Emerging Microbes & Infections最新文献

{"title":"Monocyte distribution width (MDW) as a reliable diagnostic biomarker for sepsis in patients with HIV.","authors":"Jinfeng Sun, Yueming Shao, Rui Jiang, Tangkai Qi, Jingna Xun, Yinzhong Shen, Renfang Zhang, Liu Qian, Xialin Wang, Li Liu, Zhenyan Wang, Jianjun Sun, Yang Tang, Wei Song, Shuibao Xu, Junyang Yang, Youming Chen, Yi-Wei Tang, Hongzhou Lu, Jun Chen","doi":"10.1080/22221751.2025.2479634","DOIUrl":"https://doi.org/10.1080/22221751.2025.2479634","url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis is a leading cause of death among patients with HIV, but early diagnosis remains a challenge. This study evaluates the diagnostic performance of monocyte distribution width (MDW) in detecting sepsis in patients with HIV.</p><p><strong>Methods: </strong>A prospective observational study was conducted at Shanghai Public Health Center, involving 488 hospitalized patients with HIV aged 18-65 between December 2022 and August 2023. MDW was measured at admission, and its diagnostic accuracy was compared with Sepsis-3 criteria. Survival rates on day 28 and 90 were also recorded. Additionally, five machine learning (ML) models were tested to enhance diagnostic efficacy.</p><p><strong>Results: </strong>Of 488 subjects, 90 were in the sepsis group and 398 in the control group. MDW showed a diagnostic area under the curve (AUC) of 0.82, comparable to C-reactive protein (CRP) and Procalcitonin (PCT) with AUCs of 0.78 and 0.82, respectively. With a cut-off value of 25.25, MDW had a sensitivity of 0.83 and specificity of 0.76. The positive and negative predictive values were 44% and 95%, respectively. When MDW was combined with platelet count, serum albumin, and hemoglobin in a random forest model, the AUC improved to 0.931. The model achieved a sensitivity of 1.00 and specificity of 0.732.</p><p><strong>Conclusion: </strong>MDW is a useful diagnostic marker for sepsis in patients with HIV, with strong sensitivity and specificity. Combining MDW with other lab markers can further enhance diagnostic accuracy.<b>Trial registration:</b> ClinicalTrials.gov identifier: NCT05036928..</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2479634"},"PeriodicalIF":8.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The emergence of highly resistant and hypervirulent Escherichia coli ST405 clone in a tertiary hospital over 8 years.","authors":"Min Wang, Zhijun Zhang, Zhifei Sun, Xinying Wang, Jie Zhu, Meijie Jiang, Shuping Zhao, Liang Chen, Qiang Feng, Hong Du","doi":"10.1080/22221751.2025.2479048","DOIUrl":"https://doi.org/10.1080/22221751.2025.2479048","url":null,"abstract":"<p><p>The emergence of carbapenem-resistant <i>Escherichia coli</i> (CREC) poses crucial challenges in clinical management, requiring continuous monitoring to inform control and treatment strategies. This study aimed to investigate the genomic and epidemiological characteristics of CREC isolates obtained from a tertiary hospital in China between 2015 and 2022. Next-generation sequencing was used for genomic profiling, and clinical data from patients were integrated into the analysis. ST405 (21.2%), ST167 (20.3%) and ST410 (15.9%) were the most prevalent of the 30 distinct sequence types (STs) identified among the 113 unique CREC isolates. Infections caused by the ST405 CREC clone and severe underlying diseases were associated with higher in-hospital mortality rates, particularly in patients aged ≥65 years. Furthermore, the ST405 clone exhibited a greater number of virulence and resistance genes than non-ST405 CREC clones. The virulence gene <i>eaeX</i> and resistance genes <i>mph(E)</i> and <i>msr(E)</i> were exclusively found in ST405 clones, while other virulence genes (<i>agn43</i>, <i>ipad</i> and <i>malX</i>) and resistance genes (<i>armA</i>, <i>catB3</i> and <i>arr-3</i>) were more prevalent in this clones. Additionally, ST405 showed higher minimum inhibitory concentrations for both meropenem and imipenem and showed superior growth under the meropenem challenge. Galleria mellonella virulence assays revealed that the ST405 CREC clone was more virulent than other predominant CREC STs. Our findings underscore the clinical threat posed by the ST405 CREC clone, which exhibits both enhanced virulence and extensive drug resistance. These results highlight the urgent need for stringent surveillance and targeted interventions to curb its further dissemination and prevent potential outbreaks.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2479048"},"PeriodicalIF":8.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccine Effectiveness Dynamics against Influenza and SARS-CoV-2 in Community-tested Patients in France 2023-2024.","authors":"Claire Nour Abou Chakra, François Blanquart, Vincent Vieillefond, Vincent Enouf, Benoit Visseaux, Stéphanie Haim-Boukobza, Laurence Josset, Marie-Anne Rameix-Welti, Bruno Lina, Marta C Nunes, Antonin Bal","doi":"10.1080/22221751.2025.2466699","DOIUrl":"https://doi.org/10.1080/22221751.2025.2466699","url":null,"abstract":"<p><strong>Background: </strong>The epidemiology of respiratory viruses and vaccine effectiveness (VE) in the community is not well described. This study assessed VE against a positive test of influenza (VEf) and SARS-CoV-2 (VECov).</p><p><strong>Methods: </strong>Data from two large networks of community-based laboratories in France were collected during standard of care in the 2023-2024 epidemic season (n = 511,083 RT-PCR tests). Multiplex PCR diagnostic tests were used. Patients' demographics and symptoms were reported in addition to viral sequencing results. Test-negative design was used to separately estimate VEf and VECov, overall and stratified, by time since vaccination and calendar week.</p><p><strong>Results: </strong>Adjusted VEf by age-group, sex, presence of symptoms, PCR technique, and week of testing, was 47.6% (95% CI: 44.3%-50.7%). VEf was lower in patients ≥65 years (42.0%; 95% CI: 36.6%-46.9%) than 18-64 years (52.9%; 95% CI: 48.6%-56.8%). The adjusted VEf against type A influenza, that represented 98% of typed viruses, was 51% (95% CI: 45%-56.6%) for patients vaccinated 15 days to 3 months before testing, and 35.5% (95% CI: 24.2%-45.3%) for those vaccinated 3 to 6 months before testing. For VECov, the adjusted estimate in patients vaccinated 15 days to 3 months prior to testing were 40.6% (95% CI: 7.2%-58.6%) at week 39, 24.8% (95% CI: 4.0%-38.8%) at week 45, and dropped systematically through the epidemic season as the JN.1 variant became dominant.</p><p><strong>Conclusion: </strong>This study showed moderate VEf and VECov against infection in the community and highlighted the impact of time since vaccination and age for both estimates, and the new variant emergence on VECov. These findings should be considered in future vaccination campaigns.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2466699"},"PeriodicalIF":8.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CpG oligodeoxynucleotides and pan-serotype inhibitors control neurotropic Dengue infection in novel immune competent neonatal mouse model.","authors":"Mirian Mendoza, Derek D C Ireland, Ha-Na Lee, Logan Kelly-Baker, Monica Chowdhury, Daniela Verthelyi, Mohanraj Manangeeswaran","doi":"10.1080/22221751.2025.2477668","DOIUrl":"https://doi.org/10.1080/22221751.2025.2477668","url":null,"abstract":"<p><p>Dengue virus (DENV) is a growing global public health threat. The lack of symptomatic immune competent animal models for Dengue has hindered the screening and development of effective therapeutics that can be used to control dengue virus replication and thereby control the progression to severe dengue disease. To address this, we established an infection model in neonatal C57BL/6 mice and showed that a systemic Dengue challenge leads to ataxia, seizures, paralysis, and death within 15 days. The virus was found predominantly in the eye and brain where DENV infects neurons but not astrocytes and causes extensive infiltration of macrophages and microglia activation. The response to infection included upregulation of multiple genes linked to interferons (<i>Ifna, Ifnb, Ifng, Irf7, Irf8, Mx1, Stat1</i> and <i>Bst2</i>), inflammation (<i>Il6,Tnfa</i>), complement (<i>Cfb,C1ra,C2, C3</i>), cytolysis (<i>Gzma, Gzmb, Prf1</i>) consistent with antiviral responses and inflammation together with neuroprotective regulatory signals (<i>Il27, Il10, and stat2)</i>. The increased proinflammatory signature was associated downregulation neurodevelopmental genes <i>(Calb2, Pvalb, Olig1</i> and <i>Olig2)</i>. We tested the utility of this mouse model by assessing the protection conferred by direct antivirals JNJ-A07 and ST-148 and host-directed antiviral immunomodulatory CpG oligodeoxynucleotide (ODN), alone or in combination against lethal dengue viral infection. The data showed that immunomodulatory CpG ODN and antiviral JNJ-A07 improved survival of neonatal mice, and protection from lethal neurotropic infection was optimal when treatments were combined. This study suggests that combination of an effective dengue antiviral along with a host directed therapeutic may be a useful strategy to protect against Dengue virus infections.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2477668"},"PeriodicalIF":8.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143583723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dengue Virus and Lipid Metabolism: Unraveling the Interplay for Future Therapeutic Approaches.","authors":"Ying Xie, Li Jiao, Qiangming Sun","doi":"10.1080/22221751.2025.2477647","DOIUrl":"https://doi.org/10.1080/22221751.2025.2477647","url":null,"abstract":"<p><p>In recent years, Dengue virus (DENV) has continued to pose significant health risks in tropical and subtropical areas worldwide, raising health alerts worldwide. It can cause hyperviremia in humans and can even lead to fatal clinical diseases. The life cycle of DENV is intricately linked to cellular lipids, and the virus selectively utilizes relevant enzymes involved in lipid metabolism to modulate the existing metabolic system in host cells during entry, replication, assembly, and other stages, thereby creating an environment conducive to its complete replication cycle. At present, there is a lack of effective and specific anti-DENV treatment measures. This review summarizes the recently identified lipid metabolism molecules and metabolic related diseases that affect DENV infection, explores the dependence of DENV on lipid metabolism and provides potential targets for the treatment of dengue fever (DF).</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2477647"},"PeriodicalIF":8.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence of Mpox Clade IIb Infection in Primary Human Alveolar Epithelium.","authors":"Thanaphon Namporn, Suwimon Manopwisedjaroen, Montien Ngodngamthaweesuk, Ekawat Pasomsub, Natnicha Jiravejchakul, Rattatammanoon Saengfak, Marea Jikka Nealiga, Arunsajee Sea-Be, Aalok Basu, Parichart Naruphontjirakul, Suradej Hongeng, Teresa D Tetley, Arunee Thitithanyanont, Pakatip Ruenraroengsak","doi":"10.1080/22221751.2025.2477845","DOIUrl":"https://doi.org/10.1080/22221751.2025.2477845","url":null,"abstract":"<p><p>Monkeypox virus (Mpox) has been recognized for causing distinct skin lesions and is primarily transmitted through skin and sexual contact. To date, the transmissibility and pathogenesis of the Mpox virus in distal human lung has never been completely explored. Here the transmission pathways and Mpox tropism on patient-derived air-liquid epithelium (ALE) model fabricated using isolated primary human alveolar epithelial cells (hAECs) were investigated. hAECs were cultured and exposed to the Mpox virus clade IIb isolated from patient. DNA, proteins, and the tropism were elucidated using polymerase chain reaction (PCR), Western blot and high-content fluorescent imaging. Transmission electron microscopy (TEM) was employed to systematically observe the cellular distribution of viral particles. Viral titers were determined by TCID₅₀ assay. Innate immune response and inflammatory mediators were measured using Milliplex® multiplex and ELISA analysis. Pathology at alveolar barrier integrity was determined using transepithelial electrical resistance (TEER) analysis. The study included mock-infected cells as control. Mpox virus significantly infected 42.82% of total hAEC populations. The prominent observed pathology included a significant reduction in TEER values, loss of tight junction protein, presence of tunneling nanotubes (TNTs) and syncytium morphology. Four stages of Mpox biogenesis were clearly observed without significant activation of IL-6, MIP1alpha, TNF-α, and Galectin-9, although IL-1β were subtly promoted. The developed patient-derived ALE is a versatile model for Mpox virus clade IIb infection reflecting respiratory transmission competence of the Mpox. Postinfection lung pathogenesis demonstrated alveolar barrier damage without significant inflammation, raising concerns about possible immune evasion by the virus.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2477845"},"PeriodicalIF":8.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High glucose heightens vulnerability to <i>Leishmania braziliensis</i> infection in human macrophages by hampering the production of reactive oxygen species through TLR2 and TLR4.","authors":"Ícaro Bonyek-Silva, Rana Bastos, Sara Nunes, Rafael Tibúrcio, Alexsandro Lago, Juliana Silva, Lucas P Carvalho, Ricardo Khouri, Sergio M Arruda, Aldina Barral, Viviane Boaventura, Henrique C Serezani, Edgar M Carvalho, Cláudia Ida Brodskyn, Natalia Machado Tavares","doi":"10.1080/22221751.2025.2475824","DOIUrl":"https://doi.org/10.1080/22221751.2025.2475824","url":null,"abstract":"<p><p>Diabetes increases susceptibility to infections, including <i>Leishmania braziliensis</i> (<i>Lb</i>). Our group previously demonstrated that diabetic patients with cutaneous leishmaniasis (CL) take longer to heal lesions compared to non-diabetics. Since macrophages play a critical role in CL pathogenesis, we investigated how high glucose levels impact their response during <i>Lb</i> infection. Macrophages cultured in high glucose conditions showed increased parasite load than those in normal glucose conditions. The production of inflammatory mediators was similar between glucose conditions, but basal reactive oxygen species (ROS) production was elevated under high glucose conditions and remained unchanged after <i>Lb</i> infection, indicating glucose-induced oxidative stress does not control the parasite. In contrast, macrophages in normal glucose conditions, exhibited increased ROS production only after infection<i>.</i> Additionally, high glucose reduced TLR2 and TLR4 expression, which was also observed after <i>Lb</i> infection. TLR2/4 inhibition increased <i>Lb</i> infection in normal glucose conditions, mediated by TLR-dependent ROS production. However, this mechanism was absent under high glucose conditions, where elevated basal ROS production appeared TLR-independent. Biopsies from diabetic CL patients corroborated these findings, showing decreased TLR2 and TLR4 expression compared to non-diabetics. These findings suggest that high glucose levels induce oxidative stress and reduces TLR expression, impairing macrophage functions and rendering them less effective at controlling Lb infection.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2475824"},"PeriodicalIF":8.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms Underlying Delayed loss of HBeAg and HBV DNA Following HBsAg Seroclearance in PEG-IFNα Treated Patients of chronic hepatitis B.","authors":"Bei Jiang, Guiwen Guan, Kaitao Zhao, Zhiqiang Gu, Lin Wang, Weilin Gu, Minghui Li, Yuchen Xia, Xiangmei Chen, Yifei Guo, Jiming Zhang, Zhenhuan Cao, Man-Fung Yuen, Fengmin Lu","doi":"10.1080/22221751.2025.2475847","DOIUrl":"10.1080/22221751.2025.2475847","url":null,"abstract":"<p><strong>Background & aims: </strong>A notable proportion of CHB patients undergoing PEG-IFNα based therapy experience lagged serum HBeAg and/or HBV DNA disappearance in patients achieving HBsAg loss. In this study, we explored the molecular mechanisms behind this clinical phenomenon, offering novel insights into the sustainability of chronic HBV infection.</p><p><strong>Methods: </strong>Two independent clinical cohorts were enrolled to validate this phenomenon. Then comprehensive analysis was performed using public datasets, coupled with a series of molecular biology experiments.</p><p><strong>Results: </strong>Approximately 17-20% CHB patients underwent PEG-IFNα based therapy experienced seroclearance of HBsAg, while serum HBeAg and/or HBV DNA remained positive. These patients are more prone to serum HBsAg reappearance compared to those achieving complete virological response. Analysis of public datasets revealed that compared to the PC/BCP, the SP1/SP2 promoter displayed more pronounced inhibitory epigenetic modifications in HBeAg-negative patients and SP1/SP2 in-frame mutation peaked in immune active patients. In vitro experiments demonstrated that introduced SP1/SP2 inactive mutations would enhance PC/BCP transcriptional activity by a mechanism known as adjacent transcriptional interference. Furthermore, the deletion of L-HBsAg facilitated intracellular cccDNA replenishment.</p><p><strong>Conclusion: </strong>This study elucidates that under IFNα treatment and low viral load, transcriptional suppression of SP1/SP2 promoters through mutations and/or epigenetic changes would favor the maintenance of sustain chronic HBV infection, via enhancing the transcription activity of BCP to promote cccDNA replenishment.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2475847"},"PeriodicalIF":8.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"North American-Origin Influenza A (H10) viruses in Eurasian Wild Birds (2022-2024): Implications for the Emergence of Human H10N5 Virus.","authors":"Jiaying Wu, Xiaoqing Zhang, Yubo Zhao, Shunyuan Zhang, Yanhai Wang, Wenxue Yang, Haizhou Liu, Jiang Feng, Wenzhuo Tan, Ke Wang, Qianqian Shi, Qichao Wei, Jianqing Sun, Yuan Zhang, Jianjun Chen","doi":"10.1080/22221751.2025.2465308","DOIUrl":"https://doi.org/10.1080/22221751.2025.2465308","url":null,"abstract":"<p><p>During our surveillance of avian influenza viruses (AIVs) in wild birds across China, H10Nx viruses were isolated from diverse migratory flyways between 2022 and 2024. We identified one wild-bird H10N5 strain that shared a common ancestor with the human H10N5 virus in multiple gene segments. Phylogenetic and molecular dating revealed the origin and evolution of H10N5, highlighting the need for continued monitoring.</p>","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":" ","pages":"2465308"},"PeriodicalIF":8.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first appearance of the zoonotic parasite Cryptosporidium mortiferum in human and tree and ground squirrels in Central Europe.","authors":"Martin Kváč,Alena Konvalinová,Nikola Holubová,Zuzana Hůzová,Marta Kicia,John McEvoy,Kristina Beranová,Bohumil Sak","doi":"10.1080/22221751.2025.2456148","DOIUrl":"https://doi.org/10.1080/22221751.2025.2456148","url":null,"abstract":"","PeriodicalId":11602,"journal":{"name":"Emerging Microbes & Infections","volume":"51 1","pages":"2456148"},"PeriodicalIF":13.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142989709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}