Ligament of Marshall(LOM) is a bunch of epicardial structural deterioration.Because of its complex histological structure and electrophysiological properties, LOM plays an important role in the occurrence and maintenances of atrial fibrillation(AF).In addition, more and more studies indicated that ablation of LOM could effect the clinical result of AF treatment.We reviews on the anatomy, electrophysiological characteristics of LOM and the interrelationship between LOM and AF.

In the recent years,many studies have confirmed that vascular endothelial progenitor cells(EPC)can migrate,proliferate and differentiate into mature endothelial cells.They participate in the angiogenesis not only during the process of embryonic development but also during the growth and metachoresis of tumor.Therefore,further studies on EPC are important for the understanding of the formation and treatment of tumor.This review summarizes the research progress in this field.

This paper is to analyze the clinical features of infective endocarditis (IE) and summarize the experience of surgical treatment. The retrospective review was based on 65 consecutive patients, who fulfilled the Duck criteria of the diagnosis of endocarditis, admitted from Jan 1997 to Jun 2002. There were 44 males and 21 females, with age ranged from 9 to 68 years. Pre operative blood cultures were positive in 20 out of 55 patients(45%), with Streptococcus in 8 (45%). Staphylococcus in 9 (40%), and other bacteria in 3 (15%). Echo cardiography revealed vegetations in 62 cases, involving the mitral valve in 19 cases, aortic valve in 31 case, pulmonary valve in 5 cases, tricuspid valve in 5 cases, and valsalva sinus in 2 cases. Among 65 patients, aortic valve replacement was performed in 22, mitral valve replacement in 13, combined aortic and mitral valve replacements in 5, mitral valve plasty in 3, repair of atrial septal defect in 2, ventricular septal defects in 14, rupture of Valsalva sinus in 3, correction of tetralogy of Fallot in 1, patent ductus arteriosus in 2. Four patients died in hospital. 56 patients (91%) were followed up for 6 months to 69 months. Two patients with replacement of aortic valve died 1 and 3 years later due to congestive heart failure and sepsis. In the other 54 patient, no recurrent infection was found. One year, 3 year, and 5 year survival rates were 96 6%, 90 1%,90 1%, respectively. The results suggest that urgent early diagnosis and optimal surgical intervention play key role in successful treatment of infective endocarditis.

This paper introduces the development of the MEMS at home and abroad,besides the key technology,the application in medicine and military about the MEMS also expounded in detail.

Objective We sought to investigate the attitude to the evaluation of nursing undergraduate innovative talents quality by post audience and undergraduate nursing students and to provide reference for the cultivation of innovative talents and quality standard construction.Methods Using convenient sampling method,we selected the medical staff,patients and junior undergraduate nursing students as the research object.A questionnaire survey on the nursing undergraduate innovative talents quality evaluation was carried out.Results The attitude to nursing undergraduate innovative talents quality evaluation from high to low was physicians,nurses,hospital patients and junior undergraduate nursing students.Different populations had different expectations for nursing undergraduate innovative talents.Conclusions To cultivate the nursing undergraduate innovative talents,we should not only focus on the ability of nursing scientific research and innovation,but also should be based on the moral and occupation quality.Only giving full consideration to demands and expectations of the nursing undergraduate innovative talents by all post audience,can we evaluate the talent quality more professionally,scientifically and systematically.

Objective To understand the cognition of nursing undergraduate innovative talents of college nursing graduates,provide the basis for training and evaluation of nursing undergraduate innovative talents and establishing evaluation system.Methods Using the method of qualitative research,in-depth interviews were carried out in 13 nurses who had received full-time undergraduate nursing education from a comprehensive hospital.The acquired data were collected and analyzed,and the topics were put forward.Results The demands of clinical post for undergraduate nursing talents were many-sided.The explicit achievements such as specific topic submission,articles printed,patented invention,etc.were the most intuitionistic evaluation for innovative talents.Most of the nursing students during the learning period could not understand the importance of innovation ability in nursing work,and were lack of motivation to obtain related knowledge.Many undergraduate nurses chose self-development after work simply for professional title promotion,lacking the simplicity for innovation or for solving practical problems.Conclusions For cultivation of innovative talents,school should take students as the starting point,and the different competency as orientation,perfect cultivation mode of innovative talents.The hospital should provide learning,studying abroad opportunities for nurses,construct the innovation team of department.In addition to explicit results,internal innovation consciousness and innovation spirit should also be concerned in evaluation.

Objective: To evaluate the protective effect of bone marrow stromal cells (BMSCs) transferred by Ad?ANG ex vivo on ischemic myocardium. Methods: ELISA method was used to assay the expression and secretion of angiogenin (ANG) after Ad?ANG transfection of BMSCs ex vivo. Then BMSCs with Ad?ANG were transplanted into ischemic myocardium of isogenic Lewis rats. 4 weeks later, the parameters of heart function, such as EF and EDLV, were examined by echocardiography. Survival and differentiation of transplanted BMSCs and angiogenesis were appraised by histology and transmission electron micrography. Results: ANG was found in both lysate and culture medium after transfection of BMSCs. A maximum expression of ANG was observed at 4-7 days after transfection and could still be assayed 15 days later. 4 weeks later after transplantation in the BMSCs with Ad?ANG group, heart function improved better than the single BMSCs group(P

Objective To summarize the methods and experiences of aortic arch surgery. Methods In 75 aortic arch operations, 74 were performed by using deep hypothermic circulatory arrest (DHCA), including retrograde cerebral perfusion (RCP) in 54 cases and antegrade selective cerebral perfusion (SCP) in 20 cases. Surgical procedures included ascending aortic and hemiarch grafting in 53 cases, which concomitantly included stent placement intra decending aorta in 11, patching of arch intimal tear in 6 and of decending aortic one in 3. Ascending and total arch grafting in 20 cases,which concomitantly included traditional elephant trunk procedure in 12 and stent placement intra decending aorta in 4. Simple arch aneurysm resection in 1 and arch grafting in 1. Concomitant procedures included Bentall procedure in 17 cases, AVR in 12, Cabrol procedure in 3, mitral valvuloplasty in 5 and aortic valvuloplasty in 9. DHCA time ranged from 9 to 120 min (mean 42.3 min). Results Operative mortality was 6.7%. The most common complications were respiratory insufficiency(11 cases), renal insufficience(7 cases) and temporary mental anomaly(9 cases). Conclusion DHCA+RCP and DHCA+SCP are both effective while the latter is more suitable for complex aortic arch surgery. The choice of surgical procedures depends on the nature of lesion and location of intimal tear. Preoperative condition and surgical technique are the essential factors to success in aortic arch surgery.