Antineoplastic Agents ; therapeutic use ; Aromatase Inhibitors ; therapeutic use ; Breast Neoplasms ; drug therapy ; metabolism ; pathology ; Female ; Humans ; Neoadjuvant Therapy ; Neoplasm Staging ; Nitriles ; therapeutic use ; Postmenopause ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Remission Induction ; Triazoles ; therapeutic use

Breast cancer in the elderly seems to be less aggressive than in the younger patients.Older women tend to have more localized disease or locally advanced breast cancer.Older women more frequently have phgsiological changes as well as concurrent disease that planning may limit the choice of therapy.Patient's performance status and tumor's biologic behavior should be considered when primary treatment of breast cancer other than tumor stage at presentation.Surgical operation is one of the major means for the treatment of operable breast cancer.In early breast cancer women who have ER-positive tumor that can be treated with breast conservation,or with sentinel node biopsy followed by breast irradiation and endocrine therapy,or without breast radiation.The patients with locally advanced breast cancer or who have larger,ER-positive tumor,or clinically-positive axillary nodes can be given preoperative endocrine therapy with 3~(rd) generation of aromatase inhibitors to try to convert to limited surgery.Adjuvant chemotherapy can be considered for older women with ER-negative tumor whose risk of systemic recurrence is high and who are in good health.Strict adherence to indications of adjuvant radiotherapy should be carried out for older women with breast cancer.

Face ; Humans ; Reconstructive Surgical Procedures ; methods ; Skin Neoplasms ; surgery ; Skin Transplantation ; methods ; Surgical Flaps

Thyroid nodules are common lesions which are over-treated in Mainland China. This article encourages using standard diagnostic procedures to differentiate malignant nodules from benign nodules especially by ifne needle aspiration (FNA) cytology. The proper treatment should be applied according to different FNA results to avoid overtreatment.

Objective To evaluate the efficacy and safety of three operational strategies for the management of elliptical-like benign skin lesions such as nevus,verrucous nevus,tattoo,cutaneous scar,and so on.Methods Seventy-one patients with elliptical-like benign skin lesions were included in this study,and randomly divided into three groups to be treated by three operational strategies respectively:single spindle-shaped excision and direct suture,one or more times of star-shaped excision within lesions followed by final spindle-shaped excision and suture,one or more times of S-shaped excision within lesions followed by final spindle-shaped excision and suture.The efficacy of operational strategies was evaluated by the ratio of the length of postoperative scar to that of the corresponding preoperative lesion.The clearance capacity was determined by repeated histopathological examination of lesions removed.Results Of the 71 patients,23 were managed by spindle-shaped excision and direct suture with the average ratio of the length of postoperative scar to that of preoperative lesion being 2.34,25 by star-shaped excision and suture with the average ratio being 0.90,and 23 by S-shaped excision and suture with the average ratio being 1.10.No evidence of malignancy was shown by the repeated pathological examination of resected tissues.Conclusions Both star-shaped and S-shaped excision can result in satisfying cosmetic outcomes with favorable clearance capacity in patients with elliptical-like benign skin lesions,but repeated operations are required.

Objective:To investigate the relationship between socioeconomic status (SES) and common mental disorder (CMD).Methods:A random sampling of household telephone numbers was obtained from 1995 residential telephone directories.A subject from each eligible household was selected according to the Kish method.The target population comprised noninstitutionalized Chinese residents in Hong Kong ages 18 to 65 years.A structure question- naire was used to measure some SES characteristics (age,gender,marriage,education,job,family income,house type,and house area),and Self-Reporting Questionnaire (SRQ) was used to evaluate their CMD.Results:A total of 9851 subjects (71.7%) were included in the final analysis.According to the cutoff (≥5) of SRQ,3358 subjects (34.2%) suffered from CMD.Totally,subjects with lower SES had more chances to suffer from CMD.After control- ling confounding factors,stable marriage (OR=0.763,0.697-0.835),higher education (OR=0.766,0.708- 0.830),and larger house (OR=0.906,0.849-0.968) were important factors for reduction of CMD.Conclusion: The mental health of general population is closely linked with SES,especially marriage,education,and house.

As a intersecting subject of history and medicine,history of medicine not only involves every subject of medicine but also relates to social humanities widely.History of medicine plays an important role in education of humanistic quality in higher medical colleges.To promote merging humanistic education and medical education,humanistic quality education permeating through medical education,it is necessary to offer history of medicine in medical colleges.

Humans ; Organ Sparing Treatments ; Parathyroid Glands ; surgery ; Thyroid Gland ; surgery

Humans ; Hypopharyngeal Neoplasms ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps

ObjectiveTo explore the moderating effects of self-efficacy between perfectionism and depression.MethodsUsing a convenient sampling method,a sample of 570 university students completed almost perfect scale-revised ( APS-R),general self-efficacy scale (GSE),beck depression inventory (BDI).ResultsCorrelational analyses indicated maladaptive perfectionism was positively correlated with depression ( r =0.47,P ＜0.01 ),and negatively correlated with self-efficacy ( r =- 0.24,P ＜ 0.01 ).In contrast,adaptive perfectionism was positively correlated with self-efficacy ( r =0.26,P ＜ 0.01 ),and was not correlated with depression ( r =0.05,P ＞ 0.05 ).Hierarchical regression analyses indicated the moderation effects of self-efficacy was significant (β =-0.12,P＜ 0.01 ) in that maladaptive perfectionism has closer relationship with depression when self-efficacy was low,suggesting that self-efficacy enhances the influence of maladaptive perfectionism on depression ( β =0.536,P =0.000 ),whereas high self-efficacy reduces the corresponding influence (β=0.239,P=0.018 ).ConclusionSelf-efficacy moderate the relation between maladaptive perfectionism and depression.