ABSTRACT
Chronic pain is a common clinical manifestation in patients with advanced cancer, and pain treatment is a part of cancer treatment. The titration method of opiod drugs will be recommended for relieving pain in moderate-severe pain in order to improve the quality of life of patients with advanced cancer. Individualized pain control refers to the concept that different patients show different resistance responses to opiod drugs. This article briefly reviews the classification and mechanism of cancer pain, the titration method of opiod drugs in the cancer pain control and individualized application.
ABSTRACT
Objective To observe the changes ofmacular structure and choroidal capillary blood flow density in patients with acute central serous chorioretinopathy (CSC).Methods Prospective cross-sectional study.A total of 24 eyes of 24 patients with monocular acute CSC (case group) diagnosed by clinical examination from Shanxi Eye Hospital during January and March 2018 were included in the study.The eyes (24 eyes) and contralateral eyes (24 eyes) of the patients in the case group were set to CSC group and contralateral eye group,respectively.Twenty-one eyes of 21 healthy volunteers with age and gender matching were selected as normal control group.The macular structure of the eyes were observed by OCT and OCT angiography (OCTA),and the blood vessel density of choroidal capillary layer in the circular area of the macular area with a radius of 1 mm was measured.The paired t-test was used to compare the differences in blood flow density in the choroidal capillaries between the three groups.Results The results of OCT showed that the serous neuroepithelial detachment in the macular area was observed in all eyes of the CSC group,with or without RPE detachment being 20 or 4 eyes,respectively.Of the 24 eyes in the contralateral eye group,13 eyes (54.2％) had thick choroidal RPE lesions (PPE).There was no abnormality in the retina and choroidal structure in the macular area of the normal control group.The results of OCTA showed that the blood flow density of choroidal capillaries in the CSC group,the contralateral eye group and the normal control group were 1.759 ± 0.132,1.924± 0.463,and 1.940± 0.033,respectively.Compared with the eyes of the contralateral eye group and the normal control group,the blood flow density of choroidal capillaries in the CSC group was significantly lower (t=6.611,6.474;P=0.000,0.000).There was no significant difference in the blood flow density of choroidal capillary layer between the contralateral eye group and the normal control group (t=1.328,P ＞ 0.05).In the contralateral eye group,there was no significant difference in the blood flow density of choroidal capillary layer between PPE eyes and no RPE eyes (t=0.806,P＞0.05).Conclusions There is 54.2％ of the contralateral eyes in the monocular acute CSC patients with PPE.The choroidal capillary layer blood flow density is lower than that of the contralateral and normal eyes.
ABSTRACT
Objective To explore the value of carcinoembryonic antigen ( CEA) and cancer antigen 153 ( CA153 ) in detecting tumor recurrences and to establish the optimal operating point of diagnosis of recurrences in HER-2 overexpressing breast cancer using ROC curves .Methods A total of 127 HER -2 overexpressing breast cancer patients was enrolled into this study and subdivided into two groups ,the recurrence group and the non-recurrence group .We created a ROC curve and found out the optimal operating point .Then we compared the advantage of detecting recurrences between optimal operating point in the ROC curve and the diagnostic point that we usually used .Results The recurrence groups showed significantly higher CEA and CA 153 levels than the non-recurrence groups(P<0.0001).The area under the curve(AUC)of the CEA and CA153 were 0.752 and 0.820 respectively and the optimal operating point were 3.5 ng/mL and 17.89 U/mL,respectively.The sensitivi-ties of the optimal operating point of CEA and CA 153 were 46.15%and 65.38%respectively,and the specifici-ties were 97.33%and 89.33%, respectively.Conclusion CEA and CA153 process medium value for detecting recurrences in HER-2 overexpressing breast cancer .