Some patients with atrioventricular nodal reentrant tachycardia(AVNRT) manifest “smooth” av node function curves. This review summarizes the essence,the end point of radiofrequency catheter ablation and the influence of some electrophysiological data in this AVNRT.

Objective To investigate the application value of plasma D-dimer(D-D )in the diagnosis of spontaneous bacterial per-itonitis(SBP)in patients with liver cirrhosis .Methods 137 cases of cirrhotic patients with ascites were selected and divided into SBP group and non SBP(NSBP) group .30 cases of patients with chronic liver disease and 30 healthy individuals were selected as chronic liver disease group and normal control group ,respectively .The levels of D-D and C-reactive protein(CRP) were measured in specimens from all the groups .Results The D-D levels of SBP group ,NSBP group ,chronic liver disease group and normal control group were (7 .82 ± 5 .68) ,(5 .55 ± 4 .55) ,(0 .45 ± 0 .26) and (0 .06 ± 0 .04) mg/L ,respectively .And the serum CRP levels were (30 .0 ± 29 .6) ,(16 .4 ± 20 .5) ,(5 .3 ± 1 .8) and (2 .1 ± 0 .9)mg/L ,respectively .The levels of D-D and CRP were both higher in SBP group and NSBP group than in chronic liver disease group and normal control group(P<0 .01) .The D-D and CRP levels of SBP group were both significantly higher than those of NSBP group (P<0 .05) .The ROC curve showed that the AUC ,sensitivity and specificity of D-D were 0 .650 ,0 .604 and 0 .709 ,respectively ,and those of CRP were 0 .705 ,0 .792 and 0 .582 ,respectively .Conclu-sion Plasma D-D detection was beneficial to the early diagnosis of SBP in cirrhotic patients with ascites .

Objective To study the difference of transverse incision and longitudinal incision for B-T-B graft harvesting in reconstruction of anterior cruciate ligament.Methods Sixty four cases of reconstruction of anterior cruciate ligament from January 2004 to December 2004 were observed.Transverse incisions were used in 32 cases,and longitudinal incision were chosen in the other 32.The operation time,the length of incision,the thickness of scar,the injury of saphenous nerve and the joint function of knee were compared.Results All patients were followed up more than 1 year.The average duration of surgical procedure with longitudinal incision was 11 minutes shorter than that with transverse incision.The scar of transverse incision is smaller and thinner than that of longitudinal incision.The injury of saphenous nerve and knee joint function of knee revealed no notable difference in the 2 groups.Conclusions Transverse incision for B-T-B graft harvesting in reconstruction of anterior cruciate ligament is a better choice.

Objective To explore the clinical characteristics of neuromyelitis optica(NMO).Methods The clinical data of 18 patients with NMO were analyzed retrospectively.Results Of the enrolled patients,15 cases(83.3%) were relapsing form of NMO,16 cases(88.9%) were female and the mean onset age was 36 years old.Simultaneous bilateral optic neuritis(ON) or ON occured sequentially and horizontal impairent of spinal cord were the main clinic features in these 18 patients.Of the patients who received spinal cord MRI examinations,4 cases showed the lesions located in cervical cord,6 cases in thoracic cord and 5 cases in both cervical and thoracic cord.13 cases revealed lesions in spinal cord extended across 3 or more vertebral segments.Furthermore,brain lesions were detected by MRI in 6 patients.The mean onset number of per patient was five.Seven patients presented with mild disability,7 patients with median disability,2 patients with severe disability and death of 2 patients.Conclusions Most patients with NMO are female and relapsing form accounts for the majority type.The cardinal manifestations are bilateral ON and longitudinally extensive transverse myelitis(LETM).Some patients show brain lesions that may be detected by MRI examination.Relatively high relapsing frequency of clinical event and severe impairing are common in NMO.

Objective To summarize the clinical features of chronic ruptured patellar tendon, and introduce the augmentation technique of repair of chronic ruptured patellar tendon with high strength polyester sutures and postoperative rehabilitation.Methods Six cases of chronic patellar tendon rupture were treated and reinforced with high strength polyester sutures from 2002 to 2007.Patellar tendon ruptures was primary end Ho -end repaired, and reinforced with 4 polyester sutures that were passed through in-traosseous tunnels within the patella and tibial tubercle.The surgery reestablished knee extensor continuity and restored the length of patellar tendon.Augmentation techniques were reliable, and allowed patients to walk and bend the knee, regain adequate quadriceps strength early.Postoperative rehabilitation: on the 1st day after surgery, walking upright and passive flexion of 90° was allowed, and brace protection was unnecessary; 3 weeks later, straight leg raise; 6 weeks later, brisk walking; 12 weeks later, squatting and climbing stairs; 6 months later, sports was allowed, including the jump and kick.Results All patients were followed up from 1 to 5 years.No patient sustained a re-rupture.All patients satisfied with their result.The Lysholm score were 100.Kach knee had restored full range of motion 6 months later, and regained adequate quadriceps strength.Conclusion Augmentation techniques with high strength polyester sutures is reliable and demonstrate good intermediate to long-term results.It can avoid re-operation for removal of the cerclage wire, allow patients to walk and bend the knee, regain adequate quadriceps strength early.

Objective:To investigate the effect of protein tyrosine kinase 6(PTK6) on TNF-α induced human airway epithelial barrier dysfunction and mechamism.Methods: After cultivating 16HBE cells in vitro,the recombined PTK6 and PTK6 siRNA was respectively transfected into the cells,with empty vector and scramble siRNA as control.The cells were incubated with exogenous TNF-α.Cell viability was detected by MTT assay.Cells TER and permeability were detected.ZO-1 and Occludin mRNA were analyzed by RT-PCR.PTK6,ZO-1,Occludin,p-ERK1/2,p-JNK1/2 and p-p38MAPK protein were assayed by Western blot.Results: TNF-α remarkably decreased ZO-1 and Occludin mRNA and protein and TER;increased cells permeability,as well as p-ERK1/2,p-JNK1/2 and p-p38 protein(P<0.05).Upregulation of PTK6 further decreased ZO-1 and Occludin mRNA and protein and TER,enhanced cells permeability and p-JNK1/2 and p-p38 protein(P<0.05),and downregulated PTK6 ,the changes of these indices were opposite(P<0.05).Whereas upregulation or downregulation of PTK6 had no effect on p-ERK1/2.Conclusion: Downregulation of PTK6 inhibits the phosphorylation of JNK1/2 and p38MAPK,thus improving TNF-α-induced human airway epithelial barrier dysfunction.

Objective To introduce Torg's modified Bristow procedure for recurrent anterior dislocation of the shoulder joint,and to evaluate it's clinical result.Methods 25 shoulders with recurrent anterior dislocation were treated with Torg's modified Bristow procedure from January 2002 to December 2006.Based on history,physical examination and X-ray examination,all the diagnosis were confirmed.The follow-up period ranged from 1 to 5 years,with an average of 3.1 years.Results All the cases had Hillsachs lesions and Bankart lesions.After 2 years,only one shoulder had redislocated and 96% of patients were satisfied with the operative repair.The Rowe standard rating scale:excellent 72%;good 24%;fair 4%;poor 0%.Conclusion Torg's modified Bristow procedure provided a good functional result in patients with recurrent shoulder dislocations.

Objective:To analyze the effect of insulin aspart on the islet cell secretion function, ultrasound imaging indicators and maternal and infant outcome in patients with gestational diabetes mellitus (GDM).Methods:The clinical data of 120 patients with GDM in Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University from February 2017 to July 2019 were retrospectively analyzed. Among them, 60 cases were treated with insulin aspart (observation group) and 60 cases were treated with biosynthetic human insulin (control group). The efficacy indexes, ultrasound imaging indexes and maternal and infant outcome were compared.Results:The 2 h postprandial blood glucose (2 h PBG) after breakfast on the third and fifth day of treatment in observation group was significantly lower than that in control group: (6.85 ± 0.87) mmol/L vs. (7.47 ± 1.35) mmol/L and (6.24 ± 0.59) mmol/L vs. (6.60 ± 0.87) mmol/L, and there was statistical difference ( P<0.01); there was no statistical difference in 2 h PBG after breakfast on the first day of treatment and after lunch and dinner on the first, third and fifth day of treatment between 2 groups ( P>0.05). The homeostasis model assessment-insulin resistance index (HOMA-IR) after treatment in observation group was significantly lower than that in control group (2.57 ± 0.25 vs. 3.00 ± 0.35), the homeostasis model assessment- β cell function index (HOMA-β) was significantly higher than that in control group (72.45 ± 12.33 vs. 63.66 ± 10.72), and there were statistical differences ( P<0.01). There were no statistical differences in pre-lunch blood glucose, pre-lunch initial insulin amount, pre-lunch final insulin amount and blood glucose target time between 2 groups ( P>0.05); the incidence of pre-meal hypoglycemia in observation group was significantly lower than that in control group: 8.33% (5/60) vs. 23.33% (14/60), and there was statistical difference ( P<0.05). The umbilical artery and renal artery resistance index (RI), maximum systolic blood flow velocity and end-diastolic blood flow velocity ratio (S/D) after treatment in observation group were significantly lower than those in control group (RI: 0.49 ± 0.16 vs. 0.59 ± 0.15 and 0.69 ± 0.17 vs. 0.76 ± 0.12; S/D: 2.09 ± 0.22 vs. 2.38 ± 0.26 and 5.17 ± 0.45 vs. 5.77 ± 0.63), and there were statistical differences ( P<0.01 or <0.05). There were no statistical differences in gestational age, delivery mode, neonatal body weight and the incidences of macrosomia, neonatal hypoglycemia and neonatal referral between 2 groups ( P>0.05). Conclusions:Insulin aspart can significantly improve the islet cell secretion function and ultrasound imaging indexes in the treatment of GDM, and can reduce the risk of pre-meal hypoglycemia, but the effect on maternal and infant outcome remains to be explored.

Objective To compare the clinical outcomes of anterior cruciate ligament(ACL)reconstruction by using allograft and autograft of patella tendon.Methods From August 2003 to December 2005,82 ACL reconstruction patients were studied retrospectively,including 59 cases using autograft of patellar bone-tendon-bone(BPTB)and 23 cases using BPTB allograft.Physical examination,scores of IKDC,Lysholm-Tegner and VAS as well as KT-2000 measurements were used for evaluation pre-and post-operation.Results 41 autograft and 17 allograft patients were finally followed up.One allograft patient suffered re-rupture of the reconstructed ligament.Positive ADT test were found in 5 autograft and 1 allograft patients and positive Lachman test were found in 3 autograft and 1 allograft patients.No statistically significant differences were revealed in ROM.IKDC,Lysholm-Tegner Score and KT-2000 measurements showed no significant differences between two groups,but VAS for autograft group were significantly higher than allograft group(P

Objective To evaluate the value of immature granulocytes count in diagnosing and monitoring the systemic inflam-matory response for patients with systemic inflammatory response syndrome,and to provide a new indicator of systemic inflammato-ry response.Methods 207 patients suspected of systemic inflammatory response syndrome were enrolled.The dynamic changes of immature granulocytes counts and the disease situation were recorded for all subjects.The blood samples were collected in vacuum tubes with EDTA-K2 anticoagulant.Blood cell count and immature granulocytes count were performed in Sysmex XE-2100 hema-tology analyzer.The determination of C-reactive protein and procalcitonin were also completed.The performance of immature granu-locytes in diagnosing systemic inflammatory response syndrome was evaluated by receiver operating characteristic curve analysis. Results The area under the curve of immature granulocyte count (IG #)was 0.78 in diagnosing systemic inflammatory response syndrome,with a sensitivity of 62.2 % and a specificity of 73 % at IG #> 0.1 65.The area under the curve of immature granulo-cyte percent (IG%)was 0.771 in diagnosing systemic inflammatory response syndrome,with a sensitivity of 54.1 % and a specifici-ty of 94.6 % at IG%>2.55 %.The area under the curve of C-reactive protein was 0.71 6 in diagnosing systemic inflammatory re-sponse syndrome,with a sensitivity of 67.6% and a specificity of 75.7 % at C-reactive protein> 64.15 mg/L.The area under the curve of procalcitonin was 0.772 in diagnosing systemic inflammatory response syndrome,with a sensitivity of 75.7 % and a speci-ficity of 70.3 % at procalcitonin> 0.33 mg/L.Conclusion Immature granulocyte count is beneficial for the diagnosis and the as-sessment of prognosis of systemic inflammatory response syndrome.