Induced pluripotent stem cells (iPSCs)are pluripotent stem cells obtained through transduction of specific transcription factors and reprogramming of human and animal somatic cells,Which are similar to embryonic stem cells.The iPSCs possesses characteristics of unlimited proliferation,self-reneWal and multi-differentiation.This arti-cle mainly summarized current research condition,application value and prospects of iPSCs in cardiovascular area, and its defect in application of current stage.

Objective: To analyze relative risk factors of hyperamylasemia after open-heart surgery, and provide basis for clinical prevention and treatment. Methods: A total of 521 adult patients, who received open-heart surgery under general anesthesia and low temperature in our hospital from Jan 1, 2013 to Jun 30, 2013, were selected. The 2ml peripheral venous blood was taken in each patient instant after ICU hospitalization, 24h, 48h and 72h after surgery, then serum was separated and measured for serum amylase level by Somogyi method. According to the measured results of serum amylase level, patients were divided into hyperamylasemia group (serum amylase≥500U/dl, n=76) and non- hyperamylasemia group (serum amylase<500 U/dl, n=445). Single factor and gradual Logistic regression analysis were used to analyze risk factors of hyperamylasemia in patients after open-heart surgery. Results: Gradual Logistic regression analysis indicated that cardiopulmonary bypass (CPB) time and hypotension during operation, renal dysfunction and infection after operation were independent risk factors for postoperative hyperamylasemia (OR=1.02~4.12, P<0.05 or <0.01). Conclusion: During perioperative treatment of open-heart surgery, shortening CPB time, avoiding hypotension during surgery, protecting renal function and preventing infection may reduce morbidity of postoperative hyperamylasemia and improve prognosis of patients.

Objective: To study changes of ultrastructure of atrial endothelial cells during acute atrial fibrillation (AF) in canines, and explore the possible mechanism of AF left atrial thrombosis. Methods: A total of 16 healthy adult mongrel canines were randomly and equally divided into blank control group (only received thoracotomy without pacing) and rapid atrial pacing (RAP) group (established acute AF model). Myocardial tissue of left and right appendage were taken from two groups and received hematoxylin eosin (HE) staining, then myocardial cell morphological changes was observed under ordinary light microscope; morphological changes of appendage endothelial cells was observed under electron microscope. Results: (1) Paroxysmal AF was successfully induced in all canines of RAP group; (2) There were no significant difference in morphology of appendage and endocardial tissue under ordinary light microscope between two groups; 3. Under transmission electron microscope, endothelium cell of appendage tissue presented defect of different extent, and some shedding in RAP group; while endothelial cell layer was complete with absence of necrosis and shedding in blank control group. Compared with blank control group, there was significant rise in endothelial cell incompleteness (12.5% vs. 75.0%) in RAP group, P=0.041. Conclusion: When acute atrial fibrillation occurs, endothelial cell ultrastructure has already changed, which may be related to thrombosis adhered to wall during atrial fibrillation.

Objective:To explore effects of early rehabilitation nursing on aged patients with diabetes mellitus (DM) complicated myocardial infarction (MI) .Methods :A total of 280 aged DM + MI patients in our hospital were se‐lected .According to random number table ,they were randomly divided into routine nursing group (n=140) and early rehabilitation nursing group (n=140) ,and nursing effects were compared between two groups .Results:Com‐pared with before nursing ,there were significant reductions in levels of fasting blood glucose (FBG) ,2h postprandi‐al blood glucose (2hPBG) and glycosylated hemoglobin A1c (HbA1c) after nursing in both groups , P< 0.05 all;compared with routine nursing group ,there were significant reductions in levels of FBG [ (7.9 ± 1.1) mmol/L vs . (6.8 ± 1.0) mmol/L] ,2hPBG [(9.9 ± 1.4) mmol/L vs .(8.7 ± 1.1) mmol/L] and HbA1c [(7.9 ± 0.7)% vs .(6.9 ± 0.8)% ] ,and significant rise in all item scores of quality of life and total satisfaction (85.0% vs .93.6% ) in early rehabilitation group , P< 0.05 all .Compared with routine nursing group ,there was significant reduction in inci‐dence rate of major adverse cardiovascular events (20.0% vs .9.3% ) within six-month follow-up in early rehabil‐itation nursing group , P<0.05. Conclusion:Early rehabilitation nursing could significantly reduce blood glucose lev‐el ,improve quality of life and satisfaction for nursing in aged DM + MI patients ,which is worth further extension .

A lot of basic and clinical studies have proved that limb remote ischemic preconditioning (RIPre) is a safe and effective means reducing perioperative myocardial reperfusion injury .However ,RIPre possesses specific protec‐tive window .Therefore ,researchers used repeated limb RIPre to prolong the protective window in order to explore a new prevention and rehabilitation measure for cardiovascular diseases .

Objective:To observe therapeutic effects of dexmedetomidine combined metoprolol on subarachnoid hemorrhage (SAH) complicated myocardial injury (MI) .Methods:According to random number table , a total of 131 SAH + MI pa‐tients were divided into control group (n=31) ,metoprolol group (n=34) ,dexmedetomidine group (n=32) and combined treatment group (n=34 ,received metoprolol combined dexmedetomidine ) .Plasma levels of norepinephrine (NE) ,epi‐nephrine (E) ,brain natriuretic peptide (BNP) and cardiac troponin I (cTnI ) were measured ,echocardiography etc .were used to assess MI recovery condition before and after treatment in all groups .Results:Compared with before operation , there was significant rise in LVEDd on 1d after operation ,significantly reduced on 3d after operation and recovered to nor‐mal on 7d after operation ( P<0.05 all);significant reduction in LVEF on 1d after operation ,significantly rose on 3d after operation and recovered to normal on 7d after operation ( P<0.05 all);significant rise in levels of cTnI ,BNP ,NE and E on 1d after operation ,started to reduce on 3d after operation and recovered to normal on 7d after operation in metoprolol group ,dexmedetomidine group and combined treatment group , P< 0.05 all;compared with control group ,metoprolol group and dexmedetomidine group on 7d after operation ,there was significant reduction in LVEDd ,and significant rise in LVEF and significant improvement in cardiac function ;significant reductions in plasma levels of NE [ (1.37 ± 0.08) pmol/L ,(1.05 ± 0.09) pmol/L ,(1.19 ± 0.07) pmol/L vs .(1.01 ± 0.06) pmol/L] ,E [ (6.17 ± 0.41) pmol/L ,(6.02 ± 0.34) pmol/L ,(6.06 ± 0.29) pmol/L vs .(5.26 ± 0.26) pmol/L] ,cTnI [ (0.22 ± 0.02)μg/L ,(0.11 ± 0.03)μg/L ,(0.17 ± 0.02)μg/L vs .(0.09 ± 0.01)μg/L] and BNP [ (1126.81 ± 11.27) ng/L ,(1014.09 ± 14.29) ng/L ,(1154.09 ± 16.52) ng/L vs .(954.09 ± 9.31) ng/L] in combined treatment group ,P<0.05 all .Conclusion:Either dexmedetomidine or meto‐prolol ,or their combination can effectively inhibit SAH complicated myocardial injury ,improve cardiac function ,but com‐bined treatment possesses the best effective effect .

Objective:To explore clinical significance of sinus heart rate turbulence (HRT) phenomenon in aged pa‐tients with stable angina pectoris (SAP) .Methods :A total of 120 aged SAP patients ,who received 24h DCG in our hospital from Jan 2013 to Oct 2015 ,were selected as SAP group .Meanwhile ,another 144 aged patients ,who re‐ceived 24h DCG examination simultaneously and coronary angiography results were normal ,were regarded as nor‐mal control group .According to coronary lesion severity ,SAP group was further divided into single vessel coronary disease group (single vessel group ,n=35) ,double‐vessel coronary disease group (double‐vessel group ,n=48) and multi‐vessel coronary disease group (multi‐vessel group ,n=37) .The 24h DCG ,HRT indexes ,including turbulence onset (TO) and turbulence slope (TS) ,were measured and compared among all groups .Results:Compared with normal control group ,there was significant rise in TO [(0.77 ± 0.37)% vs .(1.26 ± 0.92)% ] and significant reduc‐tion in TS [(5.45 ± 4.02) ms/RR interval vs .(1.53 ± 0.70) ms/RR interval] ,P<0.01 both ;significant rise in ab‐normal rates of TO (19.44% vs .42.50% ) ,TS (15.97% vs .31.67% ) and TO + TS (11.11% vs .30.83% ) in SAP group ,P<0.01 all .Compared with single vessel group ,there was significant rise in TO [(0.66 ± 0.22)% vs .(1.28 ± 1.11)% vs .(1.46 ± 1.20)% ] and significant reduction in TS [ (2.04 ± 0.82) ms/RR interval vs .(1.66 ± 0.38) ms/RR interval vs .(1.29 ± 0.58) ms/RR interval] in double‐vessel group and multi‐vessel group ,and TO of multi‐vessel group was significantly higher than that of double‐vessel group ,TS of multi‐vessel group was significantly low‐er than that of double‐vessel group , P<0.01 all .Conclusion:Sinus heart rate turbulence can be used as risk predic‐tor for aged patients with stable angina pectoris ,which can provide basis for clinical effective treatment and progno‐sis assessment .

Objective:To explore trend of congenital heart disease (CHD) ,analyze its epidemiological features and risk factors .Methods :A total of 2415 children diagnosed as CHD in our hospital from Jan 2012 to Jan 2015 were en‐rolled as CHD group ,another .Detection rate of every year ,constitution type and constituent ratio of each age group for CHD were counted .Multifactor Logistic regression analysis was used to analyze independent risk factors and protective factors of CHD .Results:CHD detection rate of 2012 ,2013 and 2014 was 19.42% ,34.99% and 45.59% respectively ,showing an increasing trend (P=0.018 ,0.107) .The top three types of CHD were atrial sep‐tal defect (ASD , 37.31% ) , ventricular septal defect (VSD , 30.97% ) and patent ductus arteriosus (PDA , 13.71% ) .Comparison among all age groups found that <1 year group occupied the highest proportion for all types of CHD ,prevalence rate of all types of CHD showed a gradual decreasing trend in > 1 year children ;< 4 years CHD children occupied 74. 95% for all CHD children .Multifactor Logistic regression analysis indicated that educa‐tion level of mother was independent protective factor for CHD [OR=0.488 ,P=0.011] ,threatened abortion his‐tory ,smoking history of father and interior renovation during pregnancy were independent risk factors for CHD [OR=1.748~7.151 ,P<0.05 or <0.01] .Conclusion:Detection rate of congenital heart disease shows a gradual increasing trend in recent years ,periodic inspection and early intervention focus on parents status and environmental factors must be performed in order to achieve goals of early diagnosis ,prevention and treatment .

Objective:To explore influence of rehabilitation exercise on daily living capacity in aged patients with chronic heart failure (CHF) .Methods :A total of 60 aged CHF patients were randomly and equally divided into rou‐tine treatment group (received routine CHF treatment and nursingcare ) and rehabilitation exercise group (received rehabilitation exercise based on routine treatmentgroup ) .Brain natriuretic peptide (BNP) level ,left ventricular e‐jection fraction (LVEF) ,daily living capacity and 6min walking distance (6MWD) were measured and evaluated in both groups at hospitalization and six weeks after treatment .Results:After six‐month treatment ,BNP level signifi‐cantly reduced and LVEF significantly rose in both groups ,and there were significant rise in 6MWD and daily living score in rehabilitation exercise group ,P<0.05 or <0.01 ;compared with routine treatment group ,there was signif‐icant reduction in BNP level [ (525.3 ± 113.2) pg/ml vs .(252.2 ± 114.5) pg/ml] ,and significant rise in LVEF [ (43.46 ± 9.12)% vs .(47.24 ± 8.46)% ] ,6MWD [ (286.6 ± 46.2) mm vs .(582.5 ± 55.3) mm] and daily living score [ (65.12 ± 17.6) scores vs .(82 ± 14.8) scores] in rehabilitation exercise group , P<0.05 or <0.01. Conclu‐sion:Rehabilitation exercise can significantly improve heart function ,raise daily living capacity in aged patients with chronic heart disease .

Objective: To investigate the therapeutic effect of creatine phosphate sodium (CP, Neoton) at early stage of myocardium diastolic dysfunction. Methods: A total of 138 cases with myocardium diastolic dysfunction were divided into CP group (n=109) and routine treatment group (n=29). All the patients received routine treatment. The CP group received CP treatment based on routine treatment(CP 2g+5%glucose or 0.9% sodium chloride 100ml, iv. drip, for patients with mild diastolic dysfunction was 1time/d, patients with moderate diastolic dysfunction was 2 times/d), duration was 7~14 days. Color-coded Doppler echocardiography was used to detect transmitral peak early diastolic velocity (E-wave)，transmitral peak late diastolic velocity (A-wave)，peak early diastolic velocity of mitral annulus (Ea), and peak late diastolic velocity of mitral annulus(Aa), and the value of E/A ,Ea/Aa and E/Ea were calculated. Symptoms, signs and items from echocardiography were compared between the two groups before and after treatment. Results: After treatment, all symptoms and signs of patients in two groups significantly improved (P<0.05~0.01), and the marked effective rate in CP group was significantly higher than that of routine treatment group (96.2% vs. 57.1%, P<0.01). In CP group, the marked effective rate of E/A (81.65% vs. 10.34%), Ea/Aa (83.49% vs. 13.79%) and E/Ea (92.86% vs. 12.00%) were significantly higher than those in routine treatment group (P<0.01all). Conclusion: Creatine phosphate possesses marked effect for improve patient’s condition and diastolic dysfunction.