ABSTRACT
OBJECTIVE: To investigate the clinical application of rivaroxaban and analyze the rationality, effectiveness, safety and drug interactions of its clinical application, so as to provide a basis for regulating its clinical application. METHODS: A summary of guidelines or consensus of clinical application experts at home and abroad was made to form a rationality evaluation standard for rivaroxaban. A retrospective survey was conducted on the use of rivaroxaban in all inpatient departments in a hospital in the first quarter of 2018, and the utilization rate of each department was calculated. Through the inclusion criteria, the cases that meet the requirements are analyzed for rationality, efficacy, adverse reactions and drug interactions. RESULTS: In the first quarter of 2018, there were 20 wards and 1 117 cases use of rivaroxaban. The highest utilization rate was the osteological surgery ward, which was mainly used for the prevention of postoperative thrombosis in orthopedics. In the clinical application of rivaroxaban, the prophylaxis or treatment of thromboembolism is mainly performed according to the instructions. The case of irrational rate was 27.14% all 1 028 cases of patients, with insufficient dose, lack of treatment, long course of treatment as the main reason for unreasonable, need to take active intervention measures. The clinical treatment and safety of rivaroxaban were better, with an ineffective rate of 1.17% (12/1 028) and an adverse reaction rate of 9.63% (99/1 028), of which 74.58% (88/118) belonged to hemorrhagic adverse reactions. CONCLUSION: Rivaroxaban is widely used for clinical anticoagulant therapy or prevention, and has good curative effects, but there are irrational usage, especially in terms of dose. During using, it is necessary to pay close attention to hemorrhagic-related adverse reactions. Clinical pharmacists should pay active attention to the update of the clinical application guidelines for drugs and actively communicate with doctors to jointly promote the rational use of rivaroxaban.
ABSTRACT
The aim of the present study was to accurately evaluate the association of Sox2 expression with the survival of patients with digestive tract cancers. Relevant literatures were identified by comprehensively searching databases including the Pubmed, Embase, CBMdisc, and Wanfang (up to October 2014). A meta-analysis was performed to clarify the association between Sox2 expression and overall survival or clinicopathological parameters of patients with digestive tract cancers (esophageal, gastric, and colorectal cancers). The results showed a significant association between high Sox2 expression and poor overall survival in patients with digestive tract carcinomas (HR=1.55, 95% CI=1.04-2.31), especially for patients with esophageal cancer (HR=2.04, 95%CI=1.30-3.22), colorectal cancer (HR=1.40, 95% CI=1.04-1.89), and digestive tract adenocarcinoma (HR=1.80, 95% CI=1.12-2.89), for Europeans (HR=1.98, 95% CI=1.44-2.71) or patients who did not receive neoadjuvant treatment (HR=1.73, 95% CI=1.10-2.72). Furthermore, Sox2 over-expression was highly correlated with vascular invasion (OR=1.86, 95% CI=1.25-2.77) and poor differentiation (OR=1.88, 95% CI=1.14-3.08), especially in esophageal and colorectal cancers. In conclusion, Sox2 expression may serve as a novel prognostic factor for patients with digestive tract cancers. Over-expression of Sox2 that is correlated with vascular invasion and poor differentiation suggests poor outcomes of patients with digestive tract cancers.
Subject(s)
Humans , Antineoplastic Agents , Therapeutic Uses , Biomarkers, Tumor , Genetics , Metabolism , Colorectal Neoplasms , Diagnosis , Drug Therapy , Mortality , Pathology , Esophageal Neoplasms , Diagnosis , Drug Therapy , Mortality , Pathology , Gastrointestinal Tract , Metabolism , Pathology , Gene Expression , Neoadjuvant Therapy , Methods , Neoplasm Grading , Neoplasms, Vascular Tissue , Diagnosis , Drug Therapy , Mortality , Prognosis , SOXB1 Transcription Factors , Genetics , Metabolism , Stomach Neoplasms , Diagnosis , Drug Therapy , Mortality , Pathology , Survival AnalysisABSTRACT
OBJECTIVE: To understand the application of warfarin hospitalized patients with non-valvular atrial fibrillation, summarize the clinical experience and provide reference for clinical medication, and explore the significance of clinical pharmaceutical care for warfarin. METHODS: The information of 726 cases with non-valvular atrial fibrillation hospitalized in the first cardiovascular ward from January 2012 to December 2013 were retrospectively collected and analyzed in the aspect of types of anticoagulant solution, warfarin dosage and INR monitoring. RESULTS: The anticoagulation solution commonly used in our patients with atrial fibrillation included dual antiplatelet therapy, aspirin antithrombotic therapy and warfarin anticoagulant therapy. 13.8% of the cases had initial INR of 2.0-3.0, and 43.4% of the cases attained INR target after dosage adjustment. CONCLUSION: At present the clinical application of warfarin still exists deficiencies. It is necessary to continue to raise people's awareness of warfarin and atrial fibrillation anticoagulant. Active clinical pharmaceutical care for warfarin is of great significance.