通过查阅大量中外文献,结合临床工作,从国内心理社会肿瘤学专业人员的视角,描述国内外心理社会肿瘤学的临床实践,包括痛苦筛查、癌症症状的精神科管理、心理干预的实施以及心理社会肿瘤学多学科团队建设的最新进展,指出国内心理社会肿瘤学在上述临床实践中存在的挑战和不足,并从探索适合我国国情的痛苦筛查管理的模式与流程,心理干预方法本土化和在国内建立心理社会肿瘤学多学科团队等方面对学科进一步规范发展以及如何更好地融入肿瘤临床实践提出了新的思考.

失眠是成人癌症患者的常见症状之一,在癌症病程的各个阶段都很常见,不仅影响患者的生活质量,甚至会影响到抗癌治疗和疾病结局.为进一步规范成人癌症患者失眠的诊治,中国癌症基金会肿瘤心理学协作组组织肿瘤科、精神科和以科室名称"肿瘤心理科"等开展精神卫生临床工作的多学科专家,结合国内外相关诊疗指南、循证医学证据和专家临床经验撰写本专家建议,内容包括流行病学、病因、失眠对癌症及其治疗的影响、评估及治疗过程,以及诊疗要点和注意事项,旨在引发肿瘤临床医护人员对成人癌症患者失眠问题的关注,并为成人癌症患者失眠的诊治提供指导.

分析恶性肿瘤筛查阳性结果带来的心理影响,包括积极的心理影响和消极的心理影响.阳性筛查结果带来的生存获益可能会让患者感到庆幸和安慰,并增加患者及其家属积极的促进健康的行为改变.部分阳性筛查结果可能会在短时间内给参与者带来消极的心理影响,但不会对参与者的心理造成严重或持久的伤害.提出应当通过良好的医患沟通、充分的宣教,将心理痛苦筛查及干预整合入恶性肿瘤筛查过程以预防和应对阳性筛查结果带给参与者的心理负担.

Objective:To investigate the pain, physical and psychological symptoms in outpatients with cancer pain through a follow-up program to gain some evidence for better pain and symptom management. Methods:The outpatients with cancer pain in the pain clinic in Beijing Cancer Hospital were asked to participant in the follow-up program from July 2015 to July 2016. Three times follow-ups were conducted within 3 days, two weeks and four weeks after the first visit. Numeric Rating Scale and The Chinese Versions of the Memorial Symptom Assessment Scale Short Form were used to assess the pain, physical and psychological symptoms.Results:102 patients with cancer pain participated in the follow-up, 98 completed 2 follow-ups, and 49 completed 3 follow-ups. We found that 65.7% of the patients reported moderate to severe pain at the first follow-up. The pain intensity at each follow-up was reduced compared with the previous one. The prevalence of physical and psychological symptoms was high in the patients with cancer pain in the first follow-up. The top ten symptoms besides pain were feeling irritable, lack of energy, worrying, difficulty sleeping, lack of appetite, feeling sad, nausea, constipation, and difficulty concentrating. Conclusion:Pain follow-ups for outpatients with cancer pain are helpful to find out and solve the problems in pain control, which played a positive role in pain management.

通过横断面现况调查探索北京市城六区癌症患者的抑郁及自杀意念的患病情况并分析其影响因素.结果显示,北京市城六区癌症患者抑郁总体患病率为55.8％;Logistic回归分析显示,朝阳区患者抑郁风险是西城区患者的2.496倍,化疗、家庭支持差或较差、无手术机会等是抑郁的风险因素.有自杀意念的患者比例为16.6％,自杀意念与抑郁状态密切相关,无伴侣、无手术机会是患者自杀意念的危险因素,建议对癌症患者进行抑郁及自杀意念进行定期筛查,尤其需要关注抑郁及自杀风险较高的癌症患者人群.

Psycho-Oncology is a new interdiscipline, covering oncology, social, psychology and ethics. This paper reviewed the development of Psycho-Oncology at home and abroad, pointed out the gap between China and western countries and indicated the direction of future efforts aiming at providing a reference for the development of Psycho-Oncology.

Objective To compare the efficacy and adverse effects of haloperidol and olanzapine in treatment of patients with schizophrenia.Methods A randomized,multi-center,controlled clinical trial was conducted.Patients with schizophrenia were randomly assigned into haloperidol(n = 120) and olanzapine(n = 252) groups to receive monotherapy with either drug alone for 6 weeks.The positive and negative syndrome scale(PANSS),body mass index(BMI),rating scale for extrapyramdal side effects(RSESE),barnes akathisia rating scale(BARS) and abnormal involuntary movement scale(AIMS) were assessed at baseline,2,4,and 6 weeks following treatment.Moreover,a series of parameters including blood glucose,lipid metabolism and hepatic functions were detected at same time points.Results There were no significant difference in PANSS scores between two groups at baseline.At the end of 6 weeks,the PANSS score of were lower in haloperidol group than in olanzaping group(53.31 ± 1.64 vs.58.05 ± 1.02) whereas the reduction rates of PANSS in were higher in haloperidol group than in olanzapine group(60.63 ± 2.86% vs.52.45 ± 1.80%),P 0.05.The difference at effective rates was no statistically significant between these two groups(66.7% vs.62.7%).The BMI changes(0.08 ± 0.20 kg/m2 vs.0.91 ± 0.12 kg/m2) and the percentage of cases with abnormal alanine aminotransferase level in haloperidol group were lower than that in olanzapine group at the 6 weeks(16.98% vs.28.07%);the changes of triglyeride in haplopeidol were lower than that in olanzapine group at the 4 weeks with P 0.05(0.24 ± 0.12 mmol/L vs.0.57 ± 0.07 mmol/L).The incidence rate of extrapyramidal symptoms were higher in haloperidol group than in olanzapine group(73.3% vs 10.71%,P 0.05).Conclusion These results demonstrate that haploperidol is as effective as olanzapine in treatment for schizophrenia.Olanzapine can significantly increase body weight and adverse metablic effects whereas haloperidol can cause higher incidence of extrapyramidal syndrome(EPS).The double-blind,fixed low dose studies on haloperidol with a larger sample size are needed to confirm the results of our study.

目的:通过临床观察,探讨超短波辅助治疗婴幼儿支气管肺炎的疗效。方法:对2003年来的178例3岁以下支气管肺炎患儿随机分成两组,治疗组在常规抗感染治疗下,加用超短波治疗。结果:治疗组总有效率达97%。结论:超短波辅助治疗肺炎,可减轻患儿痛苦,缩短疗程。

内皮素及其受体的相互作用可通过激活多种信号途径(如:ILK,MAPK等)和使某些标志性分子的上调或下调(如:E-cadherin,β-catenin等)来促进肿瘤的发生发展,为肿瘤的侵袭转移提供重要的理论基础。受体抑制剂的使用为治疗肿瘤提供了研究方向,肿瘤侵袭转移途径中的阻断是新的研究方向。