1.Study on the effectiveness of an information system on the prevention and control of venous thromboembolism in elderly inpatients
Xiaolan CHEN ; Xinjie TONG ; Lei PAN ; Yong WANG
Chinese Journal of Geriatrics 2020;39(5):522-525
Objective:To explore the effectiveness of an information system on the prevention and control of venous thromboembolism(VTE)in elderly inpatients.Methods:Through retrospectively reviewing medical records of Beijing Shijitan Hospital and files of all patients admitted to the geriatric department of our hospital before and after an information management system was instituted, data of those diagnosed with deep venous thrombosis of the lower extremities, intermuscular venous thrombosis and/or pulmonary thromboembolism(PE)at discharge were collected.General information, prognosis of disease, risk factors for VTE, the detection rate and assessment rate of VTE and other factors were analyzed.Methods:A total of 146 patients were enrolled, and they were mainly elderly patients from the respiratory, cardiology and integrative medicine wards.Diabetes mellitus, cancer and chronic heart failure were the top-three high-risk diseases, and most patients were at high risk or very high risk.The rate of elderly patients assessed as at high risk for VTE on admission was higher after the institution of the information system than that before the institution(93.22% vs.24.66%, P<0.05). The rate of VTE patients receiving standard diagnosis and anticoagulant treatment procedures had an upward trend since the information system became available, compared with before(8.47% vs.5.48%, P>0.05). There was a downward trend in the incidence of PE and all-cause mortality with the use of the information system(3.39% vs.9.59%, 5.08% vs.9.59%, P>0.05). Conclusions:The use of information systems can effectively increase the risk assessment rate for VTE and reduce the incidence of related adverse events in hospitalized elderly patients.
2.Homoharringtonine synergy with oridonin in treatment of t(8; 21) acute myeloid leukemia.
Weina ZHANG ; Ying LU ; Tao ZHEN ; Xinjie CHEN ; Ming ZHANG ; Ping LIU ; Xiangqin WENG ; Bing CHEN ; Yueying WANG
Frontiers of Medicine 2019;13(3):388-397
Collaboration of c-KIT mutations with AML1-ETO (AE) has been demonstrated to induce t(8; 21) acute myeloid leukemia (AML). Targeted therapies designed to eliminate AE and c-KIT oncoproteins may facilitate effective treatment of t(8; 21) AML. Homoharringtonine (HHT) features activity against tumor cells harboring c-KIT mutations, whereas oridonin can induce t(8; 21) AML cell apoptosis and AE cleavage. Therefore, studies should explore the efficacy of combination therapy with oridonin and HHT in t(8; 21) AML. In this study, we investigated the synergistic effects and mechanism of oridonin combined with HHT in t(8; 21) AML cell line and mouse model. The two drugs synergistically inhibited cell viability and induced significant mitochondrial membrane potential loss and apoptosis. Oridonin and HHT induced significant downregulation of c-KIT and its downstream signaling pathways and promoted AE cleavage. HHT increased intracellular oridonin concentration by modulating the expressions of MRP1 and MDR1, thus enhancing the effects of oridonin. The combination of oridonin and HHT prolonged t(8; 21) leukemia mouse survival. In conclusion, oridonin and HHTexert synergistic effects against t(8; 21) leukemia in vivo and in vitro, thereby indicating that their combination may be an effective therapy for t(8; 21) leukemia.