Research Status and Trend of Devices for Treating Advanced Heart Failure / 中国医学科学院学报

Heart failure (HF),a chronic progressive disease,is a global health problem and the leading cause of deaths in the global population.The pathophysiological abnormalities of HF mainly include abnormal cardiac structure (myocardium and valves),disturbance of electrophysiological activities,and weakened myocardial contractility.In addition to drug therapy and heart transplantation,interventional therapies can be employed for advanced-stage HF,including transcatheter interventions and mechanical circulatory assist devices.This article introduces the devices used for advanced HF that have been marketed or certified as innovative or breakthrough devices around the world and summarizes the research status and prospects the trend in this field.As diversified combinations of HF devices are used for the treatment of advanced HF,considerations regarding individualized HF therapy,risk-benefit evaluation on device design,medical insurance payment,post-market supervision system,and protection of intellectual property rights of high-end technology are needed,which will boost the development of the technology and industry and benefit the patients.

Recent Advance of Stainless Steel Used In Non-active Surgical Implantable Medical Device and Regulatory Perspective / 中国医疗器械杂志

Stainless steel has been widely used in non-active surgical implantable medical device of cardiovascular, orthopedics, dental and ophthalmology. In this paper, we mainly focused on development of stainless steel, as well as the material-related standard evolution. We further summarized the recent advancement of stainless steel use in surgical implantable medical device. Insight and regulatory perspective has been further demonstrated.

Lung transplantation as therapeutic option in acute respiratory distress syndrome for coronavirus disease 2019-related pulmonary fibrosis / 中华医学杂志(英文版)

BACKGROUND@#Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal medical support, have been noted to progress to irreversible fatal respiratory failure. Lung transplantation (LT) as the sole therapy for end-stage pulmonary fibrosis related to acute respiratory distress syndrome has been considered as the ultimate rescue therapy for these patients.@*METHODS@#From February 10 to March 10, 2020, three male patients were urgently assessed and listed for transplantation. After conducting a full ethical review and after obtaining assent from the family of the patients, we performed three LT procedures for COVID-19 patients with illness durations of more than one month and extremely high sequential organ failure assessment scores.@*RESULTS@#Two of the three recipients survived post-LT and started participating in a rehabilitation program. Pearls of the LT team collaboration and perioperative logistics were summarized and continually improved. The pathological results of the explanted lungs were concordant with the critical clinical manifestation, and provided insight towards better understanding of the disease. Government health affair systems, virology detection tools, and modern communication technology all play key roles towards the survival of the patients and their rehabilitation.@*CONCLUSIONS@#LT can be performed in end-stage patients with respiratory failure due to COVID-19-related pulmonary fibrosis. If confirmed positive-turned-negative virology status without organ dysfunction that could contraindicate LT, LT provided the final option for these patients to avoid certain death, with proper protection of transplant surgeons and medical staffs. By ensuring instant seamless care for both patients and medical teams, the goal of reducing the mortality rate and salvaging the lives of patients with COVID-19 can be attained.

aa155-171 Motif Deletion of MyD88 Attenuates Expression of Co-stimulatory Molecules and Cytokines in Immune Associated-cells / 中国生物工程杂志

Myeloid differentiation factor MyD88 is a critical adaptor molecule that integrates and transduces intracellular signals in inducing the differentiation of dendritic cells (DCs).The domain regions within MyD88 was searched,it could potentially affect the function of dendritic cells and found that MyD88 aa155-171 motif not only regulate the activity of transcription factor NF-?B, but also control the production of cytokines and expression of costimulatory molecules. Indeed, aa155-171 motif deleted type MyD88 (MyD88155-171) transfected RAW264.7 cells exhibited the reduced NF-?B and AP-1 activity and interrupted the expression of CD86 and B7H1. Meanwhile, lower level expression of cytokines such as IL-12,IFN-? were also observed by means of cytokine array in MyD88-/-DC trasfected with MyD88155-171 as compared to the MyD88 transfected cells. Thus, aa155-171 motif inside MyD88 could affect the expression of costimulatory molecules, production of cytokines and transduction of Toll like receptor signal pathway, suggesting that this motif may play an important role in regulating responses of innate immune system.