Objectlve:To assess the influential factors of decision-to-delivery inteval (DDI) in caesarean section, and its influence on neonatal outcomes.Methods:472 caesarean sections were divided into two groups according to Lucas's classification :the emergency caesarean sections as group 1 (291) ; and the e-lective caesarean sections as group 2 (181).It was divided into DDI ≤30 min group and DDI > 30 mir group in group 1.A retrospective study was performed in DDI, influential factors of DDI, neonatal Apgar score and umbilical arterial blood gas.Results: ①The mean DDI was 35.5±11.6 min in group 1,in wgich DDI≤30 min was 210 cases (72.2%) and 49.3 ±22.8 min in group 2, in which DDI≤30 min was 86 cases (47.5%).②IN group 1,umbilical artery pH and Apgar core at 1 min after birth could be improved sigbificantly in the cases of DDI ≤ 30 min (P<0.05) , but no correlation was found between the DDI and Apgar scrore at 5 min ,as compared with DDI ＞30MIN CASES(p＞0.05).③It was mainly influenced by time taken to get the patient into operation room in DDI >30 min (56 cases, 69.1 %).Concluslons :The recommended DDI ≤30 min is not routinely achieved even in emergency caesarean sections.Shortening DDI as far as pos-sible might improve the neonatal outcome.

Objectives To investigate the frequency, distribution and features of lymph nodes metastasis in T1/T2 squamous carcinoma and adenocarcinoma of lung, and to provide evidence for extensive dissection of lymph nodes．Methods 254 patients with T1/T2 squamous caroinoma and adenocarcinoma of lung underwent R2 surgery plus extensive dissection of hilar, interlobular and mediastinal lymph nodes according to the grouping system proposed by Naruke．Results A total of 1685 groups of lymph nodes were dissected． The metastatic rates of N1 and N2 were 20．0% and 10．2%． The differerce was very significant between T1 and T2 (P<0．01)． No, N2 metastasis was found in T1 squamous carcinoma． N2 metastatic rates were 22．0% in squamous carcinoma and 40．9% in adenocarcinoma (P<0．01)． 64．3% of squamous carcinomas spread to only one group of N2 nodes,and over 3 groups of lymph nodes were positive in 46．2% of adenocarcinonmas． Saltatory metastasis accounted for 57．5% of N2 metastasis． 13．6% of N2-positive tumors in the upper lobes metastasized to the lower mediastinum, whereas 51．6% of N2-positive tumors in the lower lobes spread to the upper mediastinum．Conclusions The frequency of lymph node metastasis increases with the growth of tumors． Metastasis occurs more frequently in adenocarcinoma than in squamous carcinoma． Tumor at any site can metastasize to the distant mediastinum． Except for T1 squamous carcinoma, radical surgery can be achieved only by extensive dissection of ipsilateral intrapulmonary and mediastinal lymph nodes．

Objective To evaluate the diagnosis and management of bronchial rupture from blunt thoracic trauma. Methods A group of 31 patients with bronchial rupture was involved. Chest roentgenography, tornography and bronchoscopy were performed on all patients. The surgical technique and complications were described.Results Diagnosis was confirmed by tomography and bronchoscopy in all the patients. End to end anastomosis was used in 26 patients. Four patients were operated with total pneurnonectomy. One patient was repaired with an intercostal muscle and rib flap with blood supply. Of the 31 patients, one died of adult respiratory distress syndrome after operation. Most patients had excellent surgical outcomes. 81％ (25/31)of the bronchial rupture were delayed in diagnosis and treatment. The classic symptoms and signs of bronchial rupture included subcutaneous emphysema, dyspnea and an intermediate coma interval. The roentgenogram showed mediastinal emphysema, pneumothorax, “drop lung” sign and marked radiodensity of hilum widened mediastinum.Conclusion Bronchoscopy is a useful and accurate method to diagnose and treat the bronchial rupture, with which surgeons can easily locate the rupture site during surgery. Surgical treatment could restore pulmonary function in most patients.

Objectives To investigate the frequency, distribution and features of lymph nodes metastasis in T1/T2 squamous carcinoma and adenocarcinoma of lung, and to provide evidence for extensive dissection of lymph nodes．Methods 254 patients with T1/T2 squamous caroinoma and adenocarcinoma of lung underwent R2 surgery plus extensive dissection of hilar, interlobular and mediastinal lymph nodes according to the grouping system proposed by Naruke．Results A total of 1685 groups of lymph nodes were dissected． The metastatic rates of N1 and N2 were 20．0% and 10．2%． The differerce was very significant between T1 and T2 (P<0．01)． No, N2 metastasis was found in T1 squamous carcinoma． N2 metastatic rates were 22．0% in squamous carcinoma and 40．9% in adenocarcinoma (P<0．01)． 64．3% of squamous carcinomas spread to only one group of N2 nodes,and over 3 groups of lymph nodes were positive in 46．2% of adenocarcinonmas． Saltatory metastasis accounted for 57．5% of N2 metastasis． 13．6% of N2-positive tumors in the upper lobes metastasized to the lower mediastinum, whereas 51．6% of N2-positive tumors in the lower lobes spread to the upper mediastinum．Conclusions The frequency of lymph node metastasis increases with the growth of tumors． Metastasis occurs more frequently in adenocarcinoma than in squamous carcinoma． Tumor at any site can metastasize to the distant mediastinum． Except for T1 squamous carcinoma, radical surgery can be achieved only by extensive dissection of ipsilateral intrapulmonary and mediastinal lymph nodes．

To investigate the impact of phenotypic knockout of CXCR4 on Molt-4 cells via intrakine technology,the C-terminal alpha-helix gene SDF-1alpha/54/KDEL of human stromal cell-derived Faceor-1 deletion is fused to a retention signal 4-peptide -KDEL that retains the newly synthesized receptor within the Molt-4 cells endoplasimc reticulum. Subsequently, PCR is used to amplify the target gene SDF-1alpha/54/ KDEL from the constructed plasmid SDF-WT-Gly x 4-Dec/PET-30a(+) at its C-terminal and subclone it into eukaryotic expression vectors pEGFP-C3 for generating recombinant vector cells by lipEGFP-C3/SDF-1alpha/54/KDEL, and then have it sequenced. After the transfection of recombinant plasmids into COS-7 posome, SDF-1alpha/54/KDEL protein is confirmed with Western blot. The recombinant plasmids pEGFP-C3/SDF-1alpha/54/KDEL are isolated and transiently transfected in Molt-4 cells by electroporation. Flow cytometric analysis shows a dramatic reduction of CXCR4 expression on Molt-4 cells. The conclusion is that SDF-1alpha/54/KDEL could assume a role in the phenotypic knockout of CXCR4, and the findings suggest that the inhibiting effect of SDF-1alpha/54 against CXCR4 is not influenced by the deletion of SDF-1alpha helix at the C terminal.
Animals ; COS Cells ; Cell Membrane ; metabolism ; Cercopithecus aethiops ; Chemokine CXCL12 ; genetics ; Cloning, Molecular ; Electroporation ; Gene Knockout Techniques ; Genetic Vectors ; genetics ; Humans ; Mutation ; Receptors, CXCR4 ; genetics ; metabolism ; Recombinant Proteins ; genetics ; Stromal Cells ; metabolism ; Transfection

Objective:To investigate the effect of situational simulation combined with video feedback in cardiopulmonary and abdominal clinical probation of diagnostics.Methods:Two hundred and twenty-four clinical undergraduates from the second affiliated hospital of Guangxi Medical University were randomized into the experimental group ( n=112) and the control group ( n=112). The experimental group applied situational simulation combined with video feedback methods in the cardiopulmonary and abdominal clinical probation. In other words, according to the assignment of diseases, two students played the role of "physician and patient" and conducted corresponding consultation and physical examination, in which the positive and negative video feedback were integrated to standardize students' physical examination skills. The control group adopted conventional teaching method. The teaching effect of the two groups was evaluated through unified and standardized scores of theoretical tests, cases analysis, and clinical skills operation, and the experimental group was conducted anonymous questionnaires to 112 students. SPSS 22.0 was used to perform the t test. Results:The evaluation results show that the average scores of theoretical tests (90.12±0.94), cases analysis (9.30±0.10) and physical examination (93.50±0.72) in the experimental group are higher than those of the control group, (83.20±1.66), (8.10±0.11), (85.00±1.75), respectively, with statistical significance ( P<0.05). All 112 questionnaires were collected, with an effective rate of 100%. The percentage of "yes" respondents is as follows, 91.1% of "Enhancing the mastery and application of knowledge"; 97.3% of "Cultivating clinical thinking"; 87.5% of "Improving doctor-patient communication skills"; however, there are 93.8% students believe that this new teaching approach takes more time to prepare before class, consequently, their initiative and enthusiasm of study and learning interest have slid into decline, with percentage of 80.4% and 83.0%, respectively. Conclusion:The teaching method of situational simulation and video feedback in cardiopulmonary and abdominal clinical probation of diagnostics is beneficial to enhance students' understanding and mastery of theoretical knowledge, standardize physical examinations, cultivate clinical thinking ability and improve the doctor-patient communication skills. However, it takes a lot of time for students to prepare before class. If they fail to make reasonable arrangements, the teaching effect will be half the effort and students' initiative and enthusiasm of learning will be reduced.