手术治疗单一局部复发或远处转移病灶乳腺癌的临床观察

探索手术治疗单一局部复发或唯一远处转移病灶乳腺癌的临床价值。收集2006年6月至2013年6月湖南省人民医院乳甲外科收治的64例局部复发或术后远处转移乳腺癌患者,其中28例为单发病灶病例。根据是否采取了包含手术的综合治疗,将其分为手术组与非手术组。回顾性分析两组的临床资料和随访数据,分析手术治疗局部复发或远处转移乳腺癌有无临床意义。结果28例都采取了含化疗的综合治疗,8例局部单发病灶与9例远处单一脏器转移病例进行了手术治疗。手术组的局部缓解率与控制率明显优于非手术组,均为100％。两组无进展生存时间（PFS）和总生存时间（（）S）比较,手术组明显长于非手术组;但在单一远处脏器转移手术组中0S没有优势。2年生存率方面手术组与非手术组比较有统计学意义。对于术后单一局部复发病灶或唯一远处脏器转移的乳腺癌患者,采取含手术的综合治疗方案能带来明显的PFS优势,若有手术机会和条件成熟,手术仍是不应放弃的有效治疗方法。     

纳米炭在分化型甲状腺癌再手术中应用价值的研究

探讨在分化型甲状腺癌（DTC）再手术中应用纳米炭对甲状旁腺保护和引导颈淋巴结清扫的作用与价值。选取2011年2月至2014年2月湖南省人民医院乳腺甲状腺外科116例D T C再手术患者,随机分为观察组（纳米炭组）64例和对照组52例,试验组在术中先向残余甲状腺或癌灶或肿大淋巴结内注射纳米炭0．1ml～0．3ml不等,对照组不使用纳米炭。观察两组辨别甲状旁腺的个数与准确性,以及在颈淋巴结清扫个数的差异。同时观察两组术后常见并发症有无差异。观察组使再手术的D T C患者的甲状旁腺识别率为92．2％,辨别出3个及以上甲状旁腺比率为75％,均明显高于对照组的28．8％、36．5％,两组比较有显著性差异（ P＜0．05）。中央区与侧颈区淋巴结清扫的个数比较,观察组明显多于对照组（P＜0．05）。观察组不增加术后并发症,而且,其一过性的甲状旁腺功能减退的并发症尚有下降趋势（P＜0．05）。纳米炭对DTC再手术中的甲状旁腺的识别率和区域淋巴结的黑染,使甲状旁腺易于识别和保护,有利于更为彻底清扫中央区和侧颈区淋巴结,尚可降低一过性甲状旁腺功能减退的并发症。     

乳腺癌患者“创伤后成长”的研究进展

近年来,乳腺癌的发病率不断上升,乳腺癌已逐渐成为危害女性健康的首位恶性肿瘤。手术给患者的身心带来很大伤害,但研究者发现,在与乳腺癌这一疾病做斗争的过程中患者会产生一种正向的心理变化,这就是积极心理学领域研究的创伤后成长。本文从创伤后成长内涵、国内外研究现状、测量工具、影响因素、干预方法等几方面对乳腺癌创伤后成长研究现状进行文献综述,为乳腺癌患者心理护理提供依据。     

同事个性化契约对员工工作退缩行为的影响:基于公平理论的视角

个性化契约作为组织中一种非标准化的工作安排,以往研究较多关注其对契约获得者的积极效应,相对忽视了对未获得者的消极影响。鉴于此,本研究基于公平理论,探讨了同事个性化契约对员工工作退缩行为的影响及其内部机理。结果发现:同事个性化契约会引发员工的工作退缩行为,员工的心理契约违背在此过程中起部分中介作用;此外,员工与组织间较高的社会交换关系会削弱同事个性化契约对员工心理契约违背的正向影响。     

农村留守儿童焦虑情绪的异质性:基于潜在剖面分析

采用中学生心理健康诊断量表（MHT）对湖南省1292名留守儿童的焦虑情绪进行施测,并用潜在剖面分析方法探究留守儿童的焦虑情绪问题是否存在异质性,以及留守儿童相关的人口学因素对焦虑情绪异质性的作用机制。结果发现,留守儿童的焦虑情绪存在明显的异质性,可以分为三种潜在类别：“严重焦虑情绪型”、“中等程度焦虑情绪型”和“低焦虑情绪型”;留守男生、小学五年级、高中二年级、留守时间越长、留守初始年龄越小的留守儿童更容易焦虑情绪严重;无论是父亲外出、母亲外出还是双亲外出对留守儿童的焦虑情绪严重性的影响是一致的。由此,应根据留守儿童的性别、年级、留守时长和留守的初始年龄等情况特点,开展针对性的预防和干预措施,缓解留守儿童焦虑。     

Counterfactual comparison modulates fairness consideration in the mini‐ultimatum game: An event‐related potentials study

Existing literature on the mini‐ultimatum game indicates that counterfactual comparison between chosen and unchosen alternatives is of great importance for individual's fairness consideration. However, it is still unclear how counterfactual comparison influences the electrophysiological responses to unfair chosen offers. In conjunction with event‐related potentials’ (ERPs) technique, the current study aimed to explore the issue by employing a modified version of the mini‐ultimatum game where a fixed set of two alternatives (unfair offer vs. fair alternative, unfair vs. hyperfair alternative, unfair offer vs. hyperunfair alternative) was presented before the chosen offer. The behavioral results showed that participants were more likely to accept unfair chosen offers when the unchosen alternative was hyperunfair than when the unchosen alternative was fair or hyperfair. The ERPs results showed that the feedback‐related negativity (FRN) elicited by unfair chosen offers was insensitive to the type of unchosen alternative when correcting for possible overlap with other components. In contrast, unfair chosen offers elicited larger P300 amplitudes when the unchosen alternative was hyperunfair than when the unchosen alternative was fair or hyperfair. These findings suggest that counterfactual comparison may take effect at later stages of fairness consideration as reflected by the P300.     

Specificity Matters: Criterion-Related Validity of Contextualized and Facet Measures of Conscientiousness in Predicting College Student Performance

To enhance the predictive validity of self-report personality measures, 2 distinct ways of increasing specificity of personality measures have been proposed in the literature—contextual specificity (i.e., providing a contextual referent) and content specificity (i.e., focusing on more specific constructs such as the Big Five facets). This study extends this line of research by examining whether there is an optimal way to configure, align, or integrate contextual and content specificity using measures of conscientiousness to predict college student success. A sample of 478 undergraduate students completed 4 measures of conscientiousness that varied in the level of content and contextual specificity. These forms of specificity were crossed to yield 4 distinct measures of conscientiousness. We then evaluated and compared the relative importance and the incremental importance of these different measures in the prediction of academic success. Superior predictive validity was found for both contextualized and facet measures of conscientiousness compared to a measure of global conscientiousness in predicting grade-point average and a broader behavioral criterion of student performance. When contextual and content specificity approaches were compared and combined, we observed the strongest predictive validity when the level of specificity is appropriately matched between predictor and criterion.     

黑色素瘤内科治疗的新进展

黑色素瘤的生物学知识在对这种疾病的药物研发上发挥了重要的作用。在过去的10年中,黑色素瘤进入了靶向治疗的新时代,这种疾病的治疗方法发生了革命性的改变。从2011年,已有4种新药被批准应用于转移性黑色素瘤的治疗,包括：伊匹单抗、维罗菲尼、达拉菲尼和曲美替尼。目前几种新药正处于3期临床试验阶段,以期更多的药物被批准用于这种...     

Bayesian analysis of mixtures in structural equation models with non‐ignorable missing data

Structural equation models (SEMs) have become widely used to determine the interrelationships between latent and observed variables in social, psychological, and behavioural sciences. As heterogeneous data are very common in practical research in these fields, the analysis of mixture models has received a lot of attention in the literature. An important issue in the analysis of mixture SEMs is the presence of missing data, in particular of data missing with a non‐ignorable mechanism. However, only a limited amount of work has been done in analysing mixture SEMs with non‐ignorable missing data. The main objective of this paper is to develop a Bayesian approach for analysing mixture SEMs with an unknown number of components and non‐ignorable missing data. A simulation study shows that Bayesian estimates obtained by the proposed Markov chain Monte Carlo methods are accurate and the Bayes factor computed via a path sampling procedure is useful for identifying the correct number of components, selecting an appropriate missingness mechanism, and investigating various effects of latent variables in the mixture SEMs. A real data set on a study of job satisfaction is used to demonstrate the methodology.