原发灶切除在转移性乳腺癌治疗中的地位

无论是国内还是世界其他国家,乳腺癌近年来已成为女性常患恶性肿瘤之首。早期乳腺癌通过手术、化疗、放疗及内分泌治疗等综合治疗后可以达到长期生存。然而对于晚期乳腺癌,特别是伴有远处转移的乳腺癌,疗效却不尽如人意。对于转移性乳腺癌,目前治疗优先选择毒性尽可能小的全身系统性治疗方案;而对于需要缓解症状或避免即将发生并发症（如皮肤溃疡、出血、真菌感染以及疼痛等）的情况可于全身治疗后行相应手术。然而对于转移性乳腺癌是否手术切除原发灶以及是否可从手术中获益,仍然充满争议。     

人工肝支持系统治疗肝衰竭的研究进展

目前肝衰竭发病率和病死率仍然较高,肝衰竭成为威胁患者生命的严重疾病。基于肝脏具有强大再生能力,人工肝支持系统作为一种“过渡”措施,为肝衰竭患者的肝功能恢复赢得时间。人工肝支持系统根据性质不同分为非生物型人工肝、生物型人工肝和混合型人工肝。目前非生物型人工肝已在肝病治疗领域被广泛应用,但生物型及混合型人工肝的临床应用还存在很多问题需要进一步研究和解决。因此本文对人工肝的作用、临床应用现状、存在问题及研究进展进行综述。     

Effects of personality traits and characteristics of child sexual abuse on maternal reactions and support

Objective

This study aimed to examine the relationship between maternal and contextual factors including maternal personality traits, the quality of mother–child relationship, the characteristics of sexual abuse and maternal outcomes: (1) maternal reactions including feelings of anger and responsibility, anger and perceptions of responsibility of the child, and (2) maternal support provided to the child following the disclosure of sexual abuse.

Perceived sources and levels of stress,general self-efficacy and coping strategies in preclinical dental students

Dental education programs are known to be highly stressful and stress can affect general health. The aims were to identify sources of stress among preclinical students and to evaluate their perceived levels of stress, self-efficacy and effective coping strategies in a private dental school. One hundred preclinical students in a Turkish private dental school were surveyed using dental environment stress (DES), perceived stress (PSS), general self-efficacy (G-SES) and brief coping scales (Brief-COPE). Age, gender, history of psychiatric treatment, factors that affected the choice of dentistry, choice rank of dental school, scholarship and income was recorded. ‘Exams and grades’ followed by ‘Fear of failing course or year’ were found to be the most stressprovoking factors. The most and the least stressprovoking DES domains were ‘Workload’ and ‘Social stressors’, respectively. ‘Social stressors’ affected male more than female (p < .05). The most and the least common coping strategies were found to be ‘Planning’, and ‘Drug’, respectively. Female used ‘Instrumental support’ more than male (p < .05). Demographic factors had impact on the perceived stress factors and levels, as well as coping strategies. Unlike previous studies establishing high stress levels in dental students, preclinical students displayed moderate level of stress. Clinical dental education might be more responsible for creating stress.     

Effects of telephone support on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease: a meta-analysis

The aim of this meta-analysis was to evaluate the effects of disease education or pulmonary rehabilitation programs assisted with telephone support on physical capacity and quality of life (QOL) in chronic obstructive pulmonary disease (COPD) patients. A systematic search of PubMed, Embase, Web of Science and The Cochrane Library was conducted until May 2017. Randomized controlled trials (RCTs) examining the effects of telephone-assisted intervention versus a control group on exercise tolerance and QOL in patients with COPD were included. Two independent authors assessed the methodological quality of the trials using the Cochrane risk of bias tool. A meta-analysis was conducted with the Revman5.3 to quantify the effects of telephone-assisted interventions on walking capacity and QOL. In total, 10 studies involving 1037 participants were included. Due to the effect of telephone-assisted interventions, statistically significant results were found on Saint-George’s Respiratory Questionnaire (SGRQ) symptom scores [standard mean difference (SMD) ?.18, 95% confidence interval (CI) ?.33, ?.03, p-value .02)], SGRQ impact scores [SMD ?.35, 95% CI ?.60, ?.10, p-value .006)], SGRQ activity scores [SMD ?.30, 95% CI ?.45, ?.15, p-value < .0001)], SGRQ total score [SMD ?.36, 95% CI ?.51, ?.21, p-value < .00001)]. The effects on 6-min walk test (6MWT) and all Chronic Respiratory Questionnaire (CRQ) subscales were not significant (p > .05) based on the insufficient evidence. In conclusion, the role of telephone-assisted interventions in the management of COPD remains equivocal. Some encouraging results were seen with regard to SGRQ symptom, SGRQ impact, SGRQ activity and SGRQ total score. We believe that more methodologically rigorous large-scale randomized controlled trials are necessary to answer this study question.     

Anti-Semitism and Islamophobia in the Netherlands: concepts,developments, and backdrops

In recent years, the Netherlands has been frequently confronted with public incidents of anti-Semitism and Islamophobia. After defining the complex concepts of anti-Semitism and Islamophobia, presenting the theoretical approach to these phenomena, and sketching the societal context in which they are embedded, this article describes the development of the numbers of reported expressions of anti-Semitism and Islamophobia in the Netherlands since the turn of the century. It notes that the general level of annual numbers of recorded incidents of the phenomena has increased since 2000 and, at the same time, there are significant fluctuations in the numbers of notified incidents per year. These fluctuations correlate to outbursts of violence in the Middle East and to acts of violence committed in the name of Islam in the West, while the general higher level of incidents of anti-Semitism and Islamophobia relates to numerous and various threats experienced in the context of the Dutch multi-ethnic society, changes in national identity, and trends in globalisation.     

The ironic impact of intergroup apologies on intergroup attitudes: Understanding the role of perceived power for post‐apology outgroup attitudes

The present research investigates how intergroup apologies, defined as apologies between two groups, affect perceived remorse and outgroup attitudes (e.g., explicit and implicit), in the context of power asymmetries. We recruited participants from two countries that differ in perceived power: South Korea and the United States. Participants read a vignette describing a violent act committed by an outgroup member (Korean or American), with or without an intergroup apology. Participants answered questions assessing perceived remorse and explicit attitudes toward the outgroup, followed by the Implicit Association Test (Greenwald, McGhee, & Schwartz, 1998). Results revealed that Koreans perceived less remorse following an intergroup apology from the United States, compared to when they did not read an intergroup apology. Further, a mediated moderation analysis indicated that perceived remorse mediated the relationship between apology and explicit attitudes towards the United States. However, an analogous effect for implicit attitudes was only marginally significant. In contrast, among American participants, no effect of the apology on perceived remorse, explicit attitudes, or implicit attitudes and no evidence for a mediation was found. We discuss the implications of these effects on understanding the effectiveness of intergroup apologies between countries that differ in perceived power.