Experiences of patients with advanced cancer coping with chronic pain: a qualitative analysis.

OBJECTIVES: To gain insight into the perceptions, and beliefs of patients with advanced cancer coping with chronic pain and to identify their attitudes and demands on pain management. METHODS: From July to September 2022, 17 patients with advanced cancer living with chronic pain were recruited from a tertiary cancer hospital in Hunan Province, China. Qualitative and semi-structured interviews were conducted individually, with 30-45 minutes for each. The Colaizzi 7-step analysis method in phenomenological research was used for data analysis. RESULTS: The experience of pain acceptance by advanced cancer patients with chronic pain was summarized into four themes: pain catastrophizing (unable to ignore the pain, try various methods to relieve the pain, exaggerating pain perception, and lack of knowledge about proper pain management), rumination (compulsive rumination and worrying rumination), avoidance coping (situational avoidance and repressive avoidance) and constructive action (setting clear value goal and taking reciprocal action). CONCLUSION: Most patients with advanced cancer had low pain acceptance and negative attitudes. Feeling helpless in the face of pain and suffering alone were their norm. Long-term negative emotions could lead to gradual depression and loss of hope for treatment, resulting in pain catastrophizing and persistent rumination. Nevertheless, a few patients accepted pain with positive attitudes. Medical professionals should pay more attention to the psychological status of advanced cancer patients with chronic pain, and employ alternative therapies, for example, cognitive behavioral therapy. More efforts are needed to reduce patients' pain catastrophizing, and promote their pain acceptance by a better understanding of pain through health education.

[Research Status and Trend of Screening for Women's Common Diseases in China].

Objective To visualize the research status and hotspots of women's common disease screening based on CiteSpace 6.1.R6,and to provide a reference for the in-depth research in this field thereafter. Methods The relevant articles were retrieved from the China National Knowledge Infrastructure with the time interval from January 1,1992 to December 13,2022.The analysis was conducted on the number of annual publications,countries(regions),institutions,author collaboration networks,keyword co-occurrence,clustering,and bursts. Results A total of 900 papers that met the criteria were included,and the number of annual publications showed a trend of first increasing and then decreasing.The cross-institutional collaboration network was mature.The research hotspots mainly covered women's health,the prevalence of women's diseases,reproductive health,and breast diseases.The hotspots have evolved from an initial focus on reproductive health care to gynecological disease management,and eventually to reproductive health and holistic health care in women. Conclusions The attention should be kept on the screening of women's common diseases.It is advisable to synchronize the screening of women's common diseases with the screening of cervical and breast cancers to expand the screening coverage,promote early disease detection and treatment,and comprehensively safeguard women's health.

Gut liver brain axis in diseases: the implications for therapeutic interventions.

Gut-liver-brain axis is a three-way highway of information interaction system among the gastrointestinal tract, liver, and nervous systems. In the past few decades, breakthrough progress has been made in the gut liver brain axis, mainly through understanding its formation mechanism and increasing treatment strategies. In this review, we discuss various complex networks including barrier permeability, gut hormones, gut microbial metabolites, vagus nerve, neurotransmitters, immunity, brain toxic metabolites, ß-amyloid (Aß) metabolism, and epigenetic regulation in the gut-liver-brain axis. Some therapies containing antibiotics, probiotics, prebiotics, synbiotics, fecal microbiota transplantation (FMT), polyphenols, low FODMAP diet and nanotechnology application regulate the gut liver brain axis. Besides, some special treatments targeting gut-liver axis include farnesoid X receptor (FXR) agonists, takeda G protein-coupled receptor 5 (TGR5) agonists, glucagon-like peptide-1 (GLP-1) receptor antagonists and fibroblast growth factor 19 (FGF19) analogs. Targeting gut-brain axis embraces cognitive behavioral therapy (CBT), antidepressants and tryptophan metabolism-related therapies. Targeting liver-brain axis contains epigenetic regulation and Aß metabolism-related therapies. In the future, a better understanding of gut-liver-brain axis interactions will promote the development of novel preventative strategies and the discovery of precise therapeutic targets in multiple diseases.

Psychometric validation of the modified Chinese version of the personalized psychological flexibility index in patients with cancer.

Objective: The aim of this study was to perform across-cultural adaptation of the English version of the personalized psychological flexibility index (PPFI) into Chinese, and to evaluate its psychometric properties in patients with cancer. Methods: This study was conducted in two phases. In phase 1, we followed Beaton's guidelines for cross-cultural adaptation of PPFI. In phase 2, we conducted a cross-sectional study to assess the validity and reliability of the PPFI among a total of 455 patients with cancer in Hunan Province of China. Item analysis was used to evaluate and screen items, while content validity, construct validity, convergent validity, and concurrent validity were used to evaluate the validity. Reliability was assessed using Cronbach's ɑ coefficient, retest reliability, and composite reliability. Results: The item-level content validity index of the modified Chinese version of PPFI (PPFI-C) ranged from 0.89 to 1.00, the scale-level CVI/universal agreement was 0.87, and the S-CVI/average was 0.99. Exploratory factor analysis identified a 14-item, three-factor structure of PPFI (item 11 deleted). Confirmatory factor analysis showed χ2/df â€‹= â€‹2.42, RMSEA â€‹= â€‹0.07, GFI â€‹= â€‹0.92, NFI â€‹= â€‹0.91, TLI â€‹= â€‹0.93, CFI â€‹= â€‹0.95, and IFI â€‹= â€‹0.95. PPFI-C demonstrated positive correlations with the 8-item Commitment Action Questionnaire, and negative correlations with Acceptance and Action Questionnaire-II, Hospital Anxiety and Depression Scale, and Short Form Quality Life Scale. The Cronbach's ɑ coefficient of modified PPFI-C stood at 0.84. Conclusions: The results suggest that the 14-item PPFI-C is a reliable and valid tool for measuring PF in Chinese patients with cancer. However, additional studies are needed to validate the psychometric properties of PPFI-C in other populations.

Anti-Na+/K+-ATPase DR antibody attenuates UUO-induced renal fibrosis through inhibition of Na+/K+-ATPase α1-dependent HMGB1 release.

Reduced Na+/K+-ATPase (NKA) activity and NKAα1 expression are engaged in the pathologies of renal diseases. NKA-mediated Src activation is not the only reason for NKA-related renal fibrosis. In this study, we found that genetic reduction of NKAα1 exhibited exacerbated tubulointerstitial lesions and fibrosis in the UUO mice model. Activation of NKAα1 with an antibody against the extracellular DR region of the NKAα1 subunit (DRm217) prevented UUO-induced tubulointerstitial lesions, preserved kidney function, and decrease renal fibrosis. Further studies revealed that NKAα1 deficiency mice exhibited high inflammation factors expression when they suffered UUO surgery, compared with NKAα1+/+ (WT) mice. DRm217 alleviated inflammatory cell infiltration, suppress NF-κB phosphorylation, and decreased inflammatory factors expression in the UUO mice model. Released HMGB1 can trigger the inflammatory response and contribute to renal fibrosis. Knockdown of NKA in renal tubular cells or in NKAα1+/- mice was associated with more susceptibility to HMGB1 release in the UUO mice model. DRm217 exerted its antifibrotic effect via inhibiting HMGB1 release. Furthermore, AMPK activation participates in the effect of DRm217 on inhibiting HMGB1 release. Our findings suggest that NKAα1 is a regulator of renal fibrosis and its DR-region is a novel target on it.

Effectiveness of virtual reality technology in symptom management of end-of-life patients: protocol of a systematic review and meta-analysis.

INTRODUCTION: With the worsening of population ageing globally, the number of the elderly with chronic and incurable diseases such as malignant tumours is gradually increasing, and the need for palliative care is growing. As a primary task in the end-of-life phase, symptom management is an essential aspect of palliative care, which aims to alleviate distressing symptoms of terminally ill patients and improve their quality of life. Virtual reality (VR) technology, which allows the creation of simulated environments in which a three-dimensional experience is generated, has been increasingly used in palliative care for symptom management. Therefore, we aim to conduct a systematic review to investigate the effects of VR-based interventions on end-of-life patients. METHODS AND ANALYSIS: This protocol for conducting a systematic review and meta-analysis will be prepared following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. We will conduct a series of searches from inception to 31 July 2022 in the following databases: PubMed, Embase, Web of Science, the Cochrane Library, JBI, EBSCO, CNKI, Wanfang and SinoMed. The key concepts of 'virtual reality' and 'end-of-life' will be combined in each database using both free-text terms and controlled vocabulary terms (eg, MeSH/Emtree terms), if available. Two independent reviewers will use raw data to explore the effectiveness of VR for symptom management in end-of-life patients. The Cochrane Risk-of-Bias tool will be used to assess the risk of bias of included studies. Disagreements will be resolved by a third independent reviewer to reach a consensus. For the included articles, Review Manager software will be used for data synthesis and I2 statistics will be used to measure the heterogeneity. Subgroup analyses and sensitivity analyses will be used to identify the source of heterogeneity. ETHICS AND DISSEMINATION: As this is a protocol for a systematic review and meta-analysis, patients will not be included in this study. For this reason, ethical approval is not required. In order to disseminate the research findings, the results and conclusions of this review will be submitted to a worldwide journal. PROSPERO REGISTRATION NUMBER: CRD42022344679.

Q-marker identification of Paris polyphylla var. yunnanensis (Franch.) Hand.-Mazz. in pulmonary metastasis of liver cancer mice.

ETHNOPHARMACOLOGICAL RELEVANCE: Rhizoma Paridis saponins (RPS) as the mainly active components of Paris polyphylla var. yunnanensis (Franch.) Hand.-Mazz., possess tumor therapeutic potential. However, the anti-tumor material basis of RPS in liver cancer pulmonary metastasis remains poorly understood. The objective of this study was to identify the distribution and anti-cancer effects of RPS in liver cancer pulmonary metastatic model. MATERIALS AND METHODS: In this study, a mouse liver cancer pulmonary metastasis model was established to determine the distribution of different saponins in the tissues by UPLC-MS and plasma protein binding rate. RESULTS: As a result, RPS prolonged the survival time and inhibited the pulmonary metastasis in H22 injected mice through its underlying mechanism. UPLC-MS identified saponins from RPS such as PVII, PH, PVI, PII, gracillin and PI in tissues, which may be regarded as the Q-markers in RPS. Surprisingly, the concentration of PI, PII and gracillin as diosgenyl saponins was higher than that of pennogenyl saponins in the liver and lung. Besides, plasma protein binding rate of PII was higher than that of PVII. CONCLUSION: These findings suggested that PVII, PH, PVI, PI, PII and gracillin are regarded as the Q-markers of RPS in liver cancer pulmonary metastasis. The concentration of PI, PII and gracillin as diosgenyl saponins was higher than that of pennogenyl saponins in the liver and lung. It would be helpful for understanding the importance of RPS with anticancer activities in the future.

Chitosan nanoparticles embedded with curcumin and its application in pork antioxidant edible coating.

Curcumin (Cur) exhibits low water solubility and insufficient dispersibility in food systems, and cannot exert its excellent antioxidant properties. In this work, Chitosan (CS) nanoparticles were prepared by ionic crosslinking method using chitosan as carrier and sodium tripolyphosphate (TPP) as crosslinking agent, then Cur was loaded to obtain curcumin nanoparticles (CNPs). CNPs presented a spherical morphology with average size of 278.9 nm. Compared with the solubility of native Cur (0.017 µg/mL) at 25 °C, the water solubility of CNPs increased to 35.92 µg/mL of more than 2100 times. In addition, the antioxidant capacity of Cur was also studied based on DPPH free radical scavenging, the results showed that with the increase of the concentration, the antioxidant capacity of CNPs was significantly increased (p < 0.05), which was higher than that of Cur at the same concentration. The edible coating was prepared by adding CNPs into sodium carboxymethyl cellulose (CMC) to study the effects of CMC-CNPs coatings in improving the quality and shelf life of fresh pork stored at 4 ± 1 °C for 15 days. The results showed that CMC-CNPs edible coating could significantly inhibit lipid oxidation of fresh pork (p < 0.05) and could be further applied in lipid rich food packaging.

Treatment for liver cancer: From sorafenib to natural products.

Liver cancer most commonly develops in patients with chronic liver disease, the etiology of which includes viral hepatitis (B and C), alcohol, obesity, dietary carcinogens, and so forth. The current treatment modalities, including surgical resection and liver transplantation, have been found far from effective. Hence, there is an obvious critical need to develop alternative strategies for the treatment of it. In this review, we discuss the formation process and therapeutic targets of liver cancer. Currently, targeted therapy is limited to sorafenib, lenvatinib, regorafenib, ramucirumab and cabozantinib which leads to a survival benefit in patients, but on the other hand is hampered by the occurrence of drug resistance. Pleasingly and importantly, there are multiple natural products undergoing clinical evaluation in liver cancer, such as polyphenols like icaritin, resveratrol, and silybin, saponins including ginsenoside Rg3 and glycyrrhizinate, alkaloid containing irinotecan and berberine and inorganic compound arsenic trioxide at present. Preclinical and clinical studies have shown that these compounds inhibit liver cancer formation owing to the influence on the anti-viral, anti-inflammation, anti-oxidant, anti-angiogenesis and anti-metastasis activity. Furthermore, a series of small molecule derivatives inspired by the aforementioned compounds are designed and synthesized according to structure-activity relationship studies. Drug combination and novel type of drug-targeted delivery system thereof have been well developed. This article is ended by a perspective remark of futuristic development of natural product-based therapeutic regimen for liver cancer treatment. We expect that this review is an account for current status of natural products as promising anti-liver cancer treatments and should contribute to its understanding.

Downregulation of reelin predicts poor prognosis for glioma.

Aim: In the present study, we studied the relationship between RELN and prognosis in glioma. Materials & methods: Expression profiles and methylation data of RELN were obtained from bioinformatic datasets. Correlations between RELN and clinicopathological features and overall survival were respectively assessed using chi-square test and Kaplan-Meier analysis. Results:RELN was downregulated in glioma, and its downregulation correlated well with glioma malignancy and overall survival. Meanwhile, hypermethylation of RELN was significantly correlated with low RELN expression. Additionally, gene set enrichment analysis demonstrated that low expression of RELN correlated with many key cancer pathways, possibly highlighting the importance of RELN in carcinogenesis of brain. Conclusion:RELN may serve as a potential prognostic marker and promising target molecule for new therapy of glioma.