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.

This report evaluates the preliminary outcomes of a "six-in-one" integrated cough and asthma center developed under a dual-contract physician model at the Changfeng Community Health Service Center in Putuo District, Shanghai. By combining the efforts of family doctors and medical specialists, the center integrated six core functions-clinical treatment, prevention, nursing, rehabilitation, pharmacy, and nutrition-into a seamless management system covering screening, diagnosis, therapy, and follow-up. Supported by specialist guidance and teaching clinics, the model significantly enhanced comprehensive respiratory disease management capabilities within the community setting. The initiative not only improved patient health outcomes but also strengthened multidisciplinary collaboration and resource efficiency, offering a replicable example for improving chronic disease management in primary care through integrated and coordinated service delivery.

This report evaluates the preliminary outcomes of a "six-in-one" integrated cough and asthma center developed under a dual-contract physician model at the Changfeng Community Health Service Center in Putuo District, Shanghai. By combining the efforts of family doctors and medical specialists, the center integrated six core functions-clinical treatment, prevention, nursing, rehabilitation, pharmacy, and nutrition-into a seamless management system covering screening, diagnosis, therapy, and follow-up. Supported by specialist guidance and teaching clinics, the model significantly enhanced comprehensive respiratory disease management capabilities within the community setting. The initiative not only improved patient health outcomes but also strengthened multidisciplinary collaboration and resource efficiency, offering a replicable example for improving chronic disease management in primary care through integrated and coordinated service delivery.

Objective To screen and establish a method for determining the biological activity of anfibatide.Meth-ods Three methods of light transmittance aggregometry(LTA),whole blood electrical impedance aggregometry,and continuous platelet count method were compared and studied.And the constant platelet counting method was chosen and verified to detect the biological activity of anfibatide.Results The RSD values of anfibatide biological activity detected by LTA,whole blood electri-cal impedance aggregometry,and continuous platelet count method were 10.3%,14.0%,and 3.6%,respectively.RSD of repeat-ability of 6 parallel test articles was 11.0%.The RSD of intermediate precision of 12 test articles for different personnel was 9.8%,and the inhibition rate of anfibatide was linear in the range of 0.3-0.5 U.The correlation coefficient was more than 0.990.The ac-tivity of three batches of anfibatide was determined,and the inhibition rate was 49.9%～53.6%.Conclusion The continuous platelet count method for determining anfibatide activity was established and verified,which can be used for quality control for an-fibatide activity since the precision and detection limit of the method met the requirement for activity assay of biological products.

Objective: To explore the relationship between split-fat sign and entering and exiting nerve sign on MRI in nerve sheath tumors (NSTs) of extremities. Methods: The MRI data of 141 patients with benign soft tissue NSTs of extremities confirmed by operation and pathology from January 2014 to July 2018 in the Second Hospital of Zhejiang University School of Medicine were retrospectively analyzed. The patients were divided into intramuscular and intermuscular groups according to the location of the tumors. The split-fat sign and entering and exiting nerve sign in the two groups were compared using χ² test. Results: There were 152 NSTs in 141 patients, including 41 intramuscular NSTs and 111 intermuscular NSTs. There were 48 split-fat sign and 14 entering and exiting nerve sign in intramuscular NSTs, while 9 split-fat sign and 190 entering and exiting nerve sign in intermuscular NSTs. Statistical analysis showed that there were statistically significant differences in split-fat sign (χ²=55.545, P<0.001) and entering and exiting nerve sign (χ²=26.969, P<0.001) between the two groups. Conclusion The split-fat sign mostly appeared in intramuscular NSTs, and the entering and exiting nerve sign mostly appeared in intermuscular NSTs.

BACKGROUND: The main manifestations of radiation pneumonitis are injury of alveolar epithelial and endothelial cells, abnormal expression of cytokines, abnormal proliferation of fibroblasts and synthesis of fibrous matrix. The occurrence of radiation pneumonitis is associated with multiplecytokine level abnormality. These cytokines can also be used as bio-markers to predict the occurrence of radiation pneumonitis. This study was to evaluate the correlation between the change of apurinic/apyrimidinic endonuclease 1/redox factor-1 (Ape1/Ref-1), intercellular adhesion molecules 1 (ICAM-1) and interleukin-17A (IL-17A) before and after radiotherapy and radiation pneumonitis for local advanced non-small cell lung cancer (NSCLC) patients with concurrent chemoradiotherapy. METHODS: NSCLC patients (68 cases) were treated with concurrent radiotherapy and chemotherapy, every patient's normal tissue were controlled with a same radation dose. 68 local advanced NSCLC patients with concurrent chemoradiotherapy were detected the levels of Ape1/Ref-1, ICAM-1 and IL-17A in serum by ELISA before radiotherapy and in the 14th week after radiotherapy. Acute and advanced radiation pulmonary injury was graded according to Radiation Therapy Oncology Group/European Organization For Research and Treatment (RTOG/EORTC) diagnostic and grading criteria. Grade 2 or more radiation pneumonitis was taken as the main end point. RESULTS: Eighteen cases out of 68 developed radiation pneumonitis, 50 of 68 cases have no radiation pneumonia development. There was no significant change of Ape1/Ref-1 levels before and after radiotherapy in radiation pneumonitis group (P>0.05). There was no significant change of Ape1/Ref-1 concentration in serum after radiotherapy between radiation pneumonitis group and non-radiation pneumonitis group (P>0.05). Compared with before radiotherapy, upregulation degree of ICAM-1 levels in radiation pneumonitis group was significantly higher than that in non- radiation pneumonitis group (P<0.05). There was no significant change of IL-17A concentration before and after radiotherapy in radiation pneumonitis group, but after radiotherapy IL-17A concentration in serum were remarkably higher than that in non-radiation pneumonitis group (P<0.05). Correlation analysis found that the change of ICAM-1 before and after radiotherapy has no obvious correlation with the incidence of radiation pneumonitis, and IL-17A change has obvious correlation with the incidence of radiation pneumonitis. CONCLUSIONS On the basis of strictly controlling radiation dose on normal tissue, IL-17A in serum could be the predictive factors of radiation pneumonitis for local advanced NSCLC patients with concurrent chemoradiotherapy.
Aged ; Carcinoma, Non-Small-Cell Lung ; blood ; drug therapy ; radiotherapy ; Chemoradiotherapy ; adverse effects ; DNA-(Apurinic or Apyrimidinic Site) Lyase ; blood ; Female ; Humans ; Intercellular Adhesion Molecule-1 ; blood ; Interleukin-17 ; blood ; Male ; Middle Aged ; Radiation Pneumonitis ; blood ; etiology

As urine flow dynamic test is widely used in clinical,merge detrusor dysfunction of benign prostatic hyperplasia treatment research also more and more.For normal detrusor contraction force and slight damage (Pdet ＞ 20 cmH2O) of the operative efficacy of BPH patients have reached a consensus of scholars both at home and abroad.For merger severely impaired detrusor contraction force (Pdet 0-20 cmH2O) at odds with the treatment of benign prostatic hyperplasia patients,in combination with related literature,now just urethral catheterization or colostomy,the transurethral resection of the prostate in the same period the bladder again after colostomy,the comprehensive treatment evaluation IⅡ transurethral resection of the prostate surgery and review these main treatment.

Objective To investigate the molecular epidemiology of human immunodefieiency viruses (HIV)-1 infected individuals in Honghe district,Yunnan Province and provide the evidence of molecular biology features of HIV-1 infection.Methods HIV-1 pol gene was amplified by reverse transcription-polymerase chain reaction (RT-PCR).Then sequencing and phylogenetic tree analysis were employed tO determine HIV-I subgenotype.The sequence alignment was performed in the database of international drug resistance tO identify resistance-associated mutations.Results The samples from 60 HIV-1 infected individuals were investigated:39 were male,21 were female,with average age 35.5 years old.Thirty-four cases were infected with HIV-I through intravenous drug abuse,12 by sexual contacts,2 were contaminated blood/blood products transfusion and 12 with unknown transmission routes.Phylogenetic analysis revealed that 53 cases (88.3%) were subtype 08-BC,6 (10.0%) were subtype 07-BC and 1 (1.7%) was subtype 01_AE.The total rate of drug resistance associated mutations was 33.3%.The major mutations in protease (PR) and reverse transcriptase (RT) regions accounted for 5.0% and 3 1.7%,respectively.The major mutations in PR region were I541M,V82VFIL,M46MI,which were found in 1 case,respectively.The mutations in RT region were as follows:4 cases were T69D,6 were A62V,1 was D67DE,1 was E44D,3 were V179D,1 was V179E.1 was K238KN,1 was L234T+P236S and 1 was V106E.Conclusions The major transmission route of HIV-I infection in Honghe district,Yunnan Province is through drug injection.The major HIV-1 subtype of HIV-infeeted individuals is 08_BC.PR inhibitor and RT inhibitor drug resistance associated mutations in HlV-1 gene have already existed.

Objective To explore the treatment of incidental gallbladder carcinoma(UGC)discovered during laparoscopic cholecystectomy(LC). Methods The clinical data of 17 cases of incidental gallbladder (carcinoma) discovered during laparoscopic cholecystectomy were reviewed retrospectively. Results 11cases with Nevin stage I or stage II were treated by LC and 1 case with Nevin stage III and 3 cases with Nevin stage V were treated by LC and radical local lymphadenectomy. 2 cases with Nevin stage IV were treated by (cholecystectomy). UGC was incidently found in 0.6% of the cases. Cases with Nevin Stage I and II were (observed) for 5 years with no recurrence. A case with Nevin Stage III was found to have recurrence within one and a half years postoperatively and had a re-operation. The prognosis of patients with Nevin Stage IV and V was poor and they were dead within a year after operation. Conclusions The incidently found gallbladder carcinoma with Nevin Stage I and II disease can be radically resected with laparoscopic cholecystectomy. The incidently found gallbladder carcinoma with Nevin Stage III and IV disease needs to be radically resected, and if the resection margin is found to be free of tumour, the prognosis is enhanced. The ones with Nevin Stage V need to be treated by local lymphadenectomy and wedge-resection of liver.

Objective To explore an efficient treatment for bladder outlet obstruction caused by small benign prostatic hyperplasia(BPH). Methods From January 1996 to January 2005,69 patients with BPH were surgically treated.Of these patients,27 cases underwent open surgery,22 transurethral resection of prostate(TURP) and 20 TURP plus transurethral incision of bladder neck(TUIBN).There were no significant differences between the 3 groups in age,disease course,preoperative prostate weight and the excised prostate weight.The efficacy of open surgery,TRUP and TURP plus TUIBN were comparatively evaluated by international prostate symptom score(IPSS),peak urinary flow rate(Qmax),post void residual drine volume(PVR) and postoperative complications.Results After operation,the mean score of IPSS of patients which treated with open surgery decreased from(24.6+3.8) to(15.1?3.8),and the Qmax increased from(8.2?3.1)ml/s to(10.5?4.2)ml/s,and the PVR decreased from(96.0?36.0)ml to(54.0?27.0)ml.The IPSS of TURP group decreased from(22.3?5.6) to(11.7?2.7),and the Qmax increased from(8.5?3.6)ml/s to(11.4?4.2)ml/s,and the PVR decreased from(105.0?39.0)ml/s to(32.0?14.0)ml/s.The IPSS of the TURP plus TUIBN group decreased from(23.6?5.7) to(6.4?2.3),and the Qmax increased from(9.1?3.8)ml/s to(19.5?6.2) ml/s,and the PVR decreased from(98.0?37.0)ml to(8.0?5.0)ml.There were significant differences between the TURP plus TUIBN group and the other two groups in the IPSS,Qmax and PVR(P