Objective To investigate the effect of mesenchymal stem cells transplatation on angiogenesis and secretion of cytokines after rat myocardial infarction. Methods Harvested rat mesenchymal stem cells were cultured and labeled in vitro. And at the same time, myocardial infarct model was set up by liquid nitrogen cryoinjuring the left ventricular free wall. 4 weeks later, 2?10 6 mesenchymal stem cells or cold D-Hanks liquid were injected into several different points of infarcted area. At 1, 2 and 4 weeks after mesenchymal stem cells transplatation, specimens were acquired from infarcted area. Then cell morphology and capillary density were measured, and vascular endothelial growth factor(VEGF) and transforming growth factor ?(TGF-?) expression levels were assayed by RT-PCR. Results Mesenchymal stem cells were alive at 1, 2 and 4 weeks after transplantation and had a trend toward differentiation and maturation in vivo. The number of capillary vessels in per infarcted area (0 1 mm 2) in experiment group increased compared with control group. And the number of capillary vessels in experimental group had a trend to decrease in experiment group(P

Objective To investigate the effect of mesenchymal stem cells transplantation on heart function and the expression of Ca 2+ -ATPase (ERCA) mRNA after rat myocardial infarction. Methods Wistar inbred rat mesenchymal stem cells were cultivated, proliferated and labeled in vitro. Myocardial infarct models were set up by liquid nitrogen cryoinjuring the free wall of left ventricle. 4 weeks later, 2?10 6 mesenchymal stem cells or cold D-Hanks solution were injected into several different points of infarcted myocardial area of experiment group and control group rats. In addition, 5 Wistar inbred rats served as normal group only got thoracotomy twice. 4 weeks after transplantation, all rats received cardiac function test and specimens from infarcted area were got for the expression assay of SERCA2 mRNA by RT-PCR. Results Mesenchymal stem cells were alive at 1, 2 and 4 weeks after transplantation and had a trend toward differentiation and maturation in vivo. Traumatic dynamic measurement was applied to assay heart function by Buxco system, which showed that SLVP and +dp/dt were the highest in normal group, next in experiment group, and the lowest in control group, which LVEDP was the lowest in normal group, next in experiment group, and the highest in control group. The expression level of SERCA2 mRNA in control group was much lower than that in normal group(0.988?0.004 VS 1.824?0.009,P

Objective To evaluate the feasibility of transfection of Sonic hedgehog gene (SHH)into bone marrow mesenchymal stem cells(BMMSC).Methods After the SHH gene was transfected into BMMSC by electroporation apparatus,the transfection rate was evaluated by fluorescence inverted microscope.The growth curves of untransfected and transfected BMMSC were drawn,respectively,to observe the influence of transfection on cells.The expression of SHH gene in the BMMSC was detected by PCR,RT-PCR,Western-blot analyses.Results Through fluorescence inverted microscope,the observed transfection rate was appropriately 30％,PCR showed a obvious increase of SHH expression in transfected cells than that in untransfected cells,and it is quantified by qPCR for appropriately 7 times.Western-blot further demonstrated that the SHH protein expression in transfected cells had a distinct increase.However,it was observed that the exponential phase of BMMSCSHH growth curve delayed.The growth curves of both overlap 12 days after transfection.Conclusions This electroporation method can transfect exogenous SHH gene into BMMSC sufficiently with the effective protein expression in BMMSCSHH.It is the foundation of further research of genetic therapy for ischemic heart disease.

Objective To investigate the survival and differentiated situation of transplanted mesenchymal stem cells ( MSCs) transfected with Sonic hedgehog (SHH) gene after chronic myocardial infarction (MI).Methods MSCs were obtained from bone marrow of limb bones by density gradient centrifugation combined with attachment culture method .SHH gene was cloned and eukaryotic expression plasmid pcDNA 3.1-SHH was constructed .Then nucleofector TM was used to transfer SHH gene into MSCs and the expres-sions of mRNA and protein of SHH gene were detected in vitro .Myocardial infarction model was established by ligating the left anterior descending branch .A total of 150μl (3 ×106 ) of MSCs transferred with SHH gene was injected into ischemic area at the fourth week after MI model was set up .Brdu immunohistochemical staining and electron microscope examination were used to detect the survival and differentiation of MSCs with SHH in vivo at the 1st, 2nd, 4th, and 8th week after MSCs SHH transplantation.Results It was con-firmed that SHH gene clone and the recombinant eukaryotic expression vector pcDNA 3.1-SHH construction were successful by gene se-quence analysis and double digestions with EcoR I and Bamh I .Reverse transcriptase polymerase chain reaction ( RT-PCR) and West-ern-blot demonstrated that the expression of SHH mRNA was significantly increased in transfected MSCs compared with untransfected MSCs.Brdu immunohistochemical staining confirmed MSCs with SHH were survived from one to eight weeks in MI area after transplan -tation.Electron microscope examination showed that MSCs had the trend to be differentiated into myocardiac -like cells in MI area at the 4th and 8th week after transplantation .Conclusions The expression of SHH mRNA was significantly increased while MSCs were transfected with SHH gene , and MSCs SHH could survive and differentiate in good condition in the transplanted recipients .Those data provide the experimental basis for further transgenic cell therapy research of ischemic heart disease .

Objective To achieve the best chance and optimize the method of operation,the clinical outcomes of 76 cases with complete atrioventricular septal defect (CAVSD) were summarized.Methods According to the Rastelli classification,there were 57 cases of type A,6 type B,and 13 type C.The repaired procedures included the two-patch technique for atrioventricular septal defect (65 cases),direct closure of ventricular septal defect (7 cases),and the Glenn bidirection shunt (4 cases).Results Two patients died.Of them,one was concomitant with double outlet right ventricle (DORV) and total anomalous pulmonary venous connection (TAPVC),died of low cardiac output syndrome; another was complicated with severe pulmonary hypertension,and the death reason was hypoxaemia and respiratory function failure.The survived patients were followed up,and the follow-up period was varied from one to ten years,mitral valve regurgitation was found in 12 cases,3 were middle and 9 were mild.Conclusions In order to prevent deteriorated condition of these patients and improve the survival rate,CAVSD should be operated as soon as the diagnosis is certain,and the co-exist malformation also should be corrected.

Objective:To analyze gene expression profiling of left ventricular myocardium in patients with chronic congestive heart failure(CHF)caused by rheumatic heart disease(RHD)with the normal controls in order to identify CHF associated target genes. Methods:The gene expression profiles of left ventricular myocardium from patients with CHF by RHD and normal controls were obtained from six human whole-genomic oligonucleotide microarrays(Affymetrix HG U133 Plus 2.0 GeneChip). GeneSpring software was used to identify the differentially expressed genes in both groups,and bioinformatic analysis was applied to analyze the target genes associated with CHF. Real-time PCR was carried out to validate the expression of three target genes. Results:We identified 102 target genes associated with CHF which were classified into 7 gene clusters. Microarray results were further confirmed by real time PCR for three genes. ATF3 was markedly down-regulated,IGFBP2 and NPPB were notably up-regulated in the left ventricular myocardium samples from CHF patients. Conclusion:A lot of differentially expressed genes,obtained by using the whole-genomic expression profiling technology,might be a contributory factor for the initiation and progression of CHF and it helpful for the understanding of underlying pathophysiological implications. Further investigation on these genes would provide a strategy to identify genetic markers and molecular events associated with CHF caused by RHD.

OBJECTIVE: To explore the effect of a new triple-branched aortic arch covered stent graft on DeBakey Type I aortic dissection, and to assess its efficacy in comparison with traditional surgery. METHODS: From January 2010 to November 2010, 38 patients of DeBakey Type I aortic dissection were treated surgically in the Second Xiangya Hospital of Central South University, in which 16 operations used triple-branched aortic arch covered stent grafts (stent graft group, SG group), 22 operations used traditional 4 sides branches aortic arch grafts (arch graft group, AG group). RESULTS: Compared with AG group, the cardiopulmonary bypass time[(138.1± 56.42) vs (179.21± 67.64) min], the clamp time [(98.56±28.08) vs (134.36±46.46) min] and the selective cerebral perfusion time[(27.3±14.76) vs (48.74±18.22) min] in SG group were obviously shortened(P<0.05). The volume of drainage 24 hours after operation in SG group also reduced[(608.93±308.15) vs (899.04±437.79) mL](P<0.05). The SG group had a lower rate of recurrent laryngeal nerve injury (6.25% vs 27.3%) and duration of hospitalization[(16.15±6.68) vs (21.18±12.69) d](P<0.05). During a following-up period of 14 to 24 months,reexamination of aortic CT angiography showed that the triple-branched aortic arch covered stent graft expanded well, and attached to the wall satisfactorily, while the corresponding false lumen of the aortic artery disappeared and the distal false lumen was filled with thrombus. The life quality of patients were good. CONCLUSION The new triple-branched aortic arch covered stent graft is appropriated for most patients with DeBakey Type I aortic dissection. Its use can simplify the aortic arch procedure,decrease the operation risk and has satisfactory results in early and middle stage after operation.
Adult ; Aneurysm, Dissecting ; surgery ; Aorta, Thoracic ; surgery ; Aortic Aneurysm ; surgery ; Blood Vessel Prosthesis Implantation ; instrumentation ; methods ; Cardiopulmonary Bypass ; Female ; Humans ; Male ; Middle Aged ; Stents ; Treatment Outcome

OBJECTIVE: To evaluate the effect of mitral annuloplasty of anterior mitral valve prolapse with artificial chord and mitral annuloplasty ring. METHODS: From March 2009 to December 2011, 32 patients having anterior mitral valve prolapse received mitral annuloplasty with artificial chord and mitral annuloplasty ring in our department, among which 27 simple anterior mitral valve plasty and 5 combine anterior-posterior mitral valve plasty were completed. RESULTS: All patients survived. Postoperative echocardiography showed no or trivial mitral regurgitation in 28 patients and mild mitral regurgitation in the other 4 patients. The diameter of the left atrium (LA) and left ventricle (LV), left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV) obviously decreased after the operation. During the follow up of 3 months to 3 years, the cardiac function of the patients improved at different degrees. CONCLUSION Reparation of anterior mitral valve prolapse with artificial chord and mitral annuloplasty ring is simple, reliable and effective, and its early to midterm result after the operation proves good.
Adolescent ; Adult ; Cardiac Surgical Procedures ; methods ; Chordae Tendineae ; surgery ; Female ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; Humans ; Male ; Middle Aged ; Mitral Valve ; surgery ; Mitral Valve Annuloplasty ; methods ; Mitral Valve Prolapse ; surgery ; Young Adult

Objective To explore methods for performance appraisal of directors of municipal hospitals in Shanghai.Methods To assess the management performance of directors of 24 tertiary hospitals each year,measured by five dimensions of social satisfaction,management efficiency,capital operation,development sustainability and staff satisfaction,and 23 indexes.Results Implementation of the performance appraisal has witnessed constant improvement of patient satisfaction and quality of medical care,as well as rational control of medical expenses and cost.In 2014 for example,the cost of emergency/outpatients per visit at such hospitals were 312 yuan and 1 5 600 yuan per hospitalization respectively,with 7.6 days of stay in average.Also improved were service efficiency,clinical research output and hospital business performance in general.Conclusion Performance appraisal of directors of public hospitals proves an important means for guiding the hospitals to adhere to public welfare, consistent with the government medical institution operation target, and to strengthen internal management of such hospitals.

OBJECTIVE: To evaluate the effect of different control levels of glucose on the serum lactic acid during operation, and to investigate the relation between glucose and lactic acid to find a new way of myocardial protection. METHODS: Volunteers were divided into an experiment group(n=38) and a control group(n=33) by random sampling and double blind method. The experiment group received intensive insulin therapy and the control group received traditional therapy. The arterial blood gas samples of all the patients at different time points after the operation were harvested in the intensive care unit for blood gas analysis. The related data were collected and analyzed. RESULTS: The serum glucose level in the 2 groups decreased firstly, then increased, and recovered finally. The serum lactic acid level in the 2 groups increased firstly, decreased later, then reincreased, and recovered finally. The highest level of the serum lactic acid was found 2 hours after the operation. There were significant differences in serum glucose and lactic acid levels at 2, 12, and 24 h after the operation in the two groups (P<0.01). The other data were not significant (P>0.05). CONCLUSION The variation of serum glucose and lactic acid level at 2, 12, 24 h after the valve replacement is consistent and significant. The serum lactic acid in the serum may be decreased by controlling the blood glucose, which provides experiment basis for myocardial protection.
Adult ; Cardiopulmonary Bypass ; adverse effects ; Double-Blind Method ; Female ; Heart Valve Prosthesis Implantation ; Humans ; Hyperglycemia ; blood ; drug therapy ; prevention & control ; Insulin ; therapeutic use ; Lactic Acid ; blood ; Male ; Middle Aged ; Postoperative Complications ; drug therapy ; prevention & control ; Rheumatic Heart Disease ; blood ; surgery