癌症研究的世纪回顾与展望

在全世界 ,癌症每年夺取 60 0万人的生命 ,并把10 0 0万人置于死亡的边缘。在中国 ,每年有 160万人得癌 ,130万人死于癌症。世界卫生组织预测癌症将是 2 1世纪人类的“头号杀手”。人类对癌的认识必需经过四个阶段 :( 1)癌是什么 (疾病种类 ) ?( 2 )癌由什么 (病因 )引发 ?( 3)癌是怎么形成的 (机理 ) ?( 4 )我们怎样战胜它 (治疗手段 ) ?1　肿瘤是由肿瘤细胞所形成公元 1836年 ,德国的ＪｏｈａｎｎｅｓＭｕｌｌｅｒ运用改进的显微镜观察癌症 ,发现并发表了“癌症是由紊乱的异常细胞所组成” ,使癌症研究进入了细胞水平 ,为肿瘤病理解剖学蓬…     

癌痛的治疗和人文关怀

大多数癌症病人会受到不同程度的癌痛困扰。癌痛治疗已成为癌症姑息治疗的一项重要内容,癌痛的科学评估与规范治疗对于改善病人的生存质量具有重要意义,同时在治疗过程中应当突出“人本思想”,体现“人文关怀”,尊重生命,关爱健康,减轻痛苦,尊重患者的权利和隐私,体现人道主义精神。     

疼痛治疗方法在晚期癌痛病人中的应用

癌症是当今严重威胁人类健康和生命的疾病之一。解除癌症疼痛对改善晚期癌症患者的生存质量、延长生存期都具有十分重要的意义。癌痛的诊断和合理的疼痛评估是治疗癌痛的基础。癌症疼痛的治疗方法虽有多种,但其目的就是使用最佳方法解除患者痛苦,消除疼痛,从而提高生存质量。因此本文从科学的角度对晚期癌痛的治疗方法进行评价和阐述。     

靠主得胜

当我上小学刚认识“癌”字的时候,觉得它每一画都那么难看、凶恶。后来除对它有一种厌恶之外,还对它无比愤恨,因为在我年幼时,癌症这个恶魔夺去了我父亲的生命。愤恨之余,天真的我感到它离自己又是那么遥远,久而久之对“癌”的认识也就渐渐淡漠了。     

激沫卡哇哇--陆扬个展

今年四月,陆扬与上海仁庐空间合作了名为“激沫卡哇哇”的个展,“激沫卡哇”是日语Kimo Kawa的音译,意为怪异的可爱,此次展览陆扬尝试将“癌细胞”转化为“怪异却乖萌”的卡通形象,调侃“癌”这一沉重话题。本次作品中的“癌宝宝”自然是取材于癌症,有三个形象,分别是分裂的状态、堆积起来的状态和吸附在人体器官或组织上时候的状态,通过各种媒介和材料展现在观众面前。不知道从什么时候开始,听到癌症已经不再稀奇了,癌症有时候并不是绝症,可还是成为太多人的终点,我们熟知的人中常常有人离开是因为癌症,提及死亡难得会有人不害怕的。他人之事与己无关,可若是真的发生在自己身上,谁不色变。“癌宝宝”动画录像中,可以认出许多已经变形的人体器官,眼睛、肠子,还有许多与医院有关的形象,长很多手的护士,药丸针管,屏幕上闪现“爱”字样,与“癌”谐音,并不是曾经的谈癌色变。     

癌症——不再相信眼泪

直到今天,癌对人类的威胁依然存在。直到今天,世界医学界尚未给这种顽疾开辟一条彻底的治疗佳径。进入20世纪,癌症已上升为人类生命的超级“杀手”,成为威胁人类最严重的灾难之一。据资料不完全统计,世界每年有六百万人患癌症,五百万     

风雨楼观台

~~(上接58页)生生变化的辩证观念,无疑都是中国古代无以伦比的思想和哲学成就。老子又是古代卓越的养生专家,“善于修道而养寿,以养寿使道学精深”。老子哲学是恢宏的生命哲学,其人生实践的突出特征是注重炼养生命的深度和厚度,延伸拓展生命的长度与广度。他的“道法自然”、“无为而治”、“治大国若烹小鲜”等学说历经苍桑,毁誉参半,穿越时空,延续至今。其大智慧跨越历史隧道对当代社会仍有重要意义。老子虽死犹荣。坐像神清气朗,庄严慈祥,高1.83米,尹喜、徐甲侍立两边。死后虽被贵族上流社会和官方忽视,但仍有秦失弟子,乡邻吊唁。《庄子…     

佛法与长寿

关于长寿的问题,从有文字记载的历史来看,始终是人类努力追求的一个理想和希望。(《书经·洪范》中列“寿”为五福之首。佛教理论中视“寿”为“命根”的同义语。的确,长寿就是有限生命的延长,这是古今中外无人不梦寐以求的事情。古人似乎认为,服药足延长生命的唯一办法。中国自古相传“后羿求不死之药于西王母”的故事,由此产生嫦娥窃服灵药而奔月的神话。这个思想长期支配人们的心灵,引起了     

癌症患者的五种心态

癌症是威胁人们生命的大敌,“谈癌色变”并非夸张。由于人的心理状态个体差异颇大,因而不同的人会对自己的厄运表现出不同的反应,在对待治疗用药上,也会表现出许多截然不同的态度。归纳癌症患者的种种心态,大体上有以下几种: 一、顺其自然的心态。当得知身患癌症后,一时产生复杂的心理是在所难免的。但能正视现实,承认这一无法改变的客观现实,并能从实际出发,积极与医生配合。接受治疗。按医嘱行事,积极了     

老年癌症患者疼痛管理

面对日益加剧的人口老龄化趋势,国际肿瘤界逐渐意识到老年肿瘤治疗问题的严重性。老年肿瘤患者在被确诊时多已处于晚期,基础疾病多,各脏器功能下降,姑息治疗对老年肿瘤患者显得非常重要,尤其是疼痛治疗。目前,因为对老年人疼痛的认识不足、评估不够、过分担心药物副作用,使得老年癌痛控制现状不容乐观。本文综述了老年癌痛的特点、评估方法及治疗原则,强调对于老年癌症患者治疗的目标不是重返工作或者延长生命,而是尽最大可能地提高生活质量,让老年癌症患者远离癌痛,真正享受到无痛人生。     

Social Constraints on Disclosure and Adjustment to Cancer

This article introduces the concept of social constraints on disclosure, puts it in a theoretical framework, and examines how it can affect adjustment to major life stressors using the exemplar of cancer. Cancer is a leading cause of death and disability worldwide. It is often life threatening, disfiguring, and unpredictable; hence, it can undermine people's basic and often positive beliefs and expectations about themselves, their future, and social relationships. For many people with cancer, it is important to come to terms psychologically with the illness – to make sense of or somehow accept the reality of it. People often do this by thinking about different aspects of the disease and its implications for their life, but also through socially processing, or talking about, their cancer-related thoughts, feelings, and concerns with others. When people experience social constraints on their disclosure of cancer-related thoughts and feelings, it can adversely affect how they think and talk about their illness, their coping behaviors, and psychological adjustment. In addition to discussing mechanisms and consequences of social constraints on disclosure, we discuss some of its determinants and future research directions.     

Loss of Humanness: The Ultimate Trauma

This paper is about chronic illness and its impact on the chronically ill and their loved ones who live through the illness and the eventual death. A new concept is introduced, the concept of "passing": physically ill people may pass as healthy even though they are physically ill. In addition to a discussion about why people choose to pass, two major paradoxes are considered. One concerns the paradox that results from "passing." The paradox is that while the falseness of "passing" keeps the self alive, it also deadens it before death. Specifically, "passing" enables the person with a physical illness to keep his well self alive with others, but results in one feeling dead, disconnected, detached, and inauthentic, before death. The second paradox involves the pressure on the chronically ill person to be heroically agentic in fighting the illness and overcoming it and, also, the pressure for this same person to be totally submissive and compliant with treatment. While in analytic treatment, the ill person can be helped to access authentic emotions and aliveness and to feel the power of authenticity.     

Death, suicide and the older adult.

Elderly people who are at high risk for suicide often have characteristics that are associated with reduced opportunity or inclination to communicate (e.g., male, living alone, residing in a low-income transient urban area, suffering from a depressive state). This paper attempts to provide converging perspectives on death and suicide from the standpoints of both the external observer and the elderly person. An interpretation of the statistical pattern is followed by a critique of current policy proposals for limiting society's response to the needs of vulnerable people on the basis of a "natural life span." Studies of elderly people themselves reveal a great diversity of attitudes toward death that is not well served by generalizations and stereotypes. However, it appears that stressful conditions of life arouse more anxiety among older people than does the prospect of death.     

A burden to others: a common source of distress for the terminally ill

Recent research into the desire for death among people with terminal illness has begun to recognize the importance of "feeling oneself a burden to others" as a factor in suicidal behaviour. In this study, 69 patients with advanced cancer underwent semi-structured interviews. The sense of self-perceived burden was found to be a common experience, reported by 39.1% of participants as a minimal or mild concern and by 38% as a moderate to extreme concern. The sense of burden showed a low correlation with physical symptoms (r = 0.02-0.24) and higher correlations with psychological problems (r = 0.35-0.39) and existential issues (r = 0.45-0.49). Comparisons of participants with high or low levels of self-perceived burden showed the importance of this factor for overall quality of life. In summary, self-perceived burden is an important but underestimated dimension of social cognition in the medically ill.     

不同阶层心理健康观念及需求状况的调查研究

运用开放式和封闭式问卷调查法 ,对不同阶层共 483人的心理健康观念及心理健康需求状况进行了调查研究。结果表明 :( 1 )不同阶层、不同年龄段的人关于心理健康标准的观念具有显著差异。 ( 2 )人们认为 ,心理健康的人应具有的最典型特征是“处世乐观、热情、诚恳”和“心平气和、与世无争、乐于助人”。 ( 3 )心理不健康的人或心理变态的人所表现的最典型特征是“性格孤僻、与人不合群”和“对生活失去信心、悲观”。 ( 4)虽然不少人认为心理健康与咨询工作者当前最急需开展的工作是“宣传心理健康知识、开展心理卫生服务” ,但只有极少的人能够正视自己的心理健康需求 ,提出自己需要心理健康服务或咨询。     

Learning about life and death in early childhood

have argued that young children initially understand biological phenomena in terms of vitalism, a mode of construal in which "life" or "life-force" is the central causal-explanatory concept. This study investigated the development of vitalistic reasoning in young children's concepts of life, the human body and death. Sixty preschool children between the ages of 3 years, 7 months and 5 years, 11 months participated. All children were initially given structured interviews to assess their knowledge of (1) human body function and (2) death. From this sample 40 children in the Training group were taught about the human body and how it functions to maintain life. The Control group (n=20) received no training. All 60 children were subsequently reassessed on their knowledge of human body function and death. Results from the initial interviews indicated that young children who spontaneously appealed to vitalistic concepts in reasoning about human body functioning were also more sophisticated in their understanding of death. Results from the posttraining interviews showed that children readily learned to adopt a vitalistic approach to human body functioning, and that this learning coincided with significant development in their understanding of human body function, and of death. The overall pattern of results supports the claim that the acquisition of a vitalistic causal-explanatory framework serves to structure children's concepts and facilitates learning in the domain of biology.     

The Will to Truth,the Death Drive and the Will to Power

This paper claims that Freud’s idea of the death drive is analogous to the will to truth in traditional philosophy and can be better understood as a truth drive. The argument is based upon Nietzsche’s interpretation of the will to truth as a concealed will to death. This interpretation emphasizes the opposition between truth and life; truth is a concept of constancy while life is a concept of change. Freud’s recognition of the conservative nature of the drives brings him to the paradoxical conclusion of the existence of a death drive. It is paradoxical, for Freud, since it considers death as a fundamental principle of life and as its aim. The paper suggests that by replacing the concept of death by the concept of truth and using Nietzsche’s idea of “the will to power” this paradox can be resolved without losing Freud’s insight of the dialectic nature of psychological life.

     

Nothing or the opposite: intersecting terror management and objective self‐awareness

The human capacity for self‐awareness allows people to envision their eventual death and thus creates the potential for debilitating anxiety. Terror management research has shown that self‐awareness exacerbates the experience of mortality salience. I suggest that self‐awareness alone can induce mortality salience through dialectical thinking. If constructs include a concept and its opposite, then focusing on one aspect should also increase awareness of the opposite. Focusing on the existing object self should thus lead to the recognition of the non‐existent self that is implied. In study 1, participants experienced one of two self‐awareness manipulations (exposure to a mirror, perceiving the self as distinctive) or no manipulation; mortality salience was measured using a death‐relevant word completion task. Both self‐awareness conditions reported significantly higher mortality salience than the control condition. In study 2, participants exposed to their reflection reported increased death salience and life salience (as measured by death‐ and life‐relevant word completion tasks) than a control group, which directly suggests that self‐awareness leads people to dialectically consider opposing facets of the self. Terror management and objective self‐awareness theories might thus be more intimately tied than was previously thought. Copyright © 2001 John Wiley & Sons, Ltd.     

Is coma morally equivalent to anencephalia?

In this article I contend that the tendency to equate coma with anencephalia is a mistake. A key idea here is that there is a type of "mental-state" predicate that is applicable to the comatose but not to anencephalics. One of the moral implications of this is that the concept of "brain death," its alleged popularity notwithstanding, is badly confused. Also, because anencephalics have no mental life, there are few moral grounds for hesitating to use anencephalics as organ donors.     

The folk psychology of souls

The present article examines how people's belief in an afterlife, as well as closely related supernatural beliefs, may open an empirical backdoor to our understanding of the evolution of human social cognition. Recent findings and logic from the cognitive sciences contribute to a novel theory of existential psychology, one that is grounded in the tenets of Darwinian natural selection. Many of the predominant questions of existential psychology strike at the heart of cognitive science. They involve: causal attribution (why is mortal behavior represented as being causally related to one's afterlife? how are dead agents envisaged as communicating messages to the living?), moral judgment (why are certain social behaviors, i.e., transgressions, believed to have ultimate repercussions after death or to reap the punishment of disgruntled ancestors?), theory of mind (how can we know what it is "like" to be dead? what social-cognitive strategies do people use to reason about the minds of the dead?), concept acquisition (how does a common-sense dualism interact with a formalized socio-religious indoctrination in childhood? how are supernatural properties of the dead conceptualized by young minds?), and teleological reasoning (why do people so often see their lives as being designed for a purpose that must be accomplished before they perish? how do various life events affect people's interpretation of this purpose?), among others. The central thesis of the present article is that an organized cognitive "system" dedicated to forming illusory representations of (1) psychological immortality, (2) the intelligent design of the self, and (3) the symbolic meaning of natural events evolved in response to the unique selective pressures of the human social environment.