恶性肿瘤皮肤表现

恶性肿瘤皮肤表现可分为肿瘤直接效应与间接效应.直接效应是指恶性肿瘤或其转移灶生长影响周围器官或组织正常功能;间接效应是指恶性肿瘤或其转移灶经复杂生物学效应影响远处器官或组织正常功能,也称为副肿瘤性皮肤病.恶性肿瘤皮肤表现发病率根据原发肿瘤而不同,可能是患者潜在肿瘤首发临床表现,并且与肿瘤复发转移相关.     

麻醉与ERAS:肿瘤手术麻醉与远期预后

围手术期多种因素包括手术创伤、肿瘤组织病理分期、低体温、输血、麻醉等,均可以直接或间接影响肿瘤细胞的侵袭、增殖能力,并引起全身炎症反应,干预机体免疫功能,因此可能促进肿瘤的复发和转移,影响预后。不同麻醉方法和药物均可以通过对患者免疫系统和肿瘤细胞的干扰,直接或间接的影响患者的预后。本文仅对麻醉方法影响肿瘤手术患者远期预后进行简述,并且提出以下问题和进行讨论:麻醉方法能改变肿瘤手术患者远期预后?麻醉药与镇痛药如何选择?目前肿瘤手术麻醉管理有何对策?麻醉、外科医生观念如何转变?     

利用同种异体移植排斥机制治疗恶性肿瘤：从辩证的角度提出的一种设想

荷瘤宿主对肿瘤的免疫反应低下，不能诱导有效的抗肿瘤免疫；器官移植时，由于供受体之间组织相容性复合物的不同，诱发移植排斥反应，往往导致移植器官功能丧失和器官死亡。利用辩证的逆向思维方法，将对器官移植不利的移植排斥反应引入恶性肿瘤的免疫治疗，可能是一条有希望的治疗途径。此设想在方法上有其可行性，而且类比大量的肿瘤免疫治疗和基因治疗的最新研究成果，此设想有可能取得预期的结果。     

浅谈肿瘤器官特异性转移机制

肿瘤转移是一个复杂的过程,具有明显的器官倾向性。随着对肿瘤转移认识的不断深化,人们发现肿瘤特异性转移与肿瘤的异质性和靶器官的作用密切相关。     

肿瘤放射治疗中的矛盾观

1用矛盾的普遍性去理解肿瘤的放射治疗 在肿瘤的放疗中始终存在着生长和抑制的矛盾,这是矛盾的普遍性.肿瘤是由过度自主性生长的机体组织演变而来的,所有的恶性肿瘤都有无限生长的特点和趋势,最终使机体过度消耗或功能受到损害而导致死亡[1],一旦发生这种特点或趋势就会伴随生命机体的始终.放射治疗就是为了消除肿瘤的这种威胁,保护机体的健康.放疗中应用的放射线所具有的共同放射生物学效应是引起细胞中遗传物质染色体中DNA损伤,从而导致细胞死亡[2].这种生物效应的表达可以从几小时、几天、几月到几年,这主要是与肿瘤的性质及不同的状态有关.组织都有修复损伤的能力,只是程度不同,一般规律是代谢越快,增生能力越强,修复能力也越强,肿瘤组织的特点是有很强的修复能力.肿瘤放射治疗就是在这种不断的杀伤与修复过程中完成最终杀灭肿瘤的目的.这种杀伤与修复矛盾存在于肿瘤放射治疗的始终,是肿瘤放射治疗基本原则的基础.     

循环肿瘤细胞的研究进展

循环肿瘤细胞（circulating tumor cells,CTCs）指自发或因诊疗操作由实体瘤或转移灶释放进入外周血循环的肿瘤细胞。CTCs能被看作液体活检,具有实时监测功能,是一种非侵入性的新型诊断工具,有助于早期发现肿瘤的微转移,可评估预后,在治疗的监测及个体化治疗上具有重要的临床意义。     

CXCR4／CXCL12在胃癌及结直肠癌中的研究进展

消化道肿瘤是一种常见的恶性肿瘤,远处转移是其预后不良的主要原因。近年来消化道肿瘤的发病率逐年上升,其相应的研究得到了广泛的重视。趋化因子对肿瘤的侵袭和转移作用也备受关注。 CXCR4及 CXCL12在肿瘤研究中已逐渐成为热点;最近研究表明,其与胃癌、结直肠癌等的转移密切相关,将为消化道肿瘤转移的防治提供新的思路。此文对CXCR4／CXCL12在胃癌及结直肠癌中的研究进展做一简要综述,CXCR4／CXCL12轴的深入研究将有望使其成为消化道肿瘤靶向治疗的特异靶点。     

肿瘤转移相关信号通路的新思考

新近我们提出了一个新的构想 :癌细胞的生物学行为 ,可能是正常细胞尤其胚胎时期的细胞所具有的功能发生紊乱或过度活跃的结果。我们提出的假想是 :肿瘤转移可能依赖于某一重要信号通路 ,此信号通路可能属于诱导胚胎时期细胞迁移的正常通路。亦即胚胎时期细胞迁移相关信号转导通路的异常可能是癌转移的关键性信号通路。由于细胞运动迁移多由相邻组织诱导产生 ,因此该通路正常时可能为旁分泌机制。进一步的文献分析发现 ,ＨＧＦ/ＳＦ(ｈｅｐａｔｏｃｙｔｅｇｒｏｗｔｈｆａｃｔｏｒ/ｓｃａｔｔｅｒｆａｃｔｏｒ)是促进细胞迁移、扩散的重要因…     

试论老年人增强心理生命力的方法

人的生命力可区分为相互联系的生理生命力与心理生命力两种。生理生命力是指机体各种组织器官的功能状态,总的表现为新陈代谢水平。一般说来,青少年的新陈代谢旺盛,其生理生命力较强。而老年人的新陈代谢衰退,其生理生命力较弱,新陈代谢微弱到不足以维持机体最起码的生命活力,人就死了。心理生命力是指主体通过心理因素影响生理生命力的状态,使其     

肿瘤的血管生成——平衡与不平衡的统一

所谓血管生成是指从已存在的血管床中产生新的血管系统。正常的血管生成被严格控制于某些短暂的、特定的生理过程 ,如生殖过程、发育过程和伤口愈合过程。而持续的血管生成是某些病理改变如肿瘤生长的特性。事实上血管生成不但是肿瘤生长所必需的 ,而且肿瘤细胞与新生血管系统的接触还是导致肿瘤侵袭和远处转移的原因。在肿瘤形成的早期并没有肿瘤血管的形成 ,这一时期被称为血管前期 (ｐｒｅｖａｓｃｕｌａｒｓｔａｇｅ) ,又称无血管期 ,此时肿瘤细胞处于休眠状态 ,肿瘤主要依靠周围组织的弥散来获取营养物质和排泄代谢产物 ,所以明显限制…     

Effects of pain on functioning and well-being in older adults with osteoarthritis of the knee

The effects of pain on functioning and well-being were examined in 367 older adults with osteoarthritis (OA) of the knee. The relationship of OA-related pain to depressive symptoms and perceived health was hypothesized to be direct as well as mediated by physical and social functioning. Results showed that OA-related pain was related to poorer physical and social functioning, had a direct effect on depressive symptoms, and direct and indirect effects on perceived health. Lower social functioning was related to more depressive symptoms, and both lower social and physical functioning predicted worse perceived health. Thus, distinguishing between physical and social functioning when examining the costs of OA-related pain is useful. Moreover, existing pain-psychological well-being models can be generalized to perceived health.     

The impact of frontal and non-frontal brain tumor lesions on Wisconsin Card Sorting Test performance

Several lesion and imaging studies have suggested that the Wisconsin Card Sorting Test (WCST) is a measure of executive dysfunction. However, some studies have reported that this measure has poor anatomical specificity because patients with either frontal or non-frontal focal lesions exhibit similar performance. This study examined 25 frontal, 20 non-frontal low-grade brain tumor patients, and 63 normal controls (NC) on the WCST. The frontal patients were also assigned to either a left frontal (n=10) group or a right frontal group (n=15) and compared with the non-frontal group and NC. It was hypothesized that the frontal brain tumor patients would display greater deficits on categories achieved and a higher number of perseverative errors than non-frontal brain tumor patients on the WCST. Finally, it was predicted that right frontal brain tumors would result in greater executive functioning deficits than left frontal or non-frontal brain tumors. Results indicated that the left frontal group achieved the fewest categories and committed the most perseverative errors compared to the other patient and normal control groups. In addition, the left frontal group committed significantly more perseverative errors than the right frontal group. These results suggest that the WCST is sensitive to the effects of low-grade brain tumors on executive functioning.     

Lovers With Happy Feet: The Interdependence of Relationship and Activity Factors for Individuals Dancing With a Romantic Partner

The significance that romantic partners ascribe to joint activities and the impact these activities have on relationship quality were examined in the context of self‐determination theory. Individuals who practice ballroom dancing with a romantic partner were invited to complete measures of motivation and perception of dyadic adjustment for their relationship and when dancing. Results from path analyses suggested direct and indirect effects of relationship motivation on satisfaction when dancing with a partner. Additionally, direct and indirect effects of motivation for dancing with a partner on relationship satisfaction were also found. Overall, this study suggests that couple functioning plays a role in joint activity functioning and satisfaction. Satisfaction in joint activities can also contribute to the overall quality of the relationship.     

肿瘤干细胞与肿瘤治疗

肿瘤可看作是由功能异质性的细胞群体所组成的,具有不定增殖能力的异常器官.最近提出的肿瘤干细胞学说认为肿瘤起源于干细胞,肿瘤生长是肿瘤组织中极少量具有特殊细胞表面标志的肿瘤干细胞增殖的结果.因此治疗的关键应是针对肿瘤干细胞,通过靶向肿瘤干细胞及其异常调节的信号转导通路来治疗肿瘤.这对传统的治疗方式提出了巨大挑战,也为有效地根治肿瘤开辟了新的思路.     

The Association Between Self-Critical Rumination and Parenting Stress: The Mediating Role of Mindful Parenting

Self-critical rumination is a type of rumination focused on the content of self-critical thoughts. Although self-criticism and rumination are two maladaptive psychological processes with a negative effect on parenting, including parenting stress, the role of self-critical rumination on parenting outcomes has never been explored. The aim of this study is to analyze the role of self-critical rumination on parenting stress and examine whether mindful parenting dimensions (listening with full attention, compassion for the child, non-judgmental acceptance of parental functioning, emotional awareness of the child, and self-regulation in parenting) mediate this association. The moderating role of child’s age in the direct and indirect effects was also examined. A sample of 265 Portuguese mothers of children/adolescents from the general community completed measures of self-critical rumination, mindful parenting, and parenting stress. Self-critical rumination was negatively associated with all mindful parenting dimensions and positively associated with parenting stress. However, only non-judgmental acceptance of parental functioning and emotional awareness of the child dimensions were significant mediators of the relationship between self-critical rumination and parenting stress. The link between self-critical rumination and parenting stress as well as the indirect effects were not moderated by the child’s age. This study identifies an important maladaptive psychological process (self-critical rumination) that explains individual differences in parenting and a mechanism that may account for the link between self-critical rumination and parenting stress, which can both be modified through intervention.     

Negative effects on family functioning from psychosocial treatments: a recommendation for expanded safety monitoring.

Whereas biomedical products are required to be tested for safety with respect to vulnerable organ systems, psychosocial treatments are not required to be tested for safety with respect to vulnerable social systems such as the family. This article provides some evidence for the need to document the potential negative effects of psychosocial treatments on family-level outcomes. Three randomized controlled trials are reviewed in which independent ratings or self-reports of family functioning were measured. Each of the 3 studies compared the efficacy of a family and a nonfamily treatment. Totally unexpectedly, the nonfamily treatment in each of the 3 trials demonstrated significant declines in family functioning. The authors suggest that psychosocial treatments with vulnerable populations have the potential to produce negative side effects on families. Therefore, it is important to conduct further research to determine whether safety studies should be required for psychosocial treatments.     

Psychological space and regulation of social behaviour

The theory of social categorization assumes that the social behaviour of people can be explained as a result of cognitive differentiation of social objects into dichotomous categories (in-group, out-group). An argument can be put forth that social Categorization is a specific instance of functioning of a cognitive system that operates as multidimensional psychological space. Distances between representations of objects in the space influence the process of application of judgements to the given object and to the degree of involvement instigated by a state of an object and tendency lo produce specific behavioural acts toward the object. Typically, the relationship has a characteristic of an exponential function. There are conditions (social and psychological) that foster a discontinuity in a functioning of a cognitive system and therefore, lead to a dichotomous classification of social phenomena, while in some other conditions a continuity may prevail. Data that seem to support the above conjecture are described.     

Long Term Child-Centered Play Therapy Effects on Academic Achievement with Normal Functioning Children

This follow up study with 23 normal functioning 1st graders examined the long-term effectiveness of Child-Centered Play Therapy (CCPT) on academic achievement. Through the use of a one-way repeated measures analysis of variance, researchers examined the use of CCPT from pre-intervention to mid-intervention (16 sessions) to post-intervention (26 sessions). Results indicated that children who participated in 26 sessions of CCPT demonstrated statistically significant improvement on the Early Achievement Composite as measured on the Young Children’s Achievement Test (YCAT), along with increases in the Reading, Mathematics, and Spoken Language subscales. Participants showed statistically consistent improvement in academic scores of the full duration of the study. Overall, the findings imply that CCPT as a long term method can support academic achievement in the school system with normal functioning 1st grade students. The outcome suggests long term CCPT is an intervention for elementary/primary school counselors to use with children who have emotional or academic needs. The findings open the door for school counselors or outside professionals to use play therapy with children in the school system as a way of providing academic support and thereby promoting the field of play therapy in the school system.     

An ecological framework for understanding risk for exposure to community violence and the effects of exposure on children and adolescents

This review covers the past decade's research on the risk for exposure to community violence and the effects of exposure on children's and adolescents' functioning. The studies are incorporated into a developmental-ecological framework that takes into account five domains of context—community and neighborhood, family and household, relationships with parents and caregivers, relationships with peers, and personal characteristics—for the purpose of identifying the risks for exposure and its effects on outcome and for suggesting the processes involved. Evidence from the literature is consistent with our proposed ecological model showing that variables in each of the five domains have both direct and indirect effects on risk for exposure and on its effects on internalizing and externalizing problems and academic functioning. Implications of adopting an ecological model for future risk research and for prevention and intervention are considered.     

The mutating preconscious archetype in present-day ecological conditions

Competition is an important force behind evolution in present-day ecological conditions, its intensity varying according to the organisms' expectations vis-à-vis resources available. On the other hand, the role of mutation in the evolutionary process can hardly be underestimated: Leading to the change of the preconsciously functioning archetype, mutation makes it impossible for the ego to realize its image. This is a consequence of the clash between the mutated, preconsciously functioning archetype and the system of ethical and moral norms functioning in the collective superego of a given population group. The type of mutation that results from the accelerated pace of evolution can be viewed as a continuity in the development of an organism's behavior. The preconsciously functioning archetype, resulting from these mutations, contains impulses and predispositions that differ markedly from the impulses and predispositions functioning in the genetically determined "pattern of behavior." In a situation where anxiety results from the inhibition of impulses and dispositions, hostility reactions are likely to occur. In its turn, reactive hostility can induce anxiety, thus creating a reaction cycle. Underlying this mechanism is the mutated, preconsciously functioning archetype, which itself is a result of the development of civilization in our contemporary world.