While biventricular assist devices(BiVADs)remain underutilized in Western countries for biventricular heart failure(BHF),their application is expanding in China.This consensus synthesizes international guidelines,medi...While biventricular assist devices(BiVADs)remain underutilized in Western countries for biventricular heart failure(BHF),their application is expanding in China.This consensus synthesizes international guidelines,medical evidence,and Chinese clinical expertise to establish standardized protocols for BiVAD management.Key recommendations include:(1)Preoperative right heart catheterization and echocardiography for central venous pressure(CVP):pulmonary capillary wedge pressure(PCWP)ratio and pulmonary artery pulsatility index(PAPi)assessment(Class I);(2)BiVAD indication in refractory BHF or high-risk right heart failure post-left ventricular assist device(LVAD)implantation(Class IIa);(3)Right atrial implantation as the preferred surgical approach(Class IIa);(4)Warfarin-based anticoagulation(INR 2.0–2.5)with aspirin,avoiding direct oral anticoagulants(DOACs)(Class III).The guidance addresses critical gaps in patient selection,pump speed titration,and complication management,positioning integrated BiVAD systems as a promising solution for complex BHF.展开更多
Mesenchymal stem cell(MSC)transplantation has been explored for the clinical treatment of various diseases.However,the current two-dimensional(2D)culture method lacks a natural spatial microenvironment in vitro.This l...Mesenchymal stem cell(MSC)transplantation has been explored for the clinical treatment of various diseases.However,the current two-dimensional(2D)culture method lacks a natural spatial microenvironment in vitro.This limitation restricts the stable establishment and adaptive maintenance of MSC stemness.Using natural polymers with biocompatibility for constructing stereoscopic MSC microenvironments may have significant application potential.This study used chitin-based nanoscaffolds to establish a novel MSC three-dimensional(3D)culture.We compared 2D and 3D cultured human umbilical cord-derived MSCs(UCMSCs),including dif-ferentiation assays,cell markers,proliferation,and angiogenesis.When UCMSCs are in 3D culture,they can differentiate into bone,cartilage,and fat.In 3D culture condition,cell proliferation is enhanced,accompanied by an elevation in the secretion of paracrine factors,including vascular endothelial growth factor(VEGF),hepa-tocyte growth factor(HGF),Interleukin-6(IL-6),and Interleukin-8(IL-8)by UCMSCs.Additionally,a 3D culture environment promotes angiogenesis and duct formation with HUVECs(Human Umbilical Vein Endothelial Cells),showing greater luminal area,total length,and branching points of tubule formation than a 2D culture.MSCs cultured in a 3D environment exhibit enhanced undifferentiated,as well as higher cell activity,making them a promising candidate for regenerative medicine and therapeutic applications.展开更多
文摘While biventricular assist devices(BiVADs)remain underutilized in Western countries for biventricular heart failure(BHF),their application is expanding in China.This consensus synthesizes international guidelines,medical evidence,and Chinese clinical expertise to establish standardized protocols for BiVAD management.Key recommendations include:(1)Preoperative right heart catheterization and echocardiography for central venous pressure(CVP):pulmonary capillary wedge pressure(PCWP)ratio and pulmonary artery pulsatility index(PAPi)assessment(Class I);(2)BiVAD indication in refractory BHF or high-risk right heart failure post-left ventricular assist device(LVAD)implantation(Class IIa);(3)Right atrial implantation as the preferred surgical approach(Class IIa);(4)Warfarin-based anticoagulation(INR 2.0–2.5)with aspirin,avoiding direct oral anticoagulants(DOACs)(Class III).The guidance addresses critical gaps in patient selection,pump speed titration,and complication management,positioning integrated BiVAD systems as a promising solution for complex BHF.
文摘Mesenchymal stem cell(MSC)transplantation has been explored for the clinical treatment of various diseases.However,the current two-dimensional(2D)culture method lacks a natural spatial microenvironment in vitro.This limitation restricts the stable establishment and adaptive maintenance of MSC stemness.Using natural polymers with biocompatibility for constructing stereoscopic MSC microenvironments may have significant application potential.This study used chitin-based nanoscaffolds to establish a novel MSC three-dimensional(3D)culture.We compared 2D and 3D cultured human umbilical cord-derived MSCs(UCMSCs),including dif-ferentiation assays,cell markers,proliferation,and angiogenesis.When UCMSCs are in 3D culture,they can differentiate into bone,cartilage,and fat.In 3D culture condition,cell proliferation is enhanced,accompanied by an elevation in the secretion of paracrine factors,including vascular endothelial growth factor(VEGF),hepa-tocyte growth factor(HGF),Interleukin-6(IL-6),and Interleukin-8(IL-8)by UCMSCs.Additionally,a 3D culture environment promotes angiogenesis and duct formation with HUVECs(Human Umbilical Vein Endothelial Cells),showing greater luminal area,total length,and branching points of tubule formation than a 2D culture.MSCs cultured in a 3D environment exhibit enhanced undifferentiated,as well as higher cell activity,making them a promising candidate for regenerative medicine and therapeutic applications.
