In recent years, scientists paid close attention to the studies of 3D printing in cardiovascular tissue engineer-ing, which has made some advances.But how to promote cardiovascular tissue engineering for clinical application still needs deeper research.Here we discussed from three cardiovascular tissues ( myocardial tissue, heart valves, coronary) , which at-tempted to retrospect the current progress of 3 D printing in cardiovascular tissue engineering and provided a guidance of further investigations.

Objective To study the effect of polymer material on adhesion , proliferation and differentiation of mouse in-duced pluripotent stem cells via co-culturing in vitro, to find a suitable polymeric biomaterials for miPSCs attachment , prolifera-tion and differentiation , forming myocardial patches as a new repair method for myocardial infarction .Methods miPSCs were recovered, passaged and cultured with PHBHHx two-dimension films and PHBHHx three-dimension films together.The mor-phology of miPSCs attached on the films was visualized under scanning electron microscope ( SEM) .The mouse induced pluri-potent stem cells were induced by differentiation medium that containing vitamin C .Control group did not add any inducer.The survival and differentiation of miPSCs were observed through immunofluorescence and flow cytometry .Results MiPSCs can grow, proliferate and differentiate on PHBHHx films both two-dimension and three-dimension.Vitamin C, as a favourable in-ducer, can markedly improve the efficiency of miPSCs differentiation of cardiomyocytes on PHBHHx films .Immunofluorescence results demonstrated positive cTnT expression.Flow cytometry measured cTnT expression: Vitamin C inducer group(47.54 ± 1.46)%>without any inducer group(7.02 ±0.95)%(P<0.05).In the process of miPSCs differentiating into myocardial cell, after adding Vitamin C, the expression quantity of cTnT:PHBHHx three-dimensional films(60.32 ±1.76)%>PHBHHx two-dimensional films(53.31 ±1.41)%>traditional cell culture(47.54 ±1.46)%(P<0.05).Conclusion iPSCs can ad-here, survive and differentiate on the PHBHHx film.Vitamin C, as a favourable inducer, can markedly improve the efficiency of miPSCs differentiation of cardiomyocytes .Relative to PHBHHx two-dimensional film culture and traditional culture , the three-dimensional PHBHHx film culture has a great advantage in the process of miPSCs differentiating into myocardial cells .

Objective To investigate the nosocomial infection status in adult patients after cardiac surgery , who suffered cardiac shock and were supported with extracorporeal membrane oxygenation(ECMO).Methods The data of this retrospec-tive analysis were collected from adult patients of postoperative cardiac shock supported with veno-arterial( VA) ECMO from January 2011 to December 2013 in the Center for Cardiac Intensive Care, Beijing Anzhen Hospital.Results 125 patients were enrolled and nosocomial infection occured in 44 patients(51 episodes), infection rate was 35.2% or 71.8 episodes per 1 000 ECMO day.Respiratory tract infection occured most(27.2%), and then bloodstream infection(12.8%).The infection increased in the extension of time.The cultivation of the phlegm and blood specimen showed that the major pathogens were gram-negative bacteria.The patients were divided into the infection and the non-infection groups, the incidence of remedially continuous renal replacement therapy were significantly higher in the infection group than that in the non-infection group and the duration of ECMO support, the lenth of postoperative hospital stay, and the lenth of ICU stay were significantly longer in the in-fection group than those in the non-infection group[40.9% vs.22.2%, P<0.05; (7.2 ±4.6) d vs.(4.9 ±2.1) d, P<0.01;(12.5 ±6.2) d vs.(9.1 ±4.9) d, P<0.01和24(13, 36) d vs.15(11,20) d, P<0.01; respectively].The pa-tients in the infection group had higher mortality compared with the patients in the non-infection group(53.5% vs.17.1%, P<0.01).Conclusion Nosocomial infection is one of the common complications of the ECMO treatment and affects the prognosis of patients.The strict aseptic technique and rational application of antibiotics may reduce the mortality .

Objective To summarize the experiences of diagnosis and treatment for blunt tracheobronchial injuries ( BTI) . Methods From January 1993 to December 2013, 15 patients were diagnosed with BTI and underwent surgical treatment at our hospital.Mean age of the 15 patients (11 men and 4 women) was 26.4 ±4.5 years.All the patients had a history of trauma, which included crushing injury in 8 cases, deceleration injury in 4, fall injury in 2, and traction-type injury in 1.BTI loca-tion: right main bronchus in eight cases, left main bronchus in four cases, upper trachea in one case, lower trachea with the right main bronchus in one case, and cervico-thoracic trachea with left main bronchus in one case .Thoracic computerized tomo-graphy was performed in 15 patients, which showed pneumothorax, subcutaneous emphysema, pneumomediastinum or falling lung sign of Kumpe.Preoperative fiberoptic bronchoscopy examination was performed in 15 cases, which included bronchial atresia in 9 cases, bronchial transection in 3 cases, laceration of trachea in 2 cases, and tracheal transection in 1 case.An e-lective surgical procedure after BTI was performed in 10 cases, and emergency surgery was performed in 5 cases.Tracheo-bron-chial laceration repair were performed in 2 cases, tracheal end-to-end reanastomosis in 1 case, and bronchial end-to-end re-anastomosis in 12 cases.Results There was no operative death, and one case was complicated with anastomotic stenosis.The average operation time was 205.7 ±41.3 minutes, and the average blood loss was 268.4 ±109 ml.The postoperative hospi-tal stay was 11.6 ±3.7 days on average.Follow-up was completed in 15 patients (mean, 29.3 months), and 15 patients were all symptomatic improvement .Conclusion The most common site of BTI was the right main bronchus near Carina parts .Al-though the diagnosis and treatment are often delayed , our findings indicate that chest CT and endoscopic findings could be used for the diagnosis of BTI.Surgical resection and reconstruction are effective methods to repair BTI successfully even many months after they occur.Often they do not require the resection of pulmonary parenchyma .

Objective To explore the application and value of three-dimensional reconstruction technology in diagnosis and surgical therapy of ground-glass opacity.Methods We analyzed 188 cases with GGO during October 2012 and October 2014 in Shanghai First People’s Hospital affiliated to Shanghai Jiao tong University School of Medicine respectively.Several relative parameters based on three-dimensional reconstruction were selected to differentiate GGO pathology .By ROC curve anal-ysis, optimal cut-off points were determined.Volume-doubling time(VDT) was calculated among 104 cases which had been following up at least for three months and compared among AAH, MIA and IAC.Results Cases’ mean age was 56.66 ± 9.673years(ranged from 27 to 82 years) with 67 males and 121 females.The diameter(P<0.001), total volume(TV)(P<0.001), the maximum CT attenuation(MAX)(P<0.001) and standard deviation of distribution of CT attenuation within the whole GGO(STD)(P=0.015) of malignant group were significant larger than those of benign ones except for average CT at-tenuation(AVG)(P=0.094).The AUC were just 0.64-0.80 when differentiated benign group from AIS, benign group from MIA and AAH from MIA in comparison to 0.70-0.95 when it comes to differentiating benign group and AAH from IAC .Ad-ditionally, the optimal cut-off points were 13.5-15.5 mm in diameter, 400-600 mm3 in TV, -110 -20 Hu in MAX and 120-160 in STD.The mean VDT was 865.00 ±111.33, 464.67 ±44.40 and 238.36 ±76.71 for AAH, MIA and IAC re-spectively(AAH/MIA P<0.001, MIA/IAC P=0.003).Conclusion The diameter, TV, MAX and STD of GGO based on three-dimensional reconstruction could discriminate GGO availably .Combined utilization of HRCT and three-dimensional re-construction has a valuable significance in diagnosis and treatment of GGO .

Gastrointestinal hemorrhage from angiodysplasiamay may be associated with degenerative aortic valve stenosis , the associated of the two conditions termed Heyde ’ s syndrome.Gastrointestinal angiodysplasia and aortic valve stenosis areboth chronic degenerative diseases, and the incidence rate increased with age.Degenerative aortic stenosis can enhance high molec-ular weight polymer damage, which subsequently increases the risk of gastrointestinal bleeding.Aortic valve replacement is considered as the first-line treatment for patients with severe aortic stenosis , and can effectively improve the outcomes of hemor-rhagic angiodysplasia and acquired coagulopathy .However, the substantial connection between aortic valve stenosis and gastro-intestinal bleeding remains unclear, and the clinical diagnosis and treatment of this syndrome need more evidences.Herein, we will review the knowledge of epidemiology, pathogenesis and clinical diagnosis and treatment of Heyde’ s syndrome.

Systolic anterior motion of mitral valve ( SAM) is a relatively uncommon complication , but it can result in se-vere left ventricular outflow tract(LVOT) obstruction and/or mitral regurgitation(MR), even can be life-threating.Echocardio-graphy is still the first-line method of SAM diagnosis.Due to LVOT obstruction and MR reducing the long-term prognosis of pa-tients with SAM, it is necessary to carry out surgical treatment for patients with SAM for whom conservative treatment are not ef-fective.Then mitral valve repair(MVREP) is the first choice.Besides, surgical techniques for treatment and prevention of SAM have made great progress which have promoted the popularization of MVREP , and the rate of MVREP in mitral valve oper-ation has been greatly improved .

Objective To imitate the pathological process of bronchiolitis obliterans(BO) post lung transplantation and in-vestigate the phenomenon of epithelial-mesenchymal transition ( EMT ) in small airway epithelial cells and its relation to BO . Methods We established the rat model of allogeneic orthotropic left lung transplantation with grafts from F 344 rats transplanted to Lewis rats by the Tri-cuff anastomosis.Then rats were daily injected intraperitoneally with cyclosporine (5 mg· kg-1 · d-1 ) for 10 days, intratracheally applied with lipopolysaccharide(0.5 mg/kg) at the 28th day and killed at the 90th day post-surger-y.We observed the histological structure of the lung grafts by HE and Masson staining , detected E-cadherin and Vimentin ex-pression in lung grafts and normal ones of F344 rats by immunohistochemistry, then analyzed the relation between small airway remodeling and the alterations in EMT markers expression .Enumeration data was analyzed with Fisher exact test and Spearman rank correlation was applied in correlation analysis .Results We found inflammatory cell infiltration , fibroplasia of bronchiole walls and significant lumen stenosis in lung graft mesenchyma.In lung grafts, the positive expression of E-cadherin was 5(total 13), which was significantly lower than that in normal lungs(7/8, P<0.05), and conversely the positive expression of Vim-entin was higher than normal ones(10/13 vs 2/8, P <0.05).The Spearman rank correlation analysis demonstrated that E-cadherin expression bear a negative correlation with Vimentin expression(r=-0.750, P<0.01).Conclusion Our study established a disease model imitating the pathological process of BO .And EMT was observed in small airway epithelial cells of the BO-exhibited lung grafts, indicating that EMT was involved in the process of BO airway remodeling .Thus it may reveal no-vel therapeutic targets for BO post lung transplantation by further investigation into the mechanism and pathological significance of EMT in small airway epithelial cells.

Objective To analyze the independent risk factors associated with acute kidney injury(AKI)after Sun’s pro-cedure in the patients with acute aortic dissection .Methods Clinical data of 400 patients who underwent Sun ’ s procedure from February 2009 to August 2013 were collected.Data included preoperative GFR, Cleveland values, CPB time and fluid balance of 24 h intra and after operation were gathered .The patients were divided into the group of AKI and the group of non-AKI accounting to the changing of serum creatinine.Results AKI was occurred in 150(37.5%) patients.Hospital mortality in AKI group was significant higher than that in the non-AKI group(11.3% vs.2.4%, P<0.05).Univariable analysis re-vealed male, BWI, hypertension, preoperative MAP,WBC, eGFR, Cleveland value, cardiopulmonary bypass time, intra and postoperative fluid balance for 24 h have significant difference between 2 groups.Multivariate logistic regression analysis showed hypertension, Cleveland value, cardiopulmonary bypass time and fluid balance were independent risk factors for AKI .Conclu-sion AKI after acute aortic dissection was a severe complication .Hypertension, Cleveland value, cardiopulmonary time and fluid balance were associated with AKI.

Objective This research is to explore the Junctophilin-2 ( JPH2 ) expression in persistent atrial fibrillation with mitral valve disease.Methods The left atrial tissue samples were taken from 34 patients with mitral valve disease who underwent cardiac surgery.16 patients were in sinus rhythm, 18 patients had persistent atrial fibrillation.Western blot tech-nique was used to test the JPH2 expression, and the RT-PCR method was used to test the JPH2 gene expression.Results The Westernblot results showed JPH2 expression down-regulated in persistent atrial fibrillation group (0.94 ±0.29 vs.1.53 ± 0.61,P<0.01).However, there was no difference with JPH2 mRNA expression between atrial fibrillation patients and sinus rhythm patients(1.76 ±1.38 vs.1.15 ±0.94, P>0.05).Expression of miRNA-24 was significantly up-regulated in patients with persistent atrial fibrillation(4.49 ±4.30 vs.1.72 ±1.08, P<0.05).There was no significant difference in mean age, gender, ejection fraction and NYHA among the two groups.But the left atrial diameter was significant larger in patients with persistent atrial fibrillation compared to those in sinus rhythm(P=0.02).Conclusion Junctophilin-2 protein down-regulation may be associated with atrial fibrillation , cause left atrial remodeling and contraction dysfunction .