Clinical and economic comparison of laparoscopic versus open hepatectomy for primary hepatolithiasis: a propensity score-matched cohort study.

BACKGROUND: It is unclear whether laparoscopic hepatectomy (LH) for hepatolithiasis confers better clinical benefit and lower hospital costs than open hepatectomy (OH). This study aim to evaluate the clinical and economic value of LH versus OH. METHODS: Patients undergoing OH or LH for primary hepatolithiasis at Yijishan Hospital of Wannan Medical College between 2015 and 2022 were divided into OH group and LH group. Propensity score matching (PSM) was used to balance the baseline data. Deviation-based cost modelling and weighted average median cost (WAMC) were used to assess and compare the economic value. RESULTS: A total of 853 patients were identified. After exclusions, 403 patients with primary hepatolithiasis underwent anatomical hepatectomy (OH n=143; LH n=260). PSM resulted in 2 groups of 100 patients each. Although LH required a longer median operation duration compared with OH (285.0 versus 240.0 min, respectively, P<0.001), LH patients had fewer wound infections, fewer pre-discharge overall complications (26 versus 43%, respectively, P=0.009), and shorter median postoperative hospital stays (8.0 versus 12.0 days, respectively, P<0.001). No differences were found in blood loss, major complications, stone clearance, and mortality between the two matched groups. However, the median overall hospital cost of LH was significantly higher than that of OH (CNY¥52,196.1 versus 45,349.5, respectively, P=0.007). Although LH patients had shorter median postoperative hospital stays and fewer complications than OH patients, the WAMC was still higher for the LH group than for the OH group with an increase of CNY¥9,755.2 per patient undergoing LH. CONCLUSION: The overall clinical benefit of LH for hepatolithiasis is comparable or even superior to that of OH, but with an economic disadvantage. There is a need to effectively reduce the hospital costs of LH and the gap between costs and diagnosis-related group reimbursement to promote its adoption.

Comparison of the effects of ampulla-guided realignment and conventional gallbladder triangle anatomy in difficult laparoscopic cholecystectomy.

OBJECTIVE: To compare the effects of ampulla-guided realignment and conventional gallbladder triangle anatomy in difficult laparoscopic cholecystectomy (DLC). METHODS: From June 2021 to August 2022, data from 100 patients undergoing DLC at Nanjing Hospital of Traditional Chinese Medicine were analyzed retrospectively. Patients were divided into two groups: the experimental group (LC with the ampulla-guided realignment) and the control group (conventional LC with triangular gallbladder anatomy), with 50 patients per group. The intraoperative blood loss, operation time, postoperative drainage tube indwelling time, hospitalization time, bile duct injury rate, operation conversion rate, and incidence of postoperative complications were recorded and compared between the two groups. The pain response and daily activities of the patients in the two groups were evaluated 48 h after the operation. RESULTS: The amount of intraoperative blood loss, postoperative drainage tube indwelling time, hospital stay, operation conversion rate, pain degree at 24 and 48 h after operation, bile duct injury incidence, and total postoperative complication rate were shorter or lower in the experimental group than those in the control group (p < 0.05). The Barthel index scores of both groups were higher 48 h after the operation than before the operation, and the experimental group was higher than the control group (p < 0.05). CONCLUSION: The ampulla-guided alignment in DLC surgery was more beneficial in promoting postoperative recovery, reducing postoperative pain response, reducing the incidence of postoperative complications, and reducing bile duct injury.

Effects of nitrogen addition on rhizosphere soil properties in a salinized grassland.

We explored the impacts of nitrogen (N) inputs and the rhizosphere effect on the properties of rhizosphere and bulk soils in a salinized grassland in Northern Shanxi under N addition rates of 0, 1, 2, 4, 8, 16, 24 and 32 g N·m-2·a-1. The results showed that N addition significantly decreased soil pH, but significantly increased Ca2+, NO3--N and inorganic nitrogen contents in rhizosphere and bulk soil. With the increases of N addition rates, the contents of Ca2+, NO3--N, inorganic nitrogen in rhizosphere and bulk soils and total nitrogen in rhizosphere soil increased gradually, whereas the contents of Na+, K+, Mg2+, NH4+-N and amino acid in rhizosphere soil, and total nitrogen in bulk soil first increased and then decreased. Results of the principal component analysis showed that the responses of soil properties to low (≤8 g·m-2·a-1) and high nitrogen addition rates (>8 g·m-2·a-1) were significantly different. Compared with bulk soil, soil pH, the contents of organic acids and amino acids in rhizosphere soil were significantly lower by 0.71 units, 44.3% and 9.8%, respectively, while the contents of K+, Ca2+, Mg2+, NH4+-N, inorganic nitrogen, total carbon and total nitrogen in rhizosphere soil were significantly higher by 51.0%, 47.6%, 20.8%, 215.5%, 139.3%, 31.7% and 65.3%, respectively. These results indicated that rhizosphere effect on soil properties was stronger than that of nitrogen addition.

Laparoscopic Single-Incision Triangulated Umbilical Surgery Adrenalectomy for Large (>5 cm) Tumors of the Adrenal Gland: Initial Experience with 16 Cases.

Background and ObjectivesLaparoscopic single-incision triangulated umbilical surgery (SITUS), which enables the extraction of intraabdominal specimens through a single umbilical incision, has yet to be used to perform adrenalectomy. We have modified SITUS to enable extraction of large (>5 cm) adrenal masses with optimal cosmetic outcomes and investigated efficacy and safety. Methods. In this retrospective study, we analyzed data of 16 patients with adrenal tumors >5 cm who had undergone adrenalectomy by SITUS between October 2015 and April 2018. Two C-shaped incisions were made around the umbilicus and sutured centripetally. After extracting the specimen, we evaluated these patients' operative/postoperative data. Results. SITUS was performed in all 16 patients without conversion to laparoscopic or open surgery. The mean operation time was 75.31 ± 21.54 min (intraperitoneal time 41.94 ± 17.57 min; incision suturing time 33.38 ± 6.34 min). The estimated median blood loss was 57.5 mL (range 30-610 mL). Drainage time and duration of hospital stay were 55.69 ± 12.92 h and 3.94 ± 0.90 d, respectively. After surgery, all incisions were hidden under the umbilicus. Three patients developed keloid diathesis, resulting in enlargement of their scars. Conclusions. SITUS is a safe and feasible procedure for removing large adrenal tumors. In addition to its cosmetic advantages, SITUS facilitates functional recovery, particularly in patients with large adrenal tumors.

The effect of Gö6976 on chronic myeloid leukemia in vitro and in vivo.

Objectives: Chronic myeloid leukemia (CML) is a malignant tumor of the blood system. Gö6976, as a type of indolocarbazole and shows strong antitumor effects, but there have been no reports on the effect of Gö6976 on CML. The objectives of this research were: (1) to explore the impact of Gö6976 on CML in vitro and in vivo; and (2) to explore the drug toxicity of Gö6976 to normal cells and animals.Methods:K562 cells and CML mice were used to explore the effect of Gö6976 on CML. Peripheral blood mononuclear cells (PBMCs), CD34+ cells, and healthy mice were used to explore the drug toxicity of Gö6976.Results: Cell experiments showed that Gö6976 could inhibit the proliferation of K562 cells and enhance the inhibitory effects of imatinib at 5 µM and 10 µM, but it had little effect on CD34+ cells or PBMCs at concentrations less than 5 µM. Animal experiments showed that 2.5 mg/kg Gö6976 could effectively inhibit the development of CML in mice, and it had almost no effects on healthy mice at 2.5 mg/kg and 10 mg/kg.Discussion: Because of the direct inhibitory effect of Gö6976 on CML and its pharmacological enhancement effect on imatinib, it is foreseeable that Gö6976 could become a new type of anti-CML medicine. And the further research is needed.Conclusion: Our findings verified that Gö6976 could effectively inhibit CML in vitro and in vivo, and it is almost nontoxic to hematopoietic cells, immune cells, and healthy mice.

[Predictive analysis of quality markers of Coptidis Rhizoma based on network pharmacology and multivariate statistical analysis].

Coptidis Rhizoma, as a bulk medicinal material, is in great demand in clinical practice. Its quality is uneven in the market due to the mixture of genuine, counterfeit and adulterants. Therefore, it is particularly important to establish a quality control system for Coptidis Rhizoma. Based on the concept of Chinese medicine quality marker(Q-marker), the potential quality markers of Coptidis Rhizoma were analyzed and predicted from the perspective of chemistry and pharmacology. The sources of the Q-markers of Coptidis Rhizoma were identified by literature retrieval. The potential Q-markers were then screened through the visualization of the "components-targets-pathways" network. High performance liquid chromatography(HPLC) was used to establish a multi-indicator qualitative and quantitative control method featuring fingerprints for 10 batches of Coptidis Rhizoma. A supervised mode of orthogonality partial least squares method-discriminant analysis(OPLS-DA) was used to screen the main marker components that caused differences between groups. The literature review results showed that the alkaloids were the main source of Coptidis Rhizoma Q-markers.The fingerprints of 13 common peaks were successfully established, and berberine, palmatine, berberine and epiberberine were selected as Q-markers of Coptidis Rhizoma, and their contents were determined.Based on the concept of the Q-marker of traditional Chinese medicine, the four components can be selected as the Q-marker of Coptidis Rhizoma after comprehensive consideration. The results of this study are not only conducive to the quality evaluation of Coptidis Rhizoma on the market, but also provide a reference for the overall quality control of Coptidis Rhizoma and lay foundation for the future exploration of the mechanism of Coptidis Rhizoma.

Short-term effects of grazing intensity on soil stoichiometric characteristics of typical grassland in the agro-pastoral ecotone of northern China.

Grazing is the dominant land use way for natural grasslands. Different grazing intensities could affect soil stoichiometry in grasslands by influencing the selective feeding by livestock, litter input, and microbial community structure. In this study, a grazing experiment was carried out in a grassland of agro-pastoral ecotone in Northern China for three years (2017-2019). The concentrations of total carbon (TC), total nitrogen (TN), dissolved organic carbon (DOC), dissolved nitrogen (DN), microbial biomass carbon (MBC), and microbial biomass nitrogen (MBN) in soils were measured. We analyzed the stoichiometric characteristics of those parameters. The results showed that different grazing intensities (1, 2, 4 sheep·0.2 hm-2) had no significant effect on soil TC after three years. The moderate grazing intensity significantly reduced soil TN in 10-20 cm layer in 2019. The light, moderate, and heavy grazing intensities significantly increased soil C/N at 10-20 cm layer, while grazing intensities did not affect soil DOC, DN and DOC/DN. The soil DOC and DN content showed a decreasing trend with the increase of grazing intensity in 2019. It indicated that continuous high intensity grazing might reduce soil dissolved nutrients. The light grazing inten-sity increased soil MBC, while heavy grazing intensity reduced soil MBC significantly, with the increase of grazing year. Different grazing intensities did not affect soil MBN and MBC/MBN.

[Effect of GÖ6976 on Proliferation of Chronic Myeloid Leukemia Cells and Its Toxicity on Normal Cells and Mice].

OBJECTIVE: To investigate the effect of GÖ6976 on the proliferation of chronic myeloid leukemia cells and its toxic effect on normal cells and mice, so as to provide experimental basis for the effectiveness and safety of its clinical application. METHODS: Different concentrations of GÖ6976 were applied to the K562 cells, human peripheral blood mononuclear cells (PBMNC) and normal BaF3 cells, MTT assay was used to detect the effect on cell proliferation. BALB/C mice were used to investigate the toxicity in vivo. The general situation, body weight and the number of white blood cells in peripheral blood were monitored during administration, the blood collected from eyeballs before and after administration was used for biochemical examination, at the same time, the liver, kidney and femurs were examined pathologically. RESULTS: GÖ6976 could significantly inhibit the proliferation of K562 cells, inhibition effect increased with increasing dose (r=0.9623). However, there was no significant change in the inhibitory effect on PBMNC and BaF3 cells. The pathological examination of organs in each group showed no abnormal manifestations such as inflammatory infiltration, while the change rate of leukocyte count in peripheral blood of high dose group fluctuated greatly (P＜0.05), which might be related to the inhibition of intracellular protein kinase C, and no abnormality was observed in blood biochemical indexes. In the low dose group, there was no significant difference in peripheral blood leukocyte count, blood biochemical index and histopathology during administration drug as compared with the control group. CONCLUSION: GÖ6976 possesses a significant inhibitory effect on the proliferation of K562 cells, and the inhibitory effect increases with increasing dose. Long-term application of 5.0 µmol/L and below concentrations of GÖ6976 shows no obvious inhibitory effect on PBMNC, BaF3 cells. Long-term application of 10 mg/kg and below concentrations of GÖ6976 shows no obvious toxic effect on BALB/c mice.

[Research Advance on Classic Wnt Pathway in Chronic Myelogenous Leukemia--Review].

Abstract　　Chronic myelogenous leukemia (CML) is a hematological malignancy that seriously threatens the lives of patients. It was found that there are abnormal classic Wnt pathway, that is, Wnt/ß-catenin signaling pathways in CML cells, moreover, Wnt/ß-catenin signaling pathway is involved in the growth and proliferation of CML cells, and closely relates with the self-renewal ability of CML leukemic stem cells. This review summarizes the recent studies on the relationship between Wnt/ß-catenin signaling pathway and CML, and the researches on the targeting inhibition of Wnt/ß-catenin signaling pathway in CML treatment, thus to provide new ideas for the treatment of CML.

[Advances in Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Myelogenous Leukemia--Review].

Abstract　　At present, allogeneic hematopoietic stem cell transplantation is still the only way to cure chronic myelogenous leukemia. With the advances of HLA matching technology, application of tyrosine kinase inhibitors before and after transplantation, improvement of postoperative immune status and fusion gene monitoring, and the control of postoperative complications, especially graft-versus-host disease etc. allogeneic hematopoietic stem cell transplantation is displaying better efficacy in the treatment of chronic myelogenous leukemia, and the quality of life of patients has also been significantly improved. This article reviews the recent research advances on the allogeneic hematopoietic stem cell transplantation and related support technologies for treatment of chronic myeloid leukemia.

The influences of "gas" viscosity on water entry of hydrophobic spheres.

An extremely thin gas film was found between a sphere and a free surface when the sphere impacted onto a water pool. That might influence the generation and evolution of water entry cavity. However, it is quite difficult to be captured through normal numerical and experimental tests. In this work, by using a finite element method we investigate the water entry of a hydrophobic sphere with gas viscosity artificially increased. The air film rupture in the early stage, contact line dynamics on a curved solid surface, and air pocket formation are investigated. The numerical results reveal that the lifetime of the gas film can be predicted by a viscous squeezing flow model qualitatively well. That relates to the fact that the gas film is much thinner than the diameter of the sphere, even when the gas viscosity is 100 times as large as the liquid one. However, inviscid flow can be found in the most part of the liquid bulk. The free surface profile (or the gas film profile) is then determined by the impact speed, namely the Weber number. More importantly, after the "gas" film ruptures at the bottom of the sphere, a contact line is generated. The contact line retracts along the sphere's surface, and the retracting speed fulfils [Formula: see text] law generally. This implies that the retracting process of the gas film is dominated by the inertia-capillary balance, rather than simply by the visco-capillary.

Morphological classification and dynamics of a two-dimensional drop sliding on a vertical plate.

A two-dimensional drop sliding down a plate under the action of gravity is numerically studied. A lattice Boltzmann method coupled with the phase field method is utilized, which can well capture the motion of the three-phase contact line. The morphologies of the sliding drop and corresponding force balance during the process are considered. It is found that there are two basic sliding modes of the drop with various gravitational and viscous effects. The viscous shear stress ( [Formula: see text] from the wall acts on the bottom of the drop, and it is divided in two parts. One is in the contact line region, and the other on the rest part of the solid-liquid interface (contacting area). The former one appears as [Formula: see text] -peaks, which are purely determined by the intrinsic contact angle ( [Formula: see text] and sliding speed. They are very local. When the gravity is small, the drop slides down very slowly, and such shear force can balance the gravity. Meanwhile, the shape of the droplet can be interestingly characterized as a "pendant drop". When the gravity increases, an additional shear force is generated mainly due to the appearing of a trail at the rear part of the drop. The de-wetting failure condition makes the sliding velocity almost constant in this regime. The present study is also valuable to understand the physics of three-dimensional drop sliding.

Competition of cation-π and exo-wall π-π interactions: a novel approach to achieve ultrasensitive response.

A novel approach to achieve ultrasensitive response was successfully developed by rationally introducing the competition between cation-π and exo-wall π-π interactions into a pillar[5]arene-based supramolecular organogel (P5N-OG). Interestingly, the P5N-OG could be used for ion detection and separation, fluorescent display materials as well as ultrasensitive logic gates.

A novel pillar[5]arene-based supramolecular organic framework gel to achieve an ultrasensitive response by introducing the competition of cationπ and ππ interactions.

Ultrasensitive response properties are an intriguing concern for stimuli-responsive materials. Herein, we report a novel method to achieve an ultrasensitive response by introducing the competition of cationπ and ππ interactions into a pillar[5]arene-based supramolecular organic framework (SOF-AMP). SOF-AMP was constructed with a novel bis-naphthalimide functionalized pillar[5]arene, which was able to form a stable supramolecular gel (SOF-AMP-G) in cyclohexanol. Interestingly, SOF-AMP-G shows an ultrasensitive response to Fe3+ through the competition of cationπ and ππ interactions. Meanwhile, the Fe3+ coordinated SOF (MSOF-Fe) shows an ultrasensitive response to H2PO4-. SOF-AMP-G displayed yellow fluorescence whereas, after the addition of 0.5 equiv. of Fe3+ to SOF-AMP-G, the yellow fluorescence was quenched. The detection limit of SOF-AMP-G for Fe3+ is 7.54 × 10-9 M. More interestingly, the Fe3+ coordinated SOF gel (MSOF-Fe-G) could sense H2PO4- with a fluorescence "turn-on". The detection limit of MSOF-Fe-G for H2PO4- is 4.21 × 10-9 M. Simultaneously, the Fe3+ and H2PO4- responsive thin films based on these SOF gels were prepared. Moreover, these SOF gels could be used as ultrasensitive ion sensors, fluorescent display materials and sensitive logic gates.

Prognostic significance of eukaryotic initiation factor 4E in hepatocellular carcinoma.

PURPOSE: Aberrant expression of eukaryotic initiation factor 4E (eIF4E) has been observed in human malignancies. However, its role in hepatocellular carcinoma (HCC) remains to be established. The purpose of this study was to detect eIF4E expression and to evaluate its clinical relevance. METHODS: The eIF4E expression was studied in ninety HCC and randomly selected thirty-one non-tumor tissues from the same patient cohort, as well as in normal hepatic and HCC cell lines. The relation between its expression and clinicopathological parameters was also analyzed. RESULTS: eIF4E expression was higher in HCC samples and cell lines compared with that in non-tumor tissues (P < 0.001) and hepatocyte LO2, respectively. eIF4E overexpression was significantly associated with tumor number (P = 0.005) and incomplete encapsulation (P = 0.001). The 5-year overall survival rate and disease-free survival rate for patients with high eIF4E expression were 32.5 and 31.2 %, respectively; and for low eIF4E expression, it was 67.9 and 64.4 %, respectively (P < 0.001). Furthermore, subgroup analysis showed that high eIF4E level predicted poorer overall survival only for incomplete encapsulation (P = 0.001) and cirrhosis (P < 0.001), but not for complete encapsulation (P = 0.804) and non-cirrhosis (P = 0.359). Multivariate analysis revealed that eIF4E overexpression was an independent indicator for both overall survival (hazard ratio, 2.015; P = 0.043) and disease-free survival (hazard ratio, 2.666; P = 0.006). CONCLUSIONS: eIF4E protein might result in the malignant progression of HCC, and its overexpression may be a powerful prognostic biomarker and therapeutic target for HCC patients.

Upregulation of cell surface estrogen receptor alpha is associated with the mitogen-activated protein kinase/extracellular signal-regulated kinase activity and promotes autophagy maturation.

Recently, accumulating evidence has implicated the dysregulation of autophagy as underlying the pathophysiology of several neurodegenerative diseases. The human neuronal cell line SH-SY5Y was exposed to 1-Methyl-4-phenylpyridinium (MPP(+)). The mechanism is that the sustained activation of the MAPK/ERK pathway by MPP(+) alters autophagy selectively at the maturation step, significant increasing in autophagy formation and delaying in autophagy degradation in SHSY5Y cells. In this study, we provided evidences that estrogen was capable of promoting SHSY5Y cells survival in MPP(+)-treated group. In particular, the up-regulation of mERα, but not mERß, was associated with a rapid and transient activation of ERK phosphorylation compatible with promoting autophagy maturation. The up-regulation of mERα changed the sustained activation of ERK phosphorylation in MPP(+)-treated group into a temporary activation. Taken together, these findings strongly support that the expression of mERα promotes the maturation of autophagosomes into functional autolysosomes by regulating ERK, determining SHSY5Y cells survival.

Image classification of liver cancer surrounding right hepatic pedicle and its guide to precise liver resection.

PURPOSE: The aim of this study was to explore the feasibility of image classification of liver cancer surrounding right hepatic pedicle (RHP) and its guide to precise liver resection. METHODS: Twenty-five patients with single liver cancer surrounding RHP were collected. According to the adjacent relationship between neoplasm and RHP shown in CT or MRI, the liver neoplasms were divided into the 4 types, type A neoplasm infiltrating or surrounding RHP, type B neoplasm locating in the anterior side of RHP, type C neoplasm locating in the dorsal side of RHP and type D neoplasm locating between the two branches. On the basis of image classification, operation project including hepatic vascular occlusion (HVO) and surgical resection procedure was designed. In the end, preoperative classification and surgical design was compared with operative results. RESULTS: The locations of liver neoplasms were completely in line with preoperative classification. The methods of HVO and range of surgical resection were essentially coincident with preoperative plan. Pringle maneuver, total hepatic and hemihepatic vascular occlusion were applied. Four patients with type A neoplasms underwent right hemihepatectomy or extended right hepatectomy. Seven with type B received right anterior lobectomy or mesohepatectomy. Six with type C underwent segment V, VI resection, and eight with type D received right anterior or posterior lobectomy. All operations were smoothly finished. CONCLUSION: Preoperative classification guided by RHP can provide the accurate location information for liver cancer surrounding RHP, contribute to choosing suitable method of HVO and reasonable range of hepatic resection for precise surgery.

Downregulation of Heparanase Expression Results in Suppression of Invasion, Migration, and Adhesion Abilities of Hepatocellular Carcinoma Cells.

OBJECTIVE: Heparanase (HPSE) is high-expressed in most malignant tumors including hepatocellular carcinoma (HCC) and promotes cancer cell invasion and migration. The aim of the study is to explore whether HPSE enhances adhesion in metastasis of HCC cells. METHODS: HPSE expressions in human HCC cells were measured with real-time RT-PCR and Western blot analysis. Four recombinant miRNA vectors pcDNATM6.2-GW/EmGFP-miR-HPSE (pmiR-HPSE) were transfected into HCCLM3 cell. HPSE expression in transfected cell was measured. The cell invasion, migration, and adhesion abilities were detected, respectively. RESULTS: Both HPSE mRNA and protein relative expression levels were higher in HepG2, BEL-7402, and HCCLM3 cells than those in normal hepatocyte (P < 0.05). HPSE showed highest expression level in HCCLM3 cell (P < 0.05). Transfection efficiencies of four miRNA vectors were 75%-85%. The recombinant vectors significantly decreased HPSE expression in transfected HCCLM3 cells (P < 0.01), and pmiR-HPSE-1 showed best interference effect (P < 0.05). pmiR-HPSE-1 significantly decreased the penetrated and migrating cells numbers and adherence rate of HCCLM3 cells (P < 0.05). CONCLUSION: HPSE is a potentiator of cell adhesion in metastasis of HCC.

Bone morphogenetic protein-2 and vascular endothelial growth factor in bone tissue regeneration: new insight and perspectives.

The study of bone tissue regeneration in orthopaedic diseases has stimulated great interest among bone tissue engineering specialists and orthopaedic surgeons. Combinations of biomaterials, growth factors and stem cells for repairing bone have been much studied and researched, yet remain a challenge for both scientists and clinicians pursuing regenerative medicine. The purpose of this review was to elucidate the role of sequential release of bone morphogenetic protein-2 and vascular endothelial growth factor in producing better outcomes in the field of bone tissue regeneration.

Expressions of heparanase and upstream stimulatory factor in hepatocellular carcinoma.

BACKGROUND: The expression of heparanase (HPSE) was associated with postoperative metastatic recurrence in patients with hepatocellular carcinoma (HCC). The six E-box binding sites in the core promoter of the HPSE gene suggested that transcription factors of E-box such as upstream stimulatory factor (USF) might regulate the transcription of the HPSE gene. The aim of our study is to measure the levels of HPSE and USF expression and investigate the relationship between USF expression and clinicopathological parameters in patients with HCC. METHODS: HPSE, USF1 and USF2 expressions in human HCC cell lines (BEL-7402, HepG2 and HCCLM3) and 15 fresh human HCC tissue samples were measured by real-time reverse transcriptase-PCR and Western blot analysis. The normal liver cell line QSG7701 or fresh normal liver tissue samples obtained from 15 additional surgical patients with hepatic rupture was used as a control. The protein expressions were determined by immunohistochemistry in paraffin-embedded human HCC tissues and corresponding non-neoplastic tumor surrounding tissues (NTST) of 57 patients. RESULTS: HPSE, USF1 and USF2 mRNA expressions were increased in HCC cell lines and HCC tissues compared with normal liver cell line and normal liver tissue. The protein expressions of HPSE, USF1 and USF2 in HCC cell lines and HCC tissues were also increased. Both USF1 and USF2 expressions were positively correlated with HPSE. USF1 and USF2 expressions were increased in patients with liver cirrhosis, worse tissue differentiation, advanced HCC stages and metastatic recurrence. CONCLUSIONS: Increased USF in HCC is associated with HPSE expression. USF might be an important factor in regulating HPSE expression and act as a novel marker of metastatic recurrence of HCC patients.