Chemotherapy cure rate of gestational trophoblastic tumor patients is high, and subsequent preghancy outcomes deserves attention. The gestational trophoblastic tumor parients after chemotherapy is recommended at least 1 year of contraception befor pregnancy, and their pregnancy outcomes are similar to those of general population. Recent siudies find that the interval between chemotherapy and the subsequent pregnancy affects preghancy outcomes. Careful prenatal monitoring is recommended in those patients who are pregnant within 6 months after chemotherapy. So, the gestational trophoblastic tumor patients after chemotherapy is recommended at least 1 year of contraception before pregnancy.

Toll like receptors (TLRs) are the most characteristic of pathogen recognition receptors.TLR signal pathway affects the outcome of cervical HPV infection,and plays double roles of promoting or inhibiting tumor in immune regulation for the process from high-risk HPV infection to cervical cancer.The polymorphism of TLR gene is closely related to the occurrence of cervical cancer.

Treatment of gynaeeological cancer frequently results in the loss of ovarian function and menopausal syndrome.The most effective treatment is hormone replacement therapy (HRT).According to the current studies,HRT does not increase the risk of recurrence or death in patients with early stage endometrial cancer and uterine leiomyosarcomas. The safety of HRT in ovarian cancer patients is inconclusive. Cervical squamous cell carcinoma, vaginal cancer and vulvar cancer are not contraindications for HRT. Estrogen replacement therapy (ERT) is contraindicated for low-grade endometrial stromal sarcomas. Therefore,after integrated risk assessment and discussion,patients with severe menopausal symptoms can be treated with HRT to improve the quality of life.

Objective To investigate probable effect of metformin on anxiety and autophagy pathway in rats with focal cerebral ischemia . Methods The rats were divided into seven groups:shame group, ischemia group, metformin group, compound C group, compound C +ischemia group, metformin+ischemia group, and metformin+compound C+ischemia group.The rats were administered with metformin 14 days and compound C 30 min pretreatment.The blood glucose level, body mass, neurological score and indicators of elevate plus maze test were recorded of two groups after 72h ischemia-perfusion.The autophagy-related protein of Atg-7, Atg-5, beclin-1 were analysed by Western blot.ResuIts Metformin had no significant effect of body mass and blood glucose level.The prior administration of metformin significantly elevated neurological score in ischemia group (P<0.01).The elevate plus maze test results showed that prior administration of metformin significantly elevated percentage of open-arms detention time in ischemia group (P<0.01), but there was no significant difference in open-arms times.Western blot result showed that prior administration of metformin significantly elevated Atg-7, Atg-5, beclin-1 protein expression in ischemia group (P<0.001).Compound C resist the above effects of metformin (P<0.01).ConcIusion The metformin improves psychological disorders and movement disability through regulation of autophagy following focal cerebral ischemia in rats.

Objective To investigate the prevalence rate of nosocomial infections and the use of antibacterial agents in Zhejiang Cancer Hospital.Methods The cross-sectional survey on nosocomial infections was conducted among inpatients in Zhejiang Cancer Hospital on August 11,2011 and June 19,2012.The differences in prevalence rates of nosocomial infections,purposes of antibacterial agents use (for treatment,for prevention,or for both treatment and prevention),methods of medication (single or combined medication),and pathogen detections between 2011 and 2012 were analyzed with x2 test.Results There were 854 and 886 patients enrolled in the study in 2011 and 2012,and the prevalence rates of nosocomial infections were 5.27％ (45/854) and 5.08％ (45/886),respectively (x2 =0.186,P ＞ 0.05).Lower respiratory tract infection was the most common nosocomial infections both in 2011 and 2012,which accounted for 28.89％ and 36.96％ of all infections,respectively; and there was no significant difference in infection sites between 2011 and 2012 (x2 =1.415,P＞0.05).Totally 154 out of 854 patients (18.03％)in 2011 and 186 out of 886 patients (20.99％) in 2012 received antibacterial agents,and single medication was the most common.There were no significant differences in the purposes and methods of medication between 2011 and 2012 (x2 =1.994 and 3.042,P ＞ 0.05).Pathogen detections were performed in 56 out of 59 patients (94.92％) and 57 out of 65 patients (87.69％) who received antibacterial agents for treatment in 2011 and 2012,respectively.The most common pathogens were Escherichia coli,Pseudomonas aeruginosa,and Acinetobacter baumanni.Conclusion The prevalence rate of nosocomial infection in Zhejiang Cancer Hospital is of the satisfactory level,which is due to the good management of antibacterial agents use.

To determine the diagnostic value as well as the evaluation value in therapy, the specific IgM and IgG anti-bodies of the infected and treated rabbits were detected using soluble egg antigen(SEA) and adult worm antigen(AWA) by ELISA. By using SEA to detect the IgM antibodies, the serum antibody level rapidly dropped 7 weeks after infection even without treatment, and those of IgM in sera detected by AWA rose early than IgG detected by SEA. After 5 month treatment, IgM detected by AWA and IgG detected by SEA were still positive. From these observations, it is evident that SEA is a better antigen to detect specific IgG in the diagnosis of schistosomiasis, AWA is a better one for early diagnosis. The use of AWA as antigen to detect IgM showed high diagnostic value both in acute and chronic schistosomiasis. However, detection of the IgM/ IgG in ELISA using SEA and AWA could not evaluate the therapeutic effect well.

Objective To investigate the diagnostic significance of basophil activation test (B A T) in ana-phylaxis to non-ionic contrast media through testing the content of CD 63, m ast cell-carboxypeptidase A 3 (M C-CPA 3), and term inal com plem ent com plex SC5b-9 of the individuals by testing their levels in the norm al im m une group and the anaphylaxis groups to β-lactam drugs and non-ionic contrast media. Methods The CD 63 expression of basophilic granulocyte in blood w as detected by flow cytom etry. The levels of M C-CPA 3 in blood serum and SC5b-9 in blood plasm a w ere detected by ELISA . Results The CD 63 expression of basophilic granulocyte in blood, the levels of M C-CPA 3 and SC5b-9 of anaphylaxis to non-ionic contrast media and β-lactam drugs w ere significantly higher than that in norm al im m une group (P<0.05). Conclusion There is activation of basophilic granulocytes, m ast cells and com plem ent system in anaphylaxis to non-ionic contrast media. B A Tcan be used to diagnose the anaphylaxis to non-ionic contrast media.

Objective To study the association between endometrioid uterine carcinomas and metabolic syndrome (MS). Methods A retrospective study was conducted on 123 patients who were admitted in Department of Gynecology Oncology, Zhejiang Cancer Hospital (study group) and 90 healthy women (control group) with matching age from Jan. 2005 to Mar. 2009. The general conditions[including age, whether menopausal, body mass index (BMI)];the risk factors for MS [including waist circumference,fasting plasma glucose, triglycerides(TG), high-density lipoprotein (HDL) and systolic and diastolic blood pressure]were analyzed. The clinical stage, histological type, and pathology differentiated degree of study group with or without MS were also analyzed by univariate analysis and Cox proportional hazards models.Results (1) The univariate survival analysis shown that there were no significant difference with age in two groups[(54.3±0.6) vs. (54.2±0.9) years;P>0.05], while the rate of menopausal, BMI(≥25 kg/m~2), the cases coupled with MS, the size of waist circumference (> 80 cm), the level of fasting plasma glucose (≥5.6 mmol/L),TG(> 1.7 mmol/L)and abnormal systolic and diastolic blood pressure in study group were higher than those in control group (67.5% vs. 48. 9%, 45.5% vs. 23.3%, 43.9% vs.18.9%, 50.4% vs. 27.8%, 53.7% vs. 21.1%, 40.7% vs. 21.1% and 40.7% vs. 25.6%,respectively, all P <0.05). The percentage of HDL(< 1.30 mmol/L) was higher in study group than that in control granp(63. 4% vs. 32. 2%, P <0.05). (2) There were not significant difference for the clinical stage, pathological type, grades between patients with or without MS in study group (P > 0.05). (3) The Logistic multivariate survival analysis shown that central obesity, higher TG, lower HDL and abnormal plasma glucose were independent risk factors for endometrioid uterine carcinomas coupled with MS (P< 0.05). Conclusion Metabolic syndrome is marginally associated with an increased risk of endometrioid uterine carcinomas, which may be the new point to screen, prevention and treatment endometrioid uterine carcinomas.

Objective To study the difference between intensity-modulated radiation therapy (IMRT) and three dimensional conformal radiation therapy (3D-CRT) for pelvic radiation of post-operative treatment with gynecologic malignant tumor. Methods A prospective investigation study was conducted on 183 patients of post-operative patients with whole pelvic radiation therapy of cervical cancer or endometrial cancer in Zhejiang Cancer Hospital [IMRT group (n=85) and 3D-CRT group (n=98)] from Oct. 2015 to Oct. 2016. The two groups received same dose (45 Gy in 25 fractions). Comparison of two groups with radiation dosimetry:the score according to the Radiation Therapy Oncology Group (RTOG) acute radiation injury grading standards before and after radiotherapy reaction, the score from functional assessment of cancer therapy scale-cervix (FACT-Cx) scale and expanded prostate cancer index composite for clinical practice (EPIC-CP) scale were also analyzed. Results (1) There were no significant effect with age, culture level, family economic condition and ratio of radiochemotherapy between two groups (all P>0.05). (2) Dosimetric comparison for IMRT vs 3D-CRT:the average dose of planning target volume (PTV) decreased(46.1 ± 0.4) vs(46.4 ± 0.5)Gy, V45 dose percentage increased(95.2 ± 1.0)%vs (93.3 ± 2.0)%, intestinal bag dose of V40 decreased(24.4 ± 6.8)%vs (36.5 ± 15.9)%, rectal V40 dose percentage decreased(73.9 ± 12.3)%vs (85.4 ± 8.4)%, and lower rectal V45 dose percentage(32.8 ± 13.4)%vs (71.5 ± 13.7)%, bladder V40 dose percentage decreased(55.5 ± 13.0)% vs (84.4 ± 13.0)%. Bone marrow V20 lower:(67.9 ± 5.4)% vs (79.5 ± 6.6)%, V10 lower:(82.1 ± 6.0)% vs (86.3 ± 6.6)%; there were significant differences (all P<0.05). There was no significant difference between the dose of V45 in the intestinal pouch and bladder (P>0.05). (3) Acute radiation injury classification for IMRT vs 3D-CRT:big or small intestine:Ⅱ-Ⅲreaction [13%(11/85) vs 24% (24/98); χ2=3.925, P=0.048], there was significant difference. Bladder: Ⅲ reaction [19% (16/85) vs 26% (25/98); χ2=1.171, P=0.279], there was no significant difference. Radiochemotherapy of bone marrow suppression:Ⅲ-Ⅳreaction (14/20), the incidence rate [26%(14/54) vs 31%(20/65);χ2=0.339, P=0.562], the difference was not statistically significant. (4) Quality of life scale by FACT-Cx scale in IMRT vs 3D-CRT:there were no significant difference before radiotherapy (82 ± 16 vs 85 ± 16;t=1.279, P=0.203), while there was significant difference after radiotherapy (76 ± 14 vs 71 ± 18;t=-2.160, P=0.032). EPIC-CP scale score:before radiotherapy they were (16±7 vs 15±6;t=-0.174, P=0.862) ,but after radiotherapy (18±7 vs 22± 7; t=3.158, P=0.002), there was significant difference between them. Before and after radiotherapy, the increased EPIC-CP scale of the IMRT group vs 3D-CRT group were 3 ± 4 and 6 ± 4, the 3D-CRT group was significantly higher, the difference was statistically significant (t=5.500, P=0.000). Conclusion IMRT has shown that there are a significant benefit for the post-operative patients with cervical cancer and endometrial cancer compared to 3D-CRT.

Objective To study the mutations of Env sequence of SIVmac239 after infection of Chinese rhesus monkeys, and compare the differences and characteristics of Gp120 sequences of enterotropic and neurotropic SIV strains. Methods Six strains of simian immunodeficiency virus were analyzed in this study: four separated from peripheral blood mononuclear cells of SIVmac239-infected monkeys and two neurotropic SIVmac251 strains.Isolated and cultured monoclonal virus was obtained by limiting dilution assay.Gp120 sequences were amplified after the RNA extraction and phylogenetic analysis was processed thereafter.So did the Gp120 amino acid sequence and N-glycosylation sites analysis of the enterotropic and neurotropic strains.Results SIVmac239 had different mutations in four rhesus monkeys.The diversity in amino acid sequences of the enterotropic and neurotropic strains concentrated in the V1 and V4 regions of Gp120.The enterotropic strains had an addition of glycosylation site in V4 but the glycosylation site changes of neurotropic strains were located in the conservative regions of C1, C2 and C3.Conclusions The addition of one glycosylation site in V4 region of GP120 and loss of one glycosylation site in C1 region are associated with enhanced enterotropism and neurotropism.The differences between the enterotropic and neurotropic strains are not dipicted in Gp120 V3 region which is closely related with the tropism of strains.