简介：SincePresidentObamaannouncedthePrecisionMedicineInitiativeintheUnitedStates,moreandmoreattentionhasbeenpaidtoprecisionmedicine.However,clinicianshavealreadyusedittotreatconditionssuchascancer.Manycardiovasculardiseaseshaveafamilialpresentation,andgeneticvariantsareassociatedwiththeprevention,diagnosis,andtreatmentofcardiovasculardiseases,whicharethebasisforprovidingprecisecaretopatientswithcardiovasculardiseases.Large-scalecohortsandmultiomicsarecriticalcomponentsofprecisionmedicine.Herewesummarizetheapplicationofprecisionmedicinetocardiovasculardiseasesbasedoncohortandomicstudies,andhopetoelicitdiscussionaboutfuturehealthcare.

简介：Somehavesuggestedtheterm“Precision”medicinereplace“Personalized”medicine.Idon’tlikeeithertermandI’lltellyouwhy.WhatisPrecision?ThewordPrecisioncanbedefinedsimplyasreproducibilityanddoesnotnecessarilymeanthatthediagnosisisaccurate.Thus,ifthemedicaldecisionisprecisebutnotnecessarilyaccurateitisnotveryuseful.Accuracyisdefinedasbeingneartothetrueordesiredvalue.e.g.consideratargetonariflerange;iftheshotshaveatightgroupinganywhereonthetarget,theyareprecisebuttheyareonlypreciseandaccurateifthattightgroupingisintheBull’seye.

简介：Somediseasesotherthancardiacdiseasecanbe“prevented”,butthepurposeofthiscommunicationwrittenbyaclinicalcardiologist,notasapreventionspecialist,istofocusstrictlyoncardiovasculardisease.Thedefinitionofpreventivemedicineinsimplesttermsmeanskeepingyourpatienthealthy.Inadditiontomaintaininghealth,ofcourse,wewanttopreventthedisabilityassociatedwithcardiacdiseaseaswellasdeathintheyoungerperson.

简介：AreviewarticlebyHaoetal.(JAmCollCardiol2017;69(24):2952–66)hashadhugerepercussionsamongthosefamiliarwithtraditionalChinesemedicine(TCM)intheinternationalacademiccommunity.ItevaluatedtheefficacyandsafetyofTCMforcardiovasculardiseaseandthepharmacologicaleffectofactiveTCMingredientsonthecardiovascularsystemandpotentialmechanisms.Wehaveseveralcomments:Firstly,wegiveabriefsummaryaddressingnonpharmacotherapyinTCM,includingacupuncture,moxibustion,Qigong,andTaiChi.Secondly,wehaveaddedtraditionalantiarrhythmicdrug–relatedrandomizedcontrolledtrialstomakethecoveragemorecomprehensive.Lastly,wesupporttheconceptthatresearchinto,developmentof,andapplicationofactiveingredientsispartofmodernTCM.

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简介：BackgroundTherequisitetechniquesforsafefetalcardiacarrestduringcardiacinterventionsneedtobefurtherdeveloped.Furthermore,littleisknownaboutthepathophysiologiceffectofcardiopulmonarybypass(CPB)atdifferentlevelsoftemperaturewithcardioplegicarrestonthedevelopingfetus.MethodsTwelvepregnantgoatswererandomlydividedintohypothermicCPBgroup(Hgroup):cardiopulmonarybypasswithperfusionat30-32℃(n=6)andnormothermicCPBgroup(Ngroup):cardiopulmonarybypasswithperfusionat36℃-38℃(n=6).Fetalcardiopulmonarybypasswasmaintainedincluding30minutesofcardiacarrest.Fetalmeanarterialbloodpressure(MAP)andheartrate(HR)weremonitored.Fetalarterialbloodsampleswereanalyzed.Thepulseindex(PI)andresistanceindex(RI)ofthefetalumbilicalarterywererecorded.ResultsThematernalweight,fetalweightandpumpflowhadnosignificantdifferencebetweenthe2groups.Afterclampremoval,twofetalheartsdidnotauto-beatinHgroup.ThefetalHRandMAPbweresignificantlydifferent(P<0.05)etweenthe2groups.Therewasremarkabledecreasinginpost-CPBfetalHRandMAPinHgroup.AstabledecreaseinpartialpressureofoxygenwithaconcomitantstableincreaseofcarbondioxidepartialpressureinHgroupwasnoted.ThelacticacidinHgroupwassignificantlyhigherthanthatintheNgroup(P<0.05).ThePIandRIinHgroupweresignificantlyelevated1hourafteroffCPBandfurthermarkedlyincreased2hoursafteroffbypass.ConclusionsFetalCPBcouldbeperformedunderbothhypothermicandnormothermicconditions.However,normothermicbypassmayprovidebetterdeliveryofoxygentofetaltissue.

简介：BackgroundOurpreviousstudyshowedthe150mg/mLfetalcardiacsupernatant(FCS)couldinducedifferentiationofBMSCsintocardiomyocye-likecellswithoutcardiomyocytetouch,butdifferentiationefficiencyisnothighenough.Inhibitionofglycogensynthasekinase-3enhancedtheproliferationandsurvivesofstemcells.Wetestedif6-bromoindirubin-3-oxime(BIO,glycogensynthasekinase-3inhibitor)enhancestheeffectsofFCSondifferentiationofBMSCsandexplorethegrowthfactorsinFCS.MethodsBMSCswereisolatedfromthefemurandtibiaoffour-week-oldmaleSprague-Dawleyratsandco-culturedwithFCS(150mg/mL)thatwasmadefromfetalheartsfromnineteen-daypregnantWistarrats.BIOwithdifferentconcentration(0,1,10,and100nM)wasintroducedinculturedishes.Transforminggrowthfactorbeta1(TGF-β1),bonemorphogeneticprotein2(BMP-2)andAktincardiacsupernatantandculturemediumwereassayedwithELISAmethods.ResultsAfterco-culturingwithFCS,beatingmyotubeswereobservedin25.9%BMSCsdishesafter1to2weeks’culture.ThelevelsofTGF-β1andBMP-2inFCSconcentrationswerenomorethanthatinyoungandadultcardiacsupernatant.AllBIOgroupssignificantlyenhancedtheeffectsofFCSondifferentiationofBMSCsintothecardiomyocyte-likecells(1nM,83%;10nM,73%;100nM,100%).AktlevelswerehigherinBMSCsculturalmediumwithFCS.ConclusionsFCScouldinducethedifferentiationofBMSCsintothecardiomyocyte-likecells.TGF-β1andBMP-2mightnotplayaroleinthedifferentiationofBMSCsinducedbyFCS.BIOenhancedtheeffectsofFCSonthedifferentiationofBMSCsintocardiomyocyte-likecells,whichmightinvolvetheAktpathway.

简介：Complicationsaremorefrequentinelderlypatientswithcoronaryheartdisease(CHD),suchasimpairedglucosetoleranceandconstipations.Itisalwaysdifficulttocurethesecomplicationsinclinicalpractice.Inthiscasewehadsuccessfullycuredaneighty-threeyearsoldmanwithCHDcomplicatingimpairedglucosetoleranceandconstipationbyintegratedChinese-Westernmedicine.