Characteristics of Familial Lung Cancer in Yunnan-Guizhou Plateau of China

Background: Lung cancer has inherited susceptibility and show familial aggregation, the characteristics of familial lung cancer exhibit population heterogeneity. Despite previous studies, familial lung cancer in China's Yunnan-Guizhou plateau remains understudied.Methods: Between 2015 and 2017, 1,023 lung cancer patients (residents of Yunnan-Guizhou plateau) were enrolled with no limitation on other parameters, 152 subjects had familial lung cancer. Clinicopathologic parameters were analyzed and compared, 4,754 lung cancer patients from NCI-GDC were used to represent a general population.Results: Familial lung cancer (FLC) subjects showed unique characters: early-onset; increased rate of female, adenocarcinoma, stage IV and other cancer history; unbalance in anatomic sites; all ruling out significant difference in smoking status. Unbalanced distribution of co-existing diseases or symptoms was also discovered. FLC patients were more likely to develop benign lesions (polyps, nodules, cysts) early in life, especially early-growth of multiple pulmonary nodules at higher frequency. Typical diseases with family history like diabetes and hypertension were also increased in FLC population. Compared to GDC data, our subject population was younger: the age peak of our FLC group was in 50–59; our sporadic group had an age peak around 60; while GDC patients' age peak was in 60–69. Importantly, the biggest difference happened in age 40–49: our FLC group and sporadic group had 3 times and 2 times higher ratio than GDC population, respectively. Moreover, the age peaks of our FLC males and FLC females were both in 50–59; while our sporadic females had the age peak in 50–59, much earlier than sporadic males (around 60–69); reflecting gender-specific or age-specific characters in our subject population.Conclusions: Familial lung cancer in China's Yunnan-Guizhou plateau showed unique clinicopathologic characters, differences were found in gender, age, histologic type, TNM stage and co-existing diseases or symptoms. Identification of hereditary factors which lead to increased lung cancer risk will be a challenge of both scientific and clinical significance

Adaptive Vague Preference Policy Learning for Multi-round Conversational Recommendation

Conversational recommendation systems (CRS) effectively address information asymmetry by dynamically eliciting user preferences through multi-turn interactions. Existing CRS widely assumes that users have clear preferences. Under this assumption, the agent will completely trust the user feedback and treat the accepted or rejected signals as strong indicators to filter items and reduce the candidate space, which may lead to the problem of over-filtering. However, in reality, users' preferences are often vague and volatile, with uncertainty about their desires and changing decisions during interactions. To address this issue, we introduce a novel scenario called Vague Preference Multi-round Conversational Recommendation (VPMCR), which considers users' vague and volatile preferences in CRS.VPMCR employs a soft estimation mechanism to assign a non-zero confidence score for all candidate items to be displayed, naturally avoiding the over-filtering problem. In the VPMCR setting, we introduce an solution called Adaptive Vague Preference Policy Learning (AVPPL), which consists of two main components: Uncertainty-aware Soft Estimation (USE) and Uncertainty-aware Policy Learning (UPL). USE estimates the uncertainty of users' vague feedback and captures their dynamic preferences using a choice-based preferences extraction module and a time-aware decaying strategy. UPL leverages the preference distribution estimated by USE to guide the conversation and adapt to changes in users' preferences to make recommendations or ask for attributes. Our extensive experiments demonstrate the effectiveness of our method in the VPMCR scenario, highlighting its potential for practical applications and improving the overall performance and applicability of CRS in real-world settings, particularly for users with vague or dynamic preferences

Advances in Foxp3+ regulatory T cells (Foxp3+ Treg) and key factors in digestive malignancies

Foxp3+ regulatory T cells (Foxp3+ Treg) play a role in regulating various types of tumors, but uncertainty still exists regarding the exact mechanism underlying Foxp3+ Treg activation in gastrointestinal malignancies. As of now, research has shown that Foxp3+ Treg expression, altered glucose metabolism, or a hypoxic tumor microenvironment all affect Foxp3+ Treg function in the bodies of tumor patients. Furthermore, it has been demonstrated that post-translational modifications are essential for mature Foxp3 to function properly. Additionally, a considerable number of non-coding RNAs (ncRNAs) have been implicated in the activation of the Foxp3 signaling pathway. These mechanisms regulating Foxp3 may one day serve as potential therapeutic targets for gastrointestinal malignancies. This review primarily focuses on the properties and capabilities of Foxp3 and Foxp3+Treg. It emphasizes the advancement of research on the regulatory mechanisms of Foxp3 in different malignant tumors of the digestive system, providing new insights for the exploration of anticancer treatments

Investigation of vascular risk factor control and secondary prevention medication compliance in acute ischemic stroke

ObjectivesThis study aimed to investigate the management of vascular risk factors, with a specific focus on understanding the various factors affecting risk factor control through an in-depth analysis of clinical data and a longitudinal follow-up of patients who have experienced ischemic strokes.MethodsA total of 1,572 participants were included in the analysis. We assessed thresholds for blood pressure (BP), low-density lipoprotein cholesterol (LDL-C), and glycated hemoglobin (HbA1c) levels to uncover the contextual conditions and factors affecting vascular risk factor control. Moreover, the study also scrutinized medication compliance at intervals of 3, 6, and 12 months post-onset. Logistic regression was used to adjust for confounding factors.ResultsAt 3, 6, and 12 months, BP,LDL, hemoglobin control targets were achieved in 50.7, 51.8, and 50.6%; 51.5, 59.4, and 50.6%; 48.1, 44.0, and 48.4%,respectively. Notably, age was associated with the achievement of BP control (odds ratio [OR], 0.96; 95% confidence intervals [CI], 0.94–0.98; p < 0.0001). Ethnic minorities (OR, 4.23; 95% CI, 1.19–15.09; p = 0.02) and individuals with coronary heart disease (OR, 0.5; 95% CI, 0.3–1.0; p = 0.05) experienced decreased BP control ratios. A previous history of stroke (OR, 1.7; 95% CI, 1.0–2.8; p = 0.03) and unrestricted alcohol consumption (OR, 3.3; 95% CI, 1.0–11.1; p = 0.05) was significantly associated with the achievement of lipid control. Furthermore, lifestyle modifications were significantly correlated with the achievement of BP control (OR, 0.19; 95% CI, 0.12–0.30; p < 0.01), blood glucose control (OR, 0.03; 95% CI, 0.01–0.08; p < 0.01), and blood lipid control (OR, 0.26; 95% CI, 0.16–0.42; p < 0.01). The absence of regular physical activity was associated with lower rates of glycemic (OR, 0.14; 95% CI, 0.06–0.36; p < 0.01) and lipid controls (OR, 0.55; 95% CI, 0.33–0.90; p = 0.01). Over time, overall medication compliance declined.ConclusionWithin the cohort of patients under medication, the compliance rate concerning vascular risk factors remains unsatisfactory. Attention should be paid to compliance with secondary prevention medications and enhance the control of vascular risk factors, as compliance emerges as the key to effective prevention