Stem cell therapy for myocardial repair after myocardial infarction is a new and promising treatment modality.But the mechanism is still not very clear.Currently,stem cells are used in clinical study to evaluate its beneficial effect on repairing infarcted/hibernating myocardium after myocardial infarction and heart failure.But there is no final conclusion on the safety of stem cell transplantation.

First of all,all tutors as well as postgraduates should have concept of innovation.Secondly,favorable environment should be built up for innovative thoughts.Finally,tutors should try their best to cultivate students'innovative thoughts and direct their creationary practice.

BACKGROUND:Latest researches suggest that delayed endothelial repair in drug-eluting stents may cause thrombosis and coronary occlusion.Therefore,a novel kind of drug stent,which is characterized by satisfactory anti-proliferative action as well as inhibitive effects on thrombosis,needs to be developed.OBJECTIVE:To summarize the recent research progress and clinical applications of drug-eluting stents (DES) and to seek the direction of new developments.RETRIEVE STRATEGY:The retrieve staffs were the research personnel for this paper.A computer-based online search was conducted in PUBMED for English language publications containing the key words of "drug eluting stents,percutaneous coronary intervention,coronary disease" from January 2002 to April 2007.Relevant data were also searched in international conference reports on the Internet between January 2005 and June 2007.The number of total retrieved Iiteratures was 15.Inclusion criteria:①reports about drug stents;②reports on research progress in the field of drug stents;③reports on the clinical application of drug stents.Exclusion criteria:low relevance and duplicated articles.LITERATURE EVALUATION:There were 264 articles about research and clinical applications of DES.Of those,42 literatures and 5 conference reports with high relevance and timeliness were included in this report.DATA SYNTHESIS:An ideal DES is comprised of a platform,a drug carrier vehicle and a pharmaceutical compound in harmony with each other.Given the ongoing development of DES materials and drugs,more effective DESs are introduced in the clinical practice.Recently,clinical data on DES encourage the interventional cardiologist to use DES in more challenging coronary lesions,such as chronic total occlusions,complex lesions and multivessel lesions.However,concern that DES may be associated with a risk of late thrombotic events arose,suggesting an imbalance between safety and efficacy of DES.Therefore,novel strategies including bioabsorbable stents,and stents coated with pro-healing agents are promising.CONCLUSION:The development of DES is a breakthrough in interventional cardiology that bring great benefit to patients with coronary disease,especially for restenosis and revascularization.Nevertheless,more endeavour will be necessary to create DES with high efficacy as well as low risk.

Soluble ST2 ( sST2 ) is protein of interleukin-1 ( IL-1 ) receptor family present in the blood which have been identified has the ability to capture IL-33, thereby inhibiting IL-33/ST2 signaling, the mechanical properties overload of myocardial cells was significantly increased .Thus, when at the onset of heart failure or chronic heart failure deteriorated , or at scarring resulted by myocardial infarction , soluble ST2 can be detected in the blood .The purpose of this review is to discuss the role of soluble ST 2 ( sST2) as a new cardiovascular marker.

Aortic Valve Insufficiency ; therapy ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; Humans ; Transcatheter Aortic Valve Replacement

Objective To evaluate the safety and efficacy of bone marrow cells(BMCs) transplantation on the improvement of cardiac function and myocardial perfusion in patients with old myocardial infarction. Methods and Results A total of 10 patients with anterior wall myocardial infarction were transplanted with autologous mononuclear BMCs through an infusion catheter which was placed with the tip in the left anterior descending coronary artery after coronary angiography and interventional therapy if necessary. After 3 months of follow-up, a significant increase of left ventricular ejection fraction(LVEF) determined by ultrasonic cardiography was found (54.5%?6.5% vs. 45.3%?9.8% before transplantation, P=0.003); 201-thallium scintigraphy (SPECT) showed that ventricular myocardial perfusion was significantly improved as the semiquantitative score of the immediate and delayed myocardial perfusion defects decreased from 29.5?5.8 and 28.6?6.3 to 23.9?5.7 and 23.0?6.1prospectively (both P

Objective To study ultrastructure changes of myocardium and morphic change of cardiomyocyte apoptosis in mice with viral myocarditis(VMC).Methods Our experiment established animal model of VMC by the way of coxsackie virus B3(CVB3) inoculation,then we studied the changes and apoptosis of cardiomyocyte by ways of microscope and electron microscope.Results The myocardial changes and inflammatory cell infiltration were found by ways of microscope and electron microscope from 5 days after virus inoculation in experimental mice,the peak changes were at 7-9 days,and were almost recoverd at 35 days.Apoptotic changes and apoptotic bodies were found by eletron microscope at 7-9 days after virus inoculation in mice with VMC.Conclusions VMC can be caused in mice after CVB3 inoculation,abnormal cardiomyocyte apoptosis can be found in VMC.

50 as group B.All patients were examined by CAG.Plaque morphology was assessed by IVUS in 14 of group A and 38 of group B before intervention.Plaque external elastic membrane,minimal lumen area,plaque area,plaque burden,lipid pool area,thickness of fibrous cap and rupture were measured by IVUS.Results Heavy smoking,excess drinking and positive family history were more frequent in group A than those in group B,while hypertension and diabetes mellitus were more common in group B.The percentage multi-vessel lesions and collateral circulation were higher in group B.IVUS results showed that vulnerable and ruptured lesions were found in most of two groups.The severity of plaque burden is milder in group A.However,they had a bigger lipid core and a thinner fibrous cap.Group B showed a more severe stenosis and bigger plaque area.Conclusion Plaque vulnerability and rupture are the most common cause substrate of AMI.There are different risk factors and different coronary artery characteristics in AMI with different ages,which suggests that different emphases should be taken in preventing AMI in patients with different ages.

Objective To evaluate the safety of intracoronary Doppler flow measurement using Doppler FloWire  Methods and Results A total of 906 patients were examined with intracoronary Doppler using a 0 014″ or a 0 018″ Doppler FloWire  For coronary flow reserve measurement, intracoronary injection of adenosine or papaverine was used Of the patients studied, 77 were cardiac transplant recipients, 829 were nontransplant patients, of whom 617 patients underwent diagnostic coronary procedures and 212 had coronary interventions In 27 (2 98%) of 906 patients adverse cardiac events were observed Fifteen (1 66%) of 906 patients developed severe transient bradycardia (asystole or Ⅱ? to Ⅲ? atrioventricular block) after intracoronary administration of adenosine Of which, 14 occurred in RCA and 1 in LAD Nine (0 99%) of 906 patients experienced coronary spasm during the passage of the Doppler wire (5 in RCA, 4 in LAD) Two (0 22%) of 906 patients developed ventricular fibrillation during the procedure Hypotension with bradycardia and ventricular extrasystole each occurred in one (0 11%) of 906 patients The incidence of complication was significantly higher in transplant recipients than in nontransplant patients underwent either diagnostic or interventional procedures (12 99% vs 2 43% vs 0 94%, P

Objective To investigate the effect of purified single clonally mesenchymal cells (SCMSCs) on cardiac function in rat models and also try to find out wheter SCMSCs serve as a better source for transplantation than UMSCs, BM-MNCs and PB-MNCs. Methods SCMSCs were isolated, cultured, purified, cloned and expanded. UMSCs were isolated primarily by their tight adherence to the culture dishes. BM-MNCs and PB-MNCs were prepared by Ficoll-Hypaque gradient centrifugation. All cell characters were verified by fluorescence- activated cell sorter (FACS). A total of 5?10~6 PB-MNCs, BM-MNCs, UMSCs, and SCMSCs were transplanted into the ischemic zone immediately after MI. The cardiac function was evaluated by hemodynamic technique 1 month after the transplantation. The vessel density and cell differentiation were determined by histological techniques. Results SCMSCs expressed over 99% of the mesenchymal cell surface protein and none of the hematopoietic stem cell surface protein. Hemodynamics showed that transplantation of snMSC led to the greatest improvement in cardiac function, compared with PB-MNCs, BM-MNCs, and UMSCs transplantation. In consistence with cardiac function recovery, SCMSCs transplantation resulted in the greatest angiogenesis in the ischemic wall, and the greatest number of transplanted SCMSCs expressed these cardiomyocyte proteins, or vascular endothelial cell marker, in comparison with the other heterogeneous cells. Conclusion Transplantation of single clonally purified non-hematopoietic mesenchymal stem cells from human bone marrow showed the greatest imporvement in cardiac function compared to UMSC, BM-MNC, and PB-MNC in this study.