BACKGROUND:Wogonin is a flavonoid extracted from the root of Scutellaria baicalensis.Previous studies have shown that baicalein has protective effects against cerebral ischemia-reperfusion injury,and can also reduce blood sugar and complications in diabetic mice,but its role and mechanism in diabetic cerebral infarction remain unclear. OBJECTIVE:To explore the effect of wogonin on nerve injury in rats with diabetic cerebral infarction and its mechanism. METHODS:Sprague-Dawley rats were randomly divided into six groups:control group,model group,low-dose wogonin group,medium-dose wogonin group,high-dose wogonin group,and high-dose wogonin+Ras homolog gene family member A(RhoA)activator group.Except for the control group,the other rats were established with diabetes and cerebral ischemia models using intraperitoneal injection of streptozotocin and middle cerebral artery occlusion.Low,medium-and high-dose wogonin groups were intragastrically given 10,20,40 mg/kg wogonin,respectively;high-dose wogonin+RhoA activator group was intragastrically given 40 mg/kg wogonin and intraperitoneally injected 10 mg/kg lysophosphatidic acid;control group and model group were given the same amount of normal saline once a day for 7 consecutive days.Rats in each group were evaluated for neurological deficits and their blood glucose levels were measured after the last dose.TTC staining was applied to detect the volume of cerebral infarction.Hematoxylin-eosin staining was applied to observe pathological changes in brain tissue.ELISA kit was applied to detect tumor necrosis factor-α,interleukin-6,malondialdehyde,and superoxide dismutase levels in brain tissue.Western blot was applied to detect the protein expression of RhoA and Rho-associated protein kinase(ROCK)2 in brain tissue. RESULTS AND CONCLUSION:Compared with the control group,the neuronal structure of rats in the model group was severely damaged,with cell necrosis and degeneration,the neurological deficit score,blood glucose level,and infarct volume were significantly elevated(P<0.05),the levels of tumor necrosis factor-α,interleukin-6,and malondialdehyde,and the protein expression of RhoA and ROCK2 in brain tissue were significantly increased(P<0.05),and the superoxide dismutase level was decreased(P<0.05).Compared with the model group,the low-,medium-,and high-dose wogonin groups showed improved neuronal damage,reduced cell degeneration and necrosis,a significant reduction in neurological deficit score,blood glucose level,infarct volume,and the levels of tumor necrosis factor-α,interleukin-6,and malondialdehyde,and the protein expression of RhoA and ROCK2 in brain tissue,and an increase in the superoxide dismutase level(P<0.05).Compared with the high-dose wogonin group,the high-dose wogonin+RhoA activator group significantly weakened the improvement in the above indexes of rats with diabetic cerebral infarction(P<0.05).To conclude,wogonin can improve the blood glucose level in rats with diabetic cerebral infarction,reduce cerebral infarction and nerve injury,and its mechanism may be related to the inhibition of RhoA/ROCK signaling pathway.

Aim To analyze the correlation between serum retinol-binding protein 4(RBP4),low density lipo-protein cholesterol to albumin ratio(LDLC/Alb),monocyte to high density lipoprotein ratio(MHR)and plaque stability in carotid atherosclerosis population and their predictive value for acute ischemic stroke(AIS).Methods A total of 197 patients with asymptomatic carotid atherosclerosis admitted to our hospital from September 2021 to January 2023 were selected for a prospective cohort study,and they were categorized into occurred group and non-occurred group according to whether AIS occurred within 12 months.Baseline information at time of visit,results of the cervical ultrasonography and serum RBP4,LDLC/Alb,MHR levels were compared between the two groups.Spearman/Pearson and receiver operating characteristic(ROC)curve were used to analyze the corr-elation of RBP4,LDLC/Alb and MHR with carotid atherosclerosis and plaque stability,and the value of predicting AIS in carotid atherosclerosis population.Hosmer-Lemeshow goodness of fit test was used to evaluate the calibration ability of serum RBP4,LDLC/Alb and MHR to jointly predict AIS in carotid atherosclerosis population.Results The carotid intima-media thickness(IMT)was higher in occurred group than that in non-occurred group.There were more soft plaques and mixed plaques in occurred group than in non-occurred group(P＜0.05).Serum levels of RBP4,LDLC/Alb and MHR were higher in occurred group than those in non-occurred group(P＜0.05).The correlation analysis showed that the levels of serum RBP4,LDLC/Alb and MHR were positively correla-ted with IMT(r=0.803,0.740,0.710)and plaque properties(r=0.736,0.685,0.703)(P＜0.001).ROC curve a-nalysis showed that the AUC of serum RBP4,LDLC/Alb and MHR in predicting AIS in carotid atherosclerosis population was 0.796,0.821 and 0.828,respectively,and the AUC of MHR was the largest;the AUC of the combination of serum RBP4,LDLC/Alb and MHR was 0.936,which was higher than that of MHR(Z=2.978,P＜0.05),the predictive sensi-tivity and specificity were 88.24％and 87.40％.Hosmer-Lemeshow goodness of fit test showed that there was no signifi-cant difference between serum RBP4,LDLC/Alb and MHR in predicting AIS and the actual observation value in carotid atherosclerosis population(P＞0.05),and the prediction model had good calibration ability.Conclusion Serum RBP4,LDLC/Alb,and MHR are positively correlated with carotid atherosclerosis and plaque stability,and can predict the occurrence of AIS.Combined detection of the three can be used as a method for early identification of potential high-risk populations for AIS,providing a new,quantifiable guidance scheme for the prevention and treatment of AIS in carotid ath-erosclerotic population.

Objective To investigate the efficacy of cannabidiol(CBD)in improving renal function and protecting the kidney in mice with unilateral ureteral obstruction(UUO).Methods A total of 24 healthy,8-week-old,WTC57BL/6 male mice were divided into the Sham group,UUO group and UUO+CBD group,with 8 rats in each group.The UUO models were established by ligating one side of the ureter and removing the contralateral kidney to ensure unilateral kidney hydronephrosis.In the UUO+CBD group,5 mg/kg CBD was intraperitoneally injected immediately after the operation,once a day for 10 days.The Sham and UUO groups were given the same amount of normal saline.Blood sample was collected through the inner canthus venous plexus of the orbit 24 hours after the last administration.The levels of serum creatinine(Scr),blood urea nitrogen(BUN),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),superoxide dismutase(SOD),and malondialdehyde(MDA)were detected with an automatic biochemistry analyzer.The histopathological sections were prepared,the pathological changes of renal tissues were observed under a light microscope,and the pathological injuries were scored.Mitochondrial quantity and morphological structure changes were observed with a transmission electron microscopy.Results Compared with the Sham group,the UUO group exhibited significantly higher levels of Scr[(22.55±3.29)μmol/L vs.(12.11±3.32)μmol/L],BUN[(18.62±2.15)mmol/L vs.(10.05±1.19)mmol/L],TNF-α[(21.04±2.56)pg/mL vs.(9.26±0.47)pg/mL],IL-1β[(10.25±1.25)pg/mL vs.(5.44±0.99)pg/mL],and MDA[(31.26±1.17)nmol/mL vs.(17.12±1.39)nmol/mL],but significantly lower level of SOD[(90.26±2.11)U/mL vs.(136.54±3.05)U/mL],all P＜0.000 1.Compared with the UUO group,the UUO+CBD group showed a significant decrease in the levels of Scr[(16.82±0.89)μmol/L vs.(22.55±3.29)μmol/L],BUN[(14.35±0.99)mmol/L vs.(18.62±2.15)mmol/L],TNF-α[(16.29±0.88)pg/mL vs.(21.04±2.56)pg/mL],IL-1β[(6.23±0.95)pg/mL vs.(10.25±1.25)pg/mL],MDA[(20.36±1.23)nmol/mL vs.(31.26±1.17)nmol/mL],and renal pathological damage score[(1.88±0.64)vs.(2.50±0.76)],but a significant increase in SOD level[(117.84±1.57)U/mL vs.(90.26±2.11)U/mL],all P＜0.000 1.Under electron microscopy,mitochondrial swelling,loss of inner membrane structure,and membrane rupture were observed in the UUO group,while the UUO+CBD group showed milder morphological changes.Conclusion CBD improves renal function in UUO model mice through anti-inflammatory,antioxidant and mitochondrial protection,and is a potential therapeutic drug for renal protection in clinic.

Objective:To investigate the effect of immune cells in blood and PD-L1 expression in tissues on prognosis of patients with post-surgery of advanced adenocarcinoma of esophagogastric junction(AEGJ)and hyperthermic intraperitoneal chemotherapy(HIPEC)treatment,and to explore the relationship between immune cells and PD-L1 level in patients with post-surgery and HIPEC treatments.Methods:A total of 46 patients with advanced AEGJ surgery and adjuvant HIPEC in the First Affiliated Hospital of Hebei North University from January 2018 to June 2019 were enrolled.Transcriptome sequencing technology was used to examine levels of blood immune cells in patients with AEGJ postoperative adjuvant HIPEC.Immunohistochemistry was applied to detect expression of PD-L1 in tissues of AEGJ,and corresponding statistical methods were used to observe the prediction of immune cells and PD-L1 levels on prognosis of patients with AEGJ,and correlation with each other.Results:As of June 30,2022,the cancer-specific survival rate(CSS),relapse free survival rate(RFS),median CSS and median RFS were 28.26％,45.65％,31 months and 24 months,respective-ly.Positive expression of PD-L1 was 52.17％,ratios of RFS and CSS between positive and negative level of PD-L1 were 16.67％,77.27％and 54.17％,90.91％,respectively;the median time of RFS(12 months vs 37 months)and CSS(24 months vs 37 months)in PD-L1 positive expression was less than those in PD-L1 negative expression separately.A total of 22 kinds of immune cells were exam-ined in this study,compared with CPS<1 group,levels of CD8+T cells,dendritic cells activated and resting NK cells were significantly decreased in CPS≥1 group(all P<0.05),while M2 macrophages in the former group were lower than those in the latter group(0.013±0.012 vs 0.033±0.003,P<0.001).Results of ROC curve showed that CD8+T cells and M2 macrophages were predictor of patients with AEGJ treatments prognosis(AUC=0.690 and 0.698,respectively).COX multivariate regression analysis revealed that CD8+T cell was an independent protective factor for CSS of AEGJ and HIPEC[HR=0.590,95％CI(0.248～0.7080],while M2 macrophage was the risk factors for AEGJ and HIPEC[HR=6.448,95％CI(1.440～9.165)].Positive expression of PD-L1 was positively correlated with level of M2 macrophages(R=0.44,P<0.01),while negatively associated with level of CD8+T cells(R=-0.47,P<0.05).Conclusion:Adjuvant HIPEC therapy maybe regulate the function of M2 macrophage and CD8+T cells,among which the level of M2 macrophage is positively related to PD-L1 expression.The increasing of M2 macrophage cells may be the risk factor for the prognosis of AEGJ patients with surgery and HIPEC-treatment.

Objective To investigate the expression levels and clinical significance of B7 homolog 3(B7-H3),peroxiredoxin 1(PRDX1),and thioredoxin(TRX)in the serum and tissues of patients with ulcerative colitis(UC)and UC-associated colorectal cancer(UC-CRC).Methods A total of 108 patients with UC who underwent examination in our hospital between January 2019 and December 2023 were enrolled in the UC group.Additionally,108 patients with UC-CRC who were examined in our hospital were included in the UC-CRC group.Furthermore,108 individuals without any abnormalities detected during colonoscopy were recruited as the control group.The serum levels of B7-H3,PRDX1,and TRX were quantified using enzyme-linked immunosorbent assay(ELISA).The expression of B7-H3,PRDX1,and TRX in tissues from UC-CRC and UC patients was assessed by immunohis-tochemistry.The diagnostic performance of serum B7-H3,PRDX1,and TRX levels for UC-CRC was evaluated by constructing receiver operating characteristic(ROC)curves.Results Compared with the control group,the serum expression levels of B7-H3,PRDX1,and TRX in both the UC group and the UC-CRC group were significantly elevated in sequence(P<0.05).In comparison to the resting UC group,the serum expression levels of B7-H3,PRDX1,and TRX in the episodic UC group also increased significantly(P<0.05).Furthermore,compared with UC patients,the positive expression rates of B7-H3,PRDX1,and TRX in the tissues of UC-CRC patients were markedly higher(P<0.05).The combination of serum B7-H3,PRDX1,and TRX demonstrated the highest AUC for diagnosing UC-CRC patients,outperforming the individual diagnostic performance of each biomarker(Z combination-B7-H3=2.829,P=0.005,Z combination-PRDX1=2.544,P=0.011,Z combination-TRX=3.673,P<0.001).Conclusion B7-H3,PRDX1,and TRX are significantly overexpressed in both the serum and tissues of UC-CRC patients,and their combined evaluation holds potential as a diagnostic tool for detecting the development of UC-CRC.

Objective:To investigate the role of adenosine triphosphatase phospholipid transporter 10a(ATP10a)methylation assay in the triage of atypical squamous cell of undetermined significance(ASC-US)and low-grade squamous intraepithelial lesions(LSIL)in cervical cytology.Methods:188 patients with cervical exfolia-ted cells of ASC-US and LSIL were selected,and High-risk human papilloma virus(HR-HPV)typing and cervical biopsy results of the patients were collected at the same time.The cervical biopsy pathology results were used as the gold standard,and they were divided into inflammation,LSIL,high grade squamous intraepithelial lesions(HSIL)and cervical squamous cell carcinoma(SCC).Classify inflammation and LSIL as LSIL-group,HSIL and SCC as HSIL+group to compare the efficacy of ATP10a methylation and HR-HPV testing for diagnosis of HSIL+in this population(including HSIL and SCC).Results:The methylation detection value of ATP10a in the inflam-mation,LSIL,HSIL,and SCC patients were 19.035(16.478,20.823),13.446(5.890,20.674),10.336(4.733,17.336),4.223(1.713,7.754),respectively.The methylation detection value of ATP10a in the LSIL-group was 17.812(10.787,20.686),while that in the HSIL+group was 7.251(3.170,14.194).There was a statistically sig-nificant difference between the groups(Z=-5.824,P＜0.001).The proportion of HR-HPV positivity in the LSIL-group was 70.9％,which was lower than that of the HSIL+group(88.2％),and the difference was statistically significant(Z=-2.887,P=0.004).The specificity,negative predictive value(NPV),and area under the receiver operating characteristic(ROC)curve(AUC)of ATP10A methylation diagnosis of HSIL+(66.0％,79.1％,and 0.747)were higher than those of HR-HPV detection(29.1％,50.7％,0.587).Sensitivity and positive predictive value(PPV)(78.8％and 65.7％)were lower than those of HR-HPV testing(88.2％and 75.0％).when using ATP10a methylation instead of HR-HPV detection for triage of cytological abnormalities(ASC-US,LSIL),the col-poscopy referral rate could be reduced to 54.3％.In the ASC-US population,the AUC(0.683)for the diagnosis of HSIL+by ATP10a methylation test was higher than that of HR-HPV test(0.599),and the difference was statisti-cally significant(P=0.028).In the LSIL population,the AUC(0.828)for the diagnosis of HSIL+by ATP10a methylation test was still higher than that of HR-HPV test(0.563),and the difference was statistically significant(P=0.005).Conclusions:ATP10a methylation levels increased with the severity of cervical lesions,and the di-agnostic efficacy of ATP10a methylation detection for the severity of cervical lesions may not be lower than HR-HPV typing.

Objective To investigate the potential mechanism of tumor-derived exosome miR-3173-5p promoting the activation of cancer-associated fibroblasts(CAFs)and regulating the proliferation,invasion and apoptosis of non-small cell lung cancer(NSCLC)cells.Methods Exosome(Exo)of NSCLC cell A549 was extracted,the morphology of Exo was observed by transmission electron microscopy,and the expression of Exo marker protein was detected by Western blot.Real-time quantitative fluorescent PCR(qRT-PCR)was used to detect the expression of miR-3173-5p in A549 cells and Exo.The binding of miR-3173-5p to F-box/WD-40 domain protein11(FBXW11)was predicted by Starbase database,and verified by luciferase reporter gene analysis.Human lung fibroblast cell line(MRC-5)was treated with Exo and Exo inhibitor GW4869 or NC inhibitor/mimic or miR-3173-5p inhibitor/mimic and/or FBXW11 overexpression/empty vector,NC group,Exo group,Exo+GW4869 group,Exo-NC inhibitor group,Exo-miR-3173-5p inhibitor group,Exo-NC mimic group,Exo-miR-3173-5p mimic group,Exo-miR-3173-5p mimic+Vector group and Exo-miR-3173-5p mimic+FBXW11 group were set up respectively.The level of CAFs marker protein[Matrix metalloproteinase-9(MMP-9),α-Smooth muscle aorta(α-SMA),Chemokine(C-X-C motif)ligand 12(CXCL12),Fibronectin,Vimentin,Interleukin-1β(IL-1β),Interleukin-6(IL-6),Interleukin-8(IL-8)]in cells of each group was detected by Western blot analysis,and the influence of exosome miR-3173-5p and FBXW11 expression on CAFs activation was analyzed.Exo and Exo-miR-3173-5P mimic were separated and the supernatant of MRC-5 cells incubated with Exo-FBXW11 was used as conditioned medium(CM)to culture A549 cells.The NC-CM group,Exo-CM group,Exo-miR-3173-5p mimic-CM group and Exo-FBXW11-CM group were set up respectively.MTT assay,Transwell assay and flow cytometry were used to detect the effects of CAFs activation on proliferation,invasion and apoptosis of NSCLC cells.Results Transmission electron microscopy showed that the diameter of exosomal vesicles derived from NSCLC cells was about 30～100 nm.Western blot analysis showed that all exosome labeled proteins were positive.The expression of miR-3173-5p(33.45±3.16)in NSCLC-derived exosomes was significantly higher than that in tumor cells(1.01±0.07),and the difference was statistically significant(t=1.263,P<0.001).MiR-3173-5p targets FBXW11 and inhibits its expression.Compared with NC group,CAFs marker protein levels in Exo group were significantly increased(t=12.214～24.908),the expression of CAFs marker protein in Exo+GW4869 group was significantly inhibited compared with Exo group(t=13.160～25.143),the differences were statistically significant(all P<0.01),respetively.Compared with Exo group,miR-3173-5p inhibitor inhibited EXO-induced CAFs marker protein expression(t=11.059～21.094),and miR-3173-5p mimic promoted the expression of CAFs marker protein(t=12.943～18.671),the differences were statistically significant(all P<0.01),respectively.Overexpression of FBXW11 reversed the induction of CAFs activation by miR-3173-5p mimic.Compared with the NC-CM group,the proliferation activity and invasion rate of A549 cells in the Exo-CM group were significantly enhanced,and the apoptosis rate was significantly inhibited(t=10.207,2.359,3.001),miR-3173-5p mimic enhanced the promoting effect of Exo-CM on proliferation and invasion of A549 cells and the inhibitory effect on apoptosis(t=9.399,3.438,3.208),while overexpression of FBXW11 can antagonize the promotion effect of Exo-CM on proliferation and invasion of A549 cells and the inhibition effect on apoptosis(t=18.868,7.070,9.813),the differences were statistically significant(all P<0.05),respectively.Conclusion Tumor-derived exosome miR-3173-5p promotes CAFs activation through targeted inhibition of FBXW11 expression,further promotes proliferation and invasion of NSCLC cells,inhibits cell apoptosis,and regulates the occurrence and development of NSCLC.

Objective To explore the role and mechanism of miR-381 in the pathogenesis of ischemic stroke(IS).Methods A total of 90 patients with IS treated in the First Affiliated Hospital of Hebei North University between January 2020 and December 2022 were selected as the IS group,while 110healthy volunteers were selected as the control group.Real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)was used to detect the difference of serum miR-381 between the two groups,and enzyme-linked immu-nosorbent assay(ELISA)was used to measure the differences of inflammatory markers interleukin-1β(IL-1β),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)between the groups.The CCK-8 assay was used to evaluate the effect of miR-381 on the ac-tivity of human umbilical vein endothelial cell(HUVEC).Use TargetScan,Western blot and luciferase reporter assays to validate whether inhibitor of kappa B kinase(IKK)was a target gene regulated by miR-381.An in vitro model of oxygen-glucose deprivation(OGD)was constructed,and the effects of miR-381 over-expression or inhibition on apoptosis-and inflammation-related proteins were de-tected by RT-qPCR and Western blot.The diagnostic value of miR-381 for IS was evaluated using receiver operating characteristic curve(ROC).Results Compared with the control group,the serum miR-381 levels in the IS group were significantly down-regulated(P＜0.05).In comparison to the mild IS group or small infarct volume group,serum miR-381 levels were significantly lower in patients with moderate to severe IS or large infarct volumes(P were＜0.05,＜0.01).Additionally,compared with the control group,the serum levels of IL-1 β,IL-6 and TNF-α in the IS group were significantly higher(P were＜0.01,＜0.05,＜0.01).Furthermore,com-pared to the mild IS group or small infarct volume group,the serum levels of IL-1 β,IL-6,and TNF-α were significantly elevated in patients with moderate to severe IS group or large infarct volume group(P were＜0.01,＜0.05).CCK-8 results indicated that miR-381 promoted the viability of HUVEC.Dual-Luciferase reporter gene assay results demonstrated that IKK was a direct target of miR-381.Western blot results showed that over-expression of miR-381 inhibited the activation of p65 and inhibitor of NF-κB(IKB)pro-teins,promoted the expression of the anti-apoptotic protein B-cell lymphoma 2(Bcl-2),and suppressed the expression of the pro-apoptotic protein Bcl-2 associated X(BAX).RT-qPCR results showed that over-expression miR-381 reduced the levels of NF-κB mRNA and BAX mRNA,and increased the levels of Bcl-2mRNA.ELISA results indicated that over-expression miR-381 decreased the serum levels of TNF-α,IL-6 and IL-1 β(P were＜0.05,＜0.01,＜0.01).ROC curve analysis showed that the sensitivity and specificity of miR-381 for diagnosing IS were 76.23％and 81.25％,respectively.Conclusion miR-381 can inhibit HUVEC apopto-sis and inflammatory responses by targeting IKK,indicating its potential as a therapeutic target for IS.

Objective:To explore the effect of remote motor imagery therapy on rehabilitation of patients with severe coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods:This randomized con-trolled study enrolled 164 patients with severe CHD undergoing PCI who admitted in the First Affiliated Hospital of Hebei North University between January 2022 and January 2024.Patients were divided into control group(n=82)and intervention group(n=82).Patients in the control group was given conventional home nursing intervention comparing to those in the intervention group receiving additional remote motor imagery therapy.Both groups were intervened for 8 weeks.Indexes of pain,psychological emotion,ability of daily living,motor function and fall were compared between two groups.Results:Compared to those in control group after intervention,patients in interven-tion group had significant lower scores of visual analogue scale(VAS)[(2.03±0.81)points vs.(5.14±0.84)points],the Hospital anxiety and depression scale(HADS)anxiety subscale(HADS-A)[(4.89±0.84)points vs.(9.05±0.78)points],HADS depression subscale(H ADS-D)[(5.31±1.10)points vs.(10.13±0.82)points],HADS total score[(10.20±1.39)points vs.(19.18±1.18)points](P＜0.001 all),and significant higher 6-min walking distance(6MWD)[(439.31±16.51)m vs.(364.94±12.76)m],peak oxygen uptake(VO2 peak)[(20.28±2.40)ml·kg-1·min-1 vs.(17.26±1.35)ml·kg-1·min-1],anaerobic threshold oxygen consumption(VO2AT)[(17.04±1.18)ml·kg-1·min-1 vs.(13.62±1.16)ml·kg-1·min-1],scores of Chinese modified Fall Efficacy Scale(MFES)[(107.28±4.84)points vs.(87.41±4.73)points],ability of daily living(ADL)scale[(78.95±3.92)points vs.(68.00±4.10)points]and Barthel index[(85.83±2.50)points vs.(69.79±3.42)points](P＜0.001 all).We detected significant lower incidence of falling(7.50％vs.21.25％)in the intervention group compared to control group(P=0.013).Conclusion:Remote motor imagery therapy may strengthen motor function and ability of daily living,and relieve pain and negative emotions in patients with severe CHD after PCI.

Objective The aim of this study is to investigate the plaque characteristics of different subtypes of middle cerebral artery(MCA)infarction,lenticulostriate artery(LSA)characteristics,and hemodynamic characteristics through high-resolution magnetic resonance vessel wall imaging(HR-MRI VWI)and perfusion weighted imaging(PWI).Methods A retrospective analysis was conducted on patients with unilateral acute or subacute MCA infarction who underwent HR-MRI VWI and PWI examinations at Qinhuangdao First Hospital from January 2022 to April 2024.Patients were divided into three groups according to the type of infarction:artery-to-artery embolism(AA),branch occlusive disease(BOD),branch occlusive disease and artery-to-artery embolism(BOD-AA).Clinical data,plaque characteristics,lenticulostriate artery characteristics,and hemodynamic characteristics were compared and analyzed among the three groups.To determine factors associated with BOD,the BOD and BOD-AA groups were merged into a BOD+group which was then compared with the AA group.To determine factors associated with the AA group,the BOD-AA and AA groups were combined into an AA+group,followed by comparison with the BOD group.Results A total of 42 patients with unilateral acute or subacute MCA infarction were included according to the inclusion and exclusion criteria.Among them,9 patients were classified as having AA,14 patients as having BOD,and 19 as having BOD-AA.The results showed that the degree of stenosis was higher in the AA+group than in the BOD group,and the difference was statistically significant(Z=-2.536,P<0.05);The number of LSA on the affected side was higher in the BOD+group than in the AA group[2.00(1.50,3.00)vs.3.00(3.00,4.00)],and the difference was statistically significant(Z=-2.889,P<0.05);The relative cerebral blood flow(rCBF)of the centrum semiovale was lower in the AA+group than in the BOD group[0.90(0.84,0.93)vs.0.99(0.97,1.03)],and the difference was statistically significant(Z=-4.555,P<0.05);The rCBF in the basal ganglia was lower in the BOD+group than in the AA group[0.89(0.83,0.93)vs.1.01(0.98,1.04)],and the difference was statistically significant(Z=-4.280,P<0.05).Conclusion Patients in BOD+have a lower degree of stenosis compared to AA group.The spatial relationship between plaques and LSA varies across different subtypes of MCA infarction.Plaques in BOD+patients are positioned closer to the LSA orifice and thus have a higher tendency to occlude the LSA orifice.The affected side has few LSAs and the rCBF in the LSA perfusion area.is lower.