早期胃癌的治疗

目前,早期胃癌（early gastric cancer,EGC）的治疗仍以开放性手术治疗为主,其预后明显优于进展期胃癌。近年来,随着对EGC浸润与转移规律的深入认识和新技术的应用,其治疗中微创外科的应用更为广泛和合理,并重视患者术后的生活质量。本文结合国内外的研究进展,深入探讨EGC的治疗方法及应用指征,特别是微创外...     

胃癌辅助化疗的选择和应用

局部进展期胃癌手术后是否给予全身辅助化疗以及关于标准方案的临床研究,一直是临床关注的热点问题,对ⅡB期以上的进展期胃癌术后给予辅助治疗已经成为共识,但对于采用何种方案作为标准方案尚缺乏循证学依据,而且东西方医学界的意见存在较大的争议,我们一方面期待具有更高级别证据的临床研究结果,另一方面在现有证据下对胃癌术后进行最大程...     

乳腺病变的常规影像学筛查方法的合理性分析

乳腺癌是妇女最常见的恶性肿瘤之一,在我国,乳腺癌的发病率和死亡率已成为城市女性恶性肿瘤的首位,且每年以3％～5％速度增长。目前乳腺癌防治日益受到重视。然而,为了阻断高危险性的乳腺向乳腺癌发展,乳腺影像学筛查正在被越来越多的女性接受。本文就各种影像检查手段对乳腺疾病特别是乳腺癌诊断的优缺点进行简要的总结,旨在指导临床医师...     

动态磁共振成像在早期乳腺癌诊断中的临床研究

评价动态增强磁共振成像在早期乳腺癌诊断中的价值。随机选取2008年10月到2011年6月本院83例经B超或B超联合钼靶检查阴性的中青年女性行乳腺MRI检查,对MRI发现可疑结节病灶的患者进行手术活检,通过病理诊断来评价MRI在诊断早期乳腺癌的准确性和临床应用价值。83例中青年女性中,发现病变7例（8．4％）,癌前改变4...     

Is emotion regulation associated with cancer-related psychological symptoms?

Objectives: This study examined the cross-sectional and prospective relationships between subjective (cognitive reappraisal, expressive suppression and experiential avoidance) and objective (high-frequency heart rate variability [HF-HRV]) measures of emotion regulation (ER) and a set of psychological symptoms (anxiety, depression, fear of cancer recurrence [FCR], insomnia, fatigue, pain, and cognitive impairments) among women receiving radiation therapy for non-metastatic breast cancer.

Design: Eighty-one participants completed a battery of self-report scales within 10 days before the start of radiotherapy (T1) and within 10 days after its end (T2; approximately 6 weeks after T1). HF-HRV at rest was measured at T1.

Results: Canonical correlation analyses revealed that higher levels of experiential avoidance and expressive suppression were cross-sectionally associated with higher levels of all symptoms, except pain, at T1 and at T2 (both p’s?<?0.0001). Higher levels of suppression and reappraisal at T1 were marginally associated with reduced FCR and with increased depression and fatigue between T1 and T2 (p?=?0.07). HF-HRV was not associated with symptoms cross-sectionally or prospectively.

Conclusions: Although preliminary, these results are consistent with the hypothesis that maladaptive ER strategies, assessed subjectively, may cross-sectionally act as a transdiagnostic mechanism underlying several cancer-related psychological symptoms.     

Psychological adjustment in patients post-curative treatment for oesophageal cancer: a longitudinal interview study

Objective: Oesophageal cancer is an increasingly prevalent disease with a demanding post-curative treatment recovery period and sustained longer-term effects. Although post-curative treatment is a key transitionary period, the process of psychological adjustment for the individual is under-researched which limits the evidence base to inform supportive care. The aim of this study was to understand the process of adjustment for oesophageal cancer patients post-curative treatment, in particular the beliefs participants hold regarding their condition and how these are appraised against their experience.

Design: Serial interviews were undertaken with six oesophageal cancer patients who have recently completed curative treatment, at baseline and at 6-month follow-up using interpretative phenomenological analysis.

Results: The findings demonstrate an effortful process of adjustment, including recognising and accepting a changed self, fostering control beliefs over the course of the illness and physical sequelae, searching for meaning, developing illness coherence and moving away from self-blame.

Conclusions: This study is the first to utilise a longitudinal qualitative design in oesophageal cancer, and provides an understanding of post-treatment adjustment over time for this clinical population through which to inform clinical practice and service development.