Hepatocellular carcinoma (HCC), commonly known as primary liver cancer, is a leading cause of cancer-related mortality worldwide, primarily attributed to changing lifestyles and dietary habits. HCC arises from liver cirrhosis, hepatic fibrosis, or hepatitis B virus infection, and is caused by disruptions in protein and lipid metabolism. These metabolic alterations, recognized as a hallmark of cancer, are pivotal in the progression of chronic liver disease to HCC. Due to its asymptomatic nature in early stages, HCC is often diagnosed at advanced stages when treatment options are limited. Despite being a potentially curative option, liver transplantation remains hindered by high costs and donor scarcity, further compounded by suboptimal long-term success rates. This review examines the critical metabolites that play a part in developing HCC, focusing on their roles as possible biomarkers for disease progression and therapeutic targets. Additionally, the influence of the gut microbiome on HCC development is discussed, highlighting its interplay with metabolic pathways. Understanding the roles of metabolites and the gut microbiome in HCC progression underscores the importance of their potential use in early detection and the development of targeted therapies, offering new avenues for improving patient outcomes.

Objective To investigate the clinical effect of rivaroxaban and enoxaparin on the prevention of lower deep vein thrombosis after arti-ficial knee joint replacement.Methods A total of 120 patients who ex-perienced first artificial knee replacement surgery were divided into two groups.And 12 h after surgery , 60 patients in treatment group were gi-ven oral rivaroxaban 10 mg · d -1 , 60 patients in control group received subcutaneous enoxaparin heparin 4000 IU · d-1.The treatment of two groups all lasted for 14 d.The incidence of deep vein thrombosis , bleed-ing, complications and long -term efficacy of patients between groups were compared.Results There were no statistical difference between treatment group and control group in terms of activated partial thrombo-plastin time ( APTT ) , blood platelets count ( PLT ) and D -dimer ( all P>0.05 ) .The incidence rate of lower deep vein thrombosis in treatment group was 11.67%( 7/60 ) and control group 15.00%( 9/60 ) , they had no significant difference ( P>0.05 ).There were no statistical difference between two groups in postoperative drainage , total amount of blood transfusion and hemorrhagic index ( all P>0.05 ).The incidence rate of petechiae in treatment group was 23.33%(14/60), and 18.33(11/60) in control group (P>0.05).There were no sta-tistical difference between two groups in visual analogue scale ( VAS) pain scores and swollen knee at first three days and seven days after operation (all P>0.05).There were no statistical difference between two groups in knee mobility and keen society score ( KSS) function scores during the follow-up half a year after operation (all P>0.05).The knee mobility and KSS function scores during the follow-up one year after operation in treatment group were higher than that in control group ( all P <0.05 ).Conclusion Rivaroxaban and enoxaparin had equivalent efficacy on the prevention of venous thrombosis after artificial knee joint replacement surgery.However, the long-term clinical effect of rivaroxaban was better .