European Journal of Gastroenterology & Hepatology最新文献

{"title":"Beyond tissue drug concentrations: additional considerations in anti-tumor necrosis factor penetration among patients with perianal fistulizing Crohn's disease.","authors":"Ali Karim, Tehreem Alam, Maheen Masood, Kajal Kumari, Hira Jamil, Mehnaz Ejaz Khokhar, Mah Noor Jamali","doi":"10.1097/MEG.0000000000003246","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003246","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 10","pages":"1239"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850167","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":"Assessing clinical outcomes in cirrhotic patients with thromboembolic complications.","authors":"Martin C Banks, Adaobi Ahanotu, Ki Jung Lee, Marwan Abougergi","doi":"10.1097/MEG.0000000000003255","DOIUrl":"10.1097/MEG.0000000000003255","url":null,"abstract":"<p><strong>Background: </strong>Cirrhosis produces a rebalanced hemostatic state that predisposes patients to bleeding and thrombosis. We evaluated hepatic outcomes associated with deep vein thrombosis (DVT), pulmonary embolism, and portal vein thrombosis (PVT) in patients with cirrhosis.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the Nationwide Readmissions Database from 2016 to 2022. Adults with cirrhosis identified during January index hospitalizations were followed through the end of the same calendar year and classified as having no thromboembolism, DVT, pulmonary embolism, or PVT. The primary outcome was liver transplantation. Secondary outcomes included in-hospital mortality, ascites, esophageal or gastric varices, variceal hemorrhage, acute liver failure, and hepatic decompensation. Survey-weighted logistic regression estimated adjusted odds ratios (aORs).</p><p><strong>Results: </strong>The weighted cohort included 365 467 patients: 363 007 without thromboembolism, 730 with DVT, 1036 with pulmonary embolism, and 694 with PVT. DVT was associated with lower odds of liver transplantation [aOR, 0.19; 95% confidence interval (CI), 0.05-0.83] and mortality (aOR, 0.54; 95% CI, 0.37-0.77). Pulmonary embolism was associated with lower odds of varices, ascites, acute liver failure, and hepatic decompensation. PVT was associated with higher odds of varices (aOR, 2.47; 95% CI, 1.95-3.13) and variceal hemorrhage (aOR, 2.83; 95% CI, 1.59-5.02).</p><p><strong>Conclusion: </strong>Thrombotic phenotypes in cirrhosis have distinct prognostic associations. PVT was associated with portal hypertensive complications, whereas apparently favorable associations with DVT and pulmonary embolism should be interpreted cautiously.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 10","pages":"1205-1212"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850150","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":"EndoFLIP for dysphagia: mind the gaps in reproducibility, false negatives, and safety.","authors":"Xiaochun Zhang, Shuwen Zhang, Jialing Shi","doi":"10.1097/MEG.0000000000003247","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003247","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 10","pages":"1238"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850140","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":"Early identification of the need for biliary drainage in acute calculous cholangitis: a prospective cohort study.","authors":"Ezgi Comoglu, Fatih Acehan, Emin Altiparmak, Ihsan Ates","doi":"10.1097/MEG.0000000000003189","DOIUrl":"10.1097/MEG.0000000000003189","url":null,"abstract":"<p><strong>Objectives: </strong>Early identification of patients with acute calculous cholangitis (AC) who will require biliary drainage at emergency department presentation is essential for appropriate triage and timely intervention; however, reliable predictors of drainage requirement remain incompletely defined.</p><p><strong>Methods: </strong>In this prospective study conducted between August 2022 and March 2023 at a tertiary referral center, 213 adult patients diagnosed with AC according to the Tokyo Guidelines 2018 were enrolled. Patients were categorized according to whether biliary drainage was performed during hospitalization. Baseline clinical and laboratory variables obtained at presentation were analyzed to identify independent predictors of drainage requirement using multivariate logistic regression adjusted for Tokyo Guidelines 2018 severity.</p><p><strong>Results: </strong>Of 213 patients, 145 (68.1%) underwent biliary drainage. History of cholecystectomy [odds ratio (OR): 5.782, 95% confidence interval (CI): 1.266-26.416, P  = 0.024], the absence of concomitant pancreatitis (OR: 7.745, 95% CI: 3.341-17.957, P  < 0.001), total bilirubin (OR: 1.184, 95% CI: 1.027-1.365, P  = 0.020), and procalcitonin (OR: 1.040, 95% CI: 1.005-1.076, P  = 0.023) were independently associated with drainage requirement. The combined predictive model demonstrated acceptable discrimination (area under the curve: 0.790, P  < 0.001). Optimal cutoffs were 3.6 mg/dl for total bilirubin and 3 μg/l for procalcitonin. During the 3-month follow-up after discharge, recurrent AC occurred in 12 patients (5.6%) and did not differ between groups.</p><p><strong>Conclusion: </strong>Readily available parameters at emergency department presentation may facilitate early risk stratification for biliary drainage in AC and may enhance individualized decision-making when integrated into routine clinical assessment. External validation in larger multicenter cohorts is warranted before routine clinical implementation.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1151-1157"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590869","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":"Early lenvatinib dose intensity is associated with survival in super-older adults (≥80 years) with hepatocellular carcinoma: a real-world comparison with atezolizumab-bevacizumab.","authors":"Masamichi Kimura, Koji Nishikawa, Jun Imamura, Kiminori Kimura","doi":"10.1097/MEG.0000000000003263","DOIUrl":"10.1097/MEG.0000000000003263","url":null,"abstract":"<p><strong>Objective: </strong>To compare lenvatinib (LEN) and atezolizumab plus bevacizumab (Atezo + Bev) as first-line therapy in super-older adults (≥80 years) with hepatocellular carcinoma (HCC) and evaluate whether early relative dose intensity (RDI) is associated with outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study included super-older adults initiating LEN or Atezo + Bev between May 2018 and August 2025. The primary endpoint was overall survival (OS); secondary endpoints included progression-free survival (PFS) and adverse events. Inverse probability of treatment weighting and multivariable Cox regression were performed. Within the LEN cohort, a day 56 landmark analysis evaluated the prognostic significance of 8-week RDI (RDI8 ≥ 75% vs. <75%).</p><p><strong>Results: </strong>Median OS was 15.6 and 10.7 months with LEN and Atezo + Bev [hazard ratio: 0.77, 95% confidence interval (CI): 0.42-1.41], whereas median PFS was 6.73 and 9.73 months, respectively (hazard ratio: 1.18, 95% CI: 0.65-2.17). IPTW and multivariable analyses yielded similar results. Within the LEN cohort, RDI8 greater than or equal to 75% was independently associated with improved OS (30.8 vs. 14.7 months; adjusted hazard ratio: 0.23, 95% CI: 0.07-0.73, P = 0.013). Grade greater than or equal to 3 adverse events occurred in 37 and 50% of the LEN and Atezo + Bev cohorts, respectively.</p><p><strong>Conclusion: </strong>Although LEN and Atezo + Bev showed no statistically significant difference in real-world survival in this exploratory cohort, these findings require validation in larger studies. Higher early LEN dose intensity was consistently associated with improved survival and may represent an important therapeutic consideration in super-older adults with HCC.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 10","pages":"1213-1223"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850133","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":"Real-world clinical effectiveness and safety of vedolizumab and ustekinumab in biologic-naive patients with noncomplicated or complex Crohn's disease: results from the EVOLVE Expansion study.","authors":"Marc Ferrante, Britt Christensen, Brian Bressler, Marielle Bassel, Neil R Brett, Lauren Gianchetti, Pravin Kamble, Shashi Adsul, Zeinab Farhat, Michael Scharl","doi":"10.1097/MEG.0000000000003193","DOIUrl":"10.1097/MEG.0000000000003193","url":null,"abstract":"<p><strong>Background: </strong>Real-world effectiveness/safety of vedolizumab and ustekinumab as first-line biologics in Crohn's disease were evaluated by disease complexity.</p><p><strong>Methods: </strong>EVOLVE Expansion (NCT05056441) was a retrospective chart review in Australia, Belgium, and Switzerland. Biologic-naive patients with Crohn's disease (≥18 years) initiated first-line biologic treatment with vedolizumab or ustekinumab. Complex Crohn's disease was defined as active fistula at treatment initiation, any prior Crohn's disease-related surgery since, or any Crohn's disease-related hospitalization within 12 months prior to treatment initiation. Baseline characteristics were balanced using inverse probability of treatment weighting. Cumulative rates of clinical response, remission, mucosal healing, and treatment persistence were estimated over 36 months. Serious adverse events (SAEs), serious infections, and health care resource use (HCRU) were evaluated.</p><p><strong>Results: </strong>Overall, 427 patients had noncomplicated Crohn's disease (vedolizumab, n =  245; ustekinumab, n =  182) and 196 had complex Crohn's disease (vedolizumab, n =  102; ustekinumab, n =  94). In both subgroups, cumulative rates (vedolizumab vs. ustekinumab) of clinical response (noncomplicated, 85.1 vs. 85.7%; complex, 79.7 vs. 81.3%), clinical remission (noncomplicated, 93.5 vs. 91.3%; complex, 82.9 vs. 80.8%), mucosal healing (noncomplicated, 91.1 vs. 91.5%; complex, 87.8 vs. 80.2%), and treatment persistence (noncomplicated, 72.2 vs. 83.7%; complex, 71.8 vs. 71.3%) over 36 months were not significantly different in patients who initiated vedolizumab or ustekinumab. In both subgroups, the risks of SAEs, Crohn's disease exacerbations, Crohn's disease-related surgeries, and Crohn's disease-related hospitalizations were similar between patients treated with vedolizumab or ustekinumab during 36 months.</p><p><strong>Conclusion: </strong>Vedolizumab and ustekinumab demonstrated similar rates of clinical outcomes, treatment persistence, safety, and HCRU in patients with complex and noncomplicated Crohn's disease during 36 months of treatment.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1158-1168"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812634","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":"Efficacy and safety of split-dose ultra-low-volume polyethylene glycol with ascorbic acid versus sodium picosulfate with magnesium citrate for bowel preparation: a systematic review and meta-analysis.","authors":"Abdallfatah Abdallfatah, Ahmed W Hageen, Dania Albader, Abdulaziz Al-Tamimi, Khalid Alsalumi, Abdulrahman Alzmmam, Mahdi Abdullah, Laith Alreshaid, Saleh Aldhuwayhi, Nourah Almarri, Wala Fallatah, Abdullah Altamimi","doi":"10.1097/MEG.0000000000003163","DOIUrl":"10.1097/MEG.0000000000003163","url":null,"abstract":"<p><p>Colonoscopy remains the gold standard for early detection and prevention of colorectal cancer, with adequate bowel cleansing being pivotal for its success. This systematic review aims to evaluate the efficacy and safety of split-dose ultra-low-volume polyethylene glycol (PEG) with ascorbic acid (Asc) versus sodium picosulfate magnesium citrate for bowel preparation. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a comprehensive literature search across Embase, PubMed, Web of Science, and Scopus from inception to July 2025. Data analysis was conducted using R version 4.2.2 (31 October 2022) and RStudio version 2022.07.2 (2009-2022, RStudio, Inc.) Our literature search yielded six eligible studies involving 3285 patients. Our findings indicate no significant differences in overall and right-sided colon adequate cleansing rates between the two regimens: risk ratio: 1.05, 95% confidence interval (CI): 0.99-1.12, P  = 0.1082; and risk ratio: 1.03, 95% CI: 0.99-1.08, P  = 0.1755, respectively. However, PEG + Asc demonstrated a significantly lower rate of vomiting compared to sodium picosulfate magnesium citrate (risk ratio: 2.58, 95% CI: 0.94-2.78, P  = 0.0008), suggesting better tolerability. Other secondary outcomes, including nausea, abdominal pain, and overall Boston Bowel Preparation Scale scores, did not show significant differences. The quality of the evidence varied across the outcomes. Our results support the comparable efficacy of both bowel preparation agents while highlighting PEG + Asc's potential advantages in tolerability. Our findings suggest that the choice between these two preparations can be tailored to the specific patient, considering their preferences or previous experiences, although some caution is advised in interpreting these findings.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1121-1129"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353972","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":"Machine learning algorithms for post-Kasai biliary atresia-like cholestasis recurrence: a conceptual framework integrating multi-omics and environmental nanoparticle exposure.","authors":"Emaan, Aisha Hanif, Neha Fatima","doi":"10.1097/MEG.0000000000003245","DOIUrl":"https://doi.org/10.1097/MEG.0000000000003245","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 10","pages":"1240-1241"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850173","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":"Systemic therapy sequence and outcomes in unresectable hepatocellular carcinoma: results from the multicenter Tokai Post ICI Sequential Therapy Registry cohort.","authors":"Mone Tsukimoto, Naoto Fujiwara, Takanori Ito, Kenji Imai, Mizuki Ariga, Takaya Suzuki, Takafumi Yamamoto, Mizuki Kawachi, Yuki Yoshida, Hirono Owa, Yasuyuki Tamai, Ryuta Shigefuku, Masahiko Tameda, Suguru Ogura, Hideaki Tanaka, Kazumasa Igura, Yasuhito Imai, Koji Takai, Masahito Shimizu, Takashi Honda, Hiroki Kawashima, Teiji Kuzuya, Hayato Nakagawa","doi":"10.1097/MEG.0000000000003256","DOIUrl":"10.1097/MEG.0000000000003256","url":null,"abstract":"<p><strong>Aim: </strong>To clarify the optimal sequencing strategy of systemic therapies for unresectable hepatocellular carcinoma that maximizes efficacy and patient outcomes.</p><p><strong>Methods: </strong>We established a multicenter retrospective Tokai Post ICI Sequential Therapy Registry cohort across four Tertiary-Care Hospitals in Japan, enrolling patients who received first-line immune checkpoint inhibitor (ICI)-based therapy between October 2020 and May 2025. Tumor response was assessed every 2-3 months by Response Evaluation Criteria in Solid Tumors version1.1 as the primary outcome. Logistic regression models evaluated predictors of response with hospital-level mixed effects.</p><p><strong>Results: </strong>A total of 368 patients were included [median age 74 years (interquartile range: 68-80 years); 303 (82%) male]; 307 (83.4%) received atezolizumab plus bevacizumab and 61 (16.6%) durvalumab plus tremelimumab. Following discontinuation, 151 (47.0%) proceeded to second-line therapy, predominantly lenvatinib ( n  = 124, 82%). Second-line lenvatinib achieved objective response rates of 12-25% and disease control rates (DCRs) exceeding 60%, independent of prior ICI regimen or response. Of 56 patients receiving third-line therapy, the sequences of atezolizumab plus bevacizumab-lenvatinib-durvalumab plus tremelimumab and durvalumab plus tremelimumab-lenvatinib-atezolizumab plus bevacizumab ( n  = 19, 28.6%) demonstrated significantly higher DCR compared with other sequences (52.6 vs. 29.7%) despite comparable liver function reserve and tumor burden. In addition, durvalumab plus tremelimumab following atezolizumab plus bevacizumab-lenvatinib showed numerically higher DCR compared with durvalumab plus tremelimumab directly after atezolizumab plus bevacizumab (53.3 vs. 29.4%).</p><p><strong>Conclusion: </strong>Consistent efficacy of second-line lenvatinib and favorable outcomes with ICI-lenvatinib-ICI sequences may underscore the clinical importance of therapy sequencing in advanced hepatocellular carcinoma, warranting prospective evaluation of optimal strategies.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1197-1204"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561153","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 impact of switching to tenofovir alafenamide on lipid profile and renal function in chronic hepatitis B: a retrospective cohort study.","authors":"Özlem Gül, Zeynep İdil Erzurum Çiçek, Samet Bila","doi":"10.1097/MEG.0000000000003268","DOIUrl":"10.1097/MEG.0000000000003268","url":null,"abstract":"<p><strong>Objective: </strong>Tenofovir alafenamide (TAF) offers favorable renal safety compared with tenofovir disoproxil fumarate (TDF) in chronic hepatitis B (CHB), but its long-term metabolic effects remain unclear. This study aimed to assess changes in lipids, atherogenic indices, fibrosis markers, and renal function after switching to TAF and identify baseline factors associated with lipid changes.</p><p><strong>Methods: </strong>This single-center retrospective cohort included CHB patients treated with TDF or entecavir for ≥24 months, switched to TAF, and followed for ≥24 months. Patients with diabetes, dyslipidemia, or chronic kidney disease were excluded. Parameters were assessed 5 times over 2 years before and after switching. Mixed-effects models and Wilcoxon signed-rank tests assessed trends and pre-post changes.</p><p><strong>Results: </strong>Fifty-nine patients were included (mean age, 52.7 ± 9.9 years; 91.5% previously on TDF). Lipid fractions increased, particularly total cholesterol (median Δ, +22.81 mg/dL; P < 0.001) and low-density lipoprotein (LDL) cholesterol (+14.29 mg/dL; P < 0.001). Ratio-based indices, including the atherogenic index of plasma (AIP), triglyceride/high-density lipoprotein (HDL), LDL/HDL, and non-HDL/HDL, remained stable. However, 22.0% crossed the AIP risk threshold, and 16.9% exceeded LDL and non-HDL cutoffs. Younger age and lower baseline LDL or HDL were associated with greater increases. Estimated glomerular filtration rate remained stable; creatinine rose without clinical significance.</p><p><strong>Conclusion: </strong>Switching to TAF was associated with clinically meaningful increases in absolute lipid fractions without worsening atherogenic ratios or renal function. Nevertheless, a minority transitioned to higher cardiometabolic risk categories, supporting individualized lipid monitoring, particularly in younger patients and those with low baseline LDL or HDL.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"38 10","pages":"1229-1235"},"PeriodicalIF":2.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850165","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}