Objective To discuss the changes of quality of life and influence factors in patients with multidrugresistant pulmonary tuber-culosis. Methods Using the SF-36 scale of 80 normal subjects and 80 cases of MDRTB patients before and after treatment and quality of life score total score evaluated dimensions. Results Between the patients with MDR-TB and the control in the total Qol scores and eight dimensionality, there were significant differences(P＜0.01), total Qol scores and eight dimensionality in 3 months or 1 year after treatment were higher than before therapy,there were significant differences(P＜0.01 ). Between 1 year after therapy in the total Qol scores and PF, PR, GH, VT, SF, ER, MH, dimensionality were lower than control groups, there were significant differences(P＜0.05 ). The main factors affecting the Qol of patients with MDR-TB were cultural level, kinds of drug resistant and reduction of counts of white blood cell. Conclusion The correlation between quality of life and education, the number of drug resistance, reduction of white blood cell in patients with multi-drugresistant pulmonary tuberculosis.

A number of medications have been proved to be able to either improve the antitumor effect of chemotherapeutics and molecular targeted drugs or reverse the resistance of tumors to chemotherapeutics and molecular targeted drugs,which are not traditionally used as anticancer drugs.Especially for late-stage tumors after multiple treatments,these agents are good alternatives when used independently or in combination with chemotherapeutics and molecular targeted drugs.These drugs include proton modulators,hypoglycemic agents and cardiovascular agents,etc.

With the rapid development of tumor immunotherapy in recent years, therapeutic cancer vaccines are attracting increased attention. Compared with personalized neoantigen vaccines, in situ vaccines could form an antigen reservoir in the tumor itself. Subsequently, antitumor immunity is initiated and the response to immune-checkpoint inhibitors of some patients improve without necessitating these patients to undergo the complicated procedures of detecting personalized antigen and customizing and synthesizing antigen peptide. At this stage, the potential of realizing the clinical translation of in situ vaccination is tremendous. In this review, we primarily introduce the mechanisms of radiotherapy and intratumoral immune injection as in situ vaccination and discuss the current status of preclinical study and clinical application of their combination to attract more attention from researchers and clinicians toward in situ vaccination.

Objective To explore the safety and feasibility of time of postoperative strict bed rest shorten to one hour among patients with CT-guided percutaneous lung biopsy.Methods From July 2016 to June 2017,we selected 140 patients with CT-guided percutaneous lung biopsy of cancer center at Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,by convenience sampling.All of the patients were randomly divided into observation group and control group,70 cases in each group.Patients of observation group kept strict bed rest for one hour and those of control group for six hours by the routine.We compared the incidence of complication and patients' comfort between two groups after surgery using t test and χ2test.Results The total of 140 patients were treated with biopsy successfully without chest infection and asphyxia after surgery.There was no statistical difference in the incidences of pneumothorax and bleeding of patients between two groups (χ2=0.341,0.119;P＞0.05);the comfort of observation group was superior to that of control group six hours after biopsy with a significant difference (t=9.683,P＜0.01).Conclusions The time of postoperative strict bed rest shorten to one hour among patients with CT-guided percutaneous lung biopsy does not increase the incidence of complications after surgery and makes patients feel more comfortable.

Soft tissue sarcoma (STS) is a highly heterogeneous group of malignant tumors originating from mesenchymal tissues. The most common sites of STS are limbs (45%), viscera (21%) and retroperitoneum (17%). The incidence of head and neck soft tissue sarcomas (HNSTS) is the lowest (5%) compared with other areas of the body. Due to numerous functional organs and delicate and complex anatomical structures of the head and neck, it is often difficult to perform radical surgical treatment. Therefore, radiotherapy plays an important role in the treatment of HNSTS. Due to its low incidence, radiotherapy for HNSTS has been rarely studied and captivated little attention. In this article, the present situation and clinical evidence of radiotherapy for HNSTS were summarized, aiming to provide reference for clinical practice.

Immunosuppressive tumor microenvironment is an important obstacle to tumor immunotherapy.Therefore,improving tumor microenvironment to enhance immune response is the key to improve the efficacy of immunotherapy.Based on the basic principle of immunology that the body has a strong response to"foreign"antigens and a weak response to preexisting antigens,pathogen infection can be combined with innate immune-related receptors to enhance the anti-tumor immune response.Pathogen vaccines can induce a"hot"tumor microenvironment with stronger antigen presentation and T lymphocyte activation,showing higher response to immunotherapy and having better security.In this review,we summarized the related studies on pathogen vaccine enhancing tumor immune response,including mixed bacterial vaccine,BCG vaccine,OK-432,synthetic vaccines based on tetanus toxin,modified vaccinia virus,influenza vaccine,Epstein-Barr virus and COVID-19 vaccine.The feasibility,application prospect and challenge of pathogen vaccine in tumor immunotherapy were discussed.

Tumor immunotherapeutics include immune checkpoint inhibitors,adoptive cellular therapy,tumor vaccines,immunomodulators,which regulate or induce anti-tumor activity by blocking immunosuppressive signals,infusing in vitro-induced anti-tumor effector cells,and enhancing the immunogenicity of tumor cells in the fight against cancer.The effect mechanisms of tumor immunotherapy is different from that of other tumor therapeutic approaches,such as surgery and chemotherapy.Therefore,in the evaluation of anti-tumor efficacy,the use of conventional imaging methods to detect the volume change of tumor lesions shows special response patterns such as"false progression"and"superprogression",which cannot timely and accurately evaluate the objective efficacy of tumor immunotherapy.This review is an attempt to focus on those challenges in evaluating immunotherapy efficacy and the latest developments of relevant evaluation criteria,and is aimed at providing reference for the scientific evaluation of tumor immunotherapy efficacy and the selection of appropriate immunotherapy strategies for tumor patients.

Ewing sarcoma(EWS)is an invasive and primary bone tumor with a high incidence in children and adolescents.The presence and extent of metastases at the time of diagnosis remains the most important prognostic factor in determining a patient's prognosis.Up now,considerable ambiguity exists regarding the optimal modality for detecting bone marrow metastases.Bone marrow biopsy and/or aspiration(BMBA)is the gold standard for determining bone marrow metastases.This invasive and painful procedure may be amenable to being replaced by 18F-FDG PET/CT because of its high sensitivity in detecting EWS bone and extraosseous metastases.This review provides an overview of the current literature,concludes that there is no longer a systematic consensus on the implementation of BMAB criteria for the diagnosis of bone marrow metastases in EWS,and summarizes the current practical strategies and clinical practices for the diagnosis of EWS bone marrow metastases accordingly.

[摘 要] 嵌合抗原受体基因修饰T细胞（CAR-T细胞）疗法是一种肿瘤免疫治疗方法：来自人体的T细胞在体外经遗传学修饰、表达特异性嵌合抗原受体（CAR），然后将其回输入患者体内，用于靶向识别和消除肿瘤细胞。尽管CAR-T细胞疗法在血液系统肿瘤治疗中取得了较为显著的成功，其在实体瘤治疗中仍面临障碍。细胞因子释放综合征（CRS）等免疫相关不良反应（irAE）制约了CAR-T细胞的安全应用，肿瘤相关抗原（TAA）的异质性限制了单一CAR-T细胞的广谱适用性，也制约了其通用型开发。鉴于此，要使CAR-T细胞疗法在实体瘤临床治疗中得到应用，还需开展进一步的改良与提升研究。本文围绕实体瘤中CAR-T细胞疗法，从“CAR基因修饰策略”、“通用免疫受体的再靶向策略”及“抗原通用性‘赋靶’策略”三个方面对CAR-T细胞领域中为提高安全性和通用性所进行的探索进行述评，系统剖析各策略的研究路径、优势及局限性，并展望未来发展方向。通过综述CAR-T细胞安全性和普适性设计策略的进展，本文旨在为实体瘤的CAR-T细胞疗法研发提供创新思路。

Tumor immunotherapy has achieved breakthroughs in the treatment of malignant tumors by activating the host immune system’s antitumor response mechanism. Among various strategies, Toll-like receptor (TLR) agonists have garnered substantial attention due to their unique immunomodulatory capabilities. This work reviews the research progress on the combination of TLR agonists with radiotherapy in tumor immunotherapy, focusing on the clinical translational potential of intratumoral injection strategies. Clinical studies have shown that the in-situ injection of TLR agonists in combination with radiotherapy can effectively suppress primary and metastatic lesions by inducing immunogenic cell death, releasing tumor antigens, activating local immune responses, and triggering abscopal effects. Moreover, novel extended-release formulations and “endogenous vaccine” designs further enhance the safety and durability of treatment. Despite several challenges such as tumor microenvironment suppression and dose optimization, TLR agonists hold promise for the treatment of “cold” tumors lacking innate immunity through combinations with immune checkpoint inhibitors, nanodelivery technologies, and precise biomarker screening.