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Shuang Li, Niman Li, Linsen Li, Yi Wang, Youshuo Liu, Yanjiao Wang, Junkun Zhan Department of Geriatrics, the Second Xiangya Hospital, Institute of Aging and Age-Related Disease Research, Central South University, Changsha, Hunan, People’s Republic of ChinaCorrespondence: Yanjiao Wang; Junkun Zhan, Department of Geriatrics, the Second Xiangya Hospital, Institute of Aging and Age-Related Disease Research, Central South University, Changsha, Hunan, People’s Republic of China, Email ls330013@163.com; zhanjunkun@csu.edu.cnBackground: Previous studies suggested protective effects of bilirubin against cardiovascular disease, with a possible gender difference. However, the relationship between serum total bilirubin (TBIL) with diabetic macro- and microvascular complications remains unknown. We aimed to examine the association of macro- and microvascular complications with serum TBIL levels.Methods: Serum TBIL was measured in 648 patients with T2DM. Demographic and clinical data were obtained from the inpatient medical record system. Serum TBIL was measured with an automatic biochemistry analyzer according to routine protocols. Parameters of vascular complications, including ankle-brachial index, carotid intima-media thickness, estimated glomerular filtration rate and the urinary albumin to creatinine ratio, were measured and calculated. The association between TBIL and diabetic macro- and microvascular complications was analyzed.Results: In multivariable logistic regression, after adjustment for age, sex, body mass index and diabetic duration, higher serum TBIL levels were significantly associated with decreased odds of microalbuminuria (OR = 0.31, [95% CI] 0.16– 0.61, P = 0.003) and chronic kidney disease (OR = 0.19, [95% CI] 0.09– 0.41, P < 0.001). These associations were only found in male but not in female patients. However, no significant relationship was found between TBIL and peripheral arterial disease or carotid hypertrophy.Conclusion: Our findings sugg

Jieyu He, Youshuo Liu Department of Geriatrics, Second Xiangya Hospital, Central South University, Changsha 410011, China Kuo et al thoroughly evaluated the safety and efficacy of intravenous tranexamic acid in revision total joint arthroplasty (TJA) via aspects of blood loss and transfusion, events of venous thromboembolism.1 We consider application of this drug of great value in revision TJA. However, we would like to address several concerns related to this meta-analysis.  Author's reply  Feng-Chih Kuo,1 Pao-Yen Lin,2 Jun-Wen Wang,1 Po-Chun Lin,1 Mel S Lee,1 Antonia F Chen3 1Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan; 2Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan; 3Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA  We read the letter from He and Liu in response to our recently published article entitled “Intravenous tranexamic acid use in revision total joint arthroplasty: a meta-analysis”1 with interest.  View the original paper by Kuo and colleagues.&nbsp