---- Cardiovascular Diseases

A. Introduction of the team

Team Leader: Prof. DONG Nianguo, national-renowned professor, doctoral instructor, winner of the State Council's Government Subsidies, young and middle-aged experts with outstanding contributions recognized by the Ministry of Health, director of Cardiovascular Surgery Department (National Clinical Key Specialty) and the director of the Organ Transplant Center (national key discipline) of HUST. A member of the American Association of Thoracic and Cardiac Surgery (AATS). Editorial Board Member of many prominent medical journals such as the Clinical Cardiovascular Disease, Innovation, International Cardiovascular Disease and Acta Med Univ SciTechnol Huazhong (Med Sci) etc.

Long-term commitment to cardiovascular clinical surgery, scientific research and teaching, performed more than 4,000 heart vessels surgical operation independently in the last five years with low mortality and rare complications, carried out various types of surgical operations on severe infant congenital valve diseases, minimally invasive valve replacement/plastic surgery, bypass surgery, minimal invasive coronary bypass surgery and artificial intelligence robot heart surgery. Especially in 2008, a total of 498 cases of heart transplantation were completed, with 96% survival rate among with 84% survived in five years, no.1 in China regarding the total number of operation in the field, created multiple domestic and international records: the first to carry out the "suboptimal / marginal hearts" surgery application in China, the largest number of heart transplantation in infants (37 cases) among which the youngest infant in Asia(3-month old, 4.25Kg), the world's oldest patient heart transplantation (76-year-old); China’s first and Asia’s third case of heart-liver joint transplantation, ranked forefront in the heart and multi-organ transplantation (4 heart-lung cases, 1 heart-liver case, 1 heart-kidney case) in China.

Team Members

B. Main Research Areas

1. Research on New Heart Valve Replacement

A series of achievements have been made in the research of tissue engineering----heart valve stent materials, seed cells and their interactions: 1) established high bionic decellularized valve scaffold handling and preparation system 2) proved that biological signal molecules and polymer materials can improve the decellularized valve scaffold’s adhesion and growth on seed cells; 3) be the pioneers in putting forward concepts like "composite stent", "active molecular improvement on biological properties", "stent modification to improve mechanical properties" and "micro-environment simulation" etc. Which were widely recognized by domestic and international counterparts; 4) In the light of the existing biological valve production process, try branched PEG cross-link modification to  construct TEHV with decellularized valve scaffold, and to improve the biomechanics performance.This research has acquired a number of patents in China, and as independent innovation of intellectual property which is expected to convert to clinical application.

2. The Research on Pathogenesis of Calcified Valvular Heart Disease

Creative research and study work on pathogenesis of CVHD: 1) discovered that in the calcified heart valves, the expression of receptor for advanced glycation end products (RAGE) increased and endoplasmic reticulum stress (ER stress) is activated. If the activity of RAGE could be inhibited by drugs or genetically removed, the ER stress could then be inhibited so that the infiltration of macrophage and the calcification in the heart valves could be reduced. 2) discovered that the macrophage participates in the calcification process of the heart valves. 3) discovered that inflammatory factors like HMGB1, IL-18 and IL-1 significantly increased in the peripheral blood of the CVHD patients. HMGB1, IL-18 and IL-1 might not only induce valvular interstitial cells to differentiate into osteoblastic cells, but also induce the calcification of valvular interstitial cells. The level of inflammatory factors in the human peripheral blood might be the biomarker which signals the clinical progress and severity of valvular heart calcification. 4) MicroRNA-204 regulates targeted the activity of osteogenic transcription factors Runx 2 and inhibits the osteoblastic differentiation and calcification of valvular interstitial cells.

C. Resources & Advantages

The Cardiovascular Department of Union Hospital Affiliated to Huazhong University of Science and Technology is the national clinical key specialty and the key subjects of Ministry of Education (specialized in heart transplantation). It is one of the earliest major centers in China performing clinical heart valve surgeries, and stayed forefront among international peers in research and development of heart valve pathology and valve replacement.In 1976, cow's pericardium valve was successfully made by the Center and used for clinical purposes, much earlier among the peers in China, and meanwhile, studies were made on its biological properties and decay mechanism. In 1978, second prize was awarded in the National Science and Technology Conference. In 1995, the Center first indicated the valve leaflet tear is a common cause for cow's pericardium valve failure, and suggested that the soft valve ring may help prevent biological valve failure, which is widely applied at home and abroad.

In 1999, regrading the Chinese coagulation/anti-coagulation predisposition, the Center first put forward the strategy of low-intensity anti-anticoagulation (INR1.7-2.0) after the mechanic valve replacement operation, which reduced the postoperation complications significantly. A series of innovative concepts were advanced in the research and development of heart valve pathology and valve replacement. More than 4o SCI papers were published and 2 national invention patents acquired, in addition, the number of heart transplantation operation ranked first in China for consecutive 4 years (2014, 2015, 2016, 2017), by which valuable biological samples were provided for clinical and basic research.

D. Achievement, Awards, Publications

The team was early pioneers and advocates of innovative concepts like “composite stent”, “improvement of biological properties by activated molecular”, “stent cross-link modification to improve mechanical properties” and “micro-environment simulation” etc. A new type of tissue engineering heart valve was successfully invented and 2 national patents acquired. The team has completed one national projects supported by the Ministry of Science and Technology, one national “863” project, and 6 projects founded by national natural science foundation with one key project. In 2016, Prof. DONG Nianguo was appointed as chief coordinator to take in charge of "National Key Research & Development Plan - Stem Cell and Transformation Research", supported by the Ministry of Science and Technology (Project No.: 2016YFA0101100, the Construction of Heart Valves Based on the Autologous Stem Cell, funds ￥28,92million).

Eight major achievements have been awarded by the Ministry of Education, the Ministry of Health and the Chinese Medical Association etc. Four first prizes known as Hubei Provincial Scientific and Technological Progress was awarded. The teams has edited the national textbook Surgery (the 8th edition) for Chinese medical undergraduates and compiled 5 medical monographs named as "Aorta Surgery", "Cardiovascular Disease Immunology", "Cardiovascular Surgery Today" etc., and published 200+ papers, including 60+ SCI.

Team Contact: Dr. LI Fei , 494609095@qq.com