Background:Colorectal cancer is one of the commonly seen malignant tumors in digestive system. Most patients with colorectal cancer were diagnosed in advanced stage and the prognosis is poor. Early diagnosis is crucial to improve the overall survival of patient. Currently,molecular markers for diagnosis of colorectal cancer has attracted more and more attention of the investigators. Aims:To investigate the expression and significance of Rab5A in colorectal cancer. Methods:Colorectal cancerous tissue and the paired para-cancer noncancerous tissue of 135 patients who underwent resection for colorectal cancer were collected. Expression of Rab5A mRNA in cancerous tissue,para-cancer noncancerous tissue,colon cancer cell lines HCT116,HT-29,LoVo and SW480 and normal colonic epithelial cell line NCM460 was determined by real-time PCR. Protein expression of Rab5A in cancerous tissue and para-cancer noncancerous tissue of 4 patients was detected by Western blotting. Protein expression of Rab5A in cancerous tissue of 110 patients was detected by immunohistochemistry. Correlations between expression of Rab5A and clinicopathological characteristics and prognosis of colorectal cancer were analyzed. Results:Expression of Rab5A mRNA in cancerous tissue was significantly higher than that in para-cancer noncancerous tissue(P=0. 003). Expression of Rab5A mRNA in colon cancer cell lines HCT116, HT-29,LoVo and SW480 was significantly higher than that in normal colonic epithelial cell line NCM460(P﹤0. 05). Protein expression of Rab5A in cancerous tissue was significantly higher than that in para-cancer noncancerous tissue. In 110 cancerous tissues,51(46. 4%)had low expression of Rab5A and 59(53. 6%)had high expression of Rab5A. Protein expression of Rab5A was significantly correlated with tumor size,serum carcinoembryonic antigen(CEA)level and TNM stage(P =0. 008;P =0. 002;P =0. 010). 3-year survival rate of patients with high Rab5A expression was significantly lower than that of patients with low Rab5A expression(52. 1% vs. 77. 5%,P ﹤0. 05). Rab5A protein expression,serum CEA level and TNM stage were correlated with the prognosis of patients with colorectal cancer( P =0.009;P =0. 006;P =0. 017)and were independent factors for prognosis(P =0. 026;P =0. 032;P=0. 014). Conclusions:Expression of Rab5A correlates with the malignant behavior of colorectal cancer and its high expression indicates a poor prognosis. Rab5A might be used as a predictor for prognosis of colorectal cancer.

Objective:To survey the knowledge levels of chronic obstructive pulmonary disease(COPD) among physicians in primary care and related factors.Methods:A questionnaire survey was conducted during December 2020 to December 2021 among 1 232 primary care doctors in Zhumadian City of Henan Province. The questionnaire included basic information, knowledge of COPD and its management, and the training received. The COPD-related knowledge levels and the influencing factors were analyzed using logistic regression model.Results:A total of 1 232 questionnaires were collected, and 1 221(99.1%) were valid, which were included in the analysis. The survey showed that the COPD-related knowledge level was significantly associated with the educational level of primary care physicians(χ2=9.91, P<0.05); and the Pearson correlation analysis showed that the knowledge level was positively correlated with educational level( r=0.09, P<0.05). In terms of risk factors, causes of acute exacerbations, and treatment and management of COPD, there was a linear relationship between the education level and knowledge level(χ2=13.86, P<0.001;χ2=20.93, P<0.001); the Pearson correlation analysis showed that the knowledge level was correlated with higher educational level( r=0.11, P<0.001; r=0.13, P<0.001). In terms of symptoms and diagnosis, there was no correlation between educational level and awareness level(χ2=1.90, P=0.168). Logistic regression model showed that compared to doctors aged 20-30, those aged 31-40 had a higher COPD-related knowledge level( OR=2.24, 95% CI: 1.16-4.30, P=0.016); compare to the doctors with associate degree, doctors with bachelor degree or above had a higher COPD-related knowledge( OR=1.71, 95% CI:1.24-2.37, P=0.001); compared to doctors without professional title, those with primary or middle-rank professional title had a higher knowledge level( OR=1.65, 95% CI: 1.28-2.13, P<0.001; OR=2.15, 95% CI: 1.46-3.16, P<0.001); compared to doctors with training time<3, those with training time ≥3 had a higher knowledge level( OR=1.15, 95% CI: 1.21-2.61, P=0.021). Conclusion:The COPD-related knowledge levels(especially in knowledge of risk factors and causes of acute exacerbations, and treatment and management of COPD) among doctors in primary care are affected by age, educational background, professional title, and the number of training sessions.

Objective:To understand the current management status of chronic obstructive pulmonary disease (COPD) in county-level hospitals in China from 2020 to 2021.Methods:This survey was led by the China Association of County Hospital President. In 2021, a questionnaire survey was conducted on 633 secondary and tertiary hospitals from 24 provinces, and the questionnaire was filled out according to the actual situation of the hospital in 2020, including diagnosis, treatment, rehabilitation and comprehensive management of COPD. The nature of the hospital was divided into public or private. The type of hospital was divided into general or specialist. The economic zones was divided into eastern, central or western. Through the content of the questionnaire, the influencing factors of the diagnosis, treatment and management capabilities of COPD in county-level hospitals were explored.Results:A total of 633 questionnaires were collected in this survey, and 26 were removed due to the incorrect information or information loss. Thus, a total of 607 questionnaires were finally included in this survey, including 425 secondary hospitals and 182 tertiary hospitals; 591 public hospitals and 16 private hospitals. For the capabilities of diagnosis and treatment, the tertiary hospital was significantly better than the secondary hospital on the availability of respiratory outpatient clinics, COPD outpatient clinics, outpatient comprehensive clinics, respiratory ward and intensive care unit (ICU) (94.5% and 78.4%, 51.1% and 32.7%, 79.7% and 67.3 %, 84.6% and 59.8%, 78.6% and 61.9%, respectively) (all P<0.01). In terms of lung function test and bronchodilation test, tertiary hospitals performed significantly better than secondary hospitals ( P<0.05). There was no difference in availability of inhaled bronchodilators and expectorant drugs among different hospital levels, nature, type, and economic zones ( P>0.05). However, the proportion of hospitals with available triple inhalation drugs was lower in secondary hospitals than tertiary hospitals. For the non-drug treatment, the proportion of general hospitals carrying out vaccination was significantly higher than that of specialized hospitals (52.7% and 28.1%, P=0.010). The tertiary hospitals performed significantly better than secondary hospitals in smoking cessation guidance (98.4% and 94.4%, P=0.031). In terms of rehabilitation, tertiary hospitals also performed significantly better than secondary hospitals (79.7% and 61.9%, P<0.001). The proportion of hospitals carrying out long-term management of COPD in tertiary hospitals was significantly higher than secondary hospitals, and the proportion in public hospitals was significantly higher than private hospitals (80.2% and 61.2%, 68.2% and 18.8%, both P<0.001). Conclusions:County hospitals in China have a good overall performance in the diagnosis and drug treatment of COPD, but need to be further improved in non-drug treatment, rehabilitation, and comprehensive management. The hospital level is the main factor affecting the management ability of COPD. The nature and type of hospital mainly affect the construction of departments and comprehensive management of COPD.

Objective:To analyze the screening status of high-risk population of chronic obstructive pulmonary disease (COPD) in areas where “Happy Breathing” project was carried out.Method:There were 1 008 518 COPD screening questionnaires (COPD-SQ) filled out in 18 pilot areas of “Happy Breathing” program from November 2017 to October 2019. Within subjects who scored 16 points or more with COPD-SQ, 63 523 of them underwent pulmonary function tests before bronchodilator inhalation. Stratified analysis, chi-square test and other statistical methods were performed to analyze the distribution of COPD high-risk groups, the prevalence of COPD among high-risk groups and risk factors of COPD.Results:Results in this study suggested that the high-risk population of COPD accounted for 18.99% (191 498/1 008 518) of the population who received the questionnaire screening. Among the high-risk population who received lung function test, 31.59% (20 070/63 523) were screened and diagnosed as COPD patients. As for risk factors of COPD, the proportion of high-risk population was higher in people with a smoking index ≥600 compared with never-smokers (54.20% vs 12.60%), and the prevalence of COPD was also higher in people with a smoking index ≥600 (35.62% vs 25.22%); people who were exposed to second-hand smoke almost every day also showed an increased proportion of high-risk groups (27.39% vs 10.97%) and a high prevalence of COPD (31.36% vs 27.93%) than those without second-hand smoke exposure; the presence or absence of biofuel exposure also caused the difference in the proportion of high-risk groups (33.92% vs 13.11%); compared with people without a family history of respiratory diseases, the proportion of high-risk groups (56.38% vs 16.42%) and the prevalence of COPD in high-risk groups (32.40% vs 29.19%) were both higher in those with family history of respiratory diseases.Conclusion:The high-risk group of COPD accounts for a high proportion of the screened population, suggesting that the “Happy Breathing” project is feasible and necessary in COPD screening, which is helpful for the development of COPD diagnosis and treatment.