Colorectal cancer is the third most common malignant tumor worldwide, causing serious harm to human health. Epigenetic modification, especially RNA methylation modification, plays a critical role in the occurrence and development of colorectal cancer via post-transcriptional regulation of mRNA and non-coding RNA expression. Among these, N6-methyladenosine (m⁶A) is the most common chemical modification in mammals, which plays an important role in the progress of cancer, including colorectal cancer. m⁶A is a dynamic and reversible process and is mainly regulated by m⁶A methyltransferase (“writers”), m⁶A demethylases (“erasers”), and m⁶A binding proteins (“readers”). Herein, we reviewed recent advances in the role of m⁶A modification in colorectal cancer and focused on the factors affecting m⁶A modification. Furthermore, we discussed the clinical application of m⁶A modifications for colorectal cancer diagnosis, prognosis, and treatment and provided guides in clinical practice. m⁶A modification and m⁶A regulators play significant roles in the occurrence and development of colorectal cancer by regulating the stability and translation of mRNAs, the maturation of miRNAs, and the function of lncRNAs. m⁶A regulators can play biological roles in colorectal cancer through m⁶A-dependent manner or m⁶A-independent manner. Multiplies of internal factors, including miRNAs and lncRNAs, and external factors can also regulate the m⁶A modification by completing with m⁶A regulators in a base complement manner, regulating the expression of m⁶A and mutating the m⁶A site. m⁶A regulators and m⁶A modificantion are diagnostic and prognostic markers for CRC. Therefore, m⁶A regulators and m⁶A modificantion may be potential therapeutic target for CRC in the future.

Background: Elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) face an elevated risk of drug-related problems (DRPs) owing to age-related decline in physiological reserve and multiple comorbidities. This study aims to systematically identify and categorize the DRPs of elderly patients with AECOPD, analyze their causes and risk factors, and evaluate the impact of pharmaceutical interventions on resolving DRPs.Methods: Elderly patients hospitalized with AECOPD at Gaochun Hospital Affiliated to Jiangsu University were enrolled in this prospective study from 1 January 2023 to 31 December 2024. Clinical pharmacists classified and documented DRPs using the Pharmaceutical Care Network Europe (PCNE) V9.1 Classification System, followed by targeted pharmaceutical interventions based on causes of DRPs.Results: A total of 544 AECOPD patients were included in the study. Among them, 393 DRPs were identified in 300 patients, resulting in an occurrence rate of 55.15%. “P2 Treatment safety” was the major DRPs (n = 177, 45.04%). Univariate and multivariate analysis showed that the number of drugs >15 (OR: 136.648, 95% CI: 38.693–482.583) and the number of comorbidities >2 (OR: 161.092, 95% CI: 43.880–591.402) were the risk factors for DRPs (P < 0.001). 472 causes were analyzed by clinical pharmacists. “C9.1 No or inappropriate outcome monitoring (including TDM)” was the most common cause of DRPs (n = 163, 34.53%). Clinical pharmacists proposed 435 interventions to address DRPs, of which 398 (91.49%) interventions were accepted. In the end, 294 (74.81%) DRPs were totally solved, and 18 (4.58%) DRPs were partially solved.Conclusion: The incidence of DRPs is high in elderly hospitalized patients with AECOPD in China. The number of comorbidities and prescription drugs are important predictors for DRPs. The active involvement of clinical pharmacists in the management of AECOPD patients can enhance both the safe and effective use of medications among elderly patients, as well as the overall quality of pharmaceutical care.