity and Metabolic Syndrome and its Components among Northern Chinese Women / 生物医学与环境科学（英文）

Objectives@#The aims of this study were to assess the associations between parity and metabolic syndrome (MetS) and its components and to evaluate the effects of body mass index (BMI) on these associations.@*Methods@#A total of 5,674 women were enrolled from Jidong and Kailuan communities (Tangshan, Hebei) in Northern China. All participants completed standardized questionnaires, physical examination, and biochemical measurements. Logistic regression analysis was used to test the associations.@*Results@#Compared with women with parity of one, nulliparous women had decreased odds ratios ( s ); those with parity of two had odds of abdominal obesity [ = 1.45, 95% confidence interval ( ) 1.17-1.81, < 0.001], high blood pressure ( = 1.26, 95% 1.03-1.54, = 0.025), elevated fasting glucose levels ( = 1.36, 95% 1.03-1.79, = 0.029), and MetS ( = 1.39, 95% 1.13-1.73, = 0.002); and those with parity of three or more had increased odds of elevated triglyceride levels ( = 1.42, 95% 1.04-1.94, = 0.027) and MetS ( = 1.50, 95% 1.10-2.05, = 0.011) after complete adjustment for confounders. Furthermore, BMI and age subgroups partially modified the associations between parity and MetS and its components.@*Conclusions@#Parity is positively associated with MetS and select components in women. BMI is an important modifier involved in the associations between parity and MetS.

Protocol of Jidong Women Health Cohort Study: Rationale, Design, and Baseline Characteristics / 生物医学与环境科学（英文）

OBJECTIVE@#The Jidong Women Health Cohort Study is a prospective cohort study on female-specific characteristics and risks of chronic diseases in Chinese women and focuses on the potential association between menopause and risks of cardiovascular disease (CVD).@*METHODS@#The study includes 4,179 female participants with an age of older than 18 years from Caofeidian district, Tangshan city, northern China. Baseline information on female-specific characteristics and potential cardiovascular risk factors was collected and all the participants underwent a physical examination with blood samples collected in 2013. To establish a better risk assessment tool of female CVD, updated information from questionnaire investigation, physical examinations and occurrence of outcome events will be collected through a longitudinal follow-up annually up to the year 2024.@*RESULTS@#At baseline, Mean age of the participants was 42.3 ± 12.8 years. Reproduction occurred in 2,948 participants (70.5%), menopausal transition in 173 (4.3%), and postmenopause in 1,058 (25.3%). The incidence of arterial hypertension, dyslipidemia, and diabetes showed significant difference across different groups stratified by Stage of Reproductive Aging Workshop (STRAW) system (P < 0.05).@*CONCLUSION@#The Jidong Women Health Cohort Study will contribute to the scientific evidence on association between female-specific characteristics and cardiovascular risks, and will also be helpful to provide a new path for early detection and prevention of CVD.

Association between Serum Alkaline Phosphatase and Carotid Atherosclerosis in a Chinese Population: A Community-based Cross-sectional Study / 生物医学与环境科学（英文）

OBJECTIVE@#This study aimed to investigate the relationship between alkaline phosphatase (ALP) and common carotid intima media thickness (IMT), carotid plaque, and extracranial carotid artery stenosis (ECAS).@*METHODS@#A total of 3,237 participants aged ⪖ 40 years were recruited from Jidong community in 2013-2014. Participants were divided into five quintile groups based on their serum ALP levels. Carotid atherosclerosis was assessed using ultrasound. Abnormal IMT, carotid plaque, and ECAS were defined as IMT > 0.9 mm, IMT > 1.5 mm, and ⪖ 50% stenosis in at least one extracranial carotid artery, respectively.@*RESULTS@#Common carotid IMT values and the prevalence of carotid plaque increased across serum ALP quintiles. Higher ALP quintiles were correlated with an increased risk of abnormal IMT [fourth quintile: odds ratio (OR) 1.78, 95% confidence interval (CI) 1.13-2.82, P = 0.0135; fifth quintile: OR = 1.82, 95% CI: 1.15-2.87, P = 0.0110] and ECAS compared to the lowest quintile (fifth quintile: OR = 1.47, 95% CI: 1.09-1.97, P = 0.0106). The association between ALP and prevalence of carotid plaque became insignificant after adjustment for confounders.@*CONCLUSION@#Serum ALP levels were independently associated with abnormal common carotid IMT and ECAS. These conclusions need to be further corroborated in future prospective cohort studies.

Association between Metabolic Syndrome and Carotid Atherosclerosis: A Cross-sectional Study in Northern China / 生物医学与环境科学（英文）

OBJECTIVE@#Increased carotid artery intima-media thickness (CIMT) and carotid plaque as manifestations of carotid atherosclerosis have been used as markers of cardiovascular disease (CVD). The components of metabolic syndrome (MetS) are linked to CVD, but the association between MetS and CVD is controversial.@*METHODS@#A total of 8,933 Chinese adults aged 40 years or older from 2010 to 2014 were selected from the Jidong and Kailuan communities. MetS was defined by the International Diabetes Federation criteria. CIMT and carotid plaque were measured using color Doppler ultrasound. Logistic regression models were used to assess the association of MetS with carotid plaque and CIMT.@*RESULTS@#MetS was found among 3,461 (3,461/8,933) participants. The odds ratio and 95% confidence internal (CI) for carotid plaques in participants with MetS was 1.16 (1.03-1.30). The risk of carotid plaques increased with the number of MetS components. The average CIMT was higher in participants with MetS (β = 0.020, 95% CI, 0.014-0.027) and in participants with more MetS components.@*CONCLUSION@#Individuals with MetS are at an increased risk for carotid atherosclerosis compared to those without MetS.

Clinical characteristics of myasthenia gravis with dysphonia as the initial symptom / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To identify clinical features and diagnostic tests that would alert the otolaryngologist to consider myasthenia gravis (MG) in the differential diagnosis of dysphonia, we reviewed the clinical characteristics of MG whose initial symptom is dysphonia.</p><p><b>METHODS</b>31 patients who presented with dysphonia as their initial and primary complaint are reported, their symptoms and signs are observed and analyzed.</p><p><b>RESULTS</b>Patients with dysphonia as their initial symptom of MG may complain of vocal fatigue, difficulty sustaining or projecting their voices, breathy voice or intermittent hoarseness. These symptoms are characterized by fluctuating weakness and abnormal fatigability. Flexible fibroendoscopic examination revealed that patients had incomplete adduction of the vocal folds, fatigue of the tensors of the vocal fold, incomplete glottic closure, vocal cord paralysis, saliva pooling over the bilateral or unilateral pyriform sinus. Neostigmine test revealed dramatic improvement in all patients. Serum levels of anti-Ach-R antibodies were tested in 19 cases, only 5 cases were abnormality. All patients had improved after treatment</p><p><b>CONCLUSIONS</b>Voice changes can be the first sign of early MG. Based on fluctuating weakness or weak voice at the end of the day, a positive neostigmine test, significantly higher circulating antibody to acetylcholine receptor, a diagnosis of MG could definitively be made.</p>