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ObjectiveTo compare the differences in thyroid hormone levels between adolescents with and without suicidal ideation， and to explore the association between thyroid hormone/suicidal ideation and the antidepressant treatment. MethodsA total of 100 patients were divided into non-suicidal ideation group and suicidal ideation group according to the SIOSS. The levels of thyroid-stimulating hormone （TSH）， triiodothyronine （T3）， thyroxine （T4）， free triiodothyronine （FT3） and free thyroxine （FT4） were compared between the two groups as well as their changes after 6 weeks of antidepressant treatment. ResultsThe levels of FT3， FT4 and T4 in the non-suicidal ideation group were higher than those in the suicidal ideation group. After 6 weeks of antidepressant treatment， the levels of FT3， FT4 and T4 in the suicide ideation group were higher than those before the treatment. The FT3 level in the male non-suicidal ideation group was higher than that in the suicidal ideation group. The levels of FT4 and T4 in the female non-suicidal ideation group were higher than those in the suicidal ideation group （all P<0.05） ConclusionThere are differences in thyroid hormone levels between adolescents with and without suicidal ideation （both with first-episode depression）， and patients with suicidal ideation have significant changes after treatment with antidepressants.
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Objective:To explore the diagnosis and treatment of hepatocellular adenoma.Methods:The clinical data of 23 hepatocellular adenoma patients admitted to the Affiliated Hospital of Qingdao University from May 2013 to May 2020 were retrospectively analyzed.Results:Fifteen patients were female, the age ranged from 21 to 60. The maximum tumor diameter was from 2.5 cm to 15 cm.Most patients (15/23) were asymptomatic. There were 20 cases (87%) with single lesion and 3 cases (13%) with multiple lesions. Contrast-enhanced CT and MRI showed enhancement in the arterial phase, and de-enhancement in the portal phase as well as in the delayed phase. All cases underwent tumor resection. Hepatocellular adenoma was confirmed by pathology with partial canceration in one case and intratumoral hemorrhage in two cases. Sixteen cases were misdiagnosed preoperatively, 20 were followed up with the median follow-up time of 36 months. Recurrence was not found.Conclusion:Hepatocellular adenoma is uncommon and often misdiagnosed. Preoperative diagnosis is dependent on MRI.Given the fact of high rate misdiagnosis and a tendency of canceration,resection is recommended.
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Objective To investigate the changes and clinical significance of thyroid function in patients with depression by detecting serum thyroid hormone levels.Methods Totally 127cases of depression in the Department of Psychiatric of our hospital from January 2016to January 2018were collected as research objects.According to the characteristics of depression, patients with unipolar depression were selected as unipolar group (n=45), while patients with bipolar depression were selected as bipolar group (n=82).Meanwhile, 53cases of healthy volunteers underwent physical examination in the same period in our hospital were collected as control group.The serum samples of three groups were collected and the serum levels of thyroid hormones (T3, T4, FT3, FT4, TSH) were detected by chemiluminescence immunoassay.The changes of thyroid function between the three groups were compared and analyzed.Results The proportion of patients with T3and T4decreased in unipolar group were significantly higher than those in bipolar group, and the proportion of patients with T3increased in unipolar group was significantly lower than that in bipolar group, and the proportion of patients with FT4decreased in unipolar group was significantly higher than that in bipolar group;and the proportion of patients with TSH increased and TSH decreased in unipolar group were significantly higher than those in bipolar group, the differences were statistically significant (P＜0.05).The level of FT3in unipolar group was significantly lower than that in bipolar group (P＜0.05), while the level of FT4in unipolar group was significantly lower than that in control group and bipolar group, and the differences were statistically significant (P＜0.05).Conclusion The level of thyroid hormone in patients with different types of depression was different, so the treatment should be distinguished.Psychological treatment should be focused on the unipolar depression patients with hypothyroidism, while attention should be paid to drug treatment for bipolar depression patients with high levels of free thyroid hormone.
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Objective@#To clarify the clinicopathologic features of hepatocellular carcinoma (HCC) patients survived more than 10 years after radical hepatectomy.@*Methods@#Two hundreds and fifty-two patients who underwent curative resection for HCC between January 1999 and March 2006 at Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qingdao University were included.There were 217 male cases and 35 female cases aging from 17 to 82 years with median age of (53.8±10.5)years. Followed by March 31 2016, clinicopathologic factors in 10-year survivors and patients who died within 10 years were compared by χ2 test, Kaplan-Meier survival analysis and Cox proportional hazards model and the prognostic factors affecting survival were identified.@*Results@#All patients were followed-up for 4.0 to 205.7 months with median time of 53.4 months. The 10-year overall survival rate was 26%, there were 62 cases(26.2%) who survived for more than 10 years after initial hepatectomy. In survival >10-year group, the paitents with ALT<40 U/L, gamma-glutamyl transpeptidase<64 U/L, albumin≥35 g/L, without liver cirrhosis and portal hypertension, Child-Pugh grade A, no blood transfusion, AFP≤20 μg/L, tumor size ≤5.0 cm, single tumor, high differentiation, TNM stage Ⅰ and TACE negative after resection were more than the patients in survival <10-year group (P<0.05). In multivariate analysis, Child-Pugh grade A, the tumor size ≤5.0 cm and TACE negative after resection were favorable independent factors associated with 10-year survival (P<0.05).@*Conclusion@#Based on the results of the study, Child-Pugh grade A, tumor size ≤5.0 cm and TACE negative after resection at initial hepatectomy might be biologically favorable conditions for patients surviving more than 10 years.
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Objective To explore the relationships between angiotensin converting enzyme (ACE) gene polymorphism of insertion/deletion(I/D) and cognition function in senile depressive patients in Chinese Han population.Methods 97 patients with major depression were recruited according to the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition criteria,and 103 healthy persons were used as controls.The Hamilton Depression Scale (HAMD) and neuropsychological tests were used to assess depressive severity and cognitive function in all patients and 44 healthy controls,respectively.The intron 16 I/D polymorphism of ACE gene was detected by polymerase chain reaction (PCR).Results The performances of neuropsychological tests in case group except TMT B were significantly poorer than those in control group (P＜ 0.001).Correlation analysis indicated that the total scores of HAMD were negatively associated with Digit Span Test forward score in senile depressive patients (r=-0.213,P=0.040).There were no significant differences between case and controls on genotype and allele frequencies of ACE gene(x-2 =1.745,P=0.418 ; x2 =0.700,P=0.403).And there were no significance in different sex,respectively (P ＞ 0.05).Furthermore,no significant differences of neuropsychological test performances were found between ACE genotypes of senile depressive patients (P ＞ 0.05).Conclusion Senile depressive patients have extensive cognitive impairments in the acute phase of illness,and working memory performance is correlated with depression severity.ACE gene Ⅰ/D polymorphism may not significantly associate with cognitive function in senile patients.
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Objective To investigate the prognosis of patients with primary liver cancer in different pathological types after hepatectomy,and to analyze the effects of clinicopathological factors on the survival.Methods The clinical data of 567 patients with primary liver cancer who received hepatectomy at the Affiliated Hospital of Qingdao University from January 1997 to December 2008 were retrospectively analyzed.All patients were divided into hepatocellular carcinoma (HCC) group,cholangiocarcinoma (CC) group and combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) group.The survival and risk factors of the patients were analyzed.All data were analyzed by using the chi-square test,t test,analysis of variance.The survival curve was drawn by the Kaplan-Meier method and the survival of the 3 groups was compared by the Log-rank test.The risk factors were analyzed by the one-way analysis of variance and COX regression model.Results The results of pathological examination confirmed that 92.9％ (527/567) patients were with HCC,4.6％ (26/576) with CC and 2.5％ (14/567)with cHCC-CC.The median cumulative survival time of patients with HCC was 48 months,which was significantly longer than 19 months of patients with CC and 14 months of patients with cHCC-CC (Log-rank value =4.354,8.847,P ＜ 0.05).The median tumor-free survival time of patients with HCC was 26 months,which was significantly longer than 9 months of patients with CC and 9 months of patients with cHCC-CC (Log-rank value =6.479,7.708,P ＜ 0.05).The tumor recurrence rate within 1 year of patients with HCC was 28.8％ (152/527),which was significantly lower than 57.7％ (15/26) of patients with CC or 9/14 of patients with cHCC-CC (F =17.046,P ＜ 0.05).No vascular thrombosis was detected in patients with CC,but the regional lymph node metastasis rate was 19.2％ (5/26),which was significantly higher than 2.8％ (15/527) of patients with HCC (x2 =19.082,P ＜ 0.05).Level of alpha-fetoprotein,TNM staging,tumor diameter,multiple foci,liver capsule invasion,satellite foci and lymph node metastasis were risk factors for the survivals of patients with primary liver cancer after hepateetomy (x2 =8.648,118.786,59.548,7.639,13.200,43.842,15.540,P ＜ 0.05).Vascular tumor thrombosis and Child-Pugh classification were the risk factors for the survivals of patients with HCC or cHCC-CC (x2 =70.446,6.230,P ＜ 0.05).TNM staging,tumor diameter,satellite foci and vascular tumor thrombusis were the independent risk factors for the survivals of patients with primary liver cancer (RR =1.420,1.050,1.513,1.899,P ＜ 0.05) ; TNM staging,tumor diameter and vascular tumor thrombosis were the independent risk factors for the survivals of patients with HCC (RR =1.432,1.888,1.052,P ＜ 0.05).TNM staging and tumor diameter were the independent risk factors for the survivals patients with CC (RR =1.473,1.503,P ＜ 0.05).Conclusion Although CC and cHCC-CC take small proportion in the primary liver cancer,the tumor recurrence rate is higher and the survival rate is lower when compared with patients with HCC.
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Objective To study the prognosis of patients with huge hepatocellular carcinoma (HCC) after R0 resection.Methods 517 patients with primary HCC who underwent R0 resection from January 1997 to December 2008 at the Affiliated Hospital of Medical College Qingdao University were analyzed retrospectively.Results The 5-and 10-years overall survivals (OS) in patients with huge HCC (≥10 cm; n=69) and in patients with HCC ＜10 cm (n=448) were 24％,18％ and 49％,30％,respectively.The median OS was 23.0 and 58.0 month (P＜0.001,log rank test) ; and the median disease-free survivals (DFS) were 15.3 and 34.8 month (P＜0.001),respectively.The recurrence rate within the first year and the extrahepatic recurrence after resection in patients with huge HCC was significantly higher than in patients with HCC ＜10 cm (44.9％ vs.24.3％,P=0.022;32.7％ vs.16.0％,P=0.004).Independent poor prognostic factors of OS and DFS for patients with huge HCC after R0 resection were portal hypertension and vascular invasion.Preoperative transcatheter arterial chemoembolization (TACE) was an independent prognostic factor for better DFS.Conclusions Surgical resection for huge HCC is safe and feasible.For huge HCC after resection,portal hypertension and vascular invasion were poor prognostic factors.Preoperative TACE improved DFS after resection.
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Objective To analyze the factors that influence the survival condition during the first year after hepatectomy in patients with hepatocellular carcinoma (HCC). Methods Five hundred twentyeight HCC cases undergoing hepatectomy were included from January 1997 to December 2008.The factors and survival outcomes in these patients were analyzed. Results There were 302 patients dying during a medium follow-up of 35 months and 1-year cumulative survival was 85％.The causes of death during first year were tumor recurrence (78.1％,75/96) and liver dyscompensation ( 19.8％,19/96).By Cox regression analysis,tumor size ≥5 cm (P =0.047 ),vascular invasion ( P =0.018),histologic moderately and poorly differentiation ( P =0.001 ) and pathologically positive margin ( P =0.004 ) were significantly associated with tumor recurrence,and portal hypertension was an independent factor for patients dying from liver dysfunction ( P =0.001 ).Positive tumor margin was the most important factor associated with postoperative death within one year (59.3％,60/96). Conclusions During the first year after HCC resection,tumor recurrence and liver dysfunction are main factors influencing HCC patients' survival,nonR0 resection is the main factor causing tumor recurrence,and portal hypertension is an independent factor for patients dying of liver dyscompensation.
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Objective To study the expressions of Cx43,CD105 and VEGF in HBV related HCC tissues and the relationships between Cx43 expression and recurrence and prognosis after cancer radical resection in HCC patients stratified by serum AFP levels. Methods The expressions of Cx43,CD105,VEGF in 234 HBV related HCC tissues were examined by tissue microarray and two-step methods of PV-6000 of immunohistochemistry and the expressions of Cx43 in 20 frozen HCC specimens were examined by RT-PCR. Results Cx43 in HCC tissues was positive as examined by both immunohistochemistry and RTPCR methods.Positive Cx43 expression is correlated with lower early recurrence ( Log Rank P =0.001 ),longer disease free survival (Log Rank P =0.026 ) and overall survival( Log Rank P =0.000 ) as showed by the Kaplan-Meier analysis in patients with AFP ＜ 400 μg/L. The expression of Cx43 is an independent prognostic factor.The positive expression of Cx43 related with lower positive expression of CD105 and VEGF (P =0.018,0.023 ),and correlated with histological differentiation (P =0.002),the number of focus (P =0.033 ),blood vessel tumor embolism ( P =0.029 ). Conclusions The expression of Cx43 is correlative with the expression of CD105 and VEGF,and is predictive of HCC early recurrence and poor prognosis after radical hepatectomy in HBV related HCC patients with serum AFP ＜ 400 μg/L.
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Objective: To study the relationships between the expressions of E-cadherin and ki-67 in the tissues of heatocellular carcinoma(HCC)and the prognosis of HCC patients after hepatectomy as well as their clinical pathology. Methods: We examine the expressions of E-cadherin and ki-67 in 255 HCC tissues by tissue microarray and PV-6000 two-step method of immunohistochemistry and analyze the correlations between their expressions and clinical pathological data, 1-year recurrent rate and overall survival time after hepatectomy. Results: The expression of E-cadherin correlated with the tumor size and the 1-year recurrent rate of positive group was higher than that of the negative group. The expression of ki-67 correlated with vascular invasion and differentiation of the tumor, the positive group showed a higher 1-year recurrent rate and a shorter overall survival time. Multivariate Cox regression analysis indicated that the expression of ki-67 was an independent risky factor. Conclusions: The negative expression of E-cadherin and the positive expression of ki-67 predict a higher recurrent rate of early stage. The expression of ki-67 is an independent risky factor which can be used to evaluate the prognosis of patients with HCC after hepatectomy.