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Does GVHD help to make beginners beyond professional APCs?
Recently, more personalized travel methods have emerged in the tourism industry, such as individual travel and self-guided travel. The service models of traditional tourism limit the diversity of service options and cannot fully meet the individual needs of tourists anymore. The aim is to integrate sparse tourism information on the Internet, thereby providing more convenient, faster, and more personalized tourism services. Based on the shortcomings of the traditional tourism recommendation system, a deep learning-based classification processing method of tourism product information is proposed. This method uses word embedding in the data preprocessing stage. The Convolutional Neural Network (CNN) is used to process review information of users and tourism service items. The Deep Neural Network (DNN) is used to process the necessary information of users and tourism service items. Also, factorization machine technology is used to learn the interaction between the extracted features to improve the prediction model. The results show that the proposed model can maintain an excellent precision of 64.2% when generating personalized recommendation lists for users. The sensitivity and accuracy of the recommendation list are better than other algorithms. By adding DNN, the word embedding method, and the factorization machine model, the precision is improved by 30%, 33.3%, and 40%, respectively. The model accuracy is the highest with 40 hidden factors, 100 convolutions, and a 100+50 combination hidden layer. Compared with traditional methods, the proposed algorithm can provide users with personalized travel products more accurately in personalized travel recommendations. The results have enriched and developed the theory of tourism service supply chain, providing a reference for constructing a personalized tourism service system.Pulmonary benign metastasizing leiomyoma (PBML) is a rare entity. We herein report a case of PBML found as multiple bilateral lung nodules 11 years after total hysterectomy. The patient was a 53-year-old woman with past surgical history of abdominal total hysterectomy for a uterine leiomyoma at the age of 42. She was referred to our department for further evaluation of multiple pulmonary nodules detected by a chest radiography. A chest computed tomography revealed multiple bilateral small lung nodules less than 10 mm in diameter. 18-fluorodeoxyglucose (FDG) positron emission tomography showed no significant FDG accumulation to these nodules. The patient finally underwent video assisted thoracoscopic wedge resection of the lower lobe of the right lung for surgical biopsy. The final pathological diagnosis was PBML, based on the comparative evaluation of the surgical specimens from the lung and the uterus. No evidence of enlargement in the remaining pulmonary nodules was noted for 9 months after surgical lung biopsy.A 61-year-old woman, who was revealed to have a 11 mm pulmonary nodule in the right middle lobe by computed tomography, was diagnosed with adenocarcinoma using bronchoscopy. Fluorodeoxyglucose-positron emission tomography (FDG-PET) showed FDG accumulation in the tumor, with a maximum standardized uptake value( SUVmax) of 2.47. Therefore, she underwent thoracoscopic right middle lobectomy. Histopathological examination revealed invasive growth of cylindrical tumor cells with clear glycogen-filled cytoplasm and a relatively high-grade nuclear atypia in tubulopapillary structures; no morula was observed. Immunohistochemically, the membranes of the tumor cells were positively stained for β-catenin, indicating high-grade fetal adenocarcinoma (pT1bN0M0, pathologic stageⅠA2). The postoperative course was uneventful, without recurrence 6 months after surgery.Lactic acidosis is a common condition observed in a patient after cardiac surgery. It is important to identify the pathogenesis of lactic acidosis since the delay of an appropriate treatment leads to high mortality. Metformin overdose has been known as a risk of lactic acidosis, and previous reports have demonstrated that continuous renal replacement therapy(CRRT) is effective. However, it has yet to be known if metformin-related lactic acidosis after cardiac surgery is treatable with CRRT. We, herein, report a case of 64-year-old diabetic male who had been on metformin treatment until 1 day before surgery. He presented lactic acidosis postoperatively and was successfully treated with CRRT. This case suggests that it is necessary to discontinue metformin no later than 2 days before surgery and that CRRT is of use for perioperative lactic acidosis in a patient on metformin.A 66-year-old man underwent catheter ablation for Wolff-Parkinson-White syndrome. When we advanced the ablation catheter clockwise in the left ventricle, it was entrapped and became unable to control. Thus, the patient underwent open heart surgery for catheter removal. During the surgery, the last few millimeters of the catheter were observed entrapped by multiple basal chordae of the posterior mitral valve. We released the catheter safely, and visual inspection of the left ventricle showed no abnormalities. His postoperative course was uneventful. Ablation catheter entrapment in the heart is a rare but severe complication that requires open heart surgery.We report a case of giant left atrial myxoma in a 52-year-old woman who developed congestive heart failure. By echocardiography, not only the myxoma but moderate degree of mitral and tricuspid regurgitation was also found. The tumor was extensively attached to the left atrial endocardium, and was excised completely together with the endocardium. No valve surgery was added. Postoperative echocardiography showed no myxoma and no mitral valve regurgitation. She was discharged in good condition on postoperative day 14.In patients with a congenitally corrected transposition of the great arteries (ccTGA), the regurgitation of the systemic atrioventricular valve (SAVV) increases and anatomical right ventricular (ARV) dysfunction often progressively develops. A low systemic ventricular ejection fraction( SVEF) is a risk factor for mortality. However, in patients with a low ejection fraction of ARV, it is unclear how to best perform valve replacement for patients with regurgitation of SAVV. A 70-year-old female with respirator discomfort was admitted to our hospital and diagnosed to have situs solitus ccTGA, severe SAVV regurgitation, and ARV dysfunction. Her ARV ejection fraction was 25% and she was therefore dependent on inotropic agents. selleck chemicals We successfully performed a tricuspid valve replacement while preserving the leaflets, the chorda tendineae's, and papillary muscles, and placing the lead for cardiac resynchronization therapy on the ARV. Her postoperative course was uneventful. Thereafter, she was discharged 6 weeks after surgery.
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