European journal of gynaecological oncology最新文献

{"title":"Analysis of risk factors and construction and validation of a predictive model for determining the risk of endometrial cancer in postmenopausal patients with abnormal uterine bleeding","authors":"","doi":"10.22514/ejgo.2023.077","DOIUrl":"https://doi.org/10.22514/ejgo.2023.077","url":null,"abstract":"The data of 174 postmenopausal patients with abnormal uterine bleeding admitted were assessed to determine associated risk factors and develop and validate a prediction model to evaluate the risk of endometrial cancer in these patients. The patients were divided into a study group and a control group, among which 62 patients were diagnosed with endometrial cancer. A binary logistic regression analysis model using multifactorial regression analysis was established, and a column line graph of the prediction model was created using the R software. The model’s goodness-of-fit test was performed using the Hosmer-Lemeshow test, and SPSS (version 27, International Business Machines Corporation, Armonk, NY, USA) was used to plot the receiver operating characteristic (ROC) curve to evaluate the model’s predictive value. Binary logistic multifactorial regression analysis revealed that elevated body mass index (BMI), human epididymal protein 4 (HE4), cancer antigen 125 (CA125), combined fibroids and thickened endometrial cancer were risk factors for endometrial cancer in patients with abnormal postmenopausal uterine bleeding, based on which a probability model for predicting the risk of developing endometrial cancer in patients with abnormal postmenopausal uterine bleeding was constructed, and represented as P = 1/[1 + exp (4.227 − 4.594X1 − 2.029X5 − 1.165X6 − 1.817X7 − 2.080X8)]. In addition, the goodness-of-fit test, assessed using Hosmer and Lemeshow, yielded an χ2 value of 14.253 and a p-value of 0.075. Furthermore, the ROC curve analysis demonstrated an area under the curve (AUC) of 0.993 (95% confidence interval (CI), 0.892–0.974; p < 0.05). In conclusion, elevated BMI, HE4 and CA125, along with the presence of combined fibroids and thickened endometrial lining, were identified as significant risk factors for endometrial cancer in postmenopausal patients with abnormal uterine bleeding. The risk prediction model developed in this study provides a scientifically sound approach to assess the risk of endometrial cancer in these patients.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136366595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"iTRAQ-based proteomics analysis reveals novel candidates for platinum resistance of epithelial ovarian cancer","authors":"","doi":"10.22514/ejgo.2023.074","DOIUrl":"https://doi.org/10.22514/ejgo.2023.074","url":null,"abstract":"Platinum-based chemotherapy is commonly used in the treatment of various cancers, including epithelial ovarian cancer (EOC). However, in EOC, chemotherapy failure is mainly caused by platinum resistance. In this present study, we aimed to identify novel biomarkers for predicting platinum chemosensitivity. Fresh specimens of 16 serous high-grade ovarian cancer (HGSC) cases were collected during cytoreductive surgery. Isobaric tags were used to identify differentially expressed proteins in platinum-resistant samples (n = 8) and platinum-sensitive samples (n = 8). Compared to platinum-sensitive samples, 741 significantly differentially expressed proteins were detected, of which 325 were upregulated and 416 were downregulated. To validate the isobaric tags for relative and absolute quantification (iTRAQ) method, western blotting was performed on two upregulated proteins, angiomotin-like protein 1 (AMOTL1) and Lumican. The results showed that platinum-resistant tumor samples expressed significantly higher levels of AMOTL1 and Lumican than platinum-sensitive tumor samples. Altogether, we identified candidate proteins related to platinum resistance in ovarian cancer. Both AMOTL1 and Lumican seem to be promising biomarkers that could distinguish between platinum-resistant and platinum-sensitive EOC.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136368236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a novel transcription factor signature for accurate cervical cancer prognosis","authors":"","doi":"10.22514/ejgo.2023.079","DOIUrl":"https://doi.org/10.22514/ejgo.2023.079","url":null,"abstract":"Cervical cancer (CC) is a leading cause of cancer-related deaths in women. During tumor development, transcriptional factors regulate the transcription of proto-oncogenes and tumor suppressor genes. We examined the possibility of using transcription factors as prognostic biomarkers for patients with cervical cancer. Single-cell RNA-sequencing data were downloaded from the Gene Expression Omnibus database to identify specific activated transcription factors in different types of cells from CC. Publicly available bulk RNA-sequencing and clinical data of CC were obtained to identify associated prognostic transcription factors using survival analysis and the random survival forest methods. Accuracy and effectiveness of the established transcription factor-related predictive random survival forest model were verified using training and test datasets. We identified specific activated transcription factors in tissue cells of cervical cancer. A 3-transcription factors (PBX4 (PBX Homeobox 4), EBF2 (EBF Transcription Factor 2) and ZNF696 (Zinc Finger Protein 696)) prognostic signature for patients with cervical cancer was constructed showing good survival prediction. Gene function enrichment analysis indicated a correlation between the prognostic characteristics and different signaling pathways associated with cancer. Using the random survival forest model based on the 3-transcription factor signature, patients with cervical cancer were stratified into low- and high-risk groups with significant variations in overall survival (p < 0.001). The area under the curve of the time-dependent receiver operator characteristic revealed a strong predictive accuracy for training and test datasets of the corresponding signature. CC has cellular heterogeneity of transcriptional activation. Our analyses provide a novel transcription factor-associated prognostic model for CC. These transcription factors could be used as effective prognostic biomarkers and potential therapeutic targets for patients with cervical cancer.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136368238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chikusetsusaponin Iva induces apoptosis and inhibits proliferation in endometrial cancer via promoting reactive oxygen species (ROS) production","authors":"","doi":"10.22514/ejgo.2023.068","DOIUrl":"https://doi.org/10.22514/ejgo.2023.068","url":null,"abstract":"Endometrial carcinoma (EC) is an epithelial malignant tumor that occurs in the endometrium. It is of great significance to explore new targets for improving the prognosis of endometrial cancer. Chikusetsusaponin Iva (CHI) is a plant compound extracted from Panacis japonica which has multiple biological activities, including anti-inflammation and anti-tumor effects. However, its possible effects on EC are unclear. Herein, we found that CHI inhibited EC cell proliferation and cell cycle, confirmed by colony formation and flow cytometry (FCM) assays. The results further confirmed that CHI stimulated the apoptosis of EC cells. Furthermore, we noticed that CHI treatment induced reactive oxygen species (ROS) in EC cells. In addition, it could suppress the Microtubule-Associated Protein Kinase (MAPK) pathway in EC cells, thereby affecting cell proliferation and apoptosis. Therefore, CHI could serve as a potential drug for EC treatment.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"148 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136115070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of proteasome inhibitor MG132 in cisplatin resistant ovarian cancer","authors":"","doi":"10.22514/ejgo.2023.055","DOIUrl":"https://doi.org/10.22514/ejgo.2023.055","url":null,"abstract":"Platinum based combined chemotherapy have been proved to be the most effective drugs for the ovarian cancer treatment, but it is difficult to treat cisplatin resistant ovarian cancer. Carbobenzoxy-L-leucy-L-Leucyl-L-Leucinal (MG132) is a reversible tripeptide aldehyde proteasome inhibitor, the purpose of this study was to observe the effect of MG132 on cisplatin resistant ovarian cancer SKOV3 cell and OVCAR-3 cell the expression of autophagy and apoptosis related factors. The cells were divided into four groups: control, MG132, cisplatin, MG132 and cisplatin combination groups. Cell growth was detected by cell counting kit-8 (CCK-8) assay. The apoptotic rates of cells and the cell cycle were detected by a flow cytometer (FCM). The Beclin1, Light chain 3 (LC3) and Caspase3 was detected by western blotting and reverse transcription-polymerase chain reaction (RT-PCR). Detection of apoptotic bodies by 4,6-Diamidino-2-phenylindole dihydrochloride (DAPI) staining. CCK-8 assay demonstrated that cell survival rate in the combination groups was lower than monotherapy group. FCM showed that apoptotic rates in the combination groups was higher than monotherapy group (p < 0.05). Western blotting and RT-PCR detected that Beclin1, LC3 and Caspase3 in the combination group were higher than monotherapy group (p < 0.05). DAPI staining showed the production of apoptotic bodies in the combination group and MG132 group. In conclusion, MG132 can inhibit the growth of cisplatin resistant ovarian cancer SKOV3 and OVCAR-3 cells, its inhibitory effect is related to apoptosis and autophagy, and it is expected to be a synergistic antitumor effect with cisplatin.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136115078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of a 3-cuproptosis-associated-lncRNA-signature that predicts the prognosis of endometrial cancer patients","authors":"","doi":"10.22514/ejgo.2023.073","DOIUrl":"https://doi.org/10.22514/ejgo.2023.073","url":null,"abstract":"Endometrial carcinoma is a common malignancy among peri-menopausal and menopausal females, even among some women of reproductive age. The treatment approach to endometrial cancer is a platinum-based regimen combined with paclitaxel, which may be unsatisfactory. A copper-mediated binding of lipoylated constituents of tricarboxylic acid cycle has been found recently, which brings about lethal protein stress and cell death, a phenomenon termed cuproptosis. As an innovative method of cell death, cuproptosis could be designed for cancer treatment and many aspects remain unaddressed. In our study, clinical, genomic, and mutational profiles of uterine corpus endometrial carcinoma (UCEC) patients were obtained from The Cancer Genome Atlas and cuproptosis-related genes and long non-coding RNAs (lncRNAs) were acquired thereafter. Co-expression and Cox regression analyses led to the development of a prognostic signature. Patients were separated into two groups (high- and low-risk groups) and survival analysis, risk score calculation, multivariate Cox analysis, and subgroup validation were implemented to determine the utility of the signature. Differentially expressed genes (DEGs) between the two groups were subjected to Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses. Immune-related functional analysis and tumor mutation burden (TMB) analysis were performed. Three independent high-risk cuproptosis-related lncRNAs were finally confirmed and incorporated into the prognostic model, including BX322234.1, LINC01545 and LINC01224. Areas under the curve for 1-, 3- and 5-year survival were 0.717, 0.688 and 0.714, respectively. The risk model served as an independent factor to predict prognosis. Patients with high-risk and low TMB tended to have poor prognoses. Enrichment analysis demonstrated that DEGs were mostly associated with immune responses. In conclusion, the three high-risk cuproptosis-related lncRNAs could predict the prognosis of UCEC patients with higher power, where patients with high-risk and low TMB are prone to have the worst prognosis, which broadens the pattern of clinical treatment and applications.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136260089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of colposcopy and LEEP results performed in gynecology and gynecological oncology surgery services","authors":"","doi":"10.22514/ejgo.2023.071","DOIUrl":"https://doi.org/10.22514/ejgo.2023.071","url":null,"abstract":"The diagnostic performances of colposcopy and Loop Electrosurgical Excision Proce-dure (LEEP) results in gynecology and gynecological oncology surgical services were evaluated. Their differences regarding biopsy numbers were investigated. The other objective was to examine factors associated with recurrence and residual lesions after LEEP. This study included the cytology results of 1217 women undergone colposcopy at our hospital colposcopy unit between 2012 and 2017. The colposcopicsensitivity, specificity, positive predictive value and negative predictive value were calculated based on LEEP results. The qualitative data were compared by employing Chi-square and Fisher’s exact tests. χ2 predicted the relation between age and number of involved margins with recurrent disease. Moreover, it predicted the link between age, cytology and number of relevant margins with residual disease. There was no significant difference regarding the diagnostic performance of two groups when LEEP was determined as the gold standard against colposcopy. The diagnostic accuracy rate was 1.83 times higher when more than 2 biopsies were taken compared to 2 or fewer. A significant increase was observed in the residual rate among women having pre-LEEP high-risk human papillomavirus (HR-HPV) positive tests compared to those with HR-HPV negative tests (48.0% vs. 15.4%, p = 0.04). Women with ≥ High grade squamous intraepithelial lesion (HSIL)-positive margins in the first conization exhibited higher residual rates compared to those with High grade squamous intraepithelial lesion (LSIL)-positive margins (50.7% vs. 9.5%, p < 0.001). Patients ofpositive surgical margins, residual lesions and cervical intraepithelial neoplasia (CIN) with HPV 16 had higher probability of persistent HPV infection after conization. There was no significant difference pertaining to the diagnostic performance of two groups. HPV 16+ and the positive surgical margin were the predictive of recurrence.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135495190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided thoracic paravertebral nerve block in patients undergoing radical mastectomy","authors":"","doi":"10.22514/ejgo.2023.083","DOIUrl":"https://doi.org/10.22514/ejgo.2023.083","url":null,"abstract":"This research aims to investigate the effect of ultrasound-guided continuous thoracic paravertebral nerve block in patients undergoing radical mastectomy. Ninety-six patients who underwent radical mastectomy were equally divided into a study group (administered with a continuous thoracic paravertebral nerve block and general anesthesia) and a control group (given conventional general anesthesia) with a random number table. At T2–T4 (T2: immediate tracheal intubation; T3: at skin incision; T4: at extubation), mean artery pressure (MAP) and hear rate (HR) were significantly lower in the study group (p < 0.05); however, there was no significant difference in blood oxygen saturation (SpO2) between the two groups at different time points. At T2–T4, cortisol (Cor) levels were significantly lower in the study group (p < 0.05). At T0–T2, there was no significant difference in the levels of adrenocorticotropic hormone (ACTH) between the two groups. At T3–T4, the levels of ACTH in the study group were significantly lower (p < 0.05). There were no significant differences in blood pressure between the two groups at any time point. At the moment of discharge from the resuscitation room and 2 hours after surgery, the numerical rating scale (NRS) score in the study group was significantly reduced (p < 0.05). The incidence of adverse reactions in the study group was 10.42%; this was lower than that in the control group (33.33%) (p < 0.05). Finally, the use of fentanyl and propofol, and the frequency of analgesic pump use, were significantly lower in the study group (p < 0.05). Ultrasound-guided thoracic paravertebral nerve block can effectively maintain hemodynamic stability, improve the stress response, reduce postoperative pain, reduce the use of anesthetic drugs, and effectively control the incidence of adverse reactions in patients undergoing radical mastectomy.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"241 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136366308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of different doses of esketamine on hemodynamic indexes, pain stress indexes, and VAS scores in patients with benign ovarian tumors undergoing laparoscopic resection induced by remifentanil","authors":"","doi":"10.22514/ejgo.2023.082","DOIUrl":"https://doi.org/10.22514/ejgo.2023.082","url":null,"abstract":"This study aimed to investigate the effects of different doses of esketamine on hemodynamic indicators, pain stress indicators and Visual Analog Scale (VAS) scores in patients undergoing laparoscopic resection for benign ovarian tumors induced by remifentanil. A total of 110 patients with benign ovarian tumors scheduled for laparoscopic resection between June and December 2023 were included in the study and divided into three groups: Group A (35 cases), Group B (37 cases), and Group C (38 cases), based on their anesthesia regimen. Anesthesia induction for all groups included propofol, remifentanil, and cisatracurium. Group A received an intravenous dose of 0.8 mg/kg esketamine, Group B received 0.6 mg/kg esketamine and Group C did not receive esketamine. The results revealed statistically significant differences in average arterial pressure and heart rate at various time points within each group (p < 0.05), and significant differences were observed in Substance P (SP) and Prostaglandin E2 (PEG2) at three different time points within each group (p < 0.05). VAS scores during and after surgery at 6 and 12 hours significantly differed among the three groups (p < 0.05). There was a significant difference in awakening time among the three groups (p < 0.05). However, there were no statistically significant differences in the incidence of adverse reactions among the three groups (p > 0.05). In conclusion, both 0.6 mg/kg and 0.8 mg/kg doses of esketamine effectively prevented remifentanil-induced hyperalgesia in patients undergoing laparoscopic resection for benign ovarian tumors, significantly reducing patient pain. Notably, the 0.6 mg/kg dose of esketamine demonstrated better hemodynamic stability, promoted patient recovery, and showed superior clinical utility compared to the 0.8 mg/kg dose.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136366616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of an immune-related metabolic gene signature to predict possible prognosis in endometrial cancer and reveals immune landscape feature","authors":"","doi":"10.22514/ejgo.2023.072","DOIUrl":"https://doi.org/10.22514/ejgo.2023.072","url":null,"abstract":"The immunotherapy of endometrial cancer (EC) has gradually attracted attention and metabolic reprogramming is associate with tumor immune infiltration. Our goal was to use proteome analysis to examine the role of immune-related metabolic genes (IRMGs) in EC. Data-independent acquisition mass spectrometry (DIA-MS) was performed on 20 EC patients, consisting of 10 high-grade and 10 low-grade cancer tissues. IRMGs were screened using Spearman correlation, and an immune-related metabolic prognosis signature (IRMPS) was constructed based on the Cancer Genome Atlas-Uterine Corpus Endometrioid Carcinoma (TCGA-UCEC) cohort using the least absolute shrinkage and selection operator (LASSO) regression analysis. We also investigated differences between different risk groups in terms of prognostic value, clinical potency, immune characteristics and therapy response. In total, 285 differentially expressed genes (DEGs) were acquired via DIA-MS. Subsequently, metabolic-DEGs and immune-DEGs were analyzed by Spearman correlation to identify 41 IRMGs. Finally, seven IRMGs, including NADH dehydrogenase (ubiquinone) 1 alpha subcomplex subunit 2 (NDUFA2), AMPK-alpha2 (PRKAA2), syntaxin binding protein 1 (STXBP1), NADH dehydrogenase (ubiquinone) 1 beta subcomplex subunit 9 (NDUFB9), ribosomal protein S27-like (RPS27L), lysolecithin acyltransferase 2 (LPCAT2) and uridine monophosphate synthetase (UMPS) were identified to establish a prognosis signature. The risk score was determined as an independent prognostic indicator, and patients in the IRMPS-high group was strong linked with adverse prognosis for EC. Additionally, IRMPS was closely related with tumor immune infiltration. Notably, the IRMPS-low group had better immune checkpoint inhibitors (ICI) treatment response and more sensitive to chemotherapy drugs. In conclusion, IRMPS can serve as a precise prognostic tool to guide the personalized treatment of EC patients.","PeriodicalId":11903,"journal":{"name":"European journal of gynaecological oncology","volume":"271 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135495188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}