Clinical Kidney Journal最新文献

{"title":"Correction to: The ERA Registry Annual Report 2022: Epidemiology of Kidney Replacement Therapy in Europe, with a focus on sex comparison.","authors":"","doi":"10.1093/ckj/sfaf107","DOIUrl":"https://doi.org/10.1093/ckj/sfaf107","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ckj/sfae405.].</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf107"},"PeriodicalIF":3.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obinutuzumab is effective for the treatment of rituximab-refractory PLA2R-associated membranous nephropathy.","authors":"Wenyan Su, Jianyi Li, Jinzhao Men, Shuo Zhong, Yunzhao Wang, Yao Zhang, Liang Xu, Jie Gao, Dan Liu, Rong Wang, Jing Sun, Haiping Wang","doi":"10.1093/ckj/sfaf026","DOIUrl":"https://doi.org/10.1093/ckj/sfaf026","url":null,"abstract":"<p><strong>Background: </strong>Clinical experience with obinutuzumab in patients with rituximab-refractory phospholipase A2 receptor (PLA2R)-associated membranous nephropathy remains limited. This study aimed to evaluate the efficacy and safety of obinutuzumab in treating patients with rituximab-refractory PLA2R-associated membranous nephropathy.</p><p><strong>Methods: </strong>A single-center retrospective study was conducted on 20 patients with rituximab-refractory PLA2R-associated membranous nephropathy who received two doses of 1 g obinutuzumab, administered 2 weeks apart. At 6 months, patients with urinary protein levels exceeding 3.5 g/d received an additional dose of 1-2 g obinutuzumab. The primary clinical outcome was a composite measure of complete or partial remission during follow-up. Continuous secondary outcomes included 24-hour urinary protein, serum albumin, serum creatinine, serum anti-PLA2R levels, and CD19 B-cell counts at the time of obinutuzumab infusion, at 3 months, and at the last visit.</p><p><strong>Results: </strong>A total of 20 patients with clinical manifestations of nephrotic syndrome were included in this study, with a median follow-up period of 9 months. The mean age of the patients was 46.25 ± 13.05 years. At a median follow-up of 4.50 months (3.00-8.25 months) after obinutuzumab therapy, remission was achieved in 16 patients. Two patients (10%) achieved complete remission, while 14 (70%) attained partial remission. At baseline, 16 out of 20 patients tested positive for serum anti-PLA2R antibodies, and immunological remission was observed in 11 of these 16 patients during follow-up. All patients experienced B-lymphocyte depletion within 1 month after receiving obinutuzumab infusion and maintained this depletion at 3 months. B-lymphocyte reconstitution was noted in 4 out of 20 patients (20%) at 6 months. No patients experienced fatal adverse events.</p><p><strong>Conclusion: </strong>Obinutuzumab mainly induces short-term partial remissions in patients with rituximab-refractory primary membranous nephropathy, which may be related to the short follow-up period. However, this study demonstrates that obinutuzumab is an effective and safe treatment for rituximab-refractory PLA2R-associated membranous nephropathy.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf026"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal myoglobin elimination using the adsorber CytoSorb or the high-flux HF80 dialyzer for patients with severe rhabdomyolysis: a comparative study.","authors":"Justa Friebus-Kardash, Jasmin Omar, Michael Jahn, Christina Scharf, Kristina Schönfelder, Anja Gaeckler, Kristina Boss, Bartosz Tyczynski, Andreas Kribben","doi":"10.1093/ckj/sfaf071","DOIUrl":"https://doi.org/10.1093/ckj/sfaf071","url":null,"abstract":"<p><strong>Background: </strong>Critically ill patients are frequently affected by severe rhabdomyolysis, consequently requiring renal replacement therapy (RRT). We asked whether CytoSorb is more potent than continuous veno-venous hemodiafiltration (CVVHDF) with the high-flux HF80 dialyzer in removing myoglobin and improving outcome for patients with rhabdomyolysis accompanied by acute kidney injury (AKI).</p><p><strong>Methods: </strong>The historical HF80 cohort consisted of 97 patients who underwent CVVHDF with the HF80 dialyzer between 2010 and 2016. The CytoSorb cohort consisted of 102 patients who underwent treatment with CytoSorb in combination with CVVHDF with the standard high-flux F60S dialyzer between 2018 and 2023.</p><p><strong>Results: </strong>Patients treated with the HF80 dialyzer achieved a median relative reduction of myoglobin of 39% after 24 h of treatment and of 69% after 3 days of treatment; this reduction was similar to the median relative myoglobin elimination achieved for the CytoSorb group (40% after 24 h and 60% after 3 days). The proportions of patients in whom return of diuresis occurred were comparable between the two extracorporeal treatments. The groups did not differ significantly in in-hospital mortality rates. The decrease in the Sequential Organ Failure Assessment (SOFA) and Simplified Acute Physiology Score II (SAPS II) scores at the end of therapy was more pronounced in the CytoSorb group (SOFA <i>P</i> <i> </i>< .0001; SAPS II <i>P</i> <i> </i>< .0001) than in the HF80 group (SOFA <i>P</i> <i> </i>= .004; SAPS II <i>P</i> <i> </i>= .03). The frequency of new-onset end-stage kidney disease among survivors was similar in both groups.</p><p><strong>Conclusions: </strong>Our analysis showed that using CytoSorb resulted in myoglobin reduction rates and clinical outcomes similar to those achieved with CVVHDF with the high-flux HF80 dialyzer for patients with rhabdomyolysis and AKI.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf071"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CD9 expression in minimal change disease and focal segmental glomerulosclerosis.","authors":"Daniel Christiadi, Hana Angelia Kawatu, Giles Walters, Mitali Fadia, Simon Jiang","doi":"10.1093/ckj/sfaf130","DOIUrl":"https://doi.org/10.1093/ckj/sfaf130","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf130"},"PeriodicalIF":3.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of finerenone in IgA nephropathy: an observational multicentre study.","authors":"Qiao-Rui Wang, Longlong Wu, Jian Huang, Hong Pan, Xin-Fei Wang, Li Li, Fei Han, Yong-Fei Wang, Miao-Lian Wu, Yi Yang","doi":"10.1093/ckj/sfaf125","DOIUrl":"https://doi.org/10.1093/ckj/sfaf125","url":null,"abstract":"<p><strong>Background: </strong>Finerenone, a non-steroidal mineralocorticoid receptor antagonist, reduces renal risks in type 2 diabetic nephropathy, but its use in immunoglobulin nephropathy (IgAN) lacks evidence. This study assessed the safety and efficacy of 6-month finerenone treatment in IgAN patients.</p><p><strong>Methods: </strong>This retrospective cohort study was mainly conducted in three Grade 3A hospitals. Patients diagnosed with IgAN and receiving standard supportive care were included. Participants were divided into the renin-angiotensin system inhibitor (RASI) and RASI + finerenone groups. The primary outcome was the percentage decrease in protein-to-creatinine ratio (PCR) over 6 months following the index study visit.</p><p><strong>Results: </strong>In total, 178 patients were included in the analysis. PCR was reduced by 45.1% in the RASI + finerenone group and 32.5% in the RASI group (<i>P</i> = .013). Compared with 18 patients (20.2%) in the control group, 33 (37.1%) had residual PCR reduced to <0.3 g/g. After 6 months, serum potassium increased by 0.17 mmol/L from baseline, with no uncontrollable hyperkalemia (persistent serum potassium >5.5 mmol/L despite treatment). In addition, one patient presented with a blood pressure <90/60 mmHg without significant clinical symptoms in the RASI + finerenone group. And eGFR decreased by 1.94 ± 6.73 mL/min/1.73 m² from baseline, but not statistically significant. There were no differences in the incidence of adverse events between the two groups.</p><p><strong>Conclusions: </strong>Finerenone added to optimized RAS blocker therapy significantly reduced PCR in IgAN patients, and its safety profile was consistent with previous reports, suggesting the need for long-term renal outcome studies.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT06460987.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf125"},"PeriodicalIF":3.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High bicarbonate replacement fluid and time to pH normalization during continuous veno-venous hemofiltration with regional citrate anticoagulation: a retrospective single-center cohort study.","authors":"Timo Mayerhöfer, Paul Köglberger, Fabian Perschinka, Georg F Lehner, Lisa Schilchegger, Romuald Bellmann, Andreas Peer, Birgit Zassler, Sebastian Schauflinger, Michael Joannidis","doi":"10.1093/ckj/sfaf117","DOIUrl":"https://doi.org/10.1093/ckj/sfaf117","url":null,"abstract":"<p><strong>Background: </strong>In critically ill patients, acid-base disorders are common before start of continuous renal replacement therapy. The aim of this study was to determine the influence of a high bicarbonate replacement fluid (30 mmol/L, Phoxilium^®) on underlying acid-base disturbances.</p><p><strong>Methods: </strong>This single-center retrospective study included patients treated with continuous veno-venous hemofiltration (CVVH) at a medical ICU from January 2018 to May 2019. All patients received CVVH with regional citrate anticoagulation (RCA) and a high bicarbonate RF (Phoxilium^®). Patients were categorized based on their initial pH. Acid-base parameters were closely monitored over 72 h at pre-specified intervals.</p><p><strong>Results: </strong>The study included 64 patients with a median age of 68 years. At the start of CVVH, 56.3% (<i>n</i> = 36) had acidemia, 12.5% (<i>n</i> = 8) had alkalemia and 32.3% (<i>n</i> = 20) had a normal pH. The median pH of patients with acidemia [0 h: 7.28 (interquartile range 7.23-7.33)] was corrected quickly to the normal range within 8 h [7.36 (interquartile range 7.29-7.4)]. The median pH of patients with alkalemia took longer (48 h) to reach normal values and patients with a normal pH showed a further pH increase within the normal range over the 72 h. All patients showed an increasing bicarbonate and base excess from 24 to 72 h.</p><p><strong>Conclusions: </strong>The RF in CVVH with RCA appears to be one of several factors influencing acid-base balance. Patients with different pre-existing acid-base disorders showed distinct correction kinetics. Prospective studies are needed to determine the clinical relevance of these findings and to optimize RF composition for better patient outcomes.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf117"},"PeriodicalIF":3.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal effects of obesity on estimated glomerular filtration rate: a Mendelian randomization and image data analysis study.","authors":"Patrik Ene, Maria K Svensson, Robin Strand, Joel Kullberg, Håkan Ahlström, Anders Larsson, Lars Lind","doi":"10.1093/ckj/sfaf116","DOIUrl":"https://doi.org/10.1093/ckj/sfaf116","url":null,"abstract":"<p><strong>Background: </strong>Obesity has been associated with onset and progression of chronic kidney disease (CKD) but causal relationship remains uncertain. This study investigated how obesity causally affects estimated glomerular filtration rate.</p><p><strong>Methods: </strong>Cross-sectional and magnetic resonance imaging (MRI) data analyses were performed within the Prospective Investigation of Obesity, Energy, and Metabolism (POEM) study (502 participants, all aged 50 years). Additionally Mendelian randomization was performed using published summary data. Outcomes were creatinine- and cystatin C-based eGFR. Body mass index (BMI) and waist circumference (WC) were used as exposure variables in the cross-sectional and Mendelian randomization analyses. In the imaging data analyses, eGFR was regressed non-parametrically on tissue volume for each 3D voxel and visualized as a correlation \"Imiomics\" map.</p><p><strong>Results: </strong>Negative correlations were shown between cystatin C-based eGFR and BMI [beta = -0.190 (95% CI: -0.280 to -0.100)] and WC [beta = -0.160 (95% CI: -0.250 to -0.060)] in an adjusted model. In contrast, a positive association was found for creatinine-based eGFR [BMI beta = 1.20 (95% CI: 0.030 to 0.210) and WC beta = 0.160 (95% CI: 0.070 to 0.260)]. Similar patterns were found using MRI analysis (Imiomics map). Mendelian randomization implied a negative causal effect of obesity-related measures on cystatin C-based eGFR [BMI beta = -0.031 (95% CI: -0.037 to -0.026) and WC beta = -0.038 (95% CI: -0.045 to -0.031)], but no statistically significant effect was found for creatinine-based eGFR.</p><p><strong>Conclusion: </strong>This study suggests a causal negative effect of obesity on cystatin C-based, but not creatinine-based eGFR. These findings warrant further research regarding estimations of kidney function when assessing obesity and CKD.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf116"},"PeriodicalIF":3.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CKD-associated pruritus in haemodialysis: a road map for diagnosis and treatment.","authors":"Joerg Latus, Antoine Lanot, Sonja Ständer, Emilio Sanchez-Alvarez, Filippo Aucella, Gil Yosipovitch","doi":"10.1093/ckj/sfaf096","DOIUrl":"https://doi.org/10.1093/ckj/sfaf096","url":null,"abstract":"<p><p>Of the wide range of symptoms affecting patients with chronic kidney disease (CKD) on haemodialysis, CKD-associated pruritus is one of the most common and burdensome, occurring at moderate-to-severe intensity in 31%-40% of patients, significantly impacting multiple aspects of quality of life, and associated with increased healthcare utilization. Despite the distressing nature of this symptom, clinicians frequently underestimate its prevalence and it is under-reported by patients who may be unaware of the availability of effective treatment options. The identification and management of CKD-associated pruritus should form an essential aspect of patient-centred care; however, patients with CKD may have multiple causes of chronic itch including those of dermatological, systemic, neuropathic and psychogenic origin, and CKD-associated pruritus must be distinguished from these. Together with its highly variable presentation in patients on haemodialysis, the range of potential causes of itch makes differential diagnosis of CKD-associated pruritus challenging. The presence of bilaterally symmetrical and non-dermatomally distributed itching, commonly affecting the back, limbs, chest and head is characteristic of CKD-associated pruritus, although approximately 50% of patients report generalized pruritus. Secondary skin lesions (including excoriation, crusts, impetigo, lichenifications and prurigo also seen in dermatological conditions) may or may not be observed, and xerosis (dry skin) that may exacerbate itching is common. Here, we provide a pragmatic approach to the identification and differential diagnosis of chronic itching in CKD-associated pruritus with the aim of supporting the effective management of this highly distressing symptom in clinical practice.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf096"},"PeriodicalIF":3.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does nighttime hypertension predict long-term kidney outcomes in patients with IgA nephropathy?","authors":"Takumi Ikeda, Kotaro Haruhara, Takaya Sasaki, Hirokazu Marumoto, Eisuke Kubo, Nobuo Tsuboi, Takashi Yokoo","doi":"10.1093/ckj/sfaf085","DOIUrl":"https://doi.org/10.1093/ckj/sfaf085","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf085"},"PeriodicalIF":3.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development, Rasch analysis and validation of the kidney symptom burden questionnaire (KSB-Q).","authors":"Derek Kyte, Benjamin R Fletcher, Mike Horton, Sarah Damery, Olalekan Lee Aiyegbusi, Nicola Anderson, Andrew Bissell, Melanie Calvert, Paul Cockwell, James Ferguson, Muirne C S Paap, Chris Sidey-Gibbons, Neil Turner, Rav Verdi, Anita Slade","doi":"10.1093/ckj/sfaf112","DOIUrl":"https://doi.org/10.1093/ckj/sfaf112","url":null,"abstract":"<p><strong>Background: </strong>Increasingly, patient-reported outcome measures (PROMs) are used to monitor chronic kidney disease (CKD) symptoms in routine clinical practice. However, such symptom measurement currently requires completion of multiple, often lengthy, PROMs, which may lead to questionnaire fatigue, lower levels of completion, and missing data. Moreover, many CKD-specific PROMs lack evidence of important measurement properties and few were developed using contemporary psychometric methods. The study objective was to develop and validate a short-form kidney symptom burden questionnaire (KSB-Q).</p><p><strong>Methods: </strong>A cross-sectional item pool survey was distributed to adults (≥18 years) with CKD stages 3-5 [including individuals not receiving kidney replacement therapy (KRT), those receiving dialysis and those with a functioning kidney transplant] in England (Birmingham, London, Sheffield, and Nottingham) from March to September 2022. Rasch measurement was used to assess the psychometric properties of the item pool. Cognitive debriefing interviews were conducted to evaluate content validity.</p><p><strong>Results: </strong>In total, 419/1464 participants responded (29% response rate), with 28% receiving dialysis and 30% in receipt of a kidney transplant. Rasch analysis indicated that nine items, one for each of nine symptom domains (fatigue, pain, memory/concentration, poor sleep, skin problems, gastrointestinal problems, dizziness, restless legs, and shortness of breath), formed a PROM with strong psychometric properties (including statistically acceptable reliability, test-retest reliability, and validity). Cognitive debriefing and survey responses confirmed content validity encompassing relevance, comprehensiveness, and clarity.</p><p><strong>Conclusions: </strong>The KSB-Q is a nine-item PROM measuring somatic symptoms. The KSB-Q demonstrates strong psychometric properties in patients with CKD stages 3-5, including those not receiving KRT, individuals receiving dialysis, and those with a functioning kidney transplant.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf112"},"PeriodicalIF":3.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}