Fitness Dance Counteracts Female Ph.D. Candidates' Stress by Affecting Emotion Regulation.

Background: The impact of stress on the nation's physical and mental health is considerable. Exercise is considered to have beneficial effects on mental health and the capacity for coping with stress. The purpose of this study is to verify the effects of fitness dance intervention on female Ph.D. candidates' stress, and compare it with the intervention effects of MBSR. Method: A repeated measurement experimental design was used to evaluate the effects of fitness dance and MBSR on Chinese female Ph.D. candidates' stress. Results: Twelve weeks of fitness dance and MBSR can reduce participants' stress from severe to moderate. Eight weeks of fitness dance can reduce the tension from perceived stress (p = 0.019) and loss of control from perceived stress (p = 0.043). Twelve weeks of fitness dance can reduce the tension from perceived stress (p < 0.000), loss of control from perceived stress (p = 0.002) and perceived stress (p = 0.001). Fitness dance and MBSR affect emotion regulation, thereby affecting stress. Fitness dance reduced participants' stress by improving their cognitive reappraisal ability. MBSR reduced participants' stress by improving their cognitive reappraisal ability and expression suppression ability. Conclusions: Fitness dance, as a method of exercise intervention, is suitable for reducing Chinese female Ph.D. candidates' stress.

A Self-Powered Triboelectric Nanogenerator Based on Intelligent Interactive System for Police Shooting Training Monitoring and Virtual Reality Interaction.

A self-powered triboelectric nanogenerator (SPTENG) based on triboelectric effect and an intelligent interactive system are fabricated for monitoring shooting training and virtual training. The SPTENG is composed of latex and PTFE and an intelligent system. Based on triboelectric effect, the SPTENG can be used to monitor the progress of trigger pressing without a power supply (this is supplied by trigger movements). Because of the flexible properties, it can be attached to a trigger conveniently to monitor the progress of trigger pressing, such as trigger time, trigger stability, etc. Meanwhile, as part of an intelligent shooting system, police can formulate a standard scheme according to signals to improve their skills. Furthermore, they can use it to train between reality and virtuality. Therefore, it has a wide development space in human-computer interaction and real-time information processing.

Anxiety Status of Female Chinese Ph.D. Candidates and Its Association with Sports.

Given that stress leads to more anxiety among female Ph.D. candidates, more attention should be paid to their healthy lifestyle options. Several studies have shown that there is a negative correlation between sports and anxiety. This study took female Chinese Ph.D. candidates' anxiety and sports participation as the research objects. A questionnaire entitled "Investigation on anxiety and sports of Ph.D. candidates" was used to explore the characteristics of anxiety in female Chinese Ph.D. candidates and to investigate the association between anxiety and sports in female Chinese Ph.D. candidates. A total of 588 Ph.D. candidates participated in the questionnaire survey. Some 21 invalid questionnaires were eliminated through the standard deviation of the items of the scale, and 567 valid questionnaires were finally obtained. The questionnaire survey was conducted online from 26 February to 15 March 2022, using the convenience sampling method. The results show that the anxiety level of female Chinese Ph.D. candidates is higher than that of male Ph.D. candidates and that the anxiety level of female Ph.D. candidates in a non-sports discipline is the highest. Weekly sports participation significantly lowers female Ph.D. candidates' anxiety level (p < 0.01). Physical fatigue caused by study and work hinders female Ph.D. candidates from participating in sports (p < 0.05). Some female Chinese Ph.D. candidates in a negative emotional state are unwilling to participate in sports (p < 0.01). Future research should formulate different types of sports intervention programs suitable for alleviating the anxiety of female Ph.D. candidates.

A Flexible TENG Based on Micro-Structure Film for Speed Skating Techniques Monitoring and Biomechanical Energy Harvesting.

Wearable motion-monitoring systems have been widely used in recent years. However, the battery energy storage problem of traditional wearable devices limits the development of human sports training applications. In this paper, a self-powered and portable micro-structure triboelectric nanogenerator (MS-TENG) has been made. It consists of micro-structure polydimethylsiloxane (PDMS) film, fluorinated ethylene propylene (FEP) film, and lithium chloride polyacrylamide (LiCl-PAAM) hydrogel. Through the micro-structure, the voltage of the MS-TENG can be improved by 7 times. The MS-TENG provides outstanding sensing properties: maximum output voltage of 74 V, angular sensitivity of 1.016 V/degree, high signal-to-noise ratio, and excellent long-term service stability. We used it to monitor the running skills of speed skaters. It can also store the biomechanical energy which is generated in the process of speed skating through capacitors. It demonstrates capability of sensor to power electronic calculator and electronic watch. In addition, as a flexible electrode hydrogel, it can readily stretch over 1300%, which can help improve the service life and work stability of MS-TENG. Therefore, MS-TENG has great application potential in human sports training monitoring and big data analysis.

An Analysis of Women's Fitness Demands and Their Influencing Factors in Urban China.

The "Healthy China 2030" plan states that it is necessary to formulate and implement physical health intervention plans for special groups, including women. Based on questionnaire data from women in seven Chinese cities, our research analyzed the status quo of women's fitness, its influencing factors, and the differences in and characteristics of different types of women's fitness demands from four aspects: demography, fitness motivation, fitness behavior, and fitness demands, so as to provide a reference for the promotion of women's fitness. A total of 3473 valid samples were completed. The questionnaire included five age groups: there were 146 in the "20-29 years old" group, 829 in the "30-39 years old" group, 1088 in the "40-49 years old" group, 1105 in the "50-59 years old" group and 305 in the "60 years old and above" group. The questionnaire used in this study was a self-made questionnaire. The contents of the questionnaire included age, occupation, educational level, family circumstances, and health status, women's fitness behavior, fitness motivation and fitness demands. The results show that the current situation of urban women's fitness in China is characterized by low frequency and short duration of exercise. The internal factors affecting women's fitness demands include fitness motivation and fitness behavior. The external factors affecting their fitness demands are social environment and family environment. The differences in women's fitness demands mainly come from women's occupation, monthly income, and family stage.

An Effective Self-Powered Piezoelectric Sensor for Monitoring Basketball Skills.

Self-powered piezoelectric sensor can achieve real-time and harmless monitoring of motion processes without external power supply, which can be attached on body skin or joints to detect human motion and powered by mechanical energy. Here, a sensor for monitoring emergent motion is developed using the PVDF as active material and piezoelectric output as sensing signal. The multi-point control function enables the sensor to monitor the sequence of force order, angle change, and motion frequency of the "elbow lift, arm extension, and wrist compression" during shooting basketball. In addition, the sensor shows can simultaneously charge the capacitor to provide more power for intelligence, typically Bluetooth transmission. The sensor shows good performance in other field, such as rehabilitation monitoring and speech input systems. Therefore, the emerging application of flexible sensors have huge long-term prospects in sport big data collection and Internet of Things (IoT).

A Portable and Flexible Self-Powered Multifunctional Sensor for Real-Time Monitoring in Swimming.

A portable and flexible self-powered biosensor based on ZnO nanowire arrays (ZnO NWs) and flexible PET substrate has been designed and fabricated for real-time monitoring in swimming. Based on the piezoelectric effect of polar ZnO NWs, the fabricated biosensor can work in both air and water without any external power supply. In addition, the biosensor can be easily attached to the surface of the skin to precisely monitor the motion state such as joint moving angle and frequency during swimming. The constant output piezoelectric signal in different relative humidity levels enables actual application in different sports, including swimming. Therefore, the biosensor can be utilized to monitor swimming strokes by attaching it on the surface of the skin. Finally, a wireless transmitting application is demonstrated by implanting the biosensor in vivo to detect angiogenesis. This portable and flexible self-powered biosensor system exhibits broad application prospects in sport monitoring, human-computer interaction and wireless sport big data.

A Self-Powered Portable Flexible Sensor of Monitoring Speed Skating Techniques.

With the development of 5G technology, contemporary technologies such as Internet of Things (IoT) and Big Data analyses have been widely applied to the sport industry. This paper focuses on the design of a portable, self-powered, flexible sensor, which does not require an external power supply. The sensor is capable of monitoring speed skating techniques, thereby helping professional athletes to enhance their performance. This sensor mainly consists of Polyvinylidene Fluoride (PVDF) with polarization after a silvering electrode and a flexible polyester substrate. Flexible sensors are attached to the push-off joint part of speed skaters and the ice skate blade. During motion, it produces different piezoelectricity signals depending on the states of motion. The monitoring and analyzing of the real-time sensor signals will adjust the athlete's skating angle, frequency, and push-off techniques, thus improving user training and enhancing performance. Moreover, the production of piezoelectric signals can charge the capacitor, provide power for small electronic equipment (e.g., wireless device), and extend the applications of wearable flexible sensors to the Big Data and IoT technologies in the sport industry.

A Stretchable and Self-Healing Hybrid Nano-Generator for Human Motion Monitoring.

Transparent stretchable wearable hybrid nano-generators present great opportunities in motion sensing, motion monitoring, and human-computer interaction. Herein, we report a piezoelectric-triboelectric sport sensor (PTSS) which is composed of TENG, PENG, and a flexible transparent stretchable self-healing hydrogel electrode. The piezoelectric effect and the triboelectric effect are coupled by a contact separation mode. According to this effect, the PTSS shows a wide monitoring range. It can be used to monitor human multi-dimensional motions such as bend, twist, and rotate motions, including the screw pull motion of table tennis and the 301C skill of diving. In addition, the flexible transparent stretchable self-healing hydrogel is used as the electrode, which can meet most of the motion and sensing requirements and presents the characteristics of high flexibility, high transparency, high stretchability, and self-healing behavior. The whole sensing system can transmit signals through Bluetooth devices. The flexible, transparent, and stretchable wearable hybrid nanogenerator can be used as a wearable motion monitoring sensor, which provides a new strategy for the sports field, motion monitoring, and human-computer interaction.

Undifferentiated embryonal sarcoma of the liver: Clinical characteristics and outcomes.

BACKGROUND: Undifferentiated embryonal sarcoma of the liver (UESL) is a rare liver malignancy originating from primary mesenchymal tissue. The clinical manifestations, laboratory tests, and imaging examinations of the disease lack specificity and the preoperative misdiagnosis rate is high. The overall prognosis is poor and survival rate is low. AIM: To investigate the diagnosis, treatment, and prognosis of UESL. METHODS: We performed a retrospective, single-center cohort study in Shengjing Hospital of China Medical University, which is a central hospital in northeast China. From 2005 to 2017, we recruited 14 patients with pathologically confirmed UESL. We analyzed the clinical manifestations, laboratory tests, imaging examinations, pathological examinations, therapy, and prognosis of these patients. RESULTS: There were nine males and five females aged 2-60 years old included in the study. The major initial symptoms were abdominal pain (71.43%) and fever (57.14%). Preoperative laboratory tests revealed that seven patients had increased leukocyte levels, four showed a decrease in hemoglobin levels, seven patients had increased glutamyl transpeptidase levels, nine had increased lactate dehydrogenase levels, and three showed an increase in carbohydrate antigen 199. There was no difference in the rate of misdiagnosis in preoperative imaging examinations of UESL between adults and children (6/6 vs 5/8, P = 0.091). The survival rate after complete resection was 6/10, while that after incomplete resection was 0/4 (P = 0.040), suggesting that complete resection is important to improve survival rate. In total, five out of the eight children achieved survival. During the follow-up, the maximum survival time was shown to be 11 years and minimum survival time was 6 mo. Six adult patients relapsed late after surgery and all of them died. CONCLUSION: Preoperative imaging examination for UESL has a high misdiagnosis rate. Multidisciplinary collaboration can improve the diagnostic accuracy of UESL. Complete surgical resection is the first choice for treatment of UESL.

GNAS promotes inflammation-related hepatocellular carcinoma progression by promoting STAT3 activation.

BACKGROUND: Hepatocellular carcinoma (HCC) is still the most common cause of cancer-related mortality worldwide and accumulating studies report that HCC is frequently linked to chronic inflammation. G-protein alpha-subunit (GNAS)-activating mutations have recently been reported to form a rare subgroup of inflammatory liver tumors. In this study, we investigated the roles of GNAS in inflammation-related HCC progression and its underlying mechanism. METHODS: Lipopolysaccharides (LPS) and diethylnitrosamine were employed to stimulate HCC cells to an induced inflammatory response. qRT-PCR, immunohistochemistry and immunoblotting were performed to detect the expression of GNAS in HCC tissues and cell lines. Expression levels of proinflammatory cytokines were detected by qRT-PCR and ELISA. N6-methyladenosine (m6A) methylation of GNAS mRNA was detected by RNA-binding protein immunoprecipitation (RIP). Transcription factors activation profiling plate array was performed to investigate the underlying mechanism in GNAS promoting interleukin-6 (IL-6) expression in HCC cells. HCC cell invasion was determined by transwell assay in vitro, and tumorigenesis was assessed with a subcutaneous xenograft mouse model of HCC. RESULTS: We found that LPS stimulation promotes GNAS expression in HCC cells through increasing m6A methylation of GNAS mRNA. The high expression level of GNAS promotes LPS-induced HCC cell growth and invasion by interacting with signal transducer and activator of transcription 3 (STAT3). Furthermore, GNAS knockdown inhibits LPS induced-IL-6 expression in HCC cells by suppressing STAT3 activation. Moreover, we found that GNAS promotes LPS-induced STAT3 activation in HCC cells through inhibiting long non-coding RNA TPTEP1 interacting with STAT3. In addition, GNAS expression promotes HCC development in mice and is related to poor survival. CONCLUSIONS: Our findings for the first time indicate a tumor-promoting role of GNAS in inflammation-related HCC progression and provide a novel potential target for HCC therapy.

Autophagy Contributes to Liver Regeneration After Portal Vein Ligation in Rats.

BACKGROUND This study investigated the effect of 70% portal vein ligation (PVL), a widely used procedure for inducing rapid liver regeneration, on the expression of autophagy-related proteins in non-ligated liver lobes in rats. MATERIAL AND METHODS Rats were subjected to either sham (n=30, major portal vein branches were exposed but kept intact) or PVL (n=30, major portal vein branches were double-ligated) operations. Liver samples were collected 12, 24, 48, 72, and 168 h after the operation. Liver volume, liver color, non-ligated liver percentage, and the expressions of light chain (LC) 3, beclin 1, and cyclin D1 in the non-ligated liver lobes were determined. RESULTS When compared to sham rats, increased (P<0.001) growth of the non-ligated liver lobes was observed in PVL rats as early as 12 h after surgery; an increased (P≤0.001) LC3 II/I ratio was observed in the non-ligated lobes of PVL rats as early as 24 h after surgery. Increased expressions of beclin 1 (P≤0.001) and cyclin D1 (P<0.001) were observed in the non-ligated lobes of PVL rats from 12 to 72 h after surgery and from 12 to 168 h after surgery, respectively, when compared to sham rats. In the non-ligated lobes, the expressions of beclin 1 and cyclin D1 were linearly and positively correlated with the LC3 II/I ratio. CONCLUSIONS Autophagy is activated in the non-ligated liver after PVL. Both beclin 1 and cyclin D1 are linearly and positively correlated with autophagy activity in the PVL-induced rapid liver regeneration model.

Beneficial impact of microwave ablation-assisted laparoscopic hepatectomy in cirrhotic hepatocellular carcinoma patients: a propensity score matching analysis.

PURPOSE: In this study, we evaluated the efficacy of microwave ablation-assisted laparoscopic hepatectomy (MLH) for the management of hepatocellular carcinoma (HCC) in cirrhotic patients. METHODS: Data from HCC patients with liver cirrhosis who underwent laparoscopic hepatectomy (LH) or MLH in Shengjing Hospital (Shenyang, China) were retrospectively analyzed from January 2013 to June 2017. The demographic characteristics, clinical features, intraoperative parameters and surgical outcomes were analyzed and compared. Propensity scores matching (PSM) analysis was used to minimize bias. RESULTS: A total of 54 patients were enrolled in the MLH group and 39 patients in the LH group. Following 1:1 matching by PSM analysis, 26 patients were selected from each group. Compared to the LH group, patients in the MLH group had significantly decreased intraoperative bleeding (48.0 vs. 203.9 ml, p < .0001) and reduced demand for hepatic inflow occlusion (0 vs. 6, p = .009). No significant difference was observed in average operation time (155.7 vs. 148.5 min) and postoperative hospitalization time (8.3 vs. 9.3 d) between the MLH and LH groups. Similarly, the 1-year and 3-year recurrence-free survival (RFS) rates as well as the 1-year and 3-year overall survival (OS) rates of the MLH and LH groups were not significantly different (83.1 vs. 82.4% and 64.6 vs. 36.6% as well as 100 vs. 95.8% and 93.8 vs. 59.1%, respectively: p > .05). CONCLUSIONS: MLH significantly decreased intraoperative bleeding and reduced the need for hepatic occlusion without compromising the surgical outcome. Therefore, microwave ablation could be a valuable tool for LH in HCC patients with cirrhosis.

Multidisciplinary management of recurrent and metastatic hepatocellular carcinoma after resection: an international expert consensus.

Hepatocellular carcinoma (HCC) is the sixth-most common cancer and the third leading cause of cancer-related death in the world. However, 40-70% patients eventually suffer from postoperative recurrence within 5 years. HCC recurrence after surgery severely affects prognosis of the patients. Nevertheless, there is an opportunity to improve patients' prognosis if doctors and researchers can recognize the importance of a standardized perioperative management and study it in clinical and pre-clinical settings. Hence, based on our own experience and published studies from other researchers, we develop this consensus regarding multidisciplinary management of locally recurrent and metastatic hepatocellular carcinoma after resection. This consensus consists of the entire course of recurrent hepatocellular carcinoma (RHCC) management, including prediction of recurrence, prevention, diagnosis, treatment and surveillance of RHCC. Consensus recommendations are presented with grades of evidences (Ia, Ib, IIa, IIb, III and IV), and strength of recommendations (A, B, C, D and E). We also develop a decision-making path for RHCC treatment, which can intuitively demonstrate the management for RHCC. It is hoped that we may make some effort to standardize the management of RHCC and ultimately understand how to improve outcomes.

Single Dose Based Ertapenem Prophylaxis Reduces Surgical Site Infection after Selective Hepatectomy of Hepatocellular Carcinoma: A Propensity Score Matching Study.

OBJECTIVE: This study aimed to assess whether a single dose of ertapenem prophylaxis was more effective than other antibiotics to prevent surgical site infection (SSI) after selective hepatectomy for hepatocellular carcinoma (HCC). METHODS: The data from HCC patients with open hepatectomy between January 2012 and June 2017 in Shengjing Hospital were retrospectively analyzed. These patients were divided into two groups: ertapenem (ER) group, where a single dose of ER was administered; non-ertapenem (NER) group, where NER antibiotics were administered. The SSI rates were compared between two groups before and after matching the propensity scores. RESULTS: The enrolled patients consisted of 78 in the ER group and 197 in the NER group. After matching the propensity scores, each group was down-selected to 65 patients. The SSI rate among the matched 130 patients was 14.6%, 7.7% occurred in the ER group and 21.5% in the NER group (P<0.05). The SSI rates in organ/space of the ER and NER groups were 3.1% and 13.8%, respectively (P<0.05). CONCLUSIONS: A single dose of ER before surgery was more effective in mitigating SSI after selective hepatectomy compared with other antibiotics use. The results imply that the selection of both antibiotics and administration timing is important for the efficacy in preventing SSI.

Differential Effects of Three Techniques for Hepatic Vascular Exclusion during Resection for Liver Cirrhosis on Hepatic Ischemia-Reperfusion Injury in Rats.

BACKGROUND/AIMS: Hepatic ischemia-reperfusion (I/R) injury is a serious concern during hepatic vascular occlusion. The objectives of this study were to assess effects of three techniques for hepatic vascular occlusion on I/R injury and to explore the underlying mechanisms. METHODS: Liver cirrhotic rats had undertaken Pringle maneuver (PR), hemihepatic vascular occlusion (HH), or hepatic blood inflow occlusion without hemihepatic artery control (WH). Levels of tumor necrosis factor alpha (TNF-α), nuclear factor kappa B (NF-κB), toll-like receptor 4 (TLR4), TIR-domain-containing adapter-inducing interferon-ß (TRIF), and hemeoxygenase 1 (HMOX1) were assayed. RESULTS: The histopathologic analysis displayed that liver harm was more prominent in the PR group, but similar in the HH and WH groups. The HH and WH groups responded to hepatic I/R inflammation similarly but better than the PR group. Mechanical studies suggested that TNF-α/NF-κB signaling and TLR4/TRIF transduction pathways were associated with the differential effects. In addition, the HH and WH groups had significantly higher levels of hepatic HMOX1 (P < 0.05) than the PR group. CONCLUSIONS: HH and WH confer better preservation of liver function and protection than the Pringle maneuver in combating I/R injury. Upregulation of HMOX1 may lead to better protection and clinical outcomes after liver resection.

Expression of hypoxia inducible factor-1α and its correlation with phosphoenolpyruvate carboxykinase after portal vein ligation in rats.

AIMS: Portal vein ligation (PVL) has been used to effectively increase future liver remnant (FLR) in hepatectomy for treatment of liver cancer. However, the underlying molecular mechanisms have not been well characterized. The present study aimed to determine expression of hypoxia inducible factor-1alpha (HIF-1α) in response to PVL and assess the correlation of HIF-1α and phosphoenolpyruvate carboxykinase (PEPCK). MAIN METHODS: Male Sprague-Dawley rats underwent PVL and were sacrificed at different time points (12, 24, 48, 72, and 168h) after surgery. Hepatic HIF-1α expression in the regenerating liver was assessed by Western blot and immunohistochemistry, in parallel; PEPCK levels were quantified by ELISA. KEY FINDINGS: We found that the ligated liver lobes diminished progressively, whereas the unligated lobes underwent compensatory regeneration after 70% ligation of portal vein branches in the PVL group. Hepatic HIF-1α and PEPCK levels in the unligated liver lobes were significantly increased in the PVL group compared to the hepatic artery ligation (HAL) and the sham (SH) operation groups. Pearson's correlation analysis revealed positive correlation between HIF-1α expression and PEPCK levels in the unligated lobes after PVL. Further analysis indicated that higher levels of HIF-1α and PEPCK in response to liver regeneration were paralleled by an increase in the ratio of the mass and volume of unligated lobes to the whole liver. SIGNIFICANCE: HIF-1α was up-regulated and positively correlated with PEPCK during liver regeneration after PVL in rats, suggesting that HIF-1α may modulate hepatic gluconeogenesis through PEPCK, which may ensure the energy supply required for liver regeneration.

Armc8 regulates the invasive ability of hepatocellular carcinoma through E-cadherin/catenin complex.

Armc8 (armadillo-repeat-containing protein 8) was proved to promote disruption of E-cadherin complex through regulating α-catenin degradation. In this study, we investigated Armc8 expression in hepatocellular carcinoma using immunohistochemistry (IHC). The positive rate of Armc8 expression in hepatocellular carcinoma was 53.9 % and higher than that in normal hepatic tissues (9.2 %) (p < 0.05). Clinicopathological analysis shows that Armc8 expression in hepatocellular carcinoma was significantly associated with larger tumor size (≥5 cm), multiple tumor numbers, higher pathological grade (media and poor), advanced TNM stages (II/III), and advanced BCLC stages (B/C). Western blot study also detected higher Armc8 expression in hepatocellular carcinoma cells including HepG2, HCC97L, and SMMC-7721 than in human hepatic cell Bel-7402. We further use specific small interfering RNAs (siRNAs) to knock down Armc8 expression in HepG2 cells and found that knockdown of Armc8 expression significantly inhibited the invasive ability of HepG2 cells. Downregulation of Armc8 expression significantly upregulated α-catenin, ß-catenin, and E-cadherin expression in HepG2 cells. Immunofluorescent study shows that knockdown of Armc8 expression restored E-cadherin expression in membrane of HepG2 cells. These results indicate that Armc8 may be a potential cancer marker in hepatocellular carcinoma and may regulate cancer invasion through E-cadherin/catenin complex.

An updated meta-analysis of randomized controlled trials assessing the effect of sorafenib in advanced hepatocellular carcinoma.

BACKGROUND: The efficacy of sorafenib in the treatment of advanced hepatocellular carcinoma (HCC) remains controversial. Therefore, we conducted a meta-analysis to evaluate the efficacy and safety of sorafenib for treating patients with advanced HCC. METHODS: The PubMed, Embase, and Web of Science databases were searched. Eligible studies were randomized controlled trials (RCTs) that assessed sorafenib therapy in patients with advanced HCC. The outcomes included overall survival (OS), time to progression (TTP), overall response rate (ORR), and toxicities. Hazard ratio (HR) and risk ratio (RR) were used for the meta-analysis and were expressed with 95% confidence intervals (CIs). RESULTS: Seven RCTs, with a total of 3807 patients, were included in this meta-analysis. All patients received sorafenib alone, or with other chemotherapeutic regimens. Pooled estimates showed that sorafenib improved the OS (HR = 0.74, 95% CI: 0.61, 0.90; P = 0.002), or TTP outcomes (HR = 0.69, 95% CI: 0.55, 0.86; P = 0.001). Subgroup analysis revealed that sorafenib was more effective in the patients with an Eastern Cooperative Oncology Group performance status (ECOG PS) of 1-2 (HR = 0.77, 95% CI: 0.60, 1.0; P = 0.05), or macroscopic vascular invasion (MVI), and/or extrahepatic spread (EHS) (H  = 0.65, 95% CI: 0.46, 0.93; P = 0.02), in terms of OS. Patients who received sorafenib did not have a higher ORR (RR = 0.85, 95% CI: 0.65, 1.11; P = 0.10). In addition, there was a slight increase in toxicity in the sorafenib group. CONCLUSION: Treatment with sorafenib significantly improved OS and TTP in patients with advanced HCC. Additional large-scale, well-designed RCTs are needed to evaluate the efficacy of sorafenib-based therapy in the treatment of advanced HCC.