Objective:To describe the special molecular and histopathological transformation of recurrent tumor in a patient with primary hepatocellular carcinoma(HCC)after liver transplantation.Methods:A case of HCC had recurrent tumor presenting special molecular and histopathological characteristics after liver transplantation.The diagnosis and treatment process of this case is reported.Results:A case of highly differentiated HCC received immune checkpoint inhibitors combined with antiangiogenic therapy after liver malignant tumor resection.Nearly one year later,due to severe liver cirrhosis,the case accepted allogeneic orthotopic transplantation of liver.More than two years later,elevated level of serum alpha fetoprotein was detected,then the PET-CT examination showed multiple suspected lesions with increased 18F-FDG metabolism in the right lobe of the liver.Liver biopsy and high-throughput sequencing were performed,and the results revealed poorly differentiated HCC with YAP1-MAML2 fusion gene.Chemotherapy with XELOX regimen and radiotherapy were administered,and no tumor progression was observed during follow-up.Conclusion:Recurrent tumors after liver transplantation in HCC patient developing into a special molecular and histopathological transformation is rarely reported.The underlying mechanism could be the dramatical alterations of immune microenvironment after liver transplantation,which consequently triggered genomic changes leading to generate novel YAP1-MAML2 fusion gene.The poor differentiation transformation after liver transplantation maybe driven by YAP1-MAML2 fusion gene.

Objective:To describe the special molecular and histopathological transformation of recurrent tumor in a patient with primary hepatocellular carcinoma(HCC)after liver transplantation.Methods:A case of HCC had recurrent tumor presenting special molecular and histopathological characteristics after liver transplantation.The diagnosis and treatment process of this case is reported.Results:A case of highly differentiated HCC received immune checkpoint inhibitors combined with antiangiogenic therapy after liver malignant tumor resection.Nearly one year later,due to severe liver cirrhosis,the case accepted allogeneic orthotopic transplantation of liver.More than two years later,elevated level of serum alpha fetoprotein was detected,then the PET-CT examination showed multiple suspected lesions with increased 18F-FDG metabolism in the right lobe of the liver.Liver biopsy and high-throughput sequencing were performed,and the results revealed poorly differentiated HCC with YAP1-MAML2 fusion gene.Chemotherapy with XELOX regimen and radiotherapy were administered,and no tumor progression was observed during follow-up.Conclusion:Recurrent tumors after liver transplantation in HCC patient developing into a special molecular and histopathological transformation is rarely reported.The underlying mechanism could be the dramatical alterations of immune microenvironment after liver transplantation,which consequently triggered genomic changes leading to generate novel YAP1-MAML2 fusion gene.The poor differentiation transformation after liver transplantation maybe driven by YAP1-MAML2 fusion gene.

In order to investigate the pharmacokinetics of propofol, 8 adult patients, ASA grade Ⅰ-Ⅱ, scheduled for elective operation under general anesthesia,served as the subjects. After the injection bolus of propofol 2mg?kg~_(-1) was given, the venous blood samples were taken at various times to measure the plasma concentrations of propofol by high performance liquid chromatography. The data were analysed using PKBP-NI program. The results showed that the disposition of propofol was mathematically described by three compartment open motile, the distribution was rapid and extensive with slow balance among three compartments,and the eliminative duration was short. It is indicated that propofol is applicable for both induction and maintenance of anesthesia.