Clinical and Experimental Nephrology最新文献

{"title":"Acute kidney injury as a prognostic determinant in cardiogenic shock: a cohort study.","authors":"Emre Cankaya, Betul Senturk Alkan, Ezgi Coskun Yenigun","doi":"10.1007/s10157-026-02875-0","DOIUrl":"https://doi.org/10.1007/s10157-026-02875-0","url":null,"abstract":"","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811904","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":"Changes in mean corpuscular volume after erythropoiesis-stimulating agent treatment are associated with renal outcomes in non-dialysis-dependent chronic kidney disease.","authors":"Raku Son, Takuya Fujimaru, Tatsuo Kagimura, Tadashi Sofue, Takao Masaki, Masaaki Nakayama, Ichiei Narita","doi":"10.1007/s10157-026-02818-9","DOIUrl":"10.1007/s10157-026-02818-9","url":null,"abstract":"<p><strong>Background: </strong>Mean corpuscular volume (MCV) is routinely measured in patients with chronic kidney disease (CKD) and anemia; however, its prognostic significance, particularly in the context of erythropoiesis-stimulating agent (ESA) therapy, remains unclear.</p><p><strong>Methods: </strong>We conducted a post hoc analysis of the BRIGHTEN study, a multicenter, prospective trial that enrolled 1219 ESA-naïve patients with non-dialysis-dependent CKD who initiated darbepoetin alfa. Patients were categorized based on changes in MCV from baseline to week 16 as either increased or decreased. The primary outcome was renal function decline, defined as the initiation of dialysis, kidney transplantation, ≥ 50% reduction in estimated glomerular filtration rate (eGFR), or an eGFR ≤ 6 mL/min/1.73 m² within 96 weeks.</p><p><strong>Results: </strong>MCV decreased in 778 (63.8%) patients during the study period. Changes in MCV were not correlated with baseline MCV values or ESA responsiveness. Over a mean follow-up of 2.46 ± 0.78 years, renal function decline occurred in 304 (39.1%) and 140 (31.7%) patients in the decreased and increased MCV groups, respectively. After adjusting for age, sex, baseline eGFR, albumin, high-sensitivity CRP, proteinuria, ferritin, transferrin saturation and ESA responsiveness, increased MCV remained independently associated with a reduced risk of renal function decline (adjusted hazard ratio 0.67; 95% confidence interval 0.53-0.85; p < 0.001).</p><p><strong>Conclusion: </strong>In ESA-naïve patients with non-dialysis-dependent CKD, an increase in MCV following ESA treatment was associated with a significantly lower risk of renal function decline. Monitoring MCV dynamics may serve as a simple, adjunctive tool for risk stratification and individualized CKD management.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"822-827"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of anthropometric and biochemical-anthropometric obesity indices with chronic kidney disease in diabetes: a KNHANES-based study.","authors":"Eun Mi Yang, Jong Im Won, Sang Heon Suh, Hong Sang Choi, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim","doi":"10.1007/s10157-026-02833-w","DOIUrl":"10.1007/s10157-026-02833-w","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a known risk factor for diabetes mellitus (DM) and chronic kidney disease (CKD), yet the relationship between various obesity-related indices and CKD remains unclear. This study evaluated the associations between eight obesity indices with CKD and identified the most useful index among patients with DM.</p><p><strong>Methods: </strong>This study used data from the Korean National Health and Nutrition Examination Survey conducted from 2007 to 2018. A total of 5,067 participants aged ≥ 20 years with DM were included. The study evaluated four traditional anthropometric obesity indices (body mass index [BMI], waist-to-height ratio [WHtR], body roundness index [BRI], conicity index [CI]) and four biochemical-anthropometric indices, including two Asian-specific indices (lipid accumulation product [LAP], visceral adiposity index [VAI], Chinese visceral adiposity index [CVAI], and new visceral adiposity index [NVAI]).</p><p><strong>Results: </strong>WHtR, BRI, CI, CVAI, and NVAI were higher in males with CKD, while only CI, CVAI, and NVAI were elevated in females. All eight indices were independently associated with CKD risk in males, whereas only the anthropometric-biochemical indices LAP, VAI, and CVAI were significantly associated with CKD in females. NVAI in males and CVAI in females exhibited the highest area under the curve values of 0.615 and 0.658, respectively.</p><p><strong>Conclusions: </strong>Various obesity indices were associated with CKD in patients with DM, although the associations differed by sex. Asian-specific indices may be the most useful for reflecting CKD in patients with DM.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"726-736"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of renal outcomes between sodium-glucose cotransporter 2 inhibitor and glucagon-like peptide 1 receptor agonist in Japanese patients with type 2 diabetes and obesity.","authors":"Yukihiro Wada, Masao Toyoda, Kazuo Kobayashi, Togo Aoyama, Akira Kanamori, Yasuo Takeuchi","doi":"10.1007/s10157-026-02845-6","DOIUrl":"10.1007/s10157-026-02845-6","url":null,"abstract":"<p><strong>Introduction: </strong>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1Ra) have shown renoprotective effects in type 2 diabetes (T2D). Our previous findings suggested superior renal outcomes with SGLT2i compared to GLP-1Ra, particularly due to greater reductions in blood pressure (BP). However, whether this benefit extends to obese patients remains unclear. This study compared renal outcomes between SGLT2i and GLP-1Ra in obese Japanese patients with T2D.</p><p><strong>Methods: </strong>This retrospective study included patients with T2D and body mass index ≥ 25 kg/m² treated with either SGLT2i (n = 439) or GLP-1Ra (n = 174) for over one year. Patients receiving both drugs were excluded. The renal composite outcome was defined as an annual decline in estimated glomerular filtration rate (eGFR) > 30%, progression of albuminuria category, or both. Propensity score matching was applied to balance baseline characteristics.</p><p><strong>Results: </strong>After matching (n = 89 per group), the incidence of renal events did not differ significantly between the two groups. The annual decline in eGFR tended to be smaller with SGLT2i than with GLP-1Ra (- 1.6 ± 3.5 vs. - 2.8 ± 5.8 mL/min/1.73 m²/year, p = 0.13). SGLT2i-treated patients also showed greater reductions in systolic BP and body weight (BW) (- 5.0 ± 19.7 vs. - 1.1 ± 18.0 mmHg, p = 0.19; - 3.3 ± 4.6 vs. - 1.9 ± 4.9 kg, p = 0.05, respectively).</p><p><strong>Conclusion: </strong>Among this population, the annual eGFR decline appeared numerically smaller with SGLT2i-tretament, without statistical significance. Greater BP and BW reductions were observed, though their impact on renal outcomes remains uncertain.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"747-756"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147467196","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":"Distinct clinicopathological features of IgA nephropathy associated with Crohn's disease: comparison with ulcerative colitis and non-IBD IgA nephropathy.","authors":"Akihiro Shimizu, Nobuo Tsuboi, Saeko Hatanaka, Shohei Fukunaga, Takaya Sasaki, Kotaro Haruhara, Masahiro Okabe, Shinya Yokote, Hiroyuki Ueda, Yuko Iwashita, Kan Uchiyama, Masato Ikeda, Takashi Yokoo","doi":"10.1007/s10157-026-02850-9","DOIUrl":"10.1007/s10157-026-02850-9","url":null,"abstract":"<p><strong>Background: </strong>IgA nephropathy (IgAN) is increasingly recognized as a complication of inflammatory bowel disease (IBD), particularly Crohn's disease (CD). Recent studies suggest that mucosal immune dysregulation and biologic therapies, particularly tumor necrosis factor (TNF)-α inhibitors, may influence the onset and progression of IgAN in IBD. However, its clinicopathological characteristics in this context remain uncertain.</p><p><strong>Methods: </strong>We conducted a retrospective, multicenter study of patients with biopsy-proven IgAN and concurrent CD. Patients with CD-associated IgAN (CD-IgAN) were compared with those with ulcerative colitis-associated IgAN (UC-IgAN) and with IgAN unassociated with IBD (non-IBD-IgAN). Clinical parameters at kidney biopsy, treatment history, and histopathological findings were evaluated. One-year outcomes included changes in proteinuria, hematuria status, and estimated glomerular filtration rate (eGFR).</p><p><strong>Results: </strong>In total, eight patients with CD-IgAN, eight patients with UC-IgAN, and 32 matched non-IBD-IgAN controls were included. Patients with CD-IgAN exhibited lower eGFR, higher serum IgA levels, and a higher prevalence of tubulointerstitial nephritis compared to non-IBD-IgAN controls. Moreover, CD-IgAN was characterized by significantly lower eGFR and a nonsignificant trend toward more advanced tubulointerstitial injury compared to UC-IgAN. The use of TNF-α inhibitors was more frequent in the CD-IgAN group. At 1 year, all groups exhibited reductions in proteinuria, with no significant differences in eGFR change or hematuria resolution.</p><p><strong>Conclusions: </strong>CD-IgAN represents a distinct clinicopathological phenotype characterized by lower kidney function and more severe tubulointerstitial injury. Although causality cannot be inferred, careful kidney monitoring should be considered in patients with CD, particularly those receiving TNF-α inhibitors.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"757-766"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503277","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":"Risk analysis and nomogram-based prediction for Double-J stent encrustation: accounting for chronic kidney disease.","authors":"Mingbin Xu, Daoyuan Li, Shuming He, Chengyang Li","doi":"10.1007/s10157-026-02829-6","DOIUrl":"10.1007/s10157-026-02829-6","url":null,"abstract":"<p><strong>Background: </strong>Double J (DJ) stent encrustation is a common postoperative complication that can lead to severe infection, obstruction, or stent retention. Existing predictive models primarily focus on indwelling time and urinary pH but have largely excluded patients with chronic kidney disease (CKD), limiting their applicability. This multicenter study aimed to develop and externally validate a nomogram for individualized prediction of DJ stent encrustation, incorporating renal function status for the first time.</p><p><strong>Methods: </strong>A total of 760 patients who underwent upper urinary tract stone surgery with postoperative DJ stent placement were retrospectively analyzed. Clinical, biochemical, and behavioral variables were evaluated. Multivariate logistic regression identified independent predictors, which were used to construct a predictive nomogram. External validation was performed using an independent cohort of 337 patients from another tertiary hospital. Model discrimination, calibration, and clinical benefit were assessed by receiver operating characteristic (ROC) curve analysis, bootstrap calibration, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Stent encrustation occurred in 121 patients (15.9%). Four variables-stent indwelling time, urine pH, daily water intake, and renal function stage-were independently associated with encrustation (p < 0.05 for all). The nomogram achieved excellent discrimination (AUC = 0.877) and maintained strong external performance (AUC = 0.884). CKD significantly increased risk in a dose-dependent manner, and interaction analysis revealed a synergistic effect between CKD and urine pH (p = 0.002), explaining the lack of independent significance of pH in CKD subgroups.</p><p><strong>Conclusion: </strong>This study established and externally validated the first nomogram for predicting DJ stent encrustation that includes CKD as a systemic variable. The model demonstrates high accuracy and generalizability, offering a practical tool for early identification of high-risk patients, particularly those with renal impairment, to guide individualized stent management and prevent irreversible renal damage.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"810-821"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282451","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":"Anti-nephrin autoantibodies in post-transplant recurrent focal segmental glomerulosclerosis: diagnostic advances and future directions.","authors":"Yoko Shirai, Motoshi Hattori","doi":"10.1007/s10157-026-02830-z","DOIUrl":"10.1007/s10157-026-02830-z","url":null,"abstract":"<p><p>Nephrotic syndrome is a common kidney disease during childhood that is characterized by alterations in the glomerular filtration barrier and leads to protein loss in the urine. Approximately 90% of cases are classified as idiopathic nephrotic syndrome, most of which are histologically diagnosed as minimal change disease (MCD). Although the majority of patients achieve remission with steroid therapy, a subset develops steroid resistance and progresses to focal segmental glomerulosclerosis (FSGS) and kidney failure. Increasing evidence suggests that MCD and idiopathic FSGS represent a disease continuum, with FSGS reflecting a more advanced stage. Although several candidates have been proposed as circulating factors, none fully explains the disease pathogenesis. This landscape changed in 2022 with the discovery of anti-nephrin autoantibodies in MCD. Subsequently, we reported that circulating anti-nephrin autoantibodies were identified by ELISA in patients with post-transplant recurrent FSGS, and punctate IgG deposition colocalizing with nephrin was consistently detected in allograft biopsy specimens obtained during recurrence. Notably, these IgG deposits resolved following remission. Collectively, these findings suggest diffuse podocytopathies as autoantibody-mediated disorders and support a shift toward autoantibody-based disease classification. Experimental and clinical studies demonstrate that anti-nephrin autoantibodies induce nephrin phosphorylation. This process may be associated with nephrin endocytosis and subsequent cytoskeletal alterations. Additionally, autoantibodies targeting slit diaphragm molecules other than nephrin have been identified. However, the pathogenic roles of these autoantibodies remain to be clarified. Collectively, these findings highlight a complex, autoantibody-driven mechanism in diffuse podocytopathies and underscore the need for standardized assays and biomarker-driven classification strategies.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"691-697"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13090191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periglomerular granulomatosis: a rare finding in microscopic polyangiitis.","authors":"Hideaki Aihara, Rina Tanaka, Tomo Suzuki","doi":"10.1007/s10157-026-02817-w","DOIUrl":"10.1007/s10157-026-02817-w","url":null,"abstract":"","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"833-834"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017105","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":"Facility-based educational systems and peritonitis incidence in peritoneal dialysis: findings from a nationwide survey in Japan.","authors":"Ai Nagashima, Takaaki Kosugi, Genri Tagami, Satoshi Kurahashi, Satoshi Ototake, Masahiro Nakagaki, Kenji Harada, Naohiro Toda, Hiroyuki Kadoya, Masahiro Eriguchi, Yukinao Sakai, Masashi Mizuno, Masaaki Nakayama, Yasuhiko Ito","doi":"10.1007/s10157-026-02842-9","DOIUrl":"10.1007/s10157-026-02842-9","url":null,"abstract":"<p><strong>Background: </strong>There have been no clear recommendations regarding the optimal timing, setting, content, and duration for peritoneal dialysis (PD) education. This nationwide survey aimed to examine current PD educational practices across Japanese facilities and explore factors associated with the incidence of PD-related peritonitis.</p><p><strong>Methods: </strong>Eligible facilities were institutional members of the Japanese Society for Peritoneal Dialysis. The questionnaire consisted of five sections covering facility characteristics, facility-level peritonitis profiles, PD education, peritonitis prophylaxis, and re-education. Associations between PD practices and the incidence of PD-related peritonitis were examined using linear and logistic regression analyses.</p><p><strong>Results: </strong>A total of 194 facilities were included between November 2024 and May 2025. The median peritonitis incidence rates in 2023 and 2024 were 0.18 and 0.20 episodes/patient-year, respectively. Regression analyses showed that an annual training frequency of two or more sessions for education staff, earlier initiation of PD education (before catheter insertion vs. around PD initiation), more frequent visits during the first month after PD initiation (once every 1-2 weeks vs. once every 3-4 weeks), and routine patient re-education were associated with lower incidence of peritonitis or higher achievement of the target incidence rate of < 0.4 episodes/patient-year.</p><p><strong>Conclusions: </strong>Regular training for patient educators, early initiation of patient education before catheter insertion, and follow-up with re-education after PD initiation were associated with lower rates of PD-related peritonitis.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"780-791"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376264","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":"Nationwide questionnaire analysis on awareness of general practitioners for the management of chronic kidney disease in Japan.","authors":"Kazuo Kobayashi, Satoru Tatematsu, Tsuguru Hatta, Taisuke Isozaki, Yosuke Nakayama, Junko Imura, Toshimasa Takahashi, Munehiro Kitada, Yasunori Utsunomiya","doi":"10.1007/s10157-026-02821-0","DOIUrl":"10.1007/s10157-026-02821-0","url":null,"abstract":"<p><strong>Background: </strong>Effectively managing a large numbers chronic kidney disease (CKD) cases requires collaboration between nephrologists and non-nephrologists. In 2024, the Japan physicians association conducted a third nationwide questionnaire survey on managing CKD. This study aimed to clarify the differences in managing CKD between nephrologists and non-nephrologists and identify remaining issues by comparing them with past surveys.</p><p><strong>Method: </strong>In the 2024 surveys, 1003 general practitioners voluntarily participated and answered 20 questions about CKD care and treatment. They were divided into 2 groups: 835 non-nephrologists and 168 nephrologists, and the differences were analyzed. Furthermore, the 2024 survey results were compared with those from the 2013 and 2019 surveys.</p><p><strong>Results: </strong>The use of CKD guidelines was significantly lower among non-nephrologists than nephrologists (55%/21% and 86%/60%, respectively; p < 0.001), and as in the past 2 surveys (p < 0.001). Estimated glomerular filtration rate assessment was widespread at 95%; nevertheless, 34% of non-nephrologists measured quantitative proteinuria compared to 82% of nephrologists (p < 0.001). This prevalence decreased with each survey and with the age of the non-nephrologists. While 75% of nephrologists prescribed renin-angiotensin system inhibitors for patients with CKD and hypertension, considering their renoprotective effects, 45% of non-nephrologists answered it (p < 0.001). While 61% of non-nephrologists prescribed sodium-glucose co-transporter 2 inhibitors to patients with CKD, regardless of diabetes complications, compared to 83% of nephrologists (p < 0.001).</p><p><strong>Conclusion: </strong>The quality of CKD management by non-nephrologists partially improved in the past decade; however, the low use of guidelines and implementation of quantitative proteinuria measurements among non-nephrologists needs to be addressed in future.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"706-717"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146092241","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}