Objective:This study aimed to analyze the factors affecting the outcome of cancer pain in patients with moderate and severe chronic cancer pain for clinical decision making. Methods: Data were collected from 426 cancer patients with moderate and severe chronic cancer pain, and the factors affecting pain treatment were analyzed. Results:A total of 85.6%of patients had good pain control in 3 days (NRS≤3). Multivariate logistic regression models showed that the pain of patients with bone metastases (P=0.026), breakthrough pain after stable pain control (P<0.001), and high MEDD (P<0.001) was poorly controlled. Moreover, age, sex, TNM stage, cause of pain, and medication ladder were not risk factors of pain control (P>0.05). Opioid combination with NSAIDs contributed to easier pain control (P=0.024). Digestive system tumors, pain intensity, limb pain, neuropathic pain, use of transdermal fentanyl matrix patch, multiple metastases in stage-IV patients were suggested to be risk factors of pain control in univariate logistic regression models (P<0.05). Conclusion: Bone metastases, breakthrough pain after pain relief, and high dose of MEDD were independent risk factors. Opioid combination with NSAIDs was a protective factor of pain control.

Virtual slides were applied in experiment teaching of pathology on trial in clinic medicine college of Sichuan university.The resuhs from the Survey showed that students and teachers preferred virtual slides in learning microscopic lesions.Virtual Slides can help us save time,promote quality of observation,carry out discussion based teaching and manage teaching documents.It can be used in network teaching after marking the lesions.

Hepatoid adenocarcinoma is a rare and unique type of adenocarcinoma,resembling hepato-cellular carcinoma in histopathology.Most cases occur in the stomach,lacking specific clinical and imaging mani-festations,which leads to high rates of missed diagnosis and misdiagnosis.Hepatoid adenocarcinoma in the perito-neal cavity is even rarer.This article reports a case of hepatoid adenocarcinoma with the manifestation of diffuse peritoneal thickening,aiming to provide reference for clinical diagnosis and treatment.

Lenvatinib mesylate is an oral receptor tyrosine kinase inhibitor against targets of vascular endothelial growth factor receptors 1-3, fibroblast growth factor receptors 1-4, platelet-derived growth factor receptor α, stem cell growth factor receptor, and rearranged during transfection, et al. Lenvatinib has been approved by the National Medical Products Administration of China on September 4,2018, for the first-line treatment of patients with unresectable hepatocellular carcinoma who have not received systematic treatment before. Up to February 2023, Lenvatinib has been listed in China for more than 4 years, accumulating a series of post-marketing clinical research evidences. Based on the clinical practice before and after the launch of lenvatinib and referring to the clinical experience of other anti-angiogenesis inhibitors, domestic multidisciplinary experts and scholars adopt the Delphi method to formulate the Chinese Expert Guidance on Overall Application of Lenvatinib in Hepatocellular Carcinoma after repeated discussions and revisions, in order to provide reference for reasonable and effective clinical application of lenvatinib for clinicians.

Lenvatinib mesylate is an oral receptor tyrosine kinase inhibitor against targets of vascular endothelial growth factor receptors 1-3, fibroblast growth factor receptors 1-4, platelet-derived growth factor receptor α, stem cell growth factor receptor, and rearranged during transfection, et al. Lenvatinib has been approved by the National Medical Products Administration of China on September 4, 2018, for the first-line treatment of patients with unresectable hepatocellular carcinoma who have not received systematic treatment before. Up to February 2023, Lenvatinib has been listed in China for more than 4 years, accumulating a series of post-marketing clinical research evidences. Based on the clinical practice before and after the launch of lenvatinib and referring to the clinical experience of other anti-angiogenesis inhibitors, domestic multidisciplinary experts and scholars adopt the Delphi method to formulate the Chinese Expert Guidance on Overall Application of Lenvatinib in Hepatocellular Carcinoma after repeated discussions and revisions, in order to provide reference for reasonable and effective clinical application of lenvatinib for clinicians.

BACKGROUND: Chemotherapy is a common treatment for advanced hepatocellular carcinoma, but the effect is not satisfactory. The study aimed to retrospectively evaluate the effects of adding all-trans-retinoic acid (ATRA) to infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX4) for advanced hepatocellular carcinoma (HCC). METHODS: We extracted the data of patients with advanced HCC who underwent systemic chemotherapy using FOLFOX4 or ATRA plus FOLFOX4 at the Eastern Hepatobiliary Surgery Hospital, First Hospital of Jilin University, and Zhejiang Sian International Hospital and retrospectively compared for overall survival. The Cox proportional hazards model was used to calculate the hazard ratios for overall survival and disease progression after controlling for age, sex, and disease stage. RESULTS: From July 2013 to July 2018, 111 patients with HCC were included in this study. The median survival duration was 14.8 months in the ATRA plus FOLFOX4 group and 8.2 months in the FOLFOX4 only group ( P  < 0.001). The ATRA plus FOLFOX4 group had a significantly longer median time to progression compared with the FOLFOX4 group (3.6 months vs. 1.8 months, P  < 0.001). Hazard ratios for overall survival and disease progression were 0.465 (95% confidence interval: 0.298-0.726; P  = 0.001) and 0.474 (0.314-0.717; P  < 0.001) after adjusting for potential confounders, respectively. CONCLUSION ATRA plus FOLFOX4 significantly improves the overall survival and time to disease progression in patients with advanced HCC.
Humans ; Carcinoma, Hepatocellular/drug therapy* ; Retrospective Studies ; Liver Neoplasms/pathology* ; Oxaliplatin/therapeutic use* ; Fluorouracil/adverse effects* ; Disease Progression ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Leucovorin/adverse effects* ; Colorectal Neoplasms/drug therapy*