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.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

AIM:To optimize the clinical dosage and administration regimen of a novel long-acting injectable aripiprazole microsphere(LZMT05)using plasma concentration data from two clinical trials.METHODS:Plasma concentrations were collected from 196 schizophrenia patients administered LZMT05,and a population pharmacokinetic(Pop-PK)model was developed.The therapeutic window was defined as the steady-state trough-to-peak concentration range(94.0-534 ng/mL)of oral ar-ipiprazole.Multiple clinical scenarios were simulat-ed to identify the optimal regimen.RESULTS:A one-compartment model with dual first-order ab-sorption and first-order elimination characterized LZMT05 pharmacokinetics.Covariates like sex and CYP2D6 genotype were integrated into the final model.Simulations demonstrated that switching from 10 mg oral aripiprazole to 350 mg LZMT05 ev-ery 4 weeks sustained concentrations within the therapeutic window with minimal peak-to-trough fluctuations.CONCLUSION:The PopPK-guided opti-mized LZMT05 regimen maintained drug exposure within the therapeutic window,suggesting favor-able efficacy and safety.

AIM To study the chemical constituents from Commelina communis L.METHODS The 95％ethanol extract from C.Communis was isolated and purified by activated charcoal,silica gel,Sephadex LH-20,and HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Seventeen compounds were isolated and identified as p-hydroxyl ethyl cinnamate(1),p-hydroxybenzaldehyde(2),vanillin(3),4-hydroxy-2,3-dimethyl-2-nonen-4-olide(4),hemeratrol A(5),chakyunglupulin B(6),chakyunglupulin A(7),2-(2-hydroxyethyl)-3-methylfumaric acid(8),N-cis-feruloyl tyramine(9),N-trans-coumaroyltyramine(10),5,6,7,3',4',5'-hexamethoxyflavone(11),N-trans-sinapoyltyramine(12),dihydro-feruloyltyramine(13),N-trans-feruloyltyramine(14),2-phenylethanol-β-D-glucoside(15),quercetin-3-O-β-D-glucoside(16),and isorhamnetin-3-O-β-D-glucopyranoside(17).CONCLUSION Compounds 4-8,10 and 11 are isolated from Commelina genus for the first time,and 1,9,12-15 are first isolated from this plant.

Objective To compare the application effects of plankton multiplex polymerase chain reac-tion-capillary electrophoresis(PCR-CE),SYBR Green Ⅰ real-time quantitative PCR(qPCR)and microwave digestion-vacuum filtration-automated scanning electron microscopy(MD-VF-Auto SEM)in the diagnosis of drowning.Methods Lung,liver and kidney tissues from 212 drowned corpses and 30 non-drowned corpses were examined respectively by the three drowning-related plankton testing methods,and the detection rates of plankton in each tissue by three methods were compared.Results In drowned corpses,the total detection rates of PCR-CE,qPCR,and MD-VF-Auto SEM were 93.9%,96.2%,and 95.3%,respectively,with no statistically significant difference(P>0.05).The detection rate of lung tissue by MD-VF-Auto SEM(100%)was higher than those of PCR-CE and qPCR(P<0.05),and there was no significant difference in the detection rates of the three methods in liver or kidney tissues(P>0.05).In non-drowning corpses,a small number of diatoms(less than 10 cells/10 g)were detected by MD-VF-Auto SEM method,only in liver and kidney tissues,while the other two methods yielded negative results for all tissues.Conclusion All three methods have good efficacy in the examination of drowned corpses.The MD-VF-Auto SEM method directly observes diatom morpho-logical characteristics through scanning electron microscopy,and the qualitative and quantitative analy-ses are intuitive and accurate.It has great advantages in the examination of difficult degradation samples.The PCR-CE method and qPCR method have a low sample demand(0.5 g),are easy to operate and have short detection time(4-7 h).They are easy to be applied in the grassroots depart-ments and are suitable for the rapid determination of drowned corpses in routin cases.The combina-tion of the two DNA methods with the MD-VF-Auto SEM method can increase the detection rate of plankton,ensuring the reliability of examination results.This combined use is of significant importance in the application of drowning diagnosis.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Aim To explore the mechanism of Lycium barbarum glycopeptide(LbGP)improving aging in rat primary ovarian granulosa cells.Methods This study divided the cells into a normal group,a DOX group,and four different LbGP concentration treatment groups post-DOX intervention.Results Cell proliferation was assessed using CCK-8,EDU,and Ki67 assays,while aging markers and mitochondrial function-related fac-tors were detected using immunofluorescence and West-ern blotting.The results showed that,compared to the DOX group,LbGP treatment significantly increased cell viability(P＜0.05)and promoted proliferation(P＜0.05).Post LbGP treatment,the β-galactosidase-posi-tive area in cells was significantly reduced compared to the DOX group(P＜0.05).Immunofluorescence re-sults indicated that,compared to the DOX group,levels of p21 and γH2AX significantly decreased(P＜0.05),while pRB increased(P＜0.05)after LbGP treatment.Western blot results showed that,compared to the DOX group,the aging phenotype proteins p21 and p53 significantly decreased(P＜0.05),and pRB notably increased(P＜0.05)in the LbGP treatment group.The release of cytC into the cytoplasm and the activated caspase-9 significantly decreased(P＜0.05);levels of CAMKK2,pAMPK,and mitochondrial calcium homeostasis regulator MCU increased(P＜0.05);nuclear energy metabolism-related proteins SirT1,PGC1α/β and ATP5A1 significantly increased(P＜0.05);compared to the DOX group,ROS levels significantly decreased after LbGP treatment(P＜0.05).Conclusions The results suggest that LbGP can ameliorate DOX-induced aging in rat primary ovar-ian granulosa cells,potentially through the upregulation of the CAMKKβ/AMPK signaling pathway,thereby im-proving mitochondrial calcium homeostasis and increas-ing the expression levels of cell energy metabolism-re-lated regulatory proteins.This provides an experimen-tal basis for LbGP's potential role in supporting the im-provement of ovarian function.

Objective To investigate the expression and clinical significance of long non-codingRNA HCG11 (lncRNA HCG11) mRNA and microRNA (miR)-4465 in patients with triple-negative breast cancer(TNBC). Methods The clinicopathological data of 110 TNBC patients hospitalized in Jiulong Hospital of Suzhou from June 2017 to June 2020 were collected,and the clinical significance of the expression of lncRNA HCG11mRNA and miR-4465 was analyzed. Results The expression of lncRNA HCG11 mRNA (1.81±0.53) in cancer tissues was higher than that in adjacent tissues (0.87±0.13),while the expression of miR-4465 (0.68±0.14) was lower than that in adjacent tissues (1.09±0.18),and the differences were statistically significant(t=18.066,18.857,all P<0.05). The results of Pearson analysis showed that lncRNA HCG11mRNA was negatively correlated with the expression of miR-4465 (r=-0.443,P<0.001). The proportion of patients with high expression of lncRNA HCG11mRNA and low expression of miR-4465 in cancer tissues with lymph node metastasis in TNM stage Ⅲ+Ⅳ was higher than that in TNM stage Ⅰ+Ⅱ,and the proportion of patients without lymph node metastasis was higher (x2=6.614,18.510;8.093,22.976,all P<0.05) The 3-year survival rate of lncRNA HCG11mRNA patients with high expression was lower than that of lncRNA HCG11mRNA patients with low expression,and the 3-year survival rate of patients with high expression of miR-4465 was higher than that of patients with low expression of miR-4465 (Log-rank x2=14.45,13.39,all P<0.05). The proportion of patients with clinical stage Ⅲ+Ⅳ in death group was higher than that in survival group (x2=12.667,18.026,all P<0.05). LncRNA HCG11mRNA(HR=2.623,95％CI:1.344～5.118) was risk factors for 3-year death in TNBC patients,while miR-4465(HR=0.891,95％CI:0.821～0.967) was a protective factor (P<0.05). Conclusion The high expression of lncRNA HCG11 mRNA and the low expression of miR-4465 in triple negatire breast cancer were related to the clinicopathological characteristics and prognosis of patients,and are expected to become prognostic marker for TNBC.

Objective To summarize the clinical features,treatment and prognosis of patients with primary central nervous system lymphoma(PCNSL)with clonal bone marrow B cells,and to explore the influence on clinical diagnosis and treatment.Methods PCNSL patients with clonal bone marrow B cells diagnosed by flow cytometry between Jan 2020 and Jul 2023 at Huashan Hospital of Fudan University were enrolled.The auxiliary examination data of these patients were collected,including complete blood count,routine biochemistry,bone marrow aspiration and biopsy,contrast-enhanced brain MRI,and whole-body PET-CT.Kaplan-Meier was used to draw the survival curve,and relevant literature was reviewed.Results A total of 223 newly diagnosed PCNSL patients were included,187 of whom completed bone marrow puncture and biopsy evaluation.We found clonal bone marrow B cells in 16 of 187 cases(8.56%)by flow cytometry.2 patients showed B lymphoma involving the bone marrow.All patients received a high-dose methotrexate based chemotherapy.The median progression free survival(PFS)of 16 patients with clonal bone marrow B cells was 11.1 months,and the median PFS of 171 patients with normal bone marrow was 12.6 months.There was no significant difference in the PFS between the two groups.Conclusion PCNSL with clonal bone marrow B cells had no specific clinical features,but bone marrow flow cytometry showed clonal B cells.High-dose methotrexate treatment regimen is effective.There was no significant difference in PFS for PCNSL patients with clonal B cells and normal findings in bone marrow.Clonal B cells in bone marrow may be caused by monoclonal B-cell lymphocytosis(MBL),lymphoma involves the bone marrow and the presence of common precursor cells.Bone marrow examination should be performed in the initial evaluation of suspected PCNSL.

Objective To investigate the expression and clinical significance of long non-codingRNA HCG11 (lncRNA HCG11) mRNA and microRNA (miR)-4465 in patients with triple-negative breast cancer(TNBC). Methods The clinicopathological data of 110 TNBC patients hospitalized in Jiulong Hospital of Suzhou from June 2017 to June 2020 were collected,and the clinical significance of the expression of lncRNA HCG11mRNA and miR-4465 was analyzed. Results The expression of lncRNA HCG11 mRNA (1.81±0.53) in cancer tissues was higher than that in adjacent tissues (0.87±0.13),while the expression of miR-4465 (0.68±0.14) was lower than that in adjacent tissues (1.09±0.18),and the differences were statistically significant(t=18.066,18.857,all P<0.05). The results of Pearson analysis showed that lncRNA HCG11mRNA was negatively correlated with the expression of miR-4465 (r=-0.443,P<0.001). The proportion of patients with high expression of lncRNA HCG11mRNA and low expression of miR-4465 in cancer tissues with lymph node metastasis in TNM stage Ⅲ+Ⅳ was higher than that in TNM stage Ⅰ+Ⅱ,and the proportion of patients without lymph node metastasis was higher (x2=6.614,18.510;8.093,22.976,all P<0.05) The 3-year survival rate of lncRNA HCG11mRNA patients with high expression was lower than that of lncRNA HCG11mRNA patients with low expression,and the 3-year survival rate of patients with high expression of miR-4465 was higher than that of patients with low expression of miR-4465 (Log-rank x2=14.45,13.39,all P<0.05). The proportion of patients with clinical stage Ⅲ+Ⅳ in death group was higher than that in survival group (x2=12.667,18.026,all P<0.05). LncRNA HCG11mRNA(HR=2.623,95％CI:1.344～5.118) was risk factors for 3-year death in TNBC patients,while miR-4465(HR=0.891,95％CI:0.821～0.967) was a protective factor (P<0.05). Conclusion The high expression of lncRNA HCG11 mRNA and the low expression of miR-4465 in triple negatire breast cancer were related to the clinicopathological characteristics and prognosis of patients,and are expected to become prognostic marker for TNBC.