Objective To investigate intraoperative neural monitoring(IONM)for prevention of recurrent laryngeal nerve injury(RLN)during thyroid cancer operation.Methods 288 cases of thyroid cancer admitted from Jun.2011 to Jun.2013 in our hospital were studied and they were divided into the observation group(140 cases) and the control group(148 cases) according to whether IONM was used during surgery.The incidence of RLN injury was compared between the 2 groups.Results The injury rate of RLN was lower in the observation group(0.67％) than in the control group(3.57％)and the operation time is shorter than the latter(P ＜0.001).There was no statistical difference for the operative bleeding volume and the average hospitalization time between the 2 groups (P ＞ 0.05).Conclusion INOM can help to shorten the operation time and reduce the incidence of RLN injury.

Objective To investigate the expression and relationship of livin and mutant p53 in hepatocellular carcinoma (HCC). Methods The expression of livin and mutant p53 were evaluated using the SP immunohistochemistry in 80 HCC tissue, 39 hepatic cirrhosis tissue, 33 normal tissue beside the hemangiomas of liver. Results The integrated A average results showed that the intension of positive expression of livin aligned by turns was HCC tissue (Median=5.09; P25～P75=3.06～8.28), hepatic cirrhosistissue(Median=3.05; P25～P75=2.49～4.25), normal liver tissue(Median=1.99; P25～P75=1.54～2.54) (P<0.001), respectively. It also showed that the intension of positive expression of p53 in HCC tissue (Median=43.13; P25～P75=20.41～78.53) was higher than that in hepatic cirrhosis tissue (Median=20.30;P25～P75=14.90～28.08), as well as in that of normal liver tissue (Median=15.52;P25～P75=12.81～21.80) (P <0.001), but it made no sense in statistics between hepatic cirrhosis tissue and normal tissue of liver. The expression of livin was obviously correlated with p53 in HCC tissue(r=0.241, P<0.05). Conclusion The overexpressian of livin and p53 and their positive correlation showed that livin may play a crucial role in the origin and development of HCC in coordination with p53.

Objective To analyze the clinical and imaging data of patients with cerebral microbleeds after acute ischemic stroke (AIS) and to explore the related risk factors of cerebral microbleeds. Methods Seventy-six patients with AIS hospitalized in the Department of Neurology of Binhai Hospital, General Hospital of Tianjin Medical University from May 2015 to October 2016 were collected. All patients were divided into a positive group (32 cases) and a negative group (44 cases) according to whether there were micro-bleeds in the magnetic resonant imaging. The clinical and imaging data of the two groups were statistically analyzed, and the differences in risk factors related to microbleeds between the two groups were compared, and receiver operating characteristic curve (ROC) was drawn, the area under the ROC curve (AUC) was calculated to evaluate the predictive value of age, history of hypertension, and leukoaraiosis for cerebral microbleeds in patients with AIS. Results The age (years: 69.5±10.1 vs. 61.3±8.7), proportion of leukoaraiosis [59.4% (19/32) vs. 34.1% (15/44)] and history of hypertension [75.0% (24/32) vs. 29.5% (13/44)] in the positive group were all higher than those in the negative group (all P < 0.05). Correlation analysis showed that the more severe lacunar infarction, the higher the incidence of cerebral microbleeds (r = 0.278, P = 0.012). Logistic regression analyses showed that age [odds ratio (OR) = 5.11, 95% confidence interval (95%CI) = 3.25 - 12.20, P = 0.001), leukoaraiosis (OR = 4.62, 95%CI = 1.08 - 16.89, P = 0.019) and history of hypertension (OR = 9.28, 95%CI = 2.09 - 38.67, P = 0.003) were the related risk factors of cerebral microbleeds in patients with AIS. ROC curve analysis showed that age, history of hypertension could predict cerebral microbleeds in patients with AIS, with the area under ROC curve (AUC) were 0.751, 0.727 (all P < 0.05), 95%CI respectively was 0.634 - 0.868, 0.610 - 0.845, the sensitivity respectively was 59.4%, 75.0%, and specificity respectively was 84.1%, 70.5%. Conclusion The age, leukoaraiosis, and history of hypertension were related to the occurrence of cerebral microbleeds; the severity degree of lacunar infarction was positively correlated with the incidence of cerebral microbleeds; age and history of hypertension have certain predictive value for AIS.

Objective:To explore the clinical value of lobar lung transplantation for end-stage lung disease patients in organ donation era.Methods:Clinical data were analyzed retrospectively for 14 cases with lobar lung transplantations between January 2016 and December 2019, including clinical outcomes and postoperative complications.Results:Eleven cases(78.6 %)had a positive etiology examination in bronchial secretion or tissue culture. There were unilateral lobar lung transplantation (n=2), bilateral lobar lung transplantation(n=2)and unilateral lobar lung transplantation and contralateral lung transplantation(n=10). Intra-operative ECMO(n=11)postoperative ECMO(n=5)were required. All survived during a 30-day perioperative period. The median time of postoperative ECMO was 1(1~11)day, the median time of extubation 4.5(0~182)day and the median time of stay in ICU 11(2~186)day. Re-operation was required for 1 case due to active bleeding in thoracic cavity. There were 10 survivors and 4 deaths. The causes of death were bronchus fistula(n=2), pulmonary infection(n=1)and renal failure(n=1)respectively.Conclusions:Lobar lung transplantation is efficacious for selected patients with end-stage lung disease.