乳腺癌术式的演变及其最佳选择

乳腺癌作为女性常见的恶性肿瘤之一,一直是肿瘤学界研究的热点和焦点。手术作为其基本的治疗手段,术式几经改变。通过对乳腺癌术式演变的历史回顾,认为正是由于对乳腺癌生物学行为研究的不断深入,使得乳腺癌手术切除范围更趋于规范和科学。而由生物医学模式向生物—心理—社会医学模式的转变,以及循证医学(EBM)研究的开展,更促进了乳腺癌术式的不断改进,以最大程度减少并发症,获得更为满意的疗效。     

食管癌诊断方法研究进展及面临的问题

食管癌诊断方法研究,涵盖流行病学、生物化学、病理学、肿瘤学、分子生物学等多学科。临床需求是医学科学进步的原动力,科技进步推动了医学发展,食管癌诊断方法的研究和正确的科研思路在控制食管癌发病率和死亡率中起重要作用。     

循证医学与卵巢癌的治疗

循证医学(EBM)是在临床实践中通过科学的方法获得最充分的证据,并对病人做出最佳诊治决策的一门科学。目前卵巢癌的治疗还存在很多不规范的问题,利用循证医学观点来指导卵巢癌治疗方案的选择,对保留患者的生育功能、生理功能、提高生活质量有着重要的指导意义。     

Processing speed in children treated for brain tumors: effects of radiation therapy and age

The current study examined processing speed in children two years post-treatment for brain tumors (BT) with radiation therapy (RT) compared to those treated with without RT. Participants included 59 children (4–17 years) with BT assessed as part of the Brain Radiation Investigative Study Consortium (BRISC). Processing speed was assessed at two time points: Time1 (3–9 months post-surgery) for 26 children who received whole brain or focal RT (RT group) and 33 treated without RT (no-RT group), and again two years later (Time2) for 42 participants (17 RT, 25 no-RT). Linear mixed effects (LME) regression analyses examined differences in cognitive and motor speed between groups and across visits, with age at Time1 (age1) treated as a moderating variable, and sex and primary tumor size as covariates. No effects for treatment group or visit were found for motor speed (Pegboard) or mean reaction time (Attention Network Task). On the Wechsler Processing Speed Index (PSI), the no-RT group performed better than the RT group, with a group-by-age interaction such that across visits, the difference between the no-RT and RT groups was larger among children who were older at initial treatment (≥10 years) than among those who were younger (<10 years). Cumulative brain injury earlier in life (tumor, surgery, plus RT) may result in greater impact on more complex tasks of cognitive efficiency. Children receiving RT showed reduced processing speed over time, with a larger group difference among those who were over 10 years at treatment.     

A performance comparison between shallow and deeper neural networks supervised classification of tomosynthesis breast lesions images

Computer Aided Decision (CAD) systems, based on 3D tomosynthesis imaging, could support radiologists in classifying different kinds of breast lesions and then improve the diagnosis of breast cancer (BC) with a lower X-ray dose than in Computer Tomography (CT) systems.In previous work, several Convolutional Neural Network (CNN) architectures were evaluated to discriminate four different classes of lesions considering high-resolution images automatically segmented: (a) irregular opacity lesions, (b) regular opacity lesions, (c) stellar opacity lesions and (d) no-lesions. In this paper, instead, we use the same previously extracted relevant Regions of Interest (ROIs) containing the lesions, but we propose and evaluate two different approaches to better discriminate among the four classes.In this work, we evaluate and compare the performance of two different frameworks both considering supervised classifiers topologies. The first framework is feature-based, and consider morphological and textural hand-crafted features, extracted from each ROI, as input to optimised Artificial Neural Network (ANN) classifiers. The second framework, instead, considers non-neural classifiers based on automatically computed features evaluating the classification performance extracting several sets of features using different Convolutional Neural Network models.Final results show that the second framework, based on features computed automatically by CNN architectures performs better than the first approach, in terms of accuracy, specificity, and sensitivity.     

Varying Levels and Types of Engagement in an Online Relationship Enhancement Program for Couples Following Breast Cancer

Engagement in online interventions, defined as the extent to which participants are involved in and attentive to the contents of the intervention, has been shown to predict treatment outcome. However, participant engagement and program completion are often quite low. Aiming to provide insights that could help improve engagement, this study explores engagement in an online intervention for young couples with breast cancer, Couplelinks, by describing the development of a method to assess engagement, presenting a framework for understanding varying engagement levels, and discussing strategies used by Couplelinks facilitators to work with participants of differing engagement levels. The measure of engagement developed for this study was a composite consisting of indices of average completion time, accountability, and attitude. Utilizing this composite measure, the following distinct “couple types,” with varying levels of engagement, were discerned: (a) “keen” couples, (b) “compliant” couples, (c) “apologetic” couples, and (d) “straggling” couples. Facilitators’ approaches to working with each type of couple and suggestions for potential therapeutic applications are discussed. The finding that couples vary in terms of engagement level, and not solely based on facilitator skill and/or involvement, supports the need to better understand the concept of engagement in order to make online interventions more effective.     

Do children transcend death? An examination of the terror management function of offspring

The concept of offspring provides a symbolic shield against the fear of death. The existential function of offspring was examined in two studies conducted in China employing real-life dependent measures. In Study 1, reminders of death through a word-completion task increased the disapproval of a birth-control policy in China. In Study 2, hospitalized patients generally preferred young family members more than other family members. Cancer patients showed this preference to a greater extent than non-cancer patients. Taken together, the findings showed that the death-anxiety-buffering function of offspring affects people's judgments and desires in real-life settings.     

Personality predictors of the time course for lung cancer onset

Numerous findings suggest that personality is linked to the incidence and experience of negative health outcomes. More specifically, trait negative affect is negatively related to a number of health outcomes. The current study expands our understanding of the link between personality and disease by examining the time course for lung cancer onset. In a sample of patients who had recently undergone surgical resection for lung cancer, a variety of negative affect related personality variables were assessed to determine their relationship with age at surgery. After controlling for smoking behavior, it was found that trait negative affect was associated with time course for lung cancer onset, such that those with higher (vs. lower) levels of trait negative affect manifested lung cancer earlier in their lives. Thus, trait negative affect represents an independent risk factor among those prone to lung cancer (i.e., smokers).     

浅谈肺癌手术的知情同意

手术在肺癌治疗中占有重要地位。胸外科医生充分告知手术利弊、患者和／或代理人充分理解告知内容是顺利完成知情同意的重要步骤。本文就肺癌手术知情同意的意义、临床工作中存在的问题及解决办法进行了初步的探讨。     

乳腺癌的现代与传统治疗模式的比较分析与思考

乳腺癌是女性最常见的恶性肿瘤之一,现代治疗模式已经广泛应用于临床。近年来,随着循证医学和基因相关技术及生物信息技术的不断发展,乳腺癌治疗方法得到不断改进,但远没有达到系统化、个体化、最优化的治疗目的。因此,现有的治疗模式值得我们去深思,并从哲学意义上探索更为完善的治疗模式。