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.

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.

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.

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.

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

Objective To investigate the effects of emodin on the migration and proliferation of vascular smooth muscle cell (VSMC) and the metabolism of emodin in VSMC. Methods The effects of emodin on the migration or proliferation of vascular smooth muscle cell were measured by “transwell" migration system and MTT assay. Results The migration of VSMC could be significantly inhibited by emodin and the inhibitory ratio was 83.8% in 5 ?g/mL emodin group. The antiproliferative effect of emodin was in a dose- and time- dependent manner. However, the supernatant concentration of emodin insignificantly dereased after culture for 24 h. The cytotoxicity of emodin and cellular ROS was not influenced by CYP inducer or inhibitor. The mRNA expression of emodin's primary metabolic enzyme (cytochrome p450 oxidase, CYP) up-regulated insignificantly after treatment of emodin for 24 h. Conclusion Emodin can inhibit the migration and proliferation of VSMC and can not be metabolized by VSMC. Emodin may be a choice for the medication of drug-eluting stent.

Objective To investigate whether host collateral vessels play a role in the cardiac repair induced by intracoronary injection of bone marrow mononuclear cell (BMMNCs) in a swine myocardial infarction (MI) model. Methods MI was induced in swine models by ligation of left anterior descending artery. Two weeks later, twenty animals with Rentrop score=0 (R0) or Rentrop score=1 (R1) received either intracoronary PBS or BM-MNCs (2?10~8 cells) infusion. Results At 6 weeks after MI, Rentrop score was significantly increased in the R1+BMT group. Ejection fraction and fractional shortening evaluated by echocardiography were increased in both R0+BMT and R1+BMT groups and the greatest improvements were seen in the R1+BMT group. Consistent with the changes in cardiac function and Rentrop score, the greatest degree of angiogenesis and cell count of engrafted BM-MNCs occurred in the R1+BMT group 6 weeks post MI. Conclusion The existence of intrinsic collateral vessels contributes to the beneficial effects for cardiac repair post MI by intracoronary BM-MNCs transplantation.

70%(59 male and 22 female,mean age 61?11 years)were enrolled in the study,IVUS was done in 55 cases before and after percutaneous coronary intervention(PCI)with 24 patients from the SFCT group and 31 patients from the conventional percutaneous coronary angioplasty(POBA).Quantitative coronary angiography(QCA)measurements included minimal lumen diameter(MLD),reference lumen diameter(RLD)and diameter stenosis(DS);IVUS measurements include external elastic membrane area(EEMA),minimal lumen area(MLA),and area stenosis(AS),style of endomembrane tear and dissection.Results All the target lesions were successfully dilated in both groups without serious complications.Mean dilated pressure was lower in the SFCT group than that in the POBA group(871.4 kPa vs 1 013.2 kPa P

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 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