Postgraduate Medical Journal最新文献

{"title":"The protective role of basal metabolic rate in cognitive decline: evidence from epidemiological and genetic studies.","authors":"Tianwei Meng, Changxing Liu, Boyu Wang, Chengjia Li, Jiawen Liu, Jia Chen, Yidi Ma, Rui Qie","doi":"10.1093/postmj/qgae159","DOIUrl":"10.1093/postmj/qgae159","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to explore the relationship between basal metabolic rate (BMR) and cognitive impairment and assess the potential of BMR as a protective factor against cognitive decline.</p><p><strong>Methods: </strong>This investigation initially conducted a cross-sectional study of American adults from 2011 to 2014 using data from the National Health and Nutrition Examination Survey. It examined the correlation between participants' BMR and cognitive functions, exploring the association with cognitive impairment. Subsequently, publicly available genome-wide association study data was used to examine potential causal links between genetically determined BMR and specific cognitive disorders using Mendelian randomization.</p><p><strong>Results: </strong>Cross-sectional findings revealed a significant positive correlation between higher BMR and cognitive scores. In Mendelian randomization analysis, BMR demonstrated an inverse causal relationship with Alzheimer's disease and Parkinson's dementia, suggesting BMR as a potential protective factor against these diseases. No causal links were found with vascular dementia, Lewy body dementia, and frontotemporal dementia.</p><p><strong>Conclusion: </strong>This study supports the role of BMR as a potential protective factor against Alzheimer's disease and Parkinson's dementia, suggesting that BMR may play an important role in preventing cognitive decline. However, due to the limitations of cross-sectional studies, further prospective studies and broader demographic samples are necessary to verify these results and explore underlying biological mechanisms. Key messages What is already known on this topic: Existing knowledge suggests a close relationship between BMR and health and cognitive functions, but detailed studies on its connection with specific cognitive impairments are still needed. What this study adds: This study found a significant positive correlation between higher BMR and cognitive improvement, potentially aiding in the prevention of Alzheimer's and Parkinson's dementia. How this study might affect research, practice, or policy: This finding guides public health strategies and personalized medicine, emphasizing the necessity for further research to validate BMR's protective effects.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"417-426"},"PeriodicalIF":3.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving senior medical workforce retention at a large teaching hospital trust.","authors":"Sarah Longwell, Hamish McLure, Sunjay Jain","doi":"10.1093/postmj/qgae152","DOIUrl":"10.1093/postmj/qgae152","url":null,"abstract":"<p><strong>Purpose: </strong>To understand senior clinicians' current thinking regarding retirement at a large teaching hospital trust, the reasons behind it, and what the trust can do to improve retention of these valuable staff.</p><p><strong>Methods: </strong>An anonymized survey followed by qualitative study from a focus group. Data from these were analysed using a thematic analysis. Participants were senior clinicians currently employed or who had taken retirement from the trust in the preceding 12 months. In total 140 respondents completed the survey, giving a response rate of 65%; 8 senior clinicians attended the focus group.</p><p><strong>Results: </strong>The commonest reasons for taking retirement were wanting to pursue leisure interests, reaching a pensionable age, and feeling unable to sustain their workloads. A significant proportion, 29%, also cited that they did not feel valued. The commonest factors that would encourage respondents to remain at work included increased flexibility, reduced hours, and ability to come off on-call rotas. The main themes from the focus group were focusing on well-being, personalized conversations, and better/more accessible information.</p><p><strong>Conclusion: </strong>Our project identified a number of reasons why clinicians are considering taking retirement, with a major theme of feeling valued underpinning decisions. This could influence strategies to help retain these experienced members of staff. We made a series of recommendations. If enacted, these would have a wider-reaching impact on more junior medical staff, aiding them to consider their own late-stage careers. They are also applicable and could easily be adapted when considering retention of other valued professionals within the trust. Key messages What is already known on this topic-We know that there is currently a medical workforce crisis at a time of greatest patient need, with an ageing workforce and senior staff who are choosing to retire early. Previous studies have reviewed the reasons behind these decisions but not specifically looked at changes that can be implemented at a local level to improve retention. What this study adds-We combined both quantitative and qualitative data from senior clinicians at a large teaching hospital trust in the North of England to understand current thinking regarding retirement and what the trust could do to improve their retention. How this study might affect research, practice, or policy-From our study we were able to make a series of recommendations that can be implemented at a local level to inform medical retention policies. These will also have wider impacts on junior medical staff and could be expanded to other healthcare professionals.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"435-440"},"PeriodicalIF":3.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resting metabolic rate in obesity.","authors":"LingHong Huang, ZhiFeng Guo, ZhengRong Jiang, YaJing Xu, HuiBin Huang","doi":"10.1093/postmj/qgae153","DOIUrl":"10.1093/postmj/qgae153","url":null,"abstract":"<p><p>The prevalence of obesity has continued to rise, and obesity and its attendant metabolic disorders are major global health threat factors. Among the current interventions for obesity, none have demonstrated sustained efficacy in achieving long-term outcomes. So, the identification of therapeutic targets is of paramount importance in the advancement and sustainability of obesity. Resting metabolic rate (RMR) constitutes 60%-75% of total energy expenditure and serves a crucial function in maintaining energy balance. Nevertheless, there exists considerable heterogeneity in RMR among individuals. Low RMR is associated with weight gain, elevating the susceptibility to obesity-related ailments. Hence, RMR will be the main focus of interest in the study of obesity treatment. In this review, we will elucidate the influence factors and mechanisms of action of RMR in obesity, with particular emphasis on the effects of obesity treatment on RMR and the alterations and influence factors of RMR in special types of populations with obesity.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"396-410"},"PeriodicalIF":3.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recipient selection for lung transplantation: perspective in decision-making.","authors":"Ertan Saribas, Sevinc Citak","doi":"10.1093/postmj/qgae144","DOIUrl":"10.1093/postmj/qgae144","url":null,"abstract":"<p><strong>Background: </strong>To determine the conditions that prevented transplant in patients referred to our center due to end-stage lung disease.</p><p><strong>Study design: </strong>Descriptive study.</p><p><strong>Place and duration of the study: </strong>Department of lung transplant clinic, Koşuyolu High Specialization Education and Research Hospital, Istanbul, Turkey, from December 2017 to January 2022.</p><p><strong>Methods: </strong>Patients with end-stage lung disease referred to our clinic were retrospectively evaluated with regard to reasons for exclusion, diagnosis, and demographic data. The Karnofsky Performance Status scoring scale was used to measure the functional status of the patients.</p><p><strong>Results: </strong>A total of 311 patients were evaluated during the study period. The mean age was 44.2 (range 4-73) years. There were 207 (66.6%) male patients. The most common indications were idiopathic interstitial pneumonia in 104 (33.4%) patients, chronic obstructive pulmonary disease in 53 (17%) patients, bronchiectasis in 49 (15.7%) patients, and cystic fibrosis in 28 (9%) patients. Of the patients, 106 (34%) were not appropriate candidates for a lung transplant. The most common reasons for refusal were preventable situations such as activity limitation and poor performance in 53 (50%) patients, weight in 49 (46.2%) patients, and smoking in 10 (9.4%) patients.</p><p><strong>Conclusion: </strong>Impaired performance status was the most common cause of lung transplant exclusion. Weight and smoking were preventable causes of exclusion. Implementing pulmonary rehabilitation in very few patients was the most important handicap. It is believed that providing optimal treatment with a multidisciplinary approach and timely referral to transplant centers will significantly reduce the reasons for exclusion. Key message What is already known on this topic?  Referring lung transplant candidates to clinics at the earliest stage is essential for assessing their condition and exploring treatment options. What this study adds?  Factors like smoking, obesity, and muscle loss can hinder the transplantation process; thus, timely interventions are crucial. The primary reason for excluding candidates from lung transplantation is the decline in performance status. How this study might affect research, practice or policy?  Programs focused on smoking cessation, weight management, and muscle strengthening can play a vital role in enhancing patients' health before transplantation. It is imperative to expand and enhance the accessibility of pulmonary rehabilitation programs.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"411-416"},"PeriodicalIF":3.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Contribution of nebulized budesonide before bronchoscopy, a prospective clinical study.","authors":"","doi":"10.1093/postmj/qgaf035","DOIUrl":"10.1093/postmj/qgaf035","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"496"},"PeriodicalIF":3.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal relationship between benign prostatic hyperplasia and prostate cancer: a bidirectional Mendelian randomization analysis.","authors":"Yi Zhang, Guangyang Ou, Rongkang Li, Lei Peng, Jianguo Shi","doi":"10.1093/postmj/qgae163","DOIUrl":"10.1093/postmj/qgae163","url":null,"abstract":"<p><strong>Objective: </strong>Our aim is to explore the relation between benign prostatic hyperplasia (BPH) and prostate cancer (PCa) from a genetic level utilizing Mendelian randomization (MR).</p><p><strong>Methods: </strong>The IEU genome-wide association studies database was surveyed for single nucleotide polymorphisms (SNPs) associated with BPH, PCa, and PCa (validation cohort). Single nucleotide polymorphisms were subjected to stringent quality control based on rigorous screening criteria. BPH and PCa risk were evaluated using the inverse-variance weighted method (IVW), MR-Egger, simple mode, weighted median, and weighted mode. Horizontal pleiotropy of single nucleotide polymorphisms was assessed using the MR-Egger intercept test, while heterogeneity was evaluated using Cochran's Q test. Reverse causality was assessed by evaluating PCa as the exposure and BPH as the outcome. A validation database was used to verify the exposure and outcome.</p><p><strong>Results: </strong>The risk of PCa increased significantly with genetically predicted BPH (IVW: OR [95% CI] = 1.3849 × 107 [2330, 8.2294 × 1010], P = 2.0814 × 10-4). In reverse MR analysis, PCa also increased the risk of BPH (IVW: OR [95% CI] = 1.0011 [1.0003, 1.0019], P = 0.0031). The findings were consistent with the MR analysis results of the PCa validation cohort. Sensitivity analyses indicated the presence of heterogeneity but no horizontal pleiotropy.</p><p><strong>Conclusion: </strong>The study presents proof of a significant bidirectional causal relationship between genetically predicted BPH and an increased risk of PCa. Key message Three research questions and three bullet points  What is already known on this topic?  Observational studies suggest a controversial relationship between BPH and PCa. MR allows investigation of causality using genetic variants as instrumental variables (IVs). What does this study add?  The study presents proof of a significant bidirectional causal relationship between genetically predicted BPH and an increased risk of PCa. How this study might affect research, practice, or policy?  Recognizing the bidirectional relationship between BPH and PCa, men diagnosed with BPH may benefit from more stringent PCa screening protocols.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"427-434"},"PeriodicalIF":3.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholecystectomy and cancer risk: evidence from National Health and Nutrition Examination Survey and Mendelian randomization.","authors":"Changlong Wei, Xiaofang Wang","doi":"10.1093/postmj/qgae135","DOIUrl":"10.1093/postmj/qgae135","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"489-491"},"PeriodicalIF":3.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive multi-omics approach reveals potential therapeutic targets and agents for osteoarthritis.","authors":"Qingxia Gao, Dawei Yao, Zuozhen Yin, Gongchang Yu, Bin Shi, Jiaying Wang","doi":"10.1093/postmj/qgae176","DOIUrl":"10.1093/postmj/qgae176","url":null,"abstract":"<p><strong>Background: </strong>The mechanisms underlying osteoarthritis (OA) remain unclear, and effective treatments are lacking. This study aims to identify OA-related genes and explore their potential in drug repositioning for OA treatment.</p><p><strong>Methods: </strong>Transcriptome-wide association studies (TWAS) were performed using genome-wide association studies summary data and expression quantitative trait loci data from the Genotype-Tissue Expression project. Differentially expressed genes between OA patients and healthy controls were identified using four datasets from the Gene Expression Omnibus database. Gene ontology and pathway enrichment analyses identified potential hub genes associated with OA. A network-based drug repositioning approach was applied to discover potential therapeutic drugs for OA.</p><p><strong>Results: </strong>Through TWAS and mRNA expression profiling, 7 and 167 OA-related genes were identified, respectively. From these, 128 OA-related genes were selected based on common biological processes. Using the maximal clique centrality algorithm, 10 core-related genes (JUN, VEGFA, FN1, CD44, PTGS2, STAT1, MAP 2K7, GRB2, EP300, and PXN) were identified for network-based drug repositioning. Consequently, 24 drugs were identified based on 128 OA-related genes and 23 drugs based on 10 core OA-related genes. Some identified drugs, such as dexamethasone, menadione, and hyaluronic acid, have been previously reported for OA and/or rheumatoid arthritis treatment. Network analysis also indicated that spironolactone, lovastatin, and atorvastatin may have potential in OA treatment.</p><p><strong>Conclusion: </strong>This study identified potential OA-related genes and explored their roles in drug repositioning, suggesting the repurposing of existing drugs and the development of new therapeutic options for OA patients. Key message What is already known on this topic The exact pathogenesis of osteoarthritis (OA) remains unclear, and currently, there are no approved drugs that can prevent, halt, or inhibit the progression of OA. What this study adds We identified 128 OA-related genes and 10 core-related genes based on common biological processes revealed by TWAS and mRNA expression profiling. Using these genes, we discovered potential drugs for OA through the Network-based drug repositioning method. How this study might affect research, practice, or policy This study provides recommendations for repositioning existing drugs and developing new treatment options for patients with OA.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"464-474"},"PeriodicalIF":3.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disentangling preventive effects of differential exercise types on tension-type headache: a component network meta-analysis of randomized controlled trials.","authors":"Qing-Feng Tao, Can Hua, Di Qin, Chao-Rong Xie, Yun-Zhou Shi, Min Chen, Hui Zheng","doi":"10.1093/postmj/qgaf055","DOIUrl":"https://doi.org/10.1093/postmj/qgaf055","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of exercise for tension-type headache (TTH) is unclear because of the complexity of exercise regimens-usually the combination of different types of exercise. We aimed to estimate the effectiveness of exercise for TTH and to test the incremental effect of each type of exercise by component network meta-analysis (CNMA).</p><p><strong>Methods: </strong>We searched Ovid Medline, Embase, and the Cochrane Library from database inception to 25 December 2023, and a supplementary search was conducted on 10 February 2025. We included randomized controlled trials of exercise, including aerobic, resistance, and stretching exercise, in adults with TTH. The primary outcome was headache frequency, and secondary outcomes were headache intensity and medication use.</p><p><strong>Results: </strong>Twelve trials with 759 participants were included. There were no significant differences between exercise and usual care in reducing headache frequency at the end of treatment with very low certainty evidence (mean difference [MD] -2.30, 95% [confidence interval] CI -8.86 to 4.26), while CNMA suggested that resistance exercise significantly reduced headache frequency (incremental mean difference [iMD] -6.00, 95% CI -9.10 to -2.90) and stretching exercise increased headache frequency (iMD 4.60, 95% CI 1.20 to 8.00). Exercise was better than usual care in reducing headache intensity (MD -2.29, 95% CI -3.23 to -1.34); the CNMA suggested that no single type of exercise had the greatest effect.</p><p><strong>Conclusion: </strong>Resistance exercise could be considered an effective and accessible treatment for patients with TTH. But our study was limited by heterogeneity and inconsistency of results, and more studies are warranted.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and survival outcomes of long-term responders for advanced nonsmall cell lung cancer patients with first-line PD-1/PD-L1 inhibitors: a multicenter retrospective study.","authors":"Zhijuan Du, Xiangwei Ge, Yao Li, Yuhui Qin, Hao Fan, Yahui Lv, Xiangyu Du, Zhefeng Liu","doi":"10.1093/postmj/qgaf045","DOIUrl":"https://doi.org/10.1093/postmj/qgaf045","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Immunotherapy has shown long-term benefits in advanced nonsmall cell lung cancer patients. However, the clinical characteristics, prognosis, and selection of appropriate therapies for long-term responders (LTR) to first-line programmed cell death protein-1/programmed cell death ligand-1 (PD-L1) inhibitors remain undetermined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;About 413 advanced nonsmall cell lung cancer patients were included from 1 June 2015 to 31 August 2021. It examined clinicopathologic data, overall survival distributions, and treatment strategies involving immune checkpoint inhibitors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the patients, 213 (51.6%) were LTRs. PD-L1 expression ≥50% was observed in 39.1% of LTR patients, higher than in non-LTR patients (21.7%). After propensity score matching, Cox univariable analysis revealed pathological type (hazard ratio [HR] 0.563; 95% confidence interval [CI]: 0.391-0.811; P = .002), bone metastasis (HR 1.820; 95% CI: 1.278-2.590; P = .001), and liver metastasis (HR 2.220; 95% CI: 1.291-3.817; P = .004) as significant predictors of LTR. The pathological type (HR 0.641; 95% CI: 0.441-0.932; P = .020), bone metastasis (HR 1.593; 95% CI: 1.106-2.293; P = .012), and liver metastasis (HR 1.820; 95% CI: 1.046-3.165; P = .034) were significant predictors of LTR in Cox multivariable analysis. Significant difference showed in overall survival (P &lt; .0001) for Pembrolizumab-chemotherapy of lung squamous cell carcinoma in LTR group compared with Sintilimab-chemotherapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Nonsquamous cell carcinoma, bone metastasis, and liver metastasis were significant predictors of LTR. LTR patients showed a higher proportion of PD-L1 expression. Compared to Sintilimab-chemotherapy, Pembrolizumab-chemotherapy may be more promising for long-term survival of lung squamous cell carcinoma patients. Key messages What is already known on this topic - Immunotherapy (IO) has demonstrated long-term survival benefits in advanced nonsmall cell lung cancer (NSCLC). However, the clinical characteristics, prognosis, and optimal treatment strategies for long-term responders (LTR) to first-line programmed cell death protein-1/programmed cell death ligand-1 inhibitors remain unclear, necessitating further investigation. What this study adds - This study identifies nonsquamous cell carcinoma, absence of bone metastasis, and absence of liver metastasis as significant predictors of LTR in NSCLC patients. LTR patients exhibit a higher proportion of programmed cell death ligand-1 expression (≥50%). Additionally, Pembrolizumab-chemotherapy shows superior overall survival outcomes for LTR with lung squamous cell carcinoma compared to Sintilimab-chemotherapy. How this study might affect research, practice, or policy - These findings provide critical insights for patient stratification and therapy optimization in NSCLC. The identification of predictive factors and superior therapeutic combina","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}