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Research Progress in Cell Transplantation for Treatment of Myocardial Infarction

The capacity for self-regeneration of the adult heart is very limited, conventional therapies cannot solve the loss of cardiomyocytes in the infarcted heart leads to continuous ventricular remodeling. Cell transplantation therapy is emerging as a novel approach for myocardial repair over conventional therapies. Various types of cell transplantation have improved cardiac function and angiogenesis in animal models and clinical settings. The safety and feasibility of some clinical trials have been initiated. In this review, we summarize the advantages and limitations of different cell types proposed for cell transplantation in myocardial infarction and give an overview of the clinical trials using this novel therapeutic approach in patients with myocardial infarction.

Research and clinical application progress of cardiac mapping in the electrophysiological mechanism of atrial fibrillation

Atrial fibrillation is one of the most common arrhythmia. Cardiac mapping technology, an important method to study the electrophysiological mechanism of atrial fibrillation, can determine the abnormal origin and record the distribution and transmission way of these atrial electrical signals. This technology offers a new way for research the electrophysiological mechanism of atrial fibrillation. The purpose of this study is to review the research progress of cardiac mapping in the electrophysiological mechanism of atrial fibrillation and clinical application.

Advances in artificial intelligence in prediction of atrial fibrillation

Atrial fibrillation (AF) is one of the most common arrhythmias. Today, there are a large number of AF patients worldwide, and incidence increases with the increase of age. However, the current diagnosis rate of AF via auxiliary examination is relatively low. In view of the widespread application of artificial intelligence (AI) in the medical field, the diagnosis of AF using AI has also become a research hotspot. This article briefly introduces the relevant aspects of AI and reviews the application of AI in AF prediction.

心内直视下射频消融改良迷宫术治疗心房颤动

目的 总结心内直视下射频消融改良迷宫手术治疗心房颤动的临床经验。 方法 2005年5月～2006年8月在心内直视手术同期采用射频消融改良迷宫手术治疗心房颤动30例，术前诊断风湿性心脏病26例，二尖瓣关闭不全3例，冠心病1例。手术采用Cardioblate TM冲洗式射频消融系统，每例患者分别应用单极系统和双极系统，按照迷宫手术线路分别于左、右心房行心内膜射频消融手术，并切除左、右心耳，同期完成相应的心脏手术。 结果 手术均顺利完成，射频消融手术时间30.5±12.6 min。术后死亡1例，其余29例顺利出院。术后当天21例患者（70.0％）转为窦性心律。29例患者出院后随访7.6±4.8个月，24例（82.8%）为窦性心律,5例（17.2％）为心房颤动或房室结性心律。 结论 心内直视下射频消融改良迷宫手术治疗心房颤动简单、有效，具有良好的临床应用前景。

胸部闭合伤的损伤严重度评估及临床意义

目的 探讨胸部闭合伤的临床特点及其损伤严重度评估的临床意义。方法 分析456例胸部闭合伤的致伤因素和死亡率，并按有无合并伤（分为单纯胸伤组、合并伤组）和结局（分为生存组、死亡组）分组进行创伤评分，分别比较不同组间的损伤严重程度。结果 致伤原因为交通伤发生率最高（60.97%）,其次为高处坠落伤(13.82%)。456例中288例合并其它部位损伤，占63.16%。死亡18例，死亡率3.95%。单纯胸伤组的格拉斯哥昏迷指数(GCS)、修正创伤评分(RTS)和生存概率(Ps)较高，损伤严重度评分(ISS)低于合并伤组，胸部简明损伤定级(AIS)评分两组间差别无显著性意义。死亡组和生存组比较，前者生理评分低，解剖评分高，生存概率亦低。结论 胸部闭合伤常合并全身多发伤，伤情判断困难。合理使用创伤评分有助于判断损伤严重度，指导临床救治。

心脏直视手术围术期尿微量蛋白变化的临床观察

目的 观察心脏直视手术围术期尿微量蛋白的变化并分析其临床意义.方法 40例心脏直视手术患者按疾病种类不同分为两组,组Ⅰ:风湿性心脏病瓣膜置换术患者(n=20);组Ⅱ:非紫绀型先天性心脏病患者(n=20).采用速率散射比浊法分别于术前1天,手术结束时,术后1天,术后3天和术后5天测定微白蛋白、转铁蛋白、免疫球蛋白G和α1-微球蛋白的浓度变化.结果 两组术后微白蛋白、转铁蛋白、免疫球蛋白G和α1-微球蛋白的浓度均明显升高(P＜0.05或P＜0.01),到达峰值后逐渐下降.两组比较,组Ⅰ术后改变较明显,持续时间也较长(P＜0.05或P＜0.01).结论 心脏直视术后存在不同程度的肾脏损害,风湿性心脏病瓣膜置换术患者术后的肾脏损害较重.尿微量蛋白测定可以敏感、准确地发现心脏直视术后亚临床肾脏损害.

华法林抗凝过量致自发性后腹膜出血一例

起源于二尖瓣瓣环的心脏粘液瘤一例

升主动脉不接触技术在非体外循环冠状动脉旁路移植术中的应用

目的 总结升主动脉不接触技术在非体外循环冠状动脉旁路移植术(offpump CABG)中的应用经验,以减少术后脑卒中的发生。 方法 回顾分析31例合并升主动脉粥样硬化冠心病患者的临床资料，男25例，女6例；年龄58~78岁，平均年龄71.3岁。5例联合应用offpump CABG和经皮腔内冠状动脉成形术（PTCA）杂交技术治疗，其余26例均采用常规胸骨正中切口径路行offpump CABG。9例双侧乳内动脉原位移植；16例以左乳内动脉为惟一的供血来源，大隐静脉或桡动脉近端与左乳内动脉端侧吻合；1例大隐静脉近端吻合到无名动脉。所有患者主动脉根部均无吻合口。 结果 5例“杂交”手术患者共经PTCA植入支架6枚，26例胸骨正中开胸患者移植血管74支（2~4支/例），全组患者手术均顺利完成，痊愈出院，无院内死亡。术后心绞痛消失24例，明显缓解7例。发生心房颤动2例，行二次开胸手术1例，肺部感染2例，切口感染1例，无围术期心肌梗死和神经系统并发症发生。随访29例，随访3个月~3年，失访2例。随访期间无死亡，1例行“杂交”手术患者术后1年心绞痛再发，其余28例患者生活质量良好，无神经、精神系统并发症发生。 结论 对合并升主动脉粥样硬化的冠心病患者，采用offpump CABG结合升主动脉不接触技术治疗，可有效地减少术后神经系统并发症的发生，临床效果满意。

Histone deacetylase: a potential target for the treatment of atrial fibrillation

Atrial fibrillation is a common arrhythmia associated with high mortality and morbidity, and the current treatment of atrial fibrillation is still limited. Histone deacetylase (HDAC) plays an important role in the pathophysiology of cardiovascular disease and promotes the occurrence of atrial fibrillation. Inhibition of HDAC may be a new therapeutic strategy through the regulation of atrial remodeling. Therefore, we reviewed the research progress of the HDAC and atrial fibrillation.