三阴性乳腺癌两个新辅助化疗疗效比较

分析多西他赛联合卡铂方案在三阴性乳腺癌新辅助化疗中的疗效及不良反应。分析2010年03月～2013年09月我院收治的84例TNBC患者临床资料,分析对比多西他赛联合卡铂（TP）方案与吡柔比星、氟尿嘧啶、环磷酰胺（CAF）方案新辅助化疗疗效及不良反应。TP组患者的有效率（RR）优于CAF组,P＜0．05。两组患者的药物不良反应无明显差异,P＞0．05。多西他赛联合卡铂方案用于三阴性乳腺癌新辅助化疗,疗效确切,耐受性良好。     

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。     

伊斯兰教临终关怀与癌性疼痛心理治疗的探讨

如何利用伊斯兰教的信仰关怀、情感关怀和死亡关怀“三关怀”,提高癌症患者临终关怀质量和癌性疼痛心理治疗效果,作者根据在宁夏回族地区癌症患者中开展临终关怀的五年实践体会,从临终关怀的宗旨和目的出发,探讨了伊斯兰教的临终关怀之信仰关怀、情感关怀和死亡关怀三种形式和内容,解释了癌性疼痛的原因、疼痛的主观和客观影响因素及心理治疗的常用方法和原则,总结了在宁夏回族地区开展临终关怀应用伊斯兰教的信仰关怀、情感关怀和死亡关怀”三关怀”与癌性疼痛心理治疗之间的关系。     

EGFR突变NSCLC二线TKIs治疗优化选择

恶性肿瘤的治疗已经进入驱动基因指导下的个体治疗时代,肺癌患者应该进行多基因检测,特别是表皮生长因子受体（EGFR）基因突变。EGFR基因突变的非小细胞肺癌（NSCLC）患者,如果一线接受了化疗,二线应该选择表皮生长因子受体一酪氨酸酶抑制剂（EGFR—TKIs）。EGFR基因突变的NSCLC患者一线EGFR—TKIs治疗失败后,二线治疗应该是个体化合理选择,包括局部放疗、化疗和继续EGFR—TKIs。目前一代和二代EGFR—TKIs药物之间未见到显著疗效差别。第三代EGFR—TKIs是目前的EGFR—TKIs耐药后的最有希望的选择,特别是针对T790M突变耐药。     

IGFBP-2及IGFBP-6在结直肠癌中的表达及意义

研究胰岛素样生长因子结合蛋白2（IGFBP-2）及胰岛素样生长因子结合蛋白6（IGFBP-6）在结直肠癌中的表达及临床意义。采用免疫组织化学法及RT-PCR方法检测结直肠癌、结直肠腺瘤及癌旁正常黏膜组织中IGFBP-2及IGFBP-6的蛋白及mRNA的表达情况,结合临床病理资料进行统计学分析。IGFBP-2及IGFBP-6蛋白的阳性表达及mRNA的表达量在三组组织中均存在异常表达情况,且差异有明显的统计学意义（P〈0.05）,在结直肠癌组IGFBP-2、IGFBP-6的阳性表达在肿瘤浸润深度、有无淋巴结转移及Duke＇s分期存在差异,有明显的统计学差异（P〈0.05）。临床可以把二者作为结直肠癌诊断及预后的早期预测指标。     

Does contact at work extend its influence beyond prejudice? Evidence from healthcare settings

This article reports on two studies investigating the role of intergroup contact on the reduction of prejudice against migrants and on organizational and health outcomes. Study 1 enrolled 624 native healthcare professionals and showed that frequent and positive contact with non-native co-workers was associated with a decrease in the professionals’ prejudice and an increase in the professionals’ perception of team functioning. These effects were mediated by reduced in-group threat perception. Study 2 enrolled 201 native patients and showed that frequent and positive contact with non-native healthcare providers was associated with a decrease in patients’ prejudice and an increase in patients’ satisfaction for the care received. These effects were mediated by reduced in-group threat perception. These novel findings showed that frequent and positive contact with non-native individuals can improve health and organizational outcomes along with facilitating positive intergroup relations.     

Mental health consequences of weight cycling in the first-year post-treatment for breast cancer

Objectives: Weight cycling is linked with advanced breast cancer diagnosis, increased risk of cancer reoccurrence and cancer-related mortality. While women treated for breast cancer report challenges with navigating their post-treatment body shape and weight, the effects of weight cycling on body image and mental health have not been elucidated. This study examined associations between weight changes and weight cycling on psychological health (i.e. weight-related guilt, shame and depressive symptoms) among women in the first-year post-treatment.

Design and Outcome Measures: Self-reported assessments of pre-cancer weight cycling, post-treatment weight-related guilt, shame and depressive symptoms, and objective assessments of weight were assessed in a longitudinal sample of 173 women treated for breast cancer (M_age = 55.01 ± 10.96 years).

Results: Based on findings from multilevel models, women experienced the most weight-related shame when their weight was heavier than their personal average. Additionally, heavier weight was associated with worse psychological health, particularly for women with a history of stable (vs. cycling) weight pre-cancer.

Conclusions: Weight cycling pre-cancer and post-treatment weight change have important implications for psychological well-being. Due to the potential psychological consequences associated with a history of weight cycling, targeted strategies are needed to improve overall health outcomes for women’s survivorship after breast cancer.     

Reducing behavioural risk factors for cancer: An affect regulation perspective

Nearly half of all cancer deaths are attributable to preventable causes, primarily unhealthy behaviours such as tobacco use, alcohol use and overeating. In this review, we argue that people engage in these behaviours, at least in part, as a means of regulating their affective states. To better understand why people engage in these behaviours and how researchers might design interventions to promote the selection of healthier methods for regulating affect, we propose a conceptual model of affect regulation. We synthesise research from both the stress and coping tradition as well as the emotion and emotion regulation tradition, two literatures that are not typically integrated. In so doing, we indicate where researchers have made headway in understanding these behaviours as affect regulation and note how our model could be used to structure future work in a way that would be particularly advantageous to cancer control efforts.     

Development of a Communication Aid to Facilitate Risk Communication in Consultations with Unaffected Women from High Risk Breast Cancer Families: A Pilot Study

The literature on risk perception in women from high-risk breast cancer families reveals persistent over-estimation of risk, even after counseling. In this study, a communication aid was designed to facilitate discussion of risk between clinical geneticists and genetic counselors and women from this high-risk population. Method: Stage 1. The aid was developed by an expert panel of clinical geneticists, genetic counselors, psychologists, an epidemiologist, an oncologist, linguists and a consumer. It was guided by the international literature on risk communication and a large multi-centre Australian study of risk communication. The 13 page full-color communication aid used varying formats of words, numbers, graphs and pie-charts to address (a) the woman’s subjective risk; (b) the population risk of breast cancer; c) the risk of inherited breast cancer; (d) the cumulative risk for women with BRCA1 and BRCA2 mutations; (e) family risk factors; (f) the woman’s suitability for genetic testing; (h) screening and management recommendations, and (i) a re-assessment of the woman’s subjective risk. Stage 2: A before–after pilot study of 38 women who were unaffected with breast cancer and were attending four Australian familial cancer clinics was undertaken. Baseline and follow-up questionnaires were completed by 27 women. Outcomes were compared to those observed in 107 similar women undergoing genetic counseling without the communication aid in 2001. Results: The risk communication aid appears to be beneficial; breast cancer genetics knowledge improved in some areas and importantly, risk perceptions improved in the cohort receiving the communication aid. Psychological measures showed no difference in anxiety or depression between the group receiving the communication aid and the comparison cohort. Women and clinicians were very positive about the usefulness of the communication aid as an adjunct to the genetic counseling consultation.