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．

目的 探讨便携式超声仪超声重点评估（e-FAST）技术在批量伤员军地联合院前救治中的应用效果。方法 抽取2021年5月—2023年10月中国人民解放军联勤保障部队第九八八医院中心急诊科收治的80例批量伤员,均开展军地联合院前救治,按照治疗方案不同分为观察组和对照组,每组患者40例,其中对照组在救治现场行基于创伤严重程度（CRAMS）评分,进行常规急救处置,救护车返院后行CT检查并进行相应伤情治疗,观察组救治现场行CRAMS评分,进行常规急救处置,院前接诊医师在现场或救护车上使用便携式超声仪按照e-FAST流程检查相应部位,初步诊断后进行相应伤情治疗,对比两组患者治疗效果,两组患者诊断时间、初次医疗接触—进入手术室时间及入院诊断与出院时确定性诊断的符合率、两组患者治疗前后CRAMS评分及CRAMS≤8分抢救成功率。结果 观察组治疗有效率为95.0%,对照组为85.0%,对比差异无统计学意义（χ²=2.222,P=0.136）;观察组患者的诊断时间（13.56±2.36）min、初次医疗接触—进入手术室时间（30.42±8.99）min均短于对照组[（23.64±5.69）、（52.27±12.60）min],差异有统计学意义（t=10.349、8.928,P<0.05）;观察组患者入院诊断与出院时确定性诊断的符合为97.5%,对照组患者入院诊断与出院时确定性诊断的符合为95.0%,差异无统计学意义（χ²=0.346,P=0.556）;治疗后两组患者的CRAMS评分均升高,且观察组（9.87±2.62）分高于对照组（8.60±2.98）分,差异有统计学意义（t=2.024,P=0.046）;观察组患者CRAMS≤8分的抢救成功率为97.50%,对照组CRAMS≤8抢救成功率为85.00%,观察组患者CRAMS≤8分的抢救成功率高于对照组（χ²=3.914,P=0.048）。结论 本研究从军地联合救治批量伤员切入,瞄准部队医院军民融合战略发展路线,本文针对便携式超声仪e-FAST应用范围前移,明显地提高急救人员院前救治能力,提高抢救成功率,值得临床参考。

Objective To explore the application effect of portable ultrasound e-FAST technology in the pre hospital treatment of batch wounded soldiers in military civilian joint hospitals．Methods Eighty batch wounded patients admitted to the emergency department of 988 Hospital from May 2021 to October 2023 were selected,all of whom underwent military civilian joint pre hospital treatment．They were divided into an observation group and a control group according to different treatment plans,with 40 patients in each group．The control group received CRAMS scores at the treatment site for routine first aid treatment,CT scans after ambulance return to the hospital for corresponding injury treatment,the observation group received CRAMS scores at the treatment site for routine first aid treatment,and the pre-hospital attending physician used a portable ultrasound instrument to examine the corresponding parts on site or in the ambulance according to the e-FAST process．After preliminary diagnosis,corresponding injury treatment was carried out．The treatment effects of the two groups of patients were compared,and the diagnosis time and initial diagnosis of the two groups of patients were compared．The time from medical contact to entering the operation room,the compliance rate of discharge and admission diagnoses,the CRAMS score before and after treatment,and the success rate of rescue with CRAMS ≤ 8 for both groups of patients were compared．Results The effective rate of treatment in the observation group was 95.0%,while in the control group it was 85.0%,which difference was not statistically significant（χ²=2.222,P=0.136）．The time to diagnosis（13.56±2.36）min,time to the operating room（30.42±8.99）min were shorter than that in the control group[（23.64±5.69）,（52.27±12.60）min],with significant difference（t=10.349,8.928,P<0.05）．The consistency between the admission diagnosis and the definitive diagnosis at discharge of the observation group patients was 97.5%,while the consistency of the control group patients was 95.0%．There was no significant difference between the groups（χ²=0.346,P=0.556）．After treatment,the CRAMS scores of both groups of patients increased,the observation group（9.87±2.62）was higher than that of the control group（8.60±2.98）（t=2.024,P=0.046）．The success rate of CRAMS ≤ 8 rescue in the observation group was 97.50%,while the success rate in the control group was 85.00%．The success rate of CRAMS ≤ 8 rescue in the observation group was higher than that in the control group（χ²=3.914,P=0.048）．Conclusions This study focuses on the joint treatment of batch wounded soldiers by military and civilian forces,aiming at the development path of military civilian integration strategy in military hospitals．The application scope of portable ultrasound e-FAST has been moved forward,which significantly improves the pre hospital treatment ability of emergency personnel and improves the success rate of rescue．It is worth clinical reference．

目的 通过研究微泡超声空化增强微波消融对兔VX2肿瘤的热消融效应来探究其在肿瘤治疗中的价值。方法 24只肝脏移植瘤兔随机分为空白对照组、单纯超声空化治疗组、单纯微波消融治疗组、超声空化联合微波消融治疗组4组。利用增强超声显示每组治疗前后肿瘤的大小、形状和轮廓并通过温度针来检测治疗区域的局部温度。结果 联合治疗组血流灌注缺损最严重,微波消融组和联合治疗组缺损体积分别为1.53±0.20和1.68±0.43(P=0.117);微波消融组以及联合治疗组消融治疗时温度达平台时间分别为(21.7±5.0)s和(10.3±5.0)s(P<0.01),最高温度(℃)分别为100.9±5.0和134.1±6.0(P<0.01)。结论 MWA联合MEUS治疗肝癌可使治疗区局部温度急剧升高至峰值温度,有望提高肝癌治疗效果。

Objective To investigate the thermal ablation effect of microbubble ultrasound cavitation combined with microwave ablation on rabbit VX2 tumors. Methods Twenty-four rabbits with liver transplantation tumors were randomly divided into four groups: blank control group, ultrasound-only cavitation treatment group, microwave-only ablation treatment group, and ultrasound-cavitation combined with microwave ablation treatment group. Enhanced ultrasound was used to show the size, shape and contour of the tumor before and after treatment in each group, and the local temperature of the treatment area was detected by a temperature needle. Results The blood flow perfusion defect was the most severe in the combined treatment group. The defect volume of the microwave ablation group and the combined treatment group were 1.53±0.20 and 1.68±0.43 (P=0.117). The temperature reached the plateau time in the microwave ablation group and the combined treatment group. It was (21.7±5.0)s and (10.3±5.0)s (P<0.01), and the highest temperature (℃) was 100.9±5.0 and 134.1±6.0 (P<0.01). Conclusion MWA combined with MEUS for liver cancer can sharply increase the local temperature in the treatment area to the peak temperature, which is expected to improve the treatment effect of liver cancer.

目的 本研究旨在探讨压迫止血法在减少实时超声引导经皮肾穿刺术后并发症中的价值。方法 选取2011年9月1日—2016年12月31日于我院行超声引导下经皮肾穿刺术患者405例。按肾穿刺后是否行立即行压迫止血法分2组,非压迫止血法为对照组(A组),压迫止血法为研究组(B组)。记录患者术前血压、凝血四项、血红蛋白、血小板等指标。记录穿刺次数及每次穿刺所取标本长度。术后24 h复查穿刺点出血情况及肾周血肿情况。穿刺术后24 h内监测血尿情况。结果 与非采用压迫止血法超声定位经皮肾穿刺术后(A组)相比,压迫止血法术后(B组)并发症发生率较低, A组肉眼血尿发生率为8.8 %,B组为4 %,差异有统计学意义(P=0.048);A组24 h肾周血肿发生率为 62.1%,B组为49.8%,差异有统计学意义(P=0.042)。结论 实时超声引导下经皮肾穿刺后立即行压迫止血法,可有效减少术后肾周血肿和血尿。

Objective To discuss how to reduce the post-biopsy complications of real-time ultrasound-guided percutaneous renal biopsy by manual compression. Methods A total of 405 ultrasound-guided biopsies were performed in 404 patients in our hospital, between September 2011 and January 2017, were recruited to this study. They were divided into 2 groups, group A biopsy without manual compression, and group B biopsy with manual compression. All patients' records were retrospectively reviewed and both pre and post biopsy information, as well as complications were collected. Results The gross hematuria rate is 8.8 % (16 patients) in group A, but in group B, the rate is 4 %. The perirenal hematoma rate at 24 h after biopsy in group A detected by ultrasound is 62.1% (113 patients), and 49.8% (116 patients, P vs group A=0.042) in group B. Conclusion Manual compression to the puncture site reduced complications like perirenal hematoma and gross hematuria after real-time ultrasound-guided renal biopsy.

       目的   探讨、对比休克指数（SI）与血乳酸水平预测院前创伤性休克患者预后中的应用。方法   于2020年12月—2023年12月收治80例创伤性休克患者，均接受SI、乳酸水平的监测。结合监测的结果进行分组：乳酸正常组：乳酸水平在2 mmol/L以下，升高组：2 mmol/L以上；SI正常组：SI在0.9以下，升高组：SI在0.9以上。观察、记录患者入院7 d后的序贯性器官功能衰竭评分（SOFA），对多器官功能障碍综合征（MODS）情况进行评估。同时观察、记录机械通气、血管活性药物的使用和住院等情况。结果   乳酸水平升高组60例，正常组20组；SI升高组58例，正常组22例，女性乳酸水平、SI，与男性比较差异无统计学意义（P＞0.05）。是否发生多器官功能障碍者的年龄、性别、SI指数比较差异无统计学意义（P＞0.05）；格拉斯哥昏迷评分（GCS）评分［（4.22±1.53）分 vs （9.46±3.82）分，t=7.816，P＜0.001］、住院时间［（23.34±5.71）d vs （12.26±2.11）d，t=11.830，P＜0.001］、基础乳酸值［（4.75±2.36）mmol/L vs （2.04±1.11）mmol/L，t=6.721，P＜0.001］与发生MODS在组间对比差异有统计学意义。SI升高组的容量复苏收缩压＞80 mmHg（%）有27例，与乳酸水平升高组比较差异有统计学意义（P＜0.05）（46.55% vs 18.18%，χ ² =12.237，P＜0.001）。乳酸水平升高组中，11例患者接受机械通气，乳酸水平均升高（P＜0.05）；9例患者使用血管活性药物，乳酸水平均升高，比较差异无统计学意义（P＞0.05）；38例住院患者，24例乳酸水平升高（P＜0.05）。13例患者接受机械通气，12例SI升高，比较差异无统计学意义（P＞0.05）；11例患者接受血管活性物治疗，8例SI升高，比较差异无统计学意义（P＞0.05）；39例患者住院，SI升高22例，比较差异有统计学意义（P＜0.05）。结论   针对重症的创伤性休克患者，当血乳酸水平升高时会大大增加MODS发生的概率，乳酸水平在对重症创伤性休克患者预后进行预测时，应用价值更高。

       Objective  To explore and compare the application of shock index（SI）and  blood lactic acid level in predicting the prognosis of patients with pre-hospital traumatic shock．Methods  From December 2020 to December 2023，80 patients with traumatic shock were enrolled，and their SI and levels of lactic acid were monitored．Patients were grouped according to the monitoring results：normal group：lactic acid level below 2 mmol/L，increased group：above 2 mmol/L；normal group：SI below 0.9，and increased group：SI above 0.9．The sequential organ failure score（SOFA）was observed and recorded 7 days after hospitalization，and the situation of multiple organ dysfunction syndrome（MODS）was evaluated．At the same time，mechanical ventilation，the use of vasoactive substances and hospitalization were observed and recorded．Results  There were 60 cases in the group with increased lactic acid level and 20 cases in the normal group．There were 58 cases of increased SI and 22 cases of normal．The lactic acid level and SI index in women were higher than those in men，with no difference（P＞0.05）．There were no differences in age，sex，SI index and the incidence of MODS（P＞0.05）．GCS score（4.22±1.53 vs 9.46±3.82），hospitalization days（23.34±5.71 vs 12.26±2.11）d，basal lactate value（4.75±2.36 vs 2.04±1.11）mmol L-1 were significantly different from those of MODS（t=11.830，P＜0.001；t=6.721，P＜0.001，P＜0.05）．There were 27 cases with volume  resuscitation systolic blood pressure ＞ 80 mmhg（%）in the group with increased SI，which was different from that of SI and lactic acid（46.55% vs18.18%，χ ² =12.237，P＜0.001；P＜0.05）．Lactic acid increased group：11 patients received mechanical ventilation，and the lactic acid levels of all 11 patients increased（P＜0.05）．Nine patients used vasoactive substances，and their lactic acid levels all increased，with no significant difference（P＞0.05）．Of the 38 inpatients，24 cases had elevated lactic acid levels（P＜0.05）．Thirteen patients received mechanical ventilation，and 12 patients had elevated SI，with no statistical significance（P＞0.05）．Eleven patients were treated with vasoactive agents，and 8 patients had increased SI，with no difference（P＞0.05）．Among the 39 patients hospitalized，22 cases had increased SI，and the difference was statistically significant（P＜0.05）．Conclusions  For patients with severe traumatic shock，when the blood lactic acid level increases，the probability of MODS will be greatly increased．Compared with SI index，lactic acid level has higher application value in predicting the prognosis of patients with severe traumatic shock．

          目的   探讨便携式超声仪超声重点评估（e-FAST）技术在批量伤员军地联合院前救治中的应用效果。方法    抽取2021年5月—2023年10月中国人民解放军联勤保障部队第九八八医院中心急诊科收治的80例批量伤员，均开展军地联合院前救治，按照治疗方案不同分为观察组和对照组，每组患者40例，其中对照组在救治现场行基于创伤严重程度（CRAMS）评分，进行常规急救处置，救护车返院后行CT检查并进行相应伤情治疗，观察组救治现场行CRAMS评分，进行常规急救处置，院前接诊医师在现场或救护车上使用便携式超声仪按照e-FAST流程检查相应部位，初步诊断后进行相应伤情治疗，对比两组患者治疗效果，两组患者诊断时间、初次医疗接触—进入手术室时间及入院诊断与出院时确定性诊断的符合率、两组患者治疗前后CRAMS评分及CRAMS≤8分抢救成功率。结果   观察组治疗有效率为95.0%，对照组为85.0%，对比差异无统计学意义（χ ² =2.222，P=0.136）；观察组患者的诊断时间（13.56±2.36）min、初次医疗接触—进入手术室时间（30.42±8.99）min均短于对照组［（23.64±5.69）、（52.27±12.60）min］，差异有统计学意义（t=10.349、8.928，P＜0.05）；观察组患者入院诊断与出院时确定性诊断的符合为97.5%，对照组患者入院诊断与出院时确定性诊断的符合为95.0%，差异无统计学意义（χ ² =0.346，P=0.556）；治疗后两组患者的CRAMS评分均升高，且观察组（9.87±2.62）分高于对照组（8.60±2.98）分，差异有统计学意义（t=2.024，P=0.046）；观察组患者CRAMS≤8分的抢救成功率为97.50%，对照组CRAMS≤8抢救成功率为85.00%，观察组患者CRAMS≤8分的抢救成功率高于对照组（χ ² =3.914，P=0.048）。结论    本研究从军地联合救治批量伤员切入，瞄准部队医院军民融合战略发展路线，本文针对便携式超声仪e-FAST应用范围前移，明显地提高急救人员院前救治能力，提高抢救成功率，值得临床参考。

       Objective  To explore the application effect of portable ultrasound e-FAST technology in the pre hospital treatment of batch wounded soldiers in military civilian joint hospitals．Methods  Eighty batch wounded patients admitted to the emergency department of 988 Hospital from May 2021 to October 2023 were selected，all of whom underwent military civilian joint pre hospital treatment．They were divided into an observation group and a control group according to different treatment plans，with 40 patients in each group．The control group received CRAMS scores at the treatment site for routine first aid treatment，CT scans after ambulance return to the hospital for corresponding injury treatment，the observation group  received CRAMS scores at the treatment site for routine first aid treatment，and the pre-hospital attending physician used a portable ultrasound instrument to examine the corresponding parts on site or in the ambulance according to the e-FAST process．After preliminary diagnosis，corresponding injury treatment was carried out．The treatment effects of the two groups of patients were compared，and the diagnosis time and initial diagnosis of the two groups of patients were compared．The time from medical contact to entering the operation room，the compliance rate of discharge and admission diagnoses，the CRAMS score before and after treatment，and the success rate of rescue with CRAMS ≤ 8 for both groups of patients were compared．Results  The effective rate of treatment in the observation group was 95.0%，while in the control group it was 85.0%，which difference was not statistically significant（χ ² =2.222，P=0.136）．The time to diagnosis（13.56±2.36）min，time to the operating room（30.42±8.99）min were shorter than that in the control group［（23.64±5.69），（52.27±12.60）min］，with significant difference（t=10.349，8.928，P＜0.05）．The consistency  between the admission diagnosis and the definitive diagnosis at discharge of the observation group patients was 97.5%，while the consistency of the control group patients was 95.0%．There was no significant difference between the groups（χ ² =0.346，P=0.556）．After treatment，the CRAMS scores of both groups of patients increased，the observation group（9.87±2.62）was higher than that of the control group（8.60±2.98）（t=2.024，P=0.046）．The success rate of CRAMS ≤ 8 rescue in the observation group was 97.50%，while the success rate in the control group was 85.00%．The success rate of CRAMS ≤ 8 rescue in the observation group was higher than that in the control group（χ ² =3.914，P=0.048）．Conclusions  This study focuses on the joint treatment of batch wounded soldiers by military and civilian forces，aiming at the development path of military civilian integration strategy in military hospitals．The application scope of portable ultrasound e-FAST has been moved forward，which significantly improves the pre hospital treatment ability of emergency personnel and improves the success rate of rescue．It is worth clinical reference．