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Purpose This study aimed to analyze the clinicopathological features, treatment, and feto-maternal outcomes of pregnancy complicated by malignant ovarian germ cell tumors (MOGCTs), to increase the awareness on this condition. Patients and methods We retrospectively reviewed the medical records of patients diagnosed with MOGCTs during pregnancy, who were treated and followed-up at Peking Union Medical College Hospital from January 2000 to December 2017. The demographic characteristics, pathological features, treatment and prognosis were analyzed. Results The histological subtypes varied in 14 patients (dysgerminoma, n=1; immature teratoma, n=4; yolk sac tumor, n=6; and mixed germ cell tumors, n=3). Ten (71.4%) patients, including three who opted for conservative therapy until childbirth, one who only received salvage chemotherapy during pregnancy, and six who underwent cystectomy or unilateral salpingo-oophorectomy during pregnancy, desired fetal preservation. After undergoing surgery, four patients chose surveillance instead of timely adjuvant chemotherapy. Eight patients delivered their babies, and the preterm delivery rate was 50.0%. One newborn died of premature birth. The median follow-up period was 44 (range: 13 to 86) months. During the current study period, 12 patients had survived and did not report any diseases. However, two died due to disease progression. Conclusion Pregnant women with MOGCTs had favorable outcomes. However, when a malignant tumor is suspected, surgery cannot be avoided. Thus, instead of timely postoperative adjuvant chemotherapy, close surveillance may be an acceptable alternative for pregnant women with low-risk MOGCTs.

Purpose: To investigate the efficacy of fertility-sparing treatment for young women with grade 2 presumed stage IA endometrioid endometrial adenocarcinoma (EEA). Methods: We performed a retrospectively review of eight patients affected by grade 2 presumed stage IA endometrioid endometrial adenocarcinoma who underwent fertility-sparing treatment in the Peking Union Medical College Hospital between 2011 and 2018. Results: The median age of patients was 26 years (range, 22–35 years). Complete response (CR) was found in seven of the eight cases. The median time to response was 3 months (range, 3–9 months). Among patients who achieved CR, three had recurrence and were treated with second-line fertility-sparing therapy. Two of the three recurrent patients achieved CR, and one patient subsequently conceived. Pregnancies and successful deliveries were achieved in two of four patients. The average follow-up period was 31 months (range, 21–77 months). Conclusions: Fertility-sparing therapy is a feasible treatment option in patients with presumed stage IA, grade 2 endometrial cancer. Although our results are encouraging, they are based on very limited numbers, and patients should be informed the risk of tumor progression during treatment. Further evaluations are still required before recommending fertility-sparing therapy to endometrial cancer patients with more advanced disease in routine practice.

Background Alpha-fetoprotein (AFP) plays a crucial role in the management of malignant ovarian germ cell tumors (MOGCTs) and is an important reference index for chemotherapy termination. However, a high level of AFP can also be caused by several benign diseases, causing confusion and impacting treatment decisions. Case presentation We described four patients who were diagnosed with MOGCTs; the histologic subtype in two of them was mixed MOGCTs (yolk sac tumor with mature teratoma), while the rest was immature teratoma. The serum AFP level of each patient was abnormal before surgery, but it was still persistently elevated around 300 ng/ml even after additional cycles of chemotherapy. All patients were thoroughly evaluated, but we did not find any evidence of disease progression or residual tumors. Liver function tests were normal, whereas serum assays revealed positive of hepatitis B surface antigen, and two patients had a high level of HBV-DNA. They were chronic carriers of hepatitis B virus and never received relevant treatments. Then they were managed with tumor surveillance and the antiviral treatment. Thereafter, the AFP levels presented a slowly decreasing trend. Conclusions False elevation of AFP in MOGCTs is a rare condition and should be assessed with a comprehensive evaluation to avoid unnecessary treatments.

This paper integrates VR technology with BIM and applies it to sports architecture design study, with regarding to the characteristics of large volume, great investment, high technical requirements and complex functions of sports architecture. VR’s advantages on immersion, perception and interaction meet the design requirements of complex space of sports architecture, break through the bottleneck in the current design process and provide an inspection method for the design scheme to eliminate blind spots. This paper focuses on the design optimization methods of space form, sight, path and signposts of sports architecture based on VR technology. By using VR to represent a built environment, the building information can be displayed hierarchically according to the research objective. By applying VR technology as a study tool to represent a building, architects can examine the space, experiment on design factors through virtual spatial experience. And a closed-loop design framework of “design-simulation-perception-feedback-design” facilitates to provide a basis for design decision-making, which will offer an innovative idea for the development of architectural design methods.

How to quickly and nondestructively estimate the freshness of salmon meat is necessary and urgent in the food safety market. Raman spectroscopy has become an appealing tool of freshness prediction, but its adaptability and robustness under different temperature conditions need to be further evaluated. In this paper, salmon meat samples stored at −18 °C, 4 °C and 20 °C were measured to test the accuracy and adaptability of Raman spectroscopy in the prediction of salmon storage time. Several preprocessing methods were compared and a novel method called long short term memory (LSTM) has been proposed and applied to spectral modeling. The results showed that the spectral bands selection of 1000–1500 cm−1 and normalization could obtain better prediction performance than other wavebands and preprocessing methods, effectively improving the accuracy of the model and reducing the predicted root mean square error (RMSE). Meanwhile, no matter at what temperature, the LSTM model was proved to have higher prediction performance and accuracy than traditional machine learning modeling methods such as support vector machine (SVM) and k-nearestneighbor (KNN). At −18 °C, the determination coefficient (R2) of the test sets in the LSTM model was 0.9986, the RMSEP was 0.24, and the prediction accuracy rate could reach 96.5%. At 4 °C, the R2, RMSEP and accuracy could reach 0.9971, 0.24 and 95% respectively. At 20 °C, the R2, RMSEP and accuracy could reach 0.999, 0.06 and 100% respectively. Therefore, Raman spectroscopy has been proven to be a stable and effective technique for predicting salmon storage time and could reach a LOD value of 0.72 day. Raman spectroscopy combined with LSTM neural network could quickly, accurately and non-destructively predict the freshness of salmon under different temperature conditions.

Rationale Ovarian yolk sac tumors (YSTs) are the second most common histologic type of ovarian germ cell tumors. Most patients are adolescent and young women, while cases in postmenopausal women were rarely reported. Due to its rarity, we know little about the treatment and prognosis of postmenopausal patients with ovarian YSTs. We reported 3 cases of mixed ovarian YST in postmenopausal females reviewed the related current English literature. Patient concerns The ages of the three patients were 61, 58 and 77 respectively. The three patients came to the hospital because of the abdominal discomfort or tenderness, and the third patient also has vaginal bleeding. Diagnoses Imaging examination revealed pelvic mass with cystic and solid components. The elevated serum AFP level and pathologcial examination confirmed mixed ovarian YST. Interventions All patients received surgery and chemotherapy. Two patients received PEB (cisplatin, etoposide, and bleomycin) chemotherapy initially and one patient received TC (paclitaxel carboplatin) chemotherapy. Outcomes One patient relapsed 8 months after diagnosis and underwent re-cytoreductive surgery. The three patients all survived at last follow-up. Lessons The diagnosis of postmenopausal ovarian YST is relatively difficult and it can coexist with other germ cell or epithelial tumors. Postmenopausal ovarian YSTs are aggressive, and may have a worse prognosis compared with those in young patients. More aggressive treatment is needed. When YST mixed with epithelial cancer components, adjuvant chemotherapy regimen should include platinum-based chemotherapy aiming at both epithelial ovarian cancer and germ cell tumors.

There is a large amount of micro debris ranging between millimeters and micrometers in space, which has significant influence on the reliability and life of spacecrafts through long-duration integrated impacts and has to be considered in designing a vehicle’s suitability to the space environment. In order to simulate the micro-impacts on exposed materials, a plasma-driven micro-particle accelerator was developed. The major processes, including the acceleration, compression and ejection of plasmas, were modeled. By comparing the theoretical simulations with the experimental results, the acceleration mechanism was clarified. Moreover, through a series of experiments, the optimum operation range was investigated, and the acceleration ability was primarily determined.