Computer-based online research was performed in Pubmed Database from January 1995 to January 2008, China National Knowledge Infrastructure (CNKI) and Vip Database from January 2001 to January 2008. Forty-four publications referred to the seeding cell sources of tissue engineering heart valve demonstrated some disadvantages of clinically used mechanical prosthetic valve and biological valve. Tissue-engineered heart valve had advantages, such as no anticoagulant therapy, infection resistance, cellular viability and the potential to grow and to repair. Seeding cells have different sources, such as blood vessels, bone marrow, blood, umbilical cord, chorionic vesicle and embryonic stem cells, with particular regard to cell phenotypes and their suitability for extracellular matrix production for tissue engineering purposes. Despite an exciting potential for tissue-engineered heart valves, significant technical barriers and clinical problems must be solved and overcome. Further studies should be conducted before widespread clinical application can be envisioned, such as biodegradable polymers, stem cell differentiation, understanding how to harvest the potential of endogenous recruitment of cells and techniques to non-invasively assess the speed and quality of tissue healing and remodeling. This needs to engender a host of novel testing strategies and methods, which will include in vivo safety studies and preclinical studies.

Objective To compare clinical effects between totally video-assisted thoracoscopic surgery and conventional median sternotomy for mitral valve replacement . Methods From March 2012 to October 2013, patients with simple mitral valve disease underwent mitral valve replacement through either right chest port -access totally video-assisted thoracoscopy ( thoracoscopy group, n=110) or conventional median sternotomy (conventional group, n=128).The time of operation, cross-clamp ascending aorta, cardiopulmonary bypass , postoperative mechanical ventilation , intensive care unit stay , postoperative hospital stay , and volume of postoperative chest drainage were compared between the two groups .All the patients were followed after 6 months postoperatively for evaluating the condition of valve regurgitation under echocardiography . Results Between the thoracoscopy group and the conventional group, no significant differences were found in time of operation [(256.2 ±28.5) min vs.(251.2 ±30.0) min, t=1.312, P=0.191], cross-clamp time of the ascending aorta [(40.0 ±2.7) min vs.(39.4 ±2.7) min, t=1.709, P=0.089], and cardiopulmonary bypass time [(74.2 ±4.1) min vs.(73.7 ±4.9) min, t =0.846, P =0.399].As compared to the conventional group, the thoracoscopy group had significantly shorter time of postoperative mechanical ventilation [(716.4 ±79.1) min vs.(811.9 ±58.8) min, t=-10.657, P=0.000], shorter length of intensive care unit stay [(26.2 ±3.6) h vs.(29.3 ±4.7) h, t=-5.640, P=0.000], shorter length of postoperative hospital stay [(9.6 ±1.2) d vs.(10.9 ±2.5) d, t=-4.982, P=0.000], and less volume of postoperative chest drainage [(328.1 ±83.2) ml vs.(561.3 ±143.9) ml, t=-14.978, P=0.000], respectively .No death happened in the two groups . No mitral valve regurgitation was seen during follow-ups at 6 months postoperatively . Conclusion For patients undergoing mitral valve replacement , totally video-assisted thoracoscopic surgery is superior to conventional median sternotomy with respect to surgical trauma .

Objective To study the diagnosis and treatment of pneumonia infected by Stenotrophomonas maltophilia (Sm) after open heart surgery.Methods The infections of Sm were proved by sputum culture.The data of risk factors?clinical feature and drug susceptibility were collected.Results Pneumonia of Sm occurred in 8 patients.They were often in poor conditions,in need of continuous mechanical ventilation and other inventions, and in use of extend-spectrum antibiotics.The infections of Sm hadn't special clinical manifestations. The isolates of Sm resistant to many antibiotics were usually found with other microorganisms.Conclusion It is important to pay more attention to pneumonia of Sm and to complete microbiological examinations in time,because patients after cardiosurgery are in great risk of the infection.

Objective:To observe whether transforming growth factor-beta 1 (TGF-?1) can improve the mechanical properties of tissue engineered heart valve (TEHV) prepared by TGF-?1 and myofibroblasts.Methods:Myofibroblasts were isolated,cultured,identified,and seeded onto the decellularized aortic valve leaflet.In the experimental group,TEHV were cultured with DMEM containing 10 ng/ml TGF-?1 for 14 days.In the control group,TEHV were cultured with DMEM only for 14 days.The contents of lysyl oxidase (LOX) and hydroxyproline,the expression of LOX and COLL-1 mRNA,and the mechanical properties of the TEHVs were analyzed in each group.Results:The contents of LOX and hydroxyproline,expression of LOX and COLL-1 mRNA,Max-load,and Max-stress were significantly higher in the experimental group than those in the control group (all P

Objective To investigate the effect and mechanism of adenovirus vector mediated SOCS 3 gene transfection in CD4+ Th cell differentiation and expression of inflammatory cytokines of mouse .Methods The CD4+ Th cells were isolated from spleen of C57bl/6 mouse and cultured .Ad‐SOCS3 were transfected into the CD4+ Th cells .PHA was used for culturing with the CD4+ Th cells .RT‐PCR were used to detect the mRNA expression ,and Western blot were used to detect the protein expression of cytokines .Results Compared with the control group ,the gene and protein expression of T‐bet ,IL‐2 ,IFN‐γ,STAT4 and IL‐12Rβ2 in the transfected group were significantly down‐regulated ,the gene and protein expression of SOCS3 ,GATA‐3 ,IL‐4 ,IL‐6 ,IL‐10 and STAT6 were significantly up‐regulated(P<0 .01) .Conclusion The results indicate that SOCS3 gene transfection can up‐regu‐late SOCS3 mRNA and protein expression in the CD4+ Th cells ,down‐regulate the JAK/STAT pathway ,inhibition of Th1 cell dif‐ferentiation ,and down regulation of inflammatory cytokine gene and protein expression ,and indirectly promote Th2 cell differentia‐tion ,and up the corresponding inflammatory cytokine gene and protein expression .

The cell adhesive properties of decellularized valve scaffolds were promoted by immobilization of valve scaffold with arginine-glycine-aspartic acid (RGD)-containing peptides. Porcine aortic valves were decellularized with trypsin/EDTA, and detergent Triton X-100. With the help of a coupling reagent Sulfo-LC-SPDP, the valve scaffolds were immobilized with glycine-arginine-glycine-aspartic acid-serine-proline-cysteine (GRGDSPC) peptide. X-ray photoelectron spectroscopy (XPS) was used for surface structure analysis. Myofibroblasts harvested from rats were seeded onto the valve scaffolds. Cell count by using microscopy and modified MTT assay were performed to assess cell adhesion. Based on the spectra of XPS, the conjugation of GRGDSPC peptide with decellularized valve scaffolds was confirmed. Both cell count and MTT assay showed that myofibroblasts were much easier to adhere to the modified valve scaffolds, which was also confirmed histologically. Our findings suggest that it is feasible to immobilize RGD-containing peptides onto decellularized valve scaffolds. And the technique can effectively promote cell adhesion, which is beneficial for in vitro tissue engineering of heart valves.

ObjectiveTo know the recent status of heart transplantation in Chinese multicenters.MethodsThe retrospectively data from 24 centers before 2010 (438 cases) and the data from China heart transplant Registry database between 2010 (149 cases from 15 centers)-2011(148 cases from 19 centers) were analyzed.Results In 2010,15 centers performed heart transplantation,including one large-scale center (60 transplants per year),3 moderate-scale centers (10 to 30 transplants per year),and 6 small-scale center (2-8 transplants per year).The rest 5 centers had one transplant per year each.In 2011,19 centers performed heart transplantation,including one large-scale center (52 transplants per year),3 moderate-scale centers (10 to 30 transplants per year),and 5 small-scale centers (2-8 transplants).The rest 8 centers had one transplant per year each.In 2010 and 2011,the median ages of heart transplant recipients were 44.6 and 42.9 years,respectively.Nonischemic cardiomyopathy was the leading indication for heart transplantation.The median donor age in 2010 and 2011was 30.2 and 30.8 years respectively.In 2010 and 2011,up to 99.3％ and 97.3％ of patients were treated with immune induction therapy,respectively.In 2010,the mortality at discharge was 10％,and that was 6％ in 2011.ConclusionAlthough total volume of heart transplants is still small in recent years,the discharge survival in China is similar to ISHLT report.

BACKGROUND: Previous studies demonstrated that smooth muscle injury or ischemia/reperfusion injury result in tissue factor (TF) increasing. However, few reports concern the expression and mechanism of TF in venous bypass grafting.OBJECTIVE: To examine changes in TF protein expression in response to venous bypass grafting.DESIGN, TIME AND SETTING: The animal observation experiment was performed at the Department of Cardiovascular Surgery, Affiliated Union Hospital of Tongji Medical College, Huazhong University of Science and Technology from May 2006 to May 2008.MATERIALS: A total of 30 Sprague-Dawley (SD) rats.METHODS: Rats were underwent interposition bypass grafting of the common carotid artery via the ipsilateral external jugular vein. Namely, the proximal end of external jugular vein was ligated at the joints of external jugular vein and internal jugular vein, and the distal end of external jugular vein was ligated before branches. The proximal and distal ends of common carotid artery were occluded by artery clamp, and a 5 mm artery was removed. The proximal end of artery was anastomosed with distal end of artery, and the frontal wall was sutured with posterior wall. After that, the proximal end of external jugular vein was cut down and coincided with the distal end of common carotid artery.MAIN OUTCOME MEASURES: The expression of TF and proliferating cell nuclear antigen (PCNA) was detected by immunohistochemistry. Meantime, TF activity in vessel protein extracts was determined with TF activity assay kit, and the thickness of intima, media were calculated by computer imaging analysis system. The contralateral external jugular veins were served as the control.RESULTS: The adventitia of all vessels showed abundant TF staining. In early vein grafts, TF staining was markedly increased in the intima and media. However, intimal and media TF staining was absent in the contralateral control jugular veins and late vein grafts. The number of PCNA positive cells was increased in the vein grafts at day 3 after grafting, obvious increased at day 7, and reached the peak at day 14. TF activity in whole-vessel protein extracts was similar in control veins and early and late vein grafts. The thickness of neointima of the vein graft increased significantly at days 7, 14, and 28, and the thickness of media increased significantly at days 14 and 28.CONCLUSION: The changes of TF expression at various time points may relate to hyperplasia of neointima.

Objective Given the significant differences of ischemia-time tolerance observed in clinical heart transplantation between heart and other solid organs,it is important to make a clinical assessment of the correlation between the cold ischemic time of the donor heart and the survival rate after heart transplantation.With these results,we may standardize the management of clinical heart transplantation by providing a proper heart cold ischemic time frame for reference.Method The clinical data of 131 orthotopic heart transplantation patients in our hospital,from September 2008 to March 2014,were collected and analyzed retrospectively.All donor hearts were preserved in histidinetryptophan-ketoglutarate solution (HTK solution) during cold ischemic time.The cold ischemia time was 103-485 min,with an average of 245.2 ± 120.4 min.According to the cold ischemic time,all patients were divided into three groups:＜ 3 h (n =62); 3-6 h (n =41); ＞6 h (n =28).Result (1) Prolonged cold ischemia time could result in high IABP usage perioperatively (postoperative IABP support rate for the three groups was 3.2％,9.8％ and 14.3％ respectively,P =0.155) and high rejection rate (incidence of rejection was 6.4％,9.8％ and 17.9％ respectively,P =0.245),but there was no statistically significant difference.(2) Three weeks after the transplantation,all EF values of the three groups were reduced within the normal range,with no significant difference.Perioperative overall survival rate was 97.7％ (128/131),while survival rate of the three groups was 97.29％ (72/74),100％ (30/30) and 96.29％ (26/27),respectively (P =0.61).(3) One-year overall survival rate was 89.87％ (71/79),and the one-year survival rate of three groups was 92.2％ (47/51),90.9％ (10/11) and 82.4％ (14/17) respectively (P=0.51).Fifty-two patients were still under 1 year follow-up period.This study aimed to illustrate the effect of different cold ischemic time on perioperative cardiac function,rejection rate,IABP usage postoperatively (intra-aortic balloon pump or intra-aortic balloon counterppulsation) and early/mid-term efficacy after transplantation.Conclusion Cold ischemic time within 6-8 h is clinically safe for heart transplantation,and can provide satisfactory early and medium-term effect.Donor heart with cold ischemia time longer than 6 h may extend the recipient inclusion criteria.But considering the safety of transplantation,these donor hearts may be more applicable for the marginal recipients.This study describes the relationship between cold ischemic time and early and medium-term effect of heart transplantation.However,its long-term effects still require further investigation.

Objective To summarize and analyze the primary data from China Heart Transplant Registry in 2013 in order to explore the current status of heart transplantation in Chink Method Seventeen transplant centers have conducted 231 cases of heart transplantation in the year 2013.We analyzed the preoperative risk factors which impacted the survival of heart transplant recipients by using univariate and multivariate logistic regression analysis.And long-term survival of the 398 heart recipients from Beijing Fu Wai Hospital,who were followed up from June 2004 to December 2013 (follow-up rate was 100 ％) was calculated by the Kaplan-Meier method.The risk factors for long-term survival of heart transplant recipients were calculated by the COX survival analysis methods.Result The mean hospital stay of the 231 recipients was 24 days.There were 25 cases who died in hospital,and the total mortality was 10.8 ％ (25/231),while the average in-hospital mortality was 2.2 ％ in the three largest centers.By using the univariate and multivariate logistic regression analysis,we found that recipients positive PRA was the only preoperative risk factor which impacted the in-hospital mortality.(OR=12.435,95％ CI 1.369～ 112.938,P =0.025).The median follow-up time of the 398 heart transplant recipients from Beijing Fu Wai Hospital was 1383 days,and the 1-,3-,5-and 7-year survival rate was 94.7％,91.6％,88.0％ and 82.6％ respectively.The univariate and multivariate COX regression analysis revealed that preoperative primary diseases (coronary heart disease vs.cardiomyopathy,P ＜ 0.01),the history of chronic obstructive pulmonary disease (P ＜ 0.01),the preoperative total bilirubin level (P＜0.05) and serum creatinine level (P＜ 0.01) were risk factors affecting long-term postoperative survival.Conclusion In China the number of heart transplants has increased in 2013.The survival rate of recipients is high in large heart transplant centers.The integrity of registration data needs to be further improved in some centers.