Family Interaction Patterns as Predictors of Vocational Identity and Career Decision-Making Self-Efficacy

The present study explored the relations of perceived family-of-origin interaction patterns (e.g., quality of family relationships, family-supported goal orientations, and degree of control and organization in the family) to vocational identity and career decision-making self-efficacy. A sample of 210 college students completed family-of-origin and vocational self-report measures. Using standard multiple regression analyses, significant variance was accounted for in vocational identity scores by achievement orientation in the family. Significant variance in career decision-making self-efficacy scores was accounted for by a number of family variables including achievement, intellectual-cultural, and moral-religious emphasis orientations and degree of family conflict and expressiveness. The findings suggest that family-of-origin interaction patterns may play small, yet significant roles in the formulation of clear and stable career goals and the promotion of self-confidence in regard to completing career planning activities. These findings warrant further empirical examination of the family systems approach to young adult career development.     

Antidepressant discontinuation in the context of cognitive behavioral treatment for panic disorder.

Cognitive behavioral treatment (CBT) has been shown to reduce risk for adverse reactions (e.g., rebound panic) following benzodiazepine taper for patients with panic disorder (PD). This study evaluated the effects of antidepressant discontinuation for patients with PD in the context of CBT. Patients with PD (n=21) on a stable dose of antidepressants completed a 12-week group CBT treatment and were randomly assigned to discontinue antidepressants during week 8 of the treatment. There were no statistically significant differences between groups at posttreatment or 6-month follow-up. Data indicate no apparent immediate or long-term adverse effects for antidepressant discontinuation for patients with PD receiving CBT.     

Measured Gene–Environment Interactions and Mechanisms Promoting Resilient Development

ABSTRACT— Childhood maltreatment elevates risk for antisocial behavior, depression, and other problems over the life span, but a subset of maltreated individuals avoids maladaptive development and shows resilience. Resilience reflects a dynamic confluence of factors that promotes positive adaptation despite exposure to adverse experiences. Recent replicated findings of gene–environment interactions (abbreviated G × E) involving maltreatment have identified two genes, monoamine oxidase A ( MAOA ) and serotonin transporter ( 5-HTT ), that moderate the association between childhood maltreatment and psychopathology. Accordingly, G × E raise new questions about potential biological mechanisms by which some individuals are able to cope adaptively and function relatively well despite experiencing early adversity. We summarize advances toward greater specification of G × E mechanisms, including genetic and environmental moderation of G × E effects and imaging genomics that provide clues regarding resilience processes in development.     

关注心房颤动的临床治疗决策

心房颤动发生率很高,我国为0．77％,估计有1000万患者。房颤分类为初发房颤、阵发性房颤、持续性房颤和永久性房颤。房颤病因众多,包括高血压病、心肌病、心衰、甲亢及冠心病等。房颤危害严重,房颤引发卒中高出5倍,房颤促进或加重心衰,房颤增加痴呆2倍。房颤增加病死率,严重降低患者生命质量。房颤治疗决策主要恢复正常窦性心律,并预防其复发和控制心室率与抗凝治疗预防血栓事件。     

1例妊娠合并急性白血病患者带来的分析与思考

通过对1例妊娠合并急性白血病患者的病例资料进行回顾分析,从孕期化疗的特点来探讨其终止妊娠及进一步化疗治疗的时机与方式,以及从该患者治疗和妊娠之间的矛盾来讨论医生在母体和婴儿生存权益的重要性,总结出医护人员的人性化与职责,深入伦理学思考临床医生对类似患者的最佳治疗应该作出的判定与决策,从而有利于构建和谐社会。     

如何才能保持拉米夫定的疗效及降低耐药——临床优化治疗策略

探讨拉米夫定的临床优化治疗策略,包括选择适用人群,用药最佳时机,预防和应对耐药的方法。旨在提高和保持拉米夫定在慢性乙型肝炎抗病毒治疗的效果。     

系统论方法在糖尿病性视网膜病变危险因素及治疗研究中的应用

全球糖尿病患者人数在不断的增多,大约10％的Ⅰ型糖尿病患者在10年后可出现糖尿病性视网膜病变,而大约95％的Ⅱ型糖尿病患者在20年后可出现糖尿病性视网膜病变。目前,糖尿病性视网膜病的发病机制尚不明确,影响其发生发展的因素也很复杂,因此,对糖尿病性视网膜病的发病危险因素及其诊治的研究,具有相当重要的意义。系统论,研究各种物质运动形态所共有的系统联系和关系,具有普遍的方法论意义,为现代医学的进步提供了全新的思维方式和科学方法论原则。本文试用系统论的整体性、优化原理阐述糖尿病性视网膜病变发病的危险因素与治疗进展,为对其深入研究提供方法论依据。     

非小细胞肺癌靶向治疗的前途与困惑

靶向治疗是运用抗肿瘤药物靶向性与肿瘤的不同特异性住点结合发生作用从而抑制肿瘤细胞生长的一种治疗手段。针对恶性肿瘤中的非小细胞肺癌,其在临床中取得了一定成效。然而,其中仍存在很多问题。本文针对吉非替尼在非小细胞肺癌中的运用,及其优点和所面临的问题,阐述如何应对完善靶向治疗的挑战。     

乳腺癌诊治过程中的多学科协作

乳腺癌是全身疾病,其治疗和诊断都需要多个学科的积极参与协作才能完成。本文就自身体会认为乳腺专科医生掌握诸如肿瘤外科技术与肿瘤内科治疗措施,熟悉乳腺癌放疗与美容整形的相关技术,并能掌握诸如乳腺B超等检查手段等多个学科知识,同时和病理等相关科室紧密协作,是处理好乳腺癌诊治过程中的多学科协作问题的一种有效方法。     

惊恐障碍药物心理干预的临床动态研究

惊恐障碍（panic disorder,PD）是综合医院常见的一种急性焦虑障碍,严重地影响患者的精神心理健康、社会功能和生活质量,并造成医疗资源的极大浪费。本研究通过动态比较药物与药物加心理治疗的疗效,为更合理的对惊恐障碍进行临床干预提供了一定决策依据。