Endocrine Practice最新文献

{"title":"Navigating Uncertainty in Adjuvant Mitotane Therapy.","authors":"Massimo Terzolo, Martin Fassnacht, Alfredo Berruti, Cristina Ronchi","doi":"10.1016/j.eprac.2025.03.012","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.03.012","url":null,"abstract":"","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771518","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":"Diabetes and Lipids: A Review and Update on Lipid Biomarkers and Cardiovascular Risk.","authors":"Yumiko Tsushima, Betul Hatipoglu","doi":"10.1016/j.eprac.2025.03.011","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.03.011","url":null,"abstract":"<p><strong>Objective: </strong>To review existing and new evidence regarding the relationship between diabetes and dyslipidemia and to provide an update on lipid biomarkers used to assess cardiovascular risk and current guidelines reflecting these changes.</p><p><strong>Methods: </strong>We conducted a literature review pertaining to diabetes and lipids using the MEDLINE/PubMed database. We reviewed articles in English and primarily published between 1994 and early 2025. Also included are guidelines published by professional organizations who are recognized nationally or internationally in the fields of diabetes, lipids, and cardiovascular disease.</p><p><strong>Results: </strong>Studies evaluating the relationship between diabetes and hypertriglyceridemia have provided practice-changing evidence. Lipid markers such as apolipoprotein B, non-HDL cholesterol, and lipoprotein (a), as well as the concept of lipid variability have emerged as treatment targets.</p><p><strong>Conclusion: </strong>Over the past 30 years, non-LDL cholesterol lipid markers have been identified to further stratify individuals with diabetes who are at risk for future cardiovascular events. Treatment targets and pharmacological therapy have been studied and continue to be updated.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751476","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":"Technology Use and Diabetes Management Across Elder Age Groups in Type 1 Diabetes and Latent Auto-Immune Diabetes of the Adult (LADA), a BETTER Registry Cross-Sectional Analysis.","authors":"Yue-Pei Wang, Laure Alexandre-Heymann, Virginie Messier, Valérie Boudreau, Aude Bandini, Barbara Kelly, Amélie Gravel, Claudia Gagnon, Anne-Sophie Brazeau, Rémi Rabasa-Lhoret","doi":"10.1016/j.eprac.2025.03.009","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.03.009","url":null,"abstract":"<p><strong>Objectives: </strong>Real-world data on diabetes management among a heterogenous aging population remain limited. This study aims to provide an overview of technology use and factors associated to its use, diabetes management and psychosocial aspects experienced by adults aged 50 and over living with type 1 diabetes (T1D) or latent autoimmune diabetes in adults (LADA).</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from the Canadian BETTER registry, mostly based on self-reported outcomes from individuals living with T1D or LADA. Comparative analyses were conducted across three age groups: 50-59, 60-69, and ≥70.</p><p><strong>Results: </strong>Participants (n=674) were predominantly Caucasian (97-98% across groups) and residing in Quebec, Canada (71-79%). Insulin pump use was similar across age groups (36-39%, p=0.822), while continuous glucose monitoring (CGM) was lower among those aged ≥70 years (85% for both 50-59 and 60-69 vs 73% for ≥70 years, p=0.020). Among other factors, having private insurance and living outside of Quebec were positively associated with both insulin pump and CGM use. A high proportion (80-86%) of participants achieved an HbA1c ≤8% across all groups. Level 2 hypoglycemia events in the last month were more frequent among participants aged 50-59 years compared to those aged ≥70 years (6.9 vs 3.4, p=0.001). Level 3 hypoglycemia, social and professional support were similar between groups. Interestingly, diabetes-related distress was lower in older age groups.</p><p><strong>Conclusions: </strong>Most individuals in this cohort adopted technology use but in lower proportion among the group aged ≥70. Overall, diabetes management was good and similar between age groups.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729473","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":"Hyperprolactinemia is associated with height attainment within or above target height in adult patients with pituitary stalk interruption syndrome.","authors":"Yuhan Wang, Jiangfeng Mao, Xi Wang, Min Nie, Junyi Zhang, Wei Zhang, Hongying Liu, Zhongyue Xu, Xueyan Wu","doi":"10.1016/j.eprac.2025.03.010","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.03.010","url":null,"abstract":"<p><strong>Objectives: </strong>Limited data exist on growth-promoting factors beyond growth hormone (GH) and insulin-like growth factor 1 (IGF-1). This study aimed to identify factors associated with growth in patients with pituitary stalk interruption syndrome (PSIS).</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 62 adult patients with PSIS between January 2021 and September 2024. Demographic data, metabolic parameters, and hormone statuses were compared. Binary logistic regression was used to assess the relationships between hyperinsulinemia, hyperprolactinemia, sex hormone replacement history, thyroxine replacement history and 1) height attainment within or above the target height and 2) height ≥ -2 SD.</p><p><strong>Results: </strong>A total of 62 patients (53 males and 9 females) were included, with a median age of 30.5 years (range: 26.0-32.4). Twelve patients achieved their target height, while the remaining patients did not. Hyperprolactinemia in adult patients with PSIS was positively associated with height attainment within or above the target height (OR 6.4, 95% CI: 1.6-24.7, P=0.007), and this association remained after adjustment for multiple confounders (OR 6.89, 95% CI: 1.19-40.81, P=0.032). Additionally, hyperprolactinemia showed a positive association with height ≥ -2 SD (OR 10.5, 95% CI: 2.8-38.5, P < 0.001), which also remained after adjusting for confounders (OR 13.8, 95% CI: 2.5-77.6, P=0.003). These associations were consistently observed in male patients.</p><p><strong>Conclusions: </strong>Hyperprolactinemia was associated with height attainment within or above the target height and in Chinese adult patients with PSIS. Additionally, a significant correlation was observed between hyperprolactinemia and height ≥ -2 SD.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729472","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":"ChatGPT-4's Accuracy in Estimating Thyroid Nodule Features and Cancer Risk from Ultrasound Images.","authors":"Esteban Cabezas, David Toro-Tobon, Thomas Johnson, Marco Álvarez, Javad R Azadi, Camilo Gonzalez-Velasquez, Naykky Singh Ospina, Oscar J Ponce, Megan E Branda, Juan P Brito","doi":"10.1016/j.eprac.2025.03.008","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.03.008","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the performance of GPT-4 and GPT-4o in accurately identifying features and categories from thyroid nodule ultrasound (TUS) images following the American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS).</p><p><strong>Methods: </strong>This comparative validation study, conducted between October 2023 and May 2024, utilized 202 thyroid ultrasound (TUS) images sourced from three open-access databases. Both complete and cropped versions of each image were independently evaluated by expert radiologists to establish a reference standard for TI-RADS features and categories. GPT-4 and GPT-4o were prompted to analyze each image, and their generated TI-RADS outputs were compared to the reference standard.</p><p><strong>Results: </strong>GPT-4 demonstrated high specificity but low sensitivity when assessing complete TUS images across most TI-RADS categories, resulting in mixed overall accuracy. For low-risk nodules (TR1), GPT-4 achieved 25.0% sensitivity, 99.5% specificity, and 93.6% accuracy. In contrast, in the higher risk TR4 category GPT-4 showed 75% sensitivity, 22.2% specificity, and 42.1% accuracy. While GPT-4 effectively identified features like smooth margins (73% vs 65% the reference standard), it struggled to identify other features like isoechoic echogenicity (5% vs, 46%), and echogenic foci (3% vs. 27%). The assessment of cropped images using both GPT-4 and GPT-4o followed similar patterns, though with slight deviations indicating a decrease in performance compared to GPT-4's assessment of complete images.</p><p><strong>Conclusion: </strong>While GPT-4 and GPT-4o models show potential for improving the efficiency of thyroid nodule triage, their performance remains suboptimal, particularly in higher-risk categories. Further refinement and validation of these models are necessary before clinical implementation.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729471","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":"Can Growth Hormone Stimulation Tests in Children Predict the Response to Growth Hormone Treatment?","authors":"Keren Smuel Zilberberg, Michal Yackobovitch-Gavan, Ariel Tenenbaum, Liron Tirosh Legmann, Liora Lazar, Moshe Phillip, Tal Oron","doi":"10.1016/j.eprac.2025.03.007","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.03.007","url":null,"abstract":"<p><strong>Objective: </strong>The efficacy of growth hormone (GH) treatment in short, healthy children diagnosed with growth hormone deficiency (GHD) or idiopathic short stature (ISS) suggests an overlap between these two conditions. Although imperfect and inconsistent, GH stimulation testing (GHST) remains the primary diagnostic tool for differentiating GHD and ISS, influencing GH treatment eligibility and dosing. This study aims to assess the clinical significance of GHST by comparing the response to GH treatment in children diagnosed with GHD or ISS based on their GHST results.</p><p><strong>Mehtods: </strong>A retrospective study in an endocrine clinic at a tertiary pediatric referral center comparing the response to GH treatment over three years in children diagnosed with GHD or ISS.</p><p><strong>Results: </strong>291 children treated with GH, 97 children diagnosed with GHD, and 194 with ISS are included in the analysis. Height significantly improved, and insulin-like growth factor-1 (IGF-1) levels increased independent of the GHST results, gender, or pubertal status (P<0.001). When adjusting for dosage, height gain was not associated with the treatment indication, GHD or ISS, or GHST peak levels.</p><p><strong>Conclusions: </strong>Our findings indicate similar responses to GH treatment in children classified as GHD or ISS based on GHST. These results suggest that the pivotal role of GHST in diagnosing and treating short children should be reconsidered.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729397","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":"Efficacy of Somapacitan in Treatment-Fatigue Adult Patients With Growth Hormone Deficiency Previously Treated With Once-Daily Growth Hormone Injections: A 24-Week Randomized Active-Controlled Trial.","authors":"Mojca Jensterle, Rok Herman, Ana Klinc, Katja Goričar, Matej Rakusa, Andrej Janež","doi":"10.1016/j.eprac.2025.03.005","DOIUrl":"10.1016/j.eprac.2025.03.005","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated the efficacy of somapacitan in a 24-week, randomized, active-controlled study in patients with growth hormone deficiency (GHD) who experienced fatigue from daily growth hormone (GH) injections.</p><p><strong>Methods: </strong>Twenty-nine adult patients with GHD, pretreated with daily GH for ≥5 years, who had reported treatment-related fatigue, were randomized to somapacitan or daily GH. Outcome measures were changes in treatment satisfaction assessed by Treatment Satisfaction Questionnaire for Medication-9, insulin-like growth factor-1 (IGF-1) standard deviation score, glucose and lipid parameters, body composition, bone mineral density (BMD), carotid intima media thickness, and reactive hyperaemia index, from baseline to week 24.</p><p><strong>Results: </strong>The difference in change in Treatment Satisfaction Questionnaire for Medication-9 score for convenience was significant, in favor of somapacitan (estimated difference, somapacitan-daily GH [95% CI]:23.2 [7.9; 38.4] points, P = .004). No differences between treatment arms in estimated changes from baseline to study-end were observed for IGF-1 levels, glucose and lipid profile, visceral adipose tissue, fat mass (%), lean body mass, and vascular parameters. There was significant difference in BMD of the lumbar spine (estimated difference, somapacitan-daily GH [95% CI] -0.036 (-0.064, -0.009) gr/cm², P = .011).</p><p><strong>Conclusion: </strong>In AGHD patients who were fatigued from the long-term daily GH injections, somapacitan was reported to be more convenient than daily GH. It was effective in maintaining IGF-1 levels and body composition, glucose, lipids, and vascular parameters, comparable to daily GH. Nonsignificant decrease in BMD with somapacitan could reflect a favorable increase in bone metabolic units, as previously observed in naïve patients with GHD during the initial 6-month period of GH therapy.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662868","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":"Early-Life Risks of Central Precocious Puberty.","authors":"Wei-Jou Yin, Jhih-Wei Hsu, Chun-Chang Chen, Emily Chia-Yu Su, San-Yuan Wang, Yan-Jen Chen, Yang-Ching Chen","doi":"10.1016/j.eprac.2025.03.004","DOIUrl":"10.1016/j.eprac.2025.03.004","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the factors in early life that may contribute to central precocious puberty (CPP).</p><p><strong>Methods: </strong>The study utilized data from the Taiwan Puberty Longitudinal Study, including 2241 children under pubertal assessment and a questionnaire of risk factors. We analyzed associations using the Fitting Generalized Linear Models in R (R Core Team, 2023), with R studio (Posit, 2023) version 4.3.1.</p><p><strong>Results: </strong>Among the 2241 children examined, 745 had CPP. Overall, higher gestational weight gain (GWG) increased the risk of CPP (odds ratio [OR]: 1.03, 95% CI: 1.01-1.05); while higher GWG served as a protective factor in females (OR: 0.97, 95% CI: 0.95-0.99). Maternal gestational diabetes mellitus (GDM) also increased the CPP risk, particularly in males (OR: 2.66, 95% CI: 1.00-7.25). Longer exclusive breastfeeding was linked to lower CPP risk overall (OR: 0.96, 95% CI: 0.93-1.00) but was not significant when analyzed by gender.</p><p><strong>Conclusions: </strong>Higher maternal GWG was associated with an increased risk of CPP overall, while GWG became negatively associated with CPP, only in females. Maternal GDM was linked to a higher risk of CPP, particularly in males. The duration of exclusive breastfeeding was inversely correlated with CPP risk, but this effect was not significant when analyzed by gender.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639670","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":"What features predict poorer outcomes in micro papillary thyroid carcinoma: a retrospective cohort study.","authors":"Shahaboddin Khamooshi, Soghra Rabizadeh, Leila Seddigh, Sahar Karimpour Reyhan, Fatemeh Mohammadi, Amirhossein Yadegar, Elahe Saffari, Alireza Esteghamati, Manouchehr Nakhjavani","doi":"10.1016/j.eprac.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.eprac.2025.03.003","url":null,"abstract":"<p><strong>Objective: </strong>Micro papillary thyroid carcinoma (MPTC), a variant of papillary thyroid carcinoma (PTC) sized ≤10 mm, is increasingly detected due to advanced ultrasound. This study aimed to describe characteristics and risk assessment of patients with Micro papillary thyroid carcinoma to predict outcomes and guide initial management.</p><p><strong>Methods: </strong>This retrospective cohort study (June 1980 - September 2023) assessed patients with MPTC using 2015 ATA (American Thyroid Association) guidelines for risk stratification and determination of response to treatment. Outcomes ranged from excellent to structural incomplete responses.</p><p><strong>Results: </strong>Among 208 patients with PTC with a primary tumor focus ≤10 mm, 68.8% were low-risk, 29.3% intermediate-risk, and 1.9% high-risk. Higher risk was linked to larger tumor size (≥7 mm) (OR=3.196, p-value=0.001) and multifocality (OR=2.431, p-value=0.004). Age (OR=0.973, p-value=0.048) and background Hashimoto's thyroiditis (OR=0.439, p-value=0.014) was found as protective factors. Excellent response to therapy observed in 48.4% of patients; while structural and biochemical incomplete responses were found to be 11.2% and 7.5%. Recurrence was detected in 14 (8.18%) patients.</p><p><strong>Conclusion: </strong>MPTC generally has a good prognosis and responds well to the treatment. Larger tumors (≥7 mm), younger age (<40 years), multifocality and absence of Hashimoto's thyroiditis correlate with a higher ATA risk and poorer outcomes.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630325","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":"Global Incidence, Risk Factors, and Temporal Trends of Adrenal Cancer: A Systematic Analysis of Cancer Registries.","authors":"Junjie Huang, Yat Ching Fung, Sze Chai Chan, Wing Sze Pang, Veeleah Lok, Lin Zhang, Xu Lin, Don Eliseo Lucero-Prisno Iii, Wanghong Xu, Zhi-Jie Zheng, Edmar Elcarte, Claire Chenwen Zhong, Mellissa Withers, Martin C S Wong","doi":"10.1016/j.eprac.2025.03.002","DOIUrl":"10.1016/j.eprac.2025.03.002","url":null,"abstract":"<p><strong>Objective: </strong>Adrenal gland cancer (AGC) is a rare cancer with a poor prognosis. Studies on this cancer have been limited. This study, for the first time, aims to analyze the global disease burden and trends of AGC in country level and examine lifestyle and socioeconomic risk factors to generate hypotheses.</p><p><strong>Methods: </strong>The Global Cancer Observatory database was used to extract the incidence rate of AGC in 2020. Age-standardized rates (ASRs) of AGC incidence and lifestyle/metabolic risk factor prevalence were obtained from databases. Linear regression and Joinpoint regression were used to assess associations with risk factors and Average Annual Percentage Change of AGC incidence.</p><p><strong>Results: </strong>Globally, there were an estimated 16 961 new AGC cases in 2020 (ASR: 0.14 per 100 000 persons). Higher disease burden was observed mainly in European regions. ASRs were comparable between sexes (males: 0.16; females: 0.14). The higher ASR was observed among the older population aged 50 to 74 years with an ASR of 0.31 compared with the younger population aged 15 to 49 years with an ASR of 0.07. Higher AGC incidence was associated with higher Human Development Index, gross domestic product, and lifestyle-related factors such as physical inactivity, obesity, hypertension, and lipid disorder (β = 0.005-0.052).</p><p><strong>Conclusion: </strong>The overall incidence trend showed a decrease, with 3 countries reporting significant decreases and 1 country reporting a significant increase. Similar patterns were observed by sex and age group, except for an overall increase among the younger population.</p>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613989","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}