COPD: Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Pharmacologic Treatment of COPD: Disparities Between Evidence and Recommendations in GOLD 2023/4.","authors":"Samy Suissa","doi":"10.1080/15412555.2025.2517622","DOIUrl":"https://doi.org/10.1080/15412555.2025.2517622","url":null,"abstract":"","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"22 1","pages":"2517622"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324690","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":"Phase-Resolved Functional Lung MRI Evaluation of Dynamic Hyperinflation Induced by Metronome-Paced Tachypnea in Patients with Chronic Obstructive Pulmonary Disease.","authors":"R A Müller, F Klimeš, A Voskrebenzev, L Behrendt, T F Kaireit, M Wernz, M Zubke, A L Kern, M R Prince, W Shen, C B Cooper, R G Barr, J M Hohlfeld, J Vogel-Claussen","doi":"10.1080/15412555.2025.2502671","DOIUrl":"10.1080/15412555.2025.2502671","url":null,"abstract":"<p><p>Hyperinflation in chronic obstructive pulmonary disease (COPD) patients worsens on exertion/exercise when breathing frequency increases. Fast breathing, paced at 40 breaths per minute using a metronome (metronome-paced tachypnea, MPT), induces dynamic hyperinflation (DH) and can be performed during MRI. MPT in combination with phase-resolved functional lung (PREFUL) MRI can be used to assess stress-driven ventilation dynamics globally and regionally. A 90 s time series of one coronal slice centered to the trachea was acquired for PREFUL MRI during 60 s of resting tidal breathing (RTB) and 30 s of MPT at 40 breaths per minute in COPD patients and healthy volunteers. MPT detected DH in 12 out of 15 COPD patients and in 1 out of 15 healthy controls. During MPT, the global fractional ventilation decreased by 20% in healthy subjects (<i>p</i> = 0.01) and by 48% in COPD patients (<i>p</i> < 0.001). The end-expiratory lung area remained stable in healthy subjects and increased significantly by 7% in COPD patients over the course of MPT (<i>p</i> = 0.004). Younger, healthy volunteers adapted to increase breathing frequency by reducing tidal volume (global fractional ventilation), while older healthy volunteers showed less tidal volume reduction (<i>p</i> = 0.036). The MPT-induced change of regional ventilation homogeneity (flow volume loop cross-correlation, FVL-CC_MPT/RTB) increased with age in healthy volunteers (<i>p</i> = 0.039) likely due to the development of compensatory dystelectasis in younger volunteers leading to reduced homogeneity during MPT. In the future, the MPT test during MR imaging may be used for COPD treatment analysis and disease monitoring.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"22 1","pages":"2502671"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282751","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":"Linking Chronic Obstructive Pulmonary Disease and Asthma with Gallstones: Evidence from a Cross-Sectional Study and Mendelian Randomization.","authors":"Dongru Du, Jiangyue Qin, Lijuan Gao, Xueru Hu, Suli Liu, Yanqiu Wu, Xiaohua Li, Fengming Luo, Yongchun Shen","doi":"10.1080/15412555.2025.2502118","DOIUrl":"https://doi.org/10.1080/15412555.2025.2502118","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether chronic obstructive pulmonary disease (COPD) and asthma increase the risk of gallstones based on the National Health and Nutrition Examination Survey (NHANES) and Mendelian randomization (MR).</p><p><strong>Methods: </strong>Data from the NHANES 2017-2023 were included in the cross-sectional study. Diagnoses of COPD, asthma and gallstones were obtained from self-report questionnaires. Multivariate logistic regression, subgroup analyses and interaction tests were applied to explore these associations. Data for MR analysis were obtained from the Finnish cohort and the Integrative Epidemiology Unit (IEU). The inverse variance weighting (IVW) estimate was applied as the main approach to determine the causality of associations.</p><p><strong>Results: </strong>A total of 8,728 participants were enrolled in the cross-sectional study. Both COPD (OR 1,842, 95% CI 1.144, 2.968, <i>p</i> = 0.015) and asthma (OR 1.434, 95% CI 1.093, 1.883, <i>p</i> = 0.012) were associated with increased gallstone risk before and after covariate adjustments, and diabetes history may interact with the COPD-gallstone association (<i>p</i> = 0.020). In MR analysis, although a causal association was observed between COPD and gallstones (OR 1.216, 95% CI 1.023, 1.445; <i>p</i> = 0.026), leave-one-out analysis suggested that the causal association disappeared without serpin family A member 1 (<i>SERPINA1</i>). No causal association was observed between asthma and gallstones (OR 1.016, 95% CI 0.932, 1.108; <i>p</i> = 0.718).</p><p><strong>Conclusions: </strong>Although both COPD and asthma were positively associated with gallstones based on NHANES, the COPD-gallstone association was largely driven by <i>SERPINA1</i>, and no causality was observed in asthma-gallstone association. The available evidence provided limited support for causal associations between obstructive lung diseases and gallstones.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"22 1","pages":"2502118"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076435","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":"Biologic Therapies for Chronic Obstructive Pulmonary Disease: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.","authors":"Tyler Pitre, Daniel Lupas, Jasmine Mah, Matthew Stanbrook, Alina Blazer, Dena Zeraatkar, Terence Ho","doi":"10.1080/15412555.2025.2449889","DOIUrl":"10.1080/15412555.2025.2449889","url":null,"abstract":"<p><strong>Background: </strong>Despite limited breakthroughs in COPD pharmacotherapy, recent trials have shown promising results for biologics in COPD patients. However, robust evidence synthesis in this area is currently lacking.</p><p><strong>Methods: </strong>We conducted a systematic review of MEDLINE, EMBASE, and Cochrane CENTRAL from inception to July 17, 2024, to identify randomized trials of biologic medications in patients with COPD. We performed a random effects frequentist network meta-analysis and present the results using relative risk (RR) and 95% confidence intervals (CI). We used the GRADE framework to rate the certainty of the evidence. Outcomes of interest included exacerbations, change in FEV1, change in quality of life, and serious adverse events.</p><p><strong>Results: </strong>Dupilumab reduced exacerbations as compared to placebo (RR 0.68 [95% CI 0.59 to 0.79]) (high certainty). Benralizumab (RR 0.89 [95% CI 0.78 to 1]), itepekimab (RR 0.81 [95% CI 0.61 to 1.07]) and tezepelumab (RR 0.83 [95% CI 0.61 to 1.12]) may reduce exacerbations as compared to placebo (all low certainty). Dupilumab probably reduced exacerbations more than mepolizumab (RR 0.74 [95% CI 0.62 to 0.89]) (moderate certainty). Dupilumab may reduce exacerbations more than tezepelumab (RR 0.82 [95% CI 1.14]) (low certainty). For all patients, no treatment improved FEV1 above the pre-specified minimal clinically important difference (MCID) of 0.1 L. Dupilumab probably has no meaningful effect on FEV1 compared to placebo (MD 0.07 [95% CI 0.02 to 0.13]) (moderate certainty). However, in the subgroup of patients with blood eosinophils ≥300/mcL, both tezepelumab (MD 0.15 [95% CI 0.05 to 0.26]) and dupilumab (MD 0.13 [95% CI 0.06 to 0.19]) probably improved FEV1 above the MCID.</p><p><strong>Conclusion: </strong>Dupilumab is effective at improving patient-relevant outcomes in COPD with higher eosinophil levels. Other biological therapies, including tezepelumab, have no important effect on patient-relevant outcomes.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"22 1","pages":"2449889"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058441","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":"The Role of Autophagy and Cell Communication in COPD Progression: Insights from Bioinformatics and scRNA-seq.","authors":"Kaiqi Ren, Lu Zou, Jingjing Yang, Yuxiu Wang, Lingfeng Min","doi":"10.1080/15412555.2024.2444663","DOIUrl":"10.1080/15412555.2024.2444663","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is characterized by restricted airflow that leads to significant respiratory difficulties. This progressive disease often results in diminished pulmonary function and the onset of additional respiratory conditions. Autophagy, a critical cellular homeostasis mechanism, plays a significant role in the exacerbation of COPD. In this study, we utilized various bioinformatics tools to identify autophagy-related genes activated by smoking in individuals with COPD. Furthermore, we explored the immune landscape of COPD through these genes, analyzing cell communication patterns using scRNA-seq data. This analysis focused on key pathways between epithelial cells and other cellular subpopulations with different autophagy scores, essential for understanding the initiation and progression of COPD.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"22 1","pages":"2444663"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482414","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":"Knowledge Domain and Emerging Trends in the Treatment of Patients with Chronic Obstructive Pulmonary Disease Combined with Respiratory Failure: A Scientometric Review Based on CiteSpace Analysis.","authors":"Yabing Chen, Jiale Sang, Lingbo Fu, Ying Zhang","doi":"10.1080/15412555.2024.2441184","DOIUrl":"10.1080/15412555.2024.2441184","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the status of research on treating chronic obstructive pulmonary disease (COPD) combined with respiratory failure internationally to reveal its development trends through visualization methods and to provide a reference and suggestions for future research directions.</p><p><strong>Methods: </strong>Literature on the treatment of COPD combined with respiratory failure published from the year of inception of the Web of Science database to December 31, 2023, was searched. CiteSpace 6.2.R7 software was used to visualize and analyze the published articles. A bibliometric analysis of the publications, keyword co-occurrence analysis, keyword clustering analysis, and keyword emergence analysis were performed to draw a correlation map and analyze the results.</p><p><strong>Results: </strong>A total of 369 articles were analyzed. An overall increasing trend was observed in the number of publications. The network of researchers was relatively dense, and a core team was clearly observed. The researchers' affiliations were mainly European universities and hospitals, and close cooperation between institutions was observed. The keyword analysis obtained high-frequency keywords such as \"noninvasive ventilation\", \"mechanical ventilation\", and \"positive pressure ventilation\". The keyword clustering analysis revealed 10 clusters, and the keyword emergence analysis yielded 20 keywords.</p><p><strong>Conclusions: </strong>The focus of attention internationally has been on respiratory failure classification and types of ventilation support, such as high-flow oxygenation and noninvasive positive pressure ventilation. Future directions should include clinical research on high-flow oxygen administration to improve patient prognosis and the application of extracorporeal carbon dioxide removal technology to enhance patients' quality of life.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"22 1","pages":"2441184"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522794","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":"Features of COPD That Lead to Stigmatisation and Its Consequences: A Framework Synthesis.","authors":"Jiwoo Sohn, Eleanor Rochester, Adejoke O Oluyase","doi":"10.1080/15412555.2025.2476435","DOIUrl":"10.1080/15412555.2025.2476435","url":null,"abstract":"<p><p>COPD is a highly stigmatised condition. To develop effective measures to reduce COPD-related stigma, it is important to understand patients' experiences and identify contributing factors. This systematic review explores qualitative evidence regarding the features of COPD leading to stigmatisation and how it can potentially influence health outcomes. Electronic databases were searched to identify primary qualitative studies focussing on stigma-related experiences of adults with COPD, published between January 1988 to August 2024. Data were synthesised using framework synthesis. Twenty-nine studies with 427 participants were included in this review. Findings fit well into six themes identified from Jones et al.'s framework of stigma dimensions and provide rich description. Smoking habit was not the only factor of stigma but also factors that contributed to disability of individuals. Patients experience COPD-related stigma mainly from themselves and healthcare professionals. Potential consequences of stigma identified are mental distress, isolation, reduced help-seeking behaviour and non-compliance to management. Collective effort by society and healthcare systems will be necessary to alleviate the stigma associated with chronic symptoms and smoking behaviour of COPD and to promote the benefit of pulmonary rehabilitation and available mental health support.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"22 1","pages":"2476435"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691405","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":"Previous <i>Moraxella catarrhalis</i> Infection as a Risk Factor of COPD Exacerbations Leading to Hospitalization.","authors":"Kyoko Yagyu, Takahiro Ueda, Atsushi Miyamoto, Riki Uenishi, Haruhiko Matsushita","doi":"10.1080/15412555.2025.2460808","DOIUrl":"10.1080/15412555.2025.2460808","url":null,"abstract":"<p><p><i>Haemophilus influenzae</i> (<i>H. influenzae</i>) and <i>Moraxella catarrhalis</i> (<i>M. catarrhalis</i>) are associated with acute exacerbation of chronic obstructive pulmonary disease (AECOPD); however, their role in the pathogenesis of COPD is unknown. We retrospectively analysed the clinical data of patients with AECOPD (modified British Medical Research Council scale score, Global Initiative for Chronic Obstructive Lung Disease [GOLD] classification, pre-admission antibiotic and inhalant usage, sputum culture and epidemic influenza virus antigen test) for association with admission frequency. Among 169 eligible patients, pathogens were and were not detected in 64 and 105, respectively. The GOLD classification grade was higher in the non-detection group with a prior antimicrobial administration rate of 21.9% than in the detection group. <i>H. influenzae</i> and <i>M. catarrhalis</i>, each identified in 24.6% of the total number of detected pathogens, were the most common infectious bacteria. The GOLD classification grade was higher in the re-hospitalisation group than in the one-time hospitalisation group (<i>p</i> < 0.01). Regarding type of pathogen, <i>M. catarrhalis</i> infection (<i>n</i> = 16) was more common in the re-hospitalisation group. History of <i>M. catarrhalis,</i> <i>H. influenzae</i> infection and GOLD grade ≥ III were risk factors for re-hospitalisation, with odds ratios of 92.7 (95% confidence interval [CI]: 3.68-2340.0, <i>p</i> < 0.01), 20.1 (CI: 1.48-274.0, <i>p</i> < 0.05) and 9.83 (CI: 2.33-41.4, <i>p</i> < 0.01), respectively. These bacterial infections and severe airway limitation were associated with increased AECOPD frequency. Routine microbial monitoring may be useful for AECOPD prevention, reducing medical burden and improving prognosis.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"22 1","pages":"2460808"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440287","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":"Efficacy and Safety of Lung Volume Reduction with Endobronchial Coil #2 and Coil #4 Results of the German Emphysema Registry-Lungenemphysemregister e.V.","authors":"Christian Grah, Shiao Li Oei, Joanna Krist, Björn Wiesemann, Bernd Schmidt, Andreas Fertl, Björn Schwick, Ralf-Harto Hübner, Birgit Becke, Karl-Josef Franke, Christian Geltner, Stephan Eisenmann, Franz Stanzel, Grit Barten-Neiner, Thomas Sgarbossa, Katarzyna Blazejczyk, Hannah Wüstefeld","doi":"10.1080/15412555.2025.2468328","DOIUrl":"10.1080/15412555.2025.2468328","url":null,"abstract":"<p><strong>Background: </strong>Clinical trials have shown beneficial results from lung volume reduction with endobronchial coils in patients with emphysema, but comprehensive safety data are not yet available for a new coil type, Coil #4. The objective of this study is to generate real-world data (RWD) on the safety and efficacy of endobronchial Coil #2 and Coil #4.</p><p><strong>Methods: </strong>This is a cohort study of prospectively collected data from the multicenter German Lung Emphysema Registry e.V. (LE-Registry) for patients with advanced lung emphysema undergoing lung volume reduction. All patients treated with Coil #2 or Coil #4 were evaluated at baseline and at 3 months for pulmonary function tests (FEV₁, FVC, RV, DLCO, pCO₂), exercise capacity, quality of life (mMRC, CAT, SGRQ), and adverse events. Descriptive statistics were used to analyze response rates and changes in clinical outcomes.</p><p><strong>Results: </strong>Data from 73 patients (37 Coil #2, 36 Coil #4) enrolled between 2017 and 2024 were evaluated. At 3 months, outcome data were available for 32 Coil #2 and 26 Coil #4 patients. In the Coil #2 cohort significant improvements in RV and SGRQ were observed. The Coil #4 cohort shows significant improvements in FVC, RV, SGRQ, and CAT. Complications occurred in 37% of Coil #2 and 37% of Coil #4 patients, with 26% of patients treated with Coil #4 experiencing pneumothorax.</p><p><strong>Conclusions: </strong>The outcomes observed in this RWD study are consistent with other published coil studies. The higher pneumothorax rate with Coil #4 is surprising and should be minimized by adapting the technique.</p><p><strong>Trial registration: </strong>DRKS00021207 registered on 29/05/2020.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"22 1","pages":"2468328"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584979","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":"Understanding the Unmet Needs, Experiences, and Perspectives of COPD Caregivers: A Scoping Review.","authors":"Saba Gholami, David Chinonyerem, Elizabeth J Cooper, John Paul Kuwornu","doi":"10.1080/15412555.2025.2481260","DOIUrl":"10.1080/15412555.2025.2481260","url":null,"abstract":"<p><p>Chronic Obstructive Pulmonary Disease (COPD) poses significant challenges, not only to patients but also to their caregivers, who often experience substantial unmet needs, stress, and emotional burdens. This scoping review synthesizes existing literature to understand the experiences, perspectives, and challenges faced by caregivers of COPD patients. A comprehensive search of multiple databases was conducted, focusing on studies addressing unmet needs, psychological experiences, and the day-to-day realities of caregivers. The review reveals that COPD caregivers frequently encounter inadequate support, insufficient information, and heightened emotional and physical strain. These factors contribute to negative mental health outcomes, including anxiety, depression, and caregiver burnout. Moreover, the review highlights the disparity in care and support services across different healthcare settings, with a particular emphasis on the need for targeted interventions that address the unique challenges of COPD caregiving. The findings underscore the importance of integrating caregivers' needs into COPD management plans and the development of policies that recognize and support their role. The review concludes with recommendations for future research to fill existing gaps in the literature and for healthcare providers to implement strategies that enhance caregiver well-being, thereby improving overall patient care.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"22 1","pages":"2481260"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802598","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}