OBJECTIVE To explore the effects of limonin on renal lesions， glucose metabolism， inflammation， and oxidative stress in gestational diabetic rats and its possible mechanisms. METHODS The model of gestational diabetic rats was established by intraperitoneal injection of streptozotocin. The diabetic rats were divided into the model group （intragastrical administration and tail vein injection of equal volume of normal saline）， limonin low-， medium-， and high-dose groups （intragastrical administration of limonin， at doses of 12.5， 25.0 and 50.0 mg/kg， and equal volume of normal saline into the tail vein）， and combination group [intragastrical administration of limonin 50.0 mg/kg + tail vein injection of c-Jun N-terminal kinase （JNK） activator Anisomycin 2 mg/kg ]， with 12 rats in each group. In addition， 12 pregnant rats were selected as the control group （intragastrical administration and tail vein injection of equal volume of normal saline）. They were given relevant medicine， once a day， for 14 consecutive days. After the last administration， fasting blood glucose （FBG）， the levels of fasting insulin （FINS）， interleukin-1β （IL-1β）， IL-6， and tumor necrosis factor-α （TNF-α） in the serum were detected； the levels of superoxide dismutase （SOD）， malondialdehyde （MDA）， glutathione peroxidase （GSH-Px）， blood urea nitrogen （BUN）， and creatinine （Cr） in the renal tissue were detected； the pathological changes of renal tissue were observed； the expressions of proteins related to the JNK/nuclear factor-κB （NF-κB） signaling pathway in the renal tissue were detected. RESULTS Compared with control group， in model group， the rats showed pathological injuries in the kidney tissue， such as glomerular atrophy， edema of renal tubular epithelial cells； the levels of FBG， FINS， IL-1β， IL-6， TNF-α， MDA， BUN and Cr， HOMA-IR， as well as the phosphorylation levels of JNK and NF-κB 0453-6602005。E-mail：mcvi45@163.com p65 proteins were increased significantly （P＜0.05）， while the levels of SOD and GSH-Px were decreased significantly （P＜0.05）. Compared with model group， in each dose group of limonin， the degree of renal tissue lesions in rats was alleviated， and the above-mentioned indicators were significantly improved （P＜0.05）， showing an obvious dose-effect relationship （P＜0.05）. Compared with high-dose limonin group， in the combination group， the degree of renal tissue lesions in rats was relatively aggravated， and the changes in the above-mentioned indicators were significantly reversed （P＜0.05）. CONCLUSIONS Limonin has a certain improvement effect on renal lesions， glucose metabolism， inflammation， and oxidative stress in pregnant rats with gestational diabetes. Its mechanism may be related to the inhibition of the JNK/NF-κB signaling pathway.

Objective:To analyze the changes in the costs of hospital rehabilitation after the reform of health insurance payments in the past 6 years, and to identify relevant factors which can provide a reference for the reform of the health insurance payment system in rehabilitation department.Methods:Information on 16, 827 patients hospitalized in the rehabilitation department of The First Affiliated Hospital of Xi′an Jiaotong University between May 2018 and May 2024 was collected and subjected to non-parametric analysis.Results:The average hospitalization cost of rehabilitation department patients over the six years was Y14, 574.92±10, 524.79. During that time the proportion of the cost attributable to Western medicine decreased from 17.1% in 2018 to 7.6% in 2024. The proportion of the patients with hypertension was 51.94%, followed by diabetes mellitus (20.10%). Those with infections had the highest total hospitalization costs. Motor disorders were the most common dysfunction (59.02%), followed by speech disorders (17.45%). Patients with swallowing disorders had the highest hospitalization costs. After the payment system shifted from fee-for-service (FFS) to payment by diagnosis-related group (DRG) in 2023, the average daily inpatient expenditures for rehabilitation patients with all types of diseases gradually declined, reaching its lowest level in 2024.Conclusions:After the health insurance payments shifted from FFS to DRG, the proportion of in patients′ total drug costs decreased annually, and the average daily costs of patients with different types of diseases also decreased significantly, but the comprehensive service fee and diagnostic costs increased.

Objective:To analyze the changes in the costs of hospital rehabilitation after the reform of health insurance payments in the past 6 years, and to identify relevant factors which can provide a reference for the reform of the health insurance payment system in rehabilitation department.Methods:Information on 16, 827 patients hospitalized in the rehabilitation department of The First Affiliated Hospital of Xi′an Jiaotong University between May 2018 and May 2024 was collected and subjected to non-parametric analysis.Results:The average hospitalization cost of rehabilitation department patients over the six years was Y14, 574.92±10, 524.79. During that time the proportion of the cost attributable to Western medicine decreased from 17.1% in 2018 to 7.6% in 2024. The proportion of the patients with hypertension was 51.94%, followed by diabetes mellitus (20.10%). Those with infections had the highest total hospitalization costs. Motor disorders were the most common dysfunction (59.02%), followed by speech disorders (17.45%). Patients with swallowing disorders had the highest hospitalization costs. After the payment system shifted from fee-for-service (FFS) to payment by diagnosis-related group (DRG) in 2023, the average daily inpatient expenditures for rehabilitation patients with all types of diseases gradually declined, reaching its lowest level in 2024.Conclusions:After the health insurance payments shifted from FFS to DRG, the proportion of in patients′ total drug costs decreased annually, and the average daily costs of patients with different types of diseases also decreased significantly, but the comprehensive service fee and diagnostic costs increased.

Objective:To identify the risk factors for ascending aortic dilatation and develop a prediction model using LASSO-Logistic regression in patients with normally functioning bicuspid aortic valves（BAV）.Methods:Eight-four adult patients with BAV diagnosed as having normal valve function by transthoracic echocardiography who attended to the General Hospital of Ningxia Medical University between June 2024 and April 2025 were prospectively selected，there were 42 patients with ascending aortic dilatation and 42 patients without dilatation.The patients were divided into a training set（60 cases）and a test set（24 cases）using stratified random sampling at a ratio of 7 to 3 via the R caret package. All subjects underwent transthoracic echocardiography，lipid and plasma matrix metalloproteinases（MMP）and tissue inhibitors（TIMP）levels detection. The inverse probability of treatment weighting（IPTW）method was employed to control for potential confounding factors. LASSO and multifactorial binary Logistic regression was applied to screen the independent risk factors for ascending aortic dilatation of BAV and development a nomogram prediction model. The accuracy，consistency and clinical applicability of the prediction model were evaluated by applying the ROC curve，calibration curve，and decision curve analysis（DCA），respectively.Results:①After adjustment for IPTW，LASSO-Logistic regression analysis identified left ventricular global longitudinal strain（LVGLS）and plasma MMP-2 levels as independent risk factors for ascending aortic dilatation in BAV patients with normal valve function.②The nomogram prediction model constructed based on the above screening features，and the area under the curve（AUC）of ROC for the training set and test set were 0.917 and 0.903，with specificities of 0.867 and 0.917，and sensitivities of 0.933 and 0.916，respectively. ③Calibration curves demonstrated satisfactory alignment，with C-indices of 0.908（95% CI=0.879～0.937）for the training set and 0.903（95% CI=0.874 - 0.932）for the test set. Hosmer-Lemeshow goodness-of-fit tests indicated strong consistency between predicted and observed outcomes，with P-values of 0.138 and 0.750 for the training and test sets，respectively.The DCA curve demonstrated that within a threshold probability range of 0.04 - 0.90 in the test set，the clinical decision-making model provided a higher net benefit rate for patients with BAV. Conclusions:LVGLS absolute value reduction and elevated plasma MMP-2 levels are independent risk factors for predicting ascending aortic dilatation in BAV patients with normal valve function. The prediction model based on LASSO-Logistic regression has good predictive value，providing a scientific basis for clinical decision-making in patients with BAV and aortic diseases.

Purpose To quantitatively evaluate the change of left ventricular myocardial work in well-functioning bicuspid aortic valves(BAV)by using left ventricular pressure-strain ring technology,and to explore the correlation between aortic dilation and myocardial work.Materials and Methods A total of 65 patients with well-functioning BAVs admitted to General Hospital of Ningxia Medical University from June 2022 to June 2023 were selected and divided into two groups according to the adjusted inner diameter of the aorta by body surface area:aortic undilated group(35 cases,theaortic diameter<40 mm or aortic size index<22 mm/m2)and aortic dilation group(30 cases,aortic diameter≥40 mm or aortic size index>22 mm/m2),34 healthy patients were enrolled in our study as the control group.The study subjects were analyzed by echocardiography to obtain the left ventricular myocardial work[global longitudinal strain(GLS),global work index(GWI),global constructive work(GCW),global work efficiency(GWE),global wasted work(GWW)]and conventional two-dimensional ultrasound parameters,and the parameters between the three groups were compared and analyzed.Results Compared with the control group,the absolute value of GLS and GWE in the non-dilated aortic group and the aortic dilated group decreased,and the GWI,GCW,GWW,ascending aortic inner diameter and ascending aortic stiffness index were significantly increased(P<0.05).Compared with the non-dilated aortic group,the absolute value of GLS and GWE in the aortic dilation group decreased,and the aortic stiffness index and GWW increased,and the difference was statistically significant(t=-3.567,-2.219,5.266,3.339,all P<0.05).The internal diameter of the ascending aorta was negatively correlated with the absolute value of GLS and GWE(r=-0.219,-0.324,both P<0.001),and positively correlated with GWI,GCW,GWW and ascending aortic stiffness index(r=0.178,0.229,0.315,0.529,all P<0.001).Conclusion Myocardial work is a new method for early detection of subclinical left ventricular myocardial dysfunction in well-functioning BAV,and has potential application value for evaluating the changes in left ventricular myocardial work under the progression of aortic disease in BAV patients.

Purpose To quantitatively evaluate the change of left ventricular myocardial work in well-functioning bicuspid aortic valves(BAV)by using left ventricular pressure-strain ring technology,and to explore the correlation between aortic dilation and myocardial work.Materials and Methods A total of 65 patients with well-functioning BAVs admitted to General Hospital of Ningxia Medical University from June 2022 to June 2023 were selected and divided into two groups according to the adjusted inner diameter of the aorta by body surface area:aortic undilated group(35 cases,theaortic diameter<40 mm or aortic size index<22 mm/m2)and aortic dilation group(30 cases,aortic diameter≥40 mm or aortic size index>22 mm/m2),34 healthy patients were enrolled in our study as the control group.The study subjects were analyzed by echocardiography to obtain the left ventricular myocardial work[global longitudinal strain(GLS),global work index(GWI),global constructive work(GCW),global work efficiency(GWE),global wasted work(GWW)]and conventional two-dimensional ultrasound parameters,and the parameters between the three groups were compared and analyzed.Results Compared with the control group,the absolute value of GLS and GWE in the non-dilated aortic group and the aortic dilated group decreased,and the GWI,GCW,GWW,ascending aortic inner diameter and ascending aortic stiffness index were significantly increased(P<0.05).Compared with the non-dilated aortic group,the absolute value of GLS and GWE in the aortic dilation group decreased,and the aortic stiffness index and GWW increased,and the difference was statistically significant(t=-3.567,-2.219,5.266,3.339,all P<0.05).The internal diameter of the ascending aorta was negatively correlated with the absolute value of GLS and GWE(r=-0.219,-0.324,both P<0.001),and positively correlated with GWI,GCW,GWW and ascending aortic stiffness index(r=0.178,0.229,0.315,0.529,all P<0.001).Conclusion Myocardial work is a new method for early detection of subclinical left ventricular myocardial dysfunction in well-functioning BAV,and has potential application value for evaluating the changes in left ventricular myocardial work under the progression of aortic disease in BAV patients.

Objective:To identify the risk factors for ascending aortic dilatation and develop a prediction model using LASSO-Logistic regression in patients with normally functioning bicuspid aortic valves（BAV）.Methods:Eight-four adult patients with BAV diagnosed as having normal valve function by transthoracic echocardiography who attended to the General Hospital of Ningxia Medical University between June 2024 and April 2025 were prospectively selected，there were 42 patients with ascending aortic dilatation and 42 patients without dilatation.The patients were divided into a training set（60 cases）and a test set（24 cases）using stratified random sampling at a ratio of 7 to 3 via the R caret package. All subjects underwent transthoracic echocardiography，lipid and plasma matrix metalloproteinases（MMP）and tissue inhibitors（TIMP）levels detection. The inverse probability of treatment weighting（IPTW）method was employed to control for potential confounding factors. LASSO and multifactorial binary Logistic regression was applied to screen the independent risk factors for ascending aortic dilatation of BAV and development a nomogram prediction model. The accuracy，consistency and clinical applicability of the prediction model were evaluated by applying the ROC curve，calibration curve，and decision curve analysis（DCA），respectively.Results:①After adjustment for IPTW，LASSO-Logistic regression analysis identified left ventricular global longitudinal strain（LVGLS）and plasma MMP-2 levels as independent risk factors for ascending aortic dilatation in BAV patients with normal valve function.②The nomogram prediction model constructed based on the above screening features，and the area under the curve（AUC）of ROC for the training set and test set were 0.917 and 0.903，with specificities of 0.867 and 0.917，and sensitivities of 0.933 and 0.916，respectively. ③Calibration curves demonstrated satisfactory alignment，with C-indices of 0.908（95% CI=0.879～0.937）for the training set and 0.903（95% CI=0.874 - 0.932）for the test set. Hosmer-Lemeshow goodness-of-fit tests indicated strong consistency between predicted and observed outcomes，with P-values of 0.138 and 0.750 for the training and test sets，respectively.The DCA curve demonstrated that within a threshold probability range of 0.04 - 0.90 in the test set，the clinical decision-making model provided a higher net benefit rate for patients with BAV. Conclusions:LVGLS absolute value reduction and elevated plasma MMP-2 levels are independent risk factors for predicting ascending aortic dilatation in BAV patients with normal valve function. The prediction model based on LASSO-Logistic regression has good predictive value，providing a scientific basis for clinical decision-making in patients with BAV and aortic diseases.

OBJECTIVE To explore the effects of isorhamnetin on the development of gastric cancer through up-regulation of solute carrier family 25 member 25 antisense RNA 1(SLC25A25-AS1).METHODS Using BALB/c nude mice as the subjects,the xenograft tumor model was established by subcutaneously inoculating human gastric cancer MKN28 cells into the axillary region.The effects of low and high doses of isorhamnetin(20 and 40 mg/kg)on the tumor volume and mass in nude mice were investigated.MKN28 cells were selected and divided into control group,isorhamnetin group(70 μmol/L,similarly hereinafter),isorhamnetin+knocking down negative control group,isorhamnetin+knocking down SLC25A25-AS1 group,isorhamnetin+overexpression negative control group and isorhamnetin+overexpressing SLC25A25-AS1 group.Effects of knocking down/overexpressing SLC25A25-AS1 on viability,apoptosis,migration and invasion ability of isorhamnetin-treated cells were detected.After verifying the targeting relationships between microRNA-212-3p(miR-212-3p)and SLC25A25-AS1,as well as phosphatase and tensin homologue deleted on chromosome 10(PTEN),the effects of knocking down/overexpressing SLC25A25-AS1 on the expression of miR-212-3p,PTEN mRNA,and PTEN protein in isorhamnetin-treated cells were investigated.RESULTS Compared with the model control group,tumor volume and mass of nude mice in the isorhamnetin low-dose and high-dose groups were reduced significantly,and the isorhamnetin high-dose group was significantly lower than the isorhamnetin low-dose group(P＜0.05).miR-212-3p had targeting relationships with SLC25A25-AS1 and PTEN.Compared with the control group,the cell viability(intervened for 24,48 h),migration number,invasion number and miR-212-3p expression of cells in the isorhamnetin group,isorhamnetin+knocking down negative control group and isorhamnetin+overexpressing negative control group were significantly reduced or decreased or down-regulated,while the apoptosis rate,mRNA and protein expressions of PTEN were significantly increased or up-regulated(P＜0.05).Compared with isorhamnetin group and isorhamnetin+knocking down negative control group,the cell viability,migration number,invasion number and miR-212-3p expression of cells in the isorhamnetin+knocking down SLC25A25-AS1 group were significantly increased or up-regulated,while the apoptosis rate,mRNA and protein expressions of PTEN were significantly reduced or down-regulated(P＜0.05).Compared with isorhamnetin group and isorhamnetin+overexpressing negative control group,the cell viability,migration number,invasion number and miR-212-3p expression of cells in isorhamnetin+overexpressing SLC25A25-AS1 group were significantly reduced or decreased or down-regulated,while the apoptosis rate,PTEN mRNA and protein expressions were significantly increased or up-regulated(P＜0.05).CONCLUSIONS Isorhamnetin may inhibit the development of gastric cancer by up-regulating the expression of SLC25A25-AS1,down-regulating miR-212-3p,and up-regulating the expression of PTEN,which is a downstream target of miR-212-3p.

Purpose To assess the right atrial and right ventricular strain and right ventricular-pulmonary artery(RV-PA)coupling in rheumatoid arthritis(RA)via two-dimensional speckle tracking.Materials and Methods Sixty patients with RA in the General Hospital of Ningxia Medical University from June 2020 to June 2022 were prospectively selected,and all RA patients were divided into three groups according to pulmonary artery systolic pressure(PASP),including group A(n=20 cases)with PASP<33 mmHg,group B(n=20 cases)with PASP 33-39 mmHg as mild ePH,and group C(n=20 cases)PASP≥40 mmHg,twenty healthy individuals were selected as the control group.All subjects underwent transthoracic echocardiography,and right atrial and right ventricular systolic function was assessed by two-dimensional speckle tracking technique,and RV-PA coupling was assessed noninvasively by right ventricular free wall strain/pulmonary artery systolic pressure(RV FWS/PASP),pulmonary function was analyzed by pulmonary function instruments.Spearman's analysis was used to analyze the correlation between right heart function and RV-PA coupling to pulmonary diffusion function.Results There were statistical differences in right ventricular base diameter,right atrium diameter,tricuspid annular plane systolic excursion,inferior vena cava diameter,PASP,right ventricular global strain,RV FWS,right atrium strain-reservoi,right atrium strain-conduit(S-CD),RV FWS/PASP among the four groups(F/H=2.369-74.880,all P<0.05).Right atrium strain-reservoi[(36.0±7.9)%vs.(30.9±7.8)%],right atrium S-CD[(19.9±6.9)%vs.(15.3±4.7)%]and RV FWS/PASP(0.96±0.19 vs.0.56±0.13)in group B were significantly lower than those of group A(t=2.040,2.262,7.704,all P<0.05).There was a good correlation between diffusing capacity of the lung for carbon monoxide single-breathmethod and right ventricular global strain,RV FWS,right atrium S-CD and RV FWS/PASP in RA patients(r=0.392,0.472,0.431,0.572,all P<0.05).Conclusion The more increases of pulmonary artery pressures,the more decreases of right heart function in RA patients,and the more uncoupling in RV-PA.Right heart dysfunction and right ventricle-pulmonary artery uncoupling have developed in RA patients with PASP 33-39 mmHg,with association of pulmonary diffusion dysfunction.

Objective To observe the value of left atrial strain combined with electrocardiogram(ECG)P-wave parameters for predicting recurrence of paroxysmal atrial fibrillation(PAF)after pulmonary vein isolation(PVI)using radiofrequency catheter.Methods Totally 88 PAF patients who planned to receive the first PVI were prospectively enrolled and divided into recurrence group(n=30)and non-recurrence group(n=58)according to results of ECG within 6 months after PVI.The patients'basic data,the transthoracic echocardiography(TTE)parameters,including left atrial reservoir strain(LASr),left atrial conduct strain(LAScd)and left atrial contraction strain(LASct),as well as ECG parameters including P-wave duration,PR interval and P/PR(the ratio of P-wave duration to PR interval)were compared between groups.Multivariate logistic regression analysis was performed of parameters being statistically different between groups to screen independent predictors for recurrence of PAF after PVI.The receiver operating characteristic curve and the area under the curve(AUC)were used to evaluate the predicting efficacy of individual independent predictors alone and their combination,and DeLong test was used for comparison.Results No significant difference of patients'basic data was found between groups(all P＞0.05).Compared with those in non-recurrence group,LASr and LAScd decreased while P/PR increased in recurrent group(all P＜0.05).LASr(OR=0.805),LAScd(OR=0.850)and P/PR(OR=1.119)were all independent predictors for recurrence of PAF after PVI(all P＜0.05),with AUC of 0.755,0.643 and 0.771,respectively,all lower than their combination(AUC=0.869)(all P＜0.05).Conclusion TTE and ECG parameters could be used to predict recurrence of PAF after PVI.The predicting efficacy of the combination of LASr,LAScd and P/PR was better than that of each alone.