CXCR4和CXCR7在甲状腺癌中的表达及病理意义

研究甲状腺癌组织中趋化因子4受体（CXCR4）和趋化因子7受体（CXCR7）的表达情况及临床病理意义。应用免疫组织化学PV-6000法及Westernblot法检测CXCR4与CXCR7在甲状腺癌中的表达。二者在甲状腺癌与甲状腺良性疾病组织的差异均具有统计学意义（P〈0．05）,在甲状腺癌中表达仅与淋巴结转移有关（P〈0．05）,CXCR4与CXCR7之间呈正相关。Westernblot结果提示二者在甲状腺癌中的表达率高于癌旁及甲状腺腺瘤。CXCR4和CXCR7的表达水平与淋巴结转移相关,可作为甲状腺癌预后的判断指标。     

纳米炭在分化型甲状腺癌再手术中应用价值的研究

探讨在分化型甲状腺癌（DTC）再手术中应用纳米炭对甲状旁腺保护和引导颈淋巴结清扫的作用与价值。选取2011年2月至2014年2月湖南省人民医院乳腺甲状腺外科116例D T C再手术患者,随机分为观察组（纳米炭组）64例和对照组52例,试验组在术中先向残余甲状腺或癌灶或肿大淋巴结内注射纳米炭0．1ml～0．3ml不等,对照组不使用纳米炭。观察两组辨别甲状旁腺的个数与准确性,以及在颈淋巴结清扫个数的差异。同时观察两组术后常见并发症有无差异。观察组使再手术的D T C患者的甲状旁腺识别率为92．2％,辨别出3个及以上甲状旁腺比率为75％,均明显高于对照组的28．8％、36．5％,两组比较有显著性差异（ P＜0．05）。中央区与侧颈区淋巴结清扫的个数比较,观察组明显多于对照组（P＜0．05）。观察组不增加术后并发症,而且,其一过性的甲状旁腺功能减退的并发症尚有下降趋势（P＜0．05）。纳米炭对DTC再手术中的甲状旁腺的识别率和区域淋巴结的黑染,使甲状旁腺易于识别和保护,有利于更为彻底清扫中央区和侧颈区淋巴结,尚可降低一过性甲状旁腺功能减退的并发症。     

手术治疗单一局部复发或远处转移病灶乳腺癌的临床观察

探索手术治疗单一局部复发或唯一远处转移病灶乳腺癌的临床价值。收集2006年6月至2013年6月湖南省人民医院乳甲外科收治的64例局部复发或术后远处转移乳腺癌患者,其中28例为单发病灶病例。根据是否采取了包含手术的综合治疗,将其分为手术组与非手术组。回顾性分析两组的临床资料和随访数据,分析手术治疗局部复发或远处转移乳腺癌有无临床意义。结果28例都采取了含化疗的综合治疗,8例局部单发病灶与9例远处单一脏器转移病例进行了手术治疗。手术组的局部缓解率与控制率明显优于非手术组,均为100％。两组无进展生存时间（PFS）和总生存时间（（）S）比较,手术组明显长于非手术组;但在单一远处脏器转移手术组中0S没有优势。2年生存率方面手术组与非手术组比较有统计学意义。对于术后单一局部复发病灶或唯一远处脏器转移的乳腺癌患者,采取含手术的综合治疗方案能带来明显的PFS优势,若有手术机会和条件成熟,手术仍是不应放弃的有效治疗方法。     

The Implicit Image of God: God as Reality and Psychological Well‐Being

Research has widely demonstrated that religiosity is related to psychological well‐being even in situations of severe illness. To assess religious beliefs, explicit measures have generally been used. In this study, we measured the belief that God is reality as opposed to myth or abstraction by using an implicit technique (the Single Category Implicit Association Test). The study was carried out in Italy, where a large majority of the population is Catholic, and the prevailing image of God is that of a compassionate and supportive father. Participants were cancer patients identifying themselves as believers. As expected, the automatic belief that God is reality (vs. abstraction) was related to beneficial outcomes: lower reported psychophysical anxiety symptoms and a weaker use of avoidance strategies to cope with stress. Thus, also, automatic religious beliefs may affect feelings and behaviors.     

The Power of Language and Labels: “The Mentally Ill” Versus “People With Mental Illnesses”

Undergraduate students (N = 221), adults in a community sample (N = 211), and professional counselors and counselors‐in‐training (N = 269) were given a measure of tolerance. Within each sample, half of the participants were given a version that used the term “the mentally ill” and half were given a version that used the term “people with mental illnesses.” Individuals receiving the version with the term “the mentally ill” had lower levels of tolerance. Professional counselors had the largest differences in tolerance on the basis of language.     

关于重大医疗纠纷行政干预认识的调查分析

为了解医患双方对重大医疗纠纷的基本认识,对上海市徐汇区35家医疗机构医患双方进行问卷调查.就医患双方对重大医疗纠纷的产生原因、救济途径、行政干预作用等方面的认知情况展开分析,从而得出为了有效解决重大医疗纠纷,需发挥行政干预作用、健全纠纷解决机制以及正确引导舆论导向的结论.     

A longitudinal study of psychosocial distress in breast cancer: Prevalence and risk factors

This longitudinal study was conducted among 102 women with non-metastasic breast cancer to identify the time evolution and prevalence of distress at specific times through diagnosis and treatment of disease: preliminary diagnosis, surgery, definitive diagnosis and chemotherapy. Additionally, the study aimed to examine the role of demographic, medical and psychosocial factors on distress. The results indicated that prevalence of distress was higher at initial diagnosis (25%) than the following time points (approximately 17%). The differences inter-individuals in the levels of distress were observed over the four assessments. No relation between distress and demographic and medical factors was found. However, psychosocial aspects were significant risk factors. Patterns of emotional suppression and specific coping responses like helplessness/hopelessness, anxious preoccupation, cognitive avoidance and fatalism were positively related to distress, whereas fighting spirit and perceived social support showed a protective role. Moreover, helplessness/hopelessness and anxious preoccupation jointly predicted 75% of cases and 98% non-cases of distress. Finally, a mediational model between emotional suppression and distress through helplessness/hopelessness was tested. Results support the necessity of routine distress screening all through the illness. Implications of data for psychosocial interventions with breast cancer patients are highlighted.     

Psychological intervention with couples coping with breast cancer: A systematic review

Objective: Information about psychological intervention with couples coping with breast cancer is not well-disseminated. This can be explained, at least in part, by the absence of knowledge about the efficacy of this kind of intervention. The aim of the present systematic review is to identify and describe psychological interventions for couples coping with breast cancer and evaluate their efficacy.

Design: Studies identified by a searching multiple literature databases related to health and psychology between 1975 and 2013. Rigorous inclusion and exclusion criteria were utilised.

Results: Of 129 abstracts, 13 were extracted for further analysis and a final ten studies were deemed eligible for inclusion. Data were extracted from each study regarding study sample characteristics, design, results and methodological limitations. The results obtained were mixed in regard to efficacy, although the overwhelming majority of studies (eight studies) found benefits for both women and their partners in some dimensions, such as quality of life, psychological distress, relationship functioning and physical symptoms associated with cancer.

Conclusion: Psychological interventions for couples coping with breast cancer appear to be effective for both women and their partners. However, further studies are needed to evaluate the efficacy of couple-based interventions and, to identify for whom and how they are more effective.     

Do stigma and its psychosocial impact differ between Asian-born Chinese immigrants and Western-born Caucasians with head and neck cancer?

Stigma appears to influence emotional distress and well-being in cancer survivors, but cross-cultural differences have been ignored. Previous studies suggest that stigma may be especially relevant for survivors of Asian origin. However, their study designs (e.g. focused on female cancers, qualitative designs, and an absence of comparison groups) limit the strength of this conclusion. We hypothesized that (1) Asian-born Chinese immigrants (AI) would report more perceived cancer-related stigma than Western-born Caucasians (WBC); and (2) the impact of stigma on emotional distress and well-being would be greater in AI as compared to WBC. Head and neck cancer survivors (n = 118 AI and n = 404 WBC) completed measures of well-being, emotional distress, and a three-item indicator of stigma in structured interviews. The majority of respondents (59%) reported one or more indicators of stigma. Stigma correlated significantly with emotional distress (r = .13, p = .004) and well-being (r = ?.09, p = .032). Contrary to our hypotheses, WBCs and AIs did not differ in reported stigma nor did we detect differences in its psychosocial impact. Stigma exerts a deleterious psychosocial impact on head and neck cancer survivors. It did not differ significantly between AI and WBC survivors.     

试论社会人群中医学信息的不对称性

简述了社会人群中产生的医学信息不对称性的根源、特点和社会效应,以及医务人员应如何正确对待这个问题.