OBJECTIVE:To explore the therapeutic effect of early use of alprostadil and the effects on PTX-3,renal function and stability of carotid plaque in patients with acute cerebral infarction. METHODS:93 patients with acute cerebral infarction in our hospital from Aug. 2011 to Aug. 2015 were selected,and divided into observation group(47 cases,2 case withdrew from the test and 45 cases completed the test)and control group(46 cases,1 case withdrew from the test and 45 cases completed the test) by odd and even number of registration order. Control group was given Citicoline sodium injection 0.5 g + Extract of ginkgo biloba leaves injection 20 ml added into Sodium chloride injection(NS)250 ml,ivgtt,qd;observation group was additionally given Al-prostadil injection 20 μg added to NS 250 ml,ivgtt,qd. They were treated for 2 weeks. Clinical efficacy,and the differences of PTX-3,blood urea nitrogen(BUN),serum creatinine(SCr),24 h urinary protein(Upro),stability of carotid plaque before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group(91.1%)was higher than control group(73.3%),the difference was statistically significant(P<0.05). There was no statisti-cal significance in PTX-3,BUN,SCr,24 h Upro between 2 groups before treatment (P>0.05). After treatment,PTX-3,BUN, SCr,24 h Upro in 2 groups decreased,and observation group was lower than control group;stability of carotid plaque in observa-tion group(100.0%)was higher than control group(64.0%),the differences were no statistically significant(P<0.05). The ad-verse reactions in 2 groups relieved themselves with no special treatment,and with no statistical significant(P>0.05). CONCLU-SIONS:The early use of alprostadil is effective for acate cerebral in farction,and can obviously reduce PTX-3 and improve renal functions,increase stability of carotid plaque with good safety.

Objective To explore the diagnostic value of MR fast imaging sequences in fetal lung congenital cystic adenomatoid malformation(CCAM).Methods 8 cases with suspected CCAM by US were examined with MRI fast sequences,including single shot turbo spin echo (SSTSE)and balanced fast field echo(B-FFE),and undergone axial,sagital and coronal scanning sections of fetal chests.MRI findings were compared with surgery(2 fetuses),autopsy (3 fetuses)and CT examination (3 fetuses).Results 7 fetuses with CCAM and 1 fetus with bronchopulmonary sequestration(BPS)diagnosed by MRI were confirmed by following surgery,autopsy and CT examination.Among the 7 CCAM cases,2 leisions were on the left side,while the other 5 lesions were on the right side.Fur-thermore,2 cases were cystic type and the rest 5 cases were mass type.The BPS was located in the lower left lung lobar.Conclusion MR fast imaging sequences in fetal can clearly demonstrate location,type and extent of CCAM and can provide important supplement information of the prenatal fetal ultrasound examination.

Objective To investigate the value of MRI in the prenatal diagnosis of abnormal fetal kidneys. Methods From December 2014 to March 2016, 51 women underwent MRI and were confirmed as having fetuses with abnormal fetal kidneys when follow up. Their clinical and MRI profiles were analyzed retrospectively, including MRI manifestation, the fetal kidney signal intensity of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC). The signal intensity of DWI and ADC of the abnormal kidney and the normal opposite kidney, and those of the normal and abnormal kidneys in different individuals were compared. The accuracies of MRI and ultrasound in evaluating abnormal fetal kidneys were also compared. Results MRI could accurately demonstrate the morphological features of abnormal fetal kidneys. There was no statistically significant difference between DWI signal intensity and ADC value of the abnormal kidney[368 ± 125,(1.516 ± 0.420)× 10-3 mm2/s] and the normal opposite one[410 ± 125,(1.362 ± 0.251)× 10-3 mm2/s], P values were 0.165 and 0.184,respectively. The DWI signal intensity of normal kidneys(401 ± 124)was higher than that of renal cysts(182 ± 40, P<0.01), and the ADC value of normal kidneys[(1.306 ± 0.252)× 10-3 mm2/s] was lower than that of renal cysts[(2.912 ± 0.235)× 10-3 mm2/s] and multicystic dysplastic kidneys[(1.870 ± 0.654)× 10-3 mm2/s], P values were<0.01 and 0.045, respectively. The diagnostic accuracy of MRI and prenatal ultrasound for abnormal fetal kidneys were 94%(63/67)and 85%(57/67), respectively. However, there was no statistical difference between the two methods (P=0.070). Conclusion MRI have an important role in the prenatal diagnosis and evaluation of abnormal fetal kidneys.

Currently the main treatment of acute myeloid leukemia (AML) is chemotherapy combining hematopoietic stem cell transplantation. However, the unbearable side effect of chemotherapy and the high risk of life-threatening infections and disease relapse following hematopoietic stem cell transplantation restrict its application in clinical practice. Thus, there is an urgent need to develop alternative therapeutic tactics with significant efficacy and attenuated adverse effects. Here, we revealed that umbilical cord-derived mesenchymal stem cells (UC-MSC) efficiently induced AML cell differentiation by shuttling the neutrophil elastase (NE)-packaged extracellular vesicles (EVs) into AML cells. Interestingly, the generation and release of NE-packaged EVs could be dramatically increased by vitamin D receptor (VDR) activation in UC-MSC. Chemical activation of VDR by using its agonist 1α,25-dihydroxyvitamin D3 efficiently enhanced the pro-differentiation capacity of UC-MSC and then alleviated malignant burden in AML mouse model. Based on these discoveries, to evade the risk of hypercalcemia, we synthetized and identified sw-22, a novel non-steroidal VDR agonist, which exerted a synergistic pro-differentiation function with UC-MSC on mitigating the progress of AML. Collectively, our findings provided a non-gene editing MSC-based therapeutic regimen to overcome the differentiation blockade in AML.