Abstract： Objective To investigate the extracellular matrix （ECM） gene expression profile of saphenous vein （SV） in end-stage renal disease （ESRD） patients undergoing coronary artery bypass grafting （CABG）. Methods Sixty-eight patients who were diagnosed as coronary artery disease by coronary angiography and admitted to Department of Cardiovascular Surgery，Zhongshan Hospital of Fudan University from July 2004 to December 2010 were enrolled in this study. According to whether or not they had preoperative ESRD history，all the 68 patients were divided into 2 groups，the ESRD group with 30 ESRD patients who needed maintenance hemodialysis，and the control group with 38 patients without preoperative renal disease. Preoperative clinical data of all the patients were collected in detail. SV samples were obtained at the time of CABG. Microarray，immunohistochemistry and Western blotting were used to investigate the expression profile of ECM genes of SV in ESRD patients undergoing CABG. Results There was no statistical difference in preoperative clinical variables between the 2 groups except the variables which were directly related to their kidney disease （P＞0.05）. There were 16 genes that were up-regulated at least 3-fold and 3 genes that were down-regulated at least 3-fold in the ECM gene expression profile of SV in the ESRD group patients before CABG. The expressions of matrix metalloproteinases-2 （MMP-2） and matrix metalloproteinases-9 （MMP-9） of the ESRD group were significantly higher than those of the control group （2.60±0.50 vs. 0.70±0.16，1.80±0.40 vs. 0.60±0.15，P＜0.01）. The expressions of tissue inhibitor of metalloproteinase-2 （TIMP-2） and tissue inhibitor of metalloproteinase-3 （TIMP-3） of the ESRD group were significantly lower than those of the control group （0.60±0.19 vs. 2.20±0.30，0.90±0.28 vs. 2.40±0.70，P＜ 0.05）. Conclusion A variety of ESRD-related risk factors of cardiovascular diseases may severely influence on the balance of ECM gene expression of SV before CABG，and the resulting imbalance is a risk factor to aggravate SV graft disease after CABG.
The establishing of myocardial tissue engineering techniques not only solve a series of issues that generate in cell and tissue transplantation after myocardial infarction, but also create a platform for selecting better materials and transplantation techniques. However, both experimental animal studies and recent clinical trials indicate that current transplantation techniques still have many defects, mainly including lack of suitable seed cells, low survival rate and low differentiation rate after transplantation. In this context, extracellular matrix （ECM）, as myocardial tissue engineering scaffold materials, has gained increasing attention and become a frontier and focus of medical research in recent years. ECM is no longer merely regarded as a scaffold or a tissue, but plays an important role in providing essential signals to influence major intracellular pathways such as cell proliferation, differentiation and metabolism. The involved models of ECM can be classified into following types：natural biological scaffold materials, synthetic polymer scaffold materials and composite scaffold materials with more balanced physical and biological properties. This review mainly introduces research progress of ECM in myocardial tissue engineering and ECM materials.
Objective To investigate pathogenesis and therapeutic prospect of abdominal aortic aneurysm (AAA). Methods Relevant literatures about pathogenesis and ways of treatment for AAA in recent years were reviewed. Results The formation of AAA are associated with heredity, anatomy, environment and biochemistry and other factors. All factors influence and interact with each other. The metabolic disequilibrium of aortic intermediate extracellular matrix plays an important role in the pathogenesis of AAA. The main reasons for the formation of AAA may be the increase of activity of matrix metalloproteinases and the disequilibrium of genetic expressions of elastin and collagen. The therapy of AAA includes surgical and medical treatment. The methods of medical treatment are still in the process of exploration and research. Conclusion The formation of AAA is a synergistical result of multiple factors, and medical treatment is an important supplement of surgical treatment.