Diagnostic Pathology最新文献

{"title":"(1, 3)-beta-D-Glucan in bronchoalveolar lavage fluid: a useful biomarker in diagnosis of invasive pulmonary infection caused by Hormographiella aspergillata?","authors":"Haiyan Ye, Jinhui He, Jing Huang, Patrick Chu, Junru Liu, Rosana Wing-Shan Poon, Fanfan Xing, Simon Kam-Fai Lo, Ricky Wing-Tong Lau, Jasper Fuk-Woo Chan, Susanna Kar-Pui Lau, Kelvin Hei-Yeung Chiu","doi":"10.1186/s13000-024-01589-9","DOIUrl":"10.1186/s13000-024-01589-9","url":null,"abstract":"<p><p>Hormographiella aspergillata is a rare hyaline mold causing invasive fungal infection in humans, until the frequent use of antifungal prophylaxis in immunocompromised hosts. Due to the high mortality of H. aspergillata infection, early recognition and treatment are crucial. Previous case reports suggested that serum (1,3)-beta-D-Glucan (BG) is one of the diagnostic aids for H. aspergillata infection. Here we report for the first time a case of pulmonary H. aspergillata infection with a negative serum BG but positive bronchoalveolar lavage fluid (BAL) BG. This may suggest that BAL BG is a useful and additional microbiological marker for prompt identification of this fatal invasive fungal infection (IFI). But it should be interpreted together with the clinical presentation, imaging, and other laboratory results.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"19 1","pages":"168"},"PeriodicalIF":2.4,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892759","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":"Combined immunohistochemistry of PRAME and p16 in the differentiation of melanocytic neoplasms, with a detailed focus on acral lesions.","authors":"Jingwei Zheng, Jie Zang, Qiuju Miao, Xuebao Shao, Hao Song, Xiaopo Wang, Ying Zhang, Hao Chen","doi":"10.1186/s13000-024-01586-y","DOIUrl":"10.1186/s13000-024-01586-y","url":null,"abstract":"<p><strong>Background: </strong>Isolated immunohistochemical indicators are limited to diagnose melanocytic neoplasms. This retrospective study is to assess the diagnostic value of combined immunohistochemical analysis targeting preferentially expressed antigen in melanoma (PRAME) and p16 in melanocytic neoplasms, with a detailed focus on arcal lesions.</p><p><strong>Methods: </strong>This was a single center cohort study from January 2022 to June 2023. A total of 165 identified cases were collected, including 112 melanomas (MMs) and 53 melanocytic nevi, which were composed of 122 acral samples and 43 non-acral samples. Immunohistochemistry(IHC) for both PRAME and p16 was performed in these cases, which was subsequently statistically analyzed to assess the diagnosis ability of PRAME and p16.</p><p><strong>Results: </strong>In total samples, the sensitivity and specificity of PRAME(+) for MM are 82.1% and 94.3% (AUC = 0.882, 95%CI:0.827-0.938), while of p16(-) for MM are 31.25% and 94.3% (AUC = 0.628, 95%CI:0.542-0.714); PRAME(+)/p16(-) (meaning as PRAME(+) or p16(-)) displayed a sensitivity and specificity of 85.7% and 88.7% for MM (AUC = 0.872, 95%CI:0.810-0.934), while PRAME(+) &p16(-) (meaning as PRAME(+) and p16(-)) revealed a sensitivity and specificity of 27.7% and 100% in MM (AUC = 0.638, 95%CI:0.555-0.722). In acral samples, PRAME(+)/p16(-) exhibited a specificity of 94.7% and a sensitivity of 86.9% for MM (AUC = 0.908, 95%CI: 0.849-0.968), with sensitivities of 90.9% for invasive MM and 82.5% for preinvasive MM, respectively; The sensitivity and specificity of PRAME(+) &p16(-) for MM is 22.6% and 100% (AUC = 0.613, 95%CI: 0.513-0.714) respectively. In non-acral samples, the sensitivity and specificity of PRAME(+)/p16(-) for MM are 82.1% and 73.3% (AUC = 0.777, 95%CI: 0.622-0.933), while of PRAME(+) &p16(-) are 42.9% and 100% (AUC = 0.714, 95%CI:0.564-0.864).</p><p><strong>Conclusion: </strong>Combined IHC of PRAME and p16 contributes to discriminating melanocytic neoplasms, especially for in situ acral MM.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"19 1","pages":"167"},"PeriodicalIF":2.4,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892824","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":"Two cases of mixed large cell neuroendocrine carcinoma and adenocarcinoma of the cervix: case report and review of the literature.","authors":"Kang-Na Wei, Xiao-Dan Fu, Min-Yuan Wang, Li-Xia Wang","doi":"10.1186/s13000-024-01592-0","DOIUrl":"10.1186/s13000-024-01592-0","url":null,"abstract":"<p><strong>Background: </strong>Mixed adenoneuroendocrine carcinoma (MANEC) of the cervix is a rare malignant tumor with high malignancy and poor prognosis, of which large-cell neuroendocrine carcinoma and HPV-independent adenocarcinoma are particularly rare, which have been reported limitedly in the literature. Here, we present 2 cases of MANEC of the cervix and discuss important considerations for diagnosing cervical poorly differentiated carcinoma.</p><p><strong>Case presentation: </strong>we reported two cases of mixed large cell neuroendocrine carcinoma and adenocarcinoma of the cervix, one HPV-independent and one HPV-associated, both with vaginal bleeding. Magnetic resonance imaging showed a mass-like shadow in the cervix, with varying degrees of invasion into the vagina or the lower part of the uterine body. Histologically, the tumors showed two components: solid and glandular areas, with solid areas containing nests of tumor cells and focal necrosis. In the glandular area, one showed gastric-type glandular changes, while the other showed usual-type glands. The solid area expressed CgA (1/2), Syn (2/2), and the glandular area expressed p16 (1/2), Muc-6 (1/2), MSH2 (1/2).</p><p><strong>Conclusion: </strong>We made a diagnosis of mixed adenoneuroendocrine carcinoma (MANEC) of the cervix and performed a literature review to better supplement epidemiological data and assist in developing standardized treatment methods.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"19 1","pages":"166"},"PeriodicalIF":2.4,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892827","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":"Aberrant bcl6 protein expression in patients with EMZL following recurrence or progression: case report of two cases.","authors":"Ming Zhang, Jianli Qu, Weiwei Guo, Yi Liu, Wei Zhang","doi":"10.1186/s13000-024-01593-z","DOIUrl":"10.1186/s13000-024-01593-z","url":null,"abstract":"<p><p>Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (EMZL) is an indolent B-cell lymphoma that can involve various anatomic sites. EMZL is derived from post-germinal center marginal zone B cells and typically lacks bcl-6 expression. Herein, we report two post-treatment cases of EMZL where unexpected bcl-6 protein expression was observed in specimens obtained following recurrence or progression. This contrasts with the primary specimens, which were negative for the bcl-6. Additionally, we confirm that the altered bcl6 expression observed in relapsed EMZL cases is independent of BCL6 gene rearrangement, as demonstrated by fluorescence in situ hybridization analysis. Relevant literature was reviewed and summarized to enhance the understanding of this phenomenon, particularly for pathologists.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"19 1","pages":"165"},"PeriodicalIF":2.4,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892786","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":"Renal sarcoidosis: renal pathology guides diagnosis and prognosis.","authors":"Aichun Liu, Yina Wang, Yu Yan, Bao Dong, Meishun Cai, Li Zuo","doi":"10.1186/s13000-024-01591-1","DOIUrl":"10.1186/s13000-024-01591-1","url":null,"abstract":"<p><strong>Background: </strong>While many studies have reported renal involvement in sarcoidosis, there is limited description of the pathological manifestations of renal sarcoidosis (RS). This study aimed to explore the standardized pathological diagnosis of RS while evaluating the relationship among pathology, clinical manifestations, and prognosis.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center study of RS in renal biopsy cases treated in our department between January 2019 and December 2023.</p><p><strong>Results: </strong>We identified 5 patients (4 men, 1 woman; median age 52 years, IQR 36-61 years). Two patients were diagnosed with non-caseating granulomatous interstitial nephritis (GTN), while two patients were diagnosed with tubulointerstitial nephritis without granulomas (TIN), and one patient was diagnosed with acute tubular necrosis (ATN). The grading of tubulointerstitial acute inflammation revealed 2 cases (case 4 and case 5) graded as (+++), with serum creatinine levels greater than 900 µmol/L at onset. Additionally, there were 2 cases (case 2 and case 3) gradedas (+), and 1 case (case 1)graded as (-), with serum creatinine levels approximately 400 µmol/L at onset. All 5 cases exhibited an interstitial fibrosis grade of (-). However, in the second renal biopsy following recurrence in case 4, the interstitial fibrosis grade increased to (++). In two patients with GTN, immunohistochemical staining revealed that the infiltrating lymphocytes were predominantly CD4 + T cells, which formed nodular granulomas and were surrounded by CD8 + T cells. A favorable response to steroid therapy was noted in all cases, especially in case 1, 2, and 3.</p><p><strong>Conclusions: </strong>The pathological manifestations of RS primarily consist of acute TIN with or without granuloma formation. Quantifying the pathological grade may assist in guiding treatment decisions and predicting prognosis.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"19 1","pages":"164"},"PeriodicalIF":2.4,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881572","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":"The current troubled state of the global pathology workforce: a concise review.","authors":"Elizabeth Walsh, Nicolas M Orsi","doi":"10.1186/s13000-024-01590-2","DOIUrl":"10.1186/s13000-024-01590-2","url":null,"abstract":"<p><p>The histopathology workforce is a cornerstone of cancer diagnostics and is essential to the delivery of cancer services and patient care. The workforce has been subject to significant pressures over recent years, and this review considers them in the UK and internationally. These pressures include declining pathologist numbers, the increasing age of the workforce, and greater workload volume and complexity. Forecasts of the workforce's future in numerous countries are also not favourable - although this is not universal. Some in the field suggest that the effects of these pressures are already coming to bear, such as the financial costs of the additional measures needed to maintain clinical services. There is also some evidence of a detrimental impact on service delivery, patient care and pathologists themselves. Various solutions have been considered, including increasing the number of training places, enhancing recruitment, shortening pathology training and establishing additional support roles within pathology departments. A few studies have examined the effect of some of these solutions. However, the broader extent of their implementation and impact, if any, remains to be determined. In this regard, it is critical that future endeavours should focus on gaining a better understanding of the benefits of implemented workforce solutions, as well as obtaining more detailed and updated pathology workforce numbers. With a concentrated effort in these areas, the future of the pathology workforce could become brighter in the face of the increased demands on its services.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"19 1","pages":"163"},"PeriodicalIF":2.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871735","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":"Prognostic factors and survival outcomes of immunohistochemically detection based-molecular subtypes of endometrial cancer-analysis of 576 clinical cases.","authors":"Xiaohui Wang, Aziz Ur Rehman Aziz, Dandan Wang, Yaping Wang, Ming Liu, Xiaohui Yu, Daqing Wang","doi":"10.1186/s13000-024-01584-0","DOIUrl":"10.1186/s13000-024-01584-0","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to identify distinct molecular subtypes of endometrial cancer (EC) by immunohistochemistry and to analyze their pathological characteristics, independent prognostic factors, and patient survival outcomes for potential clinical applications.</p><p><strong>Method: </strong>576 patients with preoperative EC confined to the uterus were divided into three subgroups based on the immunohistochemical detection method: MMR-deficiency (MMRd), P53 wild type (P53wt) and P53 abnormal (P53abn). These subgroups were retrospectively analyzed, and their pathological characteristics, prognostic factors and survival outcomes were compared.</p><p><strong>Results: </strong>We identified 401 (69.6%), 123 (21.4%), and 52 (9%) cases of P53wt, MMRd, and P53abn subgroups, respectively. A significant difference was observed in the median age of onset, tumor stage, high-grade tumor differentiation, non-endometrioid carcinoma, myometrial invasion, lymphovascular invasion, the incidence of lymph node metastasis postoperative, and expression of ER and PR receptors among the three groups. Pathological type, lymphovascular invasion, ER and PR expression were identified as independent prognostic factors for disease-free survival (DFS). Additionally, pathological type, lymphovascular invasion, myometrial invasion, and PR expression were recognized as independent prognostic factors for overall survival (OS) in the study cohort. However, the survival outcome for P53abn was the worst, with lymphovascular invasion identified as an independent prognostic factor for DFS. Lymph node status, FIGO stage, and ER expression were identified as independent prognostic factors for OS.</p><p><strong>Conclusion: </strong>The study concludes that immunohistochemical detection-based subtyping of EC holds clinical practicality and can be employed to explore both pathological and clinical prognoses for EC patients.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"19 1","pages":"162"},"PeriodicalIF":2.4,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871732","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":"Interlaboratory variability of HER2 fluorescence in situ hybridization testing in breast cancer: results of a multicenter proficiency-testing ring study in China.","authors":"Rongxue Peng, Kuo Zhang, Guigao Lin, Jinming Li","doi":"10.1186/s13000-024-01588-w","DOIUrl":"10.1186/s13000-024-01588-w","url":null,"abstract":"<p><strong>Background: </strong>Accurate detection of human epidermal growth factor receptor 2 (HER2) gene amplification via fluorescence in situ hybridization (FISH) is necessary to determine HER2 status. Although many attempts have been made to increase the consistency of the results, the actual situation still needs to be determined. To investigate the latest interlaboratory variability of HER2 FISH testing for breast cancer, a multicenter proficiency-testing ring study was conducted in China.</p><p><strong>Methods: </strong>A total of ten samples, each exhibiting distinct HER2 signal patterns and genetic heterogeneity, were distributed to 169 laboratories for HER2 FISH analysis. Data comprising both the results of the tests and feedback from questionnaires were compiled for comprehensive evaluation.</p><p><strong>Results: </strong>The overall agreement among the participating laboratories was substantial to almost perfect, with a Fleiss' kappa value of 0.765-0.911. However, it is important to note that cases with characteristics of HER2 signals near the critical cutoff range or with genetic heterogeneity showed lower congruence, poorer reproducibility, and higher variability (Fleiss' kappa: 0.582). Our questionnaire showed that 52.2% (86/168) of the participants did not perform validation after their operation procedures or interpretation criteria were updated, and 75.6% (121/160) of the participants did not establish standard interpretation procedures. Since these laboratories showed worse performance (P < 0.05), the lack of validation and interpretation procedures was speculated to be the possible underlying cause.</p><p><strong>Conclusions: </strong>This study presents the latest landscape of interlaboratory variability and accuracy of HER2 FISH testing in China and highlights potential causes for the variability. Despite many years of effort, the standardization of HER2 status determination still has a long way to go.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"19 1","pages":"161"},"PeriodicalIF":2.4,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871730","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":"ALK + anaplastic large cell lymphoma involving the bladder: case report and review of the literature.","authors":"Ying Zhao, Wenqiang Qiu, Xiangtao Weng, Chiming Gu, Siyi Li","doi":"10.1186/s13000-024-01585-z","DOIUrl":"10.1186/s13000-024-01585-z","url":null,"abstract":"<p><p>We reported a case of anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALK + ALCL) involving the bladder. The patient was a 27-year-old female, whose main clinical symptoms included fever, painless lymphadenopathy, and hematuria. Imaging studies suggested a bladder mass. The bladder mass was maximally resected through transurethral bladder tumor resection. The pathology report indicated a malignant tumor of the bladder. Based on immunohistochemical and gene rearrangement results, the diagnosis was confirmed as ALK + ALCL. After undergoing five cycles of treatment with the BV + CHP chemotherapy regimen, the patient's condition is currently stable, and no tumor recurrence was observed upon re-examination. ALK + ALCL involving the bladder is very rare, and early diagnosis is challenging. By reviewing the diagnostic and treatment process of this patient, and in conjunction with a review of modern literature on the disease's incidence characteristics, treatment protocols, and prognosis, this aims to provide a reference for clinicians in diagnosing and treating this condition, thereby reducing delays.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"19 1","pages":"157"},"PeriodicalIF":2.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853504","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":"In-depth exploration of cutaneous anthrax: clinical and pathological manifestations of a case report.","authors":"Yongjun Du, Jizhou Ma, Guozhen Liu, Zhi Chai, Hang Han, Tairen Chen, Lan Yang, Li Jing, Fangjing Xu, Yucheng Fan","doi":"10.1186/s13000-024-01587-x","DOIUrl":"10.1186/s13000-024-01587-x","url":null,"abstract":"<p><p>Anthrax is an acute infectious disease caused by Bacillus anthracis, which can infect various animals and humans. Cutaneous anthrax primarily presents as infiltrative, edematous erythema, surface vesicles, hemorrhagic vesicles, and necrotic eschar; some patients may also experience systemic symptoms such as fever and leukocytosis. With economic development and improvements in public health conditions, naturally occurring cases of cutaneous anthrax have significantly decreased, leading to limited reports on the pathological manifestations of this disease. This article reports a case of a patient with cutaneous anthrax diagnosed and treated in our hospital, aiming to explore the laboratory examinations, imaging, pathological features, and clinical treatment methods of the disease. The goal is to enhance understanding of anthrax and increase vigilance in clinical practice to avoid misdiagnosis and missed diagnosis. The described diagnostic and therapeutic processes are accurate and reliable, with no modifications or exaggerations. It is important to note that the patient's treatment may have been influenced by local social, economic, health, and epidemiological conditions, which introduces certain limitations. We hope that our colleagues will approach this study with an objective mindset for learning and reference.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"19 1","pages":"158"},"PeriodicalIF":2.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853505","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}