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Objective To analyze the spatial distribution characteristics, efficiency, and influencing factors of pension institutions in Dongguan, so as to provide reference for optimizing the resource allocation of pension institutions in Dongguan. Methods The resource allocation data of pension institutions in Dongguan were obtained by questionnaire survey, and the spatial distribution characteristics and efficiency of pension institutions were analyzed and evaluated based on GIS and three-stage DEA model. Results There was a good spatial coupling between the resources of pension institutions in Dongguan and the elderly population over 60 years old; the lowest occupancy rate was 12.50%, the highest was 100.005%, and the phenomenon of "difficulty in finding a bed" and "half of the beds were vacant" coexisted. In the third stage, the average comprehensive efficiency decreased from 0.679 to 0.635, and environmental factors had a great influence on the efficiency of resource allocation in Dongguan. There were great differences in the efficiency of pension institutions in different areas. The comprehensive efficiency of urban areas was 0.784, which exceeded the average level of the whole city (0.635). The comprehensive efficiency of the eastern industrial park was only 0.439, which did not reach the average level of the whole city. The per capita regional GDP and the level of aging had a negative impact on efficiency. Conclusion It is suggested to rationally allocate the resources of pension institutions, optimize regional development planning, promote the upgrading of institutional pension services, improve the efficiency of resource allocation, and provide improved reference scheme for improving the service level of pension institutions in Dongguan. [ABSTRACT FROM AUTHOR]

Background: The chemokine family plays an important role in the growth, invasion, and metastasis of tumors. However, most studies have only focused on a few genes or a few gene loci, and thus could not reveal the associations between functional polymorphisms of chemokine family members and tumor progression. This study aimed to determine the associations between single nucleotide polymorphisms (SNPs) of chemokine family members and the prognosis of esophageal cancer (EC). Methods: The Cox risk proportional model and log-rank test were used to analyze the associations of 16 potentially functional SNPs in 13 genes from the chemokine family with the survival of 729 Chinese patients with EC. Results: Prognostic analysis on the 16 SNPs showed that different genotypes of 5 SNPs were associated with patients' survival and the risk of death. Multivariate Cox regression analysis showed that the risk of death was higher in CCL26rs2302009 genotype A/C carriers than in A/A carriers and it was also higher in CX3CL1rs2239352 genotype T/T carriers than in C/C carriers. Stepwise Cox regression analysis showed that CCL26rs2302009 genotype A/C was an independent prognostic factor of EC, and its association with increased risk of death was stronger in patients who were ≤60 years old, female, with tumors located in the middle part of esophagus, with undifferentiated or poorly differentiated tumors, with early-stage pathologic type disease, with the longest diameter of tumor ≤5cm than in their counterparts. Conclusion: These findings suggest that CCL26rs2302009 may be a candidate biomarker for EC and its effect on death risk are associated with the histological grade, pathologic type, and the longest diameter of tumor. [ABSTRACT FROM AUTHOR]

The aim of this work was to determine whether locally advanced rectal cancer (LARC) with negative mesorectal fascia (MRF) predicted by magnetic resonance imaging (MRI) can be excluded from preoperative radiation therapy treatment. This multicenter, open-label, non-inferiority, randomized clinical trial enrolled patients with LARC within 6 to 12 cm from the anal verge and with negative MRI-predicted MRF. Participants were randomized to the intervention group (primary surgery, in which the patients with positive pathologic [CRM] circumferential margins were subjected to chemoradiotherapy [CRT] and those with negative CRM underwent adjuvant chemotherapy according to pathologic staging) or the control group (preoperative CRT, in which all patients underwent subsequent surgery and adjuvant chemotherapy). The primary endpoint was 3-year disease-free survival (DFS). A total of 275 patients were randomly assigned to the intervention (n = 140) and control (n = 135) groups, in which 33.57% and 28.15% patients were at clinical T4 stage and 85.92% and 80.45% patients were at "bad" or "ugly" risk in the intervention and control groups, respectively. There were 2 patients (1.52%) and 1 patient (0.77%) with positive CRM in the intervention and control groups, respectively (P >.05). The non-adherence rates for the intervention and control groups were 3.6% and 23.7%, respectively. After a median follow-up of 34.6 months (IQR, 18.2-45.7), 43 patients had positive events (28 patients and 15 patients in the intervention and control groups, respectively). There were 6 patients (4.4%) with local recurrence in the intervention group and none in the control group, which led to the termination of the trial. The 3-year DFS rate was 81.82% in the intervention group (95% CI, 78.18%-85.46%) and 85.37% in the control group (95% CI, 81.75%-88.99%), with a difference of –3.55% (95% CI, –3.71% to –3.39%; hazard ratio, 1.76; 95% CI, 0.94-3.30). In the per-protocol data set, the difference between 3-year DFS rates was –5.44% (95% CI, –5.63% to –5.25%; hazard ratio, 2.02; 95% CI, 1.01-4.06). Based on the outcomes of this trial, in patients with LARC and MRI-negative MRF, primary surgery could negatively influence their DFS rates. Therefore, primary surgery was an inferior strategy compared with preoperative CRT followed by surgery and cannot be recommended for patients with LARC. [ABSTRACT FROM AUTHOR]

Background: To investigate the role of interleukin (IL)‐17 in tissue and peripheral blood of perianal abscess and anal fistula. Methods: Patients with primary perianal abscess (n = 50) admitted to Jinhua Municipal Central Hospital between March 2003 and August 2004 were enrolled. Fifty patients with mixed haemorrhoids, who showed no perianal abscess or anal fistula, were also recruited as the control. After surgery, patients were followed up for 6 months. Protein and gene expression of IL‐17 was determined in surgically harvested anal tissues and peripheral blood, respectively. The relationship between IL‐17 and clinical pathological features were analysed. Results: As shown by immunohistochemistry of anorectal tissues, the positive rate of IL‐17 protein was higher in the perianal abscess group than in the control group. In patients with perianal abscess, the expression of IL‐17 significantly correlated with the diameter of the abscess (P = 0.013), the wound surface healing time (P = 0.010) and the progression into anal fistula (P = 0.003). For the gene expression of IL‐17 in peripheral blood cells, the level was significantly higher in patients with perianal abscess comparing to the control group (0.4350 ± 0.1190 versus 0.1785 ± 0.1230, P ≤ 0.001). Comparing to the recovery group, patients with their perianal abscess progressed to anal fistula showed higher levels of IL‐17 gene expression (P = 0.014). Conclusions: Expression of IL‐17 was increased in the anorectal tissues and peripheral blood of patients with perianal abscess and anal fistula. IL‐17 may play an important role in the pathogenesis of perianal abscess and anal fistula. [ABSTRACT FROM AUTHOR]

• Five Patient-derived organoids of colorectal cancer were constructed. • Non-targeted metabolic was used to explore the mechanism of Curcumin on CRC PDOs. • Intersections of curcumin-interfered metabolic pathways were used to reduce individual differences. • Nine common metabolic pathways were screened in different PDOs. Organoid is a burgeoning model that have emerged in the past decade. Tumor organoids can simulate specific aspects of the 3D structure, cell type composition and function of real tumors to make up for the deficiencies of cell models and animal models. Curcumin has been found to be effective in suppressing various phases of colorectal cancer development. Nevertheless, there is no clear evidence that the results obtained on cultured cells or animal models can be translated in humans. Therefore, we constructed patient-derived organoids of colorectal cancer to show the curcumin responses of these organoids. Then, a MS-based non-targeted metabolomic strategy was to gain a system-level understanding of the mechanism of curcumin on colorectal cancer patient-derived organoids. Then non-targeted metabonomic analysis found that curcumin mainly regulated the phenylalanine, tyrosine and tryptophan biosynthesis, nicotinate and nicotinamide metabolism, purine metabolism in the organoids of colorectal cancer. Our research provided a reference for further revealing the role of curcumin in human-derived colorectal cancer-like solid tumors. [ABSTRACT FROM AUTHOR]