Diabetic wounds remain a great challenge for clinicians globally as a lack of effective radical treatment often results in poor prognosis. Exosomes derived from adipose‑derived stem cells (ADSC‑Exos) have been explored as an appealing nanodrug delivery system in the treatment of diabetic wounds. However, the short half‑life and low utilization efficiency of exosomes limit their therapeutic effects. Low‑intensity pulsed ultrasound (LIPUS) provides a non‑invasive mechanical stimulus to cells and exerts a number of biological effects such as cavitation and thermal effects. In the present study, whether LIPUS could enhance ADSC‑Exo‑mediated diabetic wound repair was investigated and its possible mechanism of action was explored. After isolation and characterization, ADSC‑Exos were injected into mice with diabetic wounds, then the mice were exposed to LIPUS irradiation. The control mice were subcutaneously injected with PBS. Wound healing assays, laser Doppler perfusion, Masson's staining and angiogenesis assays were used to assess treatment efficiency. Then, ADSC‑Exos were cocultured with human umbilical vein endothelial cells (HUVECs), and the proliferation, migration and tube formation of HUVECs were assessed. Moreover, the cellular uptake of ADSC‑Exos in vitro and in vivo was assessed to explore the synergistic mechanisms underlying the effects of LIPUS. The in vivo results demonstrated that LIPUS increased the uptake of exosomes and prolonged the residence of exosomes in the wound area, thus enhancing angiogenesis and accelerating wound repair in diabetic mice. The in vitro results further confirmed that LIPUS enhanced the uptake efficiency of ADSC‑Exos by 10.93‑fold and significantly increased the proliferation, migration and tubular formation of HUVECs. Therefore, the present study indicates that LIPUS is a promising strategy to improve the therapeutic effects of ADSC‑Exos in diabetic wounds by promoting the cellular uptake of exosomes and enhancing angiogenesis.

The present study aimed to explore the clinical applicability of ultrasound super-resolution imaging (US SRI) for assessing renal microcirculation in patients with acute kidney injury (AKI). A total of 62 patients with sepsis were enrolled in the present study—38 with AKI and 24 control patients—from whom renal ultrasounds and clinical data were obtained. SonoVue contrast (1.5 mL) was administered through the elbow vein and contrast-enhanced ultrasound (CEUS) images were obtained on a Mindray Resona A20 ultrasound unit for 2 min. The renal perfusion time-intensity curve (TIC) was analyzed and, after 15 min, additional images were obtained to create a microscopic blood flow map. Microvascular density (MVD) was calculated and its correlation with serum creatinine (Scr) levels was analyzed. There were significant differences in heart rate, Scr, blood urea nitrogen, urine volume at 24 h, and glomerular filtration rate between the two groups (p < 0.01), whereas other characteristics, such as renal morphology, did not differ significantly between the AKI group and control group (p > 0.05). The time to peak and mean transit times of the renal cortex in the AKI group were prolonged compared to those in the control group (p < 0.01), while the peak intensity and area under the TIC were lower than those in the control group (p < 0.05). The MVD of the renal cortex in the AKI group was lower than that in the control group (18.46 ± 5.90% vs. 44.93 ± 11.65%; p < 0.01) and the MVD in the AKI group showed a negative correlation with Scr (R = −0.84; p < 0.01). Based on the aforementioned results, US SRI can effectively assess renal microcirculation in patients with AKI and is a noninvasive technique for the diagnosis of AKI and quantitative evaluation of renal microcirculation.

Background: Prostate cancer (PCa) is the leading cause of cancer-related morbidity and mortality in men worldwide. An early and accurate diagnosis is crucial for effective treatment and prognosis. Traditional invasive procedures such as image-guided prostate biopsy often cause discomfort and complications, deterring some patients from undergoing these necessary tests. This study aimed to explore the feasibility and clinical value of using ultrasound super-resolution imaging (US SRI) for non-invasively assessing the microvessel characteristics of prostate lesion. Methods: This study included 127 patients with prostate lesion who presented at Renmin Hospital of Wuhan University between November 2023 and June 2024 were included in this study. All the patients underwent transrectal US (TRUS), contrast-enhanced US (CEUS), and US SRI. CEUS parameters of time-intensity curve (TIC): arrival time (AT), rising time (RT), time to peak (TTP), peak intensity (PKI), falling time (FT), mean transit time (MTT), ascending slope (AS), descending slope (DS), D/A slope ratio (SR), and area under the TIC (AUC). US SRI parameters: microvessel density (MVD), microvessel diameter (D), microvessel velocity (V), microvessel tortuosity (T), and fractal number (FN), were analyzed and compared between prostate benign and malignant lesion. Results: The tumor markers of prostate in the malignant group were all higher than those in the benign group, and the differences were statistically significant (P < 0.001). The TIC parameters of CEUS revealed that the PKI, AS, DS, and AUC were significantly higher in the malignant group than in the benign group (P < 0.001), whereas the RT, TTP and FT in the malignant group were significantly lower (P < 0.001). Malignant lesion exhibited significantly higher MVD, larger D, faster V, greater T, and more complex FN than benign lesion (P < 0.001). Conclusions: US SRI is a promising non-invasive imaging modality that can provide detailed microvessel characteristics of prostate lesion, offering an advancement in the differential diagnosis for prostate lesion. And, US SRI may be a valuable tool in clinical practice with its ability to display and quantify microvessel with high precision.