ACEIs/ARBs (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers) constituted the cornerstone of therapy for various cardiovascular and renal disorders. The appropriate management of ACEIs/ARBs in the acute kidney injury (AKI) remained controversial. In this multicenter study involving 1,285 AKI patients, we investigated the associations of ACEIs/ARBs discontinuation (n = 436), persistence (n = 657), and initiation (n = 192) with 14-day AKI progression and mortality. Multivariate logistic regression analysis and subgroup analyses were conducted to evaluate the associations between ACEI/ARB utilization patterns and clinical outcomes. The persistence usage of ACEIs/ARBs was independently associated with lower odds of 14-day AKI progression compared to discontinuation (adjusted OR 0.44, 95

The quality of cardiopulmonary resuscitation(CPR) significantly influences survival and neurological outcomes in patients with cardiac arrest (CA). Although mechanical chest compression devices and extracorporeal cardiopulmonary resuscitation (ECPR) have demonstrated some benefits,high-quality manual CPR remained the essential first step,particularly in resource-limited settings.In this study,we examined whether opportunities existed to improve manual CPR performance using preliminary data from our recent survey conducted in a province in western China. We aim to emphasize the importance of improving manual CPR quality before implementing advanced interventions.

IntroductionWhite blood cell count, a cost-effective blood test marker, is used extensively for the diagnosis and prognosis of diseases. Nevertheless, its association with the progression and prognosis of acute kidney injury remains unclear.MethodsA retrospective analysis was conducted using data from a multicenter randomized trial on an acute kidney injury early warning system. Univariate analysis, multivariate logistic regression, and smooth curve fitting were used to evaluate the association between the white blood cell count and the progression and prognosis of acute kidney injury.ResultsA total of 5471 patients were included in the study. White blood cell counts were significantly associated with 14-day acute kidney injury progression (adjusted odds ratio: 1.04, 95% confidence interval: 1.02-1.06, P < 0.01) and 14-day mortality (adjusted odds ratio: 1.06, 95% confidence interval: 1.04-1.09, P < 0.01). However, white blood cell counts were not associated with 14-day dialysis (adjusted odds ratio: 1.01, 95% confidence interval: 0.97-1.05, P = 0.77). Further curve fitting analysis found a linear correlation between white blood cell counts and 14-day acute kidney injury progression and 14-day mortality.ConclusionWhite blood cell counts had a significant linear correlation with 14-day acute kidney injury progression and 14-day mortality, but not with 14-day dialysis.

BACKGROUND Anion gap (AG) is a cheap blood test, but the relationship between the AG at the onset of AKI and the progression and prognosis of AKI is unclear. This study explored the relationship between the AG at the onset of AKI and the progression and prognosis of AKI. MATERIAL AND METHODS We retrospectively analyzed data from a multicenter randomized study on an AKI early warning system. Univariate analysis, multivariate logistic regression, and curve fitting were used to assess the relationship between the AG at the onset of AKI and the AKI progression and prognosis of patients with AKI. RESULTS A total 5731 patients were included in our study. We found that AG at the onset of AKI was associated with 14-day AKI progression, 14-day dialysis, and 14-day mortality, and the adjusted ORs were 1.07 (1.04, 1.09), 1.09 (1.04, 1.15), and 1.10 (1.07, 1.14), respectively. Further curve fitting analysis found that there was a nonlinear correlation between the AG at the onset of AKI and 14-day AKI progression and 14-day mortality, and there was a linear correlation between the AG at the onset of AKI and 14-day dialysis. When the AG was >10 mmol/L, 14-day AKI progression and 14-day mortality were significantly increased. CONCLUSIONS An increase of AG at the onset of AKI was associated with an increased risk of 14-day AKI progression, 14-day dialysis, and 14-day mortality. Especially when the AG exceeded 10 mmol/L, the 14-day AKI progression and 14-day mortality were significantly increased, and the AG showed a linear correlation with 14-day dialysis.

Background Despite the widespread implementation of standardised cardiopulmonary resuscitation (CPR) training programmes, the actual competency of emergency healthcare providers in China has not been established. This study evaluated the alignment between theoretical knowledge and practical CPR skills among frontline clinicians. Methods In total, 586 physicians and nurses of a hospital emergency department were evaluated. Theoretical knowledge was assessed via questionnaire, while practical skills were evaluated by two certified basic life support (BLS) instructors using standardised checklists and manikin-based simulation with audiovisual feedback. Key outcomes included adherence to guidelines and quantitative CPR quality metrics. Results Participants were predominantly bachelor's degree holders (480/586; 81.91%), nurses (379/586; 64.68%) and working in tertiary hospitals (436/586; 74.40%). Furthermore, 507 (86.52%) underwent CPR training within 6 months. In the theoretical assessments, over 88% correctly identified key steps, such as the compression landmark, compression rate and compression depth. However, practical evaluation by BLS instructors revealed lower proficiency in correct pulse location (383/586; 65.36%), use of a firm surface (240/586; 40.96%), recommended compression depth (250/586; 42.66%) and compression rate (350/586; 57.17%).The mean operation score awarded by BLS instructors was 24.89 +/- 2.71. Audiovisual feedback revealed a mean compression accuracy of 17%, compression depth compliance of 34%, rate compliance of 55% and complete recoil of 77%. Additionally, subgroup analysis showed that physicians with a body weight of 50-60 kg had superior performance compared to other weight in compression depth, compression rate, and chest recoil. Conclusion Although theoretical knowledge of CPR among Chinese emergency healthcare professionals is generally strong, practical execution, especially in compression, remains insufficient, highlighting the need to improve simulation-based training.

Background Acute kidney injury (AKI) is associated with high mortality rates and long-term adverse outcomes and significantly increases medical costs. The AKI electronic alert system built the AKI diagnostic algorithm into the medical system, along with automated collection of key indications and generation of alerts. However, the relationship between the AKI electronic alert system and medical costs is still unknown. Methods An exploratory secondary analysis of data from a double-blinded, multicenter, parallel, randomized controlled trial to investigate the association between the AKI electronic alert system and medical costs. Results Finally, a total of 6030 patients were enrolled in this study. Multivariate logistic regression analysis revealed that the alert group was not significantly associated with medical costs (all p-values > 0.05). However, the rate of alert detection by an attending physician demonstrated a notable negative correlation with medical costs; adjusted effects for direct and total costs were −126.78$ and −236.82$, respectively. The curve fitting and threshold effect analysis revealed that when the rate of alert detection by an attending physician was between 18% and 59%, each unit increase in the rate corresponded to decreases in direct cost by 363.94 (−463.34, −264.55) $ and in total cost by 698.93 (−885.78, −512.07) $. Our subgroup analysis also found a significant relationship between the rate and medical costs. Conclusion The alert group did not significantly reduce medical costs compared to the usual care group. However, the rate of alert detection by an attending physician had a significant negative association with medical costs, and there was a threshold effect between them. When the rate was between 18% and 59%, medical costs decreased as the rate increased, and when the rate was < 18% or ≥ 59%, medical costs did not decrease as the rate increased.

Real-time risk monitoring is critical but challenging in intensive care units (ICUs) due to the lack of real-time updates for most clinical variables. Although real-time predictions have been integrated into various risk monitoring systems, existing systems do not address uncertainties in risk assessments. We developed a novel framework based on commonly used systems like the Sequential Organ Failure Assessment (SOFA) score by incorporating uncertainties to improve the effectiveness of real-time risk monitoring. This study included 5351 patients admitted to the Cardiothoracic ICU in the National University Hospital in Singapore. We developed machine learning models to predict long lead-time variables and computed real-time SOFA scores using predictions. We calculated intervals to capture uncertainties in risk assessments and validated the association of the estimated real-time scores and intervals with mortality and readmission. Our model outperforms SOFA score in predicting 24-h mortality: Nagelkerke’s R-squared (0.224 vs. 0.185, p < 0.001) and the area under the receiver operating characteristic curve (AUC) (0.870 vs. 0.843, p < 0.001), and significantly outperforms quick SOFA (Nagelkerke’s R-squared = 0.125, AUC = 0.778). Our model also performs better in predicting 30-day readmission. We confirmed a positive net reclassification improvement (NRI) of our model over the SOFA score (0.184, p < 0.001). Similarly, we enhanced two additional scoring systems. Incorporating uncertainties improved existing scores in real-time monitoring, which could be used to trigger on-demand laboratory tests, potentially improving early detection, reducing unnecessary testing, and thereby lowering healthcare expenditures, mortality, and readmission rates in clinical practice.

Background Sarcopenia is a senile syndrome of age-related muscle loss. It is thought to affect the development of chronic kidney disease and has a serious impact on the quality of life of the elder adults. Little is known about the association between sarcopenia and new-onset chronic kidney disease in middle-aged and elder adults. Using nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS), we conducted a longitudinal analysis to investigate the association between sarcopenia status and new-onset chronic kidney disease in middle-aged and elder adults in China. Methods The study population consisted of 3676 participants aged 45 or older selected from 2011 CHARLS database who had no history of chronic kidney disease at the baseline and completed the follow-up in 2015. A multivariate cox regression model was employed to examine the association between sarcopenia and the incidence of new-onset chronic kidney disease. Results Followed up for 4 years, a total of 873 (22.5%) new cases of chronic kidney disease occurred. Among them, participants diagnosed with sarcopenia (HR1.45; 95% CI 1.15–1.83) were more likely to develop new-onset chronic kidney disease than those without sarcopenia. Similarly, patients with sarcopenia were more likely to develop new-onset chronic kidney disease than those with possible sarcopenia (HR 1.27; 95%CI 1.00-1.60). Subgroup analysis revealed that elder adults aged between 60 and 75 years old (HR 1.666; 95%CI 1.20-22.28), with hypertension (HR 1.57; 95%CI 1.02–2.40), people with sarcopenia had a significantly higher risk of developing new-onset chronic kidney disease than those without sarcopenia (all P < 0.05). Conclusion Middle-aged and elder adults diagnosed with sarcopenia have a higher risk of developing new-onset chronic kidney disease.

Caspase-11 detection of intracellular lipopolysaccharide mediates non-canonical pyroptosis, which could result in inflammatory damage and organ lesions in various diseases such as sepsis. Our research found that lactate from the microenvironment of acetaminophen-induced acute liver injury increased Caspase-11 levels, enhanced gasdermin D activation and accelerated macrophage pyroptosis, which lead to exacerbation of liver injury. Further experiments unveiled that lactate inhibits Caspase-11 ubiquitination by reducing its binding to NEDD4, a negative regulator of Caspase-11. We also identified that lactates regulated NEDD4 K33 lactylation, which inhibits protein interactions between Caspase-11 and NEDD4. Moreover, restraining lactylation reduces non-canonical pyroptosis in macrophages and ameliorates liver injury. Our work links lactate to the exquisite regulation of the non-canonical inflammasome, and provides a basis for targeting lactylation signaling to combat Caspase-11-mediated non-canonical pyroptosis and acetaminophen-induced liver injury.

Background The sarcopenia index (SI, serum creatinine/serum cystatin C × 100) is recommended for predicting sarcopenia. There were several studies showing that lower SI is associated with poorer outcomes in the older adults. However, the cohorts studied in these researches were mainly patients hospitalized. The aim of this study was to evaluate the correlation between SI and all-cause mortality among middle-aged and older adults from the China Health and Retirement Longitudinal Study (CHARLS). Materials and methods A total of 8,328 participants meeting the criteria were enrolled in this study from CHARLS between 2011 and 2012. SI was calculated as [serum creatinine (mg/dL)/cystatin C (mg/L)] × 100. Mann-Whitney U -test and Fisher's exact test were used to assess balance in baseline characteristics. Kaplan-Meier, log-rang analysis, univariate and multivariate Cox hazard ratio regression models were used to compare the mortality between different SI levels. The dose relationship between sarcopenia index and all-cause mortality was further assessed by the cubic spline functions and smooth curve fitting. Results After adjustment for potential covariates, we found SI was significantly correlated with all-cause mortality [Hazard Ratio (HR) = 0.983, 95% confidence interval (CI) 0.977–0.988, P < 0.001]. Similarly, as SI was used as a categorical variable according to quartiles, higher SI was associated with lower mortality [Hazard Ratio (HR) = 0.44, 95% CI 0.34–0.57, P < 0.001] after adjustment for confounders. Conclusions Lower sarcopenia index was associated with higher mortality among middle-aged and older adults in China.

BackgroundCentral obesity was closely associated with hypertension. Middle-aged and older adult females, defined as those aged 45 and above, were more likely to suffer from central obesity. For waist-to-height ratio (WHtR) was used as central obesity assessment, the object of this study was to illustrate the relationship between WHtR and the incidence of hypertension in middle-aged and older adult females in China.MethodsData used in this prospective cohort study was derived from the China Health and Retirement Longitudinal Study (CHARLS) in a baseline survey from 2011 to 2012 with a follow-up duration of 4 years. The waist-to-height ratio was calculated as waist circumstance divided by height, and the cohort was divided into different groups based on WHtR level. The outcome variable was new-onset hypertension.ResultsOf the 2,438 participants included in the study, 1,821 (74.7%) had high WHtR levels (WHtR ≥ 0.5). As WHtR was closely related to new-onset hypertension in a multivariable logistics regression mode [OR: 7.89 (95% CI: 2.10–29.67)], individuals with high WHtR were also more likely to suffer from hypertension compared with low WHtR levels [OR: 1.34 (95% CI: 1.06–1.69)].ConclusionWHtR is positively related to the risk of hypertension incidents among middle-aged and older adult females. Individuals with WHtR ≥ 0.5 were more likely to suffer from hypertension.

Subsequently to the publication of the above article, a concerned reader drew to the Editors' attention that the cell invasion and migration assay data shown in Fig. 3B and D were strikingly similar to data appearing in different form in other articles by different authors. Owing to the fact that these contentious data in the above article had already been published elsewhere, or were already under consideration for publication, prior to its submission to Oncology Reports, the Editor has decided that this paper should be retracted from the Journal. After having been in contact with the authors, they agreed with the decision to retract the paper. The Editor apologizes to the readership for any inconvenience caused. [Oncology Reports 34: 595‑602, 2015; DOI: 10.3892/or.2015.4051].

Introduction Early identification of AKI was always considered to improve patients' prognosis. Some studies found that AKI early warning tools didn't affect patients' prognosis. Therefore, additional studies were necessary to explore the reasons. Methods This study was a secondary analysis of a multicenter randomized controlled trial that found electronic health record warnings for AKI did not influence patients' prognoses. Univariate, multivariate, subgroup, curve fitting, and threshold effect analysis were used to explore the association between AKI warnings detected by attending physicians and the patient's prognosis. Results A total of 6,030 AKI patients were included in the study. The patients were classified into two groups based on the rate of AKI alerts detected by attending physicians: the partial group ( n = 5,377), and the complete group ( n = 653). In comparison to the partial group, the complete group significantly decreased 14-day AKI progression, 14-day dialysis, and 14-day mortality, with adjusted ORs of 0.48 (0.33, 0.70), 0.26 (0.09, 0.77), and 0.53 (0.33, 0.84) respectively, and the complete group significantly improve the discharge to home, with an OR value of 1.50 (1.21, 1.87). When the rate of AKI alerts detected by the attending physicians as a continuity variable, we found that the rate of alerts seen by attending physicians was associated with 14-day mortality and the discharge to home, with adjusted ORs of 1.76 (1.11, 2.81) and 1.42 (1.13, 1.80). The sensitivity analysis, curve-fitting analysis, and threshold effect analysis also showed that the rate of alert seen by the attending physician was correlated with the patient's prognosis. Conclusion The rate of AKI alert detection by attending physician were related to the patient's prognosis. The higher the rate of AKI alert detection by attending physicians, the better the prognosis of patients with AKI.

Background: Hepatocellular carcinoma (HCC) is an extensive heterogeneous disease where epigenetic factors contribute to its pathogenesis. Polycomb group (PcG) proteins are a group of subunits constituting various macro-molecular machines to regulate the epigenetic landscape, which contributes to cancer phenotype and has the potential to develop a molecular classification of HCC.Results: Here, based on multi-omics data analysis of DNA methylation, mRNA expression, and copy number of PcG-related genes, we established an epigenetic classification system of HCC, which divides the HCC patients into two subgroups with significantly different outcomes. Comparing these two epigenetic subgroups, we identified different metabolic features, which were related to epigenetic regulation of polycomb-repressive complex 1/2 (PRC1/2). Furthermore, we experimentally proved that inhibition of PcG complexes enhanced the lipid metabolism and reduced the capacity of HCC cells against glucose shortage. In addition, we validated the low chemotherapy sensitivity of HCC in Group A and found inhibition of PRC1/2 promoted HCC cells' sensitivity to oxaliplatin in vitro and in vivo. Finally, we found that aberrant upregulation of CBX2 in Group A and upregulation of CBX2 were associated with poor prognosis in HCC patients. Furthermore, we found that manipulation of CBX2 affected the levels of H3K27me3 and H2AK119ub.Contributions: Our study provided a novel molecular classification system based on PcG-related genes data and experimentally validated the biological features of HCC in two subgroups. Our founding supported the polycomb complex targeting strategy to inhibit HCC progression where CBX2 could be a feasible therapeutic target.

Background Sepsis-induced acute kidney injury (S-AKI) is associated with systemic inflammatory responses and coagulation system dysfunction, and it is associated with an increased risk of mortality. However, there was no study to explore the predictive value of inflammatory and coagulation indicators for S-AKI. Methods In this retrospective study, 1051 sepsis patients were identified and divided into a training cohort (75%, n = 787) and a validation cohort (25%, n = 264) in chronological order according to the date they were admitted. Univariate analyses and multivariate logistic regression analyses were performed to identify the independent predictors of S-AKI. The logistic regression analyses (enter methods) were used to conducted the prediction models. The ROC curves were used to determine the predictive value of the constructed models on S-AKI. To test whether the increase in the AUC is significant, we used a two-sided test for ROC curves available online (http://vassarstats.net/roc_comp.html). The secondary outcome was different AKI stages and major adverse kidney events within 30 days (MAKE30). Stage 3B of S-AKI was defined as both meeting the stage 3 criteria [increase of Cr level by > 300% (≥ 4.0 mg/dL with an acute increase of ≥ 0.5 mg/dL) and/or UO < 0.3 mL/kg/h for > 24 h or anuria for > 12 h and/or acute kidney replacement therapy] and having cystatin C positive. MAKE30 were a composite of death, new renal replacement therapy (RRT), or persistent renal dysfunction (PRD). Results We discovered that cardiovascular disease, white blood cell (WBC), mean arterial pressure (MAP), platelet (PLT), serum procalcitonin (PCT), prothrombin time activity (PTA), and thrombin time (TT) were independent predictors for S-AKI. The predictive value (AUC = 0.855) of the simplest model 3 (constructed with PLT, PCT, and PTA), with a sensitivity of 77.6% and a specificity of 82.4%, had a similar predictive value comparing with the model 1 (AUC = 0.872) and the model 2 (AUC = 0.864) in the training cohort (P > 0.05). Compared with the model 1 (AUC = 0.888) and the model 2 (AUC = 0.887), the model 3 (AUC = 0.887) had a similar predictive value in the validation cohort. Moreover, model 3 had the best predictive power for predicting S-AKI in the stage 3 (AUC = 0.777), especially in stage 3B (AUC = 0.771). Finally, the model 3 (AUC = 0.843) had perfect predictive power for predicting MAKE30 in sepsis patients. Conclusion Within 24 hours after admission, the simplest model 3 (constructed with PLT, PCT, and PTA) might be a robust predictor of the S-AKI in sepsis patients, providing information for timely and efficient intervention.

Background: NSAIDs are one of the most frequently used medications and a risk factor for AKI. However, the optimal time of NSAIDs in patients with AKI is unknown.Methods: A secondary analysis of a multicenter, randomized clinical trial including adult inpatients with acute kidney injury was performed. Univariate, multivariate, and subgroup analyses were used to explore the impact of NSAIDs during the early onset of AKI on the outcome of patients with AKI.Results: A total of 6,030 patients with AKI were enrolled in the study. Following are the findings of the multi-factor analysis: NSAID treatments within 72 and 24 h before the onset of AKI were not associated with AKI progression, dialysis, or discharge from dialysis; only NSAID treatment within the 24-h onset of AKI was associated with these outcomes, and their OR values were independently 1.50 (95% CI: 1.02–2.19, p = 0.037), 4.20 (95% CI: 1.47–11.97, p = 0.007), and 0.71 (95% CI: 0.54–0.92, p = 0.011); only NSAID treatment within the 24-h onset of AKI would decrease the 14-day mortality, and the OR value was 0.52 (95% CI: 0.33–0.82, p = 0.005). The subgroup analysis revealed that in patients with age ≥65 years, CKD (chronic kidney disease), congestive heart failure, hypertension, and liver disease, NSAID treatments within the 24-h onset of AKI would deteriorate the outcome of patients with AKI.Conclusion: Before an early onset of AKI, NSAID treatment might be safe, but during the onset of AKI, even early NSAID treatment would deteriorate the outcome of patients with AKI.

Background: Intensive care unit (ICU) delirium is one of the most common clinical syndromes that results in many adverse events that affect patients, families, and hospitals. To date, there has been no tool for effectively predicting the occurrence of delirium in emergency intensive care unit (EICU) patients. Methods: We conducted a retrospective cohort study and constructed a prediction model for 319 patients in EICU, who met our inclusion criteria. We analyzed the relationship between patients' clinical data within 24 hours of admission and delirium, applied univariate and multivariate logistic regression analyses to select the most relevant variables for construction of nomogram models, then applied bootstrapping for internal validation. Results: A total of five variables, namely stomach and urinary tubes, as well as sedative, mechanical ventilation and APACHE-II scores, were selected for model construction. We generated a total of five sets of models (three sets of construction models and two sets of internal verification models), with similar predictive value. The optimal model was selected, and together with the 5 variables used to construct a nomogram. The AUC of the MFP model in all patients was 0.76 (0.70, 0.82), whereas that in non-elderly patients (<60 years old) for the full model was 0.83 (0.74, 0.91). In elderly patients (>= 60 years old), the AUC of the MFP model was 0.82 (0.73, 0.91). Conclusion: Overall, the five-marker-based prognostic tool, established herein, can effectively predict the occurrence of delirium in EICU patients.

Background Sepsis-induced acute kidney injury (S-AKI) is a significant complication and is associated with an increased risk of mortality, especially in elderly patients with sepsis. However, there are no reliable and robust predictive models to identify high-risk patients likely to develop S-AKI. We aimed to develop a nomogram to predict S-AKI in elderly sepsis patients and help physicians make personalized management within 24 h of admission. Methods A total of 849 elderly sepsis patients from the First Affiliated Hospital of Xi’an Jiaotong University were identified and randomly divided into a training set (75%, n = 637) and a validation set (25%, n = 212). Univariate and multivariate logistic regression analyses were performed to identify the independent predictors of S-AKI. The corresponding nomogram was constructed based on those predictors. The calibration curve, receiver operating characteristics (ROC)curve, and decision curve analysis were performed to evaluate the nomogram. The secondary outcome was 30-day mortality and major adverse kidney events within 30 days (MAKE30). MAKE30 were a composite of death, new renal replacement therapy (RRT), or persistent renal dysfunction (PRD). Results The independent predictors for nomogram construction were mean arterial pressure (MAP), serum procalcitonin (PCT), and platelet (PLT), prothrombin time activity (PTA), albumin globulin ratio (AGR), and creatinine (Cr). The predictive model had satisfactory discrimination with an area under the curve (AUC) of 0.852–0.858 in the training and validation cohorts, respectively. The nomogram showed good calibration and clinical application according to the calibration curve and decision curve analysis. Furthermore, the prediction model had perfect predictive power for predicting 30-day mortality (AUC = 0.813) and MAKE30 (AUC = 0.823) in elderly sepsis patients. Conclusion The proposed nomogram can quickly and effectively predict S-AKI risk in elderly sepsis patients within 24 h after admission, providing information for clinicians to make personalized interventions.

Abstract Background: Hepatocellular carcinoma (HCC) is an extensive heterogeneous disease where epigenetic factors contribute to its pathogenesis. Polycomb group (PcG) proteins are a group of subunits constituting various macro molecular machines to regulate the epigenetic landscape, which contribute to cancer phenotype and have potential to develop molecular classification of HCC. Results: Here, based on multi-omics data analysis of DNA methylation, mRNA expression and copy number of PcG-related genes, we established an epigenetic classification system of HCC, which divides the HCC patients into two subgroups with a significantly different outcome. Comparing these two epigenetic subgroups, we identified different metabolic features, which were related to epigenetic regulation of Polycomb Repressive Complex 1/2 (PRC1/2). Furthermore, we experimentally proved that inhibition of PcG complexes enhanced lipid metabolism and reduced the capacity of HCC cells against glucose shortage. In addition, we validated the low chemotherapy sensitivity of HCC in Group A, and found inhibition of PRC1/2 promoted HCC cells sensitivity to oxaliplatin in vitro and in vivo. Finally, we found that aberrant upregulation CBX2 in Group A and upregulation of CBX2 was associated with poor prognosis in HCC patients. Furthermore, we found manipulation of CBX2 affected the levels of H3K27me3 and H2AK119ub. Conclusions: Our study provided a novel molecular classification system based on PcG-related genes data, and experimentally validated the biological features of HCC in two subgroups. Our founding supported the polycomb complex targeting strategy to inhibit HCC progression where CBX2 could be a feasible therapeutic target.