目的:本研究旨在综述网络认知行为疗法(ICBT)在青少年焦虑和抑郁症患者中的应用及效果,以期为ICBT在国内的推广提供理论依据。方法:通过检索相关文献,分析ICBT在青少年焦虑和抑郁症中的应用现状、疗效和优势,重点关注自助式ICBT、治疗师有限支持的ICBT和混合式ICBT三种干预模式的特点与挑战。结果:文献分析表明,ICBT能够有效减少青少年的焦虑和抑郁症状,尤其在提高心理健康服务的可及性、降低社会污名化以及提供个性化支持方面展现了优势。然而,依从性差、长期效果不明确以及文化适应性问题仍需进一步研究和优化。结论:ICBT作为青少年焦虑抑郁症的有效干预手段,具有广泛的应用潜力。未来需要通过优化ICBT平台设计、加强专业人员培训及提升患者参与度等策略,进一步提升ICBT的应用效果,并推动其在青少年群体中的广泛应用。Objective: This study aims to review the application and efficacy of Internet-Based Cognitive Behavioral Therapy (ICBT) in adolescents with anxiety and depression, providing theoretical support for its wider use in China. Methods: A literature review was conducted to analyze the current state, efficacy, and advantages of ICBT for adolescent anxiety and depression. The focus was placed on three intervention models: self-guided ICBT, therapist-supported ICBT, and blended ICBT, highlighting their characteristics and challenges. Results: The analysis revealed that ICBT effectively reduces anxiety and depression symptoms in adolescents. It offers advantages such as improving access to mental health services, reducing social stigma, and providing personalized support. However, challenges remain regarding poor adherence, unclear long-term outcomes, and cultural adaptation, which require further study and optimization. Conclusion: ICBT is an effective intervention for adolescent anxiety and depression with significant potential for broader application. Future efforts
目的探讨腹腔镜下射频消融术(LRFA)在肝癌患者中的临床应用价值及其对血清血管内皮生长因子(VEGF)和基质金属蛋白酶-2(MMP-2)的影响。方法收集2012年1月-2013年12月该院收治的晚期原发性肝癌患者120例,将患者随机分为LRFA组和对照组。LRFA组患者采用LRFA治疗后,继续采用FOLFOX4方案化疗;对照组仅采用PIAF方案化疗。主要观察指标为健康相关生存质量(HRQL)、实体瘤疗效评价(RECIST)等级、无进展生存期和2年死亡率;次要观察指标为血清VEGF和MMP-2水平。结果与对照组相比,LRFA组患者病情进展率明显降低(28.33%vs 50.00%,P=0.015);无进展生存期明显延长(500 d vs 380 d,P=0.013);临床干预后6个月时HRQL明显增高[(80.33±5.84)vs(65.87±9.59),P=0.000];临床干预后7、14和28天以及6个月时VEGF明显降低(P值均为0.000);临床干预后14和28天以及6个月时MMP-2明显降低(P值分别为0.003、0.001和0.000)。结论 LRFA明显改善了肝癌患者临床预后,并显著降低患者VEGF、MMP-2水平。
