The purpose of this study was to explore dimensions of quality of life (QOL) perceived by Chinese Americans with disabilities with reference to improve vocational rehabilitation services to this group. Forty-three Chinese Americans/immigrants with physical disabilities participated in the study. A focus group technique was used to collect data. The participants identified the following nine dimensions of QOL: (1) contributing to society; (2) self-reliance; (3) enjoying the same rights as others; (4) not having to worry about food, clothing, housing, and transportation; (5) physical health; (6) emotional health; (7) relationships; (8) individual safety; and (9) stability and prosperity of the nation. Participants also defined six problems that prevented them from living a good life. Implications of the results for rehabilitation counselors and researchers are discussed in light of the impact of Chinese culture and immigration on the QOL of Chinese Americans/immigrants with disabilities.
8090%. The identification of gene mutation profile of non-small cell cancer allows to make a molecular portrait, which plays the crucial role in choosing the targeted therapy with tyrosine kinase inhibitors. The aimis to study the frequency and spectrum of activating mutations in non-small cell lung cancer in Tambov region. The study of the presence of mutations and the main driver gene mutation profile: EGFR, ALK, BRAF, ROS1 and PDL-1 using sections of paraffin-embedded after the surgery and biopsy in 238 patients with the help of polymerase chain reaction and immunohistochemistry. The age of patients ranged from 28 years to 82 years, with a mean age of 60.3 years. Results.Adenocarcinoma was detected in 80.3% of patients, and squamous cell variant in 19.7% of cases. The frequency of the driver gene activating mutations in non-small cell lung cancer was 29%, this index exceeded the frequency in the European population. Statistically significant predominance of female (63.6%) vs male (36.4%) was achieved. The mutation frequency increases with age. In this case, EGFR mutations were observed more often 22.3%. This index was slightly higher than in the European population. Statistically significant predominance of female was achieved. The highest frequency of mutations was demonstrated in patients 6570 years of age (24%). The deletion of exon 19 and single-nucleotide replacement L858R of exon 21 were observed in 54.5% and 45.5% of cases, respectively. The mutation of exon 19 was more often detected in male, at the same time the mutations of exons 19 and 21 in female were detected in almost the same frequency. Maximum frequency mutation rate (77.7%) in the EGFR gene was detected free from metastases to the regional lymph nodes. ALK mutations were found in 14.6% of patients, this index was slightly higher than the European level. PDL-1 expression is found in 40% male patients. Conclusion.The results of the study revealed some features of the profile of activating mutations in non-small cell lung cancer in the region. This data should be taken into account on planning and applying targeted therapy.
Key words: thyroid gland, metastases, renal cell carcinomaВведение Рак почки составляет 3,9 % от общего числа онко-логической патологии [1] и 90 % всех злокачественных новообразований почки [2]. Пик заболеваемости при-ходится на 50-60 лет. У мужчин рак почки развивается чаще, чем у женщин (соответственно 4,7 и 3,3 %, или 7-е и 9-е места [1,3]).Метастатическое поражение щитовидной железы является редким случаем, хотя эта железа после надпо-чечников наиболее васкуляризирована [4][5][6][7][8]. В лите-ратуре этот факт объясняют, ссылаясь на гипотезу R. Willis (1931), согласно которой быстрый ток крови через щитовидную железу препятствует прилипанию опухолевых клеток и, кроме того, высокое содержание кислорода и йода тормозит развитие злокачественных клеток [9].Так, H. Chen и соавт. (1999) при ретроспективном исследовании выявили за 8 лет только 10 случаев ме-тастатического поражения щитовидной железы в 1 уч-реждении [10]. K. Kobayashi и соавт. (2015) 15 лет на-блюдали 10 пациентов с метастатическим раком щитовидной железы при почечно-клеточном раке [11]. В клинике Мейо за период в 55 лет выявлено 14 паци-ентов с аналогичной патологией [12].О метастатическом поражении щитовидной желе-зы сообщается в 1,4-3 % случаев среди всех операций на этом органе [13][14][15][16][17][18]. Причем среди всех злокаче-ственных новообразований чаще всего метастазируют опухоли почки (48,1 %), колоректальный рак (10,4 %), рак легких (8,3 %), рак молочной железы (7,8 %), ме-ланома (4 %) и саркома (4 %) [17,[19][20][21]. Но по ре-зультатам вскрытий частота метастазирования коле-
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