Despite therapy with potent antiviral agents, chronic hepatitis B (CHB) patients remain at high risk of hepatocellular carcinoma (HCC). While metabolites have been rediscovered as active drivers of biological processes including carcinogenesis, the specific metabolites modulating HCC risk in CHB patients are largely unknown. Here, we demonstrate that baseline plasma from CHB patients who later developed HCC during follow-up exhibits growth-promoting properties in a case-control design nested within a large-scale, prospective cohort. Metabolomics analysis reveals a reduction in long-chain acylcarnitines (LCACs) in the baseline plasma of patients with HCC development. LCACs preferentially inhibit the proliferation of HCC cells in vitro at a physiological concentration and prevent the occurrence of HCC in vivo without hepatorenal toxicity. Uptake and metabolism of circulating LCACs increase the intracellular level of acetyl coenzyme A, which upregulates histone H3 Lys14 acetylation at the promoter region of KLF6 gene and thereby activates KLF6/p21 pathway. Indeed, blocking LCAC metabolism attenuates the difference in KLF6/p21 expression induced by baseline plasma of HCC/non-HCC patients. The deficiency of circulating LCACs represents a driver of HCC in CHB patients with viral control. These insights provide a promising direction for developing therapeutic strategies to reduce HCC risk further in the antiviral era.

Objective:To develop the Puerperal Delivery Trauma Perception Scale and test its reliability and validity.Methods:Based on the theory of unpleasant symptoms and combining literature review, semi-structured interview, and group discussion, an item pool was created. The initial version of the scale was formed through Delphi expert consultation and pre-investigation. A convenience sampling method was used to select 304 puerperal women from seven Grade-A tertiary hospitals in Wuhan for reliability and validity testing of the scale in January and February 2024.Results:The Puerperal Delivery Trauma Perception Scale includes seven dimensions and 34 items. The Cronbach's α coefficient of the scale was 0.929, the split-half reliability was 0.874, and the test-retest reliability was 0.932. Exploratory factor analysis extracted seven common factors, with a cumulative variance contribution rate of 71.221%.Conclusions:The Puerperal Delivery Trauma Perception Scale has good reliability and validity and can be used to assess the trauma perception of puerperal women in China.

Objective:To develop the Puerperal Delivery Trauma Perception Scale and test its reliability and validity.Methods:Based on the theory of unpleasant symptoms and combining literature review, semi-structured interview, and group discussion, an item pool was created. The initial version of the scale was formed through Delphi expert consultation and pre-investigation. A convenience sampling method was used to select 304 puerperal women from seven Grade-A tertiary hospitals in Wuhan for reliability and validity testing of the scale in January and February 2024.Results:The Puerperal Delivery Trauma Perception Scale includes seven dimensions and 34 items. The Cronbach's α coefficient of the scale was 0.929, the split-half reliability was 0.874, and the test-retest reliability was 0.932. Exploratory factor analysis extracted seven common factors, with a cumulative variance contribution rate of 71.221%.Conclusions:The Puerperal Delivery Trauma Perception Scale has good reliability and validity and can be used to assess the trauma perception of puerperal women in China.