转化医学与肿瘤诊治

转化医学是促进基础研究成果向临床应用转化和根据临床医学的需求从事应用基础研究的桥梁。本文以转化医学在肿瘤防治研究的实例,分析转化医学的意义,以期为使大家重视转化医学,提高肿瘤诊治水平。     

肝癌基础研究如何向临床转化

肝癌基础研究在过去数十年取得了长足的进步,而肝癌临床研究则相对滞后,二者间存在巨大的反差。如何将基因组时代发现的大量有重要意义的基础研究成果及时有效地转化为临床可用的技术方法,以进一步提高肝癌治疗效果是亟待解决的难题。转化医学研究为其搭建了一条重要桥梁。     

继发性的高血压线索来自于基本的临床检查

继发性高血压病因的检出和针对病因的治疗,不仅可以提高高血压的治愈率和控制率,有利于保护靶器官,还可以极大程度地减少医疗资源的浪费。基本的临床检查,如血、尿常规,血浆电解质,血糖,血脂,血尿酸和血清肌酐,可以为继发性高血压的诊断提供重要的线索。     

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。     

以实质心理学为基础的评估：认知诊断

评价除了了解学习者的学习情况外,同时还应该提供学习者学习状况的诊断信息,以利于教学与学习。评价应该以认知心理学对学习过程的研究,作为编制测验的实质理论依据,进行认知诊断评估。本文针对认知诊断的心理学基础：知识的习得、知识诱发、知识表征、知识结构等进行梳理,以便测验开发者对认知诊断评估有更清晰的认识。     

暴食症的诊断、治疗及其疗效

暴食症已成为目前世界上广泛流行的三大进食障碍之一,我国患者亦不在少数并有增加之势,但对暴食症的研究与治疗尚属起步阶段。文章回顾了暴食症的表征及其诊断技术,简要介绍了常见的三种治疗方法（即行为疗法、认知疗法及伴随症状改善法）,并讨论了影响暴食症疗效的诸个体因素。暴食症的诊断主要是根据美国精神疾病诊断与统计手册第四版（DSM-IV）、进食障碍检测评估表（EDE）（治疗者用）和患者用进食障碍检测问卷（EDE-Q）（患者用）,并结合过往病史和伴随症状。三类治疗方法在理论与操作层面各有倚重,均可收到一定治疗效果。但各疗法的效果与预后会因患者而异甚或迥乎相异,这是因为暴食症疗效还受到患者自身人格、社会和认知诸因素的影响,治疗者应根据特定患者选择适合该患者的疗法。     

The relationship between basic need satisfaction and emotional eating in obesity

Emotional eating has been identified as a factor that promotes the development and maintenance of obesity and hinders its treatment. This study investigated the relationship between unsatisfied basic needs and emotional eating, including the mediating factors of self‐esteem and coping strategies. The results from a survey of 136 obese individuals indicated support for a significant relationship between basic need satisfaction and emotional eating, with a mediating effect of negative coping strategies. These findings extend previous research and provide guidance on how to help individuals who engage in emotional eating by focusing on developing more adaptive coping strategies.     

The workable here and now and the why of there and then

At an earlier time our work as analysts was easier. We searched for the repressed in order to make constructions that connected the past to the present symptoms. Making these connections conscious, based upon the continuing influence of the Topographic theory, was thought to be the curative factor in psychoanalysis. Freud (1912, 1914) briefly expressed the importance of working in the present but his main focus remained the importance of reconstructing the past. The importance of working in the present started to be fully articulated approximately 30 years ago, and has become a central part of most views on technique. However, it is the contention of this paper that, while there is general agreement on the necessity of working in the here and now, the understanding of what this means or why it is useful runs along parallel lines rather than leading to a central point. Further, it is my impression there is little agreement on the reasons for interpreting the there and then. The idea of a 'workable here and now' is introduced to capture how the here and now might best include the analysand's readiness to synthesize what is offered, while a theory of the necessity for working in the here and now and the there and then is offered.     

预防导尿管相关性感染的临床问题及决策

留置导尿是一项侵袭性操作,易引起尿道黏膜损伤,且留置导尿时间过长,容易引起泌尿系统的逆行感染。为了预防导尿管相关性感染,我们从临床角度讨论是否需要更换一次性尿袋以及更换尿袋的时间,留置导尿尿道外口的清洗,留置导尿膀胱冲洗的必要性及是否应用抗生素,更换导尿管的时间及导尿管的选择等临床问题,为临床人员做该项操作时提供参考,做出正确的临床决策。     

甲状腺癌的诊治原则

甲状腺癌是内分泌系统最常见的恶性肿瘤,它的发病率正逐年增加,其诊断方法包括体格检查、超声检查、细针穿刺、影像学检查及实验室检查等,甲状腺癌的治疗以外科手术为主,对较晚期或远处转移的患者可行综合治疗(I131,放疗,化疗)。总之,甲状腺癌经合理治疗,可获得较好的预后。