Targeted protein degradation via nanoparticle-based universal strategy modifies nanoparticles with antibodies and ingeniously utilizes its cellular transport characteristics. This strategy achieved targeted degradation of extracellular proteins without complex design.Image 1.

Objective To explore imaging features of telangiectatic osteosarcoma(TOS).Methods X-ray,CT and MRI data of 37 cases of TOS confirmed by surgical pathology were retrospectively analyzed.Lesion's location,morphology,border,density/signal,enhancement pattern,presence of hemorrhage,tumor bone,fluid-fluid levels,periosteal reaction,septal nodules,epiphyseal involvement,bone destruction and surrounding sclerosis,peripheral edema and pathological fracture or not were recorded.The misdiagnosis rate of each imaging examination was calculated.Results TOS was prone to occur in the femur,humerus and tibia metaphysis,predominantly presented as eccentric,expansive and map-like osteolytic bone destruction with little or no surrounding sclerosis,showing polycystic changes,with fluid-fluid levels,hemorrhagic and tumor bone,along with periosteal reactions and marginal and septal nodule-like enhancement after enhanced scanning.The misdiagnosis rate of X-ray,non-contrast CT,enhanced CT,non-contrast MRI,enhanced MRI and preoperative biopsy for diagnosing TOS was 75.00%(24/32),50.00%(3/6),38.10%(8/21),50.00%(6/12),24.32%(9/37)and 24.32%(9/37),respectively.Conclusion TOS had certain characteristic imaging manifestations.Comprehensive imaging examinations combined with accurate pathological sampling contributed to precise diagnosis and reduction of misdiagnosis rate of TOS.

Objective To explore imaging characteristics of myxofibrosarcoma(MFS)and their correlations with prognosis.Methods Totally 32 patients with pathologically confirmed MFS were retrospectively enrolled and divided into poor prognosis(recurrence/metastasis)group(n=13)and good prognosis group(n=19).Preoperative imaging characteristics of lesions were analyzed and compared between groups,including the location,shape,size,margins,density/signal features of lesions,adjacent bone destruction,peritumoral edema,fascial tail sign,enhancement patterns and tumor vasculature.Results MFS predominantly involved the extremities,especially the lower limbs,and the lesions commonly appeared as iso-to hypodensity masses with internal isodensity fibrous septations on non-enhanced CT.On non-enhanced MRI,MFS commonly demonstrated iso-to hypointense signals on T1WI,markedly hyperintense signals on T2WI,low signal fibrous septa,high signals on diffusion weighted imaging(DWI),as well as tail signs and surrounding soft tissue edema.After administration of contrast agents,solid components of MFS demonstrated marked enhancement.No statistical difference of tumor vascularity was detected between groups(P=0.141,1-β=0.269).Poor prognosis group showed significantly higher rates of diffuse peritumoral edema and fascial tail signs than good prognosis group(both P＜0.05).Conclusion Imaging features of MFS had certain characteristics,and the tail sign and surrounding soft tissue edema were correlated with poor prognosis.

Objective To explore imaging features of telangiectatic osteosarcoma(TOS).Methods X-ray,CT and MRI data of 37 cases of TOS confirmed by surgical pathology were retrospectively analyzed.Lesion's location,morphology,border,density/signal,enhancement pattern,presence of hemorrhage,tumor bone,fluid-fluid levels,periosteal reaction,septal nodules,epiphyseal involvement,bone destruction and surrounding sclerosis,peripheral edema and pathological fracture or not were recorded.The misdiagnosis rate of each imaging examination was calculated.Results TOS was prone to occur in the femur,humerus and tibia metaphysis,predominantly presented as eccentric,expansive and map-like osteolytic bone destruction with little or no surrounding sclerosis,showing polycystic changes,with fluid-fluid levels,hemorrhagic and tumor bone,along with periosteal reactions and marginal and septal nodule-like enhancement after enhanced scanning.The misdiagnosis rate of X-ray,non-contrast CT,enhanced CT,non-contrast MRI,enhanced MRI and preoperative biopsy for diagnosing TOS was 75.00%(24/32),50.00%(3/6),38.10%(8/21),50.00%(6/12),24.32%(9/37)and 24.32%(9/37),respectively.Conclusion TOS had certain characteristic imaging manifestations.Comprehensive imaging examinations combined with accurate pathological sampling contributed to precise diagnosis and reduction of misdiagnosis rate of TOS.

Objective To explore imaging characteristics of myxofibrosarcoma(MFS)and their correlations with prognosis.Methods Totally 32 patients with pathologically confirmed MFS were retrospectively enrolled and divided into poor prognosis(recurrence/metastasis)group(n=13)and good prognosis group(n=19).Preoperative imaging characteristics of lesions were analyzed and compared between groups,including the location,shape,size,margins,density/signal features of lesions,adjacent bone destruction,peritumoral edema,fascial tail sign,enhancement patterns and tumor vasculature.Results MFS predominantly involved the extremities,especially the lower limbs,and the lesions commonly appeared as iso-to hypodensity masses with internal isodensity fibrous septations on non-enhanced CT.On non-enhanced MRI,MFS commonly demonstrated iso-to hypointense signals on T1WI,markedly hyperintense signals on T2WI,low signal fibrous septa,high signals on diffusion weighted imaging(DWI),as well as tail signs and surrounding soft tissue edema.After administration of contrast agents,solid components of MFS demonstrated marked enhancement.No statistical difference of tumor vascularity was detected between groups(P=0.141,1-β=0.269).Poor prognosis group showed significantly higher rates of diffuse peritumoral edema and fascial tail signs than good prognosis group(both P＜0.05).Conclusion Imaging features of MFS had certain characteristics,and the tail sign and surrounding soft tissue edema were correlated with poor prognosis.

Precancerous lesions of gastric cancer is a key stage in the development of gastric cancer.The reprogramming of glucose metabolism is a prominent feature of precancerous lesions of gastric cancer.Hypoxic microenvironment and hypoxia-inducible factors are important factors influencing the occurrence of glucose metabolic reprogramming.This article summarized the relationship between hypoxic microenvironment and the reprogramming of glucose metabolism in precancerous lesions of gastric cancer,and concluded the relevant research on TCM compounds and effective components to improve hypoxic microenvironment and further regulate glycolysis for the treatment of this disease.It was concluded that the mechanism may be the inhibition of angiogenesis,regulation of signaling pathways and key proteins of glycolysis,expression of multiple enzymes,reduction of lactate secretion,inhibition of cell malignant proliferation and invasion.It explored the mechanism of Chinese materia medica in improving hypoxic microenvironment and regulating glycolysis,so as to provide reference for the prevention and treatment of precancerous lesions of gastric cancer.

Background and Objectives: The search for a suitable alternative for urethral defect is a challenge in the field of urethral tissue engineering. Induced pluripotent stem cells (iPSCs) possess multipotential for differentiation. The in vitro derivation of urothelial cells from mouse-iPSCs (miPSCs) has thus far not been reported. The purpose of this study was to establish an efficient and robust differentiation protocol for the differentiation of miPSCs into urothelial cells. Methods: and Results: Our protocol made the visualization of differentiation processes of a 2-step approach possible. We firstly induced miPSCs into posterior definitive endoderm (DE) with glycogen synthase kinase-3β (GSK3β) inhibitor and Activin A. We investigated the optimal conditions for DE differentiation with GSK3β inhibitor treatment by varying the treatment time and concentration. Differentiation into urothelial cells, was directed with all-trans retinoic acid (ATRA) and recombinant mouse fibroblast growth factor-10 (FGF-10). Specific markers expressed at each stage of differentiation were validated by flow cytometry, quantitative real-time polymerase chain reaction (qRT-PCR) assay, immunofluorescence staining, and western blotting Assay. The miPSC-derived urothelial cells were successfully in expressed urothelial cell marker genes, proteins, and normal microscopic architecture. Conclusions We built a model of directed differentiation of miPSCs into urothelial cells, which may provide the evi-dence for a regenerative potential of miPSCs in preclinical animal studies.

Objective:To analyze the usage intention and key issues of medical staff to use telemedicine, for improving telemedicine service system in China.Methods:From October to November 2019, medical workers of both the inviting party and invited party who experienced telemedicine in seven provinces of Fujian, Hainan, Henan, Hunan, Guizhou, Sichuan and Qinghai were selected for an online questionnaire survey. Areas covered included their usage intention, satisfaction and cognitive appraisal of telemedicine. Descriptive statistical analysis and non-parametric test were used to discuss the intention of further use, satisfaction and challenges of medical workers in various provinces and regions.Results:1 084 valid questionnaires were recovered. The data found the overall satisfaction was 98.62%, and the proportion of their intention of further use was 98.25%, and those from the eastern and western provinces presented higher intention of usage. The top challenges as reflected by these medical workers were named as follows: timeliness of consultation progress and information feedback; long latency time; low Internet speed, poor and interrupted Internet signal; inadequate system equipments and inconvenient operation; difficulties in remote physical checkup and overall understanding of patient conditions; as well as substandard, incomplete and poor medical records.Conclusions:These medical workers are satisfied with the telemedicine services and willing to continue to use telemedicine.For those existing problems, it is suggested to strengthen the infrastructure and optimize the process of telemedicine services, so as to encourage them in greater use of telemedicine.

Objective:To analyze the actual and expected incentives and key issues of telemedicine providers in China and to provide important references for optimizing telemedicine incentive policies.Methods:The sample data came from a questionnaire survey of 1 084 providers in 7 provinces of Fujian, Hainan, Henan, Hunan, Guizhou, Sichuan and Qinghai in October and November 2019 and a semi-structured interview data at 6 hospitals in Henan province in January 2020. Descriptive analysis was used to sort such data into text data for classified summation.Results:The greatest gaps were found between actual incentives and expected ones in expense subsidies, title promotion and excellence awards, with such gaps as high as 18.65, 28.26, 29.28 percentages among providers of junior, deputy senior and senior academic titles respectively. Hospitals fall short in providing adequate incentives for telemedicine providers, not to mention lack of differentiation and diversification in personnel incentives, and poor implementation of incentive policies.Conclusions:It is suggested to strengthen incentive demand analysis, break the homogenization bottleneck of incentive policies, and consolidate internal publicity and implementation of incentive policies.

Objective: To investigate the influencing factors of the implementation of precision medical services based on clinician cognition, and provide a scientific reference for the implementation and advancement of precision medical services. Methods: Using electronic questionnaires, clinicians from 48 hospitals in 12 provinces(autonomous regions and municipalities directly under the Central Government) were surveyed from July to September 2019, with 341 valid questionnaires collected. Descriptive statistics and factor analysis were performed on the survey data. Results: Three dimensions that affect precision medical services were identified from the recovered questionnaires, namely external support factors, hospital drive capabilities, patient information provision and protection. The contribution rate of variance after orthogonal rotation was 35.157%, 22.234% and 16.343% respectively. Conclusions The external supporting factors should be developed, the hospital driving ability should be strengthened, and the patient information reception and privacy information security should be ensured to provide an important basis and guarantee for the implementation of precision medical service.