Clinical, Cosmetic and Investigational Dermatology最新文献

{"title":"Upadacitinib Coadministered with Methylprednisolone for Effective Treatment of SJS/TEN Overlap Syndrome: A Case Report.","authors":"Xiansheng Zhou, Jing Zhang, Pingxiu He, Guohong Hu, Xiaobing Wang, Shuling Kong, Weijun Liu","doi":"10.2147/CCID.S540221","DOIUrl":"10.2147/CCID.S540221","url":null,"abstract":"<p><p>Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) overlap syndrome, characterized by extensive epidermal necrosis, represents a life-threatening severe dermatological disorder.Therapeutic agents and regimens for this condition include high-dose glucocorticoids, intravenous immunoglobulin (IVIG), plasma exchange, immunosuppressants, and TNF-α inhibitors. A study demonstrates that JAK/STAT hyperactivation-characterized by interferon signature enrichment, STAT1 phosphorylation in keratinocytes/macrophages, and subsequent GBP1/WARS1-mediated cytotoxicity-drives epidermal detachment in TEN. JAK inhibitors (including JAK1-selective agents) suppressed this pathway in murine models and achieved rapid resolution in seven TEN patients.Recent clinical studies have demonstrated the therapeutic efficacy of JAK inhibitors in SJS/TEN management. In this context, we present the case of a 54-year-old woman who presented to the hospital with a 6-day history of rapidly worsening erythema, accompanied by a 4-day history of blistering and erosion. The patient received treatment with methylprednisolone (40 mg/day, weight: 49 kg) and upadacitinib (15 mg/day for 2 weeks). Combination therapy achieves rapid disease control by halting the progression of cutaneous necrosis while enabling accelerated glucocorticoid tapering. This case underscores that the combination therapy of upadacitinib and methylprednisolone can offer a promising approach for the SJS/TEN overlap syndrome.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1937-1941"},"PeriodicalIF":2.2,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12348879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844778","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":"Clinical and Molecular Insights Into Anti-MDA5 Antibody-Positive Dermatomyositis: A Single-Center Retrospective and Transcriptomic Study.","authors":"Yunli Ren, Tianqi Wu, Weiwei Shi","doi":"10.2147/CCID.S535704","DOIUrl":"10.2147/CCID.S535704","url":null,"abstract":"<p><strong>Objective: </strong>To comprehensively characterize clinical features, diagnostic challenges, and prognostic biomarkers of anti-MDA5 antibody-positive dermatomyositis (MDA5-DM), incorporating transcriptomic analysis to elucidate underlying molecular mechanisms.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 29 MDA5-DM patients, collecting detailed clinical and laboratory data. Prognostic factors were identified using LASSO regression, validated by Cox proportional hazards and Kaplan-Meier survival analyses. Public transcriptomic dataset (GSE143323) was analyzed to identify differentially expressed genes and enriched immune pathways.</p><p><strong>Results: </strong>Patients exhibited a high misdiagnosis rate (62.1%) and prevalent interstitial lung disease (96.6%), with 41.4% developing rapidly progressive ILD (RP-ILD). Serum KL-6 level emerged as an independent predictor of mortality (HR=2.96, p<0.01). Transcriptomic profiling revealed upregulation of IL-17, Toll-like receptor, and cytokine-receptor interaction pathways.</p><p><strong>Conclusion: </strong>MDA5-DM presents formidable diagnostic challenges with high misdiagnosis rates and substantial mortality risk predominantly driven by RP-ILD. Serum KL-6 represents a robust, clinically applicable prognostic biomarker warranting integration into risk stratification protocols. Transcriptomic findings illuminate critical immune-inflammatory cascades, particularly cytokine networks and IL-17 signaling, offering mechanistic insights and potential therapeutic targets. Future multicenter prospective studies are essential to validate these biomarker findings and develop composite prognostic models incorporating clinical, radiographic, and molecular parameters.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1917-1929"},"PeriodicalIF":2.2,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871789","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":"Spesolimab Treatment in GPP: Impact of IL-36RN Mutations and Concomitant Plaque Psoriasis.","authors":"Wei Li, Jingyao Liang, Yuwu Luo, Shuting Chen, Manqi Xia, Hui Ye, Bin Yang, Quan Luo","doi":"10.2147/CCID.S533564","DOIUrl":"10.2147/CCID.S533564","url":null,"abstract":"<p><p>We present a case series involving five patients with generalized pustular psoriasis (GPP) who received a single intravenous dose of 900 mg spesolimab in our department from September 2023 to January 2024. Spesolimab was effective in three patients, regardless of their IL-36RN gene mutation status. Two patients with concomitant plaque psoriasis, despite initially poor responses to spesolimab, achieved resolution of pustules after switching their therapy to ixekizumab or secukinumab. This study highlights the potential of spesolimab in managing GPP, especially in genetically distinct groups, and emphasizes the importance of tailored therapeutic approaches. These findings suggest that spesolimab can effectively treat GPP, regardless of IL-36RN gene mutation status. However, its therapeutic efficacy may be suboptimal in patients with concomitant plaque psoriasis, indicating the need for further investigation to optimize treatment outcomes in this subgroup.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1931-1935"},"PeriodicalIF":2.2,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12351184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871790","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":"Pigmented Extramammary Paget's Disease of the Axilla: Two Case Reports and a Literature Review.","authors":"Yi-Xiao Wang, Xiao-Mei Cui, Qing Zhang, Xiao-Qing Xu, Yao Sun, Min Gao, Li-Xiong Gu","doi":"10.2147/CCID.S535004","DOIUrl":"10.2147/CCID.S535004","url":null,"abstract":"<p><p>Extramammary Paget's disease is a rare intraepithelial adenocarcinoma that mainly occurs in areas rich in apocrine sweat glands, such as the vulva, perianal region, and, less commonly, in the axillary skin. Owing to the varied manifestations of extramammary Paget's disease, it is often misdiagnosed. Particularly, pigmented extramammary Paget's disease (PEMPD) can be mistaken for superficial spreading melanoma, Bowen's disease, pigmented superficial basal cell carcinoma, or seborrheic keratosis. Here, we report two cases of women with axillary pigmented plaques who were confirmed as PEMPD through histopathological and immunohistochemical analyses. One of these patients was only 31 years old, which makes her the youngest reported case of PEMPD to date. All patients underwent Mohs micrographic surgery, and no recurrence or metastasis was observed postoperatively. PEMPD is a rare clinical variant that can resemble other pigmented lesions, both clinically and histopathologically. Therefore, this report underscores the importance of accurate differential diagnosis through immunohistochemistry.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1909-1915"},"PeriodicalIF":2.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834353","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":"Combination of Three Treatment Modes of 1064 nm Nd: YAG Laser in the Treatment of Melasma: A Retrospective Observational Study.","authors":"Houhuang Qiu, Yuyun Zhu, Bingliang Wu, Siyuan Zhou, Xiang Zhou, Fuqiang Pan","doi":"10.2147/CCID.S532685","DOIUrl":"10.2147/CCID.S532685","url":null,"abstract":"<p><strong>Background: </strong>Melasma is a chronic, relapsing pigmentary disorder with a high recurrence rate. While multiple treatment options exist, long-term oral therapies are often limited by poor patient tolerance. Laser therapy offers a non-invasive and convenient alternative; however, Low-fluence QS 1064 nm Nd: YAG monotherapy has shown inconsistent efficacy and frequent relapse. To investigate a more effective laser-based approach, this retrospective study evaluates the clinical outcomes of combining Low-fluence QS 1064 nm Nd: YAG laser, Fractional-mode QS 1064 nm Nd: YAG laser, and Long-pulsed 1064 nm Nd: YAG laser in the treatment of melasma.</p><p><strong>Methods: </strong>This retrospective observational study enrolled 43 patients with clinically diagnosed melasma, all of whom underwent treatment with a 1064 nm Nd: YAG laser using a combination of three modes: low-fluence QS, fractional-mode QS, and long-pulsed settings. Each patient underwent a total of three treatment sessions. Clinical improvement was assessed using the MASI at baseline and one month after each session. Adverse events were documented throughout the treatment course. Patients were followed for 12 months post-treatment to evaluate recurrence and satisfaction.</p><p><strong>Results: </strong>MASI scores significantly decreased following the final treatment compared to baseline [13.50 (8.40-19.10) vs 5.86 ± 3.38, p < 0.001]. At the 12-month follow-up, the recurrence rate was 18.60%, with a patient satisfaction rate of 72.10%. Post-inflammatory hyperpigmentation occurred in 6.97% of cases, and transient erythema or edema in 46.51%, all of which resolved spontaneously.</p><p><strong>Conclusion: </strong>In this retrospective observational study, combination therapy with low-fluence QS 1064 nm Nd: YAG laser, fractional-mode QS 1064 nm Nd: YAG laser, and long-pulsed 1064 nm Nd: YAG laser demonstrated favorable efficacy in the treatment of melasma, with low recurrence rates and a low incidence of adverse events. These findings suggest that this combined laser approach is a promising and well-tolerated treatment modality for melasma.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1889-1900"},"PeriodicalIF":2.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834352","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":"Comparative Morphometric and Histometric Evaluation of Power-Dependent Tissue Ablation Using Fractional Carbon Dioxide Laser.","authors":"Hye Guk Ryu, Jinyoung Park, Hyemin Kim, Wanil Kim, Hwa-Rim Lee, Jeongah Ko, Sung Bin Cho","doi":"10.2147/CCID.S534637","DOIUrl":"10.2147/CCID.S534637","url":null,"abstract":"<p><strong>Background: </strong>Fractional carbon dioxide (CO₂) lasers are commonly used in dermatological resurfacing, offering precise ablation and controlled dermal remodeling. Although clinical outcomes vary with the energy and pulse settings, comparative morphometric and histometric data on power-dependent tissue interactions are limited.</p><p><strong>Objective: </strong>To evaluate and compare fractional CO₂ laser-induced microscopic thermal zones (MTZs) ablation characteristics at peak powers of 30 W and 40 W using an ex vivo porcine skin model.</p><p><strong>Methods: </strong>Ex vivo porcine skin was treated with a fractional CO₂ laser at energy levels ranging from 40 to 240 mJ under 30 W and 40 W settings. Frozen tissue was used for dermoscopic assessment of ablation diameters, while unfrozen tissue at physiological temperature (30-32°C) was analyzed histologically for ablation depth. Morphometric and histometric measurements were performed and statistically analyzed.</p><p><strong>Results: </strong>The 30 W and 40 W settings demonstrated energy-dependent increases in ablation depth and diameter. The 40 W laser consistently generated deeper ablation columns (average 11.8% deeper) with narrower surface diameters (average 7.3% narrower) and reduced peripheral carbonization. Linear regression showed strong correlations between energy and ablation depth (r > 0.91) and diameter (r > 0.91), with higher slope coefficients in the 40 W group, indicating greater ablation efficiency.</p><p><strong>Conclusion: </strong>The 40 W fractional CO₂ laser system offers enhanced precision, deeper dermal penetration, and reduced thermal diffusion compared with the 30 W, despite delivering equivalent total energy. These findings suggest that higher peak power settings may improve fractional resurfacing procedures' safety and clinical outcomes, particularly in populations with darker skin phototypes.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1901-1907"},"PeriodicalIF":2.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12338317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820707","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":"Geometric-Marking Quantification for First-Stage Excision of Large Congenital Melanocytic Nevi.","authors":"Kaixi Tan, Jianfei Zhang","doi":"10.2147/CCID.S533955","DOIUrl":"10.2147/CCID.S533955","url":null,"abstract":"<p><strong>Background: </strong>Staged excision is often needed for large CMN. Accurately determining the first-stage excision volume is critical.</p><p><strong>Objective: </strong>To introduce and evaluate a geometric-marking quantification method for precise preoperative planning of the first-stage excision volume in staged CMN removal.</p><p><strong>Methods: </strong>A prospective study was conducted on 21 patients undergoing staged excision of large CMN between January and June 2023. Preoperatively, a novel geometric-marking quantification technique was employed to calculate the maximum feasible first-stage excision volume. Surgical execution, intraoperative conditions, and postoperative recovery were observed. Relevant surgical techniques and postoperative care were examined.</p><p><strong>Results: </strong>All first-stage excisions resulted in successful tension-free primary closure. No instances of insufficient excision, suture dehiscence, or other immediate complications occurred. Postoperative recovery was favorable across all patients. All patients proceeded to successful second-stage excision for complete nevus removal.</p><p><strong>Conclusion: </strong>The geometric-marking quantification method provides a reliable, reproducible, and objective approach for planning the first-stage excision in large CMN. It achieved 100% technical success in this cohort, eliminating complications related to inaccurate volume estimation. This standardized protocol warrants clinical adoption to replace subjective estimation methods, significantly enhancing surgical outcomes and reducing complication risks.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1865-1872"},"PeriodicalIF":2.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815930","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":"Dermatofibroma: Reappraisal and Updated Review.","authors":"Leo Wan, Aileen Park, Lanah Almatroud, Amor Khachemoune","doi":"10.2147/CCID.S526191","DOIUrl":"10.2147/CCID.S526191","url":null,"abstract":"<p><p>Dermatofibromas (DF), also known as fibrous histiocytomas, are common benign cutaneous lesions characterized histologically by dermal proliferation of spindle-shaped fibrocytes, with the overlying epidermis often demonstrating hyperplasia with acanthosis, basal layer hyperpigmentation, and a characteristic \"collarette\" of epidermal hyperplasia surrounding the lesion. The etiology of DF remains debated, with theories ranging from reactive processes triggered by local trauma, such as insect bites, to spontaneous development. DF typically presents as a hyperkeratotic nodule or plaque, most often on the lower extremities, and can exhibit a wide spectrum of clinical appearances. Variants such as hemosiderotic, epithelioid, aneurysmal, and cellular DF show distinct clinical and histopathological features that may sometimes mimic malignant lesions. Dermoscopic findings can aid in diagnosis, although biopsy is often required for definitive classification. Discrepancies in the literature persist regarding the pathogenesis and classification of DF, and while DF is generally benign, rare cases of metastasizing DF have been reported. This review aims to provide an examination of DF, including its clinical manifestations, etiology, subtypes, histological features, and differential diagnoses. It also discusses dermoscopic findings, controversies in the literature, and current treatment options. A clearer understanding of its diverse presentations, along with refined diagnostic criteria, will enhance clinical management and treatment strategies.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1873-1887"},"PeriodicalIF":2.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815929","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":"A Review: Causes, Consequences, and Management Strategies of Facial Overfilling.","authors":"Cheng-Xiang Peng, Wang Xv, Yin-Jie Ao","doi":"10.2147/CCID.S539888","DOIUrl":"10.2147/CCID.S539888","url":null,"abstract":"<p><p>In recent years, Overfilled Syndrome and the associated \"Bread Bun\" phenomenon have garnered significant attention in the field of aesthetic medicine, particularly among younger populations. This article systematically reviews the causes, consequences, and management strategies of facial overfilling, aiming to provide a scientific basis for the prevention and correction of this phenomenon. The causes of overfilling involve technical, patient, and physician-related factors: technical factors include improper injection dosage, depth, and point design; patient factors primarily stem from the excessive pursuit of \"perfect\" facial features and unrealistic expectations; while physician factors are related to insufficient experience, lack of technical proficiency, and misinterpretation of aesthetic standards. The consequences of overfilling include aesthetic imbalance, health risks, and psychological issues. To effectively prevent and manage overfilling, this article proposes detailed preventive strategies, including preoperative assessment and design, patient education, intraoperative layered injection techniques, and regular postoperative follow-ups. For cases where overfilling has already occurred, non-surgical correction and surgical correction are the primary treatment methods. Additionally, psychological support and the application of portable ultrasound technology play important roles in the correction process. Future research directions include the development of quantitative assessment tools, optimization of prevention and management strategies, and the development of new filler materials and technologies. Through scientific preventive strategies, precise treatment plans, and ongoing research and innovation, the occurrence of overfilling can be effectively reduced, advancing facial filler procedures toward greater safety and naturalness.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1857-1864"},"PeriodicalIF":2.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815928","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":"Successful Treatment of Nail Lichen Planus by the Janus Kinase 1 Upadacitinib and Literature Review.","authors":"Xingyun Zhao, Jianbo Zhong, Yanzhen Xu, Yingzhi Luo, Yunmi Qiu, Liming Wu, Ping Yang","doi":"10.2147/CCID.S534496","DOIUrl":"10.2147/CCID.S534496","url":null,"abstract":"<p><p>Nail lichen planus (NLP) is a chronic inflammatory condition that can lead to considerable cosmetic and functional impairment. Failure to administer prompt and effective treatment may result in the development of permanent scarring and nail loss. The precise pathogenesis of NLP remains poorly understood, and there is currently an absence of safe and effective treatment options. Although not FDA-approved for the treatment of lichen planus, Janus kinase (JAK) inhibitors have shown considerable promise as therapeutic agents for a variety of dermatoses. This case report describes a patient with NLP who showed improvement after six months of treatment with upadacitinib, a selective JAK1 inhibitor. Changes were assessed using the Nail Lichen Planus Severity Index (NALSI) score. Following medication administration, the total score of the NALSI for the patient's nail involvement decreased from 146 to 37. However, a mild recurrence was observed following the reduction of the medication dosage (NALSI score to 47).</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"18 ","pages":"1849-1855"},"PeriodicalIF":2.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815931","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}