1.Preoperative evaluation of lung function in patients with lung cancer using two-phase dual-energy CT perfusion imaging
Lifang LING ; Yizhen JIA ; Qinmin HAO ; Wenzheng XU ; Zhibo WANG ; Jun WANG ; Liang CHEN ; Mei YUAN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(01):79-86
Objective To explore the application value of dual-phase dual-energy CT (DECT) perfusion imaging in preoperative lung function assessment of lung cancer patients. Methods Data were collected from patients with stageⅠA non-small cell lung cancer who underwent surgical treatment in the Department of Thoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, from November 2022 to June 2024. All patients underwent DECT perfusion imaging and pulmonary function testing (PFT) before surgery. PFT observation indicators included ventilation function indicators such as forced expiratory volume in one second (FEV1), forced vital capacity (FVC), 1-second rate (FEV1/FVC), maximal voluntary ventilation (MVV), and diffusion function indicators such as diffusing capacity for carbon monoxide (DLCO) and DLCO per liter of alveolar volume (DLCO/VA). The software eXamine was used to obtain quantitative parameters of DECT perfusion imaging, including volume parameters and perfusion parameters of both lungs and each lung lobe. The correlation between the volume parameters and perfusion parameters of both lungs and the ventilation and diffusion function indicators of the patients, as well as the differences in quantitative parameters of each lung lobe, was analyzed. Results The end-inspiration lung volume and biphasic volume difference were strongly positively correlated with FEV1 and FVC (r=0.636, r=0.682, r=0.614, r=0.624, P<0.001) and moderately positively correlated with MVV and DLCO (r=0.499, r=0.514, r=0.549, r=0.447, P<0.001); the end-expiration lung volume was weakly negatively correlated with DLCO/VA (r=−0.295, P=0.026); the volume ratio was positively correlated with FEV1, FVC, MVV, and MVV% (r=0.424, r=0.399, r=0.415, r=0.310, P<0.05); the end-inspiration iodine content was weakly positively correlated with DLCO/VA% (rs=0.292, P=0.030); the end-expiration iodine content was weakly positively correlated with FEV1, FVC, MVV, DLCO%, and DLCO/VA (r=0.307, r=0.299, r=0.295, r=0.366, r=0.320, P<0.05) and moderately positively correlated with DLCO (r=0.439, P<0.001); the end-inspiration iodine concentration was negatively correlated with FEV1, FVC, MVV, and MVV% (rs=−0.407, rs=−0.426, rs=−0.352, rs=−0.277, P<0.05); the end-expiratory phase iodine concentration was moderately positively correlated with DLCO/VA (r=0.403, P=0.002); both the iodine concentration difference and the iodine concentration ratio were moderately positively correlated with FEV1, FEV1%, FVC, MVV, MVV% (P<0.05). The lung volume and iodine concentration ratio values were both highest in the left upper lung lobe and lowest in the right middle lung lobe; the differences in lung volume, lung volume ratio, intrapulmonary iodine content, and intrapulmonary iodine concentration were all highest in the lower lobes of both lungs and lowest in the middle lobe of the right lung. Conclusion Dual-phase DECT perfusion imaging can accurately assess overall lung function and quantify regional lung function.
2.Current quality status and management countermeasures of occupational health technical services in Zhejiang Province
Qiuliang XU ; Feng HAN ; Peng WANG ; Zhen ZHOU ; Fei LI ; Hongwei XIE ; Yong HU ; Weiming YUAN ; Lifang ZHOU ; Hua ZOU
Journal of Environmental and Occupational Medicine 2026;43(3):341-346
Background The quality of occupational health technical services is directly linked to the protection of workers' health rights and the efficacy of occupational disease prevention and control. However, the industry still faces critical challenges: sporadic instances of institutional non-compliance and persistent irregularities in professional practice continue to undermine overall service performance. Objective To assess the current quality status of occupational health technical services in Zhejiang Province and propose countermeasures for quality improvement, providing a scientific basis for policy optimization and service delivery quality enhancement. Methods A total of 69 occupational health technical service institutions in Zhejiang Province that obtained formal accreditation as of April 30, 2024, were sampled, including 3 public institutions and 66 private institutions (comprising 3 formerly Class-A, 28 formerly Class-B, 11 formerly Class-C, and 24 newly certified institutions). Following the Technical Protocol for Quality Monitoring of Occupational Health Technical Service in Zhejiang Province and the Technical Protocol for Proficiency Testing of Occupational Health Detection in Zhejiang Province, a quality assessment task force comprising national and provincial experts was established. Evaluation was conducted across four dimensions: qualification maintenance and compliance, standardization of technical services, authenticity of technical services, and proficiency testing, utilizing a combination of document review, on-site inspections, and technical skill assessments. Results The occupational health technical service institutions in Zhejiang Province were predominantly private entities (82.5%), with significant disparities in overall service quality. The pass rates for qualification maintenance and compliance, technical service standardization, technical service authenticity, and the excellence rate for laboratory proficiency testing were 81.5%, 80.7%, 97.3%, and 90.4%, respectively. Regarding qualification maintenance, the pass rates for "environmental conditions" (49.8%, 56.7%) and "instrumentation and equipment" (58.2%、65.6%) were significantly lower for formerly Class-C and newly certified institutions compared to other categories. In terms of technical standardization, "standardized on-site inspections" recorded the lowest pass rate (67.4%), with newly certified institutions at only 48.0%. Regarding technical service authenticity, formerly Class-C institutions exhibited issues such as missing raw chromatograms for blank samples (85.7% pass rate). In laboratory proficiency testing, public and formerly Class-A institutions achieved 100% excellence rates, but the performance of formerly Class-C and newly certified institutions was comparatively weak; specifically, the failure rate for organic analysis in formerly Class-C institutions reached 20%; the failure rate for dust testing items in newly certified institutions was 10.3%. Conclusion The overall quality of occupational health technical services in Zhejiang Province still requires significant improvement, particularly in basic institutional conditions, the standardization of on-site inspections, and laboratory proficiency in organic and dust analysis. Formerly Class-C and newly certified institutions should be the primary focus of quality management efforts. Differentiated regulatory strategies are recommended, alongside strengthening interim and ex-post supervision to gradually enhance the quality of occupational health technical services across all institutions.
3.Protective effect and mechanism of genistein on etoposide-induced chondrocyte senescence
Jinhong WANG ; Tianyu CHEN ; Lifang MAO ; Yingjie ZHAO ; Renpeng ZHOU ; Wei HU ; Chao LU
Acta Universitatis Medicinalis Anhui 2026;61(4):636-643
ObjectiveTo investigate the protective effect of genistein (Gen) on etoposide-induced chondrocyte senescence and its underlying mechanism. MethodsThe C28/I2 cell line was treated with different concentrations of Gen and etoposide, and the cell viability was detected by the CCK-8 assay. The senescence model of C28/I2 chondrocytes was induced by etoposide, with Gen intervention. Senescence-associated β-galactosidase (SA-β-gal) staining was performed to detect the senescence-positive rate and staining characteristics of chondrocytes. The expressions of peroxiredoxin 6 (Prdx6), cyclin-dependent kinaseto clarify the functional necessity of Prdx6. ResultsCompared with the etoposide group, the C28/I2 chondrocyte viability significantly increased (P<0.01), the expression ofsenescence-associated proteins p21 and p16 decreased (P<0.01, P<0.05), the expression of senescence-associated genes p21 and p16 reduced (both P<0.01), the fluorescence intensity of senescence-associated proteins p21 and p16 was diminished (P<0.05, P<0.01), and the proportion of SA-β-gal-positive cells decreased (P<0.01) in the Gen+etoposide group. Compared with the Control group, the expression of Prdx6 was downregulated in the etoposide group (P<0.05). Compared with the etoposide group, the expression of Prdx6 was upregulated in the Gen+etoposide group (P<0.01). Compared with the Control group, the GPx activity significantly decreased in the si-Prdx6 group (P<0.01). Furthermore, compared with the si-Prdx6 group, the GPx activity increased in the si-Prdx6+Gen group (P<0.05). Molecular docking results revealed that Gen formed hydrogen bond interactions with the active site of Prdx6. After Prdx6 knockdown, the expression of senescence-associated genes p21 and p16 and the fluorescence intensity of senescence-associated proteins p21 and p16 both increased in the Gen+etoposide+si-Prdx6 group (both P<0.01). ConclusionGen can inhibit etoposide-induced senescence of C28/I2 chondrocytes by upregulating the expression of Prdx6. This study provides potential drug targets and experimental basis for the prevention and treatment of chondrocyte senescence-related diseases.
4.Surveillance of Oncomelania hupensis snails following interruption of schistosomiasis transmission in Yunnan Province
Siqi NING ; Yi DONG ; Chunhong DU ; Lifang WANG ; Yun ZHANG ; Yuhe HE ; Hua JIANG ; Jiayu SUN ; Chunqiong CHEN ; Jiaqi YAN ; Jihua ZHOU ; Zongya ZHANG ; Hongqiong WANG ; Meifen SHEN ; Jing SONG
Chinese Journal of Schistosomiasis Control 2026;38(2):200-206
Objective To investigate the distribution characteristics of Oncomelania hupensis snails in Yunnan Province fol-lowing interruption of schistosomiasis transmission, so as to provide the evidence for assessing the risk of schistosomiasis transmission and scientifically formulating the schistosomiasis surveillance program. Methods According to the requirements of the National Schistosomiasis Surveillance Scheme (2020 Edition), O. hupensis snail surveillance data were collected from 18 schistosomiasis-endemic counties (cities, districts) in Yunnan Province from 2020 to 2024, including area of snail survey, area of snail habitats, area of re-emerging snail habitats, number of frames surveyed, number of frames with O. hupensis snails, number of O. hupensis snails captured, and number of living snails, and the occurrence of frames with snails and mean density of living snails were calculated. Changes in snail status over the 5-year period from 2020 to 2024 and the differences in snail distributions specified by epidemic intensity, environmental type, and vegetation type were analyzed. Results The areas of snail survey increased from 1 727.96 hm2 in 2020 to 3 894.45 hm2 in 2024 (peak) across 18 schistosomiasis-endemic counties (cities, districts) in Yunnan Province during the period from 2020 through 2024. The areas of snail habitats increased from 70.36 hm2 in 2020 to a peak in 2023 (172.04 hm2), followed by a reduction to 132.36 hm2 in 2024, and the areas of re-emerging snail habitats increased from 42.71 hm2 in 2020 to a peak in 2022 (78.43 hm2), followed by a reduction to 40.21 hm2 in 2024. The occurrence of frames with snails and mean density of living snails increased from 1.24% (3 025/244 404) and (0.033 2 ± 0.038 7) snails/0.1 m2 in 2020 to peaks at 2.03% (6 231/307 563) and (0.066 9 ± 0.068 4) snails/0.1 m2 in 2023, followed by reductions to 1.04% (5 829/559 941) and (0.032 6 ± 0.057 7) snails/0.1 m2 in 2024, respectively. There was a significant difference in the occurrence of frames with snails over the 5-year study period (χ2 = 1 962.95, P < 0.05), and the occurrence of frames with snails reduced by 48.71% in 2024 relative to in 2023 (χ2 = 1 411.05, P < 0.005); however, there was no significant difference in the mean density of living snails over the 5 years (H = 5.310, P > 0.05). There were significant differences in the occurrence of frames with snails (χ2 = 481.27, P < 0.05) and mean density of living snails (H = 6.872, P < 0.05) in schistosomiasis-endemic areas with different epidemic intensities. The occurrence of frames with snails (χ2 = 25.32 and 38.70, both P values < 0.017) and mean density of living snails (Z = 28.55 and 49.96, both P values < 0.017) were higher in schistosomiasis transmission-interrupted and eliminated areas with snails than in schistosomiasis-eliminated areas without snails, and the occurrence of frames with snails (χ2 = 453.54, P < 0.017) and mean density of living snails (Z = −56.97, P < 0.017) were higher in schistosomiasis-eliminated areas with snails than in schistosomiasis transmission-interrupted areas with snails. O. hupensis snails were mainly distributed in paddy fields, dry farmlands and ditches; however, the occurrence of frames with snails (13.40%, 424/3 164) and mean density of living snails [(0.252 8 ± 0.158 7) snails/0.1 m2] were higher in ponds/weirs than in other types of environments (both P values < 0.05). Rice, dry farmland crops and weeds were main vegetations in which O. hupensis snails were distributed, and the occurrence of frames with snails (2.29%, 7 111/310 140) and mean density of living snails [(0.072 3 ± 0.018 9) snails/0.1 m2] were higher in weeds than in other types of environments (both P values < 0.05). Conclusions O. hupensis snails have been effectively controlled in Yunnan Province following implementation of integrated schistosomiasis control measures; however, there are still risk factors for schistosomiasis transmission, including reduced attention to schistosomiasis control and snail re-emergence. Improved control efforts and surveillance system construction and timely identification of risk factors of snail status and timely management are recommended to ensure the achievement of the target of schistosomiasis elimination as scheduled.
5.Association of special family structure and physical activity with psychological sub health among secondary vocational school students
DAI Yuxin, ZENG Lifang, WANG Huixia, LEI Zhenzhou, JIANG Jing, XIN Jian, LU Jinkui, CHEN Yajun
Chinese Journal of School Health 2026;47(6):766-770
Objective:
To investigate the association of special family structure and physical activity with psychological sub health among secondary vocational school students, so as to provide reference to inform mental health promotion in the population.
Methods:
From September to December 2024, a convenience sample was drawn from 16 schools including 5 141 secondary vocational school students across 8 provinces (municipalities) in China (Fujian, Chongqing, Guangdong, Guangxi, Hubei, Jiangxi, Shanghai, Zhejiang). A self developed questionnaire, Multidimensional Sub health Questionnaire of Adolescents and International Physical Activity Questionnaire Short Form were used to investigate and evaluate basic information, family structure, psychological sub health status and physical activity. Descriptive statistics and Logistic regression analysis were performed to explore relationships of special family structures and physical activity with psychological sub health in secondary vocational school students.
Results:
The detection rate of psychological sub health among secondary vocational school students was 11.0%. The reporting rates for secondary vocational school students who lost their father or lost their mother, whose parents divorced, whose parents remarried, and those from special family structures were 2.8%, 0.8%, 11.8%, 3.9%, and 14.7%, respectively. Moreover, the detection rates of psychological sub health and its sub dimensions significantly differed among secondary vocational school students grouped by family type (divorced parental families, remarried parental families and special family structures)( χ 2=5.90-22.67, all P <0.05). Binary Logistic regression indicated that maternal bereavement was associated with a higher risk of conduct problems [ AOR ( 95% CI )= 2.90(1.15-7.33)], and parental divorce was associated with a higher risk of psychological sub health ( AOR= 2.71 , 95%CI =1.04- 7.06 ) among secondary vocational school students (both P <0.05). Interaction analysis showed that both students with a special family structure and insufficient physical activity [ AOR (95% CI )=1.99(1.44-2.75)] and those with a non-special family structure and insufficient physical activity [ AOR (95% CI )=1.81(1.48-2.22)] were associated with increased risks of psychological sub health among secondary vocational school students (both P <0.01).
Conclusion
Special family structure and physical activity are associated with psychological sub health among secondary vocational school students; early identification and assessment based interventions for those with a special family structure should be strengthened, while school based physical activity should be implemented to increase physical activity levels,thereby reducing the risk of psychological sub health.
6.Surveillance of Schistosoma japonicum infections in wild murines in Yunnan Province
Meifen SHEN ; Jing SONG ; Lifang WANG ; Yun ZHANG ; Hua JIANG ; Jihua ZHOU ; Jiaqi YAN ; Jiayu SUN ; Chunqiong CHEN ; Zongya ZHANG ; Hongqiong WANG ; Chunhong DU ; Yi DONG
Chinese Journal of Schistosomiasis Control 2026;38(3):299-303
Objective To investigate the prevalence of Schistosoma japonicum infections in wild murines in schistosomiasisendemic areas of Yunnan Province, so as to provide the evidence for improving the schistosomiasis surveillance and early warning capability and implementing precise interventions in the province. Methods A total of 56 natural villages were sampled from 14 schistosomiasis-endemic counties (cities, districts) in Yunnan Province as surveillance sites from 2024 to 2025. Wild murines were captured using traps at night and characterized for species. Liver samples were collected from wild murines, S. japonicum eggs and miracidia were simultaneously detected using liver tissue compression microscopy, liver tissue homogenate microscopy, and liver tissue homogenate hatching. In addition, stool samples were collected from wild murine rectum, with S. japonicum eggs detected using a modified Kato-Katz thick smear technique and S. japonicum miracidia detected using the hatching test with nylon gauzes. Results A total of 15 577 valid murine traps were recovered, and 891 wild murines belonging to 16 species were captured, with a capture rate of 5.72%(891/15 577). The captured wild murines were predominantly districted in paddy fields, dry lands, ditches, ponds and marshlands, with Apodemus chevrieri, Rattus norvegicus, Crocidura attenuata, R. rattus sladeni, R. flavipectus, and Eothenomys miletus as dominant species. No S. japonicum eggs or miradicia were in laboratory; however, other parasites were identified in 25 wild murines. The prevalence rates of Schistosoma sinensis, Capillaria hepatica and Hymenolepis nana were 2.24% (20/891), 0.90% (8/891) and 0.56% (5/891), and the prevalence of S. sinensis and C. hepatica co-infection was 0.90% (8/891), respectively. Conclusions S. sinensis, C. hepatica and H. nana are predominant parasite species in wild murines in schistosomiasis-endemic areas of Yunan Province. No S. japonicum infection was detected during the study period; however, there is still a risk of wild murines as a potential source of infection for schistosomiasis transmission. Continuous intensified surveillance of S. japonicum infections in wild murines is a critical programme in schistosomiasis surveillance and early warning in Yunnan Province.
7.Pulchinenoside A downregulates LRP1 to inhibit the proliferation, migration, and invasion of synovial inflammatory cells
Lifang MAO ; Tianyu CHEN ; Jinhong WANG ; Hao WANG ; Yingjie ZHAO ; Renpeng ZHOU ; Wei HU ; Chao LU
Acta Universitatis Medicinalis Anhui 2026;61(9):1584-1593
ObjectiveTo investigate the effects and mechanisms of pulchinenoside A (PSA) on tumor necrosis factor-α (TNF-α) -induced abnormal proliferation, migration, and invasion of synovial fibroblasts. MethodsA synovitis model was established by stimulating SW982 synovial cells with TNF-α. The low-density lipoprotein receptor-related protein 1 (LRP1) was knocked down using LRP1-specific siRNA or inhibited by the receptor-associated protein (RAP). Cells were treated with various concentrations of PSA, and cell viability was assessed by CCK-8 assay. Protein levels of LRP1, matrix metalloproteinase-3 (MMP3), and N-cadherin were measured by Western blotting. Proliferation was evaluated using an EdU incorporation assay. Migration and invasion capacities were examined by Transwell and wound-healing assays. mRNA expression of LRP1, MMP3, N-cadherin, IL-1β, IL-6, and TNF-α was detected by reverse transcription quantitative real-time PCR (RT-qPCR). Immunofluorescence staining was used to visualize the expression of MMP3 and N-cadherin. The involvement of LRP1 was further verified with the inhibitor RAP. ResultsCompared with the TNF-α-treated model group, PSA treatment significantly reduced SW982 cell viability (P<0.05), downregulated MMP3 and N-cadherin expression (both P<0.01), and decreased the proportion of EdU-positive cells (P<0.05). Moreover, TNF-α stimulation upregulated LRP1 expression compared with normal controls (P<0.01), whereas PSA treatment reversed this increase (P<0.05). LRP1 knockdown or inhibition markedly decreased MMP3 and N-cadherin levels compared with the model group (both P<0.01). Similarly, the combination of PSA and RAP led to significant reductions in MMP3 and N-cadherin expression compared with the model group (both P<0.01). ConclusionPSA inhibits TNF-α-induced abnormal proliferation, migration, and invasion of synovial, at least in part, by downregulating LRP1 expression.
8.Safety and efficacy of a new single-needle dialysis model in maintenance hemodialysis patients
Bin ZHAO ; Lihong ZHANG ; Shen ZHAN ; Lifang LIU ; Wei LIU ; Shanshan GUO ; Guanghui XIAO ; Yuzhu WANG
Chinese Journal of Nephrology 2025;41(2):125-127
The study was a prospective observational study. A total of 24 patients who underwent maintenance hemodialysis (MHD) at Haidian Hospital in Beijing from May 2024 to June 2024 were included as the study subjects. The safety and efficacy of a new single-needle dialysis in MHD patients were evaluated. The reasons for using single-needle dialysis included waiting for the maturity of internal fistula(7 cases, 29.17%), autogenous arteriovenous fistula thrombosis occurred (6 cases, 25.00%), puncture difficulty occurred (7 cases, 29.17%), and pain sensitivity or elderly (4 cases, 16.67%). The results showed that the average blood flow was (155.65±5.90) ml/min, total blood volume was (35.92±2.65) L during single-needle dialysis. One patient had slight puncture leakage, and the puncture success rate was 95.83%. Relevant indicators of dialysis adequacy showed that the average urea clearance (Kt/V) was 0.90±0.42, urea reduction ratio was 58.31%±7.93%, and online real-time Kt/V monitoring average value was 0.98±0.55. The results suggest that the application of the new improved single-needle dialysis mode in MHD patients is safe and effective.
9.Adverse reaction surveillance analysis of domestic human papillomavirus vaccines with different production processes
Haibo WANG ; Yu LIU ; Shuchan CHENG ; Wenfei TAO ; Chunfang HU ; Lifang ZHOU ; Bangjun LYU ; Min XU ; Jieqiong HUANG
Chinese Journal of Preventive Medicine 2025;59(11):1952-1957
This study aims to compare the vaccination rates and incidence of adverse reaction rates following administration of two domestically produced human papillomavirus (HPV) vaccines in individuals aged 9-30 years,investigate the impact of distinct manufacturing processes and vaccination schedules on adverse reaction rates. From November 2023 to June 2024, the Immunization Planning Department of Liuzhou Center for Disease Control and Prevention conducted a single-center, randomized, open-label, parallel-group trial using community-based recruitment of eligible participants aged 9 to 30 years. Participants were randomly assigned to receive either of two domestically produced HPV vaccines (Walrinvax or Cecolin). As specified in the vaccine package inserts, subjects were stratified into a two-dose regimen group (aged 9-14 years) and a three-dose regimen group (aged 15-30 years). Vaccination rates were recorded, and adverse reactions within 0-30 days post-vaccination were monitored. The results showed that a total of 400 participants were enrolled. Both the full vaccination rate and the timely completion rate were significantly higher in the two-dose regimen group compared to the three-dose regimen group (Fisher′s exact test, P<0.01; χ2=7.06, P<0.01). A total of 985 doses were administered. The overall adverse reaction rate was 18.78% (185/985), with local and systemic reactions occurring at 8.02% (79/985) and 10.76% (106/985), respectively. The most frequent adverse reactions were injection site pain (4.97%, 49/985) and fever (4.47%, 44/985). No grade 4 or special-interest adverse events were reported.The incidence of adverse reactions for the two domestic HPV vaccines with different production processes (at 0/6 months) was 13.96% (55/394) and 17.46% (69/395) respectively, with no statistically significant difference (χ2=1.83, P>0.05).The adverse reaction rate was significantly lower in the 9-14 years group (9.77%) compared the 15-30 years group (24.91%)(χ 2=35.67, P<0.01). In conclusion, both domestic HPV vaccines demonstrated a favorable safety profile in the 9-30 years age group, with mostly mild adverse reactions. Compared to the three-dose schedule (15-30 years group), the two-dose HPV vaccination schedule (9-14 years group) significantly reduced the incidence of adverse reactions and improved vaccination compliance.
10.Analysis of serum bile acid profiles in patients with hepatitis B virus infection complicated with liver cirrhosis
Wang ZHANG ; Jia LIU ; Aixia LIU ; Jie SUN ; Lifang XIA ; Bo LI ; Boan LI
Chinese Journal of Experimental and Clinical Virology 2025;39(4):419-426
Objective:By analyzing the concentration distribution and hydrophilic/hydrophobic proportion differences of 15 bile acid subtypes in the serum of patients with hepatitis B virus(HBV)infection complicated with liver cirrhosis and primary biliary cholangitis(PBC)complicated with liver cirrhosis,this study aims to explore the potential associations between bile acid metabolism and these diseases,providing a reference basis for identifying disease-specific metabolic fingerprints in the diagnosis,treatment,and prognosis of liver diseases. Furthermore,building on the pharmacological mechanisms of ursodeoxycholic acid(UDCA)in the treatment of PBC,this research investigates potential therapeutic applications of bile acid drugs in HBV infection.Methods:A retrospective analysis method was adopted. We enrolled 27 HBV infection complicated with liver cirrhosis patients and 59 PBC complicated with liver cirrhosis patients who received outpatient or inpatient treatment at the Fifth Medical Center of PLA General Hospital from November 2024 to April 2025. The general data and routine clinical laboratory data of the two groups of patients were collected and analyzed. Using the ultra-high performance liquid chromatography-triple quadrupole tandem mass spectrometry(UHPLC-QqQ-MS/MS)platform,precise quantification and differential analysis of 15 bile acid subtypes were performed in serum samples. Partial least squares discriminant analysis(PLS-DA)was employed to perform discriminant analysis on serum bile acid profiles data between the two groups,and variable importance in projection(VIP)values were calculated to identify key bile acid subtypes that could differentiate the two diseases. Box plots were constructed to analyze proportion differences in serum hydrophilic and hydrophobic bile acids between the two groups,aiming to explore potential associations between bile acid metabolism and the diseases.Results:The HBV infection group and the PBC group exhibited similar impairment of routine liver function parameters. The HBV infection group had higher serum concentrations of cholic acid(CA),chenodeoxycholic acid(CDCA)and deoxycholic acid(DCA),but lower concentrations of UDCA,glycoursodeoxycholic acid(GUDCA)and tauroursodeoxycholic acid(TUDCA). The score plot generated by the PLS-DA model demonstrated significant differences in bile acid profile characteristics between the two diseases,with VIP values for UDCA,CDCA,GUDCA,TUDCA,and DCA all greater than 1. Box plots demonstrated a higher proportion of hydrophobic bile acids in the bile acid profile of the HBV infection group compared to the PBC group.Conclusion:This study found significant differences in serum bile acid profile characteristics between patients with HBV infection complicated with liver cirrhosis and those with PBC complicated with liver cirrhosis,specific bile acid subtypes such as CDCA and DCA have the potential to become specific metabolic fingerprints for these two diseases. HBV infection group exhibited higher proportion of hydrophobic bile acids in their bile acid profiles compared to PBC group. The characteristic changes in bile acid profiles can reflect the pathological characteristics of liver diseases,and their differences in hydrophilic/hydrophobic bile acids proportion represents a novel dimension independent of traditional liver function indicators,with potential value for disease prognosis assessment. UDCA or its derivatives may hold therapeutic potential for HBV infection patients with liver cirrhosis who exhibit accumulation of hydrophobic bile acids.


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