Lushang (China)

Abstract In the absence of sufficient user behavior data, game recommendation systems face the cold-start problem. To address this issue, this paper proposes a solution based on the Graph Neural Network pre-training model to alleviate the cold-start problem. The proposed model directly reconstructs cold-start user/game embeddings using a meta-learning setup based on dataset training simulations and uses an adaptive neighbor sampler to improve user interaction relations and thereby to improve game recommendation performance. Experimental results demonstrate the effectiveness and practicality of the recommendation model proposed in this study. Moreover, the proposed model is embedded in the game recommendation system to visualize the recommendation results.

ObjectiveThe histological conversion of lung adenocarcinoma (LUAD) into small-cell lung cancer (SCLC) is an important resistance mechanism for epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI)-resistant LUAD. Anlotinib has been recommended as the third-line treatment for SCLC patients. The efficacy of etoposide/platinum (EP) as the main treatment is very limited for patients with transformed SCLC. However, little is known about EP plus anlotinib for transformed SCLC. The present study retrospectively explored the clinical response to EP combined with anlotinib in patients with transformed SCLC from LUAD after EGFR-TKI failure.MethodsA total of 10 patients who underwent SCLC transformation from EGFR-TKI-resistant LUAD were retrospectively reviewed from September 1, 2019, to December 31, 2022, in three regional hospitals. All of the patients were treated with the combination regimen of EP and anlotinib for four to six cycles, followed by anlotinib maintenance therapy. The clinical efficacy indices including objective response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS), median overall survival (mOS), and toxicities were evaluated.ResultsThe median time from EGFR-TKI treatment to SCLC conversion was 20.1 ± 2.76 months (17–24 months). Genetic examination after transformation showed that 90% of the patients retained their original EGFR gene mutations. Additional driver genes were found, including BRAF mutation (10%), PIK3CA mutation (20%), RB1 loss (50%), and TP53 mutation (60%). The ORR and DCR were 80% and 100%, respectively. The mPFS was 9.0 months (95% CI, 7.9–10.1 months), and the mOS was 14.0 months (95% CI, 12.0–15.9 months). Less than 10% of grade 3 toxicities were observed, and no grade 4 toxicity and death events were reported.ConclusionThe EP plus anlotinib regimen appears to be a promising and safe strategy in transformed SCLC patients after EGFR-TKI resistance, which warrants further investigation.

This study aimed to characterize the chromosome and plasmid sequences, and determine the transferability of plasmids in carbapenem-resistance Acinetobacter baumannii DD520 and Klebsiella pneumoniae DD521 isolates from the same patient who was co-infected in a hospital in China. Both isolates DD520 and DD521 exhibited multidrug resistance phenotype, especially the former isolate which was resistant to nine classes of antimicrobials including carbapenems, quinolones, penicillins, cephalosporins, tetracyclines, phenicols, fosfomycins, sulfanilamides and aminoglycosides. Carbapenem resistance genes of blaOXA-23 and blaOXA-66 were identified on the chromosome of A. baumannii DD520, and blaKPC-2 was found in the plasmid pDD521.2 from K. pneumoniae DD521. Phylogenetic analysis revealed that A. baumannii DD520 belonged to the ST540 clone, and K. pneumoniae DD521 belonged to the ST2237 clone. Plasmid analysis suggested that blaKPC-2 was embedded into plasmid pDD521.2, which might be resulted from IS26- and Tn1721-mediated transposition. Plasmid pDD521.2 carrying blaKPC-2 successfully transferred from K. pneumoniae DD521 into Escherichia coli C600, and carbapenems resistance also transferred in the conjugation. To our knowledge, it was the first report of A. baumannii ST540 and K. pneumoniae ST2237 in the same patient in China. Both these two isolates exhibited resistance to carbapenem, which was likely to have resulted from carbapenem-resistance genes blaOXA-23 -blaOXA-66 on the chromosome of A. baumannii ST540, and blaKPC-2 in the plasmid of K. pneumoniae ST2237. Our study highlighted that effective measures were urgent to prevent and control the co-infection caused by two or more carbapenem-resistance pathogens in the same patient.

This work is devoted to establishing a comparatively accurate classification model between symptoms, constitutions, and regimens for traditional Chinese medicine (TCM) constitution analysis to provide preliminary screening and decision support for clinical diagnosis. However, for the analysis of massive distributed medical data in a cloud platform, the traditional data mining methods have the problems of low mining efficiency and large memory consumption, and long tuning time, an association rules method for TCM constitution analysis (ARA-TCM) is proposed that based on FP-growth algorithm and the open-source distributed file system in Hadoop framework (HDFS) to make full use of its powerful parallel processing capability. Firstly, the proposed method was used to explore the association rules between the 9 kinds of TCM constitutions and symptoms, as well as the regimen treatment plans, so as to discover the rules of typical clinical symptoms and treatment rules of different constitutions and to conduct an evidence-based medical evaluation of TCM effects in constitution-related chronic disease health management. Secondly, experiments were applied on a self-built TCM clinical records database with a total of 30,071 entries and it is found that the top three constitutions are mid constitution (42.3%), hot and humid constitution (31.3%), and inherited special constitution (26.2%), respectively. What is more, there are obvious promotions in the precision and recall rate compared with the Apriori algorithm, which indicates that the proposed method is suitable for the classification of TCM constitutions. This work is mainly focused on uncovering the rules of “disease symptoms constitution regimen” in TCM medical records, but tongue image and pulse signal are also very important to TCM constitution analysis. Therefore, this additional information should be considered into further studies to be more in line with the actual clinical needs.

目的 探讨采用延伸性护理服务对慢性萎缩性胃炎患者遵医行为及生活质量的影响。 方法 选择2015年3月至2016年3月在本院治疗的慢性萎缩性胃炎患者116例，根据护理方式不同将患者分为58例对照组（给予常规护理干预）与58例观察组（给予延伸性护理服务）。比较两组患者遵医行为和生活质量。 结果 在出院1年后，观察组的规范用药占91.38%、合理膳食占94.83%，高于对照组的65.52%、74.14%，差异有统计学意义（P 0.05）；在护理干预1年后，观察组的社会、心理、生理及环境领域等评分均高于对照组，差异有统计学意义（P<0.05）。 结论 采用延伸性护理服务有利于加强慢性萎缩性胃炎患者的遵医行为，同时能提高患者的生活质量。