10 of Today’s Hottest Jobs]What did we look for? Fields of study with grads—both recent grads within the past five years and those well into their careers—who enjoy an attractive combination of big paychecks and abundant employment opportunities. The undergraduate programs that we ranked can take from two to five years to complete.Take a peek at our list of the ten best college majors for your career.1. Pharmacy and PharmacologyThinkstockUnemployment rate: 3.2%Unemployment rate for recent grads: 5.4%Median salary: $105,000Median salary for recent grads: $51,200Projected job growth for this field, 2010–2020: 25%A pharmacy major can be a bit of an investment, since most states require students to earn a post-grad degree to work as a pharmacist. However, pharmacologists, who don’t necessarily require graduate training, can land jobs right out of college. Public and private labs hire recent grads to research drugs and drug interactions. But whether pharmacy undergrads go on to med school, research or some related field, they can expect to earn big salaries fast. Pharmacists stand to make six figures working in hospitals and stores. Both programs involve pharmacology, toxicology and ethics classes—and promise plenty of jobs when class lets out. Even among recent grads, unemployment is a low 5.4%.2. NursingUnemployment rate: 2.2%Unemployment rate for recent grads: 4.0%Median salary: $60,000Median salary for recent grads: $48,000Projected job growth for this field, 2010–2020: 26%Nursing has always made for a steady, well-paid career, but it's looking especially good as baby-boomers age. Demand for nurses is way up, so unemployment, even among new grads, is down. Nursing majors study a predictable list of health care subjects including anatomy, physiology and biology. While you can score an R.N. certification after two years, nurses with bachelor's degrees generally enjoy better salaries, earning potential and advancement opportunities than their less-educated peers.3. Transportation Sciences and TechnologyThinkstockUnemployment rate: 4.4%Unemployment rate for recent grads: N/AMedian salary: $68,000Median salary for recent grads: $53,100Projected job growth for this field, 2010–2020: 5%Head in the clouds? Hardly a bad thing. Aeronautics and aviation technology majors can expect to earn more than $50,000 right out of school—and as much as $90,000 midway through their careers. Most study engineering, mechanics and aerodynamics and work for airplane manufacturers. Depending on the program, transportation sciences can also include fields such as materials engineering and automotive-technology management.4. Treatment Therapy ProfessionsUnemployment rate: 2.6%Unemployment rate for recent grads: 5.4%Median salary: $62,000Median salary for recent grads: $60,400Projected job growth for this field, 2010–2020: 33%While physical therapists typically need a doctorate degree, respiratory, radiation and recreational therapists make the big bucks on a B.A. alone. Recent grads start off at $60,400, one of the highest salaries on our list. Radiation therapists, for example, stand to make $75,000, the national median for that particular therapy field, after a few years. Treatment therapy programs generally include anatomy and physiology courses, as well as chemistry, physics and pharmacology. Regardless of specialty, most therapists work in hospitals or nursing homes.[More from Kiplinger: 5 Advanced Degrees Still Worth the Debt]5. Chemical EngineeringThinkstockUnemployment rate: 3.8%Unemployment rate for recent grads: 7.5%Median salary: $86,000Median salary for recent grads: $64,500Projected job growth for this field, 2010–2020: 6%Chemical engineering majors make more money out of school than any other major on our list. If that's not enough to send you running for the chem lab, consider the fact that, a few years in, the average chemical engineer will make over $30,000 more than his friends in other fields. The work isn't easy. Chemical engineers study chemistry, physics and biology in school. But after graduation, these engineers stand to enjoy high five-figure salaries in labs and offices and a very low unemployment rate.6. Electrical EngineeringUnemployment rate: 5.0%Unemployment rate for recent grads: 7.3%Median salary: $86,000Median salary for recent grads: $57,000Projected job growth for this field, 2010–2020: 6%Electrical engineering isn't for the faint of heart or the mathematically challenged. But if you can survive four years of differential equations and circuit theory, you're on track to make $57,000 a year at your first job. That’s $20,000 more than the median salary for new grads in the top 100 majors. Long-term job growth is modest, with a 10-year projection below the 14% average for all occupations. Still, consistent demand for qualified electrical engineers keeps unemployment in check. Nearly 300,000 electrical engineers design and test components for manufacturers, engineering firms and power plants across the country.7. Medical TechnologiesThinkstockUnemployment rate: 1.4%Unemployment rate for recent grads: 5.4%Median salary: $58,000Median salary for recent grads: $45,100Projected job growth for this field, 2010–2020: 13%Medical technologists are in serious demand—so serious, in fact, that some hospitals try to tempt recent grads with perks such as sign-on bonuses. In addition to the abundance of employment opportunities, medical-technologies majors can look forward to above-average starting salaries. In school, majors study chemistry, biology and clinical laboratory skills; after graduation, they work in hospitals, doctors’ offices and diagnostic labs analyzing patient samples.8. Construction ServicesUnemployment rate: 5.4%Unemployment rate for recent grads: N/AMedian salary: $65,000Median salary for recent grads: $50,200Projected job growth for this field, 2010–2020: 17%Construction services may seem an odd choice in a down economy, when building projects can grind to a halt. Still, there's enough demand for general contractors and construction managers to keep unemployment at a tidy 5.4%. Construction-services majors study project scheduling and construction law and go on to oversee projects ranging from office buildings to power plants. The workplace isn't as glamorous as a swanky office, but new construction services grads make more money than new grads in finance, general engineering and pre-law.[More from Kiplinger: SPECIAL REPORT: New Grad’s Guide to Financial Success]9. Management Information SystemsThinkstockUnemployment rate: 4.2%Unemployment rate for recent grads: 7.4%Median salary: $71,000Median salary for recent grads: $51,000Projected job growth for this field, 2010–2020: 18%Not all computer majors are created equal, contrary to rumor and admissions-office hype. Computer-networking majors, for instance, see 8.2% unemployment and a $37,300 salary upon graduation. But management information systems majors can expect high starting salaries right out of school, and strong job and salary growth after that. The major prepares students to work in IT for big organizations—helping clueless technophobes fix their e-mail, sure, but also building, securing and maintaining a network for an entire company.10. Medical Assisting ServicesUnemployment rate: 2.9% (Average for all grads with a bachelor’s degree: 4.9%)Unemployment rate for recent grads: 5.4% (Average for top 100 majors: 7.7%)Median salary: $51,000 (Median for all grads with bachelor’s: $54,756)Median salary for recent grads: $43,000 (Median for top 100 majors: $37,000)Projected job growth for this field, 2010–2020: 31% (Average: 14%)If you don't mind following doctors' orders, medical assisting is a pretty sweet deal. The average medical assistant with a two-year associate’s degree will enjoy far better job prospects than most grads and earn nearly as much money as a young B.A.-holder. Medical-assisting majors study office administration and basic clinical skills, such as transcription, coding and lab procedures. They generally work in doctors’ offices, taking patient history, performing basic tests, and tracking insurance and other paperwork as needed.

使癌癥診治個體化，研究全球化2010年09月17日 來源： 中國醫(yī)學(xué)論壇報 作者： 金晶 關(guān)鍵詞： CSCO2010;個體化 ——訪大會開幕式致詞外賓、ASCO董事會和基金會主席MartinJ.Murphy教授 □《中國醫(yī)學(xué)論壇報》記者金晶 馬丁·默菲（MartinJ.Murphy）教授，《腫瘤學(xué)家》（TheOncologist）、《干細(xì)胞》（StemCell）雜志創(chuàng)始編委，希普爾（Hipple）癌癥研究中心創(chuàng)始人，美國國立衛(wèi)生研究院（NIH）基金會主席、美國臨床腫瘤學(xué)會（ASCO）董事會和基金會主席。作為唯一一位在本次CSCO年會開幕式上致詞的外國專家，Murphy教授接受了本報記者的專訪。 《論壇報》：在如今的腫瘤治療領(lǐng)域，靶點治療可謂是炙手可熱，您對靶向治療的看法如何？在這種熱度之下，您是否認(rèn)為我們的患者正處于被過度治療的狀態(tài)？ Murphy教授：要回答這些問題，首先要談?wù)勗谖铱磥?，靶向治療指的是什么? 多年以來，針對癌癥的治療策略基本上是根據(jù)腫瘤的類型來設(shè)計的，也就是說，對于乳腺癌，應(yīng)用針對乳腺的藥物，對于胃癌，應(yīng)用多種藥物組成的聯(lián)合方案，人們期待這些藥物對腫瘤產(chǎn)生一定作用。 之后，情況發(fā)生了改變，我們探索到了分子傳導(dǎo)通路的存在，并慢慢了解到在細(xì)胞內(nèi)，分子們通過傳導(dǎo)通路相互聯(lián)系，然后我們便想到通過靶向一條特定的分子通路、對其進(jìn)行干預(yù)，或許能夠治療的就不再僅限于某一特定器官的腫瘤，而是具有這條分子通路的所有腫瘤，也就是說不同的腫瘤可能擁有相同的分子通路，如果能識別出這些靶點，就可以針鋒相對地設(shè)計出一些分子藥物進(jìn)行干預(yù)——這就是在靶點治療背后的理論，自從第一種靶向藥物伊馬替尼出現(xiàn)之后，現(xiàn)在有越來越多的靶向藥物涌現(xiàn)出來。 至于我們的患者是否被過度治療，我想這個問題我還回答不了，因為我不了解中國的治療模式。但你提到，靶向治療現(xiàn)在非?；?，我認(rèn)為更重要的一點應(yīng)該是，選擇合適的時機，針對合適的患者應(yīng)用合適劑量的適合藥物進(jìn)行治療。如果針對某一靶點的治療不再有用，就應(yīng)該尋找其他合適的靶點或合適的治療手段。無論是傳統(tǒng)化療、免疫治療或是靶向治療，都可以是最適合的治療，但必須是在經(jīng)過深思熟慮后應(yīng)用，并且要確保用必盡其能。 《論壇報》：您認(rèn)為癌癥的診斷和治療有何前景？ Murphy教授：這個問題包含了兩個非常重要的方面，一是癌癥診斷，一是癌癥治療，這兩個方面需要被非常小心的聯(lián)系起來。讓我們以乳腺癌為例，來具體談一談。 對于乳腺癌，曾經(jīng)的診斷依據(jù)是在乳腺部位發(fā)現(xiàn)腫瘤占位性病變，隨后用手術(shù)最大程度地切除腫瘤病灶和組織，再應(yīng)用輔助放化療對付殘留病灶。而現(xiàn)在我們知道，腫瘤中存在一些特異性靶點，這是需要我們識別出來的，所以現(xiàn)在下一個診斷必須更加準(zhǔn)確，不僅需要明確腫瘤類型，還需明確分子類型。在作出正確和明確的診斷之后，結(jié)合分子缺陷，選擇應(yīng)用最恰當(dāng)?shù)幕熕幬?、免疫治療藥物和靶向治療藥物或藥物?lián)合方案，從分子水平抑制腫瘤進(jìn)一步發(fā)展。 更進(jìn)一步說，依然以乳腺癌為例，通過了解患者的雌激素受體（ER）、孕激素受體（PR）和人表皮生長因子受體2（HER2）狀態(tài)，我們發(fā)現(xiàn)了一類侵襲性很強、惡性程度很高的乳腺癌，即對大多數(shù)常規(guī)治療無反應(yīng)的三陰性乳腺癌（ER、PR和HER2均為陰性），當(dāng)我們能從分子水平對此作出診斷時，我們便找到了這類乳腺癌為何如此難治的可能原因之一，隨之開發(fā)出一些新藥，例如，多聚二磷酸腺苷核糖聚合酶（PARP）抑制劑，我們從Ⅱ期臨床試驗中發(fā)現(xiàn)，PARP抑制劑與化療藥物聯(lián)合治療可使三陰性乳腺癌患者達(dá)到長期緩解，生存期得以顯著延長，現(xiàn)在正進(jìn)行一些Ⅲ期臨床試驗以驗證Ⅱ期研究的結(jié)果?？梢姡贫ㄓ行У闹委煼桨副仨毥⒃谀茏鞒龈泳珳?zhǔn)、從分子水平可解釋的診斷基礎(chǔ)上。我相信，我也希望，將來的癌癥診斷能從分子水平明確定音，這也是使癌癥治療個體化的體現(xiàn)，不是針對乳腺癌的個體化，而是針對乳腺癌患者的個體化。 《論壇報》：您對于癌癥預(yù)防有何看法？ Murphy教授：每個人都有責(zé)任使自己免于罹患癌癥，他們應(yīng)該認(rèn)識到，通過改變自己的生活方式，是可以預(yù)防癌癥發(fā)生的。 3周之前，我到中國的深圳參加了國際抗癌聯(lián)盟（UICC）舉辦的世界抗癌領(lǐng)袖峰會。在會上，中國衛(wèi)生部部長陳竺公布了一些有關(guān)中國吸煙人口的數(shù)據(jù)，我們看到，若將吸煙者和“吸二手煙者”統(tǒng)計在內(nèi)，每天有超過十億的中國人將自己暴露在癌癥風(fēng)險之中，這里的風(fēng)險不僅僅是肺癌風(fēng)險，而是任何與煙草相關(guān)的癌癥風(fēng)險。 這就給了我們一條很強烈的信息：對于癌癥，最好的治療是預(yù)防。當(dāng)然，我并不是說良好的生活方式可以避免癌癥發(fā)生，但至少可以大大降低癌癥患病危險，減輕自己、家人和社會的負(fù)擔(dān)。我、你，我們每一個人都有責(zé)任將這個信息和概念傳播開去。 《論壇報》：您認(rèn)為，在全球抗癌大業(yè)中，中國應(yīng)該或已經(jīng)作出了怎樣的貢獻(xiàn)？ Murphy教授：這是一個很好的問題。我第一次到中國是1978年，可說與中國有著深厚的淵源。今年，由于第13屆中國抗癌協(xié)會臨床腫瘤學(xué)協(xié)作專業(yè)委員會（CSCO）學(xué)術(shù)年會的召開，我又回到中國，這是我第22次到中國，而我已經(jīng)不準(zhǔn)備再去計算我會是第幾次來中國，因為我把這里當(dāng)成了我的第二故鄉(xiāng)。 在我來往中國的這些年間，我見證了中國科學(xué)家們創(chuàng)造出的一個又一個了不起的成績，無一不在顯示著他們在探索、發(fā)展和傳遞科學(xué)方面的能力。在這期間，我看到他們與國內(nèi)、國外不同機構(gòu)間的合作越來越多、越來越緊密，合作的領(lǐng)域涵蓋了生命科學(xué)、制藥和生物技術(shù)領(lǐng)域。我想，中國的腫瘤學(xué)家們一定也對而今越來越廣泛的全球多中心合作有了深刻的認(rèn)識，我也深信，一些關(guān)于癌癥的新發(fā)現(xiàn)、新治療手段和方法正在從中國的實驗室、醫(yī)院、醫(yī)學(xué)院和大的醫(yī)學(xué)中心中萌生出來，中國正以一種持續(xù)的、越來越快的步伐來進(jìn)行這種知識和手段的更新。以我自己為例，我在1個月內(nèi)到中國2次參加會議，難道你不認(rèn)為這就是對以上所說快速發(fā)展的一個最好體現(xiàn)嗎？再沒有什么比這更讓我感到興奮、滿懷熱情和感激了。在此，我要感謝我的中國朋友們，他們總是伸出熱情的雙手，不僅是歡迎我回家，更是歡迎我與他們合作，給我以莫大的支持，我希望他們也能同我一樣興奮和激情洋溢。同時，我也要感謝你們報紙，給我這樣一個機會來闡述這些如此重要的問題，我們需要像你們一樣的媒體來向人們傳達(dá)這些信息，幫助他們了解并且避免癌癥發(fā)病風(fēng)險，以此降低癌癥發(fā)病率，感謝你們?yōu)榇怂龅墓ぷ?。摘自醫(yī)學(xué)論壇報

內(nèi)外科共話AJCC胃癌新分期http://www.cmt.com.cn/xshy/zl/csco2010/expertsview/201009/t20100926_266219.html內(nèi)外科共話AJCC胃癌新分期2010年09月26日 來源： 中國醫(yī)學(xué)論壇報 作者： 廖莉莉 關(guān)鍵詞： 胃癌;內(nèi)科;外科;分期 □《中國醫(yī)學(xué)論壇報》記者廖莉莉 在今年的CSCO年會上，有這么一群醫(yī)生，他們自己從論壇選題到組織細(xì)節(jié)無不親歷親為，目的就是為了給大家?guī)硪粓鰟e開生面的“CSCO青年專家論壇”，以展現(xiàn)我國當(dāng)代青年腫瘤醫(yī)師的風(fēng)采。他們，就是CSCO青年沙龍的諸位學(xué)子。在這些活躍在當(dāng)今腫瘤界的青年學(xué)者的精心準(zhǔn)備下，一場圍繞大腸癌肝轉(zhuǎn)移治療、美國癌癥聯(lián)合委員會（AJCC）胃癌更新熱點及乳腺癌治療的討論就此展開?，F(xiàn)擷取部分內(nèi)容，整理如下。 北京腫瘤醫(yī)院消化腫瘤內(nèi)科張小田就AJCC胃癌分期提出了幾點意見。 1.關(guān)于T3、T4a和漿膜層 對于內(nèi)科醫(yī)師來說，最新版（第7版）國際抗癌聯(lián)盟（UICC）/AJCC公布的TNM分期中，漿膜下層（Subserosa，SS）可能算是一個新鮮“面孔”。SS是指腫瘤浸潤至漿膜下結(jié)締組織且并未侵犯臨近結(jié)構(gòu)或漿膜（臟層腹膜）。而大家平時在病理報告中常見的一些描述，如侵及漿膜、侵達(dá)漿膜、侵及全層、侵及全層達(dá)漿膜外脂肪組織、侵透漿膜等，其實都是屬于新版分期中的T4a期，即侵犯或穿透漿膜。 2.活檢淋巴結(jié)數(shù)目對N分期判斷的影響 活檢淋巴結(jié)數(shù)目太少是否可以被定義為pN0?新版指南指出，無論切除或檢查的淋巴結(jié)數(shù)目多少，只要為陰性，即為pN0。因此，病理分期N0≠臨床分期N0，在診斷時的“N0”期患者，治療時可能不一定真的能作為“N0”來對待。 3.難以恰當(dāng)分期時的處理 為了準(zhǔn)確判定腫瘤分期，內(nèi)科醫(yī)生要學(xué)會讀手術(shù)記錄和病理報告。例如，須判斷術(shù)式及淋巴結(jié)清掃是否足夠。但是，當(dāng)術(shù)中描述與術(shù)后病理報告不相符時，該如何處理？AJCC分期明確指出，如果TNM不能恰當(dāng)定義，應(yīng)按照較低分期來定義，以符合整個AJCC分期原則。雖然找不到這句話的明確根據(jù)，但我們更愿意理解為，應(yīng)以一個更加積極的態(tài)度去治療我們的患者。 4.新版分期的臨床意義 將T1期細(xì)分為T1a及T1b，為早期胃癌是否應(yīng)進(jìn)行內(nèi)鏡下治療提供了明確的適應(yīng)證。而將N分期細(xì)分、將Ⅳ期劃分為M0和M1也較合理，原Ⅳ期M0分至ⅡB～ⅢC。但在我國現(xiàn)階段D2根治術(shù)不能做到100%完成的情況下，ⅢA、ⅢB、ⅢC分期是否合理？雖然對單純卵巢轉(zhuǎn)移、單純肝轉(zhuǎn)移、腹水細(xì)胞學(xué)陽性等胃癌較為特殊的轉(zhuǎn)移模式難于進(jìn)行病理分期，但臨床上卻有其獨特的治療方式。 北京腫瘤醫(yī)院普通外科李子禹對新舊版AJCC胃癌分期進(jìn)行了對比。 1.T分期的變化 與第6版UICC/AJCC分期相比，第7版分期中T分期的變化見表1和圖1。 2.N分期的變化 與第6版相比，第7版分期中N分期的變化見表2。 3.M分期的變化 與第6版相比，第7版分期中M分期變化不大，只是取消了Mx的定義（遠(yuǎn)處轉(zhuǎn)移無法評估）。