Surgical outcomes and strategy of hypertrophic obstructive cardiomyopathy

Objective： To evaluate the surgical clinical results of hypertrophic obstructive cardiomyopathy. Methods： We retrospectively collected data on 24 patients who underwent surgical management in the past ten years in two hospitals in China and Madras Medical Mission in India. Myomectomy was carried out on all patients. Among them 3 patients underwent mitral valve replacement; 2 patients underwent mitral valve repair （anterior mitral leaflet plication）; 2 patients underwent aortic valve replacement; 1 patient underwent aortic valve repair; 2 patients underwent aortic root replacement; 1 patient underwent Bentall＇s procedure and 1 patient underwent coronary artery bypass grafting because of a breached muscle bridge, Results： One patient died of post-operative heart failure. The mean follow-up time was 4.3 years, There was significant improvement in the symptomatic status. Sixteen patients were asymptomatic with good effort tolerance and only four patients had New York heart association （NYHA） Classes Ⅰ-Ⅱ due to associated valvular lesions, Conclusion： Our experience proved that symptomatic hypertrophic obstructive cardiomyopathy or non-symptomatic hypertrophic obstructive cardiomyopathy with combined heart disease is indication for surgery as surgical intervention could get better clinical results in this kind of patients compared with other non-surgical method because it beneficially reduces the systolic anterior motion （SAM） of the mitral valve leaflet, which could not be avoided by other non-surgical treatment.     

Post-abyssal ethics in education research in settings of conflict and crisis: Stories from the field

This article draws heavily on the post-abyssal philosophy of Boaventura de Sousa Santos in order to theorise new ways of thinking about research ethics in settings affected by armed conflict and crisis, and to put them into practice. Our article explores the dilemmas and tensions faced by four graduate students and a supervisor across diverse international settings. For some of us, these are places we call home, for others these are places that provide refuge to our people: Afghanistan, Jordan, Lebanon and India. We seek to deepen standard understandings of ethics as institutionalised in university forms, arguing that tidy checklists for safety and risk mitigation do not adequately address the complex affective and socio-political struggles permeating research, and the bodies of researchers, in these settings. Our main focus here is on how we can synthesise our various experiences in order to offer something of value to others who may be about to go into the field in settings affected by armed conflict and crisis. The question that we address, then, is: how can researchers avoid the limitations, obfuscations and silences of traditional institutional ethics in order to adopt a situated, embodied, post-abyssal research ethic that might open up new spaces for emotion, encounter, and engagement with struggle, risk and voicing? We use an autoethnographic approach that enables congruence with the aims of this article, and that supports our aspirations for enhanced impact through powerful narrative. We end with discussion that contains suggestions for institutions, supervisors, researchers, and for funding and professional bodies.