Surgery is one of the most important treatments for breast cancer. A part of the early breast cancer patients demand further oncoplastic breast surgery to reconstruct or restore the breast cosmosis after conventional breast conserving surgery, by oncoplastic breast surgery, which is a modern conception and technique including volume dis-placement and volume replacement. Oncoplastic breast surgery using pedicled omental flap is a new approach among volume replacement techniques. It has made some progress in recently years. A systematic review was therefore con-ducted to analyze and illuminate the present status.

Objective To analyze the differences with the expression of glucocorticoids receptor isoforms ( GRα, GRβ, GRγand GR-P ) and cytokines [ IL-6, macrophage migration inhibitory factor (MIF), IFN-γand IL-10] between patients with systemic lupus erythematosus (SLE) and rheumatoid ar-thritis ( RA) , and to further understand their correlations with disease activities.Methods Fifty-five pa-tients with SLE, forty-nine patients with RA and thirty-eight healthy subjects were recruited in this study. All patients were steroid-naive.The expression of GRα, GRβ, GRγ, and GR-P in peripheral blood mononu-clear cells at transcript levels were determined by real-time PCR.Enzyme-linked immunosorbent assay was used to detect the expression of IL-6, MIF, IFN-γand IL-10 in serum samples.Results The percentages of GRαin all subjects were the highest among four isoforms of GR, followed by GR-P, GRγand GRβ.Com-pared with healthy subjects, patients with SLE or RA showed significantly decreased expression of GRα( P<0.05), but increased expression of GR-P (P<0.05).The percentages of GR-P in patients with RA were higher than those in patients with SLE (P<0.05).The expression of GRαwas negatively correlated with SLE disease activity index (SLEDAI) and disease activity score 28 (DAS28).SLE or RA patients with high disease activity showed lower expression of GRαthan those with low disease activity.The levels of IL-6, IFN-γand MIF in patients with SLE or RA were significantly higher than those in healthy subjects ( P<0.05).A negative correlation was observed between the expression of IL-6 and GRαin patients with SLE (P<0.05).The expression of IFN-γwas negatively correlated with GRαin patients with RA (P<0.05). Conclusion There were significant differences with the expression of GR isoforms among patients with SLE, patients with RA and healthy subjects, indicating the change of internal environment in patients might be in-volved in GR alternative splicing.GRαwas the predominant isoform and was negatively correlated with dis-ease activities.Oversecretion of cytokines resulted in a decreased expression of GRα.This study would be useful for the diagnosis of the disease status and for monitoring clinical treatment.

10.3969/j.issn.2095-4344.2013.24.020

Objective To explore the teaching effects of physiology lectures and students' attitude to lectures,their suggestions for contents,forms and other aspects of lectures.Methods Random sampling questionnaire survey was conducted among 500 students of 2008 grade and 2009 grade in Xiangya medical school of central south university.The percentage of the option in the questionnaire was calculated and the findings were directly described.Results All students thought that physiology lectures were necessary.Teachers should arrange lectures which students were interested in,pay attention to inspire thinking and enhance teacher-student interaction.67.6％ of students thought that the knowledge learned from lectures can be used in expanding scientific thinking.Conclusions The lectures are popular among most students,playing an important role in cultivating students' ability of strict scientific thinking.

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Mild cognitive impairment (MCI) is a pre-clinical stage of Alzheimer's disease (AD). In recent years, transcranial direct current stimulation (tDCS), as a neuromodulation technique, has being applied in the field of cognitive intervention for MCI, but its effect is controversial because of many factors. In order to promote the application of tDCS in intervention for MCI, this study performed a systematic review of the previous studies that used tDCS to improve cognitive functions of MCI individuals. The results indicate that tDCS could improve episodic memory, working memory, and language of individuals with MCI, while there is a lack of strong evidence that supports a positive effect of tDCS on attention of individuals with MCI. The placement of electrodes, time course of treatment, and current intensity all affected the intervention effect of tDCS. Future studies should take brain networks underlying cognitive processes and personalized factors such as age and education level into consideration to design better stimulation protocols, and they should be conducted in combination with neuroimaging technologies to evaluate the intervention effect of tDCS more accurately and objectively and to discover the neural mechanisms of tDCS intervention.

Objective To investigatethe effect of LED single wave infrared red light irradiation combined with traditional Chinese medicine iontophoresis on diabetic peripheral neuropathy. Methods During May 2017 and January 2015, 120 patients with diabetic peripheral neuropathy in double lower extremities, hospitalized in the department of endocrinology in our hospital, were randomly divided into the control group and the observation group, with 60 cases in each group. The two groups were both treated with conventional interventions including strict control of blood glucose, blood pressure, diet nursing, exercise therapy, foot care and psychological counseling. In addition to the care as done in the control group, the observation group was treated with iontophoresis of traditional Chinese medicine combined with LED single wave infrared red light irradiation for 3 courses, 14 days for each course, The two groups were compared in terms of limb numbness score, dorsal artery blood flow volume, ankle brachial index and score by Toronto clinical scoring symptom before and after intervention. Results The post-treatment score of numbness in the extremities of the observation group was lower than the post-treatment score of the control group as well as the pre-treatment score of the observation group. The post-treatment blood flow of the dorsum of the foot in the observation group was greater than the post-treatment flow in the control group as well as the pre-treatment flow in the observation group and so it is with the ankle brachial index. Conclusions LED single wave infrared red light irradiation combined with traditional Chinese medicine iontophoresis can to a certain extent control and delay the process of diabetic peripheral neuropathy. It can improve the quality of life of patients.

Objective To investigate the effects of crude extract of Capparis spinosa L. fruit alka-loids (CSFA) on the maturation of murine bone marrow-derived dendritic cells (DCs). Methods CSFA was prepared and the contents were determined by high performance liquid chromatography. DCs were trea-ted with different doses (1, 2, 3 mg/ml) of CSFA. The viability of DCs, the expression of surface mole-cules and the ability of phagocytosis were detected by flow cytometry. The secretion of cytokines was meas-ured by ELISA. Western blot assay was performed to analyze the activation of key molecules in mitogen-acti-vated protein kinases ( MAPK) and nuclear factor-kappa B ( NF-κB) signaling pathways. Results The re-sults showed that CSFA alone had no significant influence on the expression of surface molecules and cyto-kines in DCs. However, it significantly decreased the expression of CD40, CD80, CD86 and MHC Ⅱ as well as the secretion of IL-12p40 and TNF-αthat were induced by lipopolysaccharides (LPS), but increased IL-10 secretion and the ability of phagocytosis after treating DCs with both CSFA and LPS. Further, the phosphorylation of p38, extracellular signal-regulated kinase (ERK) and c-Jun NH2-terminal kinase (JNK) and the nuclear translocation of NF-κBp65 induced by LPS were inhibited by CSFA. Conclusion CSFA could inhibit the maturation of DCs and the secretion of pro-inflammatory cytokines induced by LPS while in-creasing the secretion of the anti-inflammatory cytokine IL-10 and the ability of phagocytosis, which might in-volve MAPK and NF-κB signaling pathways. This study suggests that CSFA could be used as a potential im-munosuppressant.

Oncoplastic breast surgery (OBS) using omentum has been developed in the past 20 years. This study reviewed related clinical researches at home and abroad. It summarized the surgical indications, criteria of cosmetic evaluation for omentum mammary tumor, the methods of harvesting omentum and the selection of tissue flaps. Meanwhile, postoperative complications, tumor safety, advantages and disadvantages of different methods were evaluated.

Objective:To compare the self-evaluated learning behavior and achievement of eight-year-program clinical medical students on online and offline problem-based learning (PBL), and to provide references and suggestions for successful implementation of online PBL teaching.Methods:During the three semesters of September 2020 to January 2022, a survey was performed on 100 clinical medical students of 2018 eight-year program on online or offline PBL teaching in Xiangya School of Medicine, Central South University. At the end of PBL courses, the students received questionnaires to self-assess their learning behavior and achievement in online or offline PBL teaching. The data were analyzed using the paired rank sum test with the use of SPSS 26.0.Results:Before class, there were no significant differences in learning behaviors including preparation time, communication with classmates, and materials collecting and sorting between students on online and offline PBL teaching ( P>0.05). In class, no significant differences were found in students' initiative of speaking and degree of satisfaction with classmates' speaking between online and offline teaching ( P>0.05), but the students on offline teaching showed significantly better concentration of attention ( Z=-4.24, P<0.001), listening to classmates' speeches ( Z=-3.42, P=0.001), and classmates' interaction ( Z=-3.11, P=0.002) compared with those on online teaching. No significant differences were observed between online and offline PBL teaching in students' self-evaluated learning achievements including improvements in autonomous learning ability, problem-solving ability, and literature inquiry skills ( P>0.05). Conclusion:Students on online PBL teaching have generally as good pre-class preparation and in-class learning performance as those on offline PBL teaching, indicating that the online PBL mode can be well implemented, and it can also ensure almost the same learning achievement as offline teaching.