Objective:To compare the efficacy and adverse reactions of picosecond and nanosecond Nd∶YAG laser 532 nm in the treatment of seborrheic keratosis.Methods:A total of 30 patients with seborrheic keratosis were enrolled in this study. The rash size was more than 1-2 cm. Half of them were treated with picosecond laser and the other half with nanosecond Q-switched Nd∶YAG laser by wavelength of 532 nm. The treatment effect and adverse reactions were evaluated by observing the area and the disappearance of pigment. The patients were followed up for 3 months after treatment.Results:The total effective rate was 73.33% in the experimental group and 53.33% in the control group, with no significant difference between the two groups ( P>0.05), but the pain score, satisfactory score, scab shedding time and the incidence of pigmentation in the experimental group were lower than those in the control group, and the differences were statistically significant ( P<0.05). Conclusions:The 532 nm picosecond laser has a higher efficiency in treating seborrheic keratosis than 532 nm Q-switched Nd∶YAG, but it has no statistical significance. However, the self satisfaction is higher than that of the control group; the pain score, scab shedding time and the incidence of pigmentation are lower than those of the control group, with statistical significance. Therefore, picosecond 532 nm laser treatment of early seborrheic keratosis is worthy of clinical promotion.

Objective:To investigate the genomic manifestation and pathogenesis of osteosarcoma with different relapse pattens, which were respectively initially presented with bone metastasis or pulmonary metastasis.Methods:From May 1, 2021 to October 1, 2021, 38 fresh tumor specimens and some paraffin-embedded specimens of high-grade osteosarcoma were collected in Peking University People's Hospital, including 29 males and 9 females, aged 19.6±2.2 years (range, 6-61 years). Among the 38 cases, 12 cases had initial bone metastasis (group A) and 26 cases had initial lung metastasis (group B), of which 15 cases (40%, 15/38) had paired specimens of primary and metastatic lesions. Based on Illumina NovaSeq 6000, we analyzed whole-exome sequencing (WES) as well as transcriptome for osteosarcoma with paired samples in different relapse patterns. During all their treatment courses, we also collected their paired samples to reveal these tumors' evolution. We sought to redefine disease subclassifications for osteosarcoma based on genetic alterations and correlate these genetic profiles with clinical treatment courses to elucidate potential evolving cladograms.Results:We found that osteosarcoma in group A mainly carried single-nucleotide variations (83%, 10/12), displaying higher tumor mutation burden [4.9 (2.8, 12.0) & 2.4 (1.4, 4.5), P=0.010] and neoantigen load [743.0 (316.5, 1,034.5) & 128.5 (49.0, 200.5), P=0.003], while those in group B mainly exhibit structural variants (58%, 15/26). The mutation spectrum showed that there was a significant difference in age-related gene imprinting 1 between the bone metastasis group and the lung metastasis group ( P=0.005). Samples were randomly selected from group A (3 patients) to investigate immunologic landscape by multiplex immunohistochemistry, from which we noticed tertiary lymphatic structure from one patient from group A. High conservation of reported genetic sequencing over time was found in their evolving cladograms. Conclusion:Osteosarcoma with mainly single-nucleotide variations other than structural variants might exhibit biological behavior predisposing toward bone metastases with older in age as well as better immunogenicity in tumor microenvironment.