Objective The purpose of this study was to investigate the early outcome of radiofrequency ablation for the treatment of atri-al fibrillation (AF) during concomitant mitral valve replace procedures. Methods From January 2013 to September 2014,43 patients with mitral valvular disease with atrial fibrillation were enrolled in this study. The cases were classified into underwent mitral valve replace surgery concomitant with atrial fibrillation radiofrequency ablation ( RFA group) or underwent only mitral valve replace surgery ( control group) . Re-sults There was no perioperative death and stroke. RFA group’ s time of Cardiopulmonary bypass was more longer than control group. The comparison between RFA and control groups revealed no differences in terms of bleeding,24 hours’ Pleural fluid volume,the mechanical ven-tilation time and time in intensive care unit. One week after the operation,20 cases (87%) in RAF group were sinus rhythm while it was 6 cases(30%) in control group. After a follow-up of one month,RAF group had 78% remaind sinus rhythm while it was 25% in control group. Conclusion Radiofrequency ablation for the treatment of atrial fibrillation ( AF) during concomitant mitral valve replace is safe and effective.

Objective: To study the correlation between stress reaction and other psychological stress related factors in medical personnel, such as social support, life events, and coping style. Methods: 556 medical personnel were investigated with PSSS (Perceived Social Support Scale), LES (Life Event Scale), TCSQ (Trait Coping Style Questionnaire) and SRQ (Stress Reaction Questionnaire). Results: Correlation and multiple regression analysis revealed that there were statistically significant links between stress reaction and social support, life events, and coping style. Conclusion: Psychological stress is a multiple correlation system of psychological stress related factors.

Objective To observe the localization and expression of hepatocyte growth factor(HGF),c-Met and Caspase-3 in pulmonary arterioles during the formation process of pulmonary arterial hypertension(PAH) induced by left to right shunt in rats,and explore the effect of HGF and c-Met in the formative process of PAH.Methods Eighty male SD rats(aged 4-5 weeks) were randomly divided into control group and shunt group(40 each).Rats in shunt group underwent right common carotid artery-external jugular vein shunt with cannulation to reproduce PAH model of left to right shunt,and animals in control group only received sham operation.Pulmonary hemodynamic and pathologic examination were performed 4,8,12 and 16 weeks after operation in both groups,while the expression of HGF,c-Met and Caspase-3 proteins in pulmonary arterioles were determined by immunohistochemisty at the above time points.Results Pulmonary artery systolic pressure(PASP),mean pulmonary arterial pressure(mPAP) and the ratio of pulmonary to systemic circulation flow(Qp/Qs) were obviously increased in rats with A-V shunt compared with controls at all time points after operation(P

Objective To investigate the roles of the expressions of B cell lymphoma-2 (bcl-2) and Bcl-assosiated X (bax) in the pulmonary vascular remodeling (PVR) of pulmonary arterial hypertension (PAH) secondary to left-right shunt congenital heart disease (CHD).Methods A total of 80 SPF SD rats were randomly divided into 8 groups,shunt groups (SⅠ,SⅡ,SⅢ and SⅣ) and control groups (CⅠ,CⅡ,CⅢ and CⅣ).PAH rat model was established in the shunt groups by left-to-right shutting,and the control groups received sham operation.The rats from Ⅰ,Ⅱ,Ⅲ and Ⅳ groups were sacrificed in 4,8,12 and 16 weeks after operation.Mean pulmonary arterial pressure (mPAP) was recorded.Pathologic observations were made to assess pulmonary vascular remodeling.Their lung tissues were detected by in situ hybridization histochemistry (ISHH) technique and Western blotting for bcl-2 and bax.And apoptosis of pulmonary artery smooth muscle cells (PSMCs) and endothelial cells (ECs) were also detected by TUNEL.Results After 12 weeks or 16 weeks shunt,following indexes of the shunt groups were significantly higher than the control groups (P

Objective To summarize experiences in surgical treatments of 18 patients suffered from Ebstein's anomaly with intracardiac repair and bi-directional cavopulmonary shunt from January 1999 to June 2003. Methods Of 18 patients, 10 male (55.6%) and 8 female (44.4%), mean age was (18.47?13.85) years old (range from 9 months～54 years old),and mean weight of body (36.09?19.78) kg (range from 8.5～80.0 kg). All patients were in type II of Ebstein's anomaly according to WANG (Zenwei's) classification, while 15 (83.3%) were in type B, and 3 (16.7%) in type C according to Carpentier's classification. Danielson repair of Ebstein's malformation and other intracardiac repair were performed on all patients, followed by bi-directional cavopulmonary anastomosis, on pump with heart beating. Results There was no death, and no severe heart dysfunction and refractory low cardiac output in all patients postoperatively. No reoperation for residual or recurrent tricuspid incompetence was required in all patients. At follow-up of 13 (72.2%) patients ranging from 1 to 53 months, 12 patients were in New York Heart Association ((NYHA)) class I, 1 in class II. Four were with 1 grade, 2 with 2 grades tricuspid regurgitation. The patency of bi-directional cavopulmonary anastomoses was verified by echocardiography. Conclusion Ventricular unloading added to intracardiac repair appears to be effective to improve left and right ventricular function and tricuspid valve performance in Ebstein's anomaly with moderate or massive tricuspid dysfunction and physiological right ventricular outlet tract obstruction.

Objective The present study is to investigate the effect of EPO pretreatment on TNF-? expression in cultured cardiac myocytes with H/R and to explore the possible NF-?B signal transduction mechanism. Methods The model of cultured cardiac myocytes with H/R was established and the cardiac myocytes were divided into 4 groups, including EPO group (treat with EPO 10?U/ml 24?h before H/R), EPO+PDTC group (treat with EPO 10?U/mL and PDTC 5??g/ml 24?h before H/R), PDTC group (treat with PDTC 5??g /ml 24h before H/R) and control group. Change of TNF-? gene expression before and after H/R in cardiac myocytes was detected with RT-PCR and western blot. Change of NF-?B activity before and after H/R in cardiac myocytes was assayed with EMSA. Results Before H/R, there was no significant difference in TNF-? mRNA and protein expression between the 4 groups and after H/R, TNF-? mRNA and protein expression increased significantly in the 4 groups compared to control group before H/R. After H/R, TNF-? mRNA and protein expression was lower in EPO group than in the other 3 groups. Before H/R, NF-?B activity was higher in EPO group than in the other groups. After H/R, NF-?B activity increased significantly in all the 4 groups compared to the control before H/R and NF-?B activity was lower in EPO group than in the other groups. Conclusion EPO pretreatment inhibited the upregulation of TNF-? gene expression after H/R in cardiac myocytes, which might be related to the inhibition of NF-?B activation; EPO pretreatment might inhibit the activation of NF-?B after H/R through the negative feed-back mechanism of NF-?B activation.

Objective To study the relationship between ? 1-aderenergic receptor (? 1-AR) and cardiac function in hypoxic newborn guinea-pig myocardia undergoing ischemic reperfusion, and the effects of St. Thomas Hospital cardioplegic solution Ⅱ (STS) and cold blood cardioplegia (CBC) on the ? 1-AR and cardiac function. Methods Normobaric hypoxic guenia-pig model and isolated perfused working heart preparation were established. Cardiac functions were recorded by a multichannel biologic signal analyzer. Myocardial ? 1-AR density (B max ) and affinity (K d) were investigated by radial ligand binding. Results Significant decrease of B max was found in hypoxic newborn guinea-pig myocardia suffering from hypothermic (20 ℃)-ishemic reperfusion (P0.05). Conclusion The impairment of cardiac function in hypoxic newborn guinea-pig undergoing myocardial ischemic reperfusion might be associated with the decline of B max , but not with K d. Different effects of STS and CBC on cardiac function may result from their different influences on B max .

Objective To investigate the relationship between the expression of the survivin gene and CpC methylation in exon 1 of the survivin gene in CA tissue, and to study the expression of survivin protein in CA tissue and its modulation mechanism. Methods Tissue samples were obtained from the CA lesions of 30 patients, normal cervix of 10 female controls, and normal foreskin of 10 male controls. Immunohistochemistry was carried out to detect the expression of survivin protein in these specimens, RT-PCR to measure the mRNA expression of survivin, and methylation specific PCR (MSP) to analyze the methylation status of CpG island in the survivin gene exon 1. Results The positivity rate of survivin protein and mRNA was 90% (27/30) and 93.3% (28/30) in CA tissue specimens, respectively, 5% (1/20) and 5% (1/20) in control tissue specimens, respectively; there was a significant difference between the two groups of specimens in both the parameters (x2 = 35.187, 38.437, both P < 0.01). The demethylation of CpG island in the survivin gene exon 1 was observed in 86.7% (26/30) of the CA tissue specimens and in 15% (3/20) of the control tissue specimens (x2 = 10.865, P < 0.01). There was a positive correlation between the demethylation status of CpG island in exon 1 and the mRNA expression of survivin gene (x2 = 13.929, P = 0.014). Conclusions The expression of survivin protein in CA tissues might be associated with the demethylation of CpG island in exon 1 of the survivin gene, and may play a certain role in the development of CA.

Objective: To investigate the role of thrombus precursor protein (TPP) in the monitoring of anticoagulation after mechanical heart valve replacement. Methods: TPP and INR were compared between the coagulant group and control group. In the coagulant group, TPP and INR were also compared between the patients with atrial fibrillation and the patients without atrial fibrillation. The relationship between TPP levels and INR levels in 60 cases of anticoagulated patients was analyzed by linear regression. Results: It was found that the anticoagulant therapy could effectively decrease the level of TPP and increase the level of INR. In the anticoagulant group, the patients with atrial fibrillation had higher TPP level than other patients. No significant relationship was found between TPP levels and INR levels. TPP level in the patients with bleeding complications was far lower than 6 ?g/ml. Conclusion: TPP is a very valuable monitoring marker assisting INR. Patients with atrial fibrillation may require higher anticongulant intensity. INR and TPP should be tested at the same time in the patients receiving oral anticoagulation after mechanical heart valve replacement.

By analyzing the status of Cardiovascular Surgery advanced students,we discussed the characteristics and problems of clinical teaching for advanced students of Cardiovascular Surgery.Strategies of clinical teaching for advanced students of cardiovascular surgery are explored to improve the quality of clinical teaching.