目的:观察真实世界中21 d维奈克拉(VEN)联合阿扎胞苷(AZA)(21 d VA)方案治疗初诊unfit急性髓系白血病(AML)患者的疗效及安全性。方法:回顾性收集川北医学院附属医院血液内科2020年12月至2024年7月使用21 d VA方案化疗并至少完成1疗程疗...目的:观察真实世界中21 d维奈克拉(VEN)联合阿扎胞苷(AZA)(21 d VA)方案治疗初诊unfit急性髓系白血病(AML)患者的疗效及安全性。方法:回顾性收集川北医学院附属医院血液内科2020年12月至2024年7月使用21 d VA方案化疗并至少完成1疗程疗效评估的初诊unfit-AML患者的临床资料,分析真实世界中21 d VA方案的疗效及其影响因素,并评估安全性。结果:共纳入59例患者,中位年龄为67(48-87)岁。1疗程后复合完全缓解(cCR)率为74.5%,54.2%的患者微小残留病灶(MRD)转阴,其中伴NPM1突变的患者MRD阴性率较高(P=0.032)。中位随访19(2-38)个月,最佳cCR率和MRD转阴率分别为78%和64.4%,中位总生存期(OS)为12个月,中位无进展生存期(PFS)为5个月。多因素Cox回归分析显示,疗程数<4是影响PFS和OS的独立危险因素(P<0.05)。疾病缓解后,随着疗程数的增加,贫血和血小板减少好转。结论:真实世界中,21天VA方案治疗初诊unfit-AML仍有较高的有效性,且并不影响第1疗程的缓解率及MRD转阴率,尤其是伴NPM1突变的患者。展开更多
研究背景:子宫内膜异位症(EMs)是一种雌激素依赖性的慢性炎症性疾病,影响约10%的育龄期女性。EMs症状的复杂性和不典型性严重影响患者的生理和心理健康并对社会经济造成沉重的负担。然而EMs的发病机制和有效的干预措施目前尚不完全清楚...研究背景:子宫内膜异位症(EMs)是一种雌激素依赖性的慢性炎症性疾病,影响约10%的育龄期女性。EMs症状的复杂性和不典型性严重影响患者的生理和心理健康并对社会经济造成沉重的负担。然而EMs的发病机制和有效的干预措施目前尚不完全清楚。饮食作为重要干预措施在多种慢性疾病中发挥作用,然而,关于饮食在EMs中的作用相关研究较少且多为观察性研究。孟德尔随机化(MR)利用遗传变异作为工具变量可以弥补传统观察性研究的不足,因而被广泛应用于探索可改变的暴露与疾病之间的因果关系。研究方法:本研究利用双向双样本MR分析方法探究饮食与EMs之间的因果关系。分别从IEU数据库和芬兰基因联盟中获取与饮食和EMs有关的全基因组关联研究(GWAS)数据。将基因位点显著性阈值设定为P −6,并通过去除连锁不平衡(LD)及剔除与结局相关的混杂SNP等方法严格筛选出代表暴露的工具变量(IV)后进行MR分析。进一步地,利用中介MR分析探究二者之间潜在的中介因素,探究了血脂在饮食和EMs中的中介效应。为了评估研究结果的稳定性,还进行了多种敏感性分析。研究结果:本研究主要基于IVW方法,有力地证明了干果和油性鱼类的摄入与EMs之间存在因果关系,以及TG在饮食和EMs之间的中介作用。具体而言,在所有饮食因素中,干果摄入(OR = 0.72, 95% CI: 0.56~0.93, P = 0.01)和油性鱼类摄入(OR = 0.80, 95% CI: 0.66~0.97, P = 0.02)与EMs发生风险降低有关。血脂水平与EMs之间的因果关系发现TG是EMs发生的危险因素(OR = 1.15, 95% CI: 1.07-1.23, P Background: Endometriosis (EMs) is an estrogen-dependent chronic inflammatory disease with a high prevalence, affecting approximately 10% of women of reproductive age. The complexity and atypical nature of EMs symptoms severely impact patients’ physical and mental health and impose a significant socioeconomic burden. However, the pathogenesis and effective interventions for EMs remain incompletely understood. Diet, as an important intervention, plays a role in various chronic diseases. Nevertheless, research on the role of diet in EMs is limited and predominantly observational. Mendelian randomization (MR), which uses genetic variants as instrumental variables, can address the limitations of traditional observational studies and is widely used to explore causal relationships between modifiable exposures and diseases. Methods: This study employed a bidirectional two-sample Mendelian randomization (MR) approach to investigate the causal relationship between diet and EMs. Genome-wide association study (GWAS) data related to diet and EMs were obtained from the IEU database and the Finnish Gene Consortium, respectively. Genetic loci with a significance threshold of P −6 were selected, and instrumental variables (IVs) representing exposures were rigorously screened by removing linkage disequilibrium (LD) and excluding SNPs associated with confounding factors. Furthermore, mediation MR analysis was conducted to explore potential mediating factors between diet and EMs, specifically focusing on blood lipids. Finally, various sensitivity analyses were performed to evaluate the robustness of the findings. Results: Based primarily on the IVW method, this study provided strong evidence for a causal relationship between the intake of dried fruits and oily fish and EMs, as well as the mediating role of triglycerides (TG) in the relationship between diet and EMs. Specifically, among all dietary factors, the intake of dried fruits (OR = 0.72, 95% CI: 0.56~0.93, P = 0.01) and oily fish (OR = 0.80, 95% CI: 0.66~0.97, P = 0.02) was associated with a reduced risk of endometriosis. Subsequently, we explored the causal relationship between blood lipid levels and EMs and found that TG is a risk factor for EMs (OR = 1.15, 95% CI: 1.07~1.23, P < 0.01). Further analysis revealed that both dried fruit (OR = 0.81, 95% CI: 0.75~0.88, P < 0.01) and oily fish intake (OR = 0.86, 95% CI: 0.81~0.91, P < 0.01) could reduce TG levels. Mediation MR analysis showed that TG mediated the protective effects of dried fruits and oily fish on EMs, with mediation proportions of 9% (P = 0.001) and 10% (P = 0.002), respectively. Conclusions: This study, using MR analysis, found that the intake of dried fruits and oily fish is associated with a reduced risk of EMs. Blood lipid levels, particularly TG, are associated with an increased risk of endometriosis. The protective effects of dried fruits and oily fish on EMs are partially mediated by reducing TG levels.展开更多
目的:分析近6年多囊卵巢综合征随机对照研究特点,为临床应用和未来研究提供参考。方法:检索2019~2024年发表在Web of Science的多囊卵巢综合征随机对照研究,对文献基本要素开展计量学分析。结果:共纳入204篇随机对照研究,尽管2023年相...目的:分析近6年多囊卵巢综合征随机对照研究特点,为临床应用和未来研究提供参考。方法:检索2019~2024年发表在Web of Science的多囊卵巢综合征随机对照研究,对文献基本要素开展计量学分析。结果:共纳入204篇随机对照研究,尽管2023年相关文献较少,近6年多囊卵巢综合症相关随机对照研究年度发文趋势较为稳定,平均年度发文量为34篇。发文量最多的为中科院分区生殖生物学2区杂志《JOURNAL OF OVARIAN RESEARCH》,近6年共计发表PCOS相关RCT研究10篇。影响因子最高的杂志为《LANCET DIABETES & ENDOCRINOLOGY》,目前影响因子为44分。并进一步对主要结局指标和主要干预措施进行可视化分析。Aim: Analyze the characteristics of randomized controlled studies of polycystic ovary syndrome in the past 6 years, which provides reference for clinical application and future research. Methods: Retrieve the randomized controlled study of polycystic ovary syndrome published in the Web of Science from 2019 to 2024, and carried out a metric analysis of the basic elements of the literature. Results: A total of 204 randomized controlled studies were included. Although there were fewer relevant literature in 2023, the annual trend of published randomized controlled studies on polycystic ovary syndrome in the past 6 years was relatively stable, with an average annual published volume of 34 articles. The largest number of articles is “JOURNAL OF OVARIAN RESEARCH”, a journal of distinct 2 of reproductive biology of the Chinese academy of science, which has published a total of 10 PCOS-related RCT research in the past six years. The journal with the highest impact factor is “LANCET DIABETES & ENDOCRINOLOGY”, with a current impact factor of 44 points. And further visualize and analyze the main outcome indicators and main interventions.展开更多
文摘目的:观察真实世界中21 d维奈克拉(VEN)联合阿扎胞苷(AZA)(21 d VA)方案治疗初诊unfit急性髓系白血病(AML)患者的疗效及安全性。方法:回顾性收集川北医学院附属医院血液内科2020年12月至2024年7月使用21 d VA方案化疗并至少完成1疗程疗效评估的初诊unfit-AML患者的临床资料,分析真实世界中21 d VA方案的疗效及其影响因素,并评估安全性。结果:共纳入59例患者,中位年龄为67(48-87)岁。1疗程后复合完全缓解(cCR)率为74.5%,54.2%的患者微小残留病灶(MRD)转阴,其中伴NPM1突变的患者MRD阴性率较高(P=0.032)。中位随访19(2-38)个月,最佳cCR率和MRD转阴率分别为78%和64.4%,中位总生存期(OS)为12个月,中位无进展生存期(PFS)为5个月。多因素Cox回归分析显示,疗程数<4是影响PFS和OS的独立危险因素(P<0.05)。疾病缓解后,随着疗程数的增加,贫血和血小板减少好转。结论:真实世界中,21天VA方案治疗初诊unfit-AML仍有较高的有效性,且并不影响第1疗程的缓解率及MRD转阴率,尤其是伴NPM1突变的患者。
文摘研究背景:子宫内膜异位症(EMs)是一种雌激素依赖性的慢性炎症性疾病,影响约10%的育龄期女性。EMs症状的复杂性和不典型性严重影响患者的生理和心理健康并对社会经济造成沉重的负担。然而EMs的发病机制和有效的干预措施目前尚不完全清楚。饮食作为重要干预措施在多种慢性疾病中发挥作用,然而,关于饮食在EMs中的作用相关研究较少且多为观察性研究。孟德尔随机化(MR)利用遗传变异作为工具变量可以弥补传统观察性研究的不足,因而被广泛应用于探索可改变的暴露与疾病之间的因果关系。研究方法:本研究利用双向双样本MR分析方法探究饮食与EMs之间的因果关系。分别从IEU数据库和芬兰基因联盟中获取与饮食和EMs有关的全基因组关联研究(GWAS)数据。将基因位点显著性阈值设定为P −6,并通过去除连锁不平衡(LD)及剔除与结局相关的混杂SNP等方法严格筛选出代表暴露的工具变量(IV)后进行MR分析。进一步地,利用中介MR分析探究二者之间潜在的中介因素,探究了血脂在饮食和EMs中的中介效应。为了评估研究结果的稳定性,还进行了多种敏感性分析。研究结果:本研究主要基于IVW方法,有力地证明了干果和油性鱼类的摄入与EMs之间存在因果关系,以及TG在饮食和EMs之间的中介作用。具体而言,在所有饮食因素中,干果摄入(OR = 0.72, 95% CI: 0.56~0.93, P = 0.01)和油性鱼类摄入(OR = 0.80, 95% CI: 0.66~0.97, P = 0.02)与EMs发生风险降低有关。血脂水平与EMs之间的因果关系发现TG是EMs发生的危险因素(OR = 1.15, 95% CI: 1.07-1.23, P Background: Endometriosis (EMs) is an estrogen-dependent chronic inflammatory disease with a high prevalence, affecting approximately 10% of women of reproductive age. The complexity and atypical nature of EMs symptoms severely impact patients’ physical and mental health and impose a significant socioeconomic burden. However, the pathogenesis and effective interventions for EMs remain incompletely understood. Diet, as an important intervention, plays a role in various chronic diseases. Nevertheless, research on the role of diet in EMs is limited and predominantly observational. Mendelian randomization (MR), which uses genetic variants as instrumental variables, can address the limitations of traditional observational studies and is widely used to explore causal relationships between modifiable exposures and diseases. Methods: This study employed a bidirectional two-sample Mendelian randomization (MR) approach to investigate the causal relationship between diet and EMs. Genome-wide association study (GWAS) data related to diet and EMs were obtained from the IEU database and the Finnish Gene Consortium, respectively. Genetic loci with a significance threshold of P −6 were selected, and instrumental variables (IVs) representing exposures were rigorously screened by removing linkage disequilibrium (LD) and excluding SNPs associated with confounding factors. Furthermore, mediation MR analysis was conducted to explore potential mediating factors between diet and EMs, specifically focusing on blood lipids. Finally, various sensitivity analyses were performed to evaluate the robustness of the findings. Results: Based primarily on the IVW method, this study provided strong evidence for a causal relationship between the intake of dried fruits and oily fish and EMs, as well as the mediating role of triglycerides (TG) in the relationship between diet and EMs. Specifically, among all dietary factors, the intake of dried fruits (OR = 0.72, 95% CI: 0.56~0.93, P = 0.01) and oily fish (OR = 0.80, 95% CI: 0.66~0.97, P = 0.02) was associated with a reduced risk of endometriosis. Subsequently, we explored the causal relationship between blood lipid levels and EMs and found that TG is a risk factor for EMs (OR = 1.15, 95% CI: 1.07~1.23, P < 0.01). Further analysis revealed that both dried fruit (OR = 0.81, 95% CI: 0.75~0.88, P < 0.01) and oily fish intake (OR = 0.86, 95% CI: 0.81~0.91, P < 0.01) could reduce TG levels. Mediation MR analysis showed that TG mediated the protective effects of dried fruits and oily fish on EMs, with mediation proportions of 9% (P = 0.001) and 10% (P = 0.002), respectively. Conclusions: This study, using MR analysis, found that the intake of dried fruits and oily fish is associated with a reduced risk of EMs. Blood lipid levels, particularly TG, are associated with an increased risk of endometriosis. The protective effects of dried fruits and oily fish on EMs are partially mediated by reducing TG levels.
文摘目的:分析近6年多囊卵巢综合征随机对照研究特点,为临床应用和未来研究提供参考。方法:检索2019~2024年发表在Web of Science的多囊卵巢综合征随机对照研究,对文献基本要素开展计量学分析。结果:共纳入204篇随机对照研究,尽管2023年相关文献较少,近6年多囊卵巢综合症相关随机对照研究年度发文趋势较为稳定,平均年度发文量为34篇。发文量最多的为中科院分区生殖生物学2区杂志《JOURNAL OF OVARIAN RESEARCH》,近6年共计发表PCOS相关RCT研究10篇。影响因子最高的杂志为《LANCET DIABETES & ENDOCRINOLOGY》,目前影响因子为44分。并进一步对主要结局指标和主要干预措施进行可视化分析。Aim: Analyze the characteristics of randomized controlled studies of polycystic ovary syndrome in the past 6 years, which provides reference for clinical application and future research. Methods: Retrieve the randomized controlled study of polycystic ovary syndrome published in the Web of Science from 2019 to 2024, and carried out a metric analysis of the basic elements of the literature. Results: A total of 204 randomized controlled studies were included. Although there were fewer relevant literature in 2023, the annual trend of published randomized controlled studies on polycystic ovary syndrome in the past 6 years was relatively stable, with an average annual published volume of 34 articles. The largest number of articles is “JOURNAL OF OVARIAN RESEARCH”, a journal of distinct 2 of reproductive biology of the Chinese academy of science, which has published a total of 10 PCOS-related RCT research in the past six years. The journal with the highest impact factor is “LANCET DIABETES & ENDOCRINOLOGY”, with a current impact factor of 44 points. And further visualize and analyze the main outcome indicators and main interventions.
