AIM:This study aims to explore the effects and underlying mechanisms of caloric restriction(CR)on folic acid(FA)-induced acute kidney injury(AKI)in mice.METHODS:An AKI model was established by in-traperitoneal injection of FA(250 mg/kg).(1)Twenty male C57BL/6J mice(20～25 g)were randomly assigned to 4 groups(n=5):sham+ad libitum(AL),FA+AL,sham+CR,and FA+CR.The mice in CR groups were subjected to a 66%reduction in daily food intake within a limited feeding window for 2 weeks,while those in AL groups had unrestricted access to food.All mice had free access to water,and their body weight changes were monitored throughout the experi-ment.(2)An additional set of twenty male C57BL/6J mice were divided into 4 groups(n=5):control,A769662,FA,and FA+A769662.The AMP-activated protein kinase(AMPK)agonist A769662(30 mg/kg)was administered intraperito-neally for 3 d prior to FA injection.(3)Modeling of tubule-specific AMPK knockout(RT-AMPK-CKO)mice followed the same protocol as wild-type C57BL/6J mice.Blood and kidney tissues were harvested 48 h after FA injection.Serum creati-nine(SCr)and blood urea nitrogen(BUN)levels were measured using an automatic biochemical analyzer.The kidney pa-thology was examined by HE staining.The malondialdehyde(MDA)level and the reduced/oxidized glutathione(GSH/GSSG)ratio were assessed using assay kits.The protein levels of p-AMPK,AMPK,and ferroptosis-related markers were evaluated by Western blot and immunohistochemistry.RESULTS:(1)After 2 weeks,CR significantly reduced body weight and increased p-AMPK level compared with AL group(P<0.05).(2)Compared with FA+AL group,the mice in FA+CR and FA+A769662 groups exhibited notably lowered SCr and BUN levels,reduced expression of kidney injury mole-cule-1 and neutrophil gelatinase-associated lipocalin,lowered tubular injury scores,decreased long-chain fatty acid-CoA ligase 4(FACL4)and 4-hydroxynonenal levels,restored glutathione peroxidase 4(GPX4)expression,decreased MDA level,and enhanced GSH/GSSG ratio(P<0.05).(3)In the FA-induced renal injury model,RT-AMPK-CKO mice showed no significant differences compared with wild-type mice(P>0.05).However,in the FA+CR model,RT-AMPK-CKO mice failed to exhibit renal protection,with increased lipid peroxidation,elevated MDA level,and reduced GSH/GSSG ratio(P<0.05).Furthermore,CR-induced down-regulation of FACL4 and up-regulation of GPX4 were significantly reversed in RT-AMPK-CKO mice(P<0.05).CONCLUSION:The CR attenuates FA-induced AKI in mice by activating AMPK and inhibiting ferroptosis.

Objective:To characterize the epidemiology of respiratory syndrome across healthcare facilities of different types and tiers in Beijing City, to compare pathogen-testing modalities and their associations with adverse outcomes, and to identify key factors associated with progression to severe illness, thereby informing regional prevention, control, and clinical optimization.Methods:The multicenter observational cohort study was performed using outpatient and emergency department data from five sentinel hospitals in Beijing (Beijing Xiaotangshan Hospital, Beijing Chaoyang District Shuangqiao Hospital, Beijing Haidian Hospital, Beijing You′an Hospital, Capital Medical University (Beijing You′an Hospital), and Beijing Ditan Hospital, Capital Medical University (Beijing Ditan Hospital)) from October 1st, 2023 to April 9th, 2025. Dual-target (two-plex) and triple-target (three-plex) respiratory specimens were collected. Demographic characteristics, visit information, pathogen-testing modalities and results were collected, and the epidemiologic features of patients who progressed to severe illness between the influenza high-incidence season (December to May) and the non-influenza season (June to November) were compared. Categorical variables were analyzed using the chi-square test. Multivariable logistic regression was used to estimate associations between covariates and risk of progression to severe illness.Results:Among the 192 131 cases, patients visited at Beijing You′an Hospital were concentrated in the 16 to 44 year age group, accounting for 66.79%(32 532/48 708). Beijing Xiaotangshan Hospital had a broad age distribution, with older adults comprising up to 22.35% (885/3 960). Of the 47 349 respiratory specimens across the five hospitals, Beijing You′an Hospital had the highest positivity rate for dual-target testing (46.76%(1 585/3 390)), while Beijing Haidian Hospital conducted the largest number of this tests ( n=12 514). For triple-target testing, Beijing You′an Hospital again had the highest positivity rate (45.03%(2 835/6 296)), whereas Beijing Ditan Hospital tested the most specimens ( n=12 011; positivity rate was 29.73%(3 571/12 011)). The influenza season within the same period (November 2023 to January 2024) exhibited a bimodal pattern, with alternating circulation of influenza viruses and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Among 32 744 outpatients/emergency patients who progressed to severe illness, significant seasonal differences were observed by sex, age, comorbidity status, and infection type ( χ2=6.60, 189.24, 32.71 and 189.99, respectively; all P<0.05). After adjustment for sex, age group, comorbidities, and infection type, testing modality remained significantly associated with risk of progression (dual-target testing, odds ratio ( OR)=0.116, 95% confidence interval ( CI) 0.111 to 0.122, P<0.001); no testing, OR=0.063, 95% CI 0.060 to 0.065, P<0.001). Conclusions:The epidemiological pattern of respiratory pathogens undergo significant changes after October 2023, which is characterized by alternating waves of influenza viruses and SARS-CoV-2 with pronounced seasonality and diversity. Substantial inter-hospital differences are observed in testing modalities and positivity rates. Risk of progression to severe illness varies significantly by sex, age, comorbidity burden, and infection type, and is closely associated with the testing modality. These findings support strengthening multiplex pathogen testing and targeted surveillance of high-risk groups to improve early identification and precise control of febrile-respiratory syndromes.

AIM:To investigate the role and underlying mechanisms of NADPH oxidase 4(NOX4)/transient receptor potential channel subfamily C member 6(TRPC6)in the context of podocyte damage in diabetic nephropathya comprehensive investigative study was warranted.METHODS:(1)Male Sprague-Dawley rats were randomly divided in-to four distinct groups:a control group,a diabetic nephropathy group,a NOX4 inhibitor GKT137831-treated group,and a combined diabetic nephropathy with NOX4 inhibitor GKT137831-treated group,each consisting of 8～10 rats.The type 1 diabetes mellitus model was constructed via a single intraperitoneal injection of streptozotocin(STZ)(70 mg/kg),subse-quent to the successful induction of the model,GKT137831(at the dose of 5 mg/kg)was administered intraperitoneally.Regular monitoring of blood glucose levels was conducted,and urinary albumin excretion was quantified after 24 hours.Moreover,blood and kidney tissues were harvested for further analysis.(2)Mouse glomerular podocytes were divided into four distinct groups:a normal control group,a high glucose group,a GKT137831-treated group and a high glucose GKT137831-treated group.These podocytes were subsequently cultivated in vitro under high glucose conditions for 2 weeks.Thereafter,transfection of podocytes was carried out using NOX4 inhibitors and short interfering RNA targeting(siRNA)TRPC6.To detect the expression levels of NOX4 and TRPC6,a battery of techniques including Western blot,Immunohistochemistry,and reverse transcription polymerase chain reaction(RT-qPCR)were employed.(3)The morpho-logical changes of podocyte mitochondria under the condition of high glucose were observed by fluorescence confocal mi-croscopy,and the expression levels of peroxisome proliferator-activated receptor gamma coactivator 1α(PGC1α),mito-chondrial transcription factor A(TFAM),cytochromec oxidase subunit Ⅰ(COX Ⅰ)and cytochromec oxidase subunit Ⅳ(COX Ⅳ)in podocytes were assessed utilizing the Western blot technique.RESULTS:(1)Compared with normal con-trol group,mice with diabetic nephropathy manifested pronounced glomerular hypertrophy,thickening of basement mem-brane,expansion of the mesangial region,and an increased rate of urinary albumin excretion was observed.Analytical techniques such as Western blot and Immunohistochemistry showed a significant upsurge in the expression level of the NOX4 protein in kidney tissue,a diminished expression of glomerular podocyte protein(nephrin),an increased expression of interstitial cell markers(desmin),and an enhanced level of TRPC6 expression(P＜0.05).GKT137831 was assoiated with a reduction in desmin expression in renal tissue,preservation of glomerular nephrin expression,and a decrease in uri-nary albumin excretion(P＜0.05).(2)In vitro podocyte experiment,the expression of NOX4 and TRPC6 in podocyte was significantly increased in the context of high glucose(P＜0.05).Findings from Immunofluorescence and Western blot showed that GKT137831 effectively diminished the expression levels of TRPC6 and desmin while partially rescuing neph-rin expression in podocellular cells(P＜0.05).Western blot results showed that transfection of TRPC6 small interfering RNA could further promote the protective effect of GKT137831 on podiocytes.(3)Under high-glucose conditions,fluores-cence confocal microscopy revealed mitochondrial morphological damage in podocytes.However,therapeutic intervention with GKT137831 and transfection of TRPC6 siRNA partially rescued the mitochondrial structural integrity.Under high glucose conditions,immunoblot analysis demonstrated a marked decrement in the protein expression levels of PGC1α,TFAM,COX Ⅰ,and COX Ⅳ in podocytes.Importantly,GKT137831 and the transfection of TRPC6 siRNA significantly upregulated the levels of PGC1α,TFAM,COX Ⅰ,and COX Ⅳ(P＜0.05).CONCLUSION:In the context of the patho-genesis of diabetic nephropathy,the increased expression of NOX4 in the kidneys contributes to podocyte damage,with the effect being partially mediated via the TRPC6 channel.Inhibiting the NOX4-TRPC6 signaling pathway has the potential to ameliorate mitochondrial dysfunction in podocytes.This finding offers novel perspectives and strategies for the clinical di-agnosis and treatment of diabetic nephropathy.

Objective To explore the time-varying characteristics and correlation degree of autonomous rehabili-tation behavior and related symptoms of middle-aged stroke patients,and to provide a basis for clinical transitional nursing and precise rehabilitation.Methods Ecological momentary assessment was used to select 57 middle-aged stroke patients who underwent rehabilitation treatment in the Rehabilitation Medicine Department of a tertiary com-prehensive hospital in Wuhan from March 15 to August 30,2024,using convenience sampling method.Their au-tonomous rehabilitation behavior and related symptoms(fatigue,pain,emotion,sensation)were continuously monitored for 2 weeks.A hierarchical linear model was used to analyze the correlation between behavior and symptoms.Results The autonomous rehabilitation behavior of middle-aged stroke patients showed a fluctuating increasing trend,and the symptom score showed a slow decreasing trend.The hierarchical linear model showed that compared with female patients,male patients have longer duration of autonomous rehabilitation behavior(P＜0.05).The number and duration of autonomous rehabilitation behaviors in patients without fatigue were higher(P＜0.05).The number of autonomous rehabilitation behaviors in patients without pain was higher than that in patients with pain(P＜0.05).The number of autonomous rehabilitation behavior items among patients who perceived more pleasure in rehabilitation was higher than that among patients with greater difficulty in rehabilitation challenges(P＜0.05).Patients with high rehabilitation confidence have higher numbers and duration of autonomous rehabilitation behaviors compared to pa-tients with low rehabilitation confidence(P＜0.05).Conclusion There are significant individual differences and dy-namic changes in the autonomous rehabilitation behavior and related symptoms of middle-aged stroke patients.Nurs-ing staff should accurately implement personalized rehabilitation services during the transition period,enhance pa-tients'autonomy and self-management ability in home-based rehabilitation,in order to improve the overall rehabilita-tion effect.

Objective To explore the time-varying characteristics and correlation degree of autonomous rehabili-tation behavior and related symptoms of middle-aged stroke patients,and to provide a basis for clinical transitional nursing and precise rehabilitation.Methods Ecological momentary assessment was used to select 57 middle-aged stroke patients who underwent rehabilitation treatment in the Rehabilitation Medicine Department of a tertiary com-prehensive hospital in Wuhan from March 15 to August 30,2024,using convenience sampling method.Their au-tonomous rehabilitation behavior and related symptoms(fatigue,pain,emotion,sensation)were continuously monitored for 2 weeks.A hierarchical linear model was used to analyze the correlation between behavior and symptoms.Results The autonomous rehabilitation behavior of middle-aged stroke patients showed a fluctuating increasing trend,and the symptom score showed a slow decreasing trend.The hierarchical linear model showed that compared with female patients,male patients have longer duration of autonomous rehabilitation behavior(P＜0.05).The number and duration of autonomous rehabilitation behaviors in patients without fatigue were higher(P＜0.05).The number of autonomous rehabilitation behaviors in patients without pain was higher than that in patients with pain(P＜0.05).The number of autonomous rehabilitation behavior items among patients who perceived more pleasure in rehabilitation was higher than that among patients with greater difficulty in rehabilitation challenges(P＜0.05).Patients with high rehabilitation confidence have higher numbers and duration of autonomous rehabilitation behaviors compared to pa-tients with low rehabilitation confidence(P＜0.05).Conclusion There are significant individual differences and dy-namic changes in the autonomous rehabilitation behavior and related symptoms of middle-aged stroke patients.Nurs-ing staff should accurately implement personalized rehabilitation services during the transition period,enhance pa-tients'autonomy and self-management ability in home-based rehabilitation,in order to improve the overall rehabilita-tion effect.

AIM:This study aims to explore the effects and underlying mechanisms of caloric restriction(CR)on folic acid(FA)-induced acute kidney injury(AKI)in mice.METHODS:An AKI model was established by in-traperitoneal injection of FA(250 mg/kg).(1)Twenty male C57BL/6J mice(20～25 g)were randomly assigned to 4 groups(n=5):sham+ad libitum(AL),FA+AL,sham+CR,and FA+CR.The mice in CR groups were subjected to a 66%reduction in daily food intake within a limited feeding window for 2 weeks,while those in AL groups had unrestricted access to food.All mice had free access to water,and their body weight changes were monitored throughout the experi-ment.(2)An additional set of twenty male C57BL/6J mice were divided into 4 groups(n=5):control,A769662,FA,and FA+A769662.The AMP-activated protein kinase(AMPK)agonist A769662(30 mg/kg)was administered intraperito-neally for 3 d prior to FA injection.(3)Modeling of tubule-specific AMPK knockout(RT-AMPK-CKO)mice followed the same protocol as wild-type C57BL/6J mice.Blood and kidney tissues were harvested 48 h after FA injection.Serum creati-nine(SCr)and blood urea nitrogen(BUN)levels were measured using an automatic biochemical analyzer.The kidney pa-thology was examined by HE staining.The malondialdehyde(MDA)level and the reduced/oxidized glutathione(GSH/GSSG)ratio were assessed using assay kits.The protein levels of p-AMPK,AMPK,and ferroptosis-related markers were evaluated by Western blot and immunohistochemistry.RESULTS:(1)After 2 weeks,CR significantly reduced body weight and increased p-AMPK level compared with AL group(P<0.05).(2)Compared with FA+AL group,the mice in FA+CR and FA+A769662 groups exhibited notably lowered SCr and BUN levels,reduced expression of kidney injury mole-cule-1 and neutrophil gelatinase-associated lipocalin,lowered tubular injury scores,decreased long-chain fatty acid-CoA ligase 4(FACL4)and 4-hydroxynonenal levels,restored glutathione peroxidase 4(GPX4)expression,decreased MDA level,and enhanced GSH/GSSG ratio(P<0.05).(3)In the FA-induced renal injury model,RT-AMPK-CKO mice showed no significant differences compared with wild-type mice(P>0.05).However,in the FA+CR model,RT-AMPK-CKO mice failed to exhibit renal protection,with increased lipid peroxidation,elevated MDA level,and reduced GSH/GSSG ratio(P<0.05).Furthermore,CR-induced down-regulation of FACL4 and up-regulation of GPX4 were significantly reversed in RT-AMPK-CKO mice(P<0.05).CONCLUSION:The CR attenuates FA-induced AKI in mice by activating AMPK and inhibiting ferroptosis.

AIM:To investigate the role and underlying mechanisms of NADPH oxidase 4(NOX4)/transient receptor potential channel subfamily C member 6(TRPC6)in the context of podocyte damage in diabetic nephropathya comprehensive investigative study was warranted.METHODS:(1)Male Sprague-Dawley rats were randomly divided in-to four distinct groups:a control group,a diabetic nephropathy group,a NOX4 inhibitor GKT137831-treated group,and a combined diabetic nephropathy with NOX4 inhibitor GKT137831-treated group,each consisting of 8～10 rats.The type 1 diabetes mellitus model was constructed via a single intraperitoneal injection of streptozotocin(STZ)(70 mg/kg),subse-quent to the successful induction of the model,GKT137831(at the dose of 5 mg/kg)was administered intraperitoneally.Regular monitoring of blood glucose levels was conducted,and urinary albumin excretion was quantified after 24 hours.Moreover,blood and kidney tissues were harvested for further analysis.(2)Mouse glomerular podocytes were divided into four distinct groups:a normal control group,a high glucose group,a GKT137831-treated group and a high glucose GKT137831-treated group.These podocytes were subsequently cultivated in vitro under high glucose conditions for 2 weeks.Thereafter,transfection of podocytes was carried out using NOX4 inhibitors and short interfering RNA targeting(siRNA)TRPC6.To detect the expression levels of NOX4 and TRPC6,a battery of techniques including Western blot,Immunohistochemistry,and reverse transcription polymerase chain reaction(RT-qPCR)were employed.(3)The morpho-logical changes of podocyte mitochondria under the condition of high glucose were observed by fluorescence confocal mi-croscopy,and the expression levels of peroxisome proliferator-activated receptor gamma coactivator 1α(PGC1α),mito-chondrial transcription factor A(TFAM),cytochromec oxidase subunit Ⅰ(COX Ⅰ)and cytochromec oxidase subunit Ⅳ(COX Ⅳ)in podocytes were assessed utilizing the Western blot technique.RESULTS:(1)Compared with normal con-trol group,mice with diabetic nephropathy manifested pronounced glomerular hypertrophy,thickening of basement mem-brane,expansion of the mesangial region,and an increased rate of urinary albumin excretion was observed.Analytical techniques such as Western blot and Immunohistochemistry showed a significant upsurge in the expression level of the NOX4 protein in kidney tissue,a diminished expression of glomerular podocyte protein(nephrin),an increased expression of interstitial cell markers(desmin),and an enhanced level of TRPC6 expression(P＜0.05).GKT137831 was assoiated with a reduction in desmin expression in renal tissue,preservation of glomerular nephrin expression,and a decrease in uri-nary albumin excretion(P＜0.05).(2)In vitro podocyte experiment,the expression of NOX4 and TRPC6 in podocyte was significantly increased in the context of high glucose(P＜0.05).Findings from Immunofluorescence and Western blot showed that GKT137831 effectively diminished the expression levels of TRPC6 and desmin while partially rescuing neph-rin expression in podocellular cells(P＜0.05).Western blot results showed that transfection of TRPC6 small interfering RNA could further promote the protective effect of GKT137831 on podiocytes.(3)Under high-glucose conditions,fluores-cence confocal microscopy revealed mitochondrial morphological damage in podocytes.However,therapeutic intervention with GKT137831 and transfection of TRPC6 siRNA partially rescued the mitochondrial structural integrity.Under high glucose conditions,immunoblot analysis demonstrated a marked decrement in the protein expression levels of PGC1α,TFAM,COX Ⅰ,and COX Ⅳ in podocytes.Importantly,GKT137831 and the transfection of TRPC6 siRNA significantly upregulated the levels of PGC1α,TFAM,COX Ⅰ,and COX Ⅳ(P＜0.05).CONCLUSION:In the context of the patho-genesis of diabetic nephropathy,the increased expression of NOX4 in the kidneys contributes to podocyte damage,with the effect being partially mediated via the TRPC6 channel.Inhibiting the NOX4-TRPC6 signaling pathway has the potential to ameliorate mitochondrial dysfunction in podocytes.This finding offers novel perspectives and strategies for the clinical di-agnosis and treatment of diabetic nephropathy.

Objective:To characterize the epidemiology of respiratory syndrome across healthcare facilities of different types and tiers in Beijing City, to compare pathogen-testing modalities and their associations with adverse outcomes, and to identify key factors associated with progression to severe illness, thereby informing regional prevention, control, and clinical optimization.Methods:The multicenter observational cohort study was performed using outpatient and emergency department data from five sentinel hospitals in Beijing (Beijing Xiaotangshan Hospital, Beijing Chaoyang District Shuangqiao Hospital, Beijing Haidian Hospital, Beijing You′an Hospital, Capital Medical University (Beijing You′an Hospital), and Beijing Ditan Hospital, Capital Medical University (Beijing Ditan Hospital)) from October 1st, 2023 to April 9th, 2025. Dual-target (two-plex) and triple-target (three-plex) respiratory specimens were collected. Demographic characteristics, visit information, pathogen-testing modalities and results were collected, and the epidemiologic features of patients who progressed to severe illness between the influenza high-incidence season (December to May) and the non-influenza season (June to November) were compared. Categorical variables were analyzed using the chi-square test. Multivariable logistic regression was used to estimate associations between covariates and risk of progression to severe illness.Results:Among the 192 131 cases, patients visited at Beijing You′an Hospital were concentrated in the 16 to 44 year age group, accounting for 66.79%(32 532/48 708). Beijing Xiaotangshan Hospital had a broad age distribution, with older adults comprising up to 22.35% (885/3 960). Of the 47 349 respiratory specimens across the five hospitals, Beijing You′an Hospital had the highest positivity rate for dual-target testing (46.76%(1 585/3 390)), while Beijing Haidian Hospital conducted the largest number of this tests ( n=12 514). For triple-target testing, Beijing You′an Hospital again had the highest positivity rate (45.03%(2 835/6 296)), whereas Beijing Ditan Hospital tested the most specimens ( n=12 011; positivity rate was 29.73%(3 571/12 011)). The influenza season within the same period (November 2023 to January 2024) exhibited a bimodal pattern, with alternating circulation of influenza viruses and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Among 32 744 outpatients/emergency patients who progressed to severe illness, significant seasonal differences were observed by sex, age, comorbidity status, and infection type ( χ2=6.60, 189.24, 32.71 and 189.99, respectively; all P<0.05). After adjustment for sex, age group, comorbidities, and infection type, testing modality remained significantly associated with risk of progression (dual-target testing, odds ratio ( OR)=0.116, 95% confidence interval ( CI) 0.111 to 0.122, P<0.001); no testing, OR=0.063, 95% CI 0.060 to 0.065, P<0.001). Conclusions:The epidemiological pattern of respiratory pathogens undergo significant changes after October 2023, which is characterized by alternating waves of influenza viruses and SARS-CoV-2 with pronounced seasonality and diversity. Substantial inter-hospital differences are observed in testing modalities and positivity rates. Risk of progression to severe illness varies significantly by sex, age, comorbidity burden, and infection type, and is closely associated with the testing modality. These findings support strengthening multiplex pathogen testing and targeted surveillance of high-risk groups to improve early identification and precise control of febrile-respiratory syndromes.

Purpose To explore the value of contrast-enhanced ultrasound(CEUS)in the differential diagnosis of gallbladder polypoid lesions(GPLs)(diameter≥10 mm).Materials and Methods A prospective enrollment of 229 patients with GPLs who underwent cholecystectomy in 17 hospitals from December 1 2021 to June 30 2024 was conducted to analyze the relationship between general data,conventional ultrasound,CEUS characteristics and the nature of GPLs.Multivariate Logistic regression was employed to identify independent risk factors for neoplastic polyps,the differential diagnostic value of different indicators was compared.Results Among 229 patients with GPLs,there were 108 cases of cholesterol polyps,102 cases of adenoma and 19 cases of gallbladder cancer.Age(Z=-4.476,P<0.001),polyp number(χ2=15.561,P<0.001),diameter(Z=-8.149,P<0.001),echogenicity(χ2=9.241,P=0.010),vascularity(χ2=23.107,P<0.001),enhancement intensity(χ2=47.610,P<0.001),enhancement pattern(χ2=6.468,P=0.011),vascular type(χ2=84.470,P<0.001),integrity of gallbladder wall(χ2=7.662,P=0.006)and stalk width(Z=-9.831,P<0.001)between cholesterol polyps and neoplastic polyps were statistically significant.Age,location,diameter,echogenicity,enhancement pattern,vascular type and stalk width between adenoma and gallbladder cancer were statistically significant(Z=-4.333,-3.902,-5.042,all P<0.05).Multivariate Logistic regression analysis showed that hyper-enhancement,branched vascular type and stalk width were independent risk factors for neoplastic polyps(OR=4.563,5.770,3.075,all P<0.001).The combination of independent risk factors was better than single factor and diameter in the differential diagnosis of cholesterol polyps and neoplastic polyps(all P<0.01).Conclusion CEUS can effectively identify the nature of GPLs and provide a valuable imaging reference for the selection of treatment methods.

Objective: To explore the clinical efficacy of Xiaoshuan enteric-coated capsule (XSECC) in treating cerebral infarction and its potential mechanism of action. Methods: Patients with acute ischemic stroke (AIS) of the qi deficiency and blood stasis type were randomly assigned to the control and observation groups. They were evaluated using the National Institutes of Health Stroke Scale (NIHSS), Activities of Daily Living (ADL), Hachinskilnchemic Scale (HIS), Barthel Index (BI), clinical efficacy scores, and TCM syndrome scores on days 0, 14, 30, and 90. Furthermore, VEGF and BDNF levels were measured on days 30 and 90. Finally, we analyzed the changes in each scale score and vascular neurological factor in both groups. Results: After 14 days of treatment, the difference values in NIHSS, ADL, and BI were higher, and TCM syndrome and clinical efficacy scores were increased in the observation group compared with those of the control group (all P < .05). After 30 days, the NIHSS, ADL, HIS, and TCM syndrome scores were decreased compared with those of the control group, while BI and clinical efficacy scores were increased (all P < .05). After 90 days, the difference value in ADL was higher, and TCM syndrome score was increased in the observation group compared with that of the control group (P = .047, P = .005, respectively). The levels of VEGF and BDNF were higher in the observation group than in the control group on days 14, 30, and 90 (all P < .05). VEGF and BDNF levels on day 0 were associated with prognosis of patients with AIS; therefore, they have a predictive value for the prognosis of acute cerebral infarction. Conclusions XSECC therapy can improve clinical outcomes in patients with acute and recurrent cerebral infarctions. Its mechanism of action may be associated with the secretion of VEGF and BDNF.