Shengmai Injection Inducing Stem Cells In Myocardium To Differentiate Into Cardiomyocytes And Perform Myocardial Preservation In Cardiopulmonary Bypass

In the past, the adult heart had been regarded as terminally differentiated organ, cells isolated from which did not have the capability of generation and differentiation. With the development of technology in cell biology and studying much further, the opinion that there are a cluster of cells with the characteristics of stem cells in the heart have been accepted. In this study, four kinds of cell culture medium containing different concentration of Shengmai injection were used for cell expansion in order to assess whether Shengmai injection could induce stem cells in myocardium to differentiate into cardiomyocytes. Then a clinical trial would be carried out to confirm that Shengmai injection was able to extenuate myocardium ischemical reperfusion injury and to explore the ralationship between cardiac stem cells (CSC) differentiation and myocardial preservation in cardiopulmonary bypass.Part one Shengmai injection inducing the stem cells in myocardium to differentiate into cardiomyocytes in vitroObjective To isolate cells from myocardium and try to abstract cardiac stem cells, then assess whether Shengmai injection could induce stem cells in myocardium to differentiate into cardiomyocytes.Methods After patients'written consent, myocardium discarded in cardiac operation were collected and digested to dissociate and extract heart cells. A few weeks later, the cells were expanded and used to separate the stem cells by the way of immunomagnetic beads sorting. Then four kinds of cell culture medium containing different concentration of Shengmai injection were applied to induce stem cells in myocardium to differentiate into cardiomyocytes and the specificity transcription factors and protein of cardiomyocytes were detected by the method of immunocytochemical staining.Results Heart cells were isolated and expand in vitro successfully and the cell culture medium containing concentration of 5μl/ml and 10μl/ml Shengmai injection could induce stem cells in myocardium to differentiate into cardiomyocytes, but regrettably the cardiac stem cells were not able to sort from heart cells.Conclusion The cell culture medium containing appropriate concentration can induce stem cells in myocardium to differentiate into cardiomyocytes, but the cardiac stem cells were not able to sort from heart cells because of their much low number.Part Two Shengmai performing myocardia) protection during cardiopulmonary bypassObjective To comfirm that Shengmai injection can extenuate ischemia-reperfusion injury caused by cardiopulmonary bypass and determine whether Shengmai injection could induce stem cells in myocardium to differentiate into cardiomyocytes in vivo.Methods After patients'written consent, six blood samples were acquired at six time points in perioperative period which were used to test the contents of SOD,MDA,cTnl and CK-MB in serum. A small size of myocardium was taken in every patient and cardiac-specific transcription factors(GATA4,Nkx2.5)and cardiac-specific proteins(Cx 43,cTnI) were detected by the method of immunocytochemical staining.Results There was no significantly difference in serum SOD activity and MDA content between the two groups on admission. But before operation, serum SOD activity was significantly higher in the experimental group and in the day after surgery serum MDA level was significantly lower than that in the control group. And Serum cTnl and CK-MB levels were significantly different between the experimental and control group. Fluorescence intensity of NKx2.5 GATA-4 in the experimental group was significantly stronger than that of the control group, and fluorescence intensity of cTnT and Cx43 in experimental group was also stronger than that of the control group but no significant difference.Conclusion Shengmai injection could enhance the SOD activity and inhibit lipid peroxidation which extenuate ischemia-reperfusion injury caused by cardiopulmonary bypass during. Stem cells in myocardium differentiation into cardiomyocytes might also be involved in myocardial protection during cardiopulmonary bypass.Part three Preliminary characterization of acute aortic dissection in Mainland China——Comprehensive analysis of the literature in comparison with the International Registry of Acute Aortic Dissection (IRAD)Objective Acute aortic dissection (AAD) is a clinical emergencies with high morbidity and mortality. In order to more fully understand the characteristics of AAD, the International Registry of Acute Aortic Dissection (IRAD) was established but the registry had only enrolled cases from developed countries, which could not be sufficient to know the full extent of this condition. And there may also be some differences in the characteristics of AAD between IRAD countries and Mainland China(MC).Methods Reports from IRAD and MC were collected by searching in the PubMed Databases and the Chinese Journal Full-text Database, and patients'data were abstracted. The 2 groups were compared using the chi-square test, Fisher's exact test and Student's t test as appropriate.Results AAD patients from MC were significantly younger than IRAD and the percentage of male patients in the Chinese group was higher than IRAD (80.7% vs 68.6%, P<0.001). Patients in MC were less likely to present with typical symptoms and signs except for any focal neurological deficits. Different from the IRAD group, Chinese patients were prone to undergo magnetic resonance imaging (MRI) to make the diagnosis of AAD (45.5% vs 11.6%, P<0.001). The in-hospital mortality was similar between 2 groups but only smaller proportion of AAD patients in MC underwent surgical or medical treatment.Conclusions From this paper, the general characteristics of AAD patients in MC were shown and differences in some clinical variables between MC and IRAD groups still existed. However, the results need to be proved by much further studies.