Background/Aims: Liver transplantation (LT) following total hepatectomy is a life-saving treatment for hepatocellular carcinoma (HCC). The HCC recurrence after LT hinders the effectiveness of the procedure. The objective of this study is to develop a pre-operative risk stratification model based on a liquid biopsy. Methods: We conducted a comprehensive multi-omics study of 260 HCC patients from three centers, including clinical data, low-coverage whole-genome sequencing of cell-free DNA (cfDNA) from plasma, as well as whole-exome, single-nucleus RNA, and spatial transcriptomics from matched tumor and non-tumor tissues. Results: We identified cfDNA-derived copy number alteration (CNA) signatures associated with post-transplant recurrence. By integrating cfDNA-derived CNA profiles with single-cell transcriptomic data, we traced recurrence-associated cfDNA to a distinct subpopulation of malignant cells within the primary tumor. These cells were embedded in a pro-metastatic microenvironment of specialized endothelial subtypes and cancer-associated fibroblasts. Notably, most recurrence-associated lesions were detectable in cfDNA prior to liver transplantation (LT). Building on these insights, we developed the ZJU Criteria based on CNA fragments and tumor markers, a pre-LT risk prediction tool that integrates conventional clinical factors with cfDNA-derived CNA signatures, and validated it using internal and independent external cohorts. Conclusion Our findings suggest that post-transplant recurrence commonly originates from advanced subclones that emerge late during tumor evolution. The ZJU Criteria provides an accurate, non-invasive strategy that significantly improves pre-LT risk stratification and clinical decision-making for patients with HCC.

Objective: To investigate the clinical characteristics, diagnosis, treatment and prognosis of discordant lymphoma. Methods: The clinical data of one patient with discordant lymphoma at the PLA Strategic Support Force Characteristic Medical Center were retrospectively analyzed, and the related literatures were reviewed. Results: The patient was treated for thrombocytopenia and the examination showed splenomegaly. After hormone treatment, the platelet rebounded and thrombocytopenia occurred during hormone reduction. Splenectomy was performed. Postoperative pathological diagnosis of splenic marginal lymphoma was made and observed. Axillary lymph node enlargement occurred nine months later. Pathological diagnosis of diffuse large B-cell lymphoma was made by using lymph node biopsy, and the disease condition was alleviated after immunotherapy combined with chemotherapy. Conclusions Discordant lymphoma is rare and shows no special clinical manifestations. Its diagnosis should rely on pathological examination. Immunotherapy combined with chemotherapy may be more effective.

Objective To improve the method of orthotopic liver transplantation model in mice.Methods On the basis of "Qian SG" mothod,the techniques of perfusion,harvesting,and trimming of donor's liver,as well as the anastomosis of superior and inferior caval veins were improved.Operations were performed in 70 mice with improved technique(experiment group) and in 70 mice with conventional technique(control group),respectively.The operation time in both donors and recipients,and the survival rates of 48h,1 week and 1 month after operation were compared between the two groups.Results The operation time for both donors and recipients and the time of anhepatic phase were 37?2min,45?2min and 16?2min,respectively in experiment group,while they were 45?2min,54?2min and 23?2min,respectively,in control group,so that the average time for each procedure was significantly shorter(P0.05).Conclusions The improved technique may shorten the operation time and raise the survival rate,and is an ideal method for the establishment of orthotopic liver transplantation model in mice.

Objective To investigate the clinical significance of detecting mammaglobin in sentinel lymph nodes(SLN) of breast cancer. Methods In 32 breast cancer patients, methylene blue was injected around parechyma of breast cancer to locate the SLNs, and nested RT PCR(reverse transcriptase polgmecane chain reaction) was used to examine the expression of mammaglobin mRNA. Results The SLN was successfully identified in 30 of the 32 cases(93.8%).The micrometastases detection between group SLNs and non SLNs had significant statistical difference(P