非肌层浸润性膀胱癌膀胱全切手术时机的探讨

非肌层浸润性膀胱癌包括Tis,Ta,T1期膀胱癌。它们的生物学特征,恶性程度不同,治疗方式多样化。非肌层浸润性膀胱癌经过保留膀胱治疗效果良好,但仍有一部分表现为高复发和局部进展。建议BCG治疗失败的原位癌;伴有两个或者两个以上的高风险进展特征的T1G3或者是膀胱灌注治疗无效的TIG3期膀胱癌患者尽早行根治性膀胱切除术。     

电视胸腔镜下肺癌切除术应用体会

电视胸腔镜手术被视为20世纪末期胸外科界革命性的一大突破,是微创胸腔外科应用范围最为广阔的胸腔镜手术。其中,腔镜下治疗非小细胞肺癌的肺叶切除术是胸外科微创的代表性手术,其创伤小、恢复快、并发症发生率低等优点日益明显。尽管胸腔镜肺癌切除的安全性及有效性得到普遍认可,而且胸腔镜手术治疗早期肺癌患者也取得了良好的效果,但目前...     

Increased saccadic rate during smooth pursuit eye movements in patients at Ultra High Risk for developing a psychosis

Abnormalities in eye tracking are consistently observed in schizophrenia patients and their relatives and have been proposed as an endophenotype of the disease. The aim of this study was to investigate the performance of patients at Ultra High Risk (UHR) for developing psychosis on a task of smooth pursuit eye movement (SPEM). Forty-six UHR patients and twenty-eight age and education matched controls were assessed with a task of SPEM and psychiatric questionnaires. Our results showed that both the corrective and non-corrective saccadic rates during pursuit were higher in the UHR group. There were however no differences in smooth pursuit gain between the two groups. The saccadic rate was related to positive UHR symptoms. Our findings indicate that abnormalities in SPEM are already present in UHR patients, prior to a first psychotic episode. These abnormalities occur only in the saccadic system.     

‘What made me unhappy’. Experiences of,and responses to,lifestyle changes in breast cancer patients

Sixteen breast cancer patients were interviewed about any lifestyle changes they had experienced and their reactions to those changes. Data were collected and analysed via content analysis and then summary tabulations of patient responses until replication of responses was verified across patients. Results indicated that most patients suffered a reduction in recreation activities, unpleasant physical side effects from treatment and loss of feminine appearance characteristics, all of which were seen as decreases in previously available and valuable sources of social support and self-esteem. In response to these losses, patients reported a common coping strategy of avoidance or escape similar to some depressive symptomatology. Implications for counsellors are discussed.     

癌症化疗患者护患沟通环节流程化模式初探

在癌症化疗患者的整体护理中,护患沟通较之躯体护理更具挑战性,表现为沟通难做、效果难评、学生难带、绩效难考。作者尝试一种模式,把护患沟通的各环节工作流程化、任务表格化,即首先按精心设计的流程及内容完成针对性调查,找出影响与患者沟通的有关因素及患者最为关注的问题,针对性地运用各种沟通技巧逐一沟通,实现护患沟通的个体化和差异化,同时使护患沟通环节工作有模式、效果有评价、教学有路径、考核有标准。     

实现医学整合,满足门诊患者新需求——“一站式”多学科综合门诊

为了在门诊落实"一切以病人为中心"的服务理念,通过调查、了解病人的需求,改变传统的就医模式,将多学科整合,推出创新的"一站式"多学科综合门诊。改善了就诊流程,简化了就诊手续,对疑难杂症提供全方位、多学科综合诊疗,同时缩短患者就诊等候时间和多次往返各门诊的不便,减少就诊环节,实现医学整合,满足患者需求。     

结直肠癌相关肿瘤标志物的最新研究进展

结直肠癌是最常见的恶性肿瘤之一。其起病隐匿、病死率较高,治疗成功的关键在于早期发现、早期诊断,结直肠癌相关肿瘤标志物曾为此做出了贡献。近年又发现了许多新的结直肠癌相关肿瘤标志物,其中有的已进入临床应用,还将有更多标志物为结直肠癌的早期诊断、疗效观察、预后判断和复发监测提供新思路和新方法。     

大肠癌靶向药物治疗进展评述

21世纪以来,靶向药物如抗VEGF的人源化单克隆抗体(Bevacizumab,贝伐单抗)和抗EGFR单克隆抗体(人鼠嵌合性单抗Cetuximab,C225,西妥昔单抗和全人源化单抗EGFR抗体,Panitumumab,帕尼单抗)的临床应用,已使复发转移性结直肠癌患者的总生存取得了长足的进步,但临床上应如何更加合理有效地使用这些药物,仍有许多亟待解决的问题。     

重视直肠癌术后局部复发的防治

直肠癌术后局部复发是临床关注的重点与难点问题。术前准确分期、评估,选择合理治疗方案和术式,是防治局部复发的先决条件。手术遵循全直肠系膜切除(TME)原则,保证断端切缘和环周切缘完整、无癌细胞残留是防治局部复发的关键。新辅助治疗可降低T3、T4期直肠癌局部复发率。发挥直肠癌多学科综合治疗模式优势对防治直肠癌局部复发有重要作用。     

The tell-tale tasks: a review of saccadic research in psychiatric patient populations

This review focuses on saccade research with adult psychiatric patients. It begins with an introduction of the various types of saccades and the tasks used to evoke them. The functional significance of the different types of eye movements is briefly discussed. Research findings regarding the saccadic performance of different adult psychiatric patient populations are discussed in detail, with particular emphasis on findings regarding error rates, response latencies, and any specific task parameters that might affect those variables. Findings regarding the symptom, neurocognitive, and neural correlates of saccadic performance and the functional significance of patients’ saccadic deficits are also discussed. We also discuss the saccadic deficits displayed by various patient groups in terms of circuitry (e.g. cortical/basal ganglia circuits) that may be implicated in the underlying pathophysiology of several of these disorders. Future directions for research in this growing area are offered.