Search

The economic effects of tourism industry during periods of crisis, such as the COVID-19 pandemic, have received significant attention in recent years. The future is likely to pose a range of new challenges and opportunities to sustainable tourism. This paper employs the Markov-switching vector autoregressions (MSVAR) model to investigate the sustainability of tourism's economic effects in Hong Kong, both during periods of crisis and in the absence of crises. The empirical results show that: (1) The MSVAR model is effective in capturing the nonlinear relationship between the economy and tourism and allows for the categorizing of this relationship into four regimes, for example, the "major event crises" regime and the "economic crises" regime; (2) The economic effects of tourism differ noticeably across the four different regimes, and sustainability varies depending on the presence and type of crisis; (3) The Hong Kong economy, and the tourism industry in particular, exhibits high levels of stability and sustainability. In short, economic growth in Hong Kong's tourism industry is capable of rapid recovery following major crisis events, and it has the capacity to rebound quickly into new periods of rapid growth. [ABSTRACT FROM AUTHOR]

The incidence of colorectal cancer (CRC) is increasing in China. Here, we aimed to evaluate the latest demographic trends and KRAS/BRAF mutations status of Chinese CRC. Five thousand five hundred and forty‐six CRC patients diagnosed from 2010 to 2017 were involved. KRAS exon 2 and BRAFV600E mutations were detected by Sanger sequencing and high‐resolution melting analysis or allelic‐specific probe method. Gene mutation profiles and clinicopathologic characteristics of 5495 patients were analyzed. The joinpoint regression model was used to predict the demographic data in 2018. We found KRAS exon 2 and BRAFV600E mutation rates were 37.7 and 2.8% in CRC patients. Tumors with KRAS exon 2 mutations were more likely to be present in female and patients aged older than 75 years, right colon and have well‐differentiated histology. Tumors with BRAFV600E mutations were more likely to be present in the female, right colon and have poorly differentiated histology. From 2010 to 2017, the percentage of colon cancer and tubular adenocarcinoma in CRC increased substantially (from 39.3 to 51.8%, from 78.6 to 93.4%, respectively). The percentage of right colon cancer increased from 18.3 to 20.5%, which predictively may keep at 22.6% in 2018. The rise trends for patients with moderate differentiation tumor or KRAS exon 2 mutated tumor were apparent (from 50.3 to 78.6%, from 32.8 to 39.7%, respectively). In conclusion, in recent 8 years, there is a shift to the colon, especially right colon in the incidence of Chinese CRC. Moreover tubular adenocarcinoma is becoming the primary histology type. What's new? Colorectal carcinoma (CRC) is on the rise in China due to a westernized lifestyle but a thorough molecular characterization of these tumors is lacking. Here the authors determined mutation rates of KRAS and BRAF, two critical growth‐control factors, in a large study of CRC patients in China. Both mutations occurred more frequently in female patients with right‐sided CRCs but significantly differed in their differentiation state, underscoring the need for comprehensive molecular diagnostics in the management of CRC patients in China. [ABSTRACT FROM AUTHOR]

Background Few studies on anastomotic condition after rectal-cancer resection and its effect on anastomotic leakage (AL) are available up to now. This study aimed to investigate potential radiation-induced injury left on surgical margins of anterior resection after neoadjuvant chemoradiotherapy (nCRT) and its association with AL. Methods We retrospectively identified 161 consecutive patients who underwent anterior resection with nCRT, neoadjuvant chemotherapy without radiation (nCT) or no neoadjuvant therapy between 2014 and 2015. Tissue samples of resection margins were assessed using a specific histopathological score and microvessel density in submucosa. Propensity score matching was used to balance the baseline characteristics. Association between AL and histopathological features was analysed. Results AL occurred in 13 of 54 patients undergoing nCRT, 5 of 48 patients undergoing nCT and 7 of 59 patients without neoadjuvant therapy. Comparisons after matching showed median (range) histopathological scores as follows: 3 (0–8) vs 0 (0–3) vs 0 (0–2) for the proximal margin (P  < 0.001); 4 (2–9) vs 0 (0–4) vs 0 (0–3) for the distal margin (P  < 0.001). Correspondingly, mean (SD) microvessel densities were as follows: 21.7 (7.9) vs 27.2 (8.6) vs 27.3 (9.4) for the proximal margin (P  = 0.003); 18.1 (9.3) vs 25.2 (12.9) vs 24.9 (7.4) for the distal margin (P  < 0.001). Among patients undergoing nCRT, AL was associated with increased histopathological score (P  = 0.003) and decreased microvessel density (P  = 0.004) on the proximal margin. Conclusions Surgical margins of rectal-cancer resection are exposed to certain radiation-induced injury after nCRT. AL is associated with aggravated radiation damage on the proximal margin. [ABSTRACT FROM AUTHOR]

Background: Chronic radiation proctitis (CRP), a common complication after radiotherapy for pelvic malignancies, compromises patient quality of life. Vascular damage and aberrant angiogenesis in the mucosal layer are essential histological features, but changes to the submucosal layer are unclear. Thus, we evaluated the histological characteristics and distribution changes of key angiogenic factors in full-layered human CRP samples.Methods: Thirty paraffin-embedded CRP and twenty-nine non-CRP tissues were used to evaluate histopathological changes. Immunohistochemistry with anti-CD34 antibody was performed to calculate microvascular density (MVD). Frozen tissues from eight CRP patients and five non-CRP controls were collected and analyzed by antibody array, which contained sixty human angiogenesis-related factors. Quality controls with positive and negative controls were performed during antibody array analysis. Two differentially expressed factors were confirmed by ELISA.Results: CRP lesions showed vasculopathy, fibrosis, mucosal ulceration, edema, and inflammatory cell infiltration. Human angiogenesis antibody array and ELISA confirmed the increased angiostatin in CRP lesions. Immunohistochemical staining showed dispersed distribution of angiostatin throughout the mucosal and submucosal layers in CRP lesions, while angiostatin accumulated within the vessel lumens in non-CRP tissues. MVD significantly decreased in the submucosal layer of CRP, suggesting a potential association with increased angiostatin.Conclusions: Angiostatin increased and had a distinct distribution in CRP lesions. Compensatory telangiectasia in the mucosa, vessel stenosis, and reduced MVD might attenuate blood flow in the submucosa and contribute to CRP progression. Restoration of vascular functionality by promoting angiogenesis in the submucosal layer may help alleviate CRP in clinical practice. [ABSTRACT FROM AUTHOR]