1.Human umbilical cord blood mononuclear cell transplantation for extensive anterior-wall acute myocardial infarction with cardiogenic shock and severe heart failure in one case
Chinese Journal of Tissue Engineering Research 2012;16(1):99-102
BACKGROUND: Transplantation of the human umbilical cord blood mononuclear cells (HUCBCs) have received increasing attention, as a promising candidate for the cellular transplantation, but the majority of the existing studies are basic research.OBJECTIVE: To report a patient of extensive anterior-wall acute myocardial infarction with cardiogenic shock and severe heart failure, after treatment of HUCBCs transplantation. METHODS: A 73-year-old female patient with cardiogenic shock and severe heart failure after extensive anterior-wall acute myocardial infarction was treated with percutaneous coronary intervention (three scaffolds implantation) and medications, and she still appeared the symptoms of congestive heart failure, such as severe recurrent dyspnea. 2.4 × 108 HUCBCs (50 mL cell suspension) was injected into the infarcted myocardium through the left anterior descending artery by using coronary micro-guide catheter.RESULTS AND CONCLUSION: The patient reported profound clinical benefit including improvement of heart-failure-associated symptoms after the transplantation. Notably the patient did not experience the cell transplant-related side effects during 4 months of follow-up. The ejection fraction increased from 22% before the transplantation to 53% at 21 days after the transplantation. The B-type natriuretic peptide decreased from 1 730 ng/L before the transplantation, 854 ng/L after the transplantation to 264 ng/L at 21 days after the transplantation. The patient did not appear the symptoms of congestive heart failure, including dyspnea, chest distress and hypodynamia, she returned to daily activity at 4 months of follow-ups. Experimental findings indicate that the HUCBCs transplantation is an effective and safe means for patients cardiogenic shock and severe heart failure after acute myocardial infarction.
2.The short-term efficacy and safety of intensive statin therapy in acute coronary syndrome after percutaneous coronary intervention
Chinese Journal of Interventional Cardiology 2014;(6):372-375
Objective This study was designed to evaluate the short-term effect and safety of 80 mg/d atorvastatin treating on ACS patients with interventional therapy in China. Methods From August 2002 to March 2014,1746 ACS patients accepting 80mg/d atorvastatin treatment were enrolled from three province hospital. All patients were divided into three groups, 886 patients in group A with 80mg/d atorvastatin treating for 4 weeks, 562 patients in group B with 80mg/d atorvastatin treating for 8 weeks, and 298 patients in group C with 80mg/d atorvastatin treating for 12 weeks after discharge. Blood lipid level, hepatic function, renal function and creatine kinase level were tested on 4th, 8th, 12th week. Results The percentage of patients reacting lipid levels was 85.0%in group A, 86.1%in group B, 94.0%in group C and 86.9%in total. The rate of ALT/AST exceed two times of normal upper level in group A was 1.6%, in group B was 1.8%and in group C was 1.0%.The symptom of joint and muscle pain in group A was 6.3%, group B was 1.4%, group C was 2.7%. The elevation of creatine kinase in group A was 0.8%, in group B was 0.5%, and 0%in group C. The symptom of abdomen discomfort in group A was 2.3%, group B was 2.5%and group C was 4.0%. The complaint of other symptoms was 3.2%in group A, 2.1%in group B, 1.7%in group C. Conclusions Accepting 80 mg/d atorvastatin treating for ACS patients with interventional therapy is effective and safe in short term.
3.Intracoronary transplantation of autologous peripheral blood stem cells in old patients with acute myocardial infarction:5-year postoperative evaluation of cardiac function
Chinese Journal of Tissue Engineering Research 2014;(1):125-130
BACKGROUND:Myocardial infarction patients commonly appear to have left ventricular remodeling and heart failure. Because of physical characteristics, these two complications are more likely to occur in elderly patients with myocardial infarction. In recent years, stem celltransplantation in the treatment of acute myocardial infarction and heart failure has become a hot topic, and the feasibility and safety has been confirmed, but its long-term outcomes in elderly patients are stil unclear.
OBJECTIVE:To assess the long-term effect of transplantation of autologous peripheral blood stem cells on the left ventricular remodeling and heart function in the old patients with myocardial infarction.
METHODS:Thirty old patients (age ≥ 60 years) with myocardial infarction were randomly assigned to receive intracoronary transplantation of peripheral blood stem cells fol owing bone marrow cells mobilization by granulocyte colony-stimulating factor ( 300-600μg per day) subcutaneously for 5 days in addition to conventional therapy (standard drug therapy and percutaneous coronary intervention;transplantation group, n=15) or standard therapy (standard drug therapy and percutaneous coronary intervention;control group, n=15) . Complications during intervention, left ventricular function and left ventricular remodeling at baseline and 6, 12, 24, 60 months after treatment were monitored.
RESULTS AND CONCLUSION:Left ventricular function, left ventricular end diastolic volume, and left ventricular end-systolic volume were significantly improved 6,12, 24, 60 months after autologous peripheral blood stem celltransplantation compared to baseline, while these parameters remained unchanged in the control group. These parameters had statistical difference between the two groups after treatment. During the fol ow-up, no severe side effects were observed. These findings indicate that autologous peripheral blood stem celltransplantation leads to significant and longstanding improvements in left ventricular performance of old patients with myocardial infarction, and shows good safety.
4.Umbilical cord blood mononuclear cell transplantation is safe for treatment of coronary heart disease with heart failure
Chinese Journal of Tissue Engineering Research 2013;(49):8557-8562
BACKGROUND:Number of experimental and clinical studies have shown that stem celltransplantation can establish new blood vessels and improve heart function instead of necrotic myocardium, to significantly improved clinical symptoms and prognosis of cardiovascular disease patients.
OBJECTIVE:To observe the safety of human umbilical cord blood mononuclear cells transplantation in patients with coronary heart disease and heart failure.
METHODS:A total of 12 patients with coronary heart disease and heart failure (acute myocardial infarction and heart failure in six cases, old myocardial infarction and heart failure in six cases) were enrol ed in this study. Patients were treated on the basis of standard medication and percutaneous coronary intervention. The coronary pathway was established via a percutaneous catheter, and suspension of cord blood mononuclear cells was injected through microcatheter into the distal artery. Routine blood test was carried out at 1 week after celltransplantation, blood routine, liver function, kidney function, C-reactive protein, IgA, IgG were compared preoperatively and postoperatively.
RESULTS AND CONCLUSION:The incidence of adverse reactions in cord blood stem celltransplantation was 8.3%, including one case of fever. No micro-embolism occurred. During 1-week fol ow-up, no graft-versus-host disease appeared. After celltransplantation, there were no significant changes in blood routine, liver function, kidney function, C-reactive protein, IgA, IgG. These findings indicate umbilical cord blood monomuclear cells transplantation is safe in a short term for patients with coronary heart disease and heart failure.
6.MRI study of the lumbosacral canal fat in normal adults
Xiaoling ZHANG ; Bolang YU ; Ming ZHANG
Journal of Xi'an Jiaotong University(Medical Sciences) 2004;0(05):-
Objective To evaluate the clinical significance of the distribution characteristics and thickness of lumbosacral canal fat in normal adults,and to assess the relevant factors of the fat thickness.Methods Sagittal images of lumbosacral canal fat on MRI T_(1)WI in 260 normal adults were observed.The distribution characters of the fat were studied on mid-sagittal plane.The thickness of anterior and posterior epidural fat and the canal diameter were measured and analyzed.Results The anterior epidural fat showed a barred or crescent shape and segmental distribution,while the posterior epidural fat had a segmental distribution with a spindle shape.The thickness of the epidural fat varied at different levels.The fat thickness showed no statistical difference between men and women or every age group.Positive linear correlation occurred between spinal canal diameter or obesity index and the thickness of posterior epidural fat.Conclusion The distribution characteristics and thickness of the lumbosacral canal epidural fat can be used as index in diagnosing some spinal canal diseases.
7.MRI Study of the Thoracic Canal Fat in Normal Adults
Xiaoling ZHANG ; Bolang YU ; Ming ZHANG
Journal of Practical Radiology 2001;0(05):-
Objective To evaluate the clinical value of the distribution characters and thickness of fat in thoracic canal in normal adults,and to assess the relational factors of the fat thickness.Methods The distribution characters of the thoracic canal fat in 268 normal adults were studied in mid-sagittal plane on MR T_1WI.The thickness of epidural fat and the canal diameter were measured and analyzed.Results Thoracic canal fat on mid-sagittal plane was only found in posterior epidural space,mainly appearing as segmental distribution. Continuous barred or spindle shape of the fat was also seen in some cases.The thickness of fat varied at different thoracic levels.There was no statistic significance between men and women or every age group about the fat thickness.Positive linear correlation occurred between spinal canal diameter or obesity index and the fat thickness.Conclusion The distribution characters and thickness of the thoracic epidural fat can be used as references in diagnosing some spinal canal diseases.
10.Latest Progress of Biliary Atresia
yu-hua, DENG ; ming-man, ZHANG
Journal of Applied Clinical Pediatrics 2004;0(11):-
Biliary atresia(BA) is a common reason for obstructive jaundice in children.Pathogenesis of BA is unclear,and the prognosis is poor.Over the last 2 years,gene mutation,viral infection and autoimmune are considered to be the most possible reason for BA;Stool co-lor card has shown favourable perspective in early screening;Kasai is also the first choice for treatment of BA,which progressed in laparoscopic operation and robot surgery.Corticosteroids after surgery is still disputing.Now,liver transplantation is the only way for BA and cirrhosis.This article gave a review on the pathogenesis,diagnosis and treatment of BA.