ObjectiveTo screen key genes associated with neuroblastoma （NB） diagnosis and prognosis using the Gene Expression Omnibus （GEO） database， and to investigate the expression and clinical significance of nucleoporin 93 （NUP93） in NB tissues. MethodsNB gene chip data （GSE73517， GSE49710， GSE19274） were retrieved from the GEO database. Differentially expressed genes （DEGs） commonly upregulated in high-risk groups were screened. The R2 database was then used to assess the prognostic value of DEGs that were commonly upregulated in the MYCN amplification group. Finally， NUP93 expression levels in the tissues from 60 NB， 25 ganglioneuroblastoma （GNB）， and 26 ganglioneuroma （GN） cases were measured by immunohistochemistry . ResultsTwenty-five DEGs were identified as commonly upregulated in high-risk groups. Among these， 10 genes （SIVA1， NUP93， STIP1， LSM4， RAI14， MYOZ3， KNTC1， TNFRSF10B， TACC3 and CEP152） showed significantly higher expression in MYCN-amplified subgroups （P＜0.05）. Survival analysis revealed that high NUP93 expression was associated with shorter overall survival （HR = 4.0， 95% CI： 3.0，5.3， P = 1.80 × 10⁻³⁴）. Immunohistochemistry results revealed that NUP93 expression in NB tissues was significantly higher than in GNB and GN tissues （P＜0.001）. NUP93 expression was positively correlated with high mitosis-karyorrhexis index （MKI； P=0.040）， poor differentiation （P＜0.001）， and MYCN expression （r_s = 0.793， P ＜0.001）. ConclusionsHigh expression of NUP93 is associated with high MKI and poor differentiation， and predicts unfavorable prognosis in patients with NB， suggesting it may promote tumor progression by regulating MYCN. NUP93 has the potential to be a novel diagnostic biomarker and therapeutic target for NB.

Objective:To analyze the effect of joint management of type 2 diabetes mellitus (T2DM) between specialty and community under the model of National Diabetes Prevention and Control Center (DPCC).Methods:A total of 2 527 T2DM patients managed by DPCC Pingshan Center of Shenzhen from January 1, 2022 to December 31, 2024 were retrospectively included. After management, the rate of downturn, reexamination rate, blood pressure compliance rate, metabolic indicators (waist circumference, body mass index, fasting blood glucose, glycosylated hemoglobin, blood lipids) and screening rate of chronic complications of diabetes (atherosclerotic cardiovascular disease, microvascular disease, diabetic peripheral neuropathy) were analyzed. Those included 2022 ( n=564), 2023 ( n=1 477), and 2024 ( n=2 527). Results:The downturn rate in 2022, 2023 and 2024 increased year by year (22.8% vs 67.2% vs 89.9%, P<0.01), and the review rate (41.1% vs 62.2% vs 52.7%, P<0.01), complication screening rate (51.6% vs 85.3% vs 62.2%, P<0.01), blood pressure compliance rate (53.1% vs 78.0% vs 67.2%, P<0.01), body mass index compliance rate (13.2% vs 17.3% vs 28.6%, P<0.01), fasting blood glucose meeting rate (46.4% vs 60.2% vs 68.5%, P<0.01), glycated hemoglobin meeting rate (58.4% vs 63.2% vs 45.6%, P<0.01) were relatively improved. Waist circumference compliance rate (30.6% vs 27.7% vs 21.6%) and blood lipid compliance rate (33.6% vs 35.5% vs 31.9%) were not significantly improved, and the review rate, blood pressure compliance rate and complication screening rate in 2024 were lower than those in 2023 and higher than those in 2022. Conclusions:The combined management of type 2 diabetes under the DPCC model has significant effects on improving the down-conversion rate, rediagnosis rate, blood pressure compliance rate, metabolic index compliance rate and the screening rate of diabetes-related chronic complications in patients with diabetes. At the same time, it was also found that with the progress of hierarchical diagnosis and treatment, the review rate, complication screening rate, blood pressure, waist circumference, blood lipid and glycosylated hemoglobin reached the standard of patients decreased compared with the previous situation, which needs to be further analyzed and improved.

Objective:To investigate the correlation of serum FGF21 and SOST with bone mineral density and their predictive value in predicting osteoporosis in menopausal women.Methods:A total of 86 menopausal women who were examined in Northwest Women and Children's Hospital from Jan. 2021 to Jan. 2024 were chosen and separated into osteoporosis group ( n=47) and normal group ( n=39) according to whether they had osteoporosis. Serum fibroblast growth factor 21 (FGF21), osteosclerosis protein (SOST) and bone mineral density (BMD) were measured, and general data such as age, body mass index (BMI), smoking, drinking, hypertension, hyperlipidemia, and diabetes were collected and recorded. The risk factors of osteoporosis in menopausal women were analyzed by logistics regression, and the value of serum FGF21 and SOST levels in predicting osteoporosis in menopausal women was analyzed by receiver operating characteristic (ROC) curve. Results:Serum FGF21 level and bone mineral density T-value in osteoporosis group were lower than those in normal group, while SOST level was higher ( t=5.18,19.30,7.85, P<0.05). Serum FGF21 level was positively correlated with BMD, and serum SOST level was negatively correlated with it ( r=0.476、-0.424, P<0.05). The proportion of smokers and drinkers in osteoporosis group was higher than that in normal group ( χ 2=4.98、5.68, P<0.05). Serum FGF21 level was a protective factor for osteoporosis in menopausal women, and serum SOST level was a risk factor ( OR=0.770,1.194, P<0.05). The area under the curve (AUC) of serum FGF21, SOST and the combination of the two indexes for predicting osteoporosis in menopausal women were 0.800, 0.899 and 0.951, respectively, and the Jordon index were 0.505, 0.723 and 0.787, respectively. Conclusion:Serum FGF21 and SOST levels in menopausal women are correlated with BMD, which has certain predictive value for the occurrence of osteoporosis.

Objective:To analyze the effect of joint management of type 2 diabetes mellitus (T2DM) between specialty and community under the model of National Diabetes Prevention and Control Center (DPCC).Methods:A total of 2 527 T2DM patients managed by DPCC Pingshan Center of Shenzhen from January 1, 2022 to December 31, 2024 were retrospectively included. After management, the rate of downturn, reexamination rate, blood pressure compliance rate, metabolic indicators (waist circumference, body mass index, fasting blood glucose, glycosylated hemoglobin, blood lipids) and screening rate of chronic complications of diabetes (atherosclerotic cardiovascular disease, microvascular disease, diabetic peripheral neuropathy) were analyzed. Those included 2022 ( n=564), 2023 ( n=1 477), and 2024 ( n=2 527). Results:The downturn rate in 2022, 2023 and 2024 increased year by year (22.8% vs 67.2% vs 89.9%, P<0.01), and the review rate (41.1% vs 62.2% vs 52.7%, P<0.01), complication screening rate (51.6% vs 85.3% vs 62.2%, P<0.01), blood pressure compliance rate (53.1% vs 78.0% vs 67.2%, P<0.01), body mass index compliance rate (13.2% vs 17.3% vs 28.6%, P<0.01), fasting blood glucose meeting rate (46.4% vs 60.2% vs 68.5%, P<0.01), glycated hemoglobin meeting rate (58.4% vs 63.2% vs 45.6%, P<0.01) were relatively improved. Waist circumference compliance rate (30.6% vs 27.7% vs 21.6%) and blood lipid compliance rate (33.6% vs 35.5% vs 31.9%) were not significantly improved, and the review rate, blood pressure compliance rate and complication screening rate in 2024 were lower than those in 2023 and higher than those in 2022. Conclusions:The combined management of type 2 diabetes under the DPCC model has significant effects on improving the down-conversion rate, rediagnosis rate, blood pressure compliance rate, metabolic index compliance rate and the screening rate of diabetes-related chronic complications in patients with diabetes. At the same time, it was also found that with the progress of hierarchical diagnosis and treatment, the review rate, complication screening rate, blood pressure, waist circumference, blood lipid and glycosylated hemoglobin reached the standard of patients decreased compared with the previous situation, which needs to be further analyzed and improved.

Objective To investigate whether the pyroptosis-related Toll-like receptor 4(TLR4)signaling pathway influences the malignant transformation of actinic keratosis(AK)into cutaneous squamous cell carcinoma(SCC).Methods A total of 6 lesion tissue samples each from patients with AK and SCC,as well as 5 normal skin tissue samples from healthy subjects as controls,were collected from the First Affiliated Hospital of Kunming Medical University between August 2020 and August 2021.Quantitative PCR(qPCR)and Western blot analysis were performed to determine the mRNA and protein expression levels of TLR4 pathway-related factors,including TLR4,CPB1,NLRP3,IL-1β,and IL-18.TLR4/TUNEL double immunofluorescence staining was used to evaluate TLR4 expression and the level of cellular pyroptosis in tissue samples.In addition,Western blotting was performed to analyze the expression differences of pyroptosis-related core proteins(pro-caspase-1,cleaved caspase-1/p20,GSDMD,and cleaved N-terminal GSDMD)and TLR4 among the normal keratinocyte cell line HaCaT and SCC cell lines A431 and SCL-1.Results Quantitative PCR and Western blot results showed that the mRNA and protein expression levels of TLR4,CPB1,NLRP3,IL-1β,and IL-18 were significantly higher in SCC tissues than in AK and normal skin tissues(P<0.05).TLR4/TUNEL double immunofluorescence results revealed a progressive increasing trend in TLR4 expression and pyroptosis levels from normal skin to AK and further to SCC(P<0.05).Furthermore,in SCL-1 cells,the expression levels of pro-caspase-1,cleaved caspase-1/p20,cleaved N-terminal GSDMD,and TLR4 were significantly upregulated(P<0.05),whereas in A431 cells,only TLR4 expression was increased(P<0.05),and the levels of other pyroptosis-related proteins were downregulated compared to HaCaT cells(P<0.05).Conclusion The expression of the TLR4 signaling pathway gradually increased from AK to SCC,and its activation status varied among different cutaneous squamous cell carcinoma cell lines.

Objective To investigate the value of detection of pelvic floor ultrasound parameters combined with serum relaxin(RLX)and estradiol(E2)levels in diagnosis of female stress urinary incontinence(SUI).Methods A total of 127 puerperae with SUI were selected as SUI group,and another 127 puerperae without SUI during the same period were selected as control group.The pelvic floor ultrasound parameters[bladder neck descent(BND),postvoid residual angle of the bladder-u-rethra(PUVA),and urethral rotation angle(URA)]and serum RLX and E2 levels were compared between the two groups.Binary Logistic regression analysis was used to screen independent influen-cing factors of female SUI,and the diagnostic efficacy of each index alone and their combination for female SUI was analyzed through the receiver operating characteristic(ROC)curve.Results The BND,PUVA,and URA values in the SUI group were greater than those in the control group,the ser-um RLX level was higher,and the serum E2 level was lower,with statistically significant differences(P＜0.05).Binary Logistic regression analysis showed that BND,PUVA,and E2 were independent influencing factors of female SUI(P＜0.05).ROC curve analysis revealed that the areas under the curve(AUCs)for the diagnosis of female SUI by BND,PUVA,URA,RLX,and E2 alone and their combination were 0.775,0.814,0.777,0.749,0.746,and 0.932,respectively.Their sensitivities were 90.6％,86.6％,57.5％,48.8％,100.0％,and 92.1％,and the specificities were 53.5％,68.5％,91.3％,92.1％,49.6％,and 77.2％,respectively.Conclusion The com-bined detection of pelvic floor ultrasound parameters including BND,PUVA,URA,and serum RLX and E2 levels has a high diagnostic value for female SUI.

Objective:To investigate the correlation of serum FGF21 and SOST with bone mineral density and their predictive value in predicting osteoporosis in menopausal women.Methods:A total of 86 menopausal women who were examined in Northwest Women and Children's Hospital from Jan. 2021 to Jan. 2024 were chosen and separated into osteoporosis group ( n=47) and normal group ( n=39) according to whether they had osteoporosis. Serum fibroblast growth factor 21 (FGF21), osteosclerosis protein (SOST) and bone mineral density (BMD) were measured, and general data such as age, body mass index (BMI), smoking, drinking, hypertension, hyperlipidemia, and diabetes were collected and recorded. The risk factors of osteoporosis in menopausal women were analyzed by logistics regression, and the value of serum FGF21 and SOST levels in predicting osteoporosis in menopausal women was analyzed by receiver operating characteristic (ROC) curve. Results:Serum FGF21 level and bone mineral density T-value in osteoporosis group were lower than those in normal group, while SOST level was higher ( t=5.18,19.30,7.85, P<0.05). Serum FGF21 level was positively correlated with BMD, and serum SOST level was negatively correlated with it ( r=0.476、-0.424, P<0.05). The proportion of smokers and drinkers in osteoporosis group was higher than that in normal group ( χ 2=4.98、5.68, P<0.05). Serum FGF21 level was a protective factor for osteoporosis in menopausal women, and serum SOST level was a risk factor ( OR=0.770,1.194, P<0.05). The area under the curve (AUC) of serum FGF21, SOST and the combination of the two indexes for predicting osteoporosis in menopausal women were 0.800, 0.899 and 0.951, respectively, and the Jordon index were 0.505, 0.723 and 0.787, respectively. Conclusion:Serum FGF21 and SOST levels in menopausal women are correlated with BMD, which has certain predictive value for the occurrence of osteoporosis.

Objective To establish evaluation of ozagrel sodium by weighted TOPSIS method so as to provide a reference for improving the rational use of ozagrel sodium.Methods Based on the drug instructions,guidelines,relevant literatures and Delphi method,the evaluation criteria for the clinical rationality of ozagrel sodium were formulated.Attribute hierarchical model(AHM)was used to assign weights to the indicators,the weighted TOPSIS method was employed to analyze and evaluate the rationality of 108 patients that discharged from the Third People's Hospital of Henan Province from January 2021 to April 2022.Results The reponse rates of two rounds of expert advice questionnaires were 100％,the authoritative coefficients(Cr)were 0.85,0.83(＞0.70),and the experts fully affirmed the items of the standard.Among the 108 cases evaluated,37 cases(34.26％)were judged to be reasonable,52 cases(48.15％)were judged to be basically reasonable and 19 cases(17.59％)were judged to be unreasonable.The main unreasonable problems were manifested in indications,the timing of administration,drug course and monitoring of efficacy and laboratory parameters.Conclusion The method of DUE of ozagrel sodium based on weighted TOPSIS is more comprehensively and intuitively.The application of ozagrel sodium in the hospital is relatively standardized,but there are problems in the course of medication,indications,and timing of administration.So it is necessary to promote the rational use by strengthening the cooperation between pharmacists and physicians,and improving pharmaceutical intervention.

Objective To establish the drug use evaluation(DUE)criteria of recombinant human prourokinase(rhPro-UK),and to provide reference for the rational clinical application of rhPro-UK.Methods Based on the drug instructions of rhPro-UK,DUE standard rules were established by referring to relevant guidelines,expert consensus,authoritative literature and expert consultation.The medical records of hospitalized patients treated with rhPro-UK from January 2019 to May 2022 in Xilin Gol League Central Hospital were evaluated by retrospective investigation.The effectiveness of rhPro-UK was evaluated based on clinical outcome,and its safety was evaluated based on the incidence and severity of adverse reactions.Results A total of 230 cases were included,and 4 cases fully met the evaluation criteria(medication indication,medication process,medication results),accounting for 1.74％.There were 226 patients(98.26％)with irrational drug use,mainly manifested in two aspects of drug indication and drug process(administration mode and dosage).Treatment was effective in 221 patients,with an overall effective rate of 96.09％;139 patients experienced adverse reactions,with an incidence rate of 60.43％.Conclusion The clinical use of rhPro-UK in our hospital is irrational in the indication of medication and the process of medication,and the establishment of the DUE standard rules of rhPro-UK can provide a reference to standardize the clinical application of rhPro-UK and promote its rational use.

Objective To establish the drug use evaluation(DUE)standard of somatostatin and evaluate the rationality of its clinical use,so as to provide a reference for the rationally clinical application of somatostatin.Methods Based on the specification of somatostatin for injection,related guidelines and literature,DUE standard was established.Evaluate the rationality and standardization of the use of somatostatin for injection at Beihai People's Hospital from January 2021 to December 2021 based on the established DUE standards.Results A total of 407 patients were included,with a medication reasonable rate of 94.84％.The irrational use of drug included unreasonable indications(13 cases,3.19％),unreasonable drug use frequency(7 cases,1.72％),and unreasonable drug interactions(1 case,0.25％).Conclusion The somatostatin for injection DUE standard established is feasible and practical.The clinical application of somatostatin for injection in this hospital is basically reasonable,but there are still some irrational use of somatostatin,which should be strengthened for intervention.