Clinical Rheumatology最新文献

{"title":"Response to \"Temporality before complexity in JAK inhibitor cardiovascular safety analyses\".","authors":"Yuwei Wang, Leina Sun, Ruohan Yu, Weiduo Nie, Sheng-Guang Li, Fangcheng Su, Fang Cheng, Di Jin","doi":"10.1007/s10067-026-08381-8","DOIUrl":"10.1007/s10067-026-08381-8","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"6317-6318"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856977","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":"Comparative effectiveness and predictors of SRI-4 and LLDAS attainment in active systemic lupus erythematosus: a real-world study of telitacicept versus belimumab.","authors":"Xinyi Shen, Qingyi Chen, Lei Wang, Tingting Wu, Jian Wu, Erye Zhou, Tian Ren, Jing Cao, Yufeng Yin, Tao Cheng, Mingjun Wang","doi":"10.1007/s10067-026-08321-6","DOIUrl":"10.1007/s10067-026-08321-6","url":null,"abstract":"<p><strong>Objective: </strong>To compare the attainment of Systemic Lupus Erythematosus Responder Index 4 (SRI-4) and lupus low disease activity state (LLDAS) between telitacicept and belimumab in patients with active systemic lupus erythematosus (SLE), and to identify baseline clinical predictors of treatment response.</p><p><strong>Methods: </strong>This retrospective observational cohort study was conducted at a single center in China between 2020 and 2024. A total of 115 patients with active SLE received either telitacicept (n = 60, 80 mg or 160 mg weekly) or belimumab (n = 55, 10 mg/kg every 4 weeks) alongside standard therapy. The primary outcome was the SRI-4 response rate at week 24. Baseline predictors were identified using LASSO and multivariable Cox proportional hazards models.</p><p><strong>Results: </strong>Telitacicept demonstrated a significantly higher early SRI-4 response at week 4 (16.7% [10/60] vs. 3.6% [2/55]; OR 5.30, 95% CI 1.11-25.39, P = 0.037). At week 24, the SRI-4 response was 56.7% (34/60) for telitacicept compared to 40.0% (22/55) for belimumab (OR 1.96, 95% CI 0.93-4.12, P = 0.075). Univariate Cox analysis indicated a superior cumulative SRI-4 incidence for telitacicept (HR 3.03, 95% CI 1.30-7.08, P = 0.011). Multivariable analysis confirmed baseline SLEDAI-2 K (HR 1.29, 95% CI 1.17-1.42, P = 0.001) and serum albumin levels (HR 1.16, 95% CI 1.08-1.24, P = 0.001) as independent predictors of SRI-4 achievement. The incidence of total adverse events was comparable between the telitacicept and belimumab groups (38.3% [23/60] vs. 34.6% [19/55], P = 0.675).</p><p><strong>Conclusions: </strong>In clinical practice, telitacicept is associated with earlier SRI-4 attainment compared to belimumab in patients with active SLE. Baseline disease activity scores and serum albumin levels are key prognostic markers for achieving therapeutic response. Key Points • Telitacicept is associated with a significantly more rapid attainment of the SRI-4 response compared to belimumab in patients with active systemic lupus erythematosus in a real-world setting. • Baseline SLEDAI-2 K scores and serum albumin levels are identified as independent predictors for achieving early therapeutic responses. • The two BAFF/APRIL inhibitors exhibit distinct hematological impacts: telitacicept significantly improves hemoglobin levels, while belimumab is more effective at increasing platelet counts. • A higher dose of telitacicept (160 mg) may facilitate superior long-term attainment of the lupus low disease activity state (LLDAS) compared to the standard dose.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"6115-6125"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764135","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 adiposity and psoriatic arthritis beyond classical clinical predictors.","authors":"Estefanía Pardo, Stefanie Burger, Marta Loredo, Ignacio Braña, Paula Alvarez, Rubén Queiro","doi":"10.1007/s10067-026-08353-y","DOIUrl":"10.1007/s10067-026-08353-y","url":null,"abstract":"<p><strong>Background: </strong>Psoriatic arthritis (PsA) develops in a substantial proportion of patients with psoriasis. Although obesity has been linked to PsA, whether adiposity independently amplifies articular risk beyond established predictors remains incompletely defined.</p><p><strong>Objective: </strong>To explore whether adiposity showed a graded association with PsA across different clinical strata.</p><p><strong>Methods: </strong>This cross-sectional study included 519 psoriatic disease cases (27.2% with PsA). Multivariable logistic regression models assessed the association of waist circumference (per 10 cm) and body mass index (BMI) with PsA, adjusting for psoriasis duration ≥ 10 years, nail involvement, PASI, and sex. Interaction terms between adiposity measures and classical predictors were explored. Model discrimination was evaluated using the area under the receiver operating characteristic curve (AUC), and correlated AUCs were compared using the DeLong test.</p><p><strong>Results: </strong>Nail involvement (OR 3.31, p < 0.001) and psoriasis duration (OR 2.70, p < 0.001) were the strongest independent associations with PsA. An ordinal quartile-based model supported a graded association across waist circumference categories (aOR per quartile increase 1.28, 95% CI 1.05-1.56; p = 0.016). BMI showed a comparable association, and discrimination was similar between adiposity measures (AUC 0.74 vs 0.73; DeLong p = 0.33). No significant interaction was observed between adiposity and psoriasis duration or severity. Exploratory interaction analyses suggested that the adiposity-PsA association may differ according to nail involvement status.</p><p><strong>Conclusions: </strong>Adiposity was independently associated with the presence of PsA and showed a graded relationship across adiposity levels. These findings support a potential link between metabolic burden and articular disease expression in psoriatic disease.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"6153-6158"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 baseline anti-Ro52 seropositivity with connective tissue disease development following interferon-α therapy in patients with chronic hepatitis B.","authors":"Yongxin Ma, Hongyan Qian, Caixia Zheng, Chaoqiong Deng, Xiaomei Liu, Xiulan Xue, Zhibin Li, Guixiu Shi, Yuechi Sun","doi":"10.1007/s10067-026-08317-2","DOIUrl":"10.1007/s10067-026-08317-2","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to investigate whether baseline anti-Ro52 positivity was associated with the connective tissue disease (CTD) development in patients with chronic hepatitis B (CHB) receiving interferon-α (IFN-α) therapy.</p><p><strong>Design: </strong>We conducted a retrospective cohort study of patients with CHB who initiated IFN-α therapy between January 2021 and December 2023. Associations between baseline anti-Ro52 positivity and CTD development were evaluated using Kaplan-Meier analysis and Cox proportional hazards models.</p><p><strong>Results: </strong>A total of 1178 patients were included. Nine percent of CHB patients were positive for anti-Ro52 before IFN-α therapy and that 19.02% were positive after IFN-α therapy. There were 120 newly developed CTDs (120/1178, 10.19%) during IFN-α therapy, most of which were undifferentiated CTDs (UCTDs) (110/120, 91.67%). No statistically significant difference in CTD incidence was observed between the anti-Ro52 - and anti-Ro52 + groups (9.79% vs. 14.15%, P = 0.176). Multivariate Cox regression analyses revealed that female sex (HR = 1.53; 95% CI: 1.01-2.33; P = 0.045), IFN-α therapy duration ≥ 12 months (HR = 2.41; 95% CI: 1.62-3.59; P < 0.001), anti-Ro60 positivity (HR = 3.82; 95% CI: 1.82-8.03; P < 0.001), and Scl-70 positivity (HR = 5.65; 95% CI: 1.37-23.36; P = 0.017) were risk factors for CTD development in CHB patients after IFN-α therapy, whereas IFN-α therapy combined with NA therapy was associated with a decreased risk (HR = 0.56; 95% CI: 0.33-0.95; P = 0.031).</p><p><strong>Conclusion: </strong>Baseline anti-Ro52 positivity was not significantly associated with CTD development in patients with CHB receiving IFN-α therapy. Instead, CTD development appears to be associated with multiple clinical and serological characteristics, including female sex, prolonged IFN-α therapy, baseline anti-Ro60 positivity, and anti-Scl-70 positivity. Prospective studies with larger cohorts and longer follow-up are warranted to confirm these observations. Key Points • Anti-Ro52 positivity is common in CHB patients and significantly increased after IFN-α therapy. • Baseline anti-Ro52 positivity alone does not appear to be associated with subsequent CTD development in patients with CHB receiving IFN-α therapy. • Female sex, a duration of IFN-α therapy longer than 12 months, anti-Ro60 positivity, and anti-Scl70 positivity were associated with CTD development.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"6199-6211"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683639","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 \"Awareness of rheumatoid arthritis symptoms and complications among the Jordanians\".","authors":"M Vimal Kumar, Lakshmi Nagalingam, Krishna Prasanth Baalann","doi":"10.1007/s10067-026-08329-y","DOIUrl":"10.1007/s10067-026-08329-y","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"6313-6314"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789228","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":"Digital physical-activity engagement and 12-week patient-reported outcomes in inflammatory arthritis: a retrospective real-world cohort study.","authors":"Dmytro Fedkov, Daria Koliadenko, Liubov Petelytska, Christine Peine, Felix Lang, Abdullah Khalil, Oleg Iaremenko","doi":"10.1007/s10067-026-08126-7","DOIUrl":"10.1007/s10067-026-08126-7","url":null,"abstract":"<p><strong>Background: </strong>Physical activity is a key component of inflammatory arthritis (IA) management, yet real-world evidence on digital exercise-support tools remains limited.</p><p><strong>Objectives: </strong>To examine whether physical-activity action plan (PA_AP) engagement over 12 weeks is associated with changes in the Health Assessment Questionnaire (HAQ), pain, physical component score (PCS), patient global assessment (PGA), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Functional Index (BASFI).</p><p><strong>Methods: </strong>This retrospective cohort study included adults with IA using a digital application. Associations between PA_AP engagement and 12-week outcomes were estimated using ANCOVA models adjusting for age, sex, diagnosis, and baseline values. Exploratory analyses assessed individual PA_APs.</p><p><strong>Results: </strong>Among 2924 users, paired 12-week data were available for HAQ (n = 285), pain (n = 930), PGA (n = 928), PCS (n = 165), BASDAI (n = 163), and BASFI (n = 84). Overall, PA_AP engagement was associated with minor worsening in HAQ (β = 0.36, 95% CI 0.19-0.52), while no statistically significant associations were observed for PCS, PGA, BASDAI, or BASFI. Exploratory analyses identified modest statistically significant benefits for two structured modules: Exercise training, with reductions in pain (β = - 5.99, 95% CI - 9.12 to - 2.87) and PGA (β = - 5.83, 95% CI - 9.04 to - 2.62), and Yoga for rheumatism, which improved PGA (β = - 5.65, 95% CI - 10.21 to - 1.09) and showed a favourable trend for pain.</p><p><strong>Conclusion: </strong>In this real-world IA cohort, structured, disease-activity-tailored exercise and adapted yoga content delivered statistically significant benefits. However, overall PA_AP engagement showed no gains in functional or disease-activity outcomes, suggesting that more personalised, progressive, clinically guided digital physical-activity modules could offer greater therapeutic value. Key Points • Non-personalised physical-activity action plans produced only minor short-term changes in function and disease activity, with no consistent clinically meaningful improvement. • Two structured and partially individualised modules (tailored exercise training and adapted yoga) showed modest but statistically significant symptomatic benefits, particularly for pain and PGA. • Digital exercise tools may be most effective when they provide symptom-responsive adaptation, personalised progression, and physiotherapy-informed calibration rather than generic, non-progressive programmes.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"6011-6022"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789195","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":"Real-world effectiveness of tofacitinib in monotherapy or in combination with csDMARDs in patients with rheumatoid arthritis: A collaboration between Dutch registries (TOFADUDAP study).","authors":"Isabell S Nevins, Herman Kasper Glas, Floor Reimann, Reinhard Bos, Marieke P D de Buck, K Wiepke Drossaers-Bakker, Mirjam C Hegeman, Tom W J Huizinga, Sytske Anne Bergstra","doi":"10.1007/s10067-026-08362-x","DOIUrl":"10.1007/s10067-026-08362-x","url":null,"abstract":"<p><strong>Objective: </strong>To compare real-world effectiveness of tofacitinib monotherapy to adalimumab monotherapy, and tofacitinib and adalimumab in combination with csDMARDs in Rheumatoid Arthritis (RA) subgroups.</p><p><strong>Methods: </strong>Retrospective routine care data was used from six Dutch cohorts for RA patients who initiated tofacitinib or adalimumab between 2001 and 2022. Drug survival of tofacitinib monotherapy (n = 229) was compared with that of tofacitinib combination-therapy (n = 179), adalimumab monotherapy (n = 1019) and adalimumab combination-therapy (n = 1361) using Kaplan-Meier curves and Cox regression. Drug survival was evaluated as an indirect measure of treatment persistence. Exploratory analyses assessed effect modifications by anti-citrullinated protein antibody (ACPA) status and age at treatment onset in both models.</p><p><strong>Results: </strong>Patients who started tofacitinib monotherapy were older compared to other treatment groups (61 vs 55, 58 and 58 years) and had used at least one previous b/tsDMARD more often compared to the adalimumab treatment groups (36% vs 41%, 19% and 13%). Compared to tofacitinib monotherapy, the risk of drug discontinuation was similar for tofacitinib combination-therapy (aHR 1.22, 95% CI: 0.96-1.54) and adalimumab monotherapy (aHR 0.89, 95% CI: 0.73-1.09) but lower for adalimumab combination-therapy (aHR 0.78, 95% CI: 0.63-0.96). Older age was associated with significantly higher risk of drug discontinuation. No effect modification by ACPA was observed.</p><p><strong>Conclusion: </strong>Based on real-world data from six Dutch cohorts, drug discontinuation was higher for tofacitinib than for adalimumab, with similar outcomes with or without csDMARDs. Older age was associated with a higher risk of drug discontinuation independently of treatment group, although this finding may be influenced by factors beyond treatment effectiveness. Key Points • In a real-world setting tofacitinib was observed to have similar drug survival in mono- and combination therapy • ACPA status did not influence drug survival • Older age was related to a higher risk of drug discontinuation independently of treatment.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"6071-6080"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification and functional characterization of ASCC2 as a diagnostic biomarker and immune regulatory hub in Kawasaki disease.","authors":"Benyong Mi, Lingling Zhang, Songtao Tang, Chaolin Li","doi":"10.1007/s10067-026-08453-9","DOIUrl":"https://doi.org/10.1007/s10067-026-08453-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Kawasaki disease (KD) is an acute systemic vasculitis in children, yet its molecular mechanisms remain incompletely understood. This study aimed to identify downregulated candidate diagnostic biomarkers and subsequently investigate the potential functional relevance of a prioritized candidate gene in KD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Bulk transcriptomic data from GSE73461 were used for biomarker discovery and model development, while GSE68004 was used for independent external validation. Single-cell RNA sequencing data from GSE168732 were further analyzed to investigate the cellular and regulatory characteristics of the identified genes. Differential expression analysis, WGCNA, machine learning algorithms, CellChat, and scTenifold-based perturbation analysis were performed. Functional investigation of the prioritized candidate ASCC2 was performed in TNF-α-stimulated HUVECs using siRNA-mediated knockdown.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Three consistently downregulated genes (EPB42, RUNDC3A, and ASCC2) were identified as candidate diagnostic biomarkers for KD. The three-gene model achieved an AUC of 0.903 in the discovery cohort and 0.948 in the independent GSE68004 cohort. In clinically relevant febrile controls, the model showed moderate discrimination between KD and human adenovirus infection (AUC = 0.830) and between KD and Group A streptococcal infection (AUC = 0.769). Among the three genes, ASCC2 was prioritized for further biological investigation based on its associations with immune-cell populations. Single-cell analyses revealed altered intercellular communication and cell-type-specific ASCC2 expression patterns, while in silico perturbation analysis implicated ASCC2 in NK-cell cytotoxicity and cell-cycle-related regulatory programs. In TNF-α-stimulated HUVECs, ASCC2 knockdown reduced CCK-8-derived metabolic activity and induced G0/G1 cell-cycle arrest.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our findings identify EPB42, RUNDC3A, and ASCC2 as a reproducible molecular signature associated with KD. The signature robustly discriminated KD from healthy controls and showed moderate discriminatory ability against clinically relevant febrile infections, supporting its potential utility as an adjunctive molecular marker rather than a standalone diagnostic tool. Among these genes, ASCC2 was further investigated as a candidate immune-related regulator through computational and endothelial-cell functional analyses. These findings support the diagnostic potential of the three-gene panel while providing preliminary mechanistic insights into ASCC2 in KD. Key Points • EPB42, RUNDC3A, and ASCC2 were identified as a downregulated molecular signature associated with Kawasaki disease and independently validated in GSE68004. • ASCC2 was prioritized for single-cell and in silico perturbation analyses, which suggested associations with NK-cell cytotoxicity and cell-cycle-related regulatory programs. • ASCC2 depletion in TNF-α-sti","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105097","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":"Spondyloepiphyseal dysplasia with secondary osteoarthritis: a rare cause of early degenerative arthropathy.","authors":"Bekir Torun","doi":"10.1007/s10067-026-08340-3","DOIUrl":"10.1007/s10067-026-08340-3","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"6307-6309"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677238","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":"Temporality before complexity in JAK inhibitor cardiovascular safety analyses.","authors":"Mehmet Serkan Kılıçoğlu","doi":"10.1007/s10067-026-08387-2","DOIUrl":"10.1007/s10067-026-08387-2","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"6315-6316"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857053","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}