解决联邦学习中低秩适配的偏差与噪声放大问题，提升医疗场景隐私保护效果。

Integrating low-rank adaptation (LoRA) with federated learning (FL) has received widespread attention recently, aiming to adapt pretrained foundation models (FMs) to downstream medical tasks via privacy-preserving decentralized training. However, owing to the direct combination of LoRA and FL, current methods generally undergo two problems, i.e., aggregation deviation, and differential privacy (DP) noise amplification effect. To address these problems, we propose a novel privacy-preserving federated finetuning framework called \underline{D}eviation \underline{E}liminating and Nois\underline{e} \underline{R}egulating (DEeR). Specifically, we firstly theoretically prove that the necessary condition to eliminate aggregation deviation is guaranteing the equivalence between LoRA parameters of clients. Based on the theoretical insight, a deviation eliminator is designed to utilize alternating minimization algorithm to iteratively optimize the zero-initialized and non-zero-initialized parameter matrices of LoRA, ensuring that aggregation deviation always be zeros during training. Furthermore, we also conduct an in-depth analysis of the noise amplification effect and find that this problem is mainly caused by the ``linear relationship'' between DP noise and LoRA parameters. To suppress the noise amplification effect, we propose a noise regulator that exploits two regulator factors to decouple relationship between DP and LoRA, thereby achieving robust privacy protection and excellent finetuning performance. Additionally, we perform comprehensive ablated experiments to verify the effectiveness of the deviation eliminator and noise regulator. DEeR shows better performance on public medical datasets in comparison with state-of-the-art approaches. The code is available at https://github.com/CUHK-AIM-Group/DEeR.