1.Practice of Clinical Pharmacists Participating in One Case of Multiple Organ Cryptococcus Infection during Perinatal Period
Caihong ZHANG ; Wenying CHEN ; Lejia XU ; Min YANG
China Pharmacist 2016;19(10):1927-1929
Objective: To evaluate the clinical pharmacists’ role in the drug treatment of perinatal women with multiple organ cryptococcus infection. Methods:Clinical pharmacists participated in the treatment of one case of perinatal women with multiple organ cryptococcus infection and provided comprehensive pharmaceutical service, including antifungal drug selection, adverse drug reactions prevention and monitoring, glucocorticoid selection in fetal lung maturity and recommendation in lactation. Results: Clinical pharma-cists provided suggestions on the drug treatment in many ways to enhance the safety, efficiency and economic of the drug treatment, and improve the patient's compliance as well. Conclusion:Clinical pharmacists can optimize the treatment regimen and play an active role in the drug treatment of perinatal patients with cryptococcus infection.
2.High Systemic Inflammation Response Index (SIRI) Indicates Poor Outcome in Gallbladder Cancer Patients with Surgical Resection: A Single Institution Experience in China
Lejia SUN ; Wenmo HU ; Meixi LIU ; Yang CHEN ; Bao JIN ; Haifeng XU ; Shunda DU ; Yiyao XU ; Haitao ZHAO ; Xin LU ; Xinting SANG ; Shouxian ZHONG ; Huayu YANG ; Yilei MAO
Cancer Research and Treatment 2020;52(4):1199-1210
Purpose:
The systemic inflammation response index (SIRI) has been reported to have prognostic ability in various solid tumors but has not been studied in gallbladder cancer (GBC). We aimed to determine its prognostic value in GBC.
Materials and Methods:
From 2003 to 2017, patients with confirmed GBC were recruited. To determine the SIRI’s optimal cutoff value, a time-dependent receiver operating characteristic curve was applied. Univariate and multivariate Cox analyses were performed for the recognition of significant factors. Then the cohort was randomly divided into the training and the validation set. A nomogram was constructed using the SIRI and other selected indicators in the training set, and compared with the TNM staging system. C-index, calibration plots, and decision curve analysis were performed to assess the nomogram’s clinical utility.
Results:
One hundred twenty-four patients were included. The SIRI’s optimal cutoff value divided patients into high (≥ 0.89) and low SIRI (< 0.89) groups. Kaplan-Meier curves according to SIRI levels were significantly different (p < 0.001). The high SIRI group tended to stay longer in hospital and lost more blood during surgery. SIRI, body mass index, weight loss, carbohydrate antigen 19-9, radical surgery, and TNM stage were combined to generate a nomogram (C-index, 0.821 in the training cohort, 0.828 in the validation cohort) that was significantly superior to the TNM staging system both in the training (C-index, 0.655) and validation cohort (C-index, 0.649).
Conclusion
The SIRI is an independent predictor of prognosis in GBC. A nomogram based on the SIRI may help physicians to precisely stratify patients and implement individualized treatment.
3.Comparison of the Prognostic Value of Platelet-Related Indices in Biliary Tract Cancer Undergoing Surgical Resection
Lejia SUN ; Yuxi WEI ; Yang CHEN ; Wenmo HU ; Xin JI ; Haifeng XU ; Shunda DU ; Haitao ZHAO ; Xin LU ; Xinting SANG ; Shouxian ZHONG ; Huayu YANG ; Yilei MAO
Cancer Research and Treatment 2021;53(2):528-540
Purpose:
Platelet-related indices, including mean platelet volume (MPV) and plateletocrit (PCT), have been reported as new prognostic factors of overall survival (OS) in many cancers, but not yet in biliary tract cancer (BTC). We intended to assess these indices in predicting OS in BTC patients with the aim to build a new prognostic model for patients with BTC after surgical resection.
Materials and Methods:
Survival analysis and time receiver operating characteristic analysis were applied to screen the platelet indices. Univariate and multivariate Cox analyses were used to identify independent prognostic factors and develop a new prognostic model. Harrell’s C-statistics, calibration curves, and decisive curve analysis were used to assess the model.
Results:
MPV and platelet distribution width (PDW)/PCT showed the best prognostic accuracy among the platelet indices. In multivariable analysis, factors predictive of poor OS were presence of nodal involvement, Non-radical surgery, poor tumor differentiation, carbohydrate antigen 19-9 > 100 U/mL, MPV > 8.1 fl, and PDW/PCT > 190. The new model was found to be superior to the TNM staging system and our new staging system showed higher discriminative power.
Conclusion
MPV and PDW/PCT have high prognostic value in BTC patients, and the novel staging system based on these two indices showed good discrimination and accuracy compared with the American Joint Committee on Cancer 7th TNM staging system.
4.Rationality evaluation of human albumin in the treatment of liver cirrhosis based on weighted TOPSIS method
Lu LIU ; Danwei ZHENG ; Lejia XU
China Pharmacy 2022;33(23):2917-2920
OBJECTIVE To establish the drug use evaluation criteria of human albumin (HA) in the treatment of liver cirrhosis based on weighted technique for order preference by similarity to ideal solution (TOPSIS) method, and to comprehensively evaluate the utilization of HA. METHODS The drug use evaluation criteria of HA was established with reference to guidelines of liver cirrhosis treatment at home and abroad and HA prescription evaluation method, based on the HA instructions. The weighted TOPSIS method was used to evaluate the rationality of HA drug use in inpatients with liver cirrhosis diagnosed by the infection department of our hospital in 2020. RESULTS The established drug use evaluation criteria for HA included 8 evaluation indicators, i.e. baseline examination, indication, contraindication, combined use of drugs, usage and dosage, and so on; the scoring weight was set by consulting experts. According to the evaluation of the closeness degree (Ci) between the HA drug use of 1 068 medical records and the optimal plan and the worst plan in our hospital, the result showed that 133 (12.45%) were evaluated as reasonable medical records (Ci≥0.8), 576 (53.93%) as basically reasonable medical records (0.6≤Ci<0.8), and 359 (33.61%) as unreasonable medical records (Ci<0.6). The main unreasonable problems were the absence of baseline examination, non-indication medication, medication for contraindication, etc. CONCLUSIONS The drug use evaluation criteria of HA based on the weighted TOPSIS method can be used to evaluate the rational use of the drug. The drug use of HA in patients with liver cirrhosis in our hospital is reasonable, and we should continue to strengthen the management to reduce or avoid unreasonable drug use.
5.Comparison of the Prognostic Value of Platelet-Related Indices in Biliary Tract Cancer Undergoing Surgical Resection
Lejia SUN ; Yuxi WEI ; Yang CHEN ; Wenmo HU ; Xin JI ; Haifeng XU ; Shunda DU ; Haitao ZHAO ; Xin LU ; Xinting SANG ; Shouxian ZHONG ; Huayu YANG ; Yilei MAO
Cancer Research and Treatment 2021;53(2):528-540
Purpose:
Platelet-related indices, including mean platelet volume (MPV) and plateletocrit (PCT), have been reported as new prognostic factors of overall survival (OS) in many cancers, but not yet in biliary tract cancer (BTC). We intended to assess these indices in predicting OS in BTC patients with the aim to build a new prognostic model for patients with BTC after surgical resection.
Materials and Methods:
Survival analysis and time receiver operating characteristic analysis were applied to screen the platelet indices. Univariate and multivariate Cox analyses were used to identify independent prognostic factors and develop a new prognostic model. Harrell’s C-statistics, calibration curves, and decisive curve analysis were used to assess the model.
Results:
MPV and platelet distribution width (PDW)/PCT showed the best prognostic accuracy among the platelet indices. In multivariable analysis, factors predictive of poor OS were presence of nodal involvement, Non-radical surgery, poor tumor differentiation, carbohydrate antigen 19-9 > 100 U/mL, MPV > 8.1 fl, and PDW/PCT > 190. The new model was found to be superior to the TNM staging system and our new staging system showed higher discriminative power.
Conclusion
MPV and PDW/PCT have high prognostic value in BTC patients, and the novel staging system based on these two indices showed good discrimination and accuracy compared with the American Joint Committee on Cancer 7th TNM staging system.