肿瘤诊治相关肾损伤的防治决策

肿瘤患者在诊治过程中可能会引起肾脏损伤,如造影剂、化疗和靶向药物的使用等等。如何平衡肿瘤患者在诊治过程中的疗效及安全性,使患者能够接受并完成治疗,延长患者无进展生存和总生存,是肿瘤学界所面临的挑战。     

膀胱癌与尿流改道治疗策略

膀胱肿瘤是我国泌尿外科最常见的肿瘤,其中尿路上皮占95％。浸润性膀胱癌生物学行为高度恶性,治疗的主要方法是根治性膀胱切除术加盆腔淋巴结清扫术加尿流改道术。其被认为是标准的治疗方法。由于全膀胱切除术及尿流改道术常给患者带来生活质量的下降及精神上的压力,使患者很难接受这种手术。本文着重分析了患者的个体化治疗,应用辩证思维方...     

浅谈认知行为治疗在肥胖治疗中的研究与应用

肥胖的治疗方法多种多样,各自具有不同的针对性和疗效特点,如何选择是一个最佳的治疗方案这是一个富有争议的话题。近年来,在肥胖心理学研究成果的基础上,发展了一系列的认知行为治疗方法,也开始应用于肥胖的治疗之中。不少追踪研究表明,该方法对于肥胖的长期疗效较佳,表现出广泛的应用前景。     

对低危前列腺癌治疗策略的再认识及思考

前列腺癌被认为是老年男性中最常见的恶性肿瘤。近年来,PSA筛查技术的广泛使用提高了前列腺癌的检出率。但许多低危的非致命性的前列腺癌患者却承受着过度治疗所带来的毒副反应风险。作者就当前用于减少低危前列腺癌过度治疗的新策略进行描述,如观察等待和主动监测策略,并指出癌症的过度治疗是很普遍的现象。未来需要发展更多的对恶性肿瘤进...     

常见吸毒患者的临床麻醉处理

毒品滥用患者给医疗管理和临床工作带来诸多复杂性和特殊性。对吸毒患者围术期麻醉诊疗要兼顾所惠外科疾惠与毒品对吸食者的身心影响,有效地控制戒断症状和毒性反应,综合评估,辨证施为。     

肝癌的个体化治疗策略

肝细胞癌（肝癌）治疗手段已较10年前有较大变化,但国内尚缺乏较为统一的治疗指南。制定治疗指南的工作需以生存为主要评价指标,并采用临床病理指标或生物学指标将患者分类,然后比较各种治疗方案对该类患者生存的影响。     

重症急性胰腺炎预防抗生素治疗的争议

重症急性胰腺炎伴随高病死率,细菌和真菌感染是其导致死亡的主要原因之一。目前治疗一般采取预防性抗生素治疗,但预防性抗生素治疗又可能会加重二重感染。目前研究结果数量有限,结果不一。是否应该应用预防抗生素治疗仍然存在争议,期待更多设计合理的随机对照试验。     

心理治疗与普通医疗的平等性

心理治疗与普通医疗的平等性是美国心理健康服务系统面临的一个主要政策问题,强调健康保险应为心理健康和物质滥用障碍提供与普通医疗相同的承保范围。近20年来,平等性立法在美国得到了较快发展,并取得了一定效果。但由于立法本身存在的局限性及心理健康服务需求与提供双方的多重因素影响,平等性立法的实施及对其效果的评估仍存在一定困难。借鉴平等性立法的经验,得出了一些关于我国心理健康服务发展的启示。     

An Open Trial Investigation of a Transdiagnostic Group Treatment for Children With Anxiety and Depressive Symptoms

The current study investigates the feasibility and preliminary outcomes associated with a transdiagnostic emotion-focused group protocol for the treatment of anxiety disorders and depressive symptoms in youth. Twenty-two children (ages 7 to 12; M = 9.79) with a principal anxiety disorder and varying levels of comorbid depressive symptoms were enrolled in an open trial of the Emotion Detectives Treatment Protocol (EDTP; Ehrenreich-May & Bilek, 2009), an intervention adapted from existent unified protocols for the treatment of emotional disorders among adults and adolescents. Results indicate that participants experienced significant improvements in clinician-rated severity of principal anxiety disorder diagnoses (d = 1.38), the sum of all anxiety and depressive disorder severity ratings (d = 1.07), and child-reported anxiety (d = 0.47) and parent-reported depressive symptoms (d = 0.54) at the posttreatment assessment. EDTP had good retention rates and reports of high satisfaction. Thus, preliminary evidence suggests that EDTP is a feasible and potentially efficacious treatment of youth anxiety disorders and co-occurring depressive symptoms. Children experiencing a range of internalizing symptoms may benefit from this more generalized, emotion-focused treatment modality, as it offers flexibility to families and the mental health clinician, while maintaining a concurrent focus on the provision of cognitive-behavioral treatment skills vital to the amelioration of anxiety and depressive disorder symptoms in youth.     

Motivation as a predictor of outcomes in school‐based humanistic counselling

Background: Recent years have seen a growth in the provision of counselling within UK secondary schools, and research indicates that it is associated with significant reductions in psychological distress. However, little is known about the moderators and mediators of positive therapeutic benefit. In the field of adult mental health, motivation has been found to be one of the strongest predictors of therapeutic outcomes, and it was hypothesised that this may also be a predictor of outcomes for young people in school‐based counselling services. Aims: To assess the relationship between young people's motivation for counselling and its effectiveness within a secondary school setting. Sample: Eighty‐one young people (12–17 years old) who attended school‐based humanistic counselling services in Scotland. Method: Clients completed a measure of motivation for counselling at the commencement of their therapeutic work and a measure of psychological wellbeing at the commencement and termination of counselling. Results: Motivation for counselling was not found to be significantly related to outcomes. Discussion: The results indicate that the association between motivation and outcomes may be weaker in young people as compared with adults. However, a number of design factors may also account for the non‐significant findings: insufficient participants, marginal reliability of the motivation measure and social desirability effects.