Endocrine Practice最新文献

{"title":"Postoperative considerations following pituitary surgery: A guide for clinicians.","authors":"Erica A Giraldi, Adriana G Ioachimescu","doi":"10.1016/j.eprac.2025.06.018","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.018","url":null,"abstract":"<p><p>Transsphenoidal surgery represents primary treatment for pituitary adenomas (other than prolactin-secreting) and other sellar/suprasellar masses including craniopharyngiomas. Endocrine evaluation for anterior hypopituitarism and water metabolism disorders is indicated in all patients. Transient fluid restriction postoperatively in patients without vasopressin deficiency reduces the risk of hyponatremia and hospital readmission. In Cushing disease, postoperative serum cortisol levels in the first postoperative days guide further management. In acromegaly, remission is established primarily by IGF-1 measurement three months postoperatively. Patients with functioning adenomas require proactive management of comorbidities related to hormone excess and lifelong monitoring for recurrence. Surgical outcomes are superior at high-volume institutions with neurosurgical and endocrinological expertise.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526929","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":"Effects of Plasma Aldosterone and Renin Concentrations with Blood Pressure Variation and Hypertension Risk in Chinese Adults: A Population-Based Hakka Biobank Study.","authors":"Fuxiang Fang, Jingwei Lin, Mingli Li, Zheng Wen, Diman Mai, Jingwen Liu, Lingyu Ye, Yezhou Wu, Xuefang Liang, Fuhua Hu, Yibi Lan, Junwu Ran, Renzhi Tan, Yongchen Li, Libing Lai, Jinlian Li, Yongxian Wu, Zheng Lu, Shengzhu Huang, Chao Wang, Zengnan Mo","doi":"10.1016/j.eprac.2025.06.015","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.015","url":null,"abstract":"<p><strong>Objectives: </strong>The renin-angiotensin-aldosterone system (RAAS) has been implicated in regulating blood pressure (BP), yet its effects on BP-related phenotypes are not well characterized in the Chinese population.</p><p><strong>Methods: </strong>Based on 8914 participants from the Hakka Biobank (HKB) cohort of China, regression models, restricted cubic spline (RCS), and subgroup analyses were used to analyze associations of plasma aldosterone concentration (PAC), plasma renin concentration (PRC), and the aldosterone-to-renin ratio (ARR) with multiple BP-related phenotypes.</p><p><strong>Results: </strong>Multivariable regression models indicated that higher log-PAC and log-ARR, and lower log-PRC, were associated with higher systolic blood pressure, diastolic blood pressure, pulse pressure, and mean arterial pressure (all P < 0.001). A 1-unit higher log-PAC or lower log-PRC was linked to higher risks of systolic, diastolic, clinic, and systolic-diastolic hypertension, with the odds ratios (ORs) ranging from 1.67 (95% confidence interval [CI], 1.47-1.85) to 6.29 (95% CI, 4.48-8.83); and the OR of a higher log-ARR ranged from 1.66 (95% CI, 1.47-1.86) for systolic-diastolic hypertension to 2.42 (95% CI, 2.14-2.73) for clinic hypertension. Consistent associations were observed in subgroup and sensitivity analyses, as well as the participants with renin-independent aldosteronism compared to those with normal aldosterone concentration or renin-dependent aldosteronism (all P < 0.05). Moreover, RCS model revealed significant non-linear associations between log-PAC, log-PRC and log-ARR with hypertension (all P nonlinearity < 0.05).</p><p><strong>Conclusions: </strong>Higher PAC and ARR, lower PRC were associated with adverse BP variation and elevated risk of hypertension, especially among participants in the context of renin suppression or autonomous aldosterone secretion.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511701","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":"Establishing Serum Thyroglobulin Reference Values and Predictors of its Variability in an Iodine-Sufficient Population.","authors":"Irene Mamali, Georgios K Markantes, Dionysios V Chartoumpekis, Kostas B Markou, Ioannis Kioutsioukis, Marina A Michalaki","doi":"10.1016/j.eprac.2025.06.017","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.017","url":null,"abstract":"<p><strong>Objectives: </strong>Serum thyroglobulin (Tg) is a key biomarker for various thyroid conditions. However, population-specific reference values (RVs) are missing, and clinical practice relies on manufacturer-provided RVs. This study aimed to establish Tg RVs in an iodine-sufficient population using the strict National Academy of Clinical Biochemistry (NACB) criteria and to identify determinants of serum Tg levels.</p><p><strong>Methods: </strong>We screened 420 volunteers through history, physical examination, thyroid function tests (TFTs), urine iodine excretion, and thyroid ultrasonography. Thyroid volume (TTV) was estimated in a subset of the study population. We selected 140 subjects for NACB criteria-based Tg RVs determination (Cohort 1) and 154 for Tg determinant analysis (Cohort 2). Redundancy Analysis and Variation Partition were performed to quantify the explained variance of Tg from five variables -smoking, age, gender, TSH, and TTV.</p><p><strong>Results: </strong>The RVs for Tg, calculated as mean ± 2 standard deviations on log-transformed data (as per the NACB criteria), were 2.95-56.23 ng/mL, whereas those suggested by our Tg assay manufacturer are 3.5-77 ng/mL. A model including all five predictors explained only 7.5% of Tg variability, with smoking (4.8%) and TTV (2.7%) as the only significant contributors. Subgroup analysis showed that TSH had a minor impact only in men, while age and gender were not significant contributors.</p><p><strong>Conclusions: </strong>Population-specific RVs for Tg are essential in clinical decision-making. Known clinical/biochemical variables explained only a small proportion of Tg variability. Our findings underscore the need to identify additional determinants of Tg levels.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511702","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":"Risk stratification and long-term outcome of benign thyroid nodules - a 11-year cohort study.","authors":"Sapir Pinhas, Jonathan Cohen, Raviv Allon, Nadav Ben-David, Noam Koch, David Kiderman, Elchanan Zloczower, Taiba Zornitzki, Moshe Yehuda, Yonatan Lahav, Oded Cohen","doi":"10.1016/j.eprac.2025.06.016","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.016","url":null,"abstract":"<p><strong>Objectives: </strong>The recommended follow-up interval and length, as well as the indication for repat fine needle aspiration in benign nodules remains unclear up to date. The purpose of the study was to evaluate the long-term follow-up and management outcomes of benign thyroid nodules.</p><p><strong>Methods: </strong>A retrospective study included 1,224 nodules from 1,071 patients with initial benign thyroid nodules, between 2010 and 2014. Phone calls were made to obtain updated information from patients when information was missing. The main outcome of the study was a change in the nodule's ROM - defined either as a malignant pathology (when obtained) or by cytology (repeated BSRTC III, IV, V, or VI). Secondary outcomes included the yield of repeated FNA. Data included demographics, sonographic data, follow-up adherence, repeat FNA results, surgery types, and pathologic results.</p><p><strong>Results: </strong>The average follow-up period was 9.48 ± 1.72 years. 0.65% (7/1071) of patients remained without follow-up. The ROM was 3.43% (42/1224). Benign nodules >2 cm had a higher ROM compared to smaller nodules (5.3% vs. 1.3% respectively, p-value<0.001). Repeat FNA and a change in nodule size did not significantly change ROM. Among the 41 malignant nodules with documented size, 33 (80.49%) were nodules larger than 2 cm. A total of 35 cases (85.37%) were diagnosed within the first 3 years of follow-up.</p><p><strong>Conclusion: </strong>ROM for benign nodules remains considerably low, especially for nodule smaller than 2 cm. Long-term follow-up and repeated FNA and follow-up for BTSC II thyroid nodules without suspicious features should be reconsidered.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511703","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":"BILATERAL ADRENAL NODULES PRESENTING WITH MILD AUTONOMOUS CORTISOL SECRETION.","authors":"Rashi Sandooja, Oksana Hamidi, Catherine D Zhang, Prerna Dogra, Shobana Athimulam, Leili Rahimi, Camila Villavicencio Torres, Shireen R Chacko, William Young, Irina Bancos","doi":"10.1016/j.eprac.2025.06.019","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.019","url":null,"abstract":"<p><p>Benign adrenocortical adenomas are frequently diagnosed on cross-sectional imaging performed for unrelated reasons. Up to 15-20% of adrenal nodules are bilateral, representing bilateral adenomas or primary bilateral macronodular adrenal hyperplasia. Mild autonomous cortisol secretion (MACS), diagnosed based on an abnormal dexamethasone suppression test, is seen in 19-44% of patients with adrenal adenomas. Distinguishing unilateral from bilateral MACS in patients with bilateral nodules is important to guide appropriate therapy and relies on imaging phenotype, and, in some cases, on adrenal vein sampling. MACS is associated with cardiovascular morbidity, poor quality of life, frailty, and increased mortality. Reversal of MACS improves these outcomes, however, management of patients with bilateral MACS is challenging. Unilateral adrenalectomy in patients with bilateral nodules and MACS may lead to permanent remission (if MACS is unilateral), temporary remission, or improvement of the degree of MACS (if MACS is bilateral). No medical therapy is currently approved for MACS. Here, we review the presentation, diagnosis, and management of patients with bilateral adrenal nodules and MACS.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505137","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 Effect of Growth Hormone-Secreting Pituitary Adenoma Disease Activity on Thyroid Nodules.","authors":"Caiyan Mo, Tao Tong, Yao Wang, Hongyu Liu, Dan Liang, Ying Guo, Jian Xu, Liyong Zhong","doi":"10.1016/j.eprac.2025.06.013","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.013","url":null,"abstract":"<p><strong>Objective: </strong>Previous studies on thyroid nodules in patients with growth hormone-secreting pituitary adenoma (GHPA) had small sample sizes and inconsistent findings. This study aims to summarize the clinical characteristics of thyroid nodules in patients with GHPA, investigate the relationship between thyroid nodule volume and disease activity, and analyze risk factors associated with thyroid nodule development.</p><p><strong>Methods: </strong>There were 150 patients with GHPA included from a retrospective review of medical records from January 2009 to December 2024. At baseline, correlations were investigated between growth hormone (GH), insulin-like growth factor-1 (IGF-1), thyroid-stimulating hormone (TSH) with maximum thyroid nodule diameter (TND) and total thyroid nodule volume (TTNV). A binary logistic regression analysis was used to explore the risk factors for the development of thyroid nodules in patients with GHPA. Data from 54 patients were available for longitudinal follow-up measures of thyroid nodule characteristics between baseline and last follow-up.</p><p><strong>Results: </strong>The prevalence of thyroid nodules in patients with GHPA was 74%. Baseline TND and TTNV were positively correlated with age and IGF-1 levels and negatively correlated with TSH levels. Patients with thyroid nodules exhibited higher GH levels. During prospective follow-up, TND significantly decreased following a marked reduction in GH/IGF-1 levels. Logistic regression analysis identified baseline GH level as an independent risk factor for thyroid nodule occurrence.</p><p><strong>Conclusion: </strong>Chronic elevation of GH/IGF-1 levels in patients with GHPA is associated with the development and progression of thyroid nodules. Following treatment of GHPA, a reduction in GH/IGF-1 levels correlates with a decrease in thyroid nodule volume. Close monitoring of nodule growth and regular thyroid ultrasonography are recommended, particularly for nodules with malignant features.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495232","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":"Trajectories of antidiabetic medication adherence in older adults and the effect of depression and anxiety symptoms.","authors":"Giraud Ekanmian, Carlotta Lunghi, Helen-Maria Vasiliadis, Line Guénette","doi":"10.1016/j.eprac.2025.06.012","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.012","url":null,"abstract":"<p><strong>Objectives: </strong>Common mental health disorders, such as anxiety and depression, significantly impact medication adherence in various chronic conditions. However, few studies have captured the evolving nature of adherence behavior, indicating a need for further investigation. The objectives were to describe adherence trajectories to antidiabetic medications among older patients and to explore the potential association between these trajectories and the presence of anxiety and depression.</p><p><strong>Methods: </strong>We conducted a secondary analysis of the ESA-S study involving 282 elderly participants who were prevalent users of antidiabetic medications. Medication adherence was measured using claims data over a 12-month period. Group-Based Trajectory Modeling (GBTM) was employed to identify distinct adherence trajectories. The association between the presence of common mental health disorders, assessed using self-reported symptoms and diagnostic codes from medico-administrative data, and adherence trajectories was estimated through multinomial logistic regressions.</p><p><strong>Results: </strong>Four distinct adherence trajectories were identified and defined as low adherence (6.7%), fair adherence (18.1%), high adherence (37.9%), and nearly perfect adherence (37.2%). These patterns were also stable during the 12-month follow-up period. No significant association was found between common mental health disorders and medication adherence trajectories in this cohort, even after adjusting for potential confounders.</p><p><strong>Conclusion: </strong>Older patients with diabetes mostly depicted high adherence. Depression or anxiety did not impact adherence trajectories. However, our study was underpowered to detect small to moderate effects of these common mental health disorders.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474302","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":"Diagnosis and Phenotypes of Idiopathic diabetes: A systematic Review.","authors":"Rana El Nahas, Ghalia Missous, Mohannad Al-Tarakji, Mohamed Said-Ghali, Khalid Hussain, Nicholas van Panhuys, Laura Herrero, Meritxell Espino-Guarch","doi":"10.1016/j.eprac.2025.06.009","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.009","url":null,"abstract":"<p><p>Diabetes classification includes various forms, primarily Type-1 and Type-2, along with atypical types like Type-1b diabetes (T1bD), which lack classic autoimmune markers or high-risk HLA alleles, presenting diagnostic challenges and suggesting alternative pathogenic mechanisms. This review explores the potential genetic basis of these cases and the need for comprehensive testing. Seventeen studies, including case reports, cross-sectional, and cohort studies were analyzed from PubMed, Web of Science and Scopus databases up to 14 March 2024, covering 290 T1bD cases. The cases were reclassified using the American-Diabetes-Association's (ADA) criteria (autoantibody-negative, onset <35 years-old, non-obese, and not HLA-associated). Genetic testing results were reviewed, focusing on identified mutations. Reclassification identified 201 T1bD cases which 30% of autoantibody-negative T1bD cases had pathogenic variants linked to monogenic diabetes, such as maturity-onset diabetes of the young (MODY), and mutations in insulin, KCNJ11, and KLF1 genes linked to Neonatal Diabetes. Only 60 T1bD cases underwent exome sequencing, with none having whole genome sequencing, indicating limited genetic exploration. A significant proportion of T1bD cases may have an undetermined genetic basis, emphasizing the need for more comprehensive diagnostic assessments. Increased use of advanced genetic screening, such as WGS, and data sharing are vital for improving diagnosis and management, potentially enabling personalized treatment for idiopathic diabetes.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483667","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":"Thyroid Emergencies: A Narrative Review.","authors":"Margaret L Kruithoff, Benjamin J Gigliotti","doi":"10.1016/j.eprac.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.010","url":null,"abstract":"<p><p>Myxedema coma and thyroid storm are rare thyroid emergencies associated with considerable mortality and morbidity. Myxedema coma is a state of decompensated hypothyroidism with widespread multi-organ dysfunction, most notably impaired consciousness, mixed respiratory failure, and hypothermia. Thyroid storm is the extreme state of thyrotoxicosis occurring when a patient's metabolic, thermoregulatory, and cardiovascular compensatory mechanisms are surpassed. Common clinical features of thyroid storm include hyperthermia, neuropsychiatric symptoms, and tachyarrhythmias. Thyroid emergencies usually result from a precipitating event or trigger transforming a previously compensated hypothyroid or thyrotoxic state. The diagnosis of myxedema coma and thyroid storm is established from clinical features in the either already hypothyroid or thyrotoxic patient. In the case of thyroid storm, clinicians may augment their clinical reasoning with the Japanese Thyroid Association Diagnostic Criteria or the Burch-Wartofsky Point Scale. Supportive care for the cardiovascular, respiratory, and thermoregulatory manifestations, as well as possible intercurrent illness or adrenal insufficiency, play a lead role in the management. For myxedema coma, treatment typically includes high dose levothyroxine with the addition of liothyronine for critically ill patients. Management of thyroid storm is multi-pronged and stepwise, consisting of first-line thionamide and beta-adrenergic receptor antagonist therapy as first-line, inorganic iodine, as well as cholestyramine, plasmapheresis, or emergent thyroidectomy in appropriate severely ill patients.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483668","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":"Thyroid eye disease: Management, Advances and Future Opportunities.","authors":"Tamaryn Fox, Andrea Kossler, Chrysoula Dosiou","doi":"10.1016/j.eprac.2025.06.011","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.06.011","url":null,"abstract":"<p><p>Thyroid eye disease (TED), the most common extrathyroidal manifestation of Graves' disease, is a debilitating autoimmune condition that significantly impacts quality of life and can threaten vision. This review highlights advances in TED's understanding, particularly in pathophysiology, emerging treatments, novel surgical techniques, and the use of imaging and artificial intelligence (AI). Teprotumumab, the first FDA-approved drug for TED, has shown effectiveness in reducing proptosis, improving diplopia, and enhancing quality of life. Other therapies in development include alternative IGF-1 receptor antagonists, FcRn inhibitors, interleukin pathway antagonists, and TSH receptor inhibitors, all of which offer promising potential. Surgical approaches such as orbital decompression and eyelid correction have also evolved, with minimally invasive techniques gaining favor. Diagnostic advancements in biomarkers could further enhance early detection and disease monitoring. AI tools for assessing disease severity and predicting treatment outcomes are also emerging. Despite significant progress in molecular understanding and treatment options, TED remains complex, and continued research is essential to improve diagnostic precision and therapeutic outcomes.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483669","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}