核不均一核糖核蛋白A1在肿瘤发病机制中作用的研究进展

核不均一核糖核蛋白(hnRNP)家族是近年来研究较热的一组核内RNA结合蛋白,它们在许多方面参与肿瘤的发生、发展,其中hnRNP A1是对肿瘤生物学特性影响较大的hnRNP家族成员之一。目前的研究认为,hnRNP A1主要通过调节RNA表达、促进端粒延长、抑制细胞凋亡、促进细胞增殖等机制参与肿瘤的发生、发展。本文就hnRNP A1在肿瘤发病机制中的研究进展作一概述。     

疲劳发生机制研究进展

疲劳的发生是一个复杂的过程,并受到多种因素的影响,如果不能及时消除,可能会发展成一种病理现象。随着新技术的应用,疲劳的研究也取得了突破性进展。单一因素的致疲劳理论,已经逐渐被综合性疲劳理论所替代。现就近年来有关疲劳的理论研究成果以及在实验研究方面取得的新进展予以综述,以期为进一步研究疲劳提供有益的参考。     

EGFR抑制剂耐药机制的研究进展及治疗策略

EGFR是调节细胞内环境稳态的一种酪氨酸激酶,其与配体结合后可影响细胞增殖、凋亡、迁移、存活、血管生成和肿瘤发生等一系列复杂过程,EGFR抑制剂已逐渐应用于临床肿瘤治疗。但随着时间的推移,EGFR抑制剂靶向治疗出现了耐药现象。本文将对EGFR抑制剂的研究现状及耐药机制做一简短的概述,冀希为优化、整合EGFR靶向治疗提供参考。     

Exposure and reorganization: The what and how of effective psychotherapy

Even though the effectiveness of psychotherapy is generally acknowledged, researchers are yet to agree on a plausible explanation for this effectiveness or on possible mechanisms of change that are activated by psychotherapy. To enhance developments in these areas some researchers have called for a focus on treatment principles rather than treatment techniques. In this respect, the technique of exposure is instructive. Despite its common use with anxiety disorders and the successful outcomes it produces, it has only recently been considered as a treatment for other disorders. By focussing on the underlying principles of exposure it is possible to consider exposure as a transdiagnostic component of successful psychotherapies. Understanding exposure from the perspective of Perceptual Control Theory (PCT) enables the identification of a functional, rather than a conceptual or statistical, mechanism of change. Functionally, exposure can be understood as an essential precursor to the internal reorganization that is necessary for the amelioration of psychological distress. PCT suggests a more considered and widespread use of exposure in psychotherapy as a way of improving both the efficiency and the effectiveness of the treatments offered.Despite the proliferation of psychotherapies in recent years there has not been a commensurate growth in our understanding of the effective ingredients of treatment. It seems unlikely that there are multitudes of different mechanisms and processes through which psychological distress is resolved and that each of these different psychotherapies utilises a distinct item from the collection. In fact, the spawning of hundreds of different psychotherapies is perhaps the most telling sign that there may still be much work to do before the important principles of treatment are described and fundamental mechanisms of change are identified. Could a technique as mundane as exposure hold the key to effective psychotherapy? For psychotherapy, is there just one road leading to Rome but a plethora of ways to travel that road?     

A review of hearing voices groups: evidence and mechanisms of change

As a heavily stigmatized group, voice hearers often value the chance to meet others with similar experiences. As a result, Hearing Voices Groups (HVGs) are becoming increasingly common in both inpatient and outpatient settings. Where resources are constrained, HVGs are frequently viewed as a desirable alternative to individual therapy and are often preferred by service users themselves. HVGs often vary in their content and structure, with four common approaches: CBT, skills-training, mindfulness and unstructured support groups. This review evaluates the evidence for HVGs and the mechanisms of change for successful interventions. CBT was the only approach with evidence from well-controlled studies. However, several evidence-based treatments share ‘key ingredients’ which evidence suggests help reduce distress. Successful groups supply a safe context for participants to share experiences, and enable dissemination of strategies for coping with voices as well as considering alternative beliefs about voices. Future research should focus on isolating mechanisms of change and predictors of outcome in order to refine HVG approaches, rather than polarizing them and setting them against one another in efficacy trials.     

Introductory paper: Cardiovascular reactivity at a crossroads: Where are we now?

A key foundation for research into the link between stress and ill-health has been the reactivity hypothesis; cardiovascular reactivity to psychological stressors, if prolonged or exaggerated, can promote the development of cardiovascular disease. This has been extended, such that by implicating stress in the aetiology of heart disease, it is plausible that psychosocial stress correlates can influence disease risk. Effects of several risk factors and stress buffers on reactivity have been investigated, but such research warrants scrutiny. Considerable literature links heightened reactivity to objective cardiovascular outcomes, but the evidence extending the reactivity hypothesis to other health outcomes and correlates of heart disease is less clear. Here, we explore the external, concurrent, internal, and construct validity of theories arising from the reactivity hypothesis. We aim to highlight theoretical and methodological considerations to guide future research, and clarify the contribution of the reactivity hypothesis to explaining the consequences of stress.     

Fracture mechanisms and fracture pattern in men and women aged 50 years and older: a study of a 12-year population-based injury register,Umeå, Sweden

Summary

In a study of a 12-year population-based injury register, Umeå, Sweden, we analyzed the fracture mechanisms and fracture pattern in men and women 50 years and older. Low-energy trauma was responsible for the major and costliest part of the fracture panorama, but the pattern differs between age groups.

Introduction

Osteoporosis-related fracture is a major health problem: the number of hip fractures is expected to double to 2030. While osteoporosis is one of many risk factors, trauma is almost always involved. Therefore, we analyzed injury mechanisms in patients aged over 50.

Methods

We registered injury mechanism, cause, diagnosis in all trauma patients at Umeå University hospital, Sweden. This population-based register (1993–2004) comprises a total of 113,668 injuries (29,189 fractures). Patients ≥50 years contributed to 13,279 fractures.

Results

Low-energy trauma (fall <1 m) caused 53% of all fractures ≥50 years and older. In those over 75 low-energy trauma caused >80%. The seasonal variation of fractures was maximally 25%. With increasing age, proximal fractures became more common, in both upper and lower extremities. Proximal locations predominate in older age groups.

Conclusions

Low-energy trauma was responsible for the largest and costliest part of the fracture panorama. In fact, almost all fractures in middle-aged and old people were caused by low-energy mechanisms; thus, most fractures in these patients have a fragility component, and the contribution of osteoporosis-related fractures is more important than previously thought. A better understanding of injury mechanisms also in low-energy trauma is a prerequisite for preventive interventions.