Objective To investigate the clinical significance of early diagnosis and treatment of impal-pable breast tumor.Methods From Jan.2007 to Dec.2014, 570 patients with impalpable breast tumor were treated.Among them, 107 patients were found with breast nodules by ultrasound scan , 340 patients were found with nodules , calcification or distort gland structure and 123 patients were found with nipple discharge by mam-mography .They were biopsied with various methods such as wire localization guided by ultrasound , X-ray mam-mography and fiberoptic ductoscopy .All patients were treated routinely and followed up .Results The his-topathological examination results were as follows:134 cases of breast cancer (23.51%) and 436 cases of benign lesions.44 breast cancer patients were localized by ultrasound , 78 cases were localized by X-ray mammography, and 12 cases were localized by fiberoptic ductoscopy .All lesions were accurately localized and excised .During the two-year follow up, no recurrence or metastasis occurred .Conclusion Early diagnosis and treatment of im-palpable breast tumor can improve early diagnosis level of breast cancer .

Objective To summarize the strategies for nursing of skin flaps after 72 hours' transplantation of femoral skin flap for repairing soft tissue defect in lower extremity.Method One hundred and sixty trauma patients with lower extremity soft tissue defect underwent transplantation of femoral skin flap for repairing.The skin flaps were nursed within 72h after transplantation.Results The skins flaps in 160 patients receiving to repair tissue defect of lower limbs all survived.Within 72 hours after operation, 12 patients suffered from vascular crisis, which were cured after pertinent treatment.Conclusions For the patients receiving to repair tissue defect, the skin flaps should be carefully nursed. Meanwhile, preoperative psychological nursing, postoperative pain nursing and health education are critical for the survival of skin flaps.

Objective To analyse long-term follow-up outcome of cryoballoon ablation (CBA) for atrial ifbrillation (AF) in a single center and to investigate the clinical relative factors which affecting the effect. Methods The inpatient, operating and outpatient data of patients, who were treated by CBA for AF in our center from January 2009 to April 2013, were retrospectively analyzed. Left atrium diameter (LAD) was measured by transthoracic echocardiography. Failure-treatment of CBA was defined by episode of AF, atrial lfutter, atrial tachycardia lasted for 30 seconds after 3 months. Results A total of 199 patients were enrolled. The rates of phrenic nerve paralysis, pericardial effusion, transient ischemic attack were 1.5%(n=3), 0.5%(n=1), 0.5%(n=1),respectively. All complications were resolved spontaneously.152 patients had completed follow-up data after ifrst-time CBA during a long-term follow-up of mean 23±14 months, 65 patients (42.8%) treated success. 75 patients with failure-treated were (86.2%) experienced the atrial arrhythmia recurrence in ifrst 12 month. The characteristics of failure-treated patients included with older age[(62±7) years vs. (52±10) years, P=0.0379]and larger LAD[(48±6)mm vs. (43±6) mm, P<0.0001]. The Logistic analysis showed that LAD[OR=0.896(0.842,0.953), P=0.005]and age[OR=1.037 (1.000,1.076), P=0.0488]could individually predict the treat-failure after ifrst CBA, and only LAD[OR=0.876 (0.822,0.935), P < 0.0001]could individually predict the total CBA. Conclusions CBA procedure for AF is safe and effective, and the result of long-term follow-up is preferable. Most atrial arrhythmia are recurred during ifrst 12 month after CBA. LAD can individually predict the failure in treatment of CBA.

An 86-year-old female patient with pulmonary infection was treated with IV infusions of ceftriaxone sodium 2. 0 g once daily,azithromycin 0. 5 g once daily,and ambroxol hydrochloride 30 mg twice daily. About 30 minutes after the fourth infusion of azithromycin,the patient abruptly developed chest tightness and suffocation. Electrocardiography showed Ⅲ degree atrioventricular block. Azithromycin was stopped immediately and she was treated with oxygen inhalation. One hour later,the symptoms of chest tightness and suffocation disappeared. Five hours later,a repeat electrocardiography showed sinus rhythm. Azithromycin was not given again and the similar symptoms did not recur any more.

An 86-year-old female patient with pulmonary infection was treated with IV infusions of ceftriaxone sodium 2. 0 g once daily,azithromycin 0. 5 g once daily,and ambroxol hydrochloride 30 mg twice daily. About 30 minutes after the fourth infusion of azithromycin,the patient abruptly developed chest tightness and suffocation. Electrocardiography showed Ⅲ degree atrioventricular block. Azithromycin was stopped immediately and she was treated with oxygen inhalation. One hour later,the symptoms of chest tightness and suffocation disappeared. Five hours later,a repeat electrocardiography showed sinus rhythm. Azithromycin was not given again and the similar symptoms did not recur any more.