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Backgrounds: Intraplacental choriocarcinoma (IC) is an extremely rare subtype of gestational choriocarcinoma. The long-term follow-up and reproductive outcomes of IC patients remain unclear. Here, we report a series of 14 cases and conduct a literature review to assess the fertility and recurrence results of this rare disease. Results: Fourteen patients with pathologically confirmed IC treated in Peking Union Medical College Hospital between January 2002 and July 2022 were included in this study. Half of them had metastatic IC and were treated by chemotherapy with or without surgery. Only 1 patient had chemoresistant disease, but she achieved complete remission after immunotherapy. The median follow-up time was 45.5 months (range 4-192), and no recurrence occurred. One metastatic IC patient who achieved remission after chemotherapy had a full-term delivery. Among the 5 patients with fertility demands, 3 abandoned their pursuit of pregnancy because of "fear and worry about choriocarcinoma recurrence". We reviewed a total of 89 cases of IC in English and Chinese literature from 1963 to 2022, and only 5 cases with subsequent pregnancy were reported, all of them were nonmetastatic IC cases. Conclusions: IC is sensitive to chemotherapy and has good long-term remission and a low recurrence rate. Patients with metastatic or nonmetastatic IC can have good pregnancy results after treatment. Doctors should pay more attention to the psychology of these patients. Clinical trial registration: N/A. [ABSTRACT FROM AUTHOR]

To analyze the methods, feasibility, efficiency, and fertility outcomes of fertility-sparing treatment for patients with placental site trophoblastic tumor (PSTT). Clinical data of patients diagnosed with PSTT between April 1998 and April 2020 from Peking Union Medical College Hospital (PUMCH) were retrospectively collected. The clinical features, treatment, and outcomes of patients received fertility-sparing treatment were analyzed and compared with patients suffered hysterectomy. In total, 126 patients were included in the study and 29 of them received fertility-sparing treatment. Besides significantly younger age and lower proportion of antecedent term delivery were seen in fertility-sparing group than hysterectomy group, no significant differences were observed in stage, serum β-hCG level, or interval from antecedent pregnancy between the two groups. Conservative surgery was selected individualized and none of them suffered salvage hysterectomy. Patients with clinical or pathological high-risk factors received adjuvant chemotherapy, yet the fertility-sparing treatment did not significantly lengthen chemotherapy duration. All patients in fertility-sparing group achieved complete remission without relapse after 36 to 176 months of follow-up and had sixteen healthy term delivery more than one year after the treatment. Fertility-sparing treatment for PSTT can be considered for young patients with localized uterine lesions who strongly desire to preserve their fertility potential. With individualized conservative surgery and selected adjuvant chemotherapy, fertility-sparing treatment will not influence the risk of relapse or overall survival and patients will achieve favorable pregnancy and live birth outcomes. • Conservative surgery can be considered in PSTT patients with confined lesion. • Fertility-sparing treatment will not prolong the chemotherapy duration in strictly selected patients. • Fertility-sparing treatment will not influence the risk of relapse or overall survival. • Favorable pregnancy and live birth rates can be achieved in PSTT patients after fertility-sparing treatment. [ABSTRACT FROM AUTHOR]

Background: Primary cervical gestational trophoblastic neoplasias (GTNs) are extremely rare ectopic GTNs. Such lesions are difficult to diagnose clinically because of their rarity, with abnormal vaginal bleeding of a non-specific cause being the most common symptom. To that end, this retrospective study aimed to identify the clinical characteristics of cervical GTN and to explore diagnostic and therapeutic strategies.Results: Thirteen patients diagnosed with primary cervical GTN at the Department of Gynecology, Peking Union Medical College Hospital, Beijing, China, between June 1, 1988 and May 31, 2020 were included in the study. All patients had irregular vaginal bleeding, including six who presented with massive bleeding. Seven patients (53.8%) were initially misdiagnosed with a cervical pregnancy. All patients received chemotherapy; 11 (84.6%) also underwent hysterectomy because of chemoresistant lesions or uncontrolled bleeding. All patients achieved complete remission; however, two women (15.4%) experienced a relapse during the median follow-up period of 35 months. A comprehensive review of English-language literature published between 1980 and 2020 identified 22 case reports encompassing 27 patients. The definitive diagnosis was achieved via pathology in 26 of them (96.3%), and hysterectomy was performed in 21 (77.8%).Conclusions: Owing to its rarity and nonspecific symptoms, the diagnosis of primary cervical GTN is challenging and often relies on pathology. The combination of chemotherapy and hysterectomy is the main therapeutic strategy for this disease. [ABSTRACT FROM AUTHOR]

Background: Gestational trophoblastic neoplasia (GTN) with urinary system metastasis is rare. There is limited information about this situation. This study aimed to analyze clinical features, prognostic factors, and survival outcomes of patients with metastasis to the urinary system arising from GTN. Methods: Medical records of 53 consecutive GTN patients with urinary system metastases and treated at Peking Union Medical College Hospital (PUMCH) between 1990 and 2018 were reviewed. The Kaplan-Meier survival analysis was used to describe the overall survival. Prognostic factors were identified using univariate and multivariate analyses. Results: Fifty-three GTN patients with urinary tract metastasis were identified in our institution. The mean age of patients was 30.8 years (range, 23–53 years). Thirty-six (67.9%) patients achieved complete remission (CR), and the remaining 17 (32.1%) showed progressive disease. The 5-year overall survival rate of the entire cohort was 78.4%. Age ≥ 40 years was an independent risk factor for prognosis (HR 12.353, 95% CI 2.203-69.261, P = 0.004). Previous failed chemotherapy history (P = 0.040) and the presence of brain and/or liver metastases (P = 0.024) significantly influenced the survival of GTN patients with urinary tract system metastasis. Conclusion: GTN with urinary tract metastasis is a rare condition. Patients with different metastatic sites have different CR rates and prognosis. Therefore, individualized strategies should be considered for patients with different metastatic sites. Urinary system metastasis is probably not a prognostic factor in GTN patients. Patients aged ≥40, those who had previous failed multidrug chemotherapy, and presented brain and/or liver metastases showed a significant adverse outcome. [ABSTRACT FROM AUTHOR]

Objective: We investigated the clinical characteristics, treatments, and survival of patients with gestational trophoblastic neoplasia (GTN) who experienced recurrence. Factors predictive of recurrence were also investigated. Methods: Patients with GTN who recurred after completing chemotherapy at Peking Union Medical College Hospital Trophoblastic Disease Center were identified between January 2004 and December 2017. Logistic regression analysis was used to identify factors predictive of GTN recurrence. Results: A total of 1827 patients with GTN achieved complete remission (CR) at our center, of whom 118 (6.5%) experienced recurrence during follow‐up. The recurrence rates for patients initially treated at our center and those referred to us were 2.7% and 14.6%, respectively. The majority of recurrent patients received floxuridine‐based multiagent chemotherapy (n = 64). Patients who underwent surgery achieved a significantly higher CR rate than those who did not (88.6% vs 61.1%, P =.001). Although 94.1% of recurrent patients reachieved CR, 33.3% of them recurred for a second time. The 5‐year survival rate of the entire cohort was 80.4%. An interval between antecedent pregnancy and chemotherapy >12 months (OR: 6.600, 95% CI [3.217‐13.540], P <.001), and an interval from first chemotherapy to achieving β‐human chorionic gonadotropin (β‐hCG) normalization >14 weeks (OR: 2.226, 95% CI [1.080‐4.588], P =.030) were predictors of recurrence. Conclusions: Patients with recurrent GTN are prone to recurring for a second time. Surgery plays a beneficial role in the management of recurrent GTN. An interval between antecedent pregnancy and chemotherapy >12 months, and an interval from first chemotherapy to achieving β‐hCG normalization >14 weeks were predictors of recurrence. [ABSTRACT FROM AUTHOR]

A single station short-term ionospheric disturbance forecasting model has been developed with a genetic algorithm-based neural network (GA-NN). The genetic algorithm is used to optimize the initial weights of the neural network to avoid the local minimum during NN training. Using this model, the single station predictions of the ionospheric F2 layer critical plasma frequency, f oF2, with the time-scale 1–24 h in advance in the China region have been investigated. Input parameters of the forecasting GA-NN model include the Beijing time (GMT+8), season information, solar zenith angle, day number, solar activity, geomagnetic activity, neutral winds, geographic coordinates and previous values of f oF2. The training dataset in this model are obtained from the ionosonde stations in China. The data coverage is from 1990 to 2004 (more than one solar cycle) except 1995 and 2000. The data of ionospheric disturbances in 1995 (solar minimum) and 2000 (solar maximum) are used as the validation dataset. The prediction results at the different stations show that 1 h ahead prediction is more accurate than predictions of 3, 6, 12 and 24 h ahead. Comparisons between the observed and predicted values of f oF2 in the low and middle latitudes during the year of solar minimum (1995) and solar maximum (2000) indicate that, the prediction accuracy at middle latitudes are generally better than that at low latitudes. The prediction root-mean-square error (RMSE) in the low solar activity is smaller than that in the high solar activity. The ionospheric disturbances prediction results manifest that the model works well even when the observed values of f oF2 are far away from the monthly median value and the ionospheric storm lasts for 18 h. [ABSTRACT FROM AUTHOR]

Norovirus (NoV) is the most common cause of non-bacterial acute gastroenteritis (AGE) outbreaks worldwide. Eight NoV outbreaks in the Fengtai District of Beijing City, China, were identified in 2014. Samples were collected from the eight outbreaks, and 73 out of 119 samples from cases and 10 out of 59 samples from the close contacts were positive for NoVs. The genotypes were determined by sequencing analysis. Six different GII genotypes, including GII.2, 4, 6, 7, 8, 14, and 17 were found, and GII.4 was not the local major epidemic genotype in the present study. Enhanced strain surveillance is necessary for future NoV epidemics. [ABSTRACT FROM AUTHOR]

To study the thermal environment of the room which is enveloped by the phase - change concrete composite wall with night mechanical ventilation, the dynamitic heat transfer mathematical physics model of the phase - change concrete composite wall with night mechanical ventilation and thermal balance model of the room are given based on enthalpy method. The dynamic heat transfer performance and indoor thermal environment are simulated in summer and the transitional seasons when the phase - change composite walls are applied in Beijing. The influencing factors of the phase - change composite wall, such as phase - change temperature, phase - change layer thickness, ventilation rate, ventilation time, and the locations of phase - change layer and the insulation layer are analyzed. The optimal results are as follows : phase - change layer should he as the inner layer, phase - change temperature is 26°C, phase - change layer thickness is 25 mm, ventilation time is 4:00 am to 6:00 am, and ventilation rate is 25 ach/h. [ABSTRACT FROM AUTHOR]

To better evaluate the variations in concentration characteristics and source contributions of atmospheric volatile organic compounds (VOCs) during continuous haze days and non-haze days, hourly observations of atmospheric VOCs were conducted using a continuous on-line GC-FID (Airmo VOC GC-866) monitoring system during 1–15 March 2019, in urban areas of Beijing, China. The results showed that the total VOC concentrations during haze days and non-haze days were 59.13 ± 31.08 μg/m3 and 16.91 ± 7.19 μg/m3, respectively. However, the average O3 concentrations during the two haze days were lower than those of non-haze days due to the extremely low concentrations at night instead of the reported lower photochemical reaction in daytime. The ratio of OH radical concentration during haze and non-haze days indicating that the rate of photochemical reaction during haze days was higher than those of non-haze days from 13:00–19:00. The stable air conditions and the local diesel emission at night were the main reasons for the decreased O3 concentrations during haze days. Six major sources were identified by positive matrix factorization (PMF), namely, diesel exhaust, combustion, gasoline evaporation, solvent usage, gasoline exhaust, and the petrochemical industry, contributing 9.93%, 25.29%, 3.90%, 16.88%, 35.59% and 8.41%, respectively, during the whole observation period. The contributions of diesel exhaust and the petrochemical industry emissions decreased from 26.14% and 6.43% during non-haze days to 13.70% and 2.57%, respectively, during haze days. These reductions were mainly ascribed to the emergency measures that the government implemented during haze days. In contrast, the contributions of gasoline exhaust increased from 34.92% during non-haze days to 48.77% during haze days. The ratio of specific VOC species and PMF both showed that the contributions of gasoline exhaust emission increased during haze days. The backward trajectories, potential source contribution function (PSCF) and concentration weighted trajectory (CWT) showed that the air mass of VOCs during haze days was mainly affected by the short-distance transportation from the southwestern of Hebei province. However, the air mass of VOCs during non-haze days was mainly affected by the long-distance transportation from the northwest. [ABSTRACT FROM AUTHOR]

Background: Choriocarcinoma is a rare malignant neoplasm, which is classified as either gestational choriocarcinoma or nongestational choriocarcinoma. The purpose of this study was to examine the clinical characteristics of Chinese female nongestational choriocarcinoma patients and discuss our experience in treating this rare disease.Results: We conducted a single-center retrospective study on a sample of 37 nongestational choriocarcinoma patients who were diagnosed and treated at Peking Union Medical College Hospital from March 1982 to March 2020. Their demographic, clinical, laboratory, and therapeutic data were collected. Detailed information was available for all 37 individuals in our sample. The primary lesions included 34 in the ovaries, 2 in the pituitary and 1 in the stomach. The median age of onset was 22 years, and the median follow-up period spanned 41 months. The lungs (40.5%) were the most commonly observed metastatic site. All subjects were treated with surgery and multidrug chemotherapies, and a median of 4.0 courses was required to achieve complete remission. The overall complete response rate, relapse rate, and 3-year and 5-year survival rates were 81.1%, 16.7%, 80.0%, and 75.5%, respectively.Conclusions: Nongestational choriocarcinoma can be managed well using surgery and multidrug chemotherapies, but the overall outcome of nongestational choriocarcinoma is still worse than that of gestational choriocarcinoma. Mixed nongestational choriocarcinoma seems to have similar therapeutic outcomes as pure tumors. [ABSTRACT FROM AUTHOR]

Background: Treatment options for patients with high-risk chemorefractory or relapsed gestational trophoblastic neoplasia are scarce. The synergistic antitumour effect of immunotherapy and antiangiogenic drugs has been shown in many solid tumours. This phase 2 trial evaluated the activity and safety of camrelizumab (PD-1 inhibitor) plus apatinib (VEGF receptor inhibitor) in patients with high-risk chemorefractory or relapsed gestational trophoblastic neoplasia.Methods: This was a single-arm, open-label, phase 2 trial, done at a single tertiary health-care centre in Beijing, China. Women (18-70 years) with high-risk (International Federation of Gynecology and Obstetrics score ≥7) chemorefractory or relapsed gestational trophoblastic neoplasia who had received at least two lines of previously unsuccessful multidrug chemotherapy regimens and had an Eastern Cooperative Oncology Group performance status of 0-2 were eligible for inclusion. Patients received 4-week cycles of intravenous camrelizumab 200 mg every 2 weeks plus oral apatinib 250 mg once per day until disease progression or unacceptable toxicity. The primary endpoint was objective response rate assessed according to serum human chorionic gonadotrophin concentration. Activity and safety were analysed in all patients who received at least one dose of study drug. The study is ongoing, but recruitment is complete. The study is registered with ClinicalTrials.gov, NCT04047017.Findings: Between Aug 7, 2019, and March 18, 2020, 20 patients enrolled; 19 (95%) were diagnosed with choriocarcinoma and one (5%) had placental site trophoblastic tumour. The median follow-up duration was 18·5 months (IQR 14·6-20·9). The objective response rate was 55% (95% CI 32-77); ten (50%; 95% CI 27-73) patients had complete response. The most common grade 3 treatment-related adverse events were hypertension (five [25%] patients), rash (four [20%] patients), neutropenia (two [10%]), leukocytopenia (two [10%]), and aspartate aminotransferase increase (two [10%]). One patient had a treatment-related serious adverse event (aspartate aminotransferase 19-times higher than the upper limit of normal). No grade 4 or 5 treatment-related adverse events were reported.Interpretation: Camrelizumab plus apatinib showed promising antitumour activity and acceptable toxicity and could be a salvage therapy option for the treatment of high-risk chemorefractory or relapsed gestational trophoblastic neoplasia. Immune checkpoint inhibitors combined with chemotherapy for heavily-treated patients and upfront use of camrelizumab plus apatinib for patients with high-risk gestational trophoblastic neoplasia are under investigation in phase 2 trials.Funding: National Natural Science Foundation of China, Jiangsu Hengrui Pharmaceuticals. [ABSTRACT FROM AUTHOR]

To analyze the reproductive outcomes of gestational trophoblastic neoplasia (GTN) patients who were cured only by floxuridine-based regimens. This was a retrospective analysis of 464 patients who were treated with only floxuridine-based regimens at Peking Union Medical College Hospital between January 2002 and December 2013 and retained their reproductive ability. Their reproductive outcomes were analyzed. The factors affecting pregnancy intention were identified by logistic regression. Of the 464 patients (average age, 28.0 ± 5.7 years; median follow-up = 85 months), the livebirth rate was 72.2%, while the rates of spontaneous abortion, induced abortion and ectopic pregnancy were 9.2% (n = 41), 8.7% (n = 39) and 1.8% (n = 8), respectively. The GTN recurrence rate was 2.1%. The time from chemotherapy completion to first conception in the induced abortion group was significantly shorter than those in spontaneous abortion, full-term/premature, and ectopic pregnancy groups (P ≤ 0.001, <0.001, =0.015, respectively). The logistic analysis showed that the age at onset of GTN (OR = 0.899, 95% CI 0.851–0.951, P < 0.001), parity at onset of GTN (parity = 1, OR = 0.123, 95% CI 0.068–0.225, P < 0.001; parity = 2–3, OR = 0.058, 95% CI 0.014–0.232, P < 0.001) and interval from the index pregnancy to chemotherapy were independent factors affecting pregnancy intention. Among the 36 pregnancies occurring within 12 months postchemotherapy, only one choriocarcinoma occurred, and 20 culminated in induced abortions (55.6%). After floxuridine-based chemotherapy, the pregnancy rate of GTN patients after fertility-preserving treatment is comparable to that of the normal population. Pregnancy losses within one year after chemotherapy completion are mainly caused by induced abortion. • The reproductive outcomes of GTN patients after FUDR-based chemotherapy are comparable to those of the normal population. • The main factors influencing the desire for re-pregnancy include an older age and already having children. • The incidence of repeated GTD within one year was not higher than that after 1 year postchemotherapy [ABSTRACT FROM AUTHOR]

Atmospheric nanoparticle growth is a critical bridge between aerosol to clouds and climate. However, current mechanisms for nanoparticle growth are not yet fully understood due to unknown size-resolved chemical composition during the growth process. Here, we present comprehensive field measurements of the size-resolved chemical composition of the atmospheric nanoparticle growth in the size range from 10 to 100 nm using a custom-made Nanoparticle Chemical Ionization Mass Spectrometer (NPCIMS). The typical chemical compositions of nanoparticles are quantified in both positive and negative ion modes during growth processes after sensitivity calibration. The quantification results for chemical compositions show that CHO organics account for ∼80% of the newly formed particle in the growth process with diameters from 10 to 25 nm. However, the nitrate component is rarely observed during the nanoparticle growth under size-resolved mode (10–25 nm), indicating the little contribution of the nitrate component to growth at diameters below 25 nm. Different from the contribution of aminium salts to nanoparticle growth according to the previous urban observations in Mexico, the newly formed particle growth in urban Beijing is dominated by ammonium, sulfate, and organic components in the size-resolved modes (10–25 nm) in springtime. [Display omitted] • The newly formed particle growth in urban Beijing is dominated by ammonium, sulfate, and organic components in springtime. • The contribution of nitrate, protonated methylammonium and protonated C 2 amines to nanoparticles growth is little. • CHO organics account up to ～80% in the growth of the newly formed organic particle with diameters from 10 to 25 nm. [ABSTRACT FROM AUTHOR]