Pain is common in severe acute pancreatitis (SAP) and is associated with the disease severity and outcomes. The management of pain in SAP may not only relieve pain but also improve outcomes. However, pancreatic pain in SAP involves several complicated mechanisms. Poor understanding about the pain mechanism in SAP and lack of enough high-quality data on pharmacological and nonpharmacological intervention lead to a limited analgesia strategy in patients with SAP mainly managed using nonsteroidal anti-inflammatory drugs and opioids. This makes pain management in SAP challenging and may cause potential harm. This article reviewed the current management of pain in SAP by combining pain mechanisms with animal or clinical studies and proposed an analgesic ladder based on available evidence to improve pain management in patients with SAP.

Data integrity verification mechanisms play an important role in cloud environments. Recently, a lightweight identity-based cloud storage audit scheme has been proposed; this paper points out security vulnerabilities of their OffTagGen algorithm. That is, the attackers such as malicious cloud servers can forge the tags, which can destroy data integrity. By improving the construction of OffTagGen algorithm, an improved security cloud auditing protocol is proposed in this work to better protect user’s privacy. The analysis shows that the new protocol is effective and resistant to attacks.

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