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Objective To construct and validate a prognosis prediction model and a risk stratification tool for more precise and individualized evaluation of prognosis for patients following resection of esophageal squamous cell carcinoma (ESCC), and provide real-world evidence for informing optimal decision-making about adjuvant therapy. Methods The comprehensive clinical data and follow-up data were collected from consecutive patients with ESCC in the Anyang Cancer Hospital (Anyang center) from May 31, 2011 to July 31, 2018, and in the Cancer Hospital of Shantou University Medical College (Shantou center) from August 1, 2009 to December 31, 2018. Patients from the Anyang center formed the training cohort, and a two-phase selection based on backward stepwise multivariable Cox proportional hazard regression and minimization of AIC was used to construct prediction model for overall survival (OS). Bootstrap with 1 000 resamples was used for internal validation, and cohort from the Shantou center was used for external validation. Furthermore, a risk stratification tool was constructed according to the tertiles of the total points derived from nomogram in the training cohort. Results A total of 4 171 eligible patients were included in the training cohort, and 1 895 patients were included in the validation cohort. The final model incorporated nine variables: age, sex, primary tumor location, T stage, N stage, number of lymph nodes harvested, tumor size, adjuvant treatment, and preoperative hemoglobin level. A significant interaction was observed between N stage and adjuvant treatment (P < 0.001), which means that N+ stage patients were likely to benefit from addition of adjuvant therapy as opposed to surgery alone, but adjuvant therapy did not improve OS for N0 stage patients. The C-index of the model was 0.728 (95% CI: 0.713-0.742) in the training cohort, 0.722 (95% CI: 0.711-0.739) after bootstrapping, and 0.679 (95% CI: 0.662-0.697) in the external validation cohort. Calibration plots demonstrated favorable agreement between model prediction and actual observation for 1-, 3- and 5-year OS. In both training and validation cohorts, this model outperformed the seventh edition of the AJCC TNM (tumor, lymph node, and metastasis) staging system in terms of the accuracy of prognostic prediction (P < 0.05). Moreover, within each TNM staging group, this model achieved ideal risk stratification. Conclusions The prediction model constructed in this study may provide individualized survival prediction for patients with resected ESCC in China. This study also demonstrated that the N stage may be a fundamental determinant in planning postoperative adjuvant therapy for ESCC patients.

The urban-rural transition zone has obvious characteristics such as urban expansion transition, dynamic spatial structure, and a diversified human environment. It is of great significance to study the spatial interaction intensity between urban and rural transition zones. It will strengthen the cohesion of the Urban-Rural Transition Zone, promote the circulation of various elements between cities and villages, and improve the regional development capacity and competitiveness of urban and rural areas. There exists research on the change of urban spatial characteristics, the expansion of the urban outer circle, and its motive force. However, little research has been conducted on the spatial interaction and cohesion of the Urban-Rural Transition Zone. This is not helpful in coordinating the internal competition relationship between urban and rural areas, nor is it conducive to regional integration and high-quality development. Therefore, it is important to explore and analyze the spatial interaction that could form the foundation of urban and rural network cohesion. In this study, the light intensity of night light data in 2012, 2015, and 2019 was used to extract the inner boundary of the Urban-Rural Transition Zone. The light fluctuation was calculated to extract the outer boundary of the Urban-Rural Transition Zone, and the threshold value of light intensity. Light fluctuation of each phase was adjusted constantly to fit the intensity of land-use development activities in the same period. Based on existing gravity model modification ideas, this study used the proximity and traversal parameters of the improved spatial syntax sDNA model as the influence coefficient to modify the traditional gravity model. It integrated the spatial structure, road network morphology, and human activities into the influence coefficient. Further, it used night light intensity to characterize the quality of urban and rural areas and measured the Urban-Rural Transition of Guangzhou from 2012 to 2019. Finally, the study analyzed the relationship between the spatial evolution characteristics and social and economic development. The results are three-fold. First, the Urban-Rural Transition Zone in Guangzhou had a significant effect on spatial evolution-the influence of the central city spread outwards, and the rural construction effect was obvious. The Urban-Rural Transition Zone area expanded by 291.26 km² from 2012 to 2019. The small patch area was further integrated into a baseband area, and the spatial form continuity of the transition zone was enhanced. In the direction of expansion, the urban-rural transition zone generally extended from north to east, and the transition zone boundary of Conghua zone and Zengcheng district was greatly promoted. The driving force of the Urban-Rural Transition Zone Development in each region was mainly due to the growth of investment in the development of secondary and tertiary industries and real estate. Second, the interaction intensity of the Urban-Rural Transition Zone in Guangzhou showed heterogeneity in space, from large to small distribution from the inside to the outside of the transition zone. The spatial interaction network structure between urban and rural transition zones presented the characteristics of "multi direction." From the beginning, the single line network structure of the southwest had gradually developed into a multi-directional closed network connection structure. Today, the overall northeast area has been gradually developed. This multi-directional evolution is due to the improvement of people's quality of life, more convenient transportation, and continuous improvement of urban and rural land use space in the Urban-Rural Transition Zone. In terms of the total intensity of spatial interaction in the Urban-Rural Transition Zone, the northern region, represented by the Baiyun District, and the southern region, represented by the Panyu District, have higher influence and attraction. The Panyu-Baiyun spatial interaction dual-energy pole has significant characteristics, which is an important strategic node of the Guangzhou Urban-Rural Transition Zone. Third, the social and economic superiority of the Urban-Rural Transition Zone in Guangzhou is represented by three spatial hierarchies, which are driven by the radiation of the core area of the city and have developed into the Urban-Rural Transition Zone in the north, northeast, and southeast. Except for Yuexiu, Liwan, Haizhu, and Tianhe, with high urbanization rates, the unbalanced development speed of the Urban-Rural Transition Zone in other regions is obvious. Therefore, to improve the comprehensive development capacity of urban and rural areas and strengthen the cohesion of the network, each urban-rural transition zone should take the road of co-existence of joint and complementary development, attach importance to the regional development engine of the Urban-Rural Transition Zone, and enhance its potential of connecting with surrounding areas.

Marine microbial secondary metabolites with diversified structures have been found as promising sources of anti-inflammatory lead compounds. This review summarizes the sources, chemical structures, and pharmacological properties of anti-inflammatory natural products reported from marine microorganisms in the past three years (2021–2023). Approximately 252 anti-inflammatory compounds, including 129 new ones, were predominantly obtained from marine fungi and they are structurally divided into polyketides (51.2%), terpenoids (21.0%), alkaloids (18.7%), amides or peptides (4.8%), and steroids (4.3%). This review will shed light on the development of marine microbial secondary metabolites as potential anti-inflammatory lead compounds with promising clinical applications in human health. [ABSTRACT FROM AUTHOR]

Four novel resorcylic acid lactones (RALs), curvulomycins A-D (1-4), and six known congeners were isolated from the Beibu Gulf coral-derived fungus Curvularia lunata GXIMD 02512. Their structures including absolute configurations were established by extensive spectroscopic analyses along with experimental and calculated ECD spectra. Structurally, compound 3 harbors a unique γ-pyrone moiety rarely found in the natural RAL family. Notably, curvulomycin D (4) represents the first reported compound of the rare 8-membered RAL derivatives. Compounds 1 and 5 exhibited significant antiproliferative potency against two prostate cancer cell lines, with IC 50 values of 9.70 ± 0.77 μM and 7.64 ± 0.46 μM for PC-3 cells and 5.96 ± 0.43 μM and 3.15 ± 0.27 μM for 22Rv1 cells, respectively. Moreover, compound 1 inhibited clonal cell colonies in a dose-dependent manner, blocked the S and G2 phases in the PC-3 cell cycle and the G1 phase in the 22Rv1 cell cycle, which further induced apoptosis in both PC-3 and 22Rv1 cells, indicating its potential as a promising lead compound for anti-prostate cancer therapy., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (This journal is © The Royal Society of Chemistry.)

Objective: The objective was to compare the long-term overall survival (OS) of right versus left thoracic esophagectomy, and to evaluate whether surgical quality impacts comparison result., Background: Controversy regarding the optimal thoracic esophagectomy approach persists for esophageal squamous cell carcinoma (ESCC). No study has assessed the effect of surgical quality in comparison between right and left approaches., Methods: The authors consecutively recruited 5556 operable ESCC patients from two high-volume centers in China, of whom 2220 and 3336 received right and left thoracic esophagectomy, respectively. Cumulative sum was used to evaluate the learning curve for operation time of right approach, as the indicator of surgical proficiency., Results: With a median follow-up of 83.1 months, right approach, harvesting more lymph nodes, tended to have a better OS than left approach (Mean: 23.8 vs. 16.7 nodes; adjusted hazard ratio (HR)=0.93, 95% CI: 0.85-1.02). Subset analysis by the extent of lymphadenectomy demonstrated that right approach with adequate lymphadenectomy (≥15 nodes) resulted in statistically significant OS benefit compared with left approach (adjusted HR=0.86, 95% CI: 0.77-0.95), but not with limited lymphadenectomy. Subset analysis by surgical proficiency showed that proficient right approach conferred a better OS than left approach (adjusted HR=0.75, 95% CI: 0.64-0.88), but improficient right approach did not have such survival advantage., Conclusions: Surgical quality plays a crucial role in survival comparison between surgical procedures. Right thoracic esophagectomy performed with adequate lymphadenectomy and surgical proficiency, conferring more favorable survival than left approach, should be recommended as the preferred surgical procedure for localized ESCC., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)