Background. Acute ST-segment elevation myocardial infarction (STEMI) is a serious cardiovascular disease that poses a great threat to the life and health of patients. Therefore, early diagnosis is important for STEMI patient treatment and prognosis. The purpose of this study was to investigate the value of serum YKL-40 and TNF-α in the diagnosis of STEMI. Methods. From October 2020 to February 2022, 120 patients with STEMI were admitted to the Chest Pain Center of the Second People’s Hospital of Hefei, and 81 patients with negative coronary angiography were selected as the control group. Serum YKL-40 and TNF-α concentrations were measured by sandwich ELISA. Pearson correlation was used to analyze the correlation between serum YKL-40, TNF-α, and serum troponin I (cTnI) in STEMI patients; multivariate logistic regression analysis was used to screen independent risk factors for STEMI. Three diagnostic models were constructed: cTnI univariate model (model A), combined serum YKL-40 and TNF-α model other than cTnI (model B), and combined cTnI and serum YKL-40 and TNF-α model (model C). We assessed the clinical usefulness of the diagnostic model by comparing AUC with decision curve analysis (DCA). Results. Serum YKL-40 and TNF-α in the STEMI group were significantly higher than those in the control group ( P < 0.001 ). On Pearson correlation analysis, there was a significant positive correlation between serum YKL-40, TNF-α, and cTnI levels in STEMI patients. Multivariate logistic regression analysis showed that serum YKL-40 and TNF-α were independent risk factors for the development of STEMI. The results of ROC analysis showed that the area under the curve (AUC) of serum YKL-40 for predicting the occurrence of STEMI was 0.704. The AUC of serum TNF-α for predicting the occurrence of STEMI was 0.852. The AUC of cTnI as a traditional model, model A, for predicting the occurrence of STEMI was 0.875. Model B predicted STEMI with an AUC of 0.851. The addition of serum YKL-40 and serum TNF-α to the traditional diagnostic model composed of cTnI constituted a new diagnostic model; that is, the AUC of model C for predicting the occurrence of STEMI was 0.930. Model C had a better net benefit between a threshold probability of 70–95% for DCA. Conclusion. In this study, we demonstrate the utility of serum YKL-40 and TNF-α as diagnostic markers for STEMI and the clinical utility of diagnostic models by combining serum YKL-40 and TNF-α with cTnI.

<b><i>Background:</i></b> Diabetes mellitus is a metabolic disease which also causes cognitive deficits. Betaine (N,N,N-trimethylglycine), also known as trimethylglycine, has been shown to ameliorate diabetic symptoms in diabetic animals and improve cognitive ability in Alzheimer disease (AD) animals. However, the effects of betaine on cognitive deficits in diabetic animals have not been described yet. Therefore, in the current study, the effects of betaine on cognition in diabetic rats were evaluated. <b><i>Methods:</i></b> We established a diabetic rat model by injecting streptozotocin (STZ) into rats and administrated betaine to these diabetic rats. We monitored the metabolism index, and glucose and insulin levels in blood and cerebrospinal fluid. We measured inflammatory cytokine levels, including TNF-α, IL-1β, and IL-6, in serum and hippocampus. We also monitored oxidative stress in the hippocampus by measuring malondialdehyde (MDA) level and superoxide dismutase (SOD) activity. We measured the learning and memory ability of diabetic rats using the Morris water and Y maze tests and tested the phosphatidylinositol 3-kinase (PI3K)/Akt activation and p-mTOR level in the hippocampus. <b><i>Results:</i></b> Betaine improved glucose metabolism and suppressed the production of inflammatory cytokines, including TNF-α, IL-1β, and IL-6. Also, betaine decreased MDA concentration and increased SOD activity in the hippocampus of diabetic rats. Betaine ameliorated cognitive deficits in diabetic rats, and it promoted PI3K expression and Akt activation and decreased p-mTOR expression. <b><i>Conclusion:</i></b> Betaine alleviates cognitive deficits in STZ-induced diabetic rats via regulating the PI3K/Akt signaling pathway.

Background. Acute ST-elevation myocardial infarction (STEMI) is a common clinical critical illness, and accurate, reliable, simple, and easy-to-remember tools are needed in clinical practice to quickly identify the risk of this condition in STEMI patients. This study investigates the predictive value of the admission CHA2DS2-VASc score for in-hospital MACE in STEMI patients. Methods. A total of 210 STEMI patients who visited the Chest Pain Center of the Second People‘s Hospital of Hefei from December 2019 to December 2021 were retrospectively analyzed. They were divided into MACE and non-MACE groups. The receiver operating characteristic curve (ROC) was used to assess the predictive value of the CHA2DS2-VASc score for MACE events during hospitalization. Results. The CHA2DS2-VASc score was higher in the MACE group than in the non-MACE group ( P < 0.05 ), and multivariate logistic regression analysis showed that the CHA2DS2-VASc score was an independent risk factor for MACE events during hospitalization in STEMI patients (OR = 1.391, 95%CI 1.044–1.853, P = 0.024 ); ROC curve analysis showed that the area under the curve (AUC) of the CHA2DS2-VASc score was 0.744, the sensitivity was 0.64, the specificity was 0.694, and the optimal cutoff value was 3.5 in predicting the risk of MACE events during hospitalization in STEMI patients. There were no significant differences between the GRACE score (0.744 VS.0.827) and TIMI score (0.744VS.0.745) ( P > 0.05 ). Conclusion. The CHA2DS2-VASc score can successfully predict the occurrence of in-hospital MACE events in STEMI patients.

Background: Acute ST-segment elevation myocardial infarction(STEMI) is a life-threatening coronary artery disease, inflammation plays a key role in the occurrence and development of coronary atherosclerosis. Serum YKL-40 and neutrophil-lymphocyte ratios(NLR) are both inflammatory markers. The purpose of this study is to investigate the predictive value of serum YKL-40 and neutrophil/lymphocyte ratio for the severity of coronary artery disease in patients with acute ST-segment elevation myocardial infarction. Methods: A total of 120 STEMI patients admitted from October 2020 to February 2022 were included in the STEMI group. 71 patients without coronary sclerosis who underwent coronary angiography at the same time were in the control group. They were divided into the high Gensini score group (Gensini score > 64 points) and the low Gensini score group (Gensini score ≤ 64 points). Pearson correlation analysis was used to analyze the correlation between serum YKL-40 and NLR and Gensini score in the STEMI group; Multifactorial logistic regression analysis was used to study the correlation of serum YKL-40 and NLR each with coronary artery lesion degree; Receiver operating characteristic curve (ROC) to evaluate the predictive value of serum YKL-40 and NLR on coronary artery lesion degree. Results: The serum YKL-40 and NLR in the STEMI group were higher than those in the control group, the serum YKL-40, and NLR in the high Gensini score group were higher than those in the low Gensini score group, and the difference was statistically significant (P<0.05). Pearson correlation analysis showed that serum YKL-40 and NLR were positively correlated with the Gensini score in the STEMI group. Multivariate Logistic regression analysis showed that serum YKL-40 was an independent risk factor for the severity of coronary artery lesions. The ROC curve analysis showed that the area under the curve (AUC) of serum YKL-40 in the diagnosis of a high Gensini score was 0.73; The AUC of NLR in the diagnosis of a high Gensini score was 0.694. Conclusion: Both serum YKL-40 and NLR correlated with coronary artery lesion degree in STEMI patients, and serum YKL-40 was a better predictor of coronary artery lesion degree in STEMI patients than NLR.

Background This study aimed to investigate the predictive value of serum YKL-40 for major adverse cardiovascular events within 30 days after PCI for acute ST-segment elevation myocardial infarction (STEMI). Methods In this study, 120 patients with STEMI admitted to the Second People's Hospital of Hefei from October 2020 to February 2022 were included. All patients received cubital venous blood sampling before PCI to detect serum YKL-40 concentration. Patients were followed up for 30 days after PCI and divided into the MACE group (n = 27) and Non-MACE group (n = 93) according to whether MACE occurred. Univariate and multivariate Cox regression analysis was used to analyze the effect of serum YKL-40 on MACE within 30 days after PCI in STEMI patients. The predictive value of serum YKL-40 for the occurrence of MACE within 30 days after PCI in patients with STEMI was assessed by plotting receiver operating characteristic (ROC) curves. Kaplan-Meier method was used to plot the survival curve of MACE occurring 30 days after PCI in STEMI patients. Results Serum YKL-40 levels were higher in patients in the MACE group than in patients in the Non-MACE group (1431.08±445.31 vs 1028.28±558.47 ng/dL, P < 0.05); Multivariate Cox regression analysis showed that serum YKL-40 was an independent risk factor for MACE events within 30 days after PCI in STEMI patients (OR = 1.002, 95% CI 1.001 – 1.002, P = 0.003); ROC curve analysis showed that the area under the curve (AUC) of serum YKL-40 was 0.768, the sensitivity was 0.741, the specificity was 0.763, and the optimal cutoff value was 1383.91 ng/dL in predicting the risk of MACE events within 30 days after PCI in STEMI patients; Kaplan-Meier survival curve analysis showed that the MACE-free survival rate at 30 days after PCI decreased with increasing serum YKL-40 levels in STEMI patients (Log-Rank P = 0.011). Conclusions Serum YKL-40 is associated with short-term prognosis in patients with STEMI. High serum YKL-40 levels can be used as a predictor of MACE within 30 days after PCI in STEMI patients.