Objective To investigate the technique of radio-stereotactic mammography aspiration biopsy(SCNB) and the clinical usage.Methods The stereotactic mammography aspiration biopsy was performed on 38 breast focuses,the results were compared with pathology.The technique and operation skills of SCNB were studied.Results In this 38 breast focuses,the accuracy of diagnostic aspiration,misplay and false negativity were 84.2%,7.89%and 7.89% respectively.No false positive was found.Conclusion In this technique,the distance between the needle tip and focus central was calculated by computer.This is a effective,easy operate and safe tool for the localization and very valuable in the diagnosis of a early cancer.

Objective To investigate the application value of ultrasonic measurement of optic nerve sheath diameter (ONSD) in patients with craniocerebral trauma. Methods A total of 100 patients with craniocerebral trauma were selected as research subjects and randomly divided into control group and study group, with 50 patients in each group. Patients in the control group received invasive intracranial pressure (ICP) monitoring, while patients in the study group received invasive ICP monitoring combined with ultrasonic measurement of ONSD. Both groups were treated according to their actual conditions. The general information and treatment status of the two groups were observed, and the general information, ICP monitoring results, and ONSD ultrasonic measurement results of different ICP patients in the study group were compared. The correlation between ONSD and ICP in patients with craniocerebral trauma was analyzed, and the diagnostic efficacy of ONSD for ICP elevation in patients with craniocerebral trauma was also analyzed. Results At 28 days after treatment, the mean arterial pressure of the study group was higher than that of the control group, while the heart rate and respiratory rate were lower than those of the control group(P < 0.05). The mechanical ventilation time and ICU stay of the study group were shorter than those of the control group, the amount of mannitol used was less than that of the control group, and the ICP and 28-day mortality rate after treatment were lower than those of the control group (P < 0.05). Patients with ICP≥22 mmHg had higher ICP than those with ICP < 22 mmHg, and ONSD before and after the use of mannitol in different positions was greater than that in the ICP < 22 mmHg group (P < 0.05). There was a significant positive correlation between ONSD and ICP in patients with craniocerebral trauma (r=0.723, P < 0.001). The results of receiver operating characteristic curve analysis showed that the optimal cutoff value of ONSD for diagnosing ICP elevation was 5.25 mm, and the area under the curve was 0.879. Conclusion The combination of ICP monitoring and ultrasonic measurement of ONSD in the treatment of patients with craniocerebral trauma can effectively improve patients' vital signs, shorten the duration of mechanical ventilation and ICU stay, reduce the amount of mannitol used, and reduce the 28-day mortality rate. There is a significant positive correlation between ONSD and ICP in patients with craniocerebral trauma, and ONSD has a high diagnostic efficacy for ICP elevation.

Objective To assess and compare the incidence,clinical characteristics,treatment,and prognosis of acute heart failure patients from different grades hospitals in Beijing.Methods In this prospective internet prognosis registered study (Beijing AHF Registry),a total of 3 335 consecutive patients admitted to 14 emergency departments in Beijing from January 1st 2011 to September 23rd 2012 were enrolled.According to hospital grade,these patients were divided into two groups,349 patients were from secondary hospitals,and 2 956 patients were from tertiary hospitals.Results Among the 3 335 patients,the medium age was 71 (58,79) years,and male accounted for 53.16％.The most common underlying disease were coronary disease (43.27％),hypertension (17.73％),cardiomyopathy (16.07％) etc.The average treatment time in Emergency Department was 66.82 h.The emergency department mortality rate was 3.81％ (127 cases).The 30-day and 1-year cumulative all-cause mortality were 15.3％ and 32.27％,respectively.The 30-day and 1-year cumulative all-cause readmission were 15.64％ and 46.89％,respectively.Compared with patients in tertiary hospitals,patients in secondary hospitals had more onset acute heart failure patients (63.64％ vs.49.93％),shorter emergency department treatment time (12 h vs.41 h),lower discharge rate (3.43％ vs.37.45％) and emergency department mortality(1.58％ vs.4.09％).Compared with those in tertiary hospitals,1-year cumulative all-cause mortality (25.6％ vs.33.2％),cardiovascular disease mortality (20.2％ vs.26.0％),aggravated heart failure mortality (22.4％ vs.28.8％) were lower in secondary hospitals.Following propensity score matching,compared to tertiary hospitals,patients in secondary hospitals showed lower utilization rate of beta-blockers and ACEFARB (4.51％ vs.28.17％,1.41％ vs.9.58％),except the pironolactone.Conclusion Acute heart failure in emergency department is associated with a high mortality rate and readmission rate.There is still a big gap between guidelines recommend medication current treatments for acute heart failure.