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.

Objective To assess the role of the ferroptosis-associated gene GLS2 in the prognosis of pan-cancer and immunity using bioinformatics methods. Methods GLS2 expression levels in pan-cancer were profiled using publicly available databases: The Cancer Genome Atlas, GTEx, Cancer Cell Line Encyclopedia and the International Cancer Genome Consortium. The aim was to explore the role of GLS2 gene expression, gene variation survival analysis, immune infiltration, immune checkpoint related genes, TMB, and MSI in different tumors. Results Difference in GLS2 expression levels between cancer and paraneoplastic tissues was statistically significant in most cancer types, and the expression level was correlated with survival in these cancer types. A positive correlation was found between GLS2 expression and immune cell infiltration in multiple cancer types, and GLS2 expression level was positively correlated with TMB, MSI, and methylation, and its expression is an indicator for potential therapeutic response. Conclusion Pan-cancer analysis shows that the ferroptosis-related gene GLS2 can be used as a diagnostic and prognostic marker of clear cell carcinoma of kidney, adrenocortical carcinoma, lung adenocarcinoma, and pancreatic cancer.

Ferroptosis is a novel regulatory cell death characterized by iron dependence and mainly caused by the accumulation of lipid peroxides and reactive oxygen species in the cell. This process plays an important role in the development of many malignancies, and has been extensively studied in lung cancer, especially in antitumor therapy. In recent years, the role of ferroptosis in tumor immunotherapy has been gradually explored. Studies showed that targeting ferroptosis can improve the therapeutic efficacy of antitumor immunotherapy. In addition, immunotherapy and ferroptosis can work synergistically to enhance the effectiveness of antitumor therapy, suggesting a potential relationship between ferroptosis and immunotherapy and the possible reversal of immune drug resistance. This study aims to elucidate the characteristics of ferroptosis, and the role and potential clinical applications of ferroptosis in the antitumor immunotherapy of advanced non-small cell lung cancer. We also explore the role of some nanomaterials that target the onset of tumor ferroptosis in facilitating immunotherapy.

This article highlighted the invaluable expertise of Academician TONG Xiaolin in managing severe cases of COVID-19， thereby providing ideas for the treatment of severe and critically ill patients with SARS-CoV-2 infection by integrating traditional Chinese and western medicine. It is believed that COVID-19 belongs to the “cold dampness epidemic” in traditional Chinese medicine， which is caused by pathogenic qi of cold and dampness. The course of the disease can be divided into four stages： constraint， block， collapse， and deficiency， and the severe cases are mainly in the block and collapse stages. The pathogenesis at the block stage is described as epidemic toxins blocking the lung， which should be treated by diffusing the lung and unblocking the bowels， resolving phlegm and unblocking collaterals. The primary formula used is Zilong Xuanbai Chengqi Decoction （子龙宣白承气汤） with modifications based on individual condition. The pathogenesis at the collapse stage is described as internal block and external collapse， which should be treated by restoring yang to save from collapse， boosting qi to relieve collapse， diffusing the lung and unblocking the bowels， resolving phlegm and unblocking collaterals， usually with the formula Poge Zilong Xuanbai Chengqi Decoction （破格子龙宣白承气汤） with modifications.

We report a case of a long-term survivor of heart transplant who developed severe COVID-19 and was treated with a traditional Chinese medicine combined with conventional medicine. Throughout the treatment， the patient received active conventional medical treatment， and traditional Chinese medicine interventions included tonifying qi， invigorating the spleen and transforming phlegm， promoting yang and eliminating stagnation， resolving dampness and dissipating phlegm， and promoting blood circulation and eliminating stasis. The main therapeutic principles adopted were to recuperating depleted yang and rescuing the patient from collapse and to resolve phlegm and promote water. Pogezilong Xuanbai Chengqi Decoction （破格子龙宣白承气汤） with modifications was administered. In summary， it is crucial to the timely adjust the immunosuppressive regimen， combine use of various anti-infective agents with a focus on COVID-19， to protect of cardiac and renal function， and to integrate traditional Chinese medicine in the entire treatment process. As this case is rare， the diagnostic and therapeutic methods in traditional Chinese medicine， the use of immunosuppressive agents， and follow-up monitoring strategies can be a valuable reference.

Objective : To evaluate the effectiveness of interventions for human papillomavirus ( HPV ) vaccine hesitancy among female university students based on the precaution adoption process model (PAPM), so as to provide the evidence for improving the coverage of HPV vaccine in this population. Methods : HPV vaccine hesitant female students were selected using a cluster sampling method from Zhejiang Chinese Medical University, and randomly assigned to the PAPM group and control group. Students in the PAPM group received PAPM-based interventions for HPV vaccine hesitancy, while students in the control group were given routine interventions. The HPV-related knowledge, HPV vaccine-related knowledge and HPV vaccine hesitancy scores were collected from both groups prior to interventions ( T0 ), 0 ( T1 ), 1 ( T2 ) and 3 months post-interventions ( T3 ), and the effectiveness of interventions was evaluated using analysis of variance for repeated measures. Results : There were 147 students in the PAPM group and 141 students in the control group. In the PAPM group, 36.73% of the students majored in medical sciences, and 48.23% were freshmen; in the control group, 39.72% majored in medical sciences, and 50.35% were freshmen. The mean scores of HPV- and HPV vaccine-related knowledge were significantly greater in the PAPM group than in the control group, respectively ( T1, 5.29 vs. 4.91; T2, 4.27 vs. 4.22; T3, 4.22 vs. 4.04; P<0.05 ); however, no significant differences were detected in the HPV vaccine hesitancy scores between the two groups, respectively ( T1, 2.98 vs. 2.95; T2, 3.07 vs. 3.07; T3, 3.08 vs. 2.97; P>0.05 ). The mean scores of the confidence dimension ( T1, 3.37 vs. 3.23; T2, 3.48 vs. 3.40; T3, 3.38 vs. 3.25 ) and the dimension of influence by others ( T1, 3.44 vs. 3.33; T2, 3.42 vs. 3.37; T3, 3.46 vs. 3.27 ) were significantly greater in the PAPM group than in the control group (P<0.05), while the mean scores of the complacency dimension were significantly lower in the PAPM group than in the control group ( T1, 1.98 vs. 2.03; T2, 2.06 vs. 2.20; T3, 2.18 vs. 2.15; P<0.05 ). Conclusions PAPM-based interventions for HPV vaccine hesitancy may effectively improve the awareness of HPV and HPV vaccines, reduce complacency, and enhance the influence by others among female university students.

Objective:To investigate the predictive value of a nomogram based on clinical factors and gadobenate dimeglumine (Gd-BOPTA)-enhanced MRI for predicting the expression of Glypican-3 (GPC-3) in hepatocellular carcinoma (HCC).Methods:The clinical and imaging data of 85 patients with HCC confirmed by pathology in the Provincial Hospital of Shandong First Medical University from July 2018 to June 2021 were retrospectively collected. All the patients underwent Gd-BOPTA-enhanced MRI scan before operation. According to the expression of GPC-3 by immunohistochemistry, the patients were divided into GPC-3 positive group (55 cases) and GPC-3 negative group (30 cases). The clinical data of patients were collected, including gender, age, hepatitis, cirrhosis, alpha-fetoprotein (AFP), alanine aminotransferase, aspartate aminotransferase, and glutamine transferase levels. The MRI qualitative signs including tumor margin, ring enhancement, intratumoral hemorrhage, enhanced capsule, and satellite nodules were reviewed. MRI quantitative parameters including the largest tumor diameter, Gd-BOPTA-enhanced tumor-to-liver parenchyma signal ratio (TLR) and tumor enhancement ratio (TER) in arterial phase (AP), portal venous phase (PP), and hepatobiliary phase (HBP) were calculated. The independent sample t-test or Mann-Whitney U test were used to compare the quantitative data between the two groups, and the χ2 test was used to compare the qualitative data between the two groups. Multivariate logistic regression analysis was used to identify the independent predictors of GPC-3 expression, and a nomogram model was established. The receiver operating characteristic (ROC) curves were used to evaluate the predictive performance of each independent factor and nomogram, and DeLong test was used to compare differences in area under the curve (AUC). Results:There were significant differences in AFP, tumor margin, intratumoral hemorrhage, and TLR-AP, TLR-PP and TLR-HBP between GPC-3 positive and negative groups (all P<0.05). Multivariate logistic regression results showed that AFP≥20 μg/L, intratumoral hemorrhage and TLR-HBP were independent predictors of GPC-3 positive expression in HCC (OR=3.816, 4.788, 0.001, all P<0.05). The preoperative clinical and Gd-BOPTA-enhanced MRI nomogram model for predicting GPC-3 expression in hepatocellular carcinoma was established. The AUC of AFP≥20 μg/L, intratumoral hemorrhage, TLR-HBP and nomogram model in predicting GPC-3 positive expression were 0.688, 0.697, 0.808, and 0.879, respectively. The AUC of nomogram model was significantly better than those of the other three single indicator ( Z=3.82, 4.13, 2.04, P<0.001,<0.001,=0.042). Conclusion:The nomogram model based on indicators of clinical and qualitative and quantitative Gd-BOPTA-enhanced MRI has better performance in predicting the expression of HCC GPC-3 before surgery, which is higher than those of each single indicator.