非小细胞肺癌放疗时机和放疗方式的临床决策

放射治疗是非小细胞肺癌的主要治疗手段之一。大约有3／4的肺癌患者在疾病的不同时期需要做放射治疗。针对不同的患者可以选择根治性放疗、姑息性放疗、术前、术后、放化疗联合治疗等不同的治疗方式。从治疗技术上还可以选择适形、调强、立体定向放疗等。临床医生需要辨证地应用循证医学证据,针对不同的患者刺定合理的个体化治疗方案,以提高疗效。     

抑郁症的概念及分类研究历史

宫颈癌的发病率居女性恶性肿瘤的第二位,只要做到早发现、早诊断、早治疗,宫颈癌是一种可以预防和治愈的疾病。认真地做好宫颈癌的普查和随诊,能够降低宫颈癌的发病率和病死率。因为宫颈液基细胞学设备简单,方法便利,阳性检出率高,目前已成为基层医疗单位开展宫颈癌普查的重要手段。提倡宫颈癌的普查是对全社会育龄妇女健康的关怀,是医学人文精神的具体体现。全社会的妇女都应享有这种人文关怀。     

胰岛细胞再生研究的临床应用前景

胰岛细胞再生是治愈1型糖尿病和胰岛β细胞功能丧失的2型糖尿病的根本途径。体外再生和体内再生两种策略都是通过将干细胞或其他类型体细胞分化或转化为胰岛细胞后发挥胰岛素分泌功能,从而治疗糖尿病。基础研究显示,两者存在着各自的优势和面临的问题。胰岛细胞再生治疗的临床应用前景尚需要进一步加以考证。     

谈谈我国肿瘤治疗中的人文关怀

目前,人类对肿瘤的治疗其实仍然在黑暗中摸索,国内医疗系统存在着过度治疗和无效治疗、对终末期患者的漠视、放弃和治疗不足等弊端,对肿瘤患者缺乏足够的人文关怀.针对这种现状,笔者从人文角度提出了一些看法和建议,以期更加尊重生命价值,体现医学的本质.     

Differential disgust responding in people with cancer and implications for psychological wellbeing

Objectives: Evidence suggests that disgust responses, known to negatively affect psychological wellbeing, may differ in people with cancer. We performed the first quantitative investigation of three discrete types of disgust trait – disgust propensity, sensitivity and self-directed disgust – in people diagnosed with a broad range of cancers (versus cancer-free controls), and explored their associations with psychological wellbeing.

Design: In a cross-sectional survey design, 107 participants with heterogeneous cancer diagnoses, recruited from cancer charities and support groups, were matched with cancer-free controls by age and gender.

Outcome measures: Measures of the three disgust traits were taken alongside measures of anxiety and depression.

Results: Disgust sensitivity and physical self-disgust were significantly higher in the cancer than control sample, while disgust propensity and behavioural self-disgust were lower. The disgust traits had a different pattern of associations to psychological wellbeing across the two groups, with disgust sensitivity predicting depressive symptoms to a significantly greater extent in the cancer than control group.

Conclusions: People with cancer differ from matched controls in their disgust responses and these responses have significant predictive relationships with aspects of their psychological wellbeing. The results suggest that emotion-based interventions may be useful for improving psychological wellbeing in people with cancer.     

Randomized controlled trial of mindfulness-based stress reduction (MBSR) on posttraumatic growth of Chinese breast cancer survivors

Breast cancer (BC) patients in China suffered from a variety of psychology stress such as perceived stress and anxiety, posttraumatic growth (PTG) as a positive factor could promote their psychology health and quality of life. This study aimed to investigate the efficacy of mindfulness-based stress reduction (MBSR) on promoting PTG, decreasing perceived stress and anxiety of Chinese BC patients. A randomized controlled trial of 60 BC patients (Stages I–III) was conducted. They were randomly divided to the 8-week MBSR group or usual care (UC) group. PTG inventory, Perceived Stress Scale of Chinese version (CPSS) and State Trait Anxiety Inventory (STAI) evaluated the PTG level, perceived stress and anxiety at three times(before intervention-T1, after intervention-T2 and follow up at 3 months-T3). A repeated-measures analysis of variance model was used to compare each outcome measure of two groups at the three times. There was one patient discontinued the intervention and one lose to follow up in MBSR group, finally 58 BC patients completed the research. There was no difference between two groups before the intervention. The results showed significant improvements in MBSR group comparing with the UC group that PTG level was much higher after the 8-week intervention and the follow up (F = 34.73, p < .00). At the same time, CPSS (F = 14.41, p < .00) and STAI (F = 15.24, p < .00) scores were significant decreased at T2 and T3. The results showed that MBSR promoted the level of PTG and decreased perceived stress and anxiety state of Chinese BC patients, and the results persisted at three months after intervention. The research preliminary proved that MBSR was suitable to Chinese BC patients. MBSR should be recommending to BC survivors in China.     

Well-being in parents of children with cancer: The impact of parental personality,coping, and the child's quality of life

The aim of the study was to investigate the impact of parental personality, coping, and the child's quality of life on the well-being of parents of children treated for cancer. The study included 99 parents (63 mothers and 36 fathers), 41 parents during child's intensive treatment, 23 parents whose child completed intensive treatment, and 25 parents of children who completed treatment at least five years ago. The results of multivariate study have confirmed the predictive role of parental personality (especially Neuroticism); emotion-focused coping styles, and the child's quality of life (especially physical functioning) on parental well-being. About 60% of the variance in parental well-being can be attributed to the predictors. Assessing parental personality functioning and coping styles can help us identify those parents who are less emotionally stable, more prone to emotionally focused coping styles, and most likely to experience poorer well-being. Improved assessment may contribute to the development of further psychological interventions.     

QLQ-3O量表在乳腺癌化疗患者中的应用

应用EORTCQLQ-30核心量表调查初治乳腺癌化疗患者的生存质量。运用自身对比的队列研究方式,调查了42名乳腺癌化疗患者。结果显示化疗带来的生存质量的下降是显著但短暂的;某些因素对生存质量的影响较大,值得针对性地采取干预措施;对一些调查项目的修改,可以使EORTC QLQ-30量表更好地适应我国的国情和文化。