Clinical Effect Observation of Constructing PERMA Model in Psychological Intervention for Patients with Chronic Cancer Pain

Background:The constructing PERMA model in psychological intervention was applied to patients with chronic cancer pain to provide data reference for reducing pain,fear of cancer recurrence,and improving the level of psychological capital.Aim:To explore the clinical effects of constructing PERMA model in psychological intervention for patients with chronic cancer pain.Methods:A total of 98 patients with chronic cancer pain admitted to our hospital from March 2021 to March 2023 were randomly divided into two groups,49 cases in each group.The control group received routine intervention,while the research group constructed PERMA model based on the routine intervention for psychological intervention.The pain severity,fear of cancer recurrence,psychological capital and quality of life before and after intervention were compared between the two groups.Results:After two months of intervention,the pain in the research group was milder than that in the control group(p<0.05).The scores and total scores of all dimensions of fear of cancer recurrence in the research group were lower than those in the control group(p<0.05).The scores and total scores of each dimension of psychological capital in the research group were higher than those in the control group(p<0.05).The scores of all dimensions of quality of life in the research group were higher than those in the control group(p<0.05).Conclusion:The PERMA model constructed in psychological interventions for patients with chronic cancer pain can assist analgesic medications to reduce pain and alleviate the fear of cancer recurrence,increase the level of psychological capital,and thus improve quality of life.

Investigating the Physiological Mechanisms between Resistance Training and Pain Relief in the Cancer Population: A Literature Review

This literature review examines the mechanisms of how exercise, specifically in the form of resistance training, may lead to pain relief in the cancer population. Primary data from three different cancer populations: breast, prostate, and lung, will be examined. A number of experimental studies have been conducted to confirm the effectiveness of resistance training on pain relief as well as the biochemical pathways that relate to this process. In this review, we will examine 5 randomized controlled trials. For the purposes of this review, pain is defined as physical suffering or discomfort associated with illness. Pain is the body’s natural signal, bringing attention to damage that has been sustained by tissues. However, chronic pain is common in the cancer population, and often serves no good purpose but instead will negatively impact both physical and mental health. The three types of pain: nociceptive, neuropathic, and inflammatory pathways have been investigated, and the knowledge of pain mechanisms allows for the understanding of how it is associated with pain. The purpose of this exploratory literature review is to give insight on how to maximize pain-relieving effects of resistance training. Research has indicated that resistance training modulates pain pathways by upregulating the release of pain-relieving substances including beta-endorphins, anti-inflammatory cytokines, and endocannabinoids. Understanding of the benefits of resistance training may be useful in relieving cancer pain, and reproducing effects of pain-relieving strategies while minimizing the symptoms related to cancer and its treatment.

Attitudes towards pain management in hospitalized cancer patients and their influencing factors

Objective： To investigate patients＇ attitudes towards cancer pain management and analyze the factors influencing these attitudes.Methods： The self-developed Demographic and Disease-Related Information Questionnaires, Pain Management Barriers Questionnaire-Taiwan form（BQT）, and Pain Knowledge Questionnaire were administered to 363 pairs of hospitalized cancer patients and their caregivers from the oncology departments of 7 hospitals in Beijing, China.Results： The average patient score for attitudes towards pain management was 2.96±0.49. The dimension scores indicated good attitudes in three areas（scores 〈2.5）, ＂Desire to be good＂（2.22±1.04）, ＂Fatalism＂（2.08±0.81） and＂Religious fatalism＂（1.86±1.00）, and poor attitudes in six areas（scores ≥2.5）, ＂Tolerance＂（3.83±0.96）, ＂Use of analgesics as needed（p.r.n.）＂（3.73±1.01）, ＂Addiction＂（3.44±1.05）, ＂Disease progression＂（3.28±1.26）, ＂Distraction of physicians＂（3.16±1.07） and ＂Side effects＂（2.99±0.68）. Two factors were entered into the regression equation：the caregivers＇ attitudes towards cancer pain management and the patients＇ pain knowledge. These two factors explained 23.2% of the total variance in the patients＇ average scores for their attitudes towards cancer pain management.Conclusions： The patients＇ attitudes towards cancer pain management were poor and could be influenced by the caregivers＇ attitudes and the patients＇ pain knowledge, and thus need to be improved.

Adaptive Modeling of Monthly Depression Levels in Terms of Daily Assessments of Opioid Medications Taken and Pain Levels for Cancer Patients

A research study collected intensive longitudinal data from cancer patients on a daily basis as well as non-intensive longitudinal survey data on a monthly basis. Although the daily data need separate analysis, those data can also be utilized to generate predictors of monthly outcomes. Alternatives for generating daily data predictors of monthly outcomes are addressed in this work. Analyses are reported of depression measured by the Patient Health Questionnaire 8 as the monthly survey outcome. Daily measures include numbers of opioid medications taken, numbers of pain flares, least pain levels, and worst pain levels. Predictors are averages of recent non-missing values for each daily measure recorded on or prior to survey dates for depression values. Weights for recent non-missing values are based on days between measurement of a recent value and a survey date. Five alternative averages are considered: averages with unit weights, averages with reciprocal weights, weighted averages with reciprocal weights, averages with exponential weights, and weighted averages with exponential weights. Adaptive regression methods based on likelihood cross-validation (LCV) scores are used to generate fractional polynomial models for possible nonlinear dependence of depression on each average. For all four daily measures, the best LCV score over averages of all types is generated using the average of recent non-missing values with reciprocal weights. Generated models are nonlinear and monotonic. Results indicate that an appropriate choice would be to assume three recent non-missing values and use the average with reciprocal weights of the first three recent non-missing values.

Effect of hyperthermia combined with opioids on cancer pain control and surgical stress in patients with gastrointestinal cancer

BACKGROUND Surgical palliative surgery is a common method for treating patients with middle and late stage gastrointestinal tumors.However,these patients generally expe-rience high levels of cancer pain,which can in turn stimulate the body’s stress and undermine the effect of external surgery.Although opioid drugs have a signifi-cantly positive effect on controlling cancer pain,they can induce adverse drug reactions and potential damage to the body’s immune function.Hyperthermia therapy produces a thermal effect that shrinks tumor tissues.However,its effect on relieving the pain of middle and late stage gastrointestinal tumors but also the stress of surgical palliative surgery remains unclear.AIM To investigate the effect of hyperthermia combined with opioids on controlling cancer pain in patients with middle and late stage gastrointestinal cancer and evaluate its impact on surgical palliative surgical stress.METHODS This was a retrospective study using the data of 70 patients with middle and late stage gastrointestinal tumors who underwent cancer pain treatment and surgical palliative surgery in the Ninth People’s Hospital of Suzhou,China from January 2021 to June 2024.Patients were grouped according to different cancer pain control regimens before surgical palliative surgery,with n=35 cases in each group,as follows:Patients who solely used opioid drugs to control cancer pain were included in Group S,while patients who received hyperthermia treatment combined with opioid drugs were included in Group L.In both groups,we compared the effectiveness of cancer pain control(pain score,burst pain score,24-hour burst pain frequency,immune function,daily dosage of opioid drugs,and adverse reactions),surgical palliative indicators(surgery time,intraoperative bleeding,stress response),and postoperative recovery time,including first oral feeding time,postoperative hospital stay).RESULTS Analgesic treatment resulted in a significant decrease in the average pain score,burst pain score,and 24-hour burst pain frequency in both Groups L and S;however,these scores were statistically significantly lower in Group L than in Group S group(P<0.001).Analgesic treatment also resulted in significant differences,namely serum CD4+(29.18±5.64 vs 26.05±4.76,P=0.014),CD8+(26.28±3.75 vs 29.23±3.89,P=0.002),CD4+/CD8+(0.97±0.12 vs 0.83±0.17,P<0.001),between Group L and Group S,respectively.The daily dosage of opioid drugs incidence of adverse reactions such as nausea,vomiting,constipation,and difficulty urinating were statistically significantly lower in Group L than those in group S(P<0.05).Furthermore,palliative surgery time and intraoperative blood loss in Group L were slightly lower than those in Group S;however,the difference was not statistically significant(P>0.05).On the first day after surgery,serum cortisol and C-reactive protein levels of patients in group L and group S were 161.43±21.07 vs 179.35±27.86 ug/L(P=0.003)and 10.51±2.05 vs 13.49±2.17 mg/L(P<0.001),respectively.Finally,the first oral feeding time and hospitalization time after surgery in group L were statistically significantly shorter than those in group S(P<0.05).CONCLUSION Our findings showed that hyperthermia combined with opioids is effective in controlling cancer pain in patients with middle and late stage gastrointestinal tumors.Furthermore,this method can reduce the dosage of opioids used and minimize potential adverse drug reactions,reduce the patient’s surgical palliative surgical stress response,and shorten the overall postoperative recovery time required.

Transdermal Fentanyl for Management of Cancer Pain in Elderly Patients in China

Objective: Objective: To assess the effect and adverse effects of transdermal fentanyl for elderly patients with cancer pain in China. Methods: A total of 1664 elderly patients (aged 65-90 with mean age of 72.6) with cancer pain enrolled in the multicenter study from 136 institutes in China. Of them, 408 (28.8%) patients were 75 years old or older. All patients received transdermal fentanyl for the management of cancer pain. The patients were asked to record the attacks of pain, quality of life, and any side effects of the treatment. Results: Baseline mean of pain intensity was 7.34. On day 1, 3, 6, 9 15, and 30, the pain mean scores were decreased to 3.82, 2.80, 2.43, 2.11, 1.83, 1.64 (P=0.000). The effective rate was 97.18%. The mean doses of fentanyl was 31.34 g/h (25-150 g/h) initially, and 40.59 g/h and 47.50 g/h (25-200 g/h) at day 15 and day 30. At treatment day 15, the dose of fentanyl was ranger from 25 to 50 g/h in 91.8% of patients, 75 to 100 g/h in 7.5% patients, and 125 to 200 g/h only in 0.8% patients. The fine quality of life was in 25.4% patients before treatment, and was 71.15% and 73.04% at day 15 and day 30 respectively (P=0.0000). The common side effects were constipation (10.70%), nausea (11.96%), dizzy (6.85%), vomiting (3.85%), sedation (2.40%), Respiratory depression (0.12%). 86.2% patients preferred continue treated by transdermal fentanyl. Conclusions: Transdermal fentanyl for the elderly with cancer pain is effective, safe, convenient, and can improve the quality of life. Transdermal fentanyl can be recommended as a first-line drug for the treatment of elderly patients with moderate to severe cancer pain, and the initial doses is recommended as 25 g/h.

Research Progress of Traditional Chinese Medicine External Treatment for Cancer Pain

Cancer pain,as a common complication in patients with malignant tumors,is regarded as the fifth vital sign.The involvement of traditional Chinese medicine(TCM)in the treatment of malignant tumors has become a distinctive feature of oncology treatment in China.It is also an important component of cancer pain management.TCM analgesic treatments include various methods,such as internal medicine and external therapies.External analgesic therapies,in particular,are significant methods in TCM pain management and offer both local treatment and systemic regulation.These methods are simple,easy to perform,and non-invasive.They can enhance pain relief effects while reducing the difficulty of oral medication intake and avoiding adverse gastrointestinal reactions,providing new perspectives and approaches for cancer pain treatment with broad development prospects.This article provides a review of the external TCM therapies for cancer pain to share with peers in the field.

Cognition and Sociodemographic Determinants for Effective Pain Control in Patients with Cancer Pain: a Cross-sectional Survey in China

This cross-sectional study aimed to investigate cancer patients'cognitive level of pain control and to evaluate the patient-related factors or barriers to effective cancer pain management in China.In seven tertiary hospitals across China,372 patients experiencing cancer pain were surveyed through a self-designed questionnaire to assess the factors associated with effective pain control.Patients'demographic data and pain control-related factors were recorded.Cluster sampling and binary logistic regression models were used to investigate the association between predictive factors and effective pain control.The survey showed that the majority of the patients were more than 45 years old(76.3%),and 64.4%had an average annual income of more than 20000 RMB.One-third of the patients suffered from cancer pain for more than 3 months,and 75.1%received professional guidance during medication.The barriers to pain control for patients included preference to enduring pain and refusing analgesics(62.9%),negligence towards drug usage(28.5%),concerns about the addiction(48.2%)and adverse reaction(56.4%).The average annual family income,pro fessional guidance,knowledge of pain medication,adherence to analgesics,and concerns about addiction to analgesics were significantly correlated to the effect of patients'pain control.The study presents major barriers to optimal pain control among patients with cancer in China.Our findings suggest that educational programs and medical insurance reimbursement support from the government are urgently needed to overcome the cognitive barriers toward effective pain management and to relieve the economic burden among patients with cancer pain in China.

Pain acceptance in cancer patients with chronic pain in Hunan, China:A qualitative study

Objective: The purpose of this qualitative study was to describe the experiences of pain acceptance in Chinese cancer patients with chronic pain.Methods: Twelve hospitalized cancer patients with chronic pain participated in this qualitative descriptive study from August to November 2017.In-person semi-structured interviews were conducted,recorded,transcribed,and analyzed using Colaizzi's seven-step method.Results: The following four main themes and 15 subthemes emerged.Theme 1 (adaptation): pain is overwhelming and pain relief is a top priority,avoidance of pain-inducing factors,and resignation;theme 2 (emotional reactions to pain): feeling misunderstood,hopelessness,frustration,irritability,and concern for loved ones;theme 3 (functional limitations): daily life activities,social communication,and work;theme 4 (coping strategies): pharmacological therapies,behavioral strategies,social support strategies,and spiritual strategies.Conclusions: This study provides a description of cancer patients' experiences related to the need for pain acceptance.These findings provide insight into the essential role of pain acceptance and underline the need to apply acceptance-based cognitive behavioral interventions as adjunctive non-pharmacological alternatives for chronic cancer pain.

Knowledge and Attitudes of Nurses Working at King Abdulaziz University Hospital toward Cancer Pain Management

Objective: This survey aims to identify the levels of knowledge and attitudes among nurses regarding cancer pain management. Methods: This cross-sectional survey was undertaken at King Abdulaziz University Hospital, Jeddah, between September 4 and September 27, 2015. The survey instrument was a pre-set questionnaire comprising 39 closed-ended format questions. Participants were asked questions to assess their knowledge and attitudes about cancer pain management and adherence to frequent misconceptions regarding opioid therapy. The chi-square test was used to compare differences between variables. Results: One hundred twenty-eight questionnaires were completed and analyzed. A mean sample score of 41.3% was achieved on pain-related knowledge questions. The average score on all 39 questions was 16.1 ± 4.6 (range, 0 - 24). Nurses on the male medical ward were most knowledgeable compared with those on other wards (p p p p p = 0.002). Conclusion: Optimization of inpatient supportive procedures should be a specific task at King Abdulaziz University Hospital until an oncology unit with nurses specialized in cancer care is established.

Cancer Pain with Standardized Nursing

Background: The incidence of cancer pain in patients with malignant tumors is relatively high, and pain control is poor, which is closely related to many factors, especially the nursing way. Objective: To explore the effect of standardized nursing model on pain control in patients with malignant tumors. Methods: 50 patients with malignant tumors treated in the Affiliated Hospital of Chengde Medical College from January to December in 2021 were randomly divided into 25 cases in the control group and 25 cases in the observation group. The pain control and medication compliance of the two groups were compared. Results: There was no difference in the corresponding score of admission pain between the two groups (P > 0.05), and the pain score of the observation group was lower than that of the control group (P P Conclusion: Standardized cancer pain nursing can ease the pain of patients, and the medication compliance is better.

Pain and immune function in patients undergoing gastric cancer surgery following stellate ganglion block with total intravenous anesthesia

BACKGROUND Stellate ganglion block is a commonly used sympathetic nerve block technique that restores the balance of the sympathetic and vagal nervous systems of the body and inhibits sympathetic nerve activity.AIM To analyze the effect of a stellate ganglion block combined with total diploma intravenous anesthesia on postoperative pain and immune function in patients undergoing laparoscopic radical gastric cancer(GC)surgery to provide a refe-rence basis for the formulation of anesthesia protocols for radical GC surgery.METHODS This study included 112 patients who underwent laparoscopic radical surgery for GC between January 2022 and March 2024.There was no restriction on sex.The patient grouping method used was a digital random table method,and the num-ber of cases in each group was 56.The control group was administered total intravenous anesthesia,and the observation group compounded the stellate gan-glion block according to the total intravenous anesthesia protocol.Postoperative hemodynamics,pain levels,and immune indices were compared between the groups.RESULTS The heart rate and mean arterial pressure in the observation group after in-tubation were lower than those in the control group(P<0.05).Pain levels were compared between the two groups at 2 hours,12 hours,24 hours,and 48 hours after surgery(P>0.05).The number of CD3+,CD4+,and CD4+/CD8+cells at the end of surgery was higher in the observation group than in the control group,and the number of CD8+cells was lower in the observation group than in the control group(P<0.05).There were no significant differences between the two groups in terms of propofol dosage,awakening time,extubation time,or postoperative adverse reactions(P>0.05).CONCLUSION The application of a stellate ganglion block combined with total intravenous anesthesia had no significant effect on postoperative pain levels in patients undergoing laparoscopic radical GC surgery.However,it can safely reduce the effect of surgery on the immune function of patients and is worth applying in clinical practice.

Quality of Life in Cancer Patients with Pain in Beijing

Objective： To investigate the quality of life （QOL） of cancer pain patients in Beijing, and explore the effect of cancer pain control on patients＇ QOL. Methods： Self-developed demographic questionnaire, numeric rating scale and SF-36 questionnaire were used together among 643 cancer pain patients in 28 Grade 2nd to 3rd general hospitals and 2 Grade 3rd cancer hospitals. Results： The SF-36 eight dimensions scores ranged from 31.75 to 57.22 in these cancer pain patients. The t test and Wilcoxon rank sum test were used to compare the QOL between pain controlled （PC） group and pain uncontrolled （PUC） group, and the results showed that patients in PC group had the higher O, OL scores in 6 areas of SF-36 （P〈0.05）. Binary logistic regression results found that pain management satisfaction scores （P〈0.001）, family average personal monthly income （P=0.029）, current receiving chemotherapy （P=0.009） and cancer stage （P〈0.001） were the predictors to cancer pain controlled results. Conclusion： Cancer patients with pain in Beijing had poor QOL. Pain control will improve the QOL of cancer pain patients.

Awareness that early cancer lump is painless could decrease breast cancer mortality in developing countries

There are several factors which contribute to patients' reporting late to healthcare facility even after detecting the breast lump(patient delay). Amongst these, one of the important factors in low- and middle-income countries is lack of awareness that early cancer lump is painless(ECLIPs). Pain is often taken as a danger sign and absence of pain is often not taken seriously. The studies have shown that up to 98% of women in lowincome countries are unaware that a painless lump could be a warning sign of early breast cancer. This fact is significant because this could be one of the prime reasons for the women having discovered a painless lump in the breast, accidentally or by breast self-examination, presume it to be harmless and don't report early to health care facility. Therefore, creating awareness about ECLIPs could be an effective strategy to reduce mortality due to breast cancer in low- and middle-income countries. Moreover, unlike modifying risk factors which requires long term behavior modification, creating awareness about ECLIPs is easy and cost effective.

Double-blinded, Controlled, Randomized Study of Dihydrocodeine Tartrate vs Codeine Phosphate in Treating Cancer Pain

To compare the effects and adverse reactions of dihydrocodeine tartrate andcodeine phosphate in treating moderate cancer pain. Methods: Sixty-nine cases of cancer patientswith moderate pain were treated with dihydrocodeine tartrate or codeine phosphate respectively bydouble-blind, controlled randomized methods and the effects and adverse reactions were observed.Results: After administration of dihydrocodeine tartrate or codeine phosphate, in treatment group orcontrol group, the total effective rate was 86.6% and 93.6%, and common adverse symptoms includedconstipation (31.3%/12.9%), nausea (18.8%/19.7%), gastric trouble (18.8%/19.7%), skin pruritus(12.5%/10%), vomit (9.3% and 6.5%) with the difference being not significant. Conclusion: Theeffects of dihydrocodeine tartrate in treating moderate cancer pain are similar to codeinephosphate. Both them can be used to treat moderate cancer pain.

A self-management application“painhousekeeper”to control cancer pain:a randomized controlled trial study protocol

Objective:Pain is a prevalent and distressing symptom in patients with cancer which has a significant impact on patients’physical health,psychological well-being,and quality of life(QOL).Deficiency of pain care,inadequate pain communication,and reluctance toward pain medication contribute to the difficulties in improving the situation of patients with cancer pain.Fortunately,the integration of self-management and professional healthcare provides new opportunities for patients with cancer pain.Methods:A two-arm randomized controlled trial will be conducted to assess the effectiveness of self-management application compared with routine care among patients with cancer pain.Based on Orem’s self-care theory and Naylor’s transitional care theory,cancer pain self-management application“Pain-housekeeper”was developed with dual client:patient client and medical client.A total of 120 patients with cancer pain are recruited from two university-affiliated tertiary public hospitals in China.They are randomly assigned to the control group and the intervention group.The patients in the control group get routine care while the patients in the intervention group get routine care and Pain-housekeeper App.The intervention is delivered by registered doctors,nurses,and postgraduate nursing students specialized in pain care.Effect measurements for both groups are carried out with questionnaires at baseline(T0),after 4 weeks(T1)and after 12 weeks(T2).The primary outcomes include pain condition,self-efficacy,and QOL.The secondary outcomes include pain medication adherence,satisfaction,anxiety,and depression.Compliance of data submission,economic evaluation,usage,and clinical data are also considered in the test.Data for the evaluation are gathered continuously during the study period.Discussion:This article provides insight into the effectiveness of a theory-based self-management mobile application intervention delivered to patients with uncontrolled cancer pain.The results are used to help patients to improve cancer pain control,self-efficacy,and QOL.Conclusions:The findings of this article provide evidence to support the implementation of an innovative and easily accessible intervention that enhances health outcomes.

Clinical Trial Protocol: Randomized Controlled Trial of Cancer Pain Monitoring System (CAPAMOS) in Patients with Advanced Cancer

Purpose: This randomized controlled trial (RCT) protocol was designed to evaluate the effectiveness of the Cancer Pain Monitoring System (CAPAMOS), a telenursing system designed to alleviate pain in ambulatory patients with advanced cancer. Methods: The study design involved a randomized controlled trial consisting of an intervention group using CAPAMOS and a control group that received usual care. At the time of enrollment, both groups will be given a questionnaire regarding issues, such as concerns related to cancer pain and self-management of opioid medication. Patients will then receive pain relief education based on the results of the questionnaire. Subjects in the control group will receive a pain diary and pain-relief pamphlet that acts as an educational tool. They could also call the outpatient clinic if they wanted to ask for a nursing consultation. The intervention group will be able to use CAPAMOS to manage their pain and receive video consultation with a telenurse, who is an oncology nursing specialist. Educational tools will be built into CAPAMOS. The study will be conducted for one month. The primary endpoint of this study was to calculate the Japanese Brief Pain Inventory score. The secondary endpoints were to assess the opioid medication self-management, Barriers Questionnaire, Japanese EuroQol 5-dimensions 5-level, and economic evaluation. Assessment items will be evaluated at registration and 2 and 4 weeks after registration. Conclusions: A RCT based on this protocol is expected to validate the efficacy of telenursing using CAPAMOS in patients with advanced cancer and pain.

Statistic analysis of 6891 cancer-paining patients' information from Gansu Province Tumour Hospital,China

Objective： To analyze and gain the interlinking degree of the cancer pain with patients＇ cancer-species, sexuality and age etc. Methods： The information of narcotic drugs used for cancer pain patients in our hospital （Gansu Province Turnout Hospital, China） during 2002-2007 were typed in designed EXCEL form, then counted and analyzed. Results： The total number of cancer pain patients used narcotic drugs during 2002-2007 was 6891 （n = 6891 ）, among them, 4164 （60.44%） were males, and 2727 （39.56%） females. The top-range of cancer-species in those patients was as follows： lung cancer （20.39%）, gastric cancer （14.85%）, esophageal cancer （9.71%）, hysterocarcinoma （6.79%）, liver cancer （6.70%） and breast cancer （6.31%）. Conclusion： （a） The male number of cancer pain patients using narcotic drugs is higher than the female number （1.53：1）. （b） In the cases of lung cancer, gastric cancer, esophageal cancer, liver cancer and kidney cancer, the male numbers are twice more than the female numbers, and the difference between the two groups are significant. （c） Most of the cancer pain patients （over 87%） are over 40 years old.

Effectiveness and safety of acupuncture on cancer pain: a meta-analysis

Objective:The aim of the study was to evaluate the efficacy of acupuncture combined with opiates in the treatment of cancer pain through the meta-analysis system.Methods:China national knowledge infrastructure and VIP Database for Chinese technical periodicals,China Biology Medicine,PubMed,Embase databases were searched from January 2016 to February 8,2020 for the randomized controlled trials on the effects of acupuncture combined with opiates on cancer pain.Meta-analysis of ordered data was performed using Stata-MP64 and Review Manager 5.3 software.Results:A total of 242 Chinese studies and 25 English studies were retrieved.According to the inclusion and exclusion criteria,19 literatures finally were included.The fixed effect model was used to combine the total effect values,and the combined odds ratio(OR)(95%confidence interval(CI))was 2.981(2.384,3.729),suggesting that acupuncture combined with opiates was better than opiates alone in treating cancer pain(Z=9.57,P<0.05);the combination treatment could improve Karnofsky Performance Status score(Z=2.48,P=0.01),decrease Numerical Rating Scale score(Z=2.89,P=0.004);it also could reduce eruption pain frequency(Z=4.32,P<0.0001),improve the effects time(Z=2.51,P=0.01),and extend analgesia duration(Z=4.33,P<0.0001);the combination group also had lower Oxycodone dose than the control group(Z=3.193,P=0.001).At the same time,the incidence of adverse reactions was lower than that of the opiate treatment group alone,with a OR(95%CI)of 0.27(0.19,0.37)and statistical significance,Z=8.06,P<0.05.Conclusion:Acupuncture combined with opioids for cancer pain is superior to opioids alone with a lower incidence of adverse reactions.

Effect of down-regulation of voltage-gated sodium channel Nav1.7 on activation of astrocytes and microglia in DRG in rats with cancer pain

Objective:To evaluate the effect of down-regulation of Nav1.7 on the activation of astrocytes and microglia in DRG of rats with cancer pain,and explore the transmission of the nociceptive information.Methods:Lentiviral vector harboring RNAi sequence targeting the Navl.7 gene was constructed,and Walker 256 breast cancer cell and morphine was injected to build the bone cancer pain model and morphine tolerance model in rats.Lentiviral vector was injected.Rats in each model were divided into 4 groups:model group,PBS group,vehicle group and LV-Nav1.7 group.The expression levels of GFAP and OX42 in dorsal root ganglia(DRG) were measured.Results:After the animal model was built,the level of Navl.7,GFAP and OX42 was improved obviously with the time prolonged,which was statistically significant(P<0.05).The expression level of GFAP and OX42 in the DRG in the LV-Navl.7 group declined obviously compared to the model group,PBS group and vehicle group(P<0.05).Conclusions:Intrathecal injection of Navl.7 shRNA lentiviral vector can reduce the expression of Nav1.7and inhibit the activation of astrocytes and microglia in DRG.The effort is also effective in morphine tolerance bone cancer pain model rats.