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.

Hydatid disease does seriously harm to human and livestock ,and causes huge economic losses to the livestock in‐dustry .Despite the fact that people have made some success in prevention and control of animal hydatid disease after making great efforts during the past few decades ,however ,there still remain many problems and challenges .In order to facilitate the research in animal hydatid disease in China ,here we reviewed the problems and challenges in the prevention and control of this disease and put forward several proposals on the treatment and management of dogs ,immunization ,diagnose ,surveillance , etc .

Objective To evaluate the value of bispectral index(BIS)monitoring as an indicator for extubation sedation level after children's oper?ation by total intravenous anesthesia. Methods One hundred and eighty children(2?13 years old)were randomly divided into six groups with 30 cases in each. Group A kept BIS 56?60,and Group B 61?65,Group C 66?70,Group D 71?75,Group E 76?80,Group F 81?85 till extubation. All children were given fentanyl,propofol and cisatracurium besilate when induced,and maintained with propofol and remifentanil. All cases kept BIS 40?55 during the operation. Then the changes of electrocardiogram,mean arterial pressure,heart rate,SpO2,postoperative complications and recovery time were observed. Results Groups A and B were extubated at deep anesthesia,cycle stability,but with high incidence of adverse reactions and awaked with a long time. Groups E and F were extubated when awaked,but with greater stimulation and easier agitation. Groups C and D were lighter hemodynamic responses,less respiratory effects and less postoperative complications of anesthesia. Conclusion The BIS level of 66?75 is a good se?dation level for extubation,especially in the level of 71?75.

Objective To investigate the diagnosis of Crohn's disease(CD)in Ruijin hospital of School of Medicine of Shanghai Jiaotong University according to the criteria made by World Health Organization(WHO)and Chinese Medical Association.Methods The consecutive patients with CD diagnosed in Ruijin hospital between 1998 and 2007 were retrospectively analyzed.The clinical manifestation.endoscopic,radiologic and pathologic findings of all patients were re-evaluated accordingto the diagnostic criteria of CD proposed by WHO and Chinese Medical Association in 2007.The diagnostic level of CD was assessed.Results Only 5 and 10 patients were confirmed to be well consistent with the criteria of WHO and Chinese Medical Association,respectively.Two hundred and thirty-six patients were confirmed as suspected diagnosis to the criteria of Chinese Medical Association and 20 patients to WHO.The level of endoscopic diagnosis was raised,wherease the level ofpathologic diagnosis was decreased in recent years compared with that before 2004.Conclusion The pathologic diagnosis rate of CD is still at a low level.The current diagnostic level of CD is lagging behind the demand of the guidelines.

Circulating DNA is defined as a kind of extracellular DNA that exists in plasma,cerebrospinal fluid and synovial fluid.The concentration of circulating DNA of cancer patients is significantly higher than that in healthy people.The genetic and epigenetic alterations of circulating cell-free nucleic acids are relevant to cancer development and progression,for example,gene mutation,DNA methylation and microsatellite instability and so on.The quantitative and qualitative detection of circulating DNA shows promising potential value in cancer screening,diagnosis,disease monitoring treatment and prognosis.

Objective To investigate the craniofacial morphologies of Sagliker syndrome.Methods Sixteen patients were selected in this study that was diagnosed by the Department of Nephrology and the Center of Dentistry of China-Japan Friendship Hospital.They were divided into 2 groups:Sagliker syndrome group(SS) including 8 patients,and secondary hyperparathyroidism group (SHPT) including 8 patients.Cephalometric radiographs were taken from all the 16 patients.Results The hard issue measurement results had shown that in ∠SNA,∠ANB,∠NA/PA,∠MP/SN,∠MP/ FH,∠SArGo,and ∠ArGoGn,there were significantly statistical differences between the two groups.The measurements of SS were greater than that of SHPT.The soft issue measurement results had shown that in ∠LL-Bs-Pos,∠AsUL-FH,UL-EP,and ∠AsUL-BsUL,there were also significant differences between the two groups.The measurements of SS were greater than that of SHPT.In ∠BsLL-FH,there were evidently statistical differences between the two groups:the measurements of SS were greater than that of SHPT.Conclusions The facial hard and soft tissue of the patients with Sagliker syndrome have the special changes in morphologies.

Type 2 innate lymphoid cells ( ILC2s) are recently identified members of the innate lymphoid cell ( ILC) family. These cells are capable of producing Th2-type cytokines such as IL-5 and IL-13 in response to epithelial cell-derived cytokines IL-25 and IL-33 and play critical roles in allergic diseases such as bronchial asthma. Further investigations on ILC2s will enhance the better understanding of type 2 immune responses and may provide new strategies for the treatment of allergic asthma. In this review, we fo-cus on the origin, location and biological function of ILC2s as well as their possible roles in the pathogenesis of bronchial asthma.

Objective To investigate the features of gallbladder carcinoma in two-phase spiral CT, and to analysis the values of two-phase spiral CT for the differential diagnosis between gallbladder carcinoma and chronic cholecystitis. Methods The two-phase spiral CT manifestations of 30 cases of gallbladder carcinoma, proved by surgery and pathology, and 30 cases of chronic cholecystitis were analyzed. Results According to the CT findings, the gallbladder carcinoma was categorized into 3 types: intraluminal mass of gallbladder in 6 out of 30 (20.0%), thickening of the gallbladder wall in 11 (33.7%), and mass replacing the normal gallbladder in 13(43.4%). The most common enhancement patterns of the wall in gallbladder carcinoma were hyperattenuation during the arterial phase, while isoattenuation with the adjacent hepatic parenchyma during the venous phase; or hyperattenuation during both phases. The most common enhancement pattern of the wall in chronic cholecystitis was isoattenuation during both phases, with clear hypoattenuation linear shadow in the gallbladder fossa. Other ancillary features of gallbladder carcinomas included: infiltration of the adjacent parenchyma, local lymphadenopathy and intrahepatic metastasis. Conclusion Two-phase spiral CT scan can identify the features of the gallbladder carcinoma and is helpful for the differential diagnosis of these two different disease entities.

Objective To study the spiral CT features of gastrointestinal invasion by carcinoma of gallbladder. Methods Eight patients with surgical-pathologically documented gastrointestinal invasion by carcinoma of gallbladder were analyzed retrospectively. All patients underwent plain and contrast-enhanced dual-phase scanning of the abdomen. Oral contrast medium (1.2% Angiografin) was used to fill the gastrointestinal tract before CT scanning. Results There were 2 cases of gastric antrum invasion, 6 duodenal invasion and 3 colonic invasion according to the surgical and pathological findings. Spiral CT correctly diagnosed 2 gastric invasion and 4 duodenal invasion based on several imaging features, like blurring of fat plane, focal wall thickening and luminal narrowing of involved gastrointestinal segments, and mass formation. However CT was unable to diagnose the 3 cases of hepatic flexure of colon invasion. Conclusion CT is valuable for diagnosing upper gastrointestinal tract invasion by carcinoma of gallbladder, yet the diagnosis of hepatic flexure of colon invasion is still difficult.

Objective To understand teachers' cognition and behavior of PBL teaching in nursing college.Methods Eighty teachers were investigated by questionnaire at eight nursing colleges in Hunan province.The percentage was used to do statistical description.Results Totally 75 copies of valid questionnaires were returned,the effective recovery rate was 93.75％.Among all,96％ of teachers thought that teacher was the guide;85.3％ teachers thought that students were knowledge's seekers;93.3％ teachers heard of PBL teaching;81.3％ teaches thought that PBL teaching played a positive role ;74.7％ teaches understood PBL teaching by communication or reading literature; 72％ teachers were willing to try PBL teaching;46.8％ teachers emphasized on multidisciplinary knowledge fusion in teaching; 88.3％ teachers encouraged student discussion in class.The main factors effecting PBL teaching were case and problem design,teaching result evaluation,lack of expert guidance and teacher instruction.Conclusion Teachers have certain understanding of PBL.Organizers should formulate related policies for teachers and students in order to create good education environment.