1.Quality evaluation of Qingwen hufei granules based on fingerprints combined with multi-component content determination
Huiying ZHOU ; Yuan WANG ; Yani WANG ; Yun YANG ; Bo WANG ; Shuanzhu YANG ; Liping CAO ; Hong ZHANG ; Kaihua LONG
China Pharmacy 2026;37(3):338-343
OBJECTIVE To provide a scientific basis for the quality evaluation and clinical application of Qingwen hufei granules. METHODS Fourteen batches of Qingwen hufei granules were used as samples to establish high-performance liquid chromatography (HPLC) fingerprints using the Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine (2012 Edition). The chromatographic peaks were identified and the similarity was evaluated. Cluster analysis (CA), principal component analysis (PCA), and orthogonal partial least squares-discriminant analysis (OPLS-DA) were used to conduct chemical pattern recognition analysis on the 14 batches of samples. Meanwhile, the contents of neochlorogenic acid (NGA), chlorogenic acid (CHA), cryptochlorogenic acid (CGA), forsythoside A (FTA), 3,5-O-dicaffeoylquinic acid (3,5-O- DA), 4,5-O-dicaffeoylquinic acid (4,5-O-DA), and angoroside C (AGC) in the samples were determined by HPLC. RESULTS The methodological investigation results of both the fingerprint and the content determination complied with the relevant requirements. Fourteen common peaks were indicated in the HPLC fingerprints of the 14 batches of samples, and 7 of them were identified [NGA (peak 2), CHA (peak 3), CGA (peak 5), FTA (peak 11), 3,5-O-DA (peak 12), 4,5-O-DA (peak 13), and AGC (peak 14)]; the similarity of each sample was greater than 0.94. The results of CA and PCA showed that the samples could be classified into 3 categories; the results of OPLS-DA indicated that peak 4 (unknown), peak 11 (FTA), peak 8 (unknown), peak 9 (unknown), and peak 1 (unknown) were the differential components. The content ranges of NGA, CHA, CGA, 3,5-O-DA, FTA, 4,5-O-DA and AGC in the 14 batches of samples were 0.210 4-0.458 7, 0.269 1-0.506 3, 0.228 1-0.461 1, 0.443 9-1.044 6, 0.066 7-0.155 7, 0.062 8-0.143 8, and 0.057 4-0.105 7 mg/g, respectively. CONCLUSIONS The HPLC fingerprint and multi-component content determination methods established in this study are efficient and reliable, and can be used for the quality evaluation of Qingwen hufei granules.
2.Bibliometric visualization analysis of research literature of Angelica sinensis at home and abroad from 2012 to 2022 based on CiteSpace
Feifei LIU ; Liping CHEN ; Yan ZHONG ; Rong WANG ; Wenbin LI
Journal of Pharmaceutical Practice and Service 2026;44(2):88-95
Objective Based on the visualization graph analysis of the research hotspots of Angelica sinensis, predict the future research trends, and provide references for the next step of Angelica sinensis research. Methods Chinese and English literatures on Angelica sinensis collected from CNKI, WanFang, VIP and Web of Science from 2012 to 2022 were retrieved. CiteSpace 6.1.R6 software was used to perform visualization econometrics analysis on the number of publications, authors, institutions, journals, keywords and other topics. Results
3.The Effect of Fuzheng Huaji Formula (扶正化积方) for Chronic Hepatitis B on Reduction of the Incidence of Liver Cirrhosis and Hepatocellular Carcinoma:A Retrospective Cohort Study
Simiao YU ; Jiahui LI ; Jing JING ; Tingting HE ; Yongqiang SUN ; Liping WANG ; Aozhe ZHANG ; Xiaohe XIAO ; Xia DING ; Ruilin WANG
Journal of Traditional Chinese Medicine 2025;66(3):268-274
ObjectiveTo evaluate the clinical efficacy of Fuzheng Huaji Formula (扶正化积方) for chronic hepatitis B to reduce the incidence of liver cirrhosis and hepatocellular carcinoma. MethodsA retrospective cohort study was conducted, collecting medical records of 118 patients with chronic hepatitis B and 234 patients with hepatitis B-related cirrhosis who visited the hospital between January 1, 2014, and December 31, 2018. The use of Fuzheng Huaji Formula was designated as the exposure factor. Patients receiving antiviral treatment for hepatitis B without concurrent Fuzheng Huaji Formula therapy were included in the western medicine group, while those receiving antiviral treatment combined with Fuzheng Huaji Formula for a cumulative treatment lasting longer than 3 months were included in the combined treatment group. The follow-up observation period was five years. Kaplan-Meier survival analysis was used to assess the cumulative incidence of cirrhosis in patients with chronic hepatitis B and the cumulative incidence of hepatocellular carcinoma in patients with hepatitis B-related cirrhosis. Univariate and multivariate Cox regression analyses were employed to examine the factors influencing the occurrence of cirrhosis and hepatocellular carcinoma. ResultsAmong patients with chronic hepatitis B, there were 55 cases in the combined treatment group and 63 cases in the western medicine group; among patients with hepatitis B-related cirrhosis, there were 110 cases in the combined treatment group and 124 cases in the western medicine group. Five-year follow-up outcomes for chronic hepatitis B patients showed that the cumulative incidence of cirrhosis was 5.45% (3/55) in the combined treatment group and 17.46% (11/63) in the western medicine group, with a statistically significant difference between groups (Z = 2.003, P = 0.045). Five-year follow-up outcomes for hepatitis B-related cirrhosis patients showed that the cumulative incidence of hepatocellular carcinoma was 8.18% (9/110) in the combined treatment group and 22.58% (28/124) in the western medicine group, also showing a statistically significant difference (Z = 3.007, P = 0.003). Univariate and multivariate Cox regression analyses indicated that treatment with Fuzheng Huaji Formula is an independent protective factor in preventing the progression of chronic hepatitis B to cirrhosis and the progression of hepatitis B-related cirrhosis to hepatocellular carcinoma (P<0.05). ConclusionCombining Fuzheng Huaji Formula with antiviral therapy for hepatitis B can effectively intervene in the disease progression of chronic hepatitis B, reducing the incidence of cirrhosis and hepatocellular carcinoma.
4.Clinical value of breast ultrasound for diagnosis of breast masses with nipple discharges
Chinese Journal of Radiological Health 2025;34(1):114-118
Objective To examine the value of breast ultrasound for diagnosis of benign and malignant breast masses among female patients with nipple discharges, and to provide a reference for the diagnosis of patients with nipple discharges. Methods A total of 317 female patients with nipple discharges underwent breast examinations in Changzhou Maternal and Child Health Care Hospital between April 2021 and May 2024 were enrolled, and all patients underwent ultrasound, mammography, and pathologic examinations of the breast. With pathologic examination as the gold standard, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of breast ultrasound and mammography for diagnosis of benign and malignant breast masses were compared. The diagnostic value of breast ultrasound for benign and malignant breast masses was evaluated among female patients with nipple discharges. Results The study subjects had a mean age of (43.27 ± 10.71) years, and a mean nipple discharge duration of (1.11 ± 0.53) years. Moreover, 51.74% of nipple discharges were in the right-sided breast, 52.05% were spontaneous, 32.49% were bloody, and 53.63% were classified as Breast Imaging Reporting and Data System category 1 to 3. Of the 317 female patients with nipple discharges, histopathology detected 137 malignant breast masses and 180 benign masses, and the 53 masses with Breast Imaging Reporting and Data System category 5 were all malignant. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 64.23%, 77.22%, 68.22%, 73.94% and 71.61% for breast ultrasound, and 80.29%, 35.00%, 48.46%, 70.00% and 54.57% for breast mammography. The specificity (χ2=8.81, P < 0.01), positive predictive value (χ2=13.01, P < 0.01), and accuracy (χ2=19.75, P < 0.01) of breast ultrasound were significantly higher than breast mammography, while the sensitivity of breast ultrasound was significantly lower than breast mammography (χ2=65.15, P < 0.01). However, there was no significant difference in the negative predictive value between breast ultrasound and mammography (χ2=0.47, P > 0.05). Conclusion Breast ultrasound has a high accuracy for diagnosis of benign and malignant breast masses among female patients with nipple discharges, which may serve as an auxiliary tool for diagnosis of breast masses among patients with nipple discharges.
5.Establishment of a method for detecting the potency of recombinant human coagulation factor Ⅶa for injection
Rong WU ; Liping WANG ; Jinye LANG ; Yue ZHU ; Jing ZHOU ; Xun LIU ; Jing NI ; Shunbo ZHOU ; Yaling DING
Chinese Journal of Blood Transfusion 2025;38(3):415-420
[Objective] To establish a method for detecting the potency of recombinant human coagulation factor Ⅶa for injection. [Methods] By adding the sample and factor Ⅶ deficient plasma to the sample cup and activating the reaction with prothrombin time assay reagent (PT reagent), the coagulation time of the sample was determined by the change in magnetic bead swing amplitude in the sample cup. The logarithm of coagulation time was inversely proportional to the logarithm of human factor Ⅶa potency. [Results] Under the experimental conditions, the specificity of the methodology was evaluated through spiked recovery, and the recovery rates ranged from 90.0% to 110.0%. Within the range from 0.125 to 1.000 IU/mL, there was a good linear response between the potency and coagulation time of the standard and sample, with correlation coefficients r>0.99. As for the accuracy and repeatability, the recovery rates of various concentrations detected in the stock solution were 101.0%, 100.0% and 112.0%, respectively, with RSD values of 2.6%, 4.0% and 0.0%, respectively. The recovery rates of various concentrations in finished product testing were 104.0%, 94.7% and 112.0%, respectively, with RSD values of 1.9%, 2.4% and 0.0%, respectively. As for the intermediate precision, the RSD were 4.5% and 3.7%, respectively. After treated with sample diluent, the sample was tested at room temperature for 6 hours and still exhibited relatively stable biological activity. [Conclusion] This detection method is accurate, stable, easy to operate and highly automated, and is suitable for detecting the potency of recombinant human coagulation factor Ⅶa for Injection.
6.Mechanism of Fibrinogen Overexpression in Influencing Coronary Heart Disease with Syndrome of Blood Stasis in Rats Based on Mitochondrial Quality Control System
Manli ZHOU ; Liping WANG ; Weixiong JIAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):149-158
ObjectiveTo study the effect and mechanism of fibrinogen (Fib) overexpression on mitochondrial quality control system in the rat model of coronary heart disease with the syndrome of blood stasis. MethodsForty male SD rats were randomly assigned into normal, model, Fib, and empty vector (AAV) groups, with 10 rats in each group. The model, Fib, and AAV groups were fed with a high-fat diet adaptively and administrated with 3×106 U·kg-1 vitamin D3 powder by gavage after 7 days and 2×106 U·kg-1 vitamin D3 solution after 14 days. After being fed with a high-fat diet for 7 weeks, rats in each group received subcutaneous injection of isoproterenol (5 mg·kg-1) for 3 days. During the modeling period, rats in the normal group were fed with ordinary feed without any special treatment. The changes in blood lipid and hemorheological indexes of rats in each group were measured. The aorta tissue was stained with hematoxylin-eosin (HE), and the standard lead Ⅱ electrocardiograms (ECGs) of rats in each group were recorded. Enzyme-linked immunosorbent assay (ELISA) and real-time PCR were employed to verify the overexpression levels of Fib in the liver and plasma. Western blotting was employed to determine the protein levels of mitofusin 2 (Mfn2), optic atrophy protein 1 (OPA1), dynamin-related protein 1 (Drp1), phosphorylated adenosine monophosphate-activated protein kinase (p-AMPK)/adenosine monophosphate-activated protein kinase (AMPK), peroxisome proliferator-activated receptor γ-coactivator-1α (PGC-1α), PTEN-induced putative kinase 1, and Parkin. Real-time PCR was employed to determine the mRNA levels of AMPK and PGC-1α in the myocardial tissue. The changes in levels of adenosine triphosphate (ATP) and adenosine monophosphate (AMP) in the myocardial tissue were determined by ELISA. ResultsCompared with the normal group, the other three groups showed elevated levels of total cholesterol and low-density lipoprotein cholesterol (P<0.01) and no significant changes in levels of triglyceride and high-density lipoprotein cholesterol. Compared with the model group, the Fib and AAV groups showed risen levels of total cholesterol (P<0.05, P<0.01). Compared with the normal group, the model and Fib groups presented increases in low shear viscosity and middle shear viscosity (P<0.05, P<0.01), and the Fib group showcased an increase in high shear viscosity (P<0.01). Compared with the model group, the Fib group showed increases in low shear viscosity, middle shear viscosity, and high shear viscosity (P<0.05, P<0.01). Compared with the Fib group, the AAV group demonstrated decreases in low shear viscosity, middle shear viscosity, and high shear viscosity (P<0.05, P<0.01). The normal group had an complete aortic structure with well arrangement of elastic fibers. In the model group, the vascular wall became thickened and the intima was rough with inflammatory infiltration. In the Fib group, the intima calcification formed a cavity structure and the intima was abnormally proliferated, while in the AAV group, the intima smooth muscle was slightly proliferated with local calcification. The ECG of the normal group indicated sinus rhythm, and that of the model group presented ST segment oblique elevation (>0.1 mV). The ECG of the Fib group presented characteristic ST segment arch back elevation with T-wave towering, and that of the AAV group presented ST segment oblique elevation. Compared with the normal group, the model and Fib groups showed elevations in levels of liver Fib, plasma Fib, and liver Fibα mRNA (P<0.01), and the AAV group had risen levels of Fib and Fibα mRNA (P<0.01). Compared with the model group, the Fib group presented risen levels of liver Fib and Fibα mRNA (P<0.01). Compared with the Fib group, the AAV group presented decreases in levels of liver Fib, plasma Fib, and liver Fibα mRNA (P<0.01). Compared with the normal group, the other three groups had down-regulated protein and mRNA levels of Mfn2, OPA1, PINK1, Parkin, p-AMPK/AMPK, and PGC-1α (P<0.05, P<0.01) and up-regulated protein levels of Drp1 (P<0.01). Compared with those in the model group, the mRNA and protein levels of Mfn2, OPA1, PINK1, Parkin, p-AMPK/AMPK, and PGC-1α were all down-regulated (P<0.05, P<0.01) and the protein level of Drp1 was up-regulated (P<0.01) in the Fib group. Compared with the Fib group, the AAV group showed differences in protein levels of OPA1, PGC-1α, Parkin, and Drp1 (P<0.05, P<0.01) and an increasing trend in the mRNA levels of AMPK and PGC-1α with no significant difference. Compared with the normal group, the other three groups had elevated levels of ATP in the myocardial tissue (P<0.01). Compared with the model group, the Fib group showed elevated levels of ATP and AMP (P<0.01). Compared with the Fib group, the AAV group exhibited lowered levels of ATP and AMP (P<0.01). ConclusionFib can achieve the overexpression effect in the rat model of coronary heart disease with the syndrome of blood stasis. At the same time, the overexpression of Fib can induce the damage of the mitochondrial quality control system in the myocardial tissue, inhibit mitochondrial dynamics and mitochondrial biosynthesis, and down-regulate mitochondrial autophagy, thereby aggravating myocardial injury in the rat model.
7.Analysis of Medication Patterns for Ancient Epidemic Treatment Based on Data Mining
Peipei JIN ; Tongxing WANG ; Liping CHANG ; Bin HOU ; Ningxin HAN ; Xiaoqi WANG ; Zhenhua JIA
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):287-294
ObjectiveExploring the formula rules of commonly used traditional Chinese medicines(TCMs) for epidemic treatment from the Qin and Han dynasties to the Qing dynasty through data mining, providing reference for the prevention and control of contemporary epidemics. MethodsThe articles on epidemic treatment in the electronic database of Chinese Medical Code V5.0 were systematically searched, and the contents such as source, dynasty, author, diagnosis, formula name, therapeutic method and efficacy, and composition of medicines from each article that met the inclusion criteria were extracted. Then, an Excel standardized database was established, and Python programs were used for data mining to summarize the frequency of commonly used medicines and perform hierarchical cluster analysis, Pearson correlation analysis, and association rule analysis. ResultsA total of 1 595 formulas were included, involving 558 TCMs. The efficacy of these medicines could be classified into two categories, namely, expeling pathogenic factors and reinforcing healthy Qi. According to the frequency deconstruction analysis, high-frequency medicines were mainly detoxification, Fu-organ dredging, aromatization and promoting blood circulation, followed by the medicines with the effect of treating the lungs, such as clearing the lungs and resolving phlegm, clearing heat and purging the lungs, relieving cough and asthma, and purging the lungs and relieving asthma. And the proportions of acrid-warm herbs and acrid-cold herbs varied in different periods. Hierarchical clustering and correlation analysis both suggested TCMs for expeling pathogenic factors and reinforcing healthy Qi often formed stable combinations with high association degrees. Association rule analysis showed that the core acrid-warm herb was mainly Ephedrae Herba, and the core acrid-cold herb was mainly Forsythiae Fructus, resulting in the core formulas of Maxing Shigantang and Yinqiaosan. ConclusionThroughout history, the prevention and control of epidemics have been based on the principle of "preserving healthy Qi and avoiding toxic Qi", focusing on the treatment of the causes and characteristics of epidemics through detoxification, Fu-organ dredging, and aromatization, emphasizing the use of Rhei Radix et Rhizoma and other herbs to dredge Fu-organ, eliminate toxins and pathogens, and playing the role of actively intervene with symptomatic medication. And based on the external manifestations of the body's struggle between evil and righteousness, diagnose and treatment according to syndrome differentiation was performed.
8.Analysis of Medication Patterns for Ancient Epidemic Treatment Based on Data Mining
Peipei JIN ; Tongxing WANG ; Liping CHANG ; Bin HOU ; Ningxin HAN ; Xiaoqi WANG ; Zhenhua JIA
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):287-294
ObjectiveExploring the formula rules of commonly used traditional Chinese medicines(TCMs) for epidemic treatment from the Qin and Han dynasties to the Qing dynasty through data mining, providing reference for the prevention and control of contemporary epidemics. MethodsThe articles on epidemic treatment in the electronic database of Chinese Medical Code V5.0 were systematically searched, and the contents such as source, dynasty, author, diagnosis, formula name, therapeutic method and efficacy, and composition of medicines from each article that met the inclusion criteria were extracted. Then, an Excel standardized database was established, and Python programs were used for data mining to summarize the frequency of commonly used medicines and perform hierarchical cluster analysis, Pearson correlation analysis, and association rule analysis. ResultsA total of 1 595 formulas were included, involving 558 TCMs. The efficacy of these medicines could be classified into two categories, namely, expeling pathogenic factors and reinforcing healthy Qi. According to the frequency deconstruction analysis, high-frequency medicines were mainly detoxification, Fu-organ dredging, aromatization and promoting blood circulation, followed by the medicines with the effect of treating the lungs, such as clearing the lungs and resolving phlegm, clearing heat and purging the lungs, relieving cough and asthma, and purging the lungs and relieving asthma. And the proportions of acrid-warm herbs and acrid-cold herbs varied in different periods. Hierarchical clustering and correlation analysis both suggested TCMs for expeling pathogenic factors and reinforcing healthy Qi often formed stable combinations with high association degrees. Association rule analysis showed that the core acrid-warm herb was mainly Ephedrae Herba, and the core acrid-cold herb was mainly Forsythiae Fructus, resulting in the core formulas of Maxing Shigantang and Yinqiaosan. ConclusionThroughout history, the prevention and control of epidemics have been based on the principle of "preserving healthy Qi and avoiding toxic Qi", focusing on the treatment of the causes and characteristics of epidemics through detoxification, Fu-organ dredging, and aromatization, emphasizing the use of Rhei Radix et Rhizoma and other herbs to dredge Fu-organ, eliminate toxins and pathogens, and playing the role of actively intervene with symptomatic medication. And based on the external manifestations of the body's struggle between evil and righteousness, diagnose and treatment according to syndrome differentiation was performed.
9.Effects of microstructured bone implant material surfaces on osteogenic function of MC3T3-E1 osteoblasts
Liping HUANG ; Hui LI ; Xinge WANG ; Rui WANG ; Bei CHANG ; Shiting LI ; Xiaorong LAN ; Guangwen LI
Chinese Journal of Tissue Engineering Research 2025;29(10):1990-1996
BACKGROUND:The micro/nanostructured gradient biomimetic surface of implant materials can simulate the structure of the extracellular environment in human bone tissue,thereby achieving perfect bone integration function.However,further research is needed on the mechanisms by which the surface microstructure of bone implant materials regulates cell function and promotes osteogenesis. OBJECTIVE:To analyze the effect of titanium sheet microstructure surface on osteogenic differentiation of MC3T3-E1 osteoblasts. METHODS:(1)At a constant voltage of 5 V or 20 V,nanotube arrays of different diameters were prepared on the surface of titanium sheets by acid etching and anodic oxidation techniques,and were recorded as group R5 and group R20,respectively.The surface morphology,roughness,and hydrophilicity of pure titanium sheet(without acid etching or anodizing treatment)were measured in group R5 and group R20.(2)MC3T3-E1 osteoblasts of logarithmic growth stage were inoculated on the surface of pure titanium sheets,R5 group and R20 group respectively.After 24 hours of osteogenic induction culture,the expression of mechanical sensitive channel protein 1 was analyzed by RT-PCR and immunofluorescence staining.Osteoblast inducible base with or without the mechanosensitive channel protein 1 activator Yada1 was added,and alkaline phosphatase staining was performed after 7 days of culture.Alizarin red staining was performed after 14 days of culture. RESULTS AND CONCLUSION:(1)The surface of pure titanium sheets was smooth under scanning electron microscope.Relatively uniform and orderly nanotube arrays with average diameters of about 30 nm and 100 nm were observed on the surface of titanium sheets of groups R5 and R20,respectively.The results of scanning electron microscope were further verified by atomic force microscopy.The surface roughness of titanium sheet of group R5 was higher than that of pure titanium(P<0.05),and the water contact angle was lower than that of pure titanium(P<0.05).The surface roughness of titanium sheet in group R20 was higher than that in group R5(P<0.05),and the water contact angle was lower than that in group R5(P<0.05).(2)RT-PCR and immunofluorescence staining showed that the expression of mechanosensitive channel protein 1 in group R5 was higher than that in pure titanium group(P<0.05),and the expression of mechanosensitive channel protein 1 in group R20 was higher than that in group R5(P<0.05).Under the osteogenic induction,compared with the condition without Yada1,there were no significant changes in the activity of alkaline phosphatase and the deposition of calcified nodules in pure titanium group after Yada1 addition,while the activity of alkaline phosphatase and the deposition of calcified nodules in groups R5 and R20 after Yada1 addition were significantly increased(P<0.05).With or without Yada1,the alkaline phosphatase activity and calcified nodule deposition in group R5 were higher than those in pure titanium group(P<0.05),and the alkaline phosphatase activity and calcified nodule deposition in group R20 were higher than those in group R5(P<0.05).(3)The results show that the surface microstructure of titanium sheet can promote the osteogenic differentiation of osteoblast MC3T3-E1 by activating mechanosensitive channel protein 1.
10.Changes in renal function in chronic hepatitis B patients treated initially with entecavir versus tenofovir alafenamide fumarate and related influencing factors
Shipeng MA ; Yanqing YU ; Xiaoping WU ; Liang WANG ; Liping LIU ; Yuliang ZHANG ; Xin WAN ; Shanfei GE
Journal of Clinical Hepatology 2025;41(1):44-51
ObjectiveTo investigate the influence of entecavir (ETV) versus tenofovir alafenamide fumarate (TAF) on renal function in previously untreated patients with chronic hepatitis B (CHB). MethodsA retrospective analysis was performed for the clinical data of 167 previously untreated CHB patients who received ETV or TAF treatment for at least 48 weeks at the outpatient service of Department of Infectious Diseases in The First Affiliated Hospital of Nanchang University from September 2019 to November 2023, and according to the antiviral drug used, they were divided into ETV group with 117 patients and TAF group with 50 patients. In order to balance baseline clinical data, propensity score matching (PSM) was used for matching and analysis at a ratio of 2∶1, and the two groups were compared in terms of estimated glomerular filtration rate (eGFR) and the incidence rate of abnormal renal function at week 48. According to eGFR at week 48, the patients were divided into normal renal function group and abnormal renal function group. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The multivariate Logistic regression analysis was used to investigate the influencing factors for abnormal renal function, and the receiver operating characteristic (ROC) curve was used to assess the performance of each indicator in predicting abnormal renal function. The Kaplan-Meier method was used to analyze the cumulative incidence rate of abnormal renal function, and the log-rank test was used for comparison. The analysis of variance with repeated measures was used to compare the dynamic changes of eGFR during antiviral therapy in CHB patients. ResultsAfter PSM matching, there were 100 patients in the ETV group and 50 patients in the TAF group. There were no significant differences in baseline clinical data between the ETV group and the TAF group (all P>0.05), with an eGFR level of 112.29±9.92 mL/min/1.73 m2 in the ETV group and 114.72±12.15 mL/min/1.73 m2 in the TAF group. There was a reduction in eGFR from baseline to week 48 in both groups, and compared with the TAF group at week 48, the ETV group had a significantly lower eGFR (106.42±14.12 mL/min/1.73 m2 vs 112.25±13.44 mL/min/1.73 m2, t=-2.422, P=0.017) and a significantly higher incidence rate of abnormal renal function (17.00% vs 4.00%, χ2=5.092, P=0.024). After the patients were divided into normal renal function group with 131 patients and abnormal renal function group with 19 patients, the univariate analysis showed that there were significant differences between the two groups in age (Z=-2.039, P=0.041), treatment drug (ETV/TAF) (χ2=5.092, P=0.024), and baseline eGFR level (t=4.023, P<0.001), and the multivariate Logistic regression analysis showed that baseline eGFR (odds ratio [OR]=0.896, 95% confidence interval [CI]: 0.841 — 0.955, P<0.001) and treatment drug (OR=5.589, 95%CI: 1.136 — 27.492, P=0.034) were independent influencing factors for abnormal renal function. Baseline eGFR had an area under the ROC curve of 0.781 in predicting abnormal renal function in CHB patients, with a cut-off value of 105.24 mL/min/1.73 m2, a sensitivity of 73.68%, and a specificity of 82.44%. The Kaplan-Meier curve analysis showed that the patients with baseline eGFR≤105.24 mL/min/1.73 m2 had a significantly higher cumulative incidence rate of abnormal renal function than those with baseline eGFR>105.24 mL/min/1.73 m2 (χ2=22.330, P<0.001), and the ETV group had a significantly higher cumulative incidence rate of abnormal renal function than the TAF group (χ2=4.961, P=0.026). With the initiation of antiviral therapy, both the ETV group and the TAF group had a significant reduction in eGFR (F=5.259, P<0.001), but the ETV group only had a significant lower level of eGFR than the TAF group at week 48 (t=-2.422, P=0.017); both the baseline eGFR≤105.24 mL/min/1.73 m2 group and the baseline eGFR>105.24 mL/min/1.73 m2 group had a significant reduction in eGFR (F=5.712, P<0.001), and there was a significant difference in eGFR between the two groups at baseline and weeks 12, 24, 36, and 48 (t=-13.927, -9.780, -8.835, -9.489, and -8.953, all P<0.001). ConclusionFor CHB patients initially treated with ETV or TAF, ETV antiviral therapy has a higher risk of renal injury than TAF therapy at week 48.

Result Analysis
Print
Save
E-mail