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Longyi Zheng,1,* Chengjing Zhang,2,* Shichang Bu,1,* Wencheng Guo,3,* Tongtong Li,4 Ying Xu,5 Yunan Liu,4 Caimei Yuan,4 Chengwu Feng,4 Geng Zong,4 Jingwen Zhu,4 Maoying Xing,5 Xin Geng5 1Department of Endocrinology, Changhai Hospital, Naval Medical University, Shanghai, People’s Republic of China; 2Department of Nutrition, Shanghai Eastern Hepatobiliary Surgery Hospital, Shanghai, People’s Republic of China; 3Department of General Surgery and Vascular Surgery, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China; 4CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, People’s Republic of China; 5National Center for Liver Cancer, Naval Medical University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Maoying Xing; Xin Geng, Email xmyxing@sina.com; gxouc@hotmail.comBackground: Neuregulin 4 (NRG4) was known to be associated with serum lipid levels and atherosclerosis. However, it is unknown whether the role of NRG4 in lipid homeostasis is causal to atherosclerosis and whether the effect is beneficial across different atherosclerosis subtypes.Methods: We investigated the causal role of the levels of serum low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, and triglycerides regulated by NRG4 in subtypes of atherosclerosis through two sample Mendelian randomization. Aggregated genome-wide association study (GWAS) summary data for serum lipid level of 1.32 million individuals with European ancestry were obtained from the Global Lipids Genetics Consortium. GWAS summary data for four atherosclerosis subtypes (peripheral, coronary, cerebral and the other atherosclerosis) were obtained from FinnGen Consortium. Generalized inverse-variance–weighted Mendelian randomization and several sensitivity analyses were used to obtain the causal estimates.Results: A 1-SD genetically elevated LDL-C level mediated by NRG4 was validated to be nominally associated with the risk of peripheral atherosclerosis (log (odds ratio)= 4.14, 95% confidence interval 0.11 to 8.17, P = 0.04), and the other associations were not significant or could not be validated by sensitivity analyses.Conclusion: LDL-C lowering mediated by NRG4 is likely to prevent peripheral atherosclerosis.Keywords: Mendelian randomization analysis, NRG4, atherosclerosis, lipid

Jiangping Ye,1– 3 Dongxia Xu,1– 3 Rikang Yuan,1– 3 Shaoqing Cao,1– 3 Zhangyu Wang,1– 3 Yuqin Wang,1– 3 Chengsi Li,1– 3 Gangjun Zong1– 3 1Wuxi Clinical College of Anhui Medical University, Wuxi, Jiangsu, People’s Republic of China; 2Anhui Medical University Fifth Clinical Medical College, Wuxi, Jiangsu, People’s Republic of China; 3Department of Cardiology, The 904th Hospital of Joint Logistic Support Force of PLA, Wuxi, Jiangsu, People’s Republic of ChinaCorrespondence: Gangjun Zong, Email zonggj@163.comAim: The high morbidity and mortality associated with ST-segment elevation myocardial infarction (STEMI) are an urgent concern. This study aimed to investigate the ratio of lymphocyte count to C-reactive protein ratio (LCR) in multiple measurements in the perioperative period, exploring dynamic changes as the best predictor of major adverse cardiovascular events (MACE) in STEMI patients.Methods: We enrolled 205 STEMI patients, conducting blood counts at admission, 24 hours post-percutaneous coronary intervention (PCI), and at discharge. Cox proportional risk models evaluated factors independently associated with STEMI prognosis. The receiver operating characteristic (ROC) curve and the De-Long test determined the best predictor. Kaplan–Meier analysis assessed the prognostic value of LCR for STEMI patients. Statistical differences and correlations between LCR at 24 hours post-PCI and cardiovascular disease risk factors were also analyzed.Results: Gensini score (HR, 1.015; 95% CI, 1.007– 1.022; P < 0.001), total stent length (HR, 1.015; 95% CI, 1.002– 1.029; P=0.025), lipoprotein (a) (HR, 1.001; 95% CI, 1.000– 1.002; P=0.043), LCR at admission (HR, 0.995; 95% CI, 0.989– 1.000; P=0.002), and LCR at 24 hours post-PCI (HR, 0.587; 95% CI, 0.486– 0.708; P < 0.001) were independent risk factors for long-term STEMI prognosis after PCI. LCR at admission (cut-off value, 2.252; 95% CI, 0.040– 0.768; P < 0.001) and LCR at 24 hours post-PCI (cut-off value, 2.252; 95% CI, 0.831– 0.924; P < 0.001) effectively predicted MACEs occurrence, with the latter exhibiting a superior predictive effect (P< 0.001). Kaplan-Meier analysis revealed that patients with LCR at admission ≤ 50.29 and LCR at 24 hours post-PCI ≤ 2.25 had significantly higher risks of developing MACEs (Log-rank P < 0.0001).Conclusion: LCR at 24 hours post-PCI may be a superior marker for long-term MACE prediction in STEMI patients, serving as the best predictor for distant MACE occurrence.Keywords: lymphocyte, C-reactive protein, major cardiovascular adverse events, percutaneous coronary intervention, ST-segment elevation myocardial infarction

Yehong Liu,1,&ast; Jie Liu,1,&ast; Longqun Liu,2,&ast; Shaoqing Cao,1,3 Tianhui Jin,1 Liang Chen,1,3 Gangyong Wu,1,3 Gangjun Zong1,3 1Department of Cardiology, The 904th Hospital of Joint Logistic Support Force of PLA, Wuxi, Jiangsu, People’s Republic of China; 2Department of Respirology, The 904th Hospital of Joint Logistic Support Force of PLA, Wuxi, Jiangsu, People’s Republic of China; 3Department of Cardiology, Wuxi Clinical College of Anhui Medical University, Wuxi, Jiangsu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Gangyong Wu; Gangjun Zong, Email wuwangyi520@sina.com; zonggj@163.comAim: Reducing the high morbidity and mortality of ST-segment elevation myocardial infarction (STEMI) and improving patient prognosis remains a major global challenge. This study aimed to explore whether dynamic fluctuations in biomarkers are valuable predictors of prognosis in patients with STEMI.Methods: This study included 216 patients with STEMI. Blood routine tests were performed on admission, 12 h after percutaneous coronary intervention (PCI), and at discharge. Systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and pan-immune-inflammation-value (PIV) serum immune-inflammatory markers were calculated. The Cox proportional hazard model was used to assess the factors independently associated with the prognosis of STEMI. The optimal cutoff values for the inflammatory markers were calculated.Results: Eighty-five (39.35%) of the 216 patients had major adverse cardiovascular events (MACEs) during the 1-year follow-up. Most were male (81.18%) with a median age of 64 years (interquartile, 55– 69.5). Killip class ≥ II on admission (hazard ratio [HR], 1.859; 95% CI, 1.169– 2.957; P = 0.009), total stent length (HR, 1.016; 95% CI, 1.003– 1.029; P = 0.019), values of SIRI at 12 h after PCI (HR, 1.079; 95% CI, 1.050– 1.108; P < 0.001), and the Gensini score (HR, 1.014; 95% CI, 1.007– 1.022; P < 0.001) were independently associated with an increased risk of MACEs. Compared with SII, SIRI and PIV calculated at various time points and dynamically fluctuating changes, SIRI (cutoff value, 4.15; 95% CI, 0.701– 0.819; P < 0.001) and PIV (cutoff value, 622.71; 95% CI, 0.674– 0.796; P < 0.001) at 12 h after PCI showed the best efficacy for the prognosis of STEMI.Conclusion: Our study provides relevant evidence to the notion that SIRI or PIV at 12 h after PCI may be more accurate and economical predictors of long-term adverse prognosis in patients with STEMI.Keywords: systemic inflammatory response index, pan-immune-inflammation-value, ST-segment elevation myocardial infarction, major adverse cardiovascular events, prognosis, percutaneous coronary intervention

Ping Fang,1 Zhengqin Ye,1 Ran Li,1 Dunmin She,2 Guannan Zong,1 Liya Zhang,1 Ying Xue,1 Keqin Zhang1 1Department of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People’s Republic of China; 2Department of Endocrinology, Northern Jiangsu People’s Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, 225001, People’s Republic of ChinaCorrespondence: Ying Xue; Keqin Zhang, Department of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Shanghai, 200065, People’s Republic of China, Tel +86-21-66111061, Email doxy0622@163.com; 13621798084@126.comPurpose: Our aims were to investigate the pathogenesis of diabetic cardiomyopathy (DCM) and to explore the protective effect of glucagon-like peptide-1 receptor agonist (GLP-1RA) on DCM.Methods: After 12 weeks of treatment with exenatide-loaded microspheres, a long-acting GLP-1RA, in DCM mice, cardiac structure and function were evaluated by plasma B-type natriuretic peptide (BNP), echocardiography, H&E, oil red and Sirius staining. The expression of glucagon-like peptide-1 receptor in mouse heart tissue was determined by immunofluorescence staining. The label-free proteomic analysis of cardiac proteins was conducted among control, DCM and DM+GLP-1RA groups. Then, quantitative real-time PCR, Western blotting and dual-luciferase reporter assay were performed to verify the regulation of target protein by the upstream microRNA (miRNA).Results: GLP-1RA treatment obviously improved serum BNP, myocardial fibrosis, lipid deposition of the myocardium and echocardiography parameters in DCM mice. Sarcolemmal membrane-associated protein (SLMAP) was one of 61 differentially expressed cardiac proteins found in three groups by proteomic analysis. Up-regulation of microRNA-29b-3p (miR-29b-3p) and down-regulation of SLMAP were found in the ventricular myocardium of GLP-1RA-treated DCM mice. SLMAP was a target of miR-29b-3p, while GLP-1RA regulated SLMAP expression through miR-29b-3p. Furthermore, inhibition of glucagon-like peptide-1 receptor (GLP-1R) in cardiomyocytes reversed the effects of GLP-1RA on miR-29b/SLMAP.Conclusion: SLMAP may play roles in the pathogenesis of DCM and may be a target of GLP-1RA in protecting against DCM. After binding to myocardial GLP-1R, GLP-1RA can regulate the expression of myocardial SLMAP through miR-29b-3p.Keywords: diabetic cardiomyopathy, microRNA-29b-3p, proteomics, sarcolemmal membrane-associated protein, glucagon-like peptide-1 receptor agonist

Ran Li,1 Zhengqin Ye,1 Dunmin She,2,3 Ping Fang,1 Guannan Zong,1 Kerong Hu,1 Dehong Kong,1 Wei Xu,1 Ling Li,1 Yun Zhou,1 Keqin Zhang,1 Ying Xue1 1Department of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China; 2Clinical Medical College, Yangzhou University, Yangzhou, People’s Republic of China; 3Department of Endocrinology, Northern Jiangsu People’s Hospital Affiliated to Yangzhou University, Yangzhou, People’s Republic of ChinaCorrespondence: Ying Xue; Keqin Zhang, Department of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Shanghai, 200065, People’s Republic of China, Tel +86-021-66111061, Email doxy0622@163.com; keqzhang2018@163.comObjective: Although the pathogenesis of non-alcoholic fatty liver disease (NAFLD) has been extensively studied, the role of its underlying pathogenesis remains unclear, and there is currently no approved therapeutic strategy for NAFLD. The purpose of this study was to observe the beneficial effects of Semaglutide on NAFLD in vivo and in vitro, as well as its potential molecular mechanisms.Methods: Semaglutide was used to treat type 2 diabetes mellitus (T2DM) combined with NAFLD mice for 12 weeks. Hepatic function and structure were evaluated by liver function, blood lipids, liver lipids, H&E staining, oil red staining and Sirius staining. The expression of α/β hydrolase domain-6 (ABHD6) was measured by qPCR and Western blotting in vivo and in vitro. Then, dual-luciferase reporter assay was performed to verify the regulation of the upstream miR-5120 on ABHD6.Results: Our data revealed that Semaglutide administration significantly improved liver function and hepatic steatosis in T2DM combined with NAFLD mice. Furthermore, compared with controls, up-regulation of ABHD6 and down-regulation of miR-5120 were found in the liver of T2DM+NAFLD mice and HG+FFA-stimulated Hepa 1– 6 hepatocytes. Interestingly, after Semaglutide intervention, ABHD6 expression was significantly decreased in the liver of T2DM+NAFLD mice and in HG+FFA-stimulated Hepa 1– 6 hepatocytes, while miR-5120 expression was increased. We also found that miR-5120 could regulate the expression of ABHD6 in hepatocytes, while Semaglutide could modulate the expression of ABHD6 through miR-5120. In addition, GLP-1R was widely expressed in mouse liver tissues and Hepa 1– 6 cells. Semaglutide could regulate miR-5120/ABHD6 expression through GLP-1R.Conclusion: Our data revealed the underlying mechanism by which Semaglutide improves hepatic steatosis in T2DM+NAFLD, and might shed new light on the pathological role of miR-5120/ABHD6 in the pathogenesis of T2DM+NAFLD.Keywords: Semaglutide, non-alcoholic fatty liver disease, type 2 diabetes mellitus, α/β hydrolase domain-6, microRNA-5120

Ran Li,1 Dunmin She,2 Zhengqin Ye,1 Ping Fang,1 Guannan Zong,1 Yong Zhao,1 Kerong Hu,1 Liya Zhang,1 Sha Lei,1 Keqin Zhang,1 Ying Xue1 1Department of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People’s Republic of China; 2Department of Endocrinology, Northern Jiangsu People’s Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, 225001, People’s Republic of ChinaCorrespondence: Ying Xue; Keqin Zhang, Department of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Shanghai, 200065, People’s Republic of China, Tel +86-021-66111061, Email doxy0622@163.com; keqzhang2018@163.comPurpose: This study aims to investigate the renal protective effect of glucagon-like peptide 1 receptor agonist (GLP-1RA) on improving renal tubular damage in diabetic kidney disease (DKD) and to explore the potential mechanism of GLP-1RA on renal tubular protection.Methods: Long-acting GLP-1RA was used to treat DKD mice for 12 weeks. The label-free quantitative proteomic analysis of renal proteins was conducted to explore the differentially expressed proteins (DEPs) in the renal tissues of the control, DKD and GLP-1RA groups. The DEPs and markers of renal tubular injury were verified by qPCR in vivo and in vitro. The expression of glucagon-likepeptide-1 receptor (GLP-1R) in renal tubules was determined by immunofluorescence staining.Results: GLP-1RA treatment significantly improved the tubular damages in kidney tissues of DKD mice and mTEC cells stimulated by high glucose (HG). Proteomics analysis revealed that 30 proteins in kidney tissue were differentially expressed among three groups. Seminal vesicle secretory protein 6 (SVS6) was the most differentially expressed protein in kidney tissues among three groups of mice. The expression changes of Svs6 mRNA in vitro and in vivo detected by qPCR were consistent with the results of proteomic analysis. Furthermore, reduction of Svs6 expression by SVS6 siRNA could attenuate HG-stimulated tubular injury in mTEC cells. Immunofluorescence staining also found that GLP-1R was widely expressed in renal tubules in vitro and in vivo.Conclusion: GLP-1RA significantly improved renal tubular damage in DKD mice. SVS6 may be a potential therapeutic target for GLP-1RA in the treatment of DKD.Keywords: diabetic kidney disease, glucagon-like peptide-1 receptor agonist, renal tubular injury, seminal vesicle secretory protein 6

Ran Li,1,2,&ast; Xiaoyi Zhu,1,2,&ast; Mengxi Zhang,1,2,&ast; Guannan Zong,1,2 Keqin Zhang1,2 1Department of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People’s Republic of China; 2Institute of Osteoporosis and Metabolic Bone Diseases, School of Medicine, Tongji University, Shanghai, 200065, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Keqin ZhangDepartment of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, No. 389, Xincun Road, Shanghai, 200065, People’s Republic of ChinaTel +86 21-66112032Email keqzhang2018@163.comBackground: It has been reported that serum periostin levels are significantly higher in postmenopausal patients with osteoporotic fractures. Nonetheless, the levels of serum periostin in postmenopausal women with different bone mass remain unclear.Purpose: The objective of the study was to identify the levels of serum periostin in Chinese postmenopausal women with different bone mass, and the correlations between the periostin levels and the classical bone turnover markers (BTMs), and bone mineral densities (BMDs) at different sites.Patients and Methods: This study enrolled 331 Chinese postmenopausal women in Shanghai; their clinical features were collected; their levels of serum periostin and traditional BTMs were measured by ELISA or the fully automated immunoassay analyzer; their BMDs at different sites were measured by dual-energy X-ray absorptiometry (DXA).Results: According to the T-value of bone mineral density (BMD), these postmenopausal women were divided into normal group (n=84), osteopenia group (n=126) and osteoporosis group (n=121). There was no significant difference in the serum periostin levels among the above three groups of subjects. In addition, Spearman correlation analysis also revealed that no correlation was observed between the value of serum periostin and those of traditional BTMs, and BMDs at different sites, respectively. The values of traditional BTMs were negatively correlated with those of BMDs at all measured sites. Furthermore, the receiver-operating characteristic (ROC) curves analysis indicated that among the periostin and traditional BTMs mentioned above, the best predictors for postmenopausal osteoporosis in Shanghai Chinese postmenopausal women were osteocalcin (OC) and procollagen type 1 N-terminal propeptide (P1NP) [the areas under the ROC curve (AUC)=0.746 and 0.761, respectively].Conclusion: Serum periostin may not be used as a marker of systemic bone metabolism in Shanghai Chinese postmenopausal women without prior fracture. In addition, serum P1NP and OC levels may be the predictors of osteoporosis occurrence in Chinese postmenopausal women.Keywords: postmenopausal women, periostin, bone turnover markers, bone mineral density

Le Ma,1,2 Gang Liu,1 Geng Zong,1 Laura Sampson,1 Frank B Hu,1,3,4 Walter C Willett,1,3,4 Eric B Rimm,1,3,4 JoAnn E Manson,3,5,6 Kathryn M Rexrode,6 Qi Sun1,4 1Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; 2Department of Maternal, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China; 3Department of Epidemiology, Harvard T.H. Chan School of Public Health, 4Channing Division of Network Medicine, Department of Medicine, 5Department of Medicine, 6Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA Importance: Glucosinolates, a group of phytochemicals abundant in cruciferous vegetables, may have cardioprotective properties. However, no prospective study has evaluated the association of intake of glucosinolates with the risk of coronary heart disease (CHD).Objective: The objective of the study was to evaluate the association between the intake of glucosinolates and incident CHD in US men and women.Design: Prospective longitudinal cohort study.Setting: Health professionals in the USA.Participants: We followed 74,241 women in the Nurses’ Health Study (NHS; 1984–2012), 94,163 women in the NHSII (1991–2013), and 42,170 men in the Health Professionals Follow-Up Study (1986–2012), who were free of cardiovascular disease and cancer at baseline.Exposure: Glucosinolate intake was assessed using validated semi-quantitative food frequency questionnaires at baseline and updated every 2–4 years during follow-up.Main outcome measures: Incident cases of CHD were confirmed by medical record review.Results: During 4,824,001 person-years of follow-up, 8,010 cases of CHD were identified in the three cohorts. After adjustment for major lifestyle and dietary risk factors of CHD, weak but significantly positive associations were observed for glucosinolates with CHD risk when comparing the top with bottom quintiles (hazard ratio [HR]:1.09; 95% CI: 1.01, 1.17; Ptrend

Puerarin, a monomer of traditional Chinese medicine, is a key component of Pueraria radix. Both clinical and experimental researches demonstrated that puerarin has therapeutic effects on Parkinson's disease (PD). Puerarin's pharmacological mechanisms include: 1) Anti-apoptosis. Puerarin inhibits cell apoptosis through the phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K)/protein kinase B (Akt) and c-Jun N-terminal kinase (JNK) signaling pathways. Puerarin also exerts a hormone-like effect against cell apoptosis; 2) Anti-oxidative stress injury. Puerarin inhibits the Nrf2 nuclear exclusion through the GSK-3β/Fyn pathway to promote the Nrf2 accumulation in the nucleus, and then promotes the antioxidant synthesis through the Nrf2/ARE signaling pathway to protect against oxidative stress; 3) Neuroprotective effects by intervening in the ubiquitin-proteasome system (UPS) and autophagy-lysosomal pathway (ALP). Puerarin significantly enhances the activity of chaperone-mediated autophagy (CMA), which downregulates the expression of α-synuclein, reduces its accumulation, and thus improves the function of damaged neurons. Additionally, puerarin increases proteasome activity and decreases ubiquitin-binding proteins, thereby preventing toxic accumulation of intracellular proteins; 4) Alleviating inflammatory response. Puerarin inhibits the conversion of microglia to the M1 phenotype while inducing the transition of microglia to the M2 phenotype. Furthermore, puerarin promotes the secretion of anti-inflammatory factor and inhibits the expression of pro-inflammatory factors; 5) Increasing the levels of dopamine and its metabolites. Puerarin could increase the levels of dopamine, homovanillic acid (HVA) and 3,4-dihydroxyphenylacetic acid (DOPAC) in the striatum; 6) Promoting neurotrophic factor expression and neuronal repair. Puerarin increases the expression of glial cell-derived neurotrophic factor (GDNF), brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF), thereby exerting a neuroprotective effect. Moreover, the regulation of the gut microbiota by puerarin may be a potential mechanism for the treatment of PD. The current review discusses the molecular mechanisms of puerarin, which may provide insight into the active components of traditional Chinese medicine in the treatment of PD.

The current methods for reliability index calculation are less effective for in-plane shear failure of unreinforced masonry (URM) walls because there is significant uncertainty in the walls' mechanical parameters and resistance model. To address this issue, the authors propose a new method based on stochastic Gaussian process (GP) model. They conducted in-plane shear resistance experiments on six URM walls and converted the walls' deterministic shear resistance models to prior GP models, which they updated to posterior models using the experimental results. The posterior GP models specified normal probability density functions (PDFs) for shear resistance of the walls, and the PDFs linearized the walls' performance functions to the simplest form. With the linearized performance functions, the walls' failure probability was calculated by direct integration and their reliability indices were determined accordingly. The reliability indices are in good agreement with those given by the Monte Carlo simulation (MCS) using a large number of samples. The proposed method does not deal with high dimensional limit state surfaces, it relieves the influence of uncertainty of the shear resistance model, and it is time-efficient. With these features, the proposed method can facilitate the reliability index calculation for in-plane shear failure of the URM walls. [ABSTRACT FROM AUTHOR]

Pseudoangiomatous stromal hyperplasia (PASH) is a benign interstitial hyperplasia of the breast that usually occurs in premenopausal or perimenopausal women. It is usually characterized by localized lesions or clear boundary masses, and diffuse double breast enlargement is rare. PASH is considered a hormone-dependent disease that is commonly progesterone related. There are no imaging characteristics, and both benign and suspicious malignant signs can be seen. The definitive diagnosis of PASH depends on a pathological diagnosis, and it is necessary to be vigilant in distinguishing between benign and malignant tumors with similar breast histopathology. Here, we report the case of a 23-year-old multipara patient with bilateral diffuse pseudoangiomatous stromal hyperplasia of the breast during pregnancy who presented with macromastia and reviewed the literature to further understand the clinical features, pathological diagnosis, differential diagnosis, treatment and prognosis of pseudoangiomatous stromal hyperplasia of the breast.

Zu-Fei Wu,1,&ast; Wen-Tao Su,2,3,&ast; Shi Chen,4 Bai-Da Xu,2 Gang-Jun Zong,2,3 Cun-Ming Fang,1 Zheng Huang,1 Xue-Jun Hu,1 Gang-Yong Wu,2,3 Xiao-Lin Ma1 1Department of Cardiology, Xuancheng People’s Hospital, Xuanchen, Anhui, 242000, People’s Republic of China; 2Department of Cardiology, the 904th Hospital of the PLA Joint Logistics Support Force, Wuxi, Jiangsu, 214044, People’s Republic of China; 3Department of Cardiology, Wuxi Clinical College of Anhui Medical University, Wuxi, Jiangsu, 214044, People’s Republic of China; 4Department of Cardiology, Wuxi No.5 People’s Hospital, Wuxi, Jiangsu, 214044, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Gang-Yong Wu, Department of Cardiology, the 904th Hospital of the PLA Joint Logistics Support Force, Wuxi, Jiangsu, 214044, People’s Republic of China, Email wuwangyi520@sina.comObjective: To investigate the correlation between serum parathyroid hormone (PTH) levels and in-hospital major adverse cardiovascular events (MACE) in patients with acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI), and establish a risk prediction model based on parameters such as PTH for in-hospital MACE.Methods: This observational retrospective study consecutively enrolled 340 patients who underwent primary PCI for STEMI between January 2016 and December 2020, divided into a MACE group (n=92) and a control group (n=248). The least absolute shrinkage and selection operator (LASSO) and logistic regression analyses were used to determine the risk factors for MACE after primary PCI. The rms package in R-studio statistical software was used to construct a nomogram, to detect the line chart C-index, and to draw a calibration curve. The decision curve analysis (DCA) method was used to evaluate the clinical application value and net benefit.Results: Correlation analysis revealed that PTH level positively correlated with the occurrence of in-hospital MACE. Receiver operating characteristic curve analyses revealed that PTH had a good predictive value for in-hospital MACE. Multivariate logistic regression analysis indicated that Killip class II–IV, and FBG were independently associated with in-hospital MACE after primary PCI. A nomogram model was constructed using the above parameters. The model C-index was 0.894 and the calibration curve indicated that the model was well calibrated. The DCA curve suggested that the nomogram model was better than TIMI score model in terms of net clinical benefit.Conclusion: Serum PTH levels in patients with STEMI are associated with in-hospital MACE after primary PCI, and the nomogram risk prediction model based on PTH demonstrated good predictive ability with obvious clinical practical value.Keywords: parathyroid hormone, acute ST-segment elevation myocardial infarction, percutaneous coronary intervention, nomograms

ObjectiveTo investigate the dietary preference and nutritional knowledge needs of the elderly people who dined at meal service sites.MethodsUsing the form of stratified and convenience sampling method with self-designed questionnaire was used， in November 2021， to select 700 elderly people who dine at meal service sites in 7 jurisdictions in Shanghai were selected， and a self-designed questionnaire was used to investigate the basic information.Results91.64% of the elderly surveyed would eat at relatively fixed meal service sites， and the total Dietary Diversity Score （DDS9） was 3.56±1.46. 41.45% of the elderly with diseases preferred unhealthy cooking methods. Only 8.03% of the surveyed seniors said they were unwilling to accept targeted and personalized nutrition tips and reminders. Multivariate logistic regression analysis showed that the probability reaching the “understanding” level of “Food Guide Pagoda for Chinese Residents” and “Four Principles Recommended by the Core Dietary Guidelines for the Elderly” was different in the elderly with different education levels. The willingness of the elderly to expect to receive different nutrition tips and reminders was related to whether they cared about the corresponding contents. There was a statistically significant difference （P