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First-generation epithelial growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have markedly improved the treatment of non-small cell lung cancer (non-SCLC) with EGFR-sensitive mutations. However, acquired resistance to these drugs was inevitable. The transformation of lung adenocarcinoma to SCLC following treatment with EGFR-TKIs is a rare phenomenon that contributes to resistance to EGFR-TKIs. The present case concerns a 74-year-old man previously diagnosed with and treated for pneumonia; however, this was later pathologically confirmed as lung adenocarcinoma by transbronchial lung biopsy. Deletion of exon 19 of EGFR was identified by next-generation sequencing technology. The patient improved markedly when treated with gefitinib, but relapsed after 1 year, with markedly increased serum levels of neuron-specific enolase (NSE). Transformation to SCLC was detected by endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) re-biopsy, which was negative for the deletion of exon 19 of EGFR. The patient was positive for vimentin expression and refractory to etoposide and cisplatin chemotherapy, and succumbed to the disease 18 months after diagnosis. Transformation of the disease from adenocarcinoma to SCLC may have been due to cancer heterogeneity. Re-biopsy is therefore important in EGFR-TKI-resistant patients for genetic and histological re-evaluation. NSE serum levels may also be useful for detecting early SCLC transformation.

Two cationic silicone surfactants, 3-[tri-(trimethylsiloxy)]silylpropylpyridinium chloride (Si 4 pyrCl) and N -methyl-3-[tri-(trimethylsiloxy)]silylpropylpiperidinium chloride (Si 4 pipCl), were synthesized. Their aggregation behavior in aqueous solution was investigated through analyses of surface tension, electrical conductivity, dynamic light scattering (DLS), and transmission electron microscopy (TEM). Surface-tension measurements showed that the two cationic silicone surfactants decreased the surface tension of water to almost 20 mN m − 1 . This result indicated the surfactants' remarkable surface activity. The effects of inorganic salts, sodium chloride, sodium bromide, sodium iodide and sodium sulfate, on the aggregation behavior of Si 4 pyrCl and Si 4 pipCl were systematically explored. Results showed that the aggregation of Si 4 pyrCl and Si 4 pipCl was promoted by the addition of salts and that aggregation ability followed the order of NaI > NaBr > Na 2 SO 4 > NaCl. Thermodynamic parameters obtained from electrical-conductivity measurements indicated that the micellization of Si 4 pyrCl and Si 4 pipCl was entropy driven. Spherical aggregates with diameters ranging from 200 nm to 600 nm were observed by TEM, and the aggregates' diameter distribution was obtained by DLS. The extraction behavior on several metal ions (Co (II), Mn (II), Fe (III), Ni (II), Cu (II), Al (III), Sn (IV), Zn (II), Ce (III), Li (I), Mg (II), Au (III), and Pd (II)) in chloroform by the surfactants in chloroform was studied for the first time. Results showed that Si 4 pipCl and Si 4 pyrCl had good extraction ability for Au (III) and Pd (II).

In this study, we synthesized the cationic silicone surfactant tri-(trimethylsiloxy)silylpropylpyridinnium chloride (Si 4 pyrCl). We then systematically investigated the effects of organic salts such as sodium acetate, sodium oxalate, sodium citrate, sodium benzoate, and sodium salicylate on the aggregation behavior of Si 4 pyrCl in aqueous solution through surface tension and electrical conductivity analyses, dynamic light scattering (DLS), and transmission electron microscopy (TEM). The addition of organic salts promoted surfactant aggregation. The aggregation ability was observed to be in the following order: s sodium salicylate > sodium benzoate > sodium citrate > sodium oxalate > sodium acetate. The measurement of electrical conductivity shows that the micellization of Si 4 pyrCl in aqueous solution is spontaneous. Several spherical-like aggregates with a diameter of approximately 500 nm were observed via TEM. The diameter distribution was determined through DLS. This work will be of great significance for the understanding of cationic silicone surfactants and their applications in industrial production.

Backgrounds Pulmonary sarcoidosis is often complicated by pulmonary hypertension, a complication that is associated with increased disability and mortality. To this point, however, little progress has been made in the treatment of sarcoidosis associated with pulmonary hypertension (SAPH). Methods A prospective study was performed on 72 consecutive Chinese sarcoidosis patients followed at an outpatient clinic. The patients were evaluated by Doppler echocardiography and computed tomography pulmonary angiography. SAPH was confirmed by right heart catheterisation. The clinical parameters were compared before and 2 months after treatment with oral glucocorticoids. Eight stage III and IV patients with moderate to severe proximal pulmonary arterial stenosis (PAS) and SAPH underwent interventional therapy (IT) after prednisone treatment and were followed up at 3-month intervals. Results After 2 months of prednisone treatment, 32 stage III and IV patients continued to display varying degrees of PAS and SAPH. Eight patients underwent IT without severe complications and made improvements in pulmonary arterial pressure, pulmonary vascular resistance, arterial oxygen saturation and WHO functional classification, with the improvements lasting more than 3 months. Conclusions PAS caused by external compression in sarcoidosis is a significant reason for SAPH. IT is effective and safe in the treatment of PAS and SAPH.

Background The incidence and risk factors of chronic thromboembolic pulmonary hypertension (CTEPH) in patients with acute pulmonary embolism (PE) have been well reported. However, in real world, patients diagnosed with PE for the first time were usually composed of acute PE, sub-acute PE, and chronic PE, and the cumulative incidence and risk factors of CTEPH in this cohort were still unknown. Methods A prospective, long-term, follow-up study was conducted to assess the incidence of symptomatic CTEPH in consecutive patients with PE diagnosed for the first time. Patients with unexplained persistent dyspnea during follow-up underwent transthoracic echocardiography and, if the findings indicated pulmonary hypertension, ventilation-perfusion lung scanning and right heart catheterization. CTEPH was confirmed if perfusion defects were present, mean pulmonary artery pressure (mPAP) ≥25 mmHg and pulmonary artery wedge pressure (PAWP) ≤15 mmHg. Results The cumulative incidence of CTEPH in patients with PE diagnosed for the first time was 11.2% at 3 months, 12.7% at 1 year, 13.4% at 2 years, and 14.5% at 3 years. The following factors increased the risk of CTEPH: time from symptoms to treatment of PE ≥1 month (odds ratio (OR), 14.77), intermediate (OR, 37.63) to high risk PE (OR, 39.81), segmental and sub-segmental branch location of embolism (OR, 8.30) and PE-related primary risk factors (OR, 5.01). 9.4% of CTEPH patients developed from acute PE, and 90.6% from sub-acute and chronic PE. Conclusions In real world, CTEPH is a relatively common and serious complication in PE patients diagnosed for the first time. Early diagnosis and treatment of PE will decrease the incidence of CTEPH in these unspecified patients.

In clinical medicine, multidimensional time series data can be used to find the rules of disease progress by data mining technology, such as classification and prediction. However, in multidimensional time series data mining problems, the excessive data dimension causes the inaccuracy of probability density distribution to increase the computational complexity. Besides, information redundancy and irrelevant features may lead to high computational complexity and over-fitting problems. The combination of these two factors can reduce the classification performance. To reduce computational complexity and to eliminate information redundancies and irrelevant features, we improved upon a multidimensional time series feature selection method to achieve dimension reduction. The improved method selects features through the combination of the Kozachenko–Leonenko (K–L) information entropy estimation method for feature extraction based on mutual information and the feature selection algorithm based on class separability. We performed experiments on the Electroencephalogram (EEG) dataset for verification and the non-small cell lung cancer (NSCLC) clinical dataset for application. The results show that with the comparison of CLeVer, Corona and AGV, respectively, the improved method can effectively reduce the dimensions of multidimensional time series for clinical data.

Background In clinical practice, longitudinal data can be used to find trend patterns of pathema progress, such as tumour progress, along a time axis. This kind of data can be treated as time-series data. The maximum common sub-sequence is the most common method for calculating similarity of time-series data; and each point is normally treated as having the same weight. However, not all points of data within the time series should be given the same importance. According to clinical experience, the later period sub-sequence (closer to death) has a more significant effect than earlier periods in a trend analysis. Results A weighted-similarity measure based on LCSS with Constraint Window (W-LCSS-CW) Method is proposed. The results obtained from the time-series data using different weighting factors are discussed. In a study of non-small cell lung cancer using time-series data, the relative evaluation method and external evaluation method were adopted to calculate cluster effect. The results show that the proposed method, W-LCSS-CW, can improve clustering performance significantly. Clustering performance of various methods was performed using a comparison of (Cindex/Mindex). The proposed W-LCSS-CW Method was evaluated to 1.55 which was 37.02%, 48.01%, 49.64% higher than other common methods (Euclidean, DTW, STS) respectively. Conclusions The proposed W-LCSS-CW Method is recommended for monitoring time-series data of tumour patients because the incorporated weighting factor provides more convincing cluster results for medical assist support.

BACKGROUND: Monotherapy and sequential combination therapy have been widely used in the treatment of pulmonary arterial hypertension (PAH). There is limited evidence for initial combination therapy in patients with PAH, particularly those with World Health Organization (WHO) functional class III or IV. METHODS: Twenty-seven consecutive treatment-naive PAH subjects with WHO functional class III or IV PAH were randomized into 3 groups with a 1:1:1 ratio: a combination therapy group with 125 mg of bosentan twice daily plus 10 μg of iloprost 4–6 times/d; a bosentan monotherapy group with 125 mg of bosentan twice daily; and a iloprost monotherapy group with 10 μg of iloprost 4–6 times/d. Clinical and hemodynamic data were collected at baseline, 6 weeks, and 3 months. The primary end point was the change in the 6-min walk distance (6MWD) from baseline values. RESULTS: At baseline, there were no differences in demographics, WHO classification, hemodynamics, classification of PAH, or 6MWD among the 3 groups. The 6MWD significantly improved in the combination therapy group compared with the bosentan monotherapy and iloprost monotherapy groups at week 6 (P = .001) and after 3 months (P CONCLUSIONS: Initial combination therapy in treatment-naive PAH subjects with WHO functional class III or IV can significantly improve 6MWD, hemodynamics, and quality of life compared with monotherapy. Further studies with large samples and placebo controls are required to assess the tolerability and efficacy of initial combination therapy in patients with PAH. (ClinicalTrials.gov registration NCT01712997).

Effect of three inorganic electrolytes (LiCl, NaCl, and MgCl2) and four organic electrolytes, viz. tetraalkylammonium bromides ((CH3)4NBr, (C2H5)4NBr, (C3H7)4NBr, and (C4H9)4NBr) on the aggregation behavior of the anionic halogen-free surface active ionic liquid, 1-butyl-3-methylimidazolium dodecylsulfate ([C4mim][C12SO4]), in aqueous solution was studied by surface tension, steady-state fluorescence quenching, and dynamic light scattering measurements. The results show that all the electrolytes investigated have a salting-out effect, which promotes aggregate formation of [C4mim][C12SO4]. The stronger hydrophobicity of organic electrolytes is crucial for the superior influence on the surface activity of [C4mim][C12SO4]. However, the stabilization energy results obtained by quantum chemical calculations prove that although the promoting effect of organic cations (tetraalkylammonium cations) on the micellization process of [C4mim][C12SO4] is powerful, they mainly act as counterions. For a given electrolyte (i.e., NaCl), critical micelle concentration of [C4mim][C12SO4] decreases with increasing electrolyte concentration. The average aggregation number and aggregate size of [C4mim][C12SO4] were shown to change slightly in the presence of various electrolytes, except for MgCl2. Anyway, hydrophobicity together with bulkiness and hydration ability of cations of the added electrolytes are suggested to play important roles in modifying the aggregation behavior of [C4mim][C12SO4] in aqueous solution.

Pulmonary sarcoidosis is often complicated by pulmonary hypertension, a complication that is associated with increased disability and mortality. To this point, however, little progress has been made in the treatment of sarcoidosis associated with pulmonary hypertension (SAPH).A prospective study was performed on 72 consecutive Chinese sarcoidosis patients followed at an outpatient clinic. The patients were evaluated by Doppler echocardiography and computed tomography pulmonary angiography. SAPH was confirmed by right heart catheterisation. The clinical parameters were compared before and 2 months after treatment with oral glucocorticoids. Eight stage III and IV patients with moderate to severe proximal pulmonary arterial stenosis (PAS) and SAPH underwent interventional therapy (IT) after prednisone treatment and were followed up at 3-month intervals.After 2 months of prednisone treatment, 32 stage III and IV patients continued to display varying degrees of PAS and SAPH. Eight patients underwent IT without severe complications and made improvements in pulmonary arterial pressure, pulmonary vascular resistance, arterial oxygen saturation and WHO functional classification, with the improvements lasting more than 3 months.PAS caused by external compression in sarcoidosis is a significant reason for SAPH. IT is effective and safe in the treatment of PAS and SAPH.

With the purpose of extracting potential knowledge from the vast amounts of data, as well as providing auxiliary information for decision making for college admissions departments, in this paper, based on SPSS 12.0 software clementine, it mainly uses C5.0 decision tree algorithm and association rules Apriori algorithm to study the college entrance examination enrollment data, students' performance in college and employment data. It mainly focuses on the data preparation process, and shows the mining process aimed at two different goals and the valuable information dug out during these processes. The results of study shows that this kind of information can provide decision making for the department in charge of admissions. Keywords-data mining; admissions; clementine; decision

User interests drift modeling is the fundamental and key technology of Personal Recommendation System (PRS), and is arising more and more attention by researcher from home and abroad. At present, web user interests drift model is in its original phase for the reason of many aspects, and there also exist some problems need to be studied continually and deeply. Considering of web user interests might change with time flying, huge of surfing data and many influence factors need to be concerned, because user interests changes constantly with time flying. A novel web user interest drift pattern modeling method is proposed. First, this paper takes user interests as time series via using hidden Markvo model, which may properly map the sequential characteristics of user interests. Second, improved GSP searching algorithm is used to find the frequent pattern from user interest sequence. Finally, forgetting mechanism is used to solve interests drift problem, and time window is used to store current user interest pattern, and the old interests will elapse with the new interests coming constantly. Plenty of online experiments were done to verify the reasonability of the user interests drift model. Via experiments, conclusion can be drawn that this method can work perfectly and efficiently, which may firmly grasp user interests drift rule in time. Therefore, personal recommendation system using these interests drift model can recommend the latest information for web user, only according to user's potential interests changing.