Neurolytic celiac plexus block (NCPB) is an effective method used to alleviate upper abdominal pain or back pain caused by pancreatic cancer and other malignancies. NCPB can relieve cancer pain to improve the quality of life and cause fewer side effects than conventional analgesic drugs. This article systemically reviewed NCPB methodology and research progress in clinical appli-cations.

To study the general characteristics of cancer pain and to improve cancer pain diagnosis and treatment lev-el by prospective and open cross-sectional assessment of the clinical characteristics of patients with moderate to severe cancer pain. Methods:Patients with moderate to severe cancer pain were observed upon initial admission to the hospital from December 2012 to De-cember 2013. We assessed pain intensity, location, characteristics, and predisposing and mitigating factors and classified the pain by pathophysiology. Results:A total of 310 patients with moderate (101 cases, 32.58%) and severe (209 cases, 67.42%) pains were as-sessed. The top five cancers identified were lung cancer (102 cases, 32.90%), colorectal cancer (30 cases, 9.68%), pancreatic cancer (27 cases, 8.71%), breast cancer (24 cases, 7.74%), and gastric cancer (20 cases, 6.54%). These patients reported 533 cancer pain locations, including waist (132 cases), abdominal (125 cases), chest (88 cases), lower limb (71 cases), shoulder, neck, and upper limb (47 cases), pelvis (33 cases), perineal area (23 cases), and head and face (14 cases). The pain location of the pancreatic cancer was 90.63%consis-tent with the primary tumor site. The pathophysiology of the pain was classified as follows:bone pain (145 cases, 27.20%), visceral pain (138 cases, 25.89%), soft tissue pain (126 cases, 23.64%), and neuropathic pain (124 cases, 23.27%). The incidence of visceral pain in pancreatic cancer was 92.59%. Conclusion:A variety of common malignancies could cause moderate to severe pain, especially lung cancer. The clinical manifestation of pancreatic cancer pain is visceral pain. The location of this cancer was consistent with the pri-mary tumor site. No apparent specificity was observed in other cancer types.

Adjuvant analgesics refer to a group of drugs that are used not only to treat certain diseases but also to induce analge-sia. Such drugs demonstrate different mechanisms based on the complexity of cancer pain. Thus, opioids, nonsteroidal drugs, and adju-vant analgesics are often combined to control cancer pain. According to the WHO three-step analgesic ladder, adjuvant analgesics can be used at any cancer stage, and the usage of these drugs combined with opioids can reduce the required dosages of these pain relievers, thereby alleviating the adverse reactions associated with opioid use. Moreover, these drugs are particularly suitable for neuropathic pain patients who are not fully sensitive to opioids. The commonly used adjuvant analgesics include antidepressants, anticonvulsants, local administration drugs, corticosteroids, and N-methyl-D-aspartate (NMDA) receptor antagonists. Various adjuvant analgesics also differ in usage and dosage based on primary disease treatment. Therefore, clinical doctors should determine the adverse reactions, proper dos-age, and subsequent amount of dosage to be added in a few days or weeks to achieve balance between the desired effect and adverse re-actions.

Cancer pain can seriously disturb patients′quality of life.Intractable cancer pain not ame-nable to standard analgesics is a horrifying truth in parts of the patients.Interventional pain management tech-niques can be an effective alternative for those patients.Based on the evidence of evidence-based medicine, celiac plexus block or splanchnic nerve block are recommended for the management of upper abdominal cancer pain,pelvic cancer pain can be managed with superior hypogastric plexus block,and back pain due to vertebral compression fractures with tumor invasion can be managed with percutaneous vertebroplasty or kyphoplasty. Intercostal nerve block for chest wall cancer pain,ganglion impar block and saddle block for perineal pain due to pelvic tumors should be used only in the context of an experimental study or in cases of compassionate use with no other available forms of effective pain relief.

Objective:To compare efficacy of percutaneous vertebroplasty (PVP) with radiotherapy and radiotherapy alone for bone me-tastasis pain. Methods:A total of 247 bone metastasis patients with pain were analyzed. The radiotherapy group comprised 158 cases, whereas the combination group comprised 89 cases. We mainly observed the effect of pain treatment, behavioral states, and im-proved emotional condition. The side effects and complications were also investigated. Daily medicine consumption of background pain treatment was observed between the two groups. Analysis was done by SPSS 17.0 statistical software. Numerical variables were analyzed using t test and comparisons between groups used chi-square test. Results:The VAS scores of radiotherapy group decreased from 8.12±1.45 to 3.06±1.68 after treatment (P<0.05), and combination group VAS scores from 8.46±1.73 to 2.45±1.47 (P<0.05). The time to pain relief following PVP and radiotherapy were 1.63±0.81 and 8.56±2.87 days, respectively (P<0.001). The breakthrough pain frequency was 4.56 ± 1.98 times/day, which decreased to 1.57 ± 0.98 times/day after PVP (P<0.05). By contrast, the breakthrough pain frequency was 4.73±2.24 times/day before treatment, which decreased to 3.56±1.56 times/day after radiotherapy. No serious compli-cations were observed in the two groups. The depression and anxiety mood in the combination group improved after treatment. Daily medicine consumption in radiotherapy group increased after therapy. However, daily medicine consumption in combination group was reduced after therapy. Conclusion:PVP with radiotherapy can effectively relieve bone metastasis pain and improve patients' quality of life and it is worthy of promotion in clinical practice.

Neuropathic cancer pain (NCP) arises from physical or chemical damage to peripheral or central neurons or in the neural conduction system.The mechanisms of NCP include pain directly related to tumor involvement,pain associated with chemotherapy,radiotherapy and surgery,neuropathic syndromes associated with paraneoplastic syndromes,inflammation and other factors.A detailed history and careful physical examination are important means of diagnosis of NCP.The clinical evaluation of NCP should use standardized pain assessment scale.Till now,the treatments of NCP include opioid combined with auxiliary analgesic drugs,interventional treatment and gene treatment.Deciding treatment strategies according to the pathogenesis of NCP,multidisciplinary collaboration,combined therapy with different analgesic drugs and technologies are the therapeutic directions for NCP.

Objective To investigate the relationship between the expression of vascular endothelial growth factor C (VEGF-C) and vascular endothelial growth factor receptor-3 (VEGF-R3) in peripheral blood of patients with lung cancer and the pathological characteristics, and to assess the ability to evaluate lymphatic and distant metastasis of the two marks.Methods VEGF-C and VEGF-R3 were detected by enzyme-linked immunosorbent assay (ELISA) in 124 patients with lung cancer and 30 normal controls, and used to analyze the relationship with the pathological characteristics of lung cancer.Results The serum levels [M(QR)] of VEGF-C and VEGF-R3 in patients with lung cancer were 283.57 (120.70) pg/ml and 62.72 (43.02) ng/ml, significantly higher than the control whose VEGF-C and VEGF-R3 were 234.62 (129.20) ng/ml and 43.08 (17.07) pg/ml, respectively (Z=-2.840, P=0.005;Z=-3.834, P<0.001).No correlation was found between the expression of VEGF-C and age, sex, primary tumor site, T stage (Z=-0.949, P=0.343;Z=-0.454, P=0.649;Z=-1.168, P=0.243;Z=-1.694, P=0.090).But the expression of VEGF-C was significantly related with pathologic type, N stage and M stage (χ2=8.829, P=0.012;χ2=27.148, P<0.001;Z=-2.221, P=0.026).However, the expression of VEGF-R3 was not correlated with age, sex, the site of the primary lesion, pathological type and T, N, M stage (Z=-0.558, P=0.577;Z=-0.599, P=0.549;Z=-0.703, P=0.482;χ2=1.166, P=0.558;Z=-0.680, P=0.496;χ2=0.353, P=0.950;Z=-1.523, P=0.128).Conclusion The expressions of VEGF-C and VEGF-R3 in patients with lung cancer are higher than those in normal control, and the expression of VEGF-C is related with patho-logic type, N stage and M stage.The detection of VEGF-C in peripheral blood of lung cancer is expected to be an assistant marker for the evaluation of lymph node metastasis and blood metastasis, but VEGF-R3 does not show its value.

Objective:To investigate the safety and reliability of endoscopic mucosal resection (EMR) in the treatment of gastrointestinal neuroendocrine tumors (GI-NETs) with a diameter of ≤10mm.Methods:From February 2015 to June 2019, 40 cases of gastrointestinal neuroendocrine tumors with a diameter of ≤10mm underwent EMR in Yantaishan Hospital of Yantai City were retrospectively analyzed to evaluate the safety and reliability of EMR surgery.Results:All 40 cases were performed endoscopically by EMR. The en bloc resection rate and RO resection rate reached 100%. The lesions were all confined to the submucosa and did not infiltrate the muscularis propria. Postoperative pathological classification: NET G1: 35 cases, NET G2 grade: 5 cases, no NET G3 grade cases. There were no complications such as bleeding and perforation during and after the operation. Follow-up: 1 case was lost to follow-up, 1 patient died of other diseases, and the remaining 38 cases were followed up for an average of 27.8 months (5-46 months) without local recurrence or distant metastasis.Conclusion:For well-differentiated G1 and G2 gastrointestinal neuroendocrine tumors with a diameter ≤10mm, EMR is a safe and reliable treatment.

Objective To observe the pain behavioral performance of rats that different sensory nerve fibers were transected,and examine the expression of brain-derived neurotrophic factor(BDNF) in these models.Methods Twenty-four rats were divided into three groups according to random number table method:SUR group,GS group and SHAM group, which received sural nerve transection, gastrocnemius-soleus nerve transection or sham operation respectively.There were 8 rats in every group.The expression of BDNF in the lumbar 5 DRG and spinal dorsal horn were detected,and the types of damaged cells were also observed.Results In GS group, 50% paw-withdrawal thresholds were significantly decreased on the ipsilateral hind paw compared with baseline and with those in SHAM group,and the paw-withdrawal durations in response to the thermal stimulus increased significantly (P＜0.01 ＝.In contrast, no change was found in SUR group(P＞0.05 ).The expression of BDNF in the lumbar 5 DRG ( (37.87 ± 4.23 ) % ) and spinal dorsal horn ( (21.9 ± 3.1 ) % ) was significantly higher in GS group than in SHAM group( ( 17.31 ± 2.12 ) %, ( 12.6 ± 1.3 ) % ), and no significant difference was found between SUR and SHAM groups(P＞0.05 ).FG opposite cells which also expressed BDNF in GS group were more than those in SUR group ( (47.7 ± 1.8) % and (26.7 ± 2.3 ) % ) (P ＜ 0.01 ＝.The percentage in N200 and FG double positive cells to N200 positive cells in GS group was significantly increased in GS group than those in SUR group ( (47.7 ±1.8 ) %, (26.7 ± 2.3 ) % ) (P ＜ 0.01 ＝.Conclusion The data suggest that injury of the sensory nerve innervating skin does not produce hyperalgesia, but injury of the sensory nerve innervating muscle does.Different kinds of neuron were damaged and the differences of BDNF expression is essential for this difference.

Objective To examine the Criterion-related validity of the competency model of armed police sergeant.Methods 513 armed police soldiers were evaluated by 2 leaders with competency model of armed police sergeant.5 equidistant grades rating method was used.The list of excellent soldiers were collected.Results ( 1 ) There were significant differences on 17 items of competency scores between excellent soldier group and average soldier group (P ＜ 0.05 ), except for one item of competency.Furthermore, there were significant differences on 4 factor scores and sum scores between excellent soldier group and average soldier group (P ＜ 0.05 ).( 2 ) The predictive probability were 72.6 % (A) ,71.3% (B) predicting excellent soldiers by the sum scores of competency model.Conclusion The Criterion-related validity of the competency model of armed police sergeant is acceptable.It can be used in the selecting and training of armed police sergeant.