With the constant deepening of the reform in the health system and the further development of community healthcare services in China, the status and functions of outpatient emergency treatment in hospitals have been put under challenge. Judging from the actual conditions of current China, outpatient emergency treatment in hospitals still occupies a decisive position. It is imperative to transform its functions, enhance pre hospital emergency treatment, supervision of critical cases and healthcare of the general population, broaden programs of medical services, expand channels of economic benefits, and actively adapt to the development in the reform of community healthcare services.

Objective To evaluate the effectiveness of real time ultrasound guided drainage tube placing under xiphoid. Methods Fifty-one eases of hydropericardium were refractory to traditional therapy.They were used the systemic chemotherapy regime composed of amikacin, levofloxaein aminosalicylate beside other one or two anti-tuberculosis drug never used before, placing drainage tube beneath xiphoid for periodic draining and infusing regime of isoniazide rifampine and dexamthasone. The average course was 3 months.Results All the 51 cases underwent a successful pericardium puncture without any complications. The rainage tubes were placed for 21 to 60 days with mean of (32 ± 3) days; drainage volume range from 1700 to 3800 ml,mean was (2400 ± 55)ml. All the patient showed clinical improvement, complete absorption of hydroperieardium, no constrictive periearditis occurred. Conclusions Ultrasound guided pericardium puncture and drainage tube placing is safe without hurting myoeardium. Indwelled tube this way facilitate sustained eomplete drainage lavage and drug infusing, and its effectiveness is reproducible.

Objective:To develop an efficient and robust method based on three dimensional facial landmarks for evaluating chin region asymmetry at the soft tissue level and to compare it with the tradi-tional mirror-overlap analysis method in order to test its availability.Methods:Standard symmetrical face was used for mental tubercle coordinate transformation so as to filter soft tissue three dimensional spatial angle and construct corresponding three dimensional spatial angle wireframe template.Ten patients aged 12-32 years with clinical chin region asymmetry diagnosis at the Department of Orthodontics of Peking University Hospital of Stomatology from November 2020 to November 2021 were randomly selected.Three dimensional soft tissue face scan data of the patients were collected by three dimensional face scanner and the landmark points were automatically determined by the Meshmonk non-rigid registration algorithm pro-gram,and in this way,the asymmetric three dimensional spatial angle wireframe template and corre-sponding spatial angle parameters were generated.Mirror-overlap analysis of face scan data was also per-formed in Geomagic Studio 2015 software and deviation color maps were generated.This study took mirror-overlap analysis as the gold standard method,the response rate of chin region asymmetry was eva-luated by the outcomes of the mirror-overlap analysis and three dimensional spatial angle wireframe tem-plate analysis.Results:Nine three dimensional spatial angle indicators were selected through coordinate transformation,and the response rate was calculated using mirror-overlap analysis as the gold standard method.Among these ten selected patients,the response rate of the total chin region asymmetry was 90％(9/10).Using the deviation value of mirror-overlap analysis as a reference,the response rate of chin region asymmetry in the X dimension was 86％,the response rate of chin region asymmetry in the Y dimension was 89％,and the response rate of chin region asymmetry in the Z dimension was 100％.Conclusion:The three dimensional soft tissue spatial angle wireframe template proposed in this study has some feasibility in evaluating chin region asymmetry at the soft tissue level,and its ability to recognize asymmetry separately in the three dimensional direction is better than the mirror-overlap analysis method,and the indicators recognition rate still needs to be further improved.