Clinical and Translational Gastroenterology最新文献

{"title":"The impact of esophagogastric varices on the outcomes of patients with cholangiocarcinoma.","authors":"Tzu-Han Ma, Yu-Jen Chen, Chun-Ting Ho, Pei-Chang Lee, Tsung-Chieh Yang, Hui-Chun Huang, Yi-Hsiang Huang, Ming-Huan Chen, Jiing-Chyuan Luo, Ming-Chih Hou, Jaw-Ching Wu, Chien-Wei Su","doi":"10.14309/ctg.0000000000000930","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000930","url":null,"abstract":"<p><strong>Background aim: </strong>Esophagogastric varices (EGV) are known to correlate with a poorer prognosis in patients with liver cirrhosis or hepatocellular carcinoma. However, their clinical significance in patients with cholangiocarcinoma (CCA) remains unknown. This study aimed to investigate the impact of EGV on the outcomes of patients with CCA.</p><p><strong>Methods: </strong>This retrospective study enrolled 923 consecutive treatment-naive patients diagnosed with CCA between January 2013 and December 2023. Among these, 321 patients received esophagogastroduodenoscopy (EGD) at the time of CCA diagnosis. The primary endpoint was to assess the impact of EGV on overall survival (OS) in patients with CCA, while the secondary endpoint was to identify the predictive factors for the occurrence of EGV.</p><p><strong>Results: </strong>Of the patients analyzed, 47 (14.6%) were diagnosed with EGV by EGD. Among these, 39 patients did not receive primary prophylaxis for EGV bleeding and were classified as the EGV group, while the remaining 274 (85.4%) formed the non-EGV group. The median OS was shorter in the EGV group than in the non-EGV group (182 vs. 357 days, p=0.009). Multivariate analyses identified the presence of EGV as an independent risk factor for poorer OS (hazard ratio: 1.823, confidence interval: 1.248- 2.663, p = 0.002). Besides, fibrosis- 4 (FIB-4) scores > 2.67 and albumin-bilirubin (ALBI) grades > 1 were predictive factors for EGV occurrence.</p><p><strong>Conclusion: </strong>While the prevalence of concurrent EGV in CCA patients was relatively low, its presence was associated with a poorer prognosis. The FIB-4 scores and ALBI grades predicted the occurrence of EGV.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between chitinase 3-like protein 1 and severe non-alcoholic fatty liver disease: a large prospective cohort study in UK Biobank.","authors":"Jiafeng Zou, Yu Yan, Anguo Liu, Haoye Zhang, Zhenguo Liu","doi":"10.14309/ctg.0000000000000929","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000929","url":null,"abstract":"<p><strong>Introduction: </strong>Chitinase-3-like protein 1 (CHI3L1) is a glycoprotein involved in inflammation and fibrosis, but its association with non-alcoholic fatty liver disease (NAFLD) remains unclear. The present study investigated the association between serum CHI3L1 levels and the risk of severe NAFLD in a large prospective cohort.</p><p><strong>Methods: </strong>A prospective cohort study was conducted using UK Biobank data from 50,334 participants. Serum CHI3L1 levels were measured at baseline. Severe NAFLD cases were identified using hospital records. Cox proportional hazards models evaluated the association between CHI3L1 levels and severe NAFLD risk. Restricted cubic spline (RCS) analysis assessed potential non-linearity. Subgroup and mediation analyses were conducted to explore effect modifiers and underlying pathways.</p><p><strong>Results: </strong>Over a median follow-up of 16 years, 766 severe NAFLD cases were identified. Higher CHI3L1 levels were significantly associated with increased severe NAFLD risk (HR = 1.45, 95% CI: 1.34-1.58, P < 0.001). RCS analysis revealed a linear positive association without evidence of non-linearity. Stratified analyses showed consistent associations across subgroups, with no significant interactions. Mediation analysis identified HDL and ALT as partial mediators, explaining 6.38% and 2.86% of the total effect, respectively, while the direct effect of CHI3L1 remained dominant.</p><p><strong>Discussion: </strong>Elevated CHI3L1 levels are associated with an increased risk of severe NAFLD. These findings suggest that CHI3L1 may serve as a novel biomarker and potential contributor to NAFLD progression, offering insights into the inflammatory and metabolic mechanisms underlying the disease.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stool-Based Proteomic Signature for the Non-Invasive Classification of Crohn's Disease and Ulcerative Colitis Using Machine Learning.","authors":"Elmira Shajari, David Gagné, Francis Bourassa, Mandy Malick, Patricia Roy, Jean-François Noël, Hugo Gagnon, Maxime Delisle, François-Michel Boisvert, Marie Brunet, Jean-François Beaulieu","doi":"10.14309/ctg.0000000000000925","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000925","url":null,"abstract":"<p><strong>Introduction: </strong>Crohn's disease and ulcerative colitis have overlapping symptoms, but they differ in pathology and treatment. Currently, distinguishing between these diseases involves invasive procedures such as colonoscopy and histopathology. Fecal proteins, stable and in direct contact with inflammation, offer a non-invasive alternative. This study focuses on using high-throughput data-independent acquisition mass spectrometry and machine learning to develop an accurate biomarker signature from complex stool samples.</p><p><strong>Methods: </strong>Stool samples obtained from 69 active patients were analyzed. Analysis of the stool proteome led to the identification and quantification of approximately 1,250 proteins. The samples were divided into training and testing groups. After data processing, various feature selection algorithms were applied on the training group to determine proteins that were significantly different between the Crohn's disease and ulcerative colitis groups. Additionally, six machine learning algorithms were evaluated to identify the best-performing classifiers.</p><p><strong>Results: </strong>Sixteen proteins were selected based on several feature selection algorithms and six models were trained based on them. According to the performance metrics of each algorithm on the training dataset, the Naïve Bayes model was selected. For performance validation, the final predictive model was applied to 16 blind prospective samples as the test dataset. Notably, the model achieved an AUC of 0.96 on both the training and test datasets, highlighting its robustness and stability.</p><p><strong>Discussion: </strong>This study demonstrates the potential of combining multiple stool protein biomarkers via high-throughput data-independent acquisition mass spectrometry and machine learning tools to develop a predictive model for efficiently distinguishing Crohn's disease from ulcerative colitis.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fecal Microbiota and Bile Acid Profiles in Early-Stage Hepatocellular Carcinoma: A Matched Case-Control Study.","authors":"Yael R Nobel, Heekuk Park, Alice M Tillman, Dwayne Seeram, Dalia H Moallem, Anna Intara, Renu Nandakumar, Medini K Annavajhala, Angela Gomez-Simmonds, Elizabeth C Verna, Anne-Catrin Uhlemann","doi":"10.14309/ctg.0000000000000928","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000928","url":null,"abstract":"<p><strong>Introduction: </strong>Early identification of hepatocellular carcinoma (HCC) is critical to reduce mortality. Diagnostic tools are limited for early disease. Intestinal microbiota may contribute to HCC risk directly and via metabolites, particularly bile acids (BA), offering potential noninvasive biomarkers.</p><p><strong>Methods: </strong>This was a case-control study of patients with cirrhosis with or without early-stage HCC, matched based on liver disease severity. Comprehensive analyses of fecal microbiota composition and function were performed.</p><p><strong>Results: </strong>There were 98 patients in the study (49 patients per group). Subjects with HCC were older (median 64 vs. 60 years, p<0.01) and more likely to have Hepatitis C (78% vs. 43%, p<0.01). Alpha diversity, beta diversity, and genes and pathways related to BA metabolism did not differ between groups overall, but alpha diversity did differ within the subset of patients with metabolic-associated steatotic liver disease (MASLD). There was differential abundance of multiple taxa between groups, including higher abundance of Klebsiella pneumoniae in cases. Increased concentration of secondary BA, which are microbiota-dependent, was associated with higher odds of HCC (adjusted OR 2.4, p=0.02); however, addition of microbial or BA features to a model with clinical data alone did not improve HCC prediction.</p><p><strong>Discussion: </strong>When accounting for liver disease severity, there were limited differences in intestinal microbiota composition and BA metabolism between subjects with or without early-stage HCC. Promising areas for future study of microbiota-based HCC biomarkers were identified, including a focus on the subpopulation of patients with MASLD.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating Molecular Drivers of Bone Remodeling in Pancreatitis.","authors":"Rachel L Hill, Dhiraj Yadav, Phil A Hart, David C Whitcomb, Kristen J McQuerry, Kelsey N Karnik, Kimberly M Stello, Darwin L Conwell, Madhumathi Rao","doi":"10.14309/ctg.0000000000000926","DOIUrl":"10.14309/ctg.0000000000000926","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatitis-associated osteopathy is a clinically significant but mechanistically underexplored complication of pancreatic disease. We aimed to characterize stage-specific alterations in bone remodeling biomarkers across the spectrum of disease: recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP).</p><p><strong>Methods: </strong>In a cross-sectional analysis of North American Pancreatitis Study 2 (NAPS2) participants, we measured serum mechanistic (sclerostin, DKK1, RANKL, OPG), hormonal (FGF23, insulin, leptin), and modulatory (osteopontin, oncostatin, osteoactivin) markers in controls (n = 30), RAP (n = 40), and CP (n = 40) using a multiplex assay. Group differences were assessed with ANOVA, Fisher's exact test, and Kruskal Wallis; multivariable regression identified predictors of biomarker variation.</p><p><strong>Results: </strong>Eight of ten biomarkers differed significantly among groups. Sclerostin, DKK1, RANKL, and OPG were elevated in RAP and CP versus controls, with the highest values in CP. The RANKL/OPG ratio was greatest in CP. FGF23 was increased in RAP, while insulin was reduced in CP. Osteopontin and oncostatin were elevated in pancreatitis groups, with osteopontin increasing progressively from control to RAP to CP. Several bone biomarker patterns varied by sex, tobacco, and alcohol use. Stepwise regression identified several significant predictors.</p><p><strong>Conclusions: </strong>These findings represent the most comprehensive bone metabolism biomarker profiling in pancreatitis to date, revealing stage-specific dysregulation of bone remodeling. Findings suggest a shift toward increased bone resorption and impaired formation with disease progression. Larger longitudinal studies are needed for marker validation, to clarify mechanisms, and guide targeted interventions to reduce bone loss and fracture risk in this high-risk population.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining the Liver Donor Risk Index with Machine Perfusion: A Bayesian Approach.","authors":"Tomohiro Tanaka, Daniel Sewell","doi":"10.14309/ctg.0000000000000921","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000921","url":null,"abstract":"<p><strong>Background: </strong>The Donor Risk Index (DRI) is a widely used liver transplant allograft risk model but does not account for the increasing adoption of Machine Perfusion (MP).</p><p><strong>Methods: </strong>Using Bayesian updating, we incorporated MP into the DRI framework (DRI-MP). A Bayesian proportional hazards model with informative priors derived from the original DRI was applied to OPTN data from January 2022 to June 2024. Model performance was assessed using Harrell's Concordance (C)-statistic, calibration plots, and Brier scores.</p><p><strong>Results: </strong>DRI-MP, defined as DRI × 0.7 for MP cases, improved 90-day graft survival discrimination (Harrell's C-statistic: = 0.546 vs. 0.535, p = 0.040), while maintaining robust calibration.</p><p><strong>Conclusion: </strong>The Bayesian-updated DRI-MP modestly improves donor risk discrimination, reflecting contemporary transplant practice and providing an implementable tool with continuity from the original DRI.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Yield of Genetic Testing in Serrated Polyposis Syndrome.","authors":"Ira Upadhye, Husam Al Maliki, Victoria Cuthill, Andrew Latchford, Kevin Monahan","doi":"10.14309/ctg.0000000000000923","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000923","url":null,"abstract":"<p><strong>Introduction: </strong>Serrated polyposis syndrome (SPS) is clinically defined by the presence of multiple serrated polyps in the colon and rectum and is associated with increased colorectal cancer risk. SPS is the most prevalent polyposis condition however its genetic basis remains poorly characterised. The British Society of Gastroenterology recommends gene panel testing for all SPS patients to rule out other polyposis conditions. This study aimed to evaluate the diagnostic yield of genetic testing in SPS patients.</p><p><strong>Methods: </strong>We conducted a retrospective, cross-sectional analysis using the Polyposis Registry from St. Mark's Hospital, London, a national referral centre in the United Kingdom. SPS patients who underwent genetic testing between 4 April 2009 to 9 February 2024 and met the SPS WHO criteria were included. Genetic variants were identified from test reports, and clinical data was extracted from medical records.</p><p><strong>Results: </strong>In total, 573 people with SPS were identified in our registry, of whom 258 underwent genetic testing. Of these, 119 underwent target gene testing and 139 underwent multi-gene panel testing (MGPT). No pathogenic variants were detected through targeted genetic testing. On MGPT, pathogenic germline variants were found in four patients (2.9%), including three with Lynch syndrome (two with PMS2, one with MSH2) and one with an RNF43 variant.</p><p><strong>Conclusion: </strong>Genetic testing demonstrated a low diagnostic yield in this SPS cohort, suggesting undefined genetic risk or involvement of other pathophysiological factors. Therefore, genetic testing appears to have limited utility in SPS patients and may primarily identify those with an incidental diagnosis of Lynch syndrome.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunogenicity and Safety of Recombinant Herpes Zoster Vaccine in Patients with Inflammatory Bowel Disease on Vedolizumab or Anti-TNF therapy.","authors":"Freddy Caldera, Harshitha Mogallapalli, Abdul-Rahman Abusalim, Francis A Farraye, Mary S Hayney","doi":"10.14309/ctg.0000000000000924","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000924","url":null,"abstract":"<p><strong>Background: </strong>Patients with inflammatory bowel disease (IBD) are at increased risk of herpes zoster (HZ) and should receive the recombinant herpes zoster vaccine (RZV). We sought to assess the immunogenicity and safety of RZV series in patients receiving anti-tumor necrosis factor (TNF) therapy compared to those receiving vedolizumab.</p><p><strong>Methods: </strong>This single-center prospective study enrolled patients with IBD on vedolizumab or anti-TNF monotherapy receiving RZV. Primary outcome assessed cell-mediated immunity (CMI) differences between groups post-vaccination. Secondary outcomes included humoral response, sustained immunity, and safety monitoring for adverse events and IBD flares. Assessments occurred at baseline, 30, 240, and 425 days post-vaccination. Statistical analyses included non-parametric Mann-Whitney U tests for between-group comparisons and Wilcoxon signed-rank tests for within-group changes, with significance set at p<0.05.</p><p><strong>Results: </strong>Thirty-three patients enrolled (16 vedolizumab, 17 anti-TNF). CMI responses increased post-vaccination in both groups (median 56 cells/million [IQR 21-102] vs 33 cells/million [IQR 11-73]; p=0.13), with no significant difference between treatment groups. Both groups showed strong antibody responses to vaccination (pre-immunization median: 349.9 mIU/ml [IQR 276.8-402.5] vs. 90-day median: 605.0 mIU/ml [IQR 525.6-641.0]; p<0.001). CMI responses remained elevated at both day 240 and 425 assessments. Antibody levels remained elevated through day 425 (549.1 mIU/ml, IQR 516.1-585.6), substantially higher than pre-vaccination levels. No IBD flares occurred; most adverse events were mild and transient.</p><p><strong>Conclusions: </strong>RZV demonstrated robust immunogenicity and favorable safety profile in IBD patients receiving either vedolizumab or anti-TNF therapy. Both cellular and humoral immune responses persisted through 425 days post-vaccination.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Comment on: Does Prior Bariatric Surgery Predispose to Acetaminophen-Related Acute Liver Failure?\"","authors":"Mehmet Akif Yağli, Aslı Çifcibaşı Örmeci, Sabahattin Kaymakoğlu","doi":"10.14309/ctg.0000000000000910","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000910","url":null,"abstract":"","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Lumen Imaging Probe (FLIP) Predictors of Esophageal Clearance in Symptomatic Post-Fundoplication Patients: Opening Diameter Has Greater Value Than Distensibility Index.","authors":"Ryan Flanagan, Edward Hurtte, Mayssan Muftah, Brent Hiramoto, Jennifer X Cai, C Prakash Gyawali, Walter W Chan","doi":"10.14309/ctg.0000000000000922","DOIUrl":"https://doi.org/10.14309/ctg.0000000000000922","url":null,"abstract":"<p><strong>Background: </strong>Clinically relevant esophagogastric junction metrics on functional lumen imaging probe (FLIP) in post-fundoplication patients remain unclear.</p><p><strong>Methods: </strong>63 symptomatic post-fundoplication patients underwent FLIP, barium esophagram, and high-resolution manometry. Logistic regressions and receiver-operating characteristic curves for distensibility index (DI) at 60 mL and maximal diameter were generated to predict impaired clearance.</p><p><strong>Results: </strong>Maximal diameter (OR:0.77, CI:0.62-0.96,p=0.02, AUROC=0.73), but not DI, independently predicted impaired clearance. Diameter >16.5 mm achieved >90% sensitivity for normal clearance; DI <2.0 mm2/mmHg and diameter <8 mm were >90% specific for impaired clearance.</p><p><strong>Conclusions: </strong>Maximal diameter on post-fundoplication FLIP predicts impaired clearance and discriminates better than DI.</p>","PeriodicalId":10278,"journal":{"name":"Clinical and Translational Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}