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《广州医药》编辑部

广州医药杂志服务号
医院管理

城市医疗集团心房颤动的机会性筛查成本效益分析

Cost-effectiveness analysis of opportunistic atrial fibrillation screening in urban medical consortiums

:639-650
 
      目的 评估在城市医疗集团模式下,于医院就诊人群中实施基于单导联心房颤动(房颤)检测棒的机会性房颤筛查的长期成本效益。方法 基于经广州市本地流行病学数据校准的Markov模型,比较未筛查与基于单导联房颤检测棒的不同筛查频率(季度、半年、年度)的机会性筛查策略,从卫生服务提供方视角评估成本与质量调整生命年(QALY),计算增量净货币收益(INMB)与成本效果比(ICER),并进行概率及情景敏感性分析。结果 所构建的房颤模型具有良好的预测效度。在基线假设下,季度筛查策略表现最优,相较未筛查组可增加0.525 5个QALY,节省成本15?626.61元,INMB为85 312.14元。敏感性分析显示,抗凝治疗依从性对成本效益影响最大。情景分析中,不同灵敏度与特异度假设未改变最优策略结论。结论 在城市医疗集团情境下,针对65岁及以上就诊老年人群的基于单导联房颤检测棒的季度机会性房颤筛查具备稳健的成本效益。结合分级诊疗体系和全流程管理,以依从性管理作为干预重点,能够最大化卒中预防收益并提高资源配置效率。

      Objective To evaluate the long-term cost-effectiveness of opportunistic atrial fibrillation(AF)screening using a single-lead handheld ECG device among hospital-attending adults within an urban medical consortium.Methods No screening and opportunistic screening at different frequencies(quarterly,semiannual,and annual)were compared by a Markov model calibrated to Guangzhou-specific epidemiological data.From the healthcare provider perspective,we estimated costs and quality-adjusted life-years(QALYs),calculated incremental net monetary benefit(INMB)and incremental cost-effectiveness ratio(ICER),and performed probabilistic and scenario sensitivity analyses.Results The AF model demonstrated good predictive validity.Under the baseline scenario,quarterly screening was the optimal strategy,yielding a gain of 0.525 5 QALYs,cost savings of CNY 15 626.61,and an INMB of CNY 85 312.14 versus no screening.Sensitivity analyses indicated that adherence to anticoagulation had the greatest impact on cost-effectiveness.Scenario analyses varying diagnostic sensitivity and specificity did not change the conclusion regarding the optimal strategy.Conclusions In the context of an urban medical consortium,quarterly opportunistic AF screening based on a single-lead handheld ECG device for hospital-attending adults aged ≥65 years is robustly cost-effective.Integrating screening into tiered care with end-to-end management,while prioritizing adherence management,can maximize stroke-prevention benefits and improve resource allocation efficiency.

论著

住院老年患者PICC相关性血栓的影响因素分析

Analysis of influencing factors for PICC-related thrombosis in hospitalized elderly patients

:433-445
 
      目的 调查住院老年患者因经外周静脉置入中心静脉导管(PICC)而引发的血栓情况,并分析其影响因素,为老年患者置入PICC产生的相关性血栓(PICC-CRT)和症状性血栓的评估与干预提供借鉴。方法 在2023年1月—2023年12月期间,选取广州市第一人民医院接受PICC置管的317例住院老年患者。采用包括患者一般情况调查表、运动功能评定、肌力检测、 Barthel指数评定、Padua评分等多种工具进行综合评估。采用多因素 Logistic 回归构建 PICC-CRT 及症状性血栓的预测模型,并应用逐步回归法优化变量筛选过程。模型性能通过 ROC 曲线进行评估。结果 去除临床资料不完整的患者40例,最终纳入277例患者的完整资料,其中123例患者出现了PICC-CRT,发生率为44.40%(123/277)。血栓分级中,I级78例,Ⅱ级37例,Ⅲ级8例。无症状血栓83例,占67.48%,发生率29.96%(83/277);症状性血栓40例,占32.52 %,发生率14.44%(40/277)。单因素分析联合多因素Logistic回归显示,卒中史、凝血酶原时间(PT)、导管留置时间是住院老年患者PICC-CRT的关键因素(P<0.05),预测模型ROC曲线下面积为0.719;置管史、恶性肿瘤史、导管留置时间、置管后并发症数量是住院老年患者PICC症状性血栓的独立影响因素(P<0.05),预测模型ROC曲线下面积为0.812。结论 文章总结了PICC-CRT和症状性血栓独特的影响因素,基于关键因素构建了预测模型预测其发生,为护理人员预防PICC-CRT和症状性血栓的发生提供了参考。

   Objective To explore the incidence of thrombosis associated with peripherally inserted central catheter(PICC)placement in hospitalized elderly patients and to analyze its influencing factors,in order to provide a reference for the assessment and prevention of PICC-catheter related thrombosis(PICC-CRT)and symptomatic thrombosis in this population.Methods A total of 317 elderly inpatients who underwent PICC placement at a tertiary hospital in Guangzhou between January and December 2023 were enrolled.Comprehensive assessments were conducted using general patient information forms,motor function evaluation,muscle strength testing,Barthel Index,and Padua score.Multivariate Logistic regression analysis was used to construct predictive models for PICC-CRT and symptomatic thrombosis,with variable selection optimized via stepwise regression.Model performance was evaluated using receiver operating characteristic(ROC)curve analysis.Results After excluding 40 patients with incomplete clinical data,277 cases were included in the final analysis.Among them,123 patients developed PICC-CRT,with an incidence rate of 44.40%(123/277).Thrombosis was graded as Grade I in 78 cases,Grade II in 37 cases,and Grade III in 8 cases.Asymptomatic thrombosis occurred in 83 cases(29.96%),accounting for 67.48% of PICC-CRT;symptomatic thrombosis occurred in 40 cases(14.44%),accounting for 32.52%.Univariate and multivariate Logistic regression analyses identified history of stroke,prothrombin time(PT),and catheter dwell time as key risk factors for PICC-CRT(P<0.05),with the area under the curve(AUC)of 0.719.History of catheterization,malignancy,catheter dwell time,and number of post-catheterization complications were independent predictors of symptomatic thrombosis(P<0.05),with an AUC of 0.812.Conclusions This study identified distinct risk factors for PICC-CRT and symptomatic thrombosis in elderly inpatients.Predictive models based on key variables may provide useful references for clinical staff in preventing the occurrence of PICC-related and symptomatic thrombosis.
论著

全球、地区及国家非酒精性脂肪性肝病负担的三十年演变:基于年龄-时期-队列分析

The three-decade evolution of the global,regional,and national burden of nonalcoholic fatty liver disease:an age-period-cohort analysis

:563-574
 
       目的 评估过去30年,204个国家和地区非酒精性脂肪性肝病(NAFLD)伤残调整生命年(DALYs)的变化趋势,以及年龄-时期-队列效应。方法 所有数据来源于全球疾病负担研究(GBD)数据。针对1990—2019年204个国家和地区NAFLD的DALYs趋势进行分析,采用折点回归模型评估年龄标化DALYs率年均百分比变化(APC);同时,利用年龄-时期-队列模型评估年龄、时期及出生队列对NAFLD的DALYs的影响。结果 1990—2019年,NAFLD的DALYs总量增加了62.92%,全人群DALYs率(每10万人)也增加了12.65%,而年龄标化DALYs率则由1990年的63.28(95%UI:48.58,80.86)下降至2019年的53.33(95%UI:40.73,68.29),降幅约为15.72%。全球范围内,APC模型估算的DALYs净漂移为每年-0.88%(95%CI:-0.91~ -0.85)。无论是DALYs总量、全人群DALYs率还是年龄标化DALYs率,其在女性和男性中的变化趋势与总体趋势一致。尽管全球及按社会人口学指数(SDI)分组的5个区域中,≥80岁人群的DALYs时间趋势逐步上升,但仅高SDI区域的上升趋势较为明显。折点回归分析显示,1990—2019年,年龄标化DALYs率呈现“先缓慢上升、后下降、再上升、最终下降”的波动趋势,总体为下降趋势,1990—2019年平均APC为-0.58%。年龄-时期-队列模型表明,全球、各区域及国家均存在不利的年龄效应,而时期效应与出生队列效应在不同区域总体呈有利趋势,但也存在一定差异。结论 1990—2019年,全球NAFLD的DALYs总量和全人群DALYs率上升,而年龄标化DALYs率总体下降,高SDI地区老年人负担上升更明显。年龄-时期-队列分析显示全球普遍存在不利的年龄效应,时期和出生队列效应总体有利但区域差异显著。

      Objective To evaluate the trends in the disability-adjusted life years(DALYs)of nonalcoholic fatty liver disease(NAFLD)and the effects of age-period-cohort in 204 countries and regions in the past 30 years.Methods All data were obtained from the Global Burden of Disease Study 2019.Trends in DALYS for NAFLD were assessed in 204 countries and territories from 1990 to 2019,and trends in the annual percentage change(APC)of age-standardized DALY rate were assessed by a joinpoint regression model.And age-period-cohort models were used to assess the effects of age-period-cohort on DALYs for NAFLD.Results From 1990 to 2019,the number of DALYs due to NAFLD increased by 62.92%,and all-age DALY rate per 100,000 population also increased by 12.65%,while the age-standardized DALY rate decreased from 63.28(48.58,80.86)in 1990 to 53.33(40.73,68.29)in 2019,a decrease of about 15.72%.Globally,the APC model estimated a net drift for DALYs of -0.88%(95%CI:-0.91,-0.85)per year,and for the number of DALYs,all-age DALYs rate,age-standardized DALY rate and net drift in female and male,the change trend of all regions over the past 30 years were consistent with the total population.Although the time trend of NAFLD DALYs among people over 80 years old was gradually rising in the world and five regions grouped according to socio‐demographic index(SDI),only the high SDI region had a more obvious time trend.Globally,the joinpoint regression analysis showed the age-standardized DALY rate appeared a trend of first gradually upward and then downward and then upward and finally downward during 1990-2019.Overall there was a downward trend,with an average APC of -0.58 during 1990 to 2019.Age-period-cohort model showed that unfavourable age effects were found in the world,all regions and countries,while the period and birth cohorts effects in different regions were favorable,but there were also some differences.Conclusions From 1990 to 2019,the global DALYs and all-age DALY rates of NAFLD increased,whereas the age-standardized DALY rate showed an overall decline,with a more pronounced burden among older adults in high-SDI regions.The age-period-cohort analysis revealed unfavorable age effects worldwide,while period and birth cohort effects were generally favorable but varied considerably across regions.
医院管理

基于药品集中带量采购政策下的医院药品供应保障的现状及对策分析

Analysis of the current situation and countermeasures of hospital drug supply guarantee based on the policy of centralized and volume-based procurement

:529-533
 
       目的 分析药品集中带量采购(集采)政策下医院药品供应保障实况,提出优化政策及保障的对策建议。方法 通过提取重庆市渝北区人民医院2023年1月—2024年12月集采药品供应采购数据,描述性统计分析集采药品供应情况。结果 采购的416个中标药品中,69个在购销合同期内短缺,短缺率16.59%。短缺原因与企业生产能力、季节性需求波动相关,季节性强,以慢性病药和抗感染药为主。结论 建议建立监测平台、完善报告制度、制定应急预案、评估供货能力,保障供应。
   Objective To analyzes the current situation of hospital drug supply guarantee under the policy of centralized and volume-based procurement(hereinafter referred to as “central procurement”),and proposes optimization strategies and suggestions for the policy and guarantee.Methods By extracting the procurement data of drugs supplied through centralized procurement at Yubei District People’s Hospital in Chongqing from January 2023 to December 2024,descriptive statistical analysis of the drug supply situation through centralized procurement was conducted.Results Among the 416 selected drugs purchased,69 were in short supply during the contract period,with a shortage rate of 16.59%.The reasons for the shortage were related to the production capacity of the enterprise,seasonal demand fluctuations,strong seasonality,and mainly chronic diseases and anti-infective.Conclusions It is suggested to build a monitoring platform,improve the reporting system,formulate emergency plans,and evaluate the supply capacity to ensure supply.
论著

下背痛对中国人群健康负担的影响趋势分析及预测模型构建

Trend analysis and prediction model construction of the impact of low back pain on the health burden in the Chinese population

:843-856
 
       目的 探究1990—2023年中国人群下背痛(LBP)疾病负担,并预测2024—2040年LBP疾病负担发展趋势,为公共卫生政策制定提供数据支撑。方法 基于GBD2023数据库,采用Joinpoint模型、分解分析(decomposition analysis)量化我国LBP负担变化趋势,最后通过ARIMA(autoregressive integrated moving average model)模型预测未来趋势。结果 2023年我国LBP患病人数达9 532.40万人,发病人数为4 138.36万人,伤残调整生命年(DALYs),虽然患病人数、发病人数及DALYs绝对数较1990年显著增长,但年龄标准化率(ASR)均呈显著下降趋势(AAPC依次为-0.90%、-0.84%、-0.89%)。分解分析表明,人口年龄结构是我国LBP疾病负担增长的主要正向驱动因素,流行病学趋势变化对患病率和DALYs起关键抑制作用,且存在明显性别差异。ARIMA模型预测显示,2024—2040年男性和女性LBP相关ASR将持续下降,但我国女性LBP负担仍高于男性。结论 我国LBP负担沉重,受人口结构、性别差异、行为与职业等多方面因素影响,未来需通过分人群、分职业精准干预及多部门协同,持续降低疾病负担。

     Objective To explore the characteristics of disease burden of low back pain(LBP) in the Chinese population from 1990 to 2023,and predict its development trend from 2024 to 2040,so as to provide data support for the formulation of public health policies.Methods Based on the Global Burden of Disease Study 2023(GBD 2023) database,the Joinpoint model and decomposition analysis were adopted to quantify the changing trend of LBP burden in China.The autoregressive integrated moving average(ARIMA) model was used to predict the future trend,with the data for prediction stratified by gender and age group.Results In 2023,the number of LBP patients in China reached 95.3240 million,the number of incident cases was 41.3836 million,and the disability-adjusted life years(DALYs) were 10.6359 million person-years.Although the absolute numbers of prevalent cases,incident cases,and DALYs increased significantly compared with 1990,the age-standardized rates(ASRs) all showed a significant downward trend(average annual percentage changes were -0.90%,-0.84%,and -0.89%,respectively).Decomposition analysis revealed that population age structure was the primary positive driving factor for the growth of LBP disease burden in China,while changes in epidemiological trends played a key inhibitory role in prevalence and DALYs,with significant gender differences.ARIMA model prediction indicated that the LBP-related ASRs would continue to decrease in both males and females from 2024 to 2040,but the LBP burden in females would remain higher than that in males in China.Conclusions The baseline burden of LBP in China is heavy,affected by multiple factors such as population structure,gender differences,behavioral and occupational factors.In the future,targeted interventions for specific populations and occupations,as well as multi-sectoral collaboration,are needed to continuously reduce the disease burden.
论著

体外诊断试剂临床试验中执行EP09c统计分析的方法探讨

A methodology study on the implementation of EP09c statistical analysis in clinical trials of in vitro diagnostic reagents

:818-828
 
       目的 在体外诊断试剂(IVDR)临床试验中,准确快速地完成EP09c的统计分析工作。方法 利用MedCalc软件对差异图(Difference Plot)执行偏倚量化;利用SPSS或MedCalc软件的回归模型对散点图(Scatter Plot)执行偏倚量化;差异图和散点图被用于确认偏倚量化结果的正确性。结果 MedCalc的差异图确定工作样本的低浓度数据符合恒定标准差分布,偏倚为0.10(0.09,0.28);高浓度数据符合恒定变异系数分布,偏倚为-5.0%(中位数:-7.2%,1.5%)或-3.2%(Hodges-Lehmann中位数:-5.5%,-0.8%)。散点图确认Passing&Bablok回归和加权线性回归(权重1/xi 1.4)适用于工作样本的数据,回归方程分别为y=0.122+0.952xR2=0.983)和y=0.269+0.977xR2=0.981)。结论 偏倚量化结果必须得到差异图和散点图的确认,否则结果的正确性无法保证。

      Objective To perform accurate and efficient statistical analysis of EP09c in clinical studies of in vitro diagnostic reagents(IVDR).Methods Bias quantification was performed on the difference plot using MedCalc.Bias quantification was conducted on the scatter plot using regression modeling in SPSS and MedCalc.The difference plot and scatter plot were employed to corroborate the accuracy of the bias quantification results.Results Difference plots demonstrated that the low-concentration data of the working sample exhibited a constant standard deviation distribution with a bias of 0.10(0.09,0.28),while the high-concentration data conformed to a constant coefficient of variation distribution with a bias of -5.0%(median:-7.2%,1.5%) or -3.2%(Hodges-Lehmann median:-5.5%,-0.8%).Scatter plots confirmed that Passing & Bablok(P-B) regression and weighted least square(WLS) regression(weight 1/xi 1.4) were applicable to the data from the working sample,with the resulting regression equations being y=0.122+0.952xR2=0.983) and y=0.269+0.977xR2=0.981),respectively.Conclusions The results of bias quantification must be confirmed by difference plot and scatter plot,otherwise the correctness of the results cannot be assured.

论著

放血疗法治疗小儿发热的 meta 分析

Efficacy of bloodletting therapy in the treatment of pediatric fever:A meta-analysis

:299-307
 
    目的   探讨放血疗法对小儿发热的疗效。方法   检索包括中国生物医学文献数据库(CBM)、CNKI、万方、维普、PubMed、Embase、Web of Science、Cochrane Library等8个中、英文数据库自建库至2025年5月所发表的放血疗法治疗小儿发热的随机对照试验研究(RCT),2名研究人员根据Cochrane系统评价手册(5.1.0版)推荐的偏倚风险评估表对所纳入文献进行质量评估,采用RevMan 5.4软件对纳入文献质量进行系统分析。结果  纳入19项RCT,共2 224例患儿,其中观察组1 118例、对照组1 106例。放血疗法能够提高小儿发热的临床疗效[OR=4.18,95% CI(3.00,5.38),P<0.001];降低患儿24 h内高热复发率[OR=0.12,95% CI(0.05,0.34),P<0.001];缩短平均退热时间[MD=-1.78,95% CI(-2.56,-1.00),P<0.001]。结论  放血疗法能够提高小儿发热的临床疗效,降低复发率,缩短退热时间,可作为小儿发热的辅助治疗方法。
       Objective  To explore the efficacy of bloodletting therapy treatment on pediatric fever by meta-analysis.Methods  The randomised controlled trials(RCTs)examining bloodletting therapy for paediatric fever were  retrieved from eight Chinese and English databases—China Biomedical Literature Database(CBM),CNKI,Wanfang,VIP,PubMed,Embase,Web of Science,and Cochrane Library—covering publications from the establishment of each database up to May 2025.Two researchers assessed study quality using the risk of bias assessment tool recommended in the Cochrane Handbook for Systematic Reviews(version 5.1.0).RevMan 5.4 software was employed for systematic analysis of included studies.Results  Nineteen RCTs involving 2 224 patients were ultimately included,comprising 1 118 patients in the observation group and 1 106 in the control group.Results indicated that bloodletting therapy significantly improved clinical efficacy in paediatric fever(OR=4.18,95% CI[3.00,5.38],P<0.001),reduced the recurrence rate of high fever within 24 hours(OR=0.12,95% CI[0.05,0.34],P<0.001),and shortened the average time to fever resolution(MD=-1.78,95% CI[-2.56,-1.00],P<0.001).Conclusions  Bloodletting therapy can improve the clinical efficacy of pediatric fever,reduce the recurrence rate and shorten the time of fever reduction,and can be used as an adjunctive treatment for pediatric fever.
医院管理

《医疗保障基金使用监督管理条例》实施情况调查分析——以广东省为例

Investigation and analysis on the implementation of the “Regulation on the Supervision and Administration of the Use of Healthcare Security Funds” :Based on data from Guangdong Province

:248-256
 
       目的 了解《医疗保障基金使用监督管理条例》(以下简称《条例》)在广东省实施的情况,分析其存在的问题与挑战, 提出改进建议。方法 依据《条例》设计调查问卷,采用便利抽样方法 , 针对广东省医保基金相关监管人员和医院工作人员展开问卷调查, 并进一步围绕相关主题展开深度访谈, 以便更全面地了解《条例》的实施情况。结果 回收有效问卷1 473份, 数据分析显示《条例》的实施有效遏制了违规行为、提高了监管效率、落实了信用管理制度、促进了服务规范性与费用合理化, 但同时也存在着部分违规行为仍难以监管、政策培训效果欠佳、技术支撑能力薄弱等问题。结论 在持续推进现有各项监管举措的基础上, 需进一步细化《条例》的具体内容, 加大政策培训与宣传力度, 持续完善技术支撑手段, 以提升基金监管效能。
        Objective To understand the specific implementation of the “Regulation on the Supervision and Administration of the Use of Healthcare Security Funds”(hereinafter referred to as the “Regulations”)in Guangdong Province, analyze its existing problems and challenges, and propose improvement suggestions.Methods A questionnaire was designed based on the “Regulations”, and a convenience survey method was adopted to conduct questionnaire surveys among regulatory personnel related to medical insurance funds and hospital staff.Further in-depth interviews were conducted around relevant themes to gain a more comprehensive understanding of the implementation of the “Regulations.” Results The implementation of the “Regulations” has effectively curbed violations, improved regulatory efficiency, implemented a credit management system, and promoted service standardization and cost rationalization.However, challenges remain,such as difficulties in regulating certain violations, suboptimal policy training outcomes, and weak technical support capabilities.Conclusions On the basis of continuously advancing existing regulatory measures, it is necessary to further refine the specific content of the “Regulations” strengthen policy training and publicity efforts, and continuously improve information technology support methods to better enhance the effectiveness of fund supervision.
论著

重性抑郁障碍患者肠道菌群特征与SSRIs类抗抑郁药疗效的关联分析

Analysis of the association between gut microbiota characteristics and efficacy of SSRIs antidepressants in patients with major depressive disorder

:233-239
 
      目的 探讨重性抑郁障碍(MDD)患者肠道菌群特征与选择性5-羟色胺再摄取抑制剂(SSRIs)疗效的关联性, 筛选可预测SSRIs疗效的肠道菌群生物标志物。方法 选取2024年5月—2025年5月宁夏回族自治区人民医院收治的90例MDD患者, 根据SSRIs治疗8周后疗效分为应答组56例和无应答组34例, 并选择30例健康对照, 采集基线粪便样本进行16S rRNA基因测序, 分析肠道菌群α多样性、菌属相对丰度差异,并通过相关性分析、多因素Logistic回归及ROC曲线评估菌群标志物对SSRIs疗效的预测价值。结果 MDD患者肠道菌群Chao1指数、Shannon指数低于健康对照(P<0.05), 应答组与无应答组α多样性无差异(P>0.05)。应答组基线Blautia、双歧杆菌属、粪球菌属丰度高于无应答组(P<0.05), 大肠杆菌-志贺菌属丰度低于无应答组(P<0.05)。基线Blautia、双歧杆菌属、粪球菌属丰度与SSRIs治疗8周HAMD-17减分率呈正相关(r分别为0.390、0.420、0.350,均P<0.05), 三者联合预测SSRIs疗效的ROC曲线下面积(AUC)为0.910(灵敏度83.9%,特异度85.3%)。结论 MDD患者存在肠道菌群结构异常, 基线Blautia、双歧杆菌属、粪球菌属丰度可作为SSRIs疗效的潜在预测标志物,为MDD个体化治疗提供实验依据。
       Objective To explore the association between gut microbiota characteristics and the efficacy of selective serotonin reuptake inhibitors(SSRIs)in patients with major depressive disorder(MDD), and to screen gut microbiota biomarkers for predicting SSRIs efficacy.Methods A total of 90 MDD patients(divided into responders[n=56] and non-responders[n=34] based on 8-week SSRIs efficacy)and 30 healthy controls were enrolled from May 2024 to May 2025.Fecal samples were collected for 16S rRNA gene sequencing to analyze gut microbiota α diversity and genus-level relative abundance.Correlation analysis, multivariate logistic regression, and receiver operating characteristic curve were used to evaluate the predictive value of microbiota markers for SSRIs efficacy.Results The Chao1 and Shannon indices of gut microbiota in MDD patients were significantly lower than those in healthy controls(P<0.05), with no difference between responders and non-responders(P>0.05).Responders had higher baseline abundances of Blautia,Bifidobacterium, and Coprococcus(P<0.05), and lower abundance of Escherichia-Shigella compared to non-responders.Baseline abundances of Blautia,Bifidobacterium(P<0.05), and Coprococcus were positively correlated with 8-week HAMD-17 reduction rate(r=0.390, 0.420, 0.350; all P<0.05).The combined prediction of these three genera for SSRIs efficacy showed an area under the curve of 0.910(sensitivity 83.9%, specificity 85.3%).Conclusions MDD patients exhibit abnormal gut microbiota structure.Baseline abundances of Blautia,Bifidobacterium, and Coprococcus may serve as potential predictive biomarkers for SSRIs efficacy, providing experimental basis for personalized treatment of MDD.
论著

LAMP3 基因表达与肾癌之间的因果关系:一项基于孟德尔随机化分析的研究

Causal relationship between LAMP3 gene expression and renal cancer:A Mendelian randomization analysis

:88-94
 
       目的   探讨溶酶体相关膜蛋白3(LAMP3)与肾癌发病风险之间的因果关系,为肾癌的分子致病机制提供新的理论依据。方法   基于全基因组关联研究(GWAS)数据,采用孟德尔随机化分析方法,评估LAMP3基因表达与肾癌的因果关系。并通过GEPIA2分析LAMP3表达对肾癌总体生存期(OS)及无病生存期(DFS)的关系。结果  LAMP3基因变异与肾癌风险呈正相关,提示LAMP3的表达可能增加肾癌的发病风险。此外,GEPIA2分析进一步显示,LAMP3的高表达与肾癌患者的低总体生存期(OS)及无病生存期(DFS)显著相关。结论   本研究通过孟德尔随机化分析探讨了LAMP3基因表达与肾癌的因果关系,结果表明LAMP3可能是肾癌的潜在致病因子,并与肾癌预后相关。这为肾癌的分子致病机制研究提供了重要的理论依据,并为未来的生物标志物和靶向治疗策略的开发提供了新的思路。
        Objective  To investigate the causal  relationship  between LAMP3 expression and  renal cancer  risk  using Mendelian randomization analysis,providing a theoretical basis for understanding the molecular mechanisms underlying renal cancer.Methods  This study utilized data from genome-wide association studies(GWAS)and employed Mendelian randomization analysis to assess the causal relationship between LAMP3 gene expression and renal cancer.Additionally,GEPIA2 was used to examine the association between LAMP3 expression and overall survival(OS)and disease-free survival(DFS)in renal cancer patients.Results  Variants in the LAMP3 gene were positively correlated with renal cancer risk,suggesting that LAMP3 expression may increase the likelihood of developing renal cancer.Furthermore,GEPIA2 analysis  revealed that high expression of LAMP3 was significantly associated with lower OS and DFS in renal cancer patients.Conclusions  This study explored the causal  relationship between LAMP3 gene expression and renal cancer through Mendelian randomization analysis.The results indicate that LAMP3 may be a potential pathogenic factor in renal cancer and is associated with poor prognosis.These findings provide important theoretical insights into the molecular mechanisms of  renal cancer and offer new perspectives for the development of biomarkers and targeted therapeutic strategies in the future.
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