Diabetic Medicine最新文献

{"title":"Hypoglycaemic stimulation of macrophage cytokine release is suppressed by AMP-activated protein kinase activation.","authors":"Jiping Zhang, Alice E Pollard, Eleanor F Pearson, David Carling, Benoit Viollet, Kate L J Ellacott, Craig Beall","doi":"10.1111/dme.15456","DOIUrl":"https://doi.org/10.1111/dme.15456","url":null,"abstract":"<p><strong>Aims: </strong>Acute hypoglycaemia promotes pro-inflammatory cytokine production, increasing the risk for cardiovascular events in diabetes. AMP-activated protein kinase (AMPK) is regulated by and influences the production of pro-inflammatory cytokines. We sought to examine the mechanistic role of AMPK in low glucose-induced changes in the pro-inflammatory cytokine macrophage migration inhibitory factor (MIF), which is elevated in people with diabetes.</p><p><strong>Methods: </strong>Macrophage cell line Raw264.7 cells, primary macrophage bone marrow-derived macrophages obtained from wild-type mice or AMPK γ1 gain-of-function mice, were used, as were AMPKα1/α2 knockout mouse embryonic fibroblasts (MEFs). Allosteric AMPK activators PF-06409577 and BI-9774 were used in conjunction with inhibitor SBI-0206965. We examined changes in protein phosphorylation/expression using western blotting and protein localisation using immunofluorescence. Metabolic function was assessed using extracellular flux analyses and luciferase-based ATP assay. Cytokine release was quantified by enzyme-linked immunosorbent assay (ELISA). Oxidative stress was detected using a fluorescence-based reactive oxygen species (ROS) assay, and cell viability was examined using flow cytometry.</p><p><strong>Results: </strong>Macrophages exposed to low glucose showed a transient and modest activation of AMPK and a metabolic shift towards increased oxidative phosphorylation. Moreover, low glucose increased oxidative stress and augmented the release of macrophage MIF. However, pharmacological activation of AMPK by PF-06409577 and BI-9774 attenuated low glucose-induced MIF release, with a similar trend noted with genetic activation using AMPKγ1 gain-of-function (D316A) mice, which produced a mild effect on low glucose-induced MIF release. Inhibition of NFĸB signalling diminished MIF release and AMPK activation modestly but significantly reduced low glucose-induced nuclear translocation of NFĸB.</p><p><strong>Conclusions: </strong>Taken together, these data indicate that pharmacological AMPK activation suppresses the release of MIF from macrophages caused by energy stress, suggesting that AMPK activation could be a useful strategy for mitigating hypoglycaemia-induced inflammation.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15456"},"PeriodicalIF":3.2,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881594","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":"Effect of the SGLT2 inhibitor ipragliflozin on the expression of genes that regulate skin function.","authors":"Nobutomo Ikarashi, Keito Tabata, Yui Shinozaki, Risako Kon, Hiroyasu Sakai, Tomoo Hosoe","doi":"10.1111/dme.15505","DOIUrl":"https://doi.org/10.1111/dme.15505","url":null,"abstract":"<p><strong>Aims: </strong>Skin disorders occur more frequently with sodium-dependent glucose cotransporter type 2 (SGLT2) inhibitors than with other antidiabetic drugs. We conducted basic research using ipragliflozin, with the aim of identifying new measures to prevent skin disorders caused by SGLT2 inhibitors.</p><p><strong>Methods: </strong>db/db type 2 diabetes model mice were orally administered ipragliflozin (10 mg/kg or 30 mg/kg) once a day for 28 days and skin function genes were analysed by real-time RT-PCR or Western blotting.</p><p><strong>Results: </strong>No difference in the expression level of collagen (Col1a1 and Col1a2) in the skin was detected between the ipragliflozin treatment group and the control group. On the other hand, the expression levels of enzymes involved in the synthesis and decomposition of hyaluronic acid (Has2 and Hayl1) and enzymes involved in the synthesis and decomposition of ceramide (Sptlc1, Sptlc2, Asah1, and Acer1) were significantly decreased by the administration of ipragliflozin. Furthermore, the expression levels of filaggrin (Flg), loricrin (Lor), elastin (Eln), and aquaporin-3 (Aqp3) in the skin were lower in the ipragliflozin treatment group than in the control group.</p><p><strong>Conclusions: </strong>It was revealed that ipragliflozin reduces the expression of genes involved in skin barrier and moisturizing functions, which this may be one of the mechanisms through which this drug causes skin disorders.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15505"},"PeriodicalIF":3.2,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876561","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":"Disordered eating attitudes and behaviours among older adults with type 1 diabetes: An exploratory study.","authors":"Gabriella T Ercolino, Jessica Sprinkles, Angela Fruik, Rashmi Muthukkumar, Nikhita Gopisetty, Xiaorui Qu, Laura A Young, Elizabeth J Mayer-Davis, Angelica Cristello Sarteau, Anna R Kahkoska","doi":"10.1111/dme.15504","DOIUrl":"10.1111/dme.15504","url":null,"abstract":"<p><strong>Aims: </strong>We explored the prevalence of disordered eating behaviours (DEBs) and attitudes among older adults with type 1 diabetes (T1D) and associations with demographic and clinical variables.</p><p><strong>Methods: </strong>Adults aged ≥65 years with T1D from a university-affiliated hospital system completed an electronic survey (September to November 2023) including the Diabetes Eating Problem Survey-Revised (DEPS-R). Clinical data were extracted from medical records.</p><p><strong>Results: </strong>Seventy-seven older adults (mean [SD] age: 71.8 [4.1]; mean [SD] HbA1c [mmol/mol]: 51 [12]; BMI [kg/m²]: 27.3 [4.7]) with T1D completed the DEPS-R. Mean DEPS-R score was 11.5 (6.0), with 5.2% (n = 4) having clinically significant DEBs (score ≥ 20). We found a positive linear association between DEPS-R score and BMI (adjusted p = 0.002). There was no significant association with HbA1c.</p><p><strong>Conclusions: </strong>Older adults with T1D endorsed variable degrees of DEBs. Greater DEBs were associated with higher BMI; more research is needed to characterise this relationship.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15504"},"PeriodicalIF":3.2,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876556","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":"The impact of residual diabetic toe osteomyelitis at the conservative surgical resection margins on prognosis.","authors":"Haojie Sun, Weidong Deng, Shanwen Si, Xuekui Liu, Houfa Geng, Jun Liang","doi":"10.1111/dme.15502","DOIUrl":"https://doi.org/10.1111/dme.15502","url":null,"abstract":"<p><strong>Aims: </strong>The study is to investigate how residual osteomyelitis at conservative surgical resection margins affects the prognosis of diabetic toe osteomyelitis.</p><p><strong>Methods: </strong>In this retrospective study, 67 participants with diabetic toe osteomyelitis who underwent conservative surgery were evaluated. The diagnosis of osteomyelitis was based on histopathology, and bone histopathology was done on the resection bone. After discharge, a 16-week follow-up was conducted, focusing on the wound healing time as the primary outcome. Cox regression analysis was employed as the primary method to analyse the risk factors that influence wound healing.</p><p><strong>Results: </strong>Among the 67 participants, 48 (71.6%) had positive bone margins, while 19 (28.4%) had negative bone margins. Participants with positive bone margins experienced an average healing time of 60.78 ± 18.50 days, whereas those with negative bone margins had an average healing time of 55.19 ± 14.60 days (p = 0.285). Bone margins (positive vs. negative) did not have an impact on wound healing (HR, 1.195 [95% CI, 0.668-2.136]; p = 0.549). Ankle-brachial index was identified as a factor influencing wound healing (HR, 5.399 [95% CI, 1.145-25.455]; p = 0.033). There was no statistical difference between the two groups in terms of wound healing rates (40 of 48 [83.3%] vs. 16 of 19 [84.2%], p = 0.93), inpatient days (19.48 ± 5.25 vs. 18.26 ± 4.79 days, p = 0.385) and duration of antibiotics (32.33 ± 5.64 vs. 30.53 ± 6.93 days, p = 0.272).</p><p><strong>Conclusion: </strong>The residual osteomyelitis in diabetic toe osteomyelitis post-conservative surgery does not impact the wound healing.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15502"},"PeriodicalIF":3.2,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853507","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":"Towards standardization of person-reported outcomes (PROs) in pediatric diabetes research: A consensus report.","authors":"Katharine Barnard-Kelly, David Marrero, Maartje de Wit, Frans Pouwer, Kamlesh Khunti, Norbert Hermans, Jessica S Pierce, Lori Laffel, Richard I G Holt, Tadej Battelino, Diana Naranjo, Jacqueline Fosbury, Lawrence Fisher, William Polonsky, Jill Weissberg-Benchell, Korey K Hood, Oliver Schnell, Laurel H Messer, Thomas Danne, Revital Nimri, Soren Skovlund, Julia K Mader, Jennifer L Sherr, Desmond Schatz, Simon O'Neill, Emma Doble, Marissa Town, Karin Lange, Carine de Beaufort, Linda Gonder-Frederick, Sarah S Jaser, Alon Liberman, David Klonoff, Nuha A Elsayed, Raveendhara R Bannuru, Ramzi Ajjan, Christopher Parkin, Frank J Snoek","doi":"10.1111/dme.15484","DOIUrl":"https://doi.org/10.1111/dme.15484","url":null,"abstract":"<p><strong>Background: </strong>Diabetes ranks among the most common chronic conditions in childhood and adolescence. It is unique among chronic conditions, in that clinical outcomes are intimately tied to how the child or adolescent living with diabetes and their parents or carers react to and implement good clinical practice guidance. It is widely recognized that the individual's perspective about the impact of trying to manage the disease together with the burden of self-management should be addressed to achieve optimal health outcomes. Standardized, rigorous assessment of behavioural and mental health outcomes is crucial to aid understanding of person-reported outcomes alongside, and in interaction with, physical health outcomes. Whilst tempting to conceptualize person-reported outcomes as a focus on perceived quality of life, the reality is that health-related quality of life is multi-dimensional and covers indicators of physical or functional health status, psychological well-being and social well- being.</p><p><strong>Methods: </strong>In this context, this Consensus Statement has been developed by a collection of experts in diabetes to summarize the central themes and lessons derived in the assessment and use of person-reported outcome measures in relation to children and adolescents and their parents/carers, helping to provide a platform for future standardization of these measures for research studies and routine clinical use.</p><p><strong>Results: </strong>This consensus statement provides an exploration of person-reported outcomes and how to routinely assess and incorporate into clincial research.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15484"},"PeriodicalIF":3.2,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845996","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":"Enhanced glucose processing in gestational diabetes diagnosis: Effects on health equity and clinical outcomes.","authors":"Danielle L Jones, Laura C Kusinski, Peter Barker, Keith Burling, Ian Halsall, Elizabeth Turner, Coralie Glenn-Sansum, Abby Rand, Jenny Finch, Genessa Peters, Geraldine Upson, Edward Mullins, Claire L Meek","doi":"10.1111/dme.15476","DOIUrl":"https://doi.org/10.1111/dme.15476","url":null,"abstract":"<p><strong>Objectives: </strong>Gestational diabetes is diagnosed using an oral glucose tolerance test (OGTT), which has limited accuracy, reproducibility and practicality. We assessed the effect of enhanced pre-analytical glucose processing upon glucose concentrations, gestational diabetes diagnosis, health equity and pregnancy outcomes, and if HbA1c was a suitable alternative.</p><p><strong>Methods: </strong>We recruited pregnant women with ≥1 risk factor to a prospective observational cohort study of pregnancy hyperglycaemia, endocrine causes, lipids, insulin and autoimmunity (OPHELIA), from nine UK centres. During a 75 g antenatal OGTT (National Institute of Health and Care Excellence criteria), standard glucose processing was compared to enhanced glucose processing (storage on ice, rapid centrifugation, aliquoting and freezing <2.5 h).</p><p><strong>Results: </strong>We recruited 1308 participants of mean (SD) age 31.5 years (5.0) and BMI 33.0 kg/m² (6.8) of 82.5% white ethnicity, representative of the UK population. Enhanced glucose processing resulted in glucose levels ~0.6 mmol/L higher than standard glucose processing, increasing gestational diabetes diagnosis from 9% to 22%. Women with gestational diabetes on enhanced but not standard glucose processing (n = 165) were younger (31.9 vs. 33.2 years, p = 0.035), with a higher BMI (36.5 vs. 33.9 kg/m²; p = 0.003), different ethnic distribution (p = 0.025) and delivered more large-for-gestational age infants (37.0% vs. 22.3%; p = 0.006) compared to women with gestational diabetes on standard processing alone. HbA1c was not a suitable alternative predictor of gestational diabetes diagnosis (Area under receiver operator curve 0.74; 95% CI 0.68-0.79).</p><p><strong>Conclusions: </strong>An OGTT with enhanced glucose processing would support more accurate, equitable diagnosis of gestational diabetes, but with increased diagnosis rates.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15476"},"PeriodicalIF":3.2,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834445","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":"Removing barriers to management of adults with type 2 diabetes on insulin using continuous glucose monitoring in UK primary care practice: An expert consensus.","authors":"Samuel Seidu, Lorraine Avery, Heather Bell, Pam Brown, Jane Diggle, Su Down, Ritesh Dua, Patrick Holmes, Rahul Mohan, Nicola Milne, Thinzar Min, James Ridgeway, Waqas Tahir, Sanjay Tanna","doi":"10.1111/dme.15500","DOIUrl":"https://doi.org/10.1111/dme.15500","url":null,"abstract":"<p><strong>Aims: </strong>This expert consensus reviews the reality of primary care clinical management of people with type 2 diabetes (T2D) on non-intensive insulin therapy, with an emphasis on the use of continuous glucose monitoring (CGM) technology for effective care in this participant group. Here, we identify key unmet needs for skills and systems development within this frontline healthcare setting, along with major challenges and opportunities associated with managing these changes effectively.</p><p><strong>Methods: </strong>The authors participated in two primary care consensus panels held on 28 November 2023 and on 21 May 2024. The focus for these expert panels was to understand the unmet needs within primary care to manage adults with T2D treated with non-intensive insulin therapy and incorporating the use of CGM systems. A Delphi Survey was undertaken among a wider group of Primary Care Diabetes Technology Network members in the United Kingdom, to understand prevalent attitudes to management of adults with T2D on insulin and using CGM in primary care. Based on these activities, a series of consensus statements were tested in a second Delphi Survey.</p><p><strong>Results: </strong>The activities described, involving primary care healthcare professionals (HCPs) with expertise in diabetes management, identified a series of training and educational needs within UK general practice that are central to skills development for the care of adults with T2D on insulin therapy and the application of CGM technology. Potential barriers to effective primary care management of people with T2D using CGM devices were identified. Areas of concern included confidence in national and local guidelines for the management of T2D using CGM systems, lack of experience on the part both of HCPs and people with T2D, clinical workflows and systems, as well as inbuilt resistance to change among primary care teams. However, the expert group were clear that the goal of providing care for people with T2D on non-intensive insulin therapy using CGM technology as standard of care could be met (94.3%, n = 33). This will deliver clinical benefits for people with T2D, and improvements to clinical workflows in primary care. Cost-savings to the health service were also identified as an outcome.</p><p><strong>Conclusions: </strong>The need to adapt to the management of people with T2D on insulin therapy puts significant pressure on current workflows and skills for primary care teams. Steps in overcoming these immediate pressures, to ensure effective clinical management of people with T2D, are discussed, along with a series of consensus statements that identify the key areas of change to manage. Ultimately, the great majority of expert primary care HCPs were confident or very confident that using CGM technology will become the standard of care for people with T2D treated with insulin in primary care.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15500"},"PeriodicalIF":3.2,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827928","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":"A special issue on from bench to bedside: An integrated and multidisciplinary approach to tackling diabetic kidney disease","authors":"Janaka Karalliedde,&nbsp;Claire E. Hills","doi":"10.1111/dme.15501","DOIUrl":"10.1111/dme.15501","url":null,"abstract":"","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827926","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":"Diabetic foot disease: Assessing adherence of national acute and screening referral pathways with NICE guidelines.","authors":"Amy Jones, Aleksandra Staniszewska, Robert Hinchliffe","doi":"10.1111/dme.15478","DOIUrl":"https://doi.org/10.1111/dme.15478","url":null,"abstract":"","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15478"},"PeriodicalIF":3.2,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823993","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":"The association between glycaemic variability and sleep quality and quantity in adults with type 1 and type 2 diabetes: A systematic review.","authors":"Cecilia T Pham, Aleena Ali, Leonid Churilov, Sara Baqar, Christel Hendrieckx, David N O'Neal, Mark E Howard, Elif I Ekinci","doi":"10.1111/dme.15485","DOIUrl":"https://doi.org/10.1111/dme.15485","url":null,"abstract":"<p><strong>Aims: </strong>Individuals with diabetes frequently encounter sleep disturbances, which can detrimentally impact glycaemic management. We reviewed the relationship between sleep outcomes and glycaemic variability in adults with diabetes.</p><p><strong>Methods: </strong>We systematically searched Medline, EMBASE and Cochrane Library (2002-March 2023) for studies evaluating sleep and glycaemic variability in adults with type 1 and type 2 diabetes. Among the 3049 records, 27 met the inclusion criteria (type 1 diabetes studies = 22). Due to methodological heterogeneity, a qualitative analysis was conducted.</p><p><strong>Results: </strong>Most studies measuring sleep quality (5 out 7; 71%) reported a significant association with glycaemic variability in type 1 and type 2 diabetes. Sleep duration was not significantly associated with glycaemic variability in type 1 diabetes, whereas other sleep metrics yielded inconclusive results. Hybrid closed-loop pump interventions (n = 12) demonstrated varying sleep outcomes with improved glycaemic variability. Similarly, sleep interventions (n = 3) consistently enhanced sleep but not glycaemic variability. Limitations included moderate to high risk of study bias, confounders, methodological heterogeneity and limited type 2 diabetes data.</p><p><strong>Conclusions: </strong>A potential association between sleep quality and glycaemic variability exists. However, associations with other sleep metrics remain elusive, with no discernible association between sleep duration and glycaemic variability in type 1 diabetes. Despite advancements in continuous glucose monitoring and ambulatory sleep monitoring, standardised sleep assessment methodologies are lacking in real-world studies. Establishing standard protocols for sleep assessment and defining optimal sleep targets are crucial for meaningful comparisons between studies. Understanding the complex interplay between sleep and glycaemic variability holds promise in improving diabetes management and sleep health.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15485"},"PeriodicalIF":3.2,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812678","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}