PBL教学法在肿瘤放射治疗教学中的价值

目的 探析以问题为基础（PBL）教学法在肿瘤放射治疗教学中的应用价值。方法 选取2019年8月—2021年8月期间在我院肿瘤放射治疗科参加教学200名的实习生作为研究对象,按计算机分组法将以上人员随机分为试验组和对照组,每组100名,对照组实施传统教学,试验组实施PBL教学,对比两组人员经不同方式教学后的理论考核成绩、技能操作成绩,统计其教学结果的优良率,并对所有参与本次教学调查的实习生进行满意度调查。结果 试验组在PBL教学法下的理论成绩略低于对照组,经对比差异无统计学意义（P> 0.05）;该组人员的技能操作考核成绩高于对照组、教学结果优良率92.00%(92/100)高于对照组82.00%(82/100)、教学满意率95.00%(95/100)高于对照组80.00%(80/100),以上数据经对比差异有统计学意义（P<0.05）。结论 将PBL教学法用于肿瘤放射治疗科的临床教学中可在保证实习生掌握扎实理论知识基础上更好的提升其临床实践能力,此教学方法对保证实习生的教学结果、提高其对的教学方法的满意率均有着重要价值。     

Dermatofibrosarcoma protuberans of the scalp

Dermatofibrosarcoma protuberans is a rare entity. Due to its high propensity for local recurrence, knowledge of the appropriate management, both surgical and medical, is important for optimal patient outcomes.     

NCCN老年肿瘤临床指引(2005.1版)

1 目录 NCCN老年肿瘤专家组成员（附后） 筛选、评估和结果（SAO—1） 特别需要考虑的问题（SAO-2） 特定年龄组患者的期望寿命的上、中、下四分位数分布情况（SAO—A）     

Les antiangiogéniques : limites actuelles en oncologie thoracique

Antiangiogenic agents appear as major therapeutic options in renal, colorectal and breast cancer. Their part in thoracic oncology is still limited today except for bevacizumab. We review the current limits of antiangiogenic agents in terms of efficacy, activity, tolerance and therapeutic strategies. Problems about predictive biomarkers and cost-effectiveness of antiangiogenic agents in thoracic oncology are also mentioned.     

Perioperative Oral Administration of Cystine and Theanine Enhances Recovery After Distal Gastrectomy

Background: It has been reported that cystine and theanine, amino acids related to glutathione synthesis, have immunomodulatory effects, such as suppressing inflammation after strenuous exercise. In this study, we examined the effects of oral administration of cystine and theanine during the perioperative period as a pilot study. Methods: Forty‐three cases of distal gastrectomy for cancer conducted in our department were assigned to the cystine and theanine group (CT group) or to the placebo control group (P group), and a randomized, single‐blind, parallel‐group study was then performed. Cystine (700 mg) and theanine (280 mg) or a placebo was administered to participants for 10 continuous days (4 days before to 5 days after surgery). Changes in pre‐ and postoperative interleukin (IL)–6, C‐reactive protein (CRP), albumin, white blood cell (WBC) count, neutrophil count, total lymphocyte count, resting energy expenditure (REE), and body temperature were compared and examined. Results: Ten patients were excluded, leaving 33 patients in the study. The CT group had significantly lower IL‐6 values (postoperative day [POD] 4), CRP levels (POD 7), neutrophil counts (POD 4), and body temperatures (POD 5) than the P group (P < .05). In addition, REE in the P group peaked on day 1 (1.14 ± 0.16 [pre‐ and postoperative ratio]), whereas the CT group did not show any increase on POD 1 (0.99 ± 0.21, P < .05 vs P group). Conclusions: This study suggests that oral administration of cystine and theanine during the perioperative period may alleviate postgastrectomy inflammation and promote recovery after surgery.     

Whole body MRI: Improved lesion detection and characterization with diffusion weighted techniques

Diffusion‐weighted imaging (DWI) is an established functional imaging technique that interrogates the delicate balance of water movement at the cellular level. Technological advances enable this technique to be applied to whole‐body MRI. Theory, b‐value selection, common artifacts and target to background for optimized viewing will be reviewed for applications in the neck, chest, abdomen, and pelvis. Whole‐body imaging with DWI allows novel applications of MRI to aid in evaluation of conditions such as multiple myeloma, lymphoma, and skeletal metastases, while the quantitative nature of this technique permits evaluation of response to therapy. Persisting signal at high b‐values from restricted hypercellular tissue and viscous fluid also permits applications of DWI beyond oncologic imaging. DWI, when used in conjunction with routine imaging, can assist in detecting hemorrhagic degradation products, infection/abscess, and inflammation in colitis, while aiding with discrimination of free fluid and empyema, while limiting the need for intravenous contrast. DWI in conjunction with routine anatomic images provides a platform to improve lesion detection and characterization with findings rivaling other combined anatomic and functional imaging techniques, with the added benefit of no ionizing radiation. J. Magn. Reson. Imaging 2013;38:253–268. © 2013 Wiley Periodicals, Inc.     

A randomised trial of nursing interventions supporting recovery of the postmastectomy patient

Aims and objectives. This ABC to recovery study evaluated the combined and separate components of preoperative education and the effectiveness of wearing the Papilla Gown. Background. Surgical removal of the breast may lead to activity limitation, self‐image issues, discomfort and later complication of lymphoedema. Design. This study used experimental and longitudinal design. Methods. One hundred and forty‐five women undergoing mastectomies for stages two and three breast cancer were randomised into four groups: education and Papilla Gown, education only, gown only and control. The outcomes of activity (A), body image (B), comfort (C), knowledge and lymphoedema were assessed at baseline and/or 1 week and 6 months using three measures. All 145 participants completed the study questionnaires at first two measures, and forty‐six of these participants completed the questionnaires at 6 months postoperatively. The setting for the study included two clinics and hospitals. To examine statistical significance at each time point after surgery, 2‐way anova s were performed on ABC, knowledge and tape measurement to see whether there were any statistically significant differences between the four groups. All reported p‐values are two sided. All statistical analyses were performed using sas 9.2 for Windows. Results. The mean age of the sample was 55 years. The study revealed that women who received the combined intervention demonstrated greater activity. Women who wore the gown only had a greater comfort level and decreased lymphoedema. Women that received preoperative education experienced increased knowledge. Conclusions. Outcomes suggest that the combined intervention (ABCs to recovery) can improve recovery following mastectomy. Relevance to clinical practice. The results will be used to further modify the intervention and to increase awareness of nurse practitioners and other healthcare professionals of the specific needs of postmastectomy patients.     

Critical Summaries of Innovations in Palliative Care Pharmacotherapy

ABSTRACT

Timely and important studies are reviewed and commentaries provided by leading palliative care clinicians. Symptoms, interventions, and treatment-related adverse events addressed in this issue are: the effect of sorafenib on sarcopenia; defining, classifying, and assessing cancer breakthrough pain; treatment of opioid-dependent human immunodeficiency virus (HIV) patients (clinic-based versus referred treatment); the predictors and course of depression in metastatic cancer patients; and the effectiveness of treatment agreements and urine analysis for reducing opioid misuse in outpatients with chronic noncancer pain.     

妇科腹腔镜手术几种激光对兔子宫壁损伤的实验研究

为掌握妇科腹腔镜手术所应用的激光器的治疗剂量，对几种激光引起的兔子宫壁热损伤进行观察。实验研究证实：所有激光产生的损伤程度与所用的剂量呈正相关。术后４８ｈ与即刻损伤程度相比，半导体激光的损伤程度明显加深、加宽；但ＣＯ２激光和ＮｄＹＡＧ激光接触式光刀无显著变化。说明应用激光行妇科腹腔镜手术治疗时，所产生的损伤与应用的功率密度有关，为临床合理选用腹腔镜下的激光治疗提供依据     

Is surgery necessary for incidentally discovered adrenal masses in children?

Background

There are no guidelines that exist to direct the management of incidental adrenal masses (IAM) in children. The aim of this study was to determine if there is a subset of IAMs that could be safely observed.

Methods

A retrospective analysis was conducted of all adrenal masses that were either resected or biopsied between 1990 and 2002 (n = 91) at the Hospital for Sick Children, Toronto. IAM was defined as a solitary adrenal mass discovered by either physical examination (n = 6; 23.1%) or diagnostic imaging for other indications (n = 20; 76.9%), without metastases or biochemical activity.

Results

Twenty-six (28.6%) IAMs were detected (mean age, 4.6 years [range, antenatal to 17 years]; 11 boys, 15 girls). Pathologic diagnoses included neuroblastoma (n = 7), ganglioneuroma (n = 6), adrenocortical adenoma (n = 4), adrenal cyst/pseudocyst (n = 3), adrenal hemorrhage (n = 3), ganglioneuroblastoma (n = 1), nodular cortical hyperplasia (n = 1), and teratoma (n = 1). Eight masses were malignant (30.8%). Two of the 5 masses discovered on antenatal ultrasound scan were neuroblastoma. In comparing the benign with malignant lesions, there was no significant difference in mean size (4.8 cm v 4.3 cm; P = .57), radiologic characteristics, or mode of presentation. Benign lesions occurred more frequently in older children (mean age, 6.5 years v 1.3 years; P = .03).

Conclusions

Clear guidelines cannot be established to predict benign IAM in children. Given the high proportion of malignant lesions, we recommend that all pediatric IAMs should be resected.