Clinical therapeutics最新文献

{"title":"Pancreatitis and Pancreatic Cancer Risk Among Patients With Type 2 Diabetes Receiving Dipeptidyl Peptidase 4 Inhibitors: An Updated Meta-Analysis of Randomized Controlled Trials","authors":"Adili Tuersun MS ,&nbsp;Guanxin Hou BS ,&nbsp;Gang Cheng PhD","doi":"10.1016/j.clinthera.2024.06.015","DOIUrl":"10.1016/j.clinthera.2024.06.015","url":null,"abstract":"<div><h3>Purpose</h3><p>This meta-analysis sought to assess the relationship between dipeptidyl peptidase-4 inhibitors (DPP-4) and the risk of pancreatitis and pancreatic cancer by synthesizing data from randomized, controlled trials, in light of the conflicting findings from observational studies and previous meta-analyses.</p></div><div><h3>Methods</h3><p>Cochrane, Embase, ClinicalTrials.gov, and PubMed databases that compared the use of DPP-4 inhibitors and that reported pancreatitis and pancreatic cancer events in patients with diabetes mellitus Type 2 (T2DM) were searched using specific terms. Studies were included if they satisfied the following inclusion criteria: They were randomized trials comparing DPP-4 inhibitors use in patients with T2DM; The study's duration was longer than 24 weeks; And they reported pancreatitis and pancreatic cancer events. Stata 15 MP was used to analyze the data, and odds ratios (OR) with 95% confidence intervals (CI) were used to represent the results.</p></div><div><h3>Findings</h3><p>A total of 81,737 participants with T2DM were included in the analysis. The results showed that during a mean follow-up period of 24 to 520 weeks, The use of DPP-4 inhibitors was not associated with an increased risk of pancreatitis (Peto-OR 0.97; 95% CI: 0.74, 1.27) or pancreatic cancer (Peto-OR = 0.88; 95% CI: 0.59, 1.30).</p></div><div><h3>Implications</h3><p>Current evidence fails to validate a significant correlation between DPP-4 therapy and pancreatitis or pancreatic cancer. However, subgroup analyses showed that sitagliptin was associated with a significant reduction in pancreatitis risk compared to the control group; furthermore, when comparing different types of control medications, a significant decrease in pancreatic cancer risk was observed among DPP-4 users compared to GLP-1 users.</p></div>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859289","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":"Effectiveness of Mesotherapy in Post-COVID Pain Syndrome: Retrospective Cohort Study of 96 Patients","authors":"","doi":"10.1016/j.clinthera.2024.05.004","DOIUrl":"10.1016/j.clinthera.2024.05.004","url":null,"abstract":"<div><h3>Purpose</h3><p>Musculoskeletal pain may occur after becoming infected with SARS-Cov2. This study was designed to evaluate the efficacy of mesotherapy in treating chronic pain following COVID-19 infection.</p></div><div><h3>Methods</h3><p><span><span>A retrospective review was conducted of the records of 96 patients with post-COVID pain syndrome. Those who were eligible for oral therapy or mesotherapy, included in the study. Patients receiving oral treatment with </span>diclofenac potassium, </span>thiocolchicoside<span><span> and cyanocobalamin<span> were included in one group (n = 46), and patients receiving intradermal mesotherapy with 2% lidocaine + cyanocobalamin were included in another group (n = 50). The results of the Visual Analogue Scale (VAS) and the Leeds Assessment of Neuropathic </span></span>Symptoms and Signs (LANSS) were individually assessed before and one week after the treatment.</span></p></div><div><h3>Findings</h3><p>The participants were 40.2 ± 11.1 years old on average. Of the participants, 35.4% (n = 34) were male and 64.6% (n = 62) were female. Before treatment, there was no statistically significant difference between the patients in terms of VAS and LANSS scores. Following the treatment, a notable positive response was observed in both groups. Nevertheless, when compared to the oral treatment group, the mesotherapy group exhibited a more pronounced enhancement in VAS and LANSS scores (<em>P</em> &lt; 0.001, <em>P</em> &lt; 0.001, respectively).</p></div><div><h3>Implications</h3><p>While both mesotherapy and oral therapy offer benefits in reducing pain and alleviating neuropathic symptoms in post-COVID pain syndrome, mesotherapy stands out as an especially effective and well-tolerated treatment method, surpassing the efficacy of the oral alternative.</p></div>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442262","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":"Physiologically Based Pharmacokinetic Model for Predicting Omadacycline Pharmacokinetics and Pharmacodynamics in Healthy and Hepatic Impairment Populations","authors":"Ailin Zhang MS ,&nbsp;Yuxuan Sun MS ,&nbsp;Meiling Zuo MS ,&nbsp;Huiyu Wei ,&nbsp;Jingtao Chen ,&nbsp;Mingfeng Zhao MD ,&nbsp;Wenjie Yang MM ,&nbsp;Liqin Zhu PhD","doi":"10.1016/j.clinthera.2024.06.014","DOIUrl":"10.1016/j.clinthera.2024.06.014","url":null,"abstract":"<div><h3>Purpose</h3><p>Omadacycline is a new broad-spectrum aminomethylcycline antibiotic. However, there have been limited pharmacokinetic and pharmacodynamic (PK/PD) studies of omadacycline in patients with hepatic impairment. The aim of this study was to explore the PK/PD of omadacycline intravenous administration in healthy and hepatically impaired populations.</p></div><div><h3>Methods</h3><p>A physiologically based pharmacokinetic (PBPK) model of omadacycline was developed and validated based on published demographic data and the physiochemical properties of omadacycline. The PK processes in healthy adults were simulated and then extrapolated to a hepatically impaired population. Monte Carlo simulations were performed for PD evaluation by calculating the probability of target attainment (PTA) and the cumulative fraction of response (CFR) of the approved dosages.</p></div><div><h3>Findings</h3><p>In the hepatically impaired population, there was no significant difference in the maximum concentration (C_max) compared with the healthy population, while the area under the plasma concentration-time curve from the first data point extrapolated to infinity (AUC_inf) showed a slight increase. Monte Carlo simulations indicated that the dosage of 200 mg once daily or 100 mg twice daily intravenously (loading dose) and 100 mg once daily intravenously (maintenance dose) could cover the common pathogens of community-acquired bacterial pneumonia (CABP) and acute bacterial skin and skin structure infections (ABSSSI) : <em>Streptococcus pneumoniae, Haemophilus influenzae</em>, and <em>Staphylococcus aureus</em>.</p></div><div><h3>Implications</h3><p>Hepatic impairment exerts little impact on the PK properties of omadacycline, and no dosage adjustments are necessary for patients with mild and moderate hepatic impairment. Current dosing regimens are predicted to produce satisfactory therapeutic effects against non–drug-resistant strains of <em>Staphylococcus aureus, Streptococcus pneumoniae</em>, and <em>Haemophilus influenzae</em> but may not produce the desired AUC/MIC ratios in patients with <em>Escherichia coli</em> or <em>Klebsiella pneumoniae</em>.</p></div>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787520","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":"A Phase I Dose-Escalation Study of The Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Polyethylene Glycol-Erythropoietin (PEG-EPO) in Healthy Subjects","authors":"Chaoying Hu ,&nbsp;Wanling Sun ,&nbsp;Yuanyuan Wu ,&nbsp;Junlong Huang ,&nbsp;Xiangrong Zhang ,&nbsp;Lan Zhang","doi":"10.1016/j.clinthera.2024.06.018","DOIUrl":"10.1016/j.clinthera.2024.06.018","url":null,"abstract":"<div><h3>Purpose</h3><p>This first-in-human trial aimed to investigate the pharmacokinetics and pharmacodynamics characteristics and safety and tolerability of single ascending doses of subcutaneous polyethylene glycol-erythropoietin (PEG-EPO) in healthy subjects.</p></div><div><h3>Methods</h3><p>In this phase I, randomized, double-blind, placebo-controlled, dose-escalating trial, subjects were sequentially enrolled into 7 cohorts with 12 subjects in each cohort and randomized in a 5:1 ratio to receive a single dose of 0.2, 0.4, 0.8, 1.6, 2.4, 3.6, or 4.8 µg/kg PEG-EPO or matching placebo. Safety and tolerability including dose-limiting toxicities (DLTs) were assessed. Pharmacokinetics parameters, including C_max, AUC_0-inf, <em>T</em>_max, and <em>t</em>_1/2, and pharmacodynamics parameters, including reticulocyte count and hemoglobin content, were evaluated.</p></div><div><h3>Findings</h3><p>Eighty-four subjects (median age 30.4 years and 77.4% male) were enrolled. No subjects developed DLTs. Any grade treatment-related adverse events occurred in 66.7% of the subjects, but most (92.9%) were mild. No serious adverse events and no death occurred. Forty percent of the subjects receiving PEG-EPO had iron decreased, 27.1% reported ferritin decreased, 25.7% showed unsaturated iron binding capacity increased, and 17.1% had neutrophil count decreased. <em>C</em>_max exhibited a dose-disproportionate rise from a geometric mean of 525 pg/mL with 0.2 µg/kg PEG-EPO to 23196 pg/mL with 4.8 µg/kg PEG-EPO. The mean t_1/2 ranged between 82.4 ± 21.3 h with 0.4 µg/kg PEG-EPO and 160.6 ± 65.7 h with 1.6 µg/kg PEG-EPO. AUC_0-inf displayed a largely dose-proportional rise from 226264.5 pg*h/mL with 0.2 µg/kg PEG-EPO to 5206434.0 pg*h/mL with 4.8 µg/kg PEG-EPO. The absolute reticulocyte count increased with escalating doses of PEG-EPO, with the mean maximal change from baseline between 3.2 ± 1.5*10^10/L (Q1,Q3 1.8-3.6*10^10/L) with PEG-EPO 0.2 µg/kg and 9.3 ± 4.0*10^10/L (Q1,Q3 6.2-13.5*10^10/L) with 3.6 µg/kg PEG-EPO. The mean maximal change from baseline in the mean hemoglobin content ranged between 5.9 ± 4.4 g/L (Q1,Q3 3.5,7.0) with 0.2 µg/kg PEG-EPO and 15.4 ± 8.7 g/L (Q1,Q3 10.5,20.0) with 2.4 µg/kg PEG-EPO.</p></div><div><h3>Implications</h3><p>This trial demonstrated that PEG-EPO was safe and tolerable in healthy subjects. The subcutaneous route of administration allows outpatient treatment and the pharmacokinetics characteristics of PEG-EPO support less frequent dosing regimens and effective treatment for chronic kidney disease patients with anemia.</p></div><div><h3>Trial registration</h3><p>clinicaltrials.gov identifier: NCT03657238.</p></div>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0149291824001930/pdfft?md5=c371f70c3c8154cc0edf78c2f1a3d742&pid=1-s2.0-S0149291824001930-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906137","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":"Artificial Intelligence, Drug Development and Frameworks: An Opportunity to Enhance Understanding","authors":"Paul Beninger MD, MBA","doi":"10.1016/j.clinthera.2024.07.005","DOIUrl":"10.1016/j.clinthera.2024.07.005","url":null,"abstract":"","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897008","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":"Dosing Strategy of Ramosetron to Prevent Postoperative Nausea and Vomiting and Development of Prediction Models Using Data Obtained From Randomized Controlled Trials: A Comparative Study","authors":"","doi":"10.1016/j.clinthera.2024.05.003","DOIUrl":"10.1016/j.clinthera.2024.05.003","url":null,"abstract":"<div><h3>Purpose</h3><p>The study aimed to compare the postoperative nausea and vomiting (PONV) preventive effect of repeated administration of ramosetron with the standard treatment group and compare models to predict the incidence of PONV using machine-learning techniques.</p></div><div><h3>Methods</h3><p>A total of 261 patients scheduled for breast surgery were analyzed to evaluate the effectiveness of repeated intravenous administration of ramosetron. All patients were administered 0.3 mg ramosetron just before the end of surgery. For the repeated dose of ramosetron group, an additional dose of 0.3 mg was administered at 4, 22, and 46 hours after the end of the surgery. Postoperative nausea, vomiting, and retching were evaluated using the Rhodes Index of Nausea, Vomiting, and Retching at 6, 24, and 48 hours postoperatively. Previously published randomized controlled data were combined with the data of this study to create a new dataset of 1390 patients, and machine-learning–based PONV prediction models (classification tree, random forest, extreme gradient boosting, and neural network) was constructed and compared with the Apfel model.</p></div><div><h3>Findings</h3><p>Fifty patients (38.5%) and 60 patients (45.8%) reported nausea, vomiting, or retching 48 hours postoperatively in the standard and repeated-dose groups, respectively (<em>P</em> = 0.317, χ² test). Median sensitivity, specificity, and accuracy of the Apfel model analyzed using the training set were 0.815, 0.344, and 0.495, respectively.</p></div><div><h3>Implications</h3><p>The repeated administration of ramosetron did not reduce the incidence of PONV. The Apfel model had high sensitivity, however, its specificity and accuracy were lower than that in machine-learning–based models.</p></div>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0149291824001103/pdfft?md5=b90fe5cbe43e9777f73668b323ff3911&pid=1-s2.0-S0149291824001103-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426544","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":"Ceftobiprole Medocaril Sodium","authors":"Paul Beninger MD, MBA","doi":"10.1016/j.clinthera.2024.06.007","DOIUrl":"10.1016/j.clinthera.2024.06.007","url":null,"abstract":"","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603397","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":"Pharmacodynamics Between a Dual Delayed-Release Formulation of Low-Dose Esomeprazole and Famotidine in Healthy Korean Subjects","authors":"Young-Sim Choi PhD ,&nbsp;Jun Gi Hwang MD, PhD ,&nbsp;Jae-Won Kim Master ,&nbsp;Hyojin Min Master ,&nbsp;Chang-Hwan Seong Master ,&nbsp;Sung Hee Hong ,&nbsp;Na Young Kim ,&nbsp;Min Kyu Park MD, PhD","doi":"10.1016/j.clinthera.2024.06.013","DOIUrl":"10.1016/j.clinthera.2024.06.013","url":null,"abstract":"<div><h3>Purpose</h3><p><span>Gastritis, one of the most common clinically diagnosed conditions, is defined as the infiltration of inflammatory cells into the </span>gastric mucosa<span>. Drugs for gastritis include histamine-2 receptor antagonists and proton pump inhibitors<span><span> (PPIs), which reduce acidity in the stomach, and antacids<span>, which neutralize acid. Esomeprazole<span><span> is a PPI for gastroesophageal reflux disease and gastric and </span>duodenal ulcers that has been shown to be safe and effective at a 10 mg dose. Dual-release drugs have not yet been approved for the treatment of gastritis domestically or internationally. In this study, a dual delayed-release (DR) esomeprazole (10 mg), was compared to </span></span></span>famotidine (20 mg) to determine its effectiveness in the treatment of gastritis.</span></span></p></div><div><h3>Methods</h3><p>This study was a randomized, open-label, multiple-dose, 2-treatment, 2-period, 2-sequence crossover study with a 7-day washout between periods. In each period, the subjects were administered one dose of esomeprazole (10 mg) or famotidine (20 mg) for 7 days at each period. The 24-hour gastric pH was recorded after single and multiple doses. The percentage of time (duration%) that the pH was maintained above 4 in the 24 hours after 7 days of repeated dosing was evaluated.</p></div><div><h3>Findings</h3><p>The mean percentages of time that the gastric pH was above 4 after multiple doses over 7 days of a dual DR esomeprazole (10 mg) and famotidine (20 mg) was 47.31% ± 14.85% and 23.88% ± 10.73%.</p></div><div><h3>Implications</h3><p>Multiple doses of a dual DR esomeprazole (10 mg) showed effective gastric acid secretion suppression compared to famotidine with comparable safety and tolerability. These results provide evidence supporting the clinical use of a dual DR esomeprazole (10 mg) to treat gastritis.</p><p>ClinicalTrials.gov identifier: NCT04967014.</p></div>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733733","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":"Genetically Proxied IL-6 Receptor Inhibition and Coronary Artery Disease Risk in a Japanese Population","authors":"","doi":"10.1016/j.clinthera.2024.04.015","DOIUrl":"10.1016/j.clinthera.2024.04.015","url":null,"abstract":"","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0149291824001073/pdfft?md5=7115560616ce61269c14efca2c3b68e5&pid=1-s2.0-S0149291824001073-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184007","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":"Repurposing Drugs to Treat Novel Infections: A Proposal for a Decision-Making Framework for Clinicians","authors":"","doi":"10.1016/j.clinthera.2024.06.004","DOIUrl":"10.1016/j.clinthera.2024.06.004","url":null,"abstract":"<div><h3>Purpose</h3><p><span>Global fears regarding future epidemics of new and re-emerging infections will prompt clinicians to try out unconventional treatments based on limited evidence, including the repurposing of existing drugs. The dilemma involves balancing clinical intuition with the need to rely on low-quality information because of the scarcity of definitive evidence. An example was </span>ivermectin<span><span>; with its potential antiviral properties, it was promoted for its efficacy in treating </span>coronavirus disease 2019<span> despite conflicting outcomes in clinical trials and varying expert opinions. This article describes the development of a decision-making framework to resolve such dilemmas.</span></span></p></div><div><h3>Methods</h3><p>The case study from Sri Lanka illustrates multiple challenges faced by clinicians. As the horrific details of deaths in countries such as Italy spread on social media, there was panic and an unprecedented demand for clinicians and health services to provide effective treatment. This led to the popularity of drugs such as ivermectin and several herbal cures. However, there was no consensus among experts on the efficacy of ivermectin, which eventually led to the authorities to recommend limited approval for use under physician supervision.</p></div><div><h3>Findings</h3><p>The situation lent itself to a framework with 4 elements: prerequisites, applying an appropriate decision-making tool (eg, multiple criteria decision-making methods), ethical considerations, and sensitive communication.</p></div><div><h3>Implications</h3><p>We propose this framework for clinicians when they face similar situations with demands to repurpose medicines with inconclusive evidence of efficacy to combat devastating infections from new or re-emerging infections.</p></div>","PeriodicalId":10699,"journal":{"name":"Clinical therapeutics","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537762","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}