The use of child drawings to explore the dual↔group analytic field in child analysis

Awareness that the child is part of a complex relational system has ensured that all child analysts agree on the necessity of establishing a therapeutic alliance with the parents. Unconscious conflictual dynamics involve the child analyst and include him, from the time of the initial consultation, in an analytic field that is closer to that of a group than to the bi‐personal set‐up of therapy with adults. Through a clinical example, the author hypothesizes that the child’s drawings and play can be viewed as tools capable of mapping the unconscious emotions present in an analytic field that extends beyond the analyst–child couple. Play and drawings can be used in the relationship with the parents not in an explanatory sense, but as a probe with which to explore the universe of unconscious emotions present in the group field. The images or the story of the play used with this particular modality prove to be an attractive pathway that is effective in facilitating the alpha function of each of the members of the group. Furthermore, in this sense, they create the conditions for an occasion through which the parents can become more aware of their own unconscious emotions that have been entrusted to the child and expressed through his symptomatology. The possibility for the little group of subjects involved in a child analysis for oscillation in a dual–group field permits not only a shared experience of knowledge, but also a shared creativity aimed at knowledge of emotional truth (O).     

恶性肿瘤临床决策中应重视的问题

恶性肿瘤是特殊的疾病,临床决策具有高度复杂性。医患共同决策是应遵循的基本原则,多科室合作是决策成功的保障,生命质量是应予以高度关注的课题,人文思想是现代医生必备的素养。     

对肿瘤患者输血的思考

就肿瘤患者输血相关的几个问题进行探讨,提出如何权衡输血对肿瘤患者的有益作用与危害,在肿瘤患者输血中如何进行自体输血及血液替代品的应用,从而推进我国输血医学的发展。     

p63在涎腺肿瘤组织研究的思考

通过对p53家族成员p63的结构、机能和在组织发育和肿瘤发生中的作用及其在涎腺肿瘤组织表达的研究的回顾,我们体会到p63分子复杂性所蕴涵的深刻哲学内涵,如其在细胞周期调控和凋亡的作用。这种研究使我们认识到应该用辨证的思维方法去认识分析客观事物。     

Poisson Multilevel Models with Small Samples

Recent methodological studies have investigated the properties of multilevel models with small samples. Previous work has primarily focused on continuous outcomes and little attention has been paid to count outcomes. The estimation of count outcome models can be difficult because the likelihood has no closed-form solution, meaning that approximation methods are required. Although adaptive Gaussian quadrature (AGQ) is generally seen as the gold standard, its comparative performance has been investigated with larger samples. AGQ approximates the full likelihood, a function that is known to produce biased estimates with small samples with continuous outcomes. Conversely, penalized quasi-likelihood (PQL) is considered to be a less desirable approximation; however, it can approximate the restricted likelihood function, a function that is known to perform well with smaller samples with continuous outcomes. The goal of this paper is to compare the small sample bias of full likelihood methods to the linearization bias of PQL with restricted likelihood. Simulation results indicate that the linearization bias of PQL is preferable to the finite sample bias of AGQ with smaller samples.     

小我争面子、大我争面子与社会排斥感相关研究

以599名大学生为研究对象,探究了大学生小我争面子、大我争面子与社会排斥感之间的关系。结果发现,大学生小我争面子与直接排斥感、间接排斥感和整体社会排斥感呈显著正相关,大学生大我争面子与直接排斥感、间接排斥感及整体社会排斥感呈显著负相关。回归分析发现,小我争面子正向预测社会排斥感的各个维度和总体社会排斥感,大我争面子则负向预测社会排斥感的各个维度和总体社会排斥感。方差差异分析发现,相对于低年级大学生,高年级大学生有更高的小我争面子意识和更低的大我争面子意识,后者体验到的社会排斥感亦较高。研究为在教育过程中帮助难以融入集体的学生提供了新的干预方法,对于遭到社会排斥感的学生可引导其为团体（班集体、学生社团等）大我争面子,以减少其在学生群体中体验到的排斥感。最后分析并讨论了本研究的不足和未来研究展望。     

EGF对A431细胞中MMP-12表达的调节

基质金属蛋白酶（MMPs）和表皮生长因子（EGF）与肿瘤的发生和转移有密切关系,为了研究EGF对MMP-12的调节机制,我们用不同浓度的EGF处理人表皮癌细胞（A431细胞）后,观察MMP-12的表达变化。结果显示使用不同浓度EGF处理A431细胞后,MMP-12的mRNA和蛋白水平均有所升高。因此,在A431细胞中,EGF通过上调MMP-12的表达可能会促进肿瘤的侵袭和转移。     

肿瘤相关物质在肿瘤诊断及疗效观察中的意义

探讨TSGF（tumor supplied group of factors肿瘤相关物质）检测在肿瘤诊断及疗效观察中的意义。用比色法测定恶性肿瘤患者、良性疾病患者及健康查体者血清TSGF含量,用SPSS软件包进行分析。结果是I期肿瘤患者TSGF阳性率66.67％和总阳性率75.67％之间统计学无明显差异;恶性肿瘤组阳性率（75.67％）明显高于良性疾病组（18.76％）和健康查体组（8.27％）;特异性达84.57％;6种恶性肿瘤患者TSGF含量及阳性率无显著差异;恶性肿瘤治疗有效组TSGF阳性率（38.24％）明显低于治疗前（94.12％）。结论认为TSGF具有早期性、敏感性、特异性、广谱性。     

临床肿瘤治疗决策的思考

肿瘤是一种全身性疾病,虽表现为局部的肿块,但其实质是全身免疫功能受损导致某些组织失去控制的异常生长,机体内部由于肿瘤的生长而发生了许多改变。肿瘤治疗的目的在于延长患者生存时间,即与疾病共生存。肿瘤并发症的治疗和术后肿瘤复发或再生的预防在改善生存方面发挥着重要作用。严格的技术准入和规范化治疗是提高治疗效果的保证。     

非小细胞肺癌靶向治疗的前途与困惑

靶向治疗是运用抗肿瘤药物靶向性与肿瘤的不同特异性住点结合发生作用从而抑制肿瘤细胞生长的一种治疗手段。针对恶性肿瘤中的非小细胞肺癌,其在临床中取得了一定成效。然而,其中仍存在很多问题。本文针对吉非替尼在非小细胞肺癌中的运用,及其优点和所面临的问题,阐述如何应对完善靶向治疗的挑战。