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{"title":"\"Post-Kasai Portoenterostomy Cholangitis: What Have We Learnt So Far?\"","authors":"Arghya Samanta, Moinak S Sarma","doi":"10.1016/j.jceh.2024.102471","DOIUrl":"https://doi.org/10.1016/j.jceh.2024.102471","url":null,"abstract":"<p><p>Post-Kasai portoenterostomy (KPE) cholangitis is one of the most common complications that has a negative impact on liver function and native liver survival. Early diagnosis and judicious empiric antimicrobial management are, therefore, important to prevent further liver damage and decompensation. However, there is no consensus regarding the standard definition of post-KPE cholangitis, and established guidelines on evaluation and management are also lacking. Metagenomic next-generation sequencing, a new molecular diagnostic technique, has the potential for detecting broader spectrum of pathogens, especially in blood culture-negative patients. Antibiotic prophylaxis to prevent cholangitis has been widely used, but questions over the choice of antibiotics, route of administration, and optimal duration remain unsettled. The available evidence on the efficacy of antibiotic prophylaxis in preventing cholangitis has shown conflicting results. This review offers a summary of the current research on advances in diagnostic approaches, including molecular techniques, and therapeutic challenges in managing intractable cholangitis.</p>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"102471"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Outcomes of an On-Demand Transfusion Strategy Versus Prophylactic Transfusion of Platelets in Patients With Liver Cirrhosis and Severe Thrombocytopenia Undergoing High-Risk Procedures: A <i>Post Hoc</i> Analysis of Two Randomized Controlled Trials.","authors":"Sagnik Biswas, Sanchita Gupta, Shubham Mehta, Shekhar Swaroop, Arnav Aggarwal, Ayush Agarwal, Sarthak Saxena, Tushar Sehgal, Samagra Aggarwal, Deepak Gunjan, Baibaswata Nayak, Shivanand Gamanagatti, Shalimar","doi":"10.1016/j.jceh.2024.102467","DOIUrl":"https://doi.org/10.1016/j.jceh.2024.102467","url":null,"abstract":"<p><strong>Background: </strong>There are limited studies assessing whether prophylactic platelet transfusions prior to high-risk procedures reduce the risk of bleeding in patients with liver cirrhosis.</p><p><strong>Methods: </strong>We performed a <i>post hoc</i> analysis of two prior randomized clinical trials (CTRI/2017/12/010822 and CTRI/2021/05/033464), which compared thromboelastography-guided prophylactic platelet transfusion to standard-of-care (empirical prophylactic transfusion for all patients prior to the procedure) or on-demand transfusion (no prophylactic transfusions). We aimed to assess the risk of major procedure-related bleeding or mortality among patients who had received prophylactic platelet transfusions versus those who did not (on-demand transfusions).</p><p><strong>Results: </strong>A total of 118 patients were included in the analysis, with baseline demographics well matched between groups. The leading etiologies of cirrhosis were cryptogenic (42, 35.6%) and autoimmune liver disease (30, 25.4%). The most common procedures performed were percutaneous liver biopsy (73, 61.8%), followed by transjugular intrahepatic portosystemic shunt (14, 11.9%) and transarterial chemoembolization (14, 11.9%). No episode of major bleeding or procedure-related mortality occurred in either group, though minor bleeding occurred in 5 patients. A significantly lower number of patients in the on-demand group required platelet transfusions than those receiving empirical transfusions as part of standard care.</p><p><strong>Conclusion: </strong>Procedure-related bleeding rates were not significantly higher among patients with liver cirrhosis undergoing high-risk procedures without prophylactic platelet transfusions than in those who received them. Larger randomized trials are required to validate these findings from our <i>post hoc</i> analysis.</p>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"102467"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-device-field integration for mitochondria-targeting dysfunction and tumor therapy by home-tailored pyroelectric nanocomposites.","authors":"Zhe Liu, Yanxi Yang, Xinru Kong, Xueli Ren, Fengqi Xuan","doi":"10.1016/j.biomaterials.2024.122990","DOIUrl":"10.1016/j.biomaterials.2024.122990","url":null,"abstract":"<p><p>In spite of the hypoxia tumor microenvironment, an efficacious treatment with minimal invasiveness is highly desirable. Among common cellular organelles, mitochondria is a common target for inductive cellular apoptosis and tumor proliferation inhibition. Nevertheless, tumor hypoxic circumstances always give rise to poor therapeutic efficiency and instead lead to lesion recurrence and unsatisfactory prognosis. Herein, a home-tailored pyroelectric nanocomposites of BTO@PDA-FA-DOX-EGCG have been developed via a layer-by-layer synthesis to serve a cutting-edge tumor treatment with specific mitochondria-targeting, hypoxia-relieving, chemo-photodynamic performance and high anti-tumor efficacy. In particular, this therapeutic modality is featured as drug-device-field integration (DDFI) by combining chemo-drugs of DOX and EGCG, a commercially available medical laser and physical pyroelectric fields, which synergistically contributed to continuing ROS production and consequently cell apoptosis and tumor growth inhibition. Meanwhile, an anti-tumor mechanism of immune actuation and mitochondria dysfunction was elucidated by analyzing specific biomarkers of mitochondria complexes and MMPs, and therefore this research opened up a potential pathway for advanced tumor treatment by incorporating nanocomposites, medical devices and physical fields in a DDFI manner.</p>","PeriodicalId":254,"journal":{"name":"Biomaterials","volume":"316 ","pages":"122990"},"PeriodicalIF":12.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycerol-3-Phosphate Dehydrogenase 1 Deficiency and Steatotic Liver Disease in Children: Our Cases and Review of Literature.","authors":"Ankit Agrawal, Anshu Srivastava, Amita Moirangthem, Suzena M Singh, Dhriti Kodethoor, Srinivas S Vadlapudi, Moinak S Sarma, Ujjal Poddar","doi":"10.1016/j.jceh.2024.102484","DOIUrl":"10.1016/j.jceh.2024.102484","url":null,"abstract":"<p><strong>Introduction: </strong>Glycerol-3-phosphate dehydrogenase 1 (GPD1) deficiency is an autosomal recessive disorder causing hypertriglyceridemia, hepatomegaly, fatty liver, and hepatic fibrosis in infancy. It is an under-recognized cause of pediatric steatotic liver disease (SLD) with only 36 cases reported worldwide.</p><p><strong>Method: </strong>We analyzed the clinical profile of our five cases diagnosed by exome sequencing (ES) and reviewed the published cases till December 2023 using PubMed search.</p><p><strong>Results: </strong>Five unrelated boys (6-24months) presented with hepatomegaly, hypertriglyceridemia, transaminase elevation, and fatty liver. ES revealed compound heterozygous mutations in two and homozygous mutation in three including two novel mutations (c.917T >C, c.905C > G). All received supportive therapy, and fenofibrate was successfully used in one case for progressive hypertriglyceridemia. Globally, 36 cases (age at diagnosis: 6 [1-164 months]) have been reported. Majority had hepatomegaly (94.4%), 22.2% each had splenomegaly and growth failure. Hypertriglyceridemia (97.2%) was nearly universal, 100% had fatty liver, and hypoglycaemia (11.2%) was uncommon. Liver biopsy (n = 18) demonstrated steatosis in all, fibrosis in 94.4%, and cirrhosis in 22.2%. During follow-up (11-376 months), hepatomegaly resolved in 35.2%, triglycerides, and transaminases normalized in 29.1% and 31.5%, respectively. No pancreatitis, cardiac events, or liver decompensation was reported.</p><p><strong>Conclusion: </strong>GPD1 is an uncommon cause of SLD, raised transaminases and hypertriglyceridemia in young children. Diagnosis is confirmed by genetic testing. Supportive therapy, parental counseling about the disease nature and close follow-up is recommended.</p>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"102484"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to 'Application of a microfluidic chip-based 3D co-culture to test drug sensitivity for individualized treatment of lung cancer' [Biomaterials 34 (2013) 14772].","authors":"Zhiyun Xu, Yanghui Gao, Yuanyuan Hao, Encheng Li, Yan Wang, Jianing Zhang, Wenxin Wang, Zhancheng Gao, Qi Wang","doi":"10.1016/j.biomaterials.2024.123033","DOIUrl":"10.1016/j.biomaterials.2024.123033","url":null,"abstract":"","PeriodicalId":254,"journal":{"name":"Biomaterials","volume":" ","pages":"123033"},"PeriodicalIF":12.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142890816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioactive phosphorus dendrimers deliver protein/drug to tackle osteoarthritis via cooperative macrophage reprogramming.","authors":"Huxiao Sun, Mengsi Zhan, Yu Zou, Jie Ma, Jiajia Liang, Guo Tang, Regis Laurent, Serge Mignani, Jean-Pierre Majoral, Xiangyang Shi, Mingwu Shen","doi":"10.1016/j.biomaterials.2024.122999","DOIUrl":"10.1016/j.biomaterials.2024.122999","url":null,"abstract":"<p><p>Reprogramming imbalanced synovial macrophages and shaping an immune microenvironment conducive to bone and cartilage growth is crucial for efficient tackling of osteoarthritis (OA). Herein, we present a co-delivery nanosystem based on generation 2 (G2) hydroxyl-terminated bioactive phosphorus dendrimers (G2-OH₂₄) that were loaded with both catalase (CAT) and quercetin (Que). The created G2-OH₂₄/CAT@Que complexes exhibit a uniformly distributed spherical morphology with a size of 138.8 nm, possess robust stability, and induce macrophage reprogramming toward anti-inflammatory M2 phenotype polarization and antioxidation through cooperative CAT-catalyzed oxygen generation, Que-mediated mitochondrial homeostasis restoration, and inherent immunomodulatory activity of dendrimer. Such macrophage reprogramming leads to chondrocyte apoptosis inhibition and osteogenic differentiation of bone mesenchymal stem cells. Administration of G2-OH₂₄/CAT@Que to an OA mouse model results in attenuation of pathological features such as cartilage degeneration, bone erosion, and synovitis through oxidative stress alleviation and inflammatory factor downregulation in inflamed joints. Excitingly, the G2-OH₂₄/CAT@Que also polarized macrophages in adherent effusion monocytes (AEMs) extracted from joint cavity effusions of OA patients to M2 phenotype and downregulated reactive oxygen species levels in AEMs. This study suggests a promising nanomedicine formulation of phosphorus dendrimer-based co-delivery system to effectively tackle OA through the benefits of full-active ingredients of dendrimer, drug, and protein.</p>","PeriodicalId":254,"journal":{"name":"Biomaterials","volume":"316 ","pages":"122999"},"PeriodicalIF":12.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vanadium single-atoms coordinated artificial peroxidases as biocatalyst-linked immunosorbent assay for highly-sensitive carcinoembryonic antigen immunoassay.","authors":"Minjia Yuan, Rui Yan, Zhenyang Zhao, Qinlong Wen, Xiaodong Xie, Mohsen Adeli, Shuang Li, Chong Cheng","doi":"10.1016/j.biomaterials.2024.123008","DOIUrl":"10.1016/j.biomaterials.2024.123008","url":null,"abstract":"<p><p>In medical and biomedical fields, enzyme-mimetic nanomaterials have garnered significant interest as efficacious signal enhancers for biocatalyst-linked immunosorbent assays (BLISA). Despite the burgeoning enthusiasm, engineering artificial biocatalysts that exhibit both exceptional catalytic proficiency and pronounced colorimetric signal output remains a formidable challenge. Inspired by the heme structures and biocatalytic activities of horseradish peroxidase, we introduce the synthesis of vanadium single-atoms (SAV) coordinated artificial peroxidases as BLISA for highly sensitive and selective carcinoembryonic antigen (CEA) immunoassay. Our synthesized SAV exhibits peroxidase (POD)-like activity that is both efficacious and highly specific, surpassing the performance of many other single-atom-structured materials. The SAV-linked immunoassay demonstrates an ultrasensitive response to the target antigen (CEA), with a linear detection range spanning 0.03-10 ng/mL and an impressively low detection limit of 0.335 ng/mL. This straightforward and robust immunoassay technique not only achieves superior signal amplification compared to traditional natural enzymes but also boasts high precision, commendable reproducibility, and remarkable specificity, aligning closely with conventional enzyme-linked immunosorbent assay for CEA detection in serum samples. This study offers a blueprint for designing artificial peroxidase-based colorimetric nanosystems, promoting the evolution of ultrasensitive BLISA applications for the early diagnosis and intervention of cancer.</p>","PeriodicalId":254,"journal":{"name":"Biomaterials","volume":"316 ","pages":"123008"},"PeriodicalIF":12.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Potential and Mechanistic Insights of a Novel Synthetic α-Lactalbumin-Derived Peptide for the Treatment of Liver Fibrosis.","authors":"Sara Maher, Shimaa Atta, Manal Kamel, Olfat A Hammam, Hend Okasha","doi":"10.1016/j.jceh.2024.102488","DOIUrl":"10.1016/j.jceh.2024.102488","url":null,"abstract":"<p><strong>Background: </strong>Liver fibrosis is a serious global health issue, but current treatment options are limited due to a lack of approved therapies capable of preventing or reversing established fibrosis.</p><p><strong>Aim: </strong>This study investigated the antifibrotic effects of a synthetic peptide derived from α-lactalbumin in a mouse model of thioacetamide (TAA)-induced liver fibrosis.</p><p><strong>Methods: </strong><i>In silico</i> analyses were conducted to assess the physicochemical properties, pharmacophore features, and docking interactions of the peptide. Mice with induced fibrosis were treated with three different doses of the synthetic peptide (2.5, 5, or 10 μg/kg, twice weekly for 8 weeks). Immunohistochemistry, antioxidant enzyme levels, IGF-1 levels, and expression of fibrosis-related genes were assessed.</p><p><strong>Results: </strong>Peptide interacted with human prothrombin's many sites with varying binding affinities. Besides, ligand similarity analysis identified 26 thrombin inhibitors with high Tanimoto scores. The peptide exhibited antifibrotic effects with dose-dependent improvements. The upregulated expression of IGF-1 in all treated groups compared with the pathological untreated group. In contrast, fibrotic markers such as TIMP, PDGF-α, and TGF-β were upregulated in the untreated pathological group but downregulated in the peptide-treated groups. The assessment of IGF-1 concentration in sera demonstrated that the peptide-treated groups exhibited an increase in IGF-1 levels. Histopathological examination of peptide-treated groups showed normal hepatic architecture with hepatocytes arranged in thin plates. Immunohistochemical results of high dose peptide-treated group showed a few numbers of positive αSMA with mild proliferating cell nuclear antigen expression.</p><p><strong>Conclusion: </strong>The synthetic α-lactalbumin peptide shows promise as an antifibrotic therapy. Its safety and effectiveness are supported by <i>in silico</i> and <i>in vivo</i> analyses. The peptide's pharmacophore characteristics and potential as a thrombin inhibitor combine with its ability to downregulate fibrotic markers and maintain liver tissue integrity. These findings concluded the potential of this peptide as a promising therapeutic candidate for liver fibrosis, warranting further investigation.</p>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":"15 3","pages":"102488"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacteria-based biohybrids for remodeling adenosine-mediated immunosuppression to boost radiotherapy-triggered antitumor immune response.","authors":"Xirui Wu, Junjun Zhang, Zheng Deng, Xianglong Sun, Yifan Zhang, Cai Zhang, Jiadong Wang, Xinke Yu, Guangbao Yang","doi":"10.1016/j.biomaterials.2024.123000","DOIUrl":"10.1016/j.biomaterials.2024.123000","url":null,"abstract":"<p><p>Radiotherapy (RT) can trigger immunogenic cell death (ICD) in tumor cells and release adenosine triphosphate (ATP) to activate antitumor immunity. However, the formation of immunosuppressive adenosine (ADO) mediated by ectonucleotidases including CD39 and CD73, can exacerbate the immunosuppressive effects. Herein, a radiosensitizer-based metal-organic framework (MOF) composed of bismuth (Bi) and ellagic acid (EA) was synthesized in situ on the surface of Escherichia coli Nissle 1917 (EcN) to serve as a carrier for the CD39 inhibitor sodium polyoxotungstate (POM-1). This therapeutic platform, acting as a radiosensitizer, significantly enhances cytotoxicity against tumor cells while effectively inducing ICD and releasing high concentrations of ATP. Subsequently, the released POM-1 increases the levels of pro-inflammatory extracellular ATP while preventing tumor immunosuppression caused by the accumulation of ADO. Additionally, as a natural immune adjuvant, EcN further promotes the maturation of dendritic cells (DCs) and the infiltration of cytotoxic T lymphocytes (CTLs). As a result, such treatment initiates the destruction of established tumor growth and induces strong abscopal effects, leading to a significant inhibition of tumor metastases. This strategy presents a bacterial-based biohybrid system that facilitates RT-induced ICD while simultaneously limiting the degradation of ATP into ADO, thereby achieving sustained anti-tumor immunity.</p>","PeriodicalId":254,"journal":{"name":"Biomaterials","volume":"316 ","pages":"123000"},"PeriodicalIF":12.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesoporous polydopamine nanoparticle-based tolerogenic vaccine induces antigen-specific immune tolerance to prevent and treat autoimmune multiple sclerosis.","authors":"Ngoc Man Phan, Thanh Loc Nguyen, Dong Kwang Min, Jaeyun Kim","doi":"10.1016/j.biomaterials.2024.122997","DOIUrl":"10.1016/j.biomaterials.2024.122997","url":null,"abstract":"<p><p>Multiple sclerosis (MS) is a chronic neurological disorder derived from autoreactive immune system attacking the protective myelin sheath that surrounds nerves in the central nervous system (CNS). Here, a tolerogenic nanovaccine for generating an antigen-specific immune tolerance for treating MS is proposed. It consisted of a mesoporous polydopamine (mPDA) nanoparticle, characterized by high reactive oxygen species (ROS)-scavenging property, loaded with MS-derived autoantigen. Intravenous vaccination of autoantigen-loaded mPDA could induce tolerogenic dendritic cells (DCs) with low expression of co-stimulatory molecules while presenting peptide epitopes. The tolerogenic DCs induced peripheral regulatory T-cells (Tregs), thereby reducing infiltration of autoreactive CD4⁺ T-cells and inflammatory antigen-presenting cells (APCs) into the CNS. In MS-mimicking mouse model, the tolerogenic nanovaccine prevented MS development in the early therapeutic setup and exhibited an enhanced recovery from complete paralysis in the late therapeutic model. The current platform could be exploited to treat other autoimmune diseases where disease-dependent autoantigen peptides are delivered.</p>","PeriodicalId":254,"journal":{"name":"Biomaterials","volume":"316 ","pages":"122997"},"PeriodicalIF":12.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}