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191.
鼻咽癌是我国高发恶性肿瘤之一,发病率为头颈部恶性肿瘤之首。鼻咽癌对放疗、化疗均敏感。单纯的放射治疗虽然能够使早期患者获得很好的局部控制率,但是对于局部晚期患者而言,其5年生存率难以令人满意,治疗失败主要是因为区域复发和远处转移。化学治疗对放疗起到了补充作用,临床应用目前主要有同期化疗、辅助化疗、诱导化疗三种。本文对过去20年间化疗在局部晚期鼻咽癌治疗中的应用归纳总结。  相似文献   
192.
妊娠合并结核是一种对母婴健康危害极大的妊娠期疾病。在妊娠期结核病中,多数患者无明显症状,早期症状与妊娠期某些生理反应相似,加之妊娠与结核病的相互影响,x线、CT等重要的影像学检查受限,致使本病易被误诊或误治。某些抗结核药物对母婴的不良影响,使其治疗难以实施,由于结核病本身及治疗后可能对胎儿的影响,在临床上是否终止妊娠往往难以决策。本文就妊娠合并结核诊治过程中的相关问题进行综述,以期为临床诊治决策提供帮助。  相似文献   
193.
近几年随着循证医学证据的不断增加,各国对心力衰竭指南进行了更新.主要是2012年欧洲心脏病学会(ESC)与心衰学会公布的心力衰竭新指南、2011年澳大利亚和新西兰慢性心力衰竭诊治指南、2010年英国国立健康与临床优化研究所(NICE)慢性心力衰竭诊治指南、2009美国心脏病学会(ACC)/美国心脏协会(AHA)实践指南工作组成人心力衰竭诊疗指南及2010年我国的急性心力衰竭指南等.各国指南对心力衰竭的诊断和治疗都提出了具体的意见和建议,其中不乏亮点,如对慢性心力衰竭患者更加重视血运重建的治疗作用、推荐心力衰竭治疗的一种新型β受体阻滞剂奈必洛尔等等.我们对以上几个指南做了浅要分析,以取长补短更规范的诊治心力衰竭患者.  相似文献   
194.
尽管30年前鲍林与卡梅伦曾经用静脉注射+口服大剂量维生素C(10克/天)治疗肿瘤患者,并验证抗坏血酸的抗癌功效,但梅约医疗中心的口服双盲试验否定了他们的结论.沉寂30年后,鲍林的继承者瑞欧丹通过不懈的努力用科学实验和医疗实践证明,通过静脉滴注大剂量抗坏血酸,令其在血浆达到一定浓度,可以杀死多种癌细胞,从而作为化疗药物可以有效治疗恶性肿瘤.30年来的临床实践现已总结为“瑞欧丹规程”.近年来,他们的成就受到美国主流医学和媒体的高度重视.与一般化疗药物相比,该法的好处是基本没有副作用,延长生存期,提高存活质量(QOF).这是一项重大科学发现和成就.该疗法的确立意义重大,将推动癌的治疗及预防,乃至其他疾病如冠心病、感染性疾病及炎症的治疗及预防,提高人类健康水平.  相似文献   
195.
The legitimacy of adult's accounts of child sexual abuse depends on the consistency of the story they tell about this experience. But there are a variety of influences that conspire to create dynamic variation in retrospective accounts of child sexual abuse. In a study of an experimental New Zealand commune called Centrepoint, participants showed considerable variation in accounting for the child sexual abuse that was known to have occurred there. We used a narrative methodology to show the variation between stories that highlighted abuse and suffering and others that represented an idyllic childhood within which sex between children and adults was normalised. There was also considerable variation within individual participant's accounts. The variation within and between accounts was shaped by features such exposure to contradictory experiences, different social positioning in relation to child sexual abuse, shifts in memory and interpretation over time, differences between insider and outsider perspectives on child sexual activity at the commune and alternative perspectives on victimhood. This research challenges the mythology that accounts of child sexual abuse should be expected to be clear and consistent. Instead, variation should be treated the rule rather than the exception in these accounts. Copyright © 2012 John Wiley & Sons, Ltd.  相似文献   
196.
Although there is a great need for substance abuse services among the homeless, many homeless individuals do not use those services. This study examined barriers and supports related to service use. Participants recognized a need for treatment and significant barriers to accessing care.  相似文献   
197.
198.
Abstract

What the literature reports that adolescents need within their parent-adolescent relationships, as well as what adolescents with serious emotional disturbances may experience within their parent-adolescent relationships are discussed. A framework for providing parent-adolescent group intervention for psychiatrically hospitalized adolescents and their parents to promote positive interaction and co-occupation are provided. Summaries of the parent-adolescent activity group experiences of three families are provided to illustrate how different adolescent psychiatric issues and family dynamics might be addressed in a parent adolescent activity group.  相似文献   
199.
Abstract

Discrepant alcohol use between partners has been shown to impact couples’ relationship functioning, emphasizing couples therapists’ need for careful assessment and informed treatment. This study recruited 514 participants from online crowdsourcing platforms to participate in an online survey. Participants were predominantly male (62.4%), heterosexual (76.1%), and Caucasian (47.6%). Ages ranged from 18 to 65 years and mean age was 33. Results indicated a negative association between couple satisfaction and both alcohol-related conflict and discrepant alcohol consumption. Being female combined with higher levels of alcohol discrepancies and couple satisfaction predicted increased alcohol-related conflict.  相似文献   
200.
In this paper we describe psychotherapeutic work carried out in a paediatric hospital to illustrate the important contribution of a psychoanalytically-oriented approach in a hospital context. The work concerns an adolescent boy who had undergone several surgical operations with the result that some of his natural orifices were obstructed and artificial ones had to be created. He was referred to us because he refused pharmacological and rehabilitative treatment necessary prior to further surgery and his eventual recovery. The boy's experience of loss of control of his life and the more primitive anxieties of not feeling safely contained in his physical and psychic skin emerged and were worked through in the psychotherapeutic relationship. The parallel work with medical staff reduced the risk of splitting and acting out by the patient and professionals. The approach adopted enabled this boy to resume his medical treatment and his developmental process.  相似文献   
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