Objective To observe the clinical efficacy of thumb-tack needling therapy combined with Oxycodone Hydrochloride Sustained-Release Tablets in treating patients with severe cancer pain caused by malignant tumors.Methods A total of 60 patients diagnosed with severe cancer pain who were admitted to the Traditional Chinese Medicine Department of Qingpu Branch,Zhongshan Hospital Affiliated to Fudan University between November 2023 and December 2024 were selected as study subjects.Patients were randomly divided into an observation group and a control group using a random number table,with 30 cases in each group.The control group received conventional western medicine pain management,while the observation group received additional thumb-tack needling therapy based on the control group's treatment.The treatment duration was 2 weeks.After treatment,clinical efficacy was evaluated by observing changes in European Quality of Life-5 Dimensions(EQ-5D)scores,Numerical Rating Scale(NRS)scores,Cancer Pain Self-Efficacy Scale(CPSS)scores,and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30)scores in both groups before and after treatment.Changes in serum levels of prostaglandin E2,endothelin-1,β-endorphin,and substance P were also compared.Safety and adverse reactions were assessed.Results(1)The total analgesic effective rate was 76.67％(23/30)in the observation group and 46.67％(14/30)in the control group.The total effective rate in the observation group was significantly higher than that in the control group,with a statistically significant difference(P＜0.05).(2)After treatment,serum levels of prostaglandin E2,endothelin-1,β-endorphin,and substance P were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(3)After treatment,EQ-5D scores,NRS scores,and CPSS scores were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(4)After treatment,EORTC QLQ-C30 scores were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(5)The incidence of adverse reactions was 53.33％(16/30)in the observation group and 83.33％(25/30)in the control group.The incidence of adverse reactions in the observation group was significantly lower than that in the control group,with a statistically significant difference(P＜0.05).Conclusion Thumb-tack needling therapy combined with Oxycodone Hydrochloride Sustained-Release Tablets significantly alleviates pain symptoms,improves health status and self-efficacy,and enhances the quality of life in patients with severe cancer pain caused by malignant tumors.

Objective: To evaluate the risk factors of hypercoagulability in the patients with chronic kidney disease (CKD) by thrombelastograph.Methods:According to the maximal elasticity of thrombus(MA),221 patients with chronic kidney disease under-going thromboelastography were divided into two groups: low coagulation group (MA<69mm, n=139) and high coagulation group (MA≥69mm,n=82). The basic conditions of the two groups were analyzed respectively, including gender, age, height, weight, concomitant diseases such as diabetes mellitus,hyperlipidemia and nephrotic syndrome,medication situation such as recombinant hu-man erythropoietin,anti-platelet drugs and hormones,renal function such as CKD1-3 stages and CKD4-5 stages,clotting parameter re-sponse time(R value),clotting time(K value),angle α,maximum thrombus(MA)and the other coagulation-related indicators such as platelet PLT,and binary logistic regression was used to analyze the risk factors causing hypercoagulability. Results:There were no significant differences in age,gender,height and weight etc(P>0.05)while there were significant differences in concomitant diseases, drug use,renal function, coagulation indicators including thrombus elasticity and blood index between the groups (P<0.05). The risk factors of hypercoagulation mainly included disease factors (diabetes OR 1.895,95% CI 1.082-3.318, nephrotic syndrome OR 2.501,95% CI 1.429-4.379,CKD4-5 stage OR 1.989,95% CI 1.136-3.483),and drug factors(recombinant human erythropoietin rHuEPO)(OR 2.254,95% CI 1.207-4.208). Conclusion: In the patients with CKD, diabetes mellitus, nephrotic syndrome and CKD4-5 stages increase the hypercoagulability of patients,and rHuEPO also increases the risk of hypercoagulability in the patients with renal anemia.

Delphi method is a kind of forecasting method with several rounds of consultation with experts. It has three major characteristics including anonymity,information feedback and statistical analysis of results. With the continuous development of the method,its application fields is widened from the initial development of sociology to clinical medicine,psychology,nursing and so on. Since pharmacy and clinical medicine is inseparable,Delphi method used in pharmacy field has become the new direction of pharmaceutical research,and it can provide a new method for the pharmaceutical regulations,medical risk assessment and development of clinical pharmacy. In the paper,the application of Delphi method in the field of pharmacy was summarized in order to provide new ideas for the development of pharmacy.