目的:肿瘤微环境(TME)在各种癌症的发生发展中起着关键作用,本研究旨在探讨肺腺癌(LUAD)中TME相关基因的作用。方法:研究数据来源于TCGA及GEO数据库。首先提取出TME相关的差异表达基因(DEGs),然后采用非负矩阵分解(NMF)聚类方法识别不同亚型。通过单因素Cox回归分析和Lasso回归分析筛选具有预后意义的基因,构建预后模型。最后,采用受试者工作特征曲线(ROC)和决策曲线分析(DCA)对模型进行验证。结果:高危组患者的生存时间明显更短。单因素和多因素Cox回归分析证实,风险评分是影响LUAD患者预后的独立危险因素。模型的预测稳定性不受年龄及性别的影响,且能反映TME相关免疫特征。结论:我们构建的包含5个TME相关基因的预后模型的预测性能较为稳定、准确,未来可能为肺癌的个体化治疗提供新的方向和依据。Objective: Tumor microenvironment (TME) plays a key role in the occurrence and development of various cancers. This study aims to investigate the role of TME-related genes in LUAD (lung adenocarcinoma). Methods: The study data were obtained from the TCGA and GEO databases. DEGs (differentially expressed genes) related to TME were first extracted. Then, NMF (nonnegative matrix factorization) clustering was applied to identify different subtypes. Univariate Cox regression analysis and Lasso regression analysis were performed to screen genes with prognostic significance to construct the prognostic characteristics. Finally, ROC (receiver operating characteristic) curve and DCA (decision curve analysis) were used to verify the MODEL. Results: Patients in the high-risk group had a significantly shorter survival time. Univariate analysis and multivariate Cox regression analysis confirmed that the risk score was an independent risk factor for the outcome of LUAD patients. The prediction stability of the model was not affected by age and sex and could reflect TME-related immune characteristics. Conclusion: We constructed a prognostic model containing five TME-related genes, and the prediction performance of the model was relatively stable and accurate, which might provide a new direction and basis for the individualized treatment of lung cancer in the future.
目的:本研究旨在通过孟德尔随机化(Mendelian Randomization, MR)分析探讨肠道微生物群与哮喘之间的因果关系。方法:从MiBioGen数据库下载人类肠道微生物群数据集,包含18,340名参与者的遗传数据,保留196个细菌类群作为暴露因素。结局变量数据来自IEU OpenGWAS数据库,包含39,049例哮喘患者和298,110例对照。采用逆方差加权(Inverse Variance Weighted, IVW)、MR-Egger、简单模式(Simple Mode, SM)、加权中位数(Weighted Median, WM)和加权模式(Weighted Mode, WME)方法进行孟德尔随机化分析,其中IVW法作为主要分析方法。敏感性分析用于验证结果的可靠性。结果:IVW分析结果显示,Candidatus Soleaferrea属(OR = 1.009, 95% CI: 1.003~1.015, P = 0.002)、克里斯滕森菌科R-7群(OR = 1.019, 95% CI: 1.009~1.029, P Objective: The aim of this study is to explore the causal relationship between intestinal microbiota and asthma through Mendelian Randomization (MR) analysis. Method: The human gut microbiota dataset, encompassing genetic data from 18,340 participants and including 196 bacterial taxa as exposure factors, was downloaded from the MiBioGen database. Outcome variable data were sourced from the IEU OpenGWAS database, comprising 39,049 asthma patients and 298,110 controls. Mendelian Randomization (MR) analysis was conducted using the Inverse Variance Weighted (IVW), MR-Egger, Simple Mode (SM), Weighted Median (WM), and Weighted Mode (WME) methods, with IVW serving as the primary analytical approach. Sensitivity analyses were performed to validate the reliability of the results. Results: The IVW analysis revealed that the genera Candidatus Soleaferrea (OR = 1.009, 95% CI: 1.003~1.015, P = 0.002), Christensenellaceae R-7 group (OR = 1.019, 95% CI: 1.009~1.029, P < 0.001), Akkermansia (OR = 1.008, 95% CI: 1.000~1.016, P = 0.049), and Lachnospira (OR = 1.027, 95% CI: 1.015~1.038, P < 0.001) were associated with an increased risk of asthma. In contrast, Clostridium sensu stricto 1 (OR = 0.992, 95% CI: 0.984~1.000, P = 0.045) and Bifidobacterium (OR = 0.989, 95% CI: 0.982~0.995, P < 0.001) were associated with a decreased risk of asthma. Sensitivity analysis did not identify any outlier SNPs. Conclusion: This study identified causal relationships between six gut microbiota and asthma. Specifically, the genera Cand
随着屈光手术技术的发展,患者对术后视觉质量的关注已逐渐超越单纯的裸眼视力提升。波前像差引导的LASIK技术通过个性化切削设计和精确的波前测量,显著减少术后高阶像差(HOAs)的发生,优化了术后视觉效果,成为近年来屈光手术领域的研究热点。然而,术后视觉质量仍可能受到高阶像差的负面影响,表现为眩光、光晕、夜间视力下降以及对比敏感度降低等问题,这些仍是影响患者满意度和术后效果的核心难题。本文系统综述了波前像差引导的LASIK手术在减少术后高阶像差和优化视觉质量方面的优势,详细探讨了术后高阶像差的变化规律及其对视觉质量的多维影响,分析了相关影响因素及技术局限性。结合现有研究成果,本文展望了波前像差技术未来在设备改进、个性化设计及术后管理等方面的发展方向,以期为进一步提升手术设计和患者满意度提供科学依据。With the advancement of refractive surgical techniques, patients’ focus on postoperative visual quality has gradually shifted from mere improvement in unaided visual acuity to a more comprehensive assessment. Wavefront-guided LASIK technology, through personalized ablation designs and precise wavefront measurements, significantly reduces the occurrence of postoperative higher-order aberrations (HOAs), thereby optimizing postoperative visual outcomes. This approach has become a research hotspot in the field of refractive surgery in recent years. However, postoperative visual quality may still be negatively affected by higher-order aberrations, manifested as glare, halos, reduced night vision, and decreased contrast sensitivity. These issues remain core challenges affecting patient satisfaction and surgical outcomes. This review systematically summarizes the advantages of wavefront-guided LASIK surgery in reducing postoperative higher-order aberrations and optimizing visual quality. It also discusses in detail the patterns of changes in higher-order aberrations and their multidimensional impact on visual quality, analyzing relevant influencing factors and technical limitations. In light of existing research, the article also anticipates future developments of wavefront aberration technology in areas such as equipment improvements, personalized design, and postoperative management, aiming to provide scientific evidence for further enhancing surgical design and patient satisfaction.
伴随社会老龄化进一步加重,年龄相关性白内障已经成为全球关注的公共卫生问题,通过手术方式实现人工晶状体置换是解决白内障的重要手段。随着科技的进步,白内障手术已从复明性手术转变为屈光性手术,追求尽可能地改善患者术后的视觉质量及视觉效果,准确计算人工晶状体屈光度是手术的关键,根据患者期望的近视力水平选择合适人工晶状体更能提高术后满意度。本文通过查阅国内外相关文献,对于影响多焦点人工晶状体选择的因素作一综述。With the further aging of society, age-related cataract has become a public health problem of global concern, and the surgical realization of IOL replacement is an important means to solve cataracts. With the advancement of science and technology, cataract surgery has been transformed from restorative surgery to refractive surgery, aiming to improve patients’ postoperative visual quality and visual outcome as much as possible. Accurate calculation of IOL refraction is the key to surgery, and selecting the appropriate IOL according to the patient’s desired level of near visual acuity is more likely to improve postoperative satisfaction. In this article, we review the factors that influence the selection of multifocal IOLs by reviewing the relevant national and international literature.
心血管疾病(cardiovascular disease, CVD)与糖尿病以及慢性肾脏病(chronic kidney disease, CKD)均是最常见的疾病。已有的流行病学研究与临床研究均有证据支持三者之间相互关联,并且定义了心脏–代谢–肾脏疾病CMR (cardio-metabolic-renal disease)这一概念。三者之间相互联系,相互影响,具有显著的流行病学、病理生理学和预后意义。既往研究发现高糖状态可以诱发心肾系统损害,然而三者之间如何影响以及影响的具体程度仍然存在争议,因此本综述主要概括了糖尿病,分别陈述了包括1型糖尿病、2型糖尿病与心血管之间的相互关联,并讨论了涉及肾脏病的部分。Cardiovascular disease (CVD), diabetes and chronic kidney disease (CKD) are the most common diseases. The existing epidemiological research and clinical research all have evidence to support the correlation among them, and have defined the concept of CMR (cardiac-metabolic-renal disease). The three are interconnected and influence each other, holding significant epidemiological, pathophysiological, and prognostic implications. In previous studies, high glucose can induce damage to the heart and kidney system. However, how and to what extent it affects the heart and kidney system is still controversial. Therefore, this review mainly summarizes diabetes, respectively states the correlation between type 1 diabetes, type 2 diabetes and the cardiovascular system, and discusses the part involving kidney disease.
妊娠期生理性胰岛素抵抗(IR)是维持胎儿营养供给的重要适应性改变,然而病理性IR已成为影响母婴健康的关键病理基础。近年研究表明,IR不仅与复发性流产、妊娠期糖尿病(GDM)、妊娠期高血压疾病(HDP)等常见产科并发症密切相关,更会通过表观遗传机制对子代远期代谢功能产生跨代影响。本文系统阐述IR导致妊娠并发症的分子机制,重点解析IR通过影响卵母细胞质量、子宫内膜容受性、血管内皮功能等途径引发不良妊娠结局的作用通路,并对当前干预策略的临床证据进行循证评价。Physiological Insulin Resistance (IR) during pregnancy is an important adaptive change to maintain fetal nutrition supply. However, pathological IR has become a key pathological basis affecting the health of both the mother and the fetus. Recent studies have shown that IR is not only closely related to common obstetric complications such as recurrent miscarriage, Gestational Diabetes Mellitus (GDM), and Hypertensive Disorders of Pregnancy (HDP), but also has a trans-generational impact on the long-term metabolic function of offspring through epigenetic mechanisms. This article systematically expounds on the molecular mechanisms by which IR leads to pregnancy complications, focuses on analyzing the pathways through which IR causes adverse pregnancy outcomes by affecting oocyte quality, endometrial receptivity, vascular endothelial function, etc., and conducts an evidence-based evaluation of the clinical evidence of current intervention strategies.
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