ABSTRACT
OBJECTIVE To provide reference for chronic disease management in grass-root institution . METHODS System structure design and audit class setting of the regional pretrial center in Changning district of Shanghai were introduced. The number of prescriptions/medical orders from the start of application to February 28，2022 were counted. The prescriptions/medical orders intercepted by the system ，prescriptions/medical orders intervened by physicians ，chronic disease types and drug use of regional multiple chronic diseases were counted and analyzed. RESULTS Compared with the data when the center was on line in September 2021，total qualified rate of prescriptions/medical orders （97.67％ vs. 86.42％）significantly increased ，the number of prescriptions/ medical orders intercepted by the system and intervened by physicians decreased by 55.39％ and 72.67％ in February 2022， respectively. The top five diseases were hypertension （26.52％），coronary heart disease （20.53％），sleep disorders （16.71％），diabetes（15.24％）and bone diseases （14.09％）. Among them ， there were many problematic prescriptions involving coronary heart disease ，sleep disorder and bone disease. CONCLUSIONS The incidence of chronic diseases among community residents remains high. In addition to common chronic diseases such as coronary heart disease ，hypertension and diabetes ，the incidence of sleep disorders and bone diseases is also increasing. With the help of the regional pretrial center ，the focus of chronic disease management can be adjusted timely ，drug supervision can be carried out in real time so as to improve the level of rational drug use in grass-root institution.
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Background: Colorectal cancer (CRC) is one of the most common cancers in China and even in the world, and metastasis is the main cause of death. However, there is lack of sufficient molecular biomarkers for predicting effectively the occurrence of metastasis. Aims: To explore the expression of fibulin-2 (FBLN2) in CRC and the underlying mechanism of its effect on tumor invasion and metastasis. Methods: Bioinformatics data of PRJNA218851 data set from the SRA database were extracted to screen CRC metastasis-associated genes. Then these differentially expressed genes were applied for gene enrichment analysis to identify the most significant pathways. Data from TCGA and clinical CRC samples were used to analyze the expression of FBLN2 in CRC tissues and normal tissues, and the relationship between FBLN2 and clinicopathological features and prognosis of CRC patients. Expression of FBLN2 in normal colorectal mucosal cell line, CRC cell lines, and clinical CRC samples was detected by real-time PCR. After FBLN2 was knockdown or over expressed in CRC cells, CCK-8 assay, clone formation assay, Transwell cell invasion and migration assay, and wound healing assay were performed to observe the effect of FBLN2 on the proliferation, invasion and migration abilities of CRC cells. Gene set enrichment analysis was conducted to screen the potential downstream pathway of FBLN2, and then the pathway screened was verified. Results: The expression of FBLN2 was low in eight CRC cell lines and CRC tissues, yet the expression in metastatic CRC was significantly higher than that in non-metastatic ones. Compared with CRC patients with low FBLN2 expression, CRC patients with high FBLN2 expression were prone to have lymph node metastasis and distant metastasis, and with higher clinical stage and poorer prognosis. Knockdown of FBLN2 could decrease the invasion and migration abilities of CRC cells, but had no impact on cell proliferation. FBLN2 was positively correlated with CDH2, Snai1 and vimentin, indicating that the epithelial-mesenchymal transition (EMT) pathway might be the downstream pathway of FBLN2. Conclusions: FBLN2 is low expressed in CRC but the expression is increased in metastatic CRC. Therefore, it might be used as a molecular biomarker for screening early metastasis. FBLN2 might enhance CRC invasion and metastasis through activating EMT pathway and is associated with poor prognosis.
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Objective To investigate the relationship between genetic variants in the Toll-like receptor (TLR) pathway genes and susceptibility of gastric cancer (GC) and esophageal squamous cell carcinoma (ESCC).Methods The data of whole genome association studies of the high-risk population of GC and ESCC in China were analyzed by adaptive rank-truncated product (ARTP) method in pathway and gene level.The associations between single nucleotide polymorphism (SNP) and susceptibility of GC and ESCC were analyzed with additive model of unconditional Logistic regressions.PLINK 1.07 and SPSS 19.0 software were performed for statistical analyses,and ARTP package in R3.0.2 was used for pathway and gene level analysis.Results In gene-level analyses,eight genes were found to be associated with susceptibility of GC (P ＜0.05) and six genes were associated with susceptibility of ESCC (P ＜ 0.05).In single SNP-level analyses,21 SNPs were statistically correlated with susceptibility of GC (P ＜ 0.01),and 11 SNPs were statistically correlated with susceptibility of ESCC (P ＜0.01).Conclusions Some genetic variants in TLR pathway are associated with risk of GC and ESCC.The potential molecular mechanisms need further investigation.