Gut最新文献

{"title":"Response to: correspondence on ‘Revisiting the role of sphincterotomy in sphincter of Oddi disorder: a critical appraisal of the RESPOnD study’ by Zeng","authors":"Gregory A Cote","doi":"10.1136/gutjnl-2025-334962","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-334962","url":null,"abstract":"Thanks to Dr Zeng for his insightful comments1 about our recent publication on 12-month outcomes of endoscopic retrograde cholangiopancreatography (ERCP) for sphincterotomy for sphincter of Oddi disorders (SOD).2 Many of the comments were addressed in the discussion of the paper, especially the significance of the unmeasured placebo response and greater importance of patient characteristics such as somatisation and opioid exposure compared with physician-defined factors like a dilated duct. We disagree that RESPOnD’s heterogeneous patient population reduces the study’s generalisability. RESPOnD subjects represent the full spectrum of SOD subtypes and thus have lower selection bias compared with more stringent enrolment criteria. For example, restricting subjects …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"21 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting lipid dysregulation in colorectal cancer: critical appraisal of pro-inflammatory bias and therapeutic implications","authors":"Xudong Zhu","doi":"10.1136/gutjnl-2025-335153","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-335153","url":null,"abstract":"We read with interest the article by Soundararajan et al , titled ‘Integration of lipidomics with targeted, single cell, and spatial transcriptomics defines an unresolved pro-inflammatory state in colon cancer’ published in Gut.1 The study presents a comprehensive analysis of lipid dysregulation in colorectal cancer (CRC), highlighting a pro-inflammatory lipidomic profile and defective lipid class switching. While the integration of multiomics data is commendable, we raise critical concerns about the study’s methodology, interpretation and translational relevance. 1. Prostaglandin (PGE2/PGD2) temporal roles neglected: The authors attributed defective resolution of inflammation in CRC to insufficient PGE2/PGD2 signalling and proposed therapeutic induction of lipid class switching. However, this hypothesis oversimplifies the role of prostaglandins. Studies by Serhan et al emphasised that lipid mediator dynamics were …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"20 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumour-intrinsic alterations and stromal matrix remodelling promote Wnt-niche independence during diffuse-type gastric cancer progression","authors":"Lars J S Kemp, Jooske L Monster, Colin S Wood, Martijn Moers, Marjolein J Vliem, Antoine A Khalil, Nigel B Jamieson, Lodewijk A A Brosens, Liudmila L Kodach, Jolanda M van Dieren, Tanya M Bisseling, Rachel S van der Post, Martijn Gloerich","doi":"10.1136/gutjnl-2024-334589","DOIUrl":"https://doi.org/10.1136/gutjnl-2024-334589","url":null,"abstract":"Background Development of diffuse-type gastric cancer (DGC) starts with intramucosal lesions that are primarily composed of differentiated, non-proliferative signet ring cells (SRCs). These indolent lesions can advance into highly proliferative and metastatic tumours, which requires suppression of DGC cell differentiation. Objective Our goal was to identify molecular changes contributing to the progression of indolent to aggressive DGC lesions. Design We conducted spatial transcriptomic analysis of patient tumours at different stages of hereditary DGC, comparing transcriptional differences in tumour cell populations and tumour-associated cells. We performed functional analysis of identified changes in a human gastric ( CDH1 KO) organoid model recapitulating DGC initiation. Results Our analysis reveals that distinct DGC cell populations exhibit varying levels of Wnt-signalling activity, and high levels of Wnt signalling prevent differentiation into SRCs. We identify multiple adaptations during DGC progression that converge on Wnt signalling, allowing tumour cells to remain in an undifferentiated state as they disseminate away from the gastric stem cell niche. First, DGC cells establish a cell-autonomous source for Wnt-pathway activation through upregulated expression of Wnt-ligands and ‘secreted frizzled-related protein 2’ ( SFRP2 ) that potentiates ligand-induced Wnt signalling. Second, early tumour development is marked by extracellular matrix remodelling, including increased deposition of collagen I whose interactions with DGC cells suppress their differentiation in the absence of exogenous Wnt ligands. Conclusions Our findings demonstrate that tumour cell-derived ligand expression and extracellular matrix remodelling sustain Wnt signalling during DGC progression. These complementary mechanisms promote niche independence enabling expansion of undifferentiated DGC cells needed for the development of advanced tumours. Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Normalised and averaged data of the Nanostring DSP analysis has been added as a supplementary table. Raw counts of the Nanostring DSP analysis and whole exome sequencing data are available on request.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"14 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143758154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"British Society of Gastroenterology guidelines for diagnosis and management of autoimmune hepatitis","authors":"Dermot Gleeson, Rosemary Bornand, Ann Brownlee, Harpreet Dhaliwal, Jessica K Dyson, Janeane Hails, Paul Henderson, Deirdre Kelly, George F Mells, Rosa Miquel, Ye H Oo, Anthea Sutton, Andrew Yeoman, Michael A Heneghan","doi":"10.1136/gutjnl-2024-333171","DOIUrl":"https://doi.org/10.1136/gutjnl-2024-333171","url":null,"abstract":"Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease which, if untreated, often leads to cirrhosis, liver failure and death. The last British Society of Gastroenterology (BSG) guideline for the management of AIH was published in 2011. Since then, our understanding of AIH has advanced in many areas. This update to the previous guideline was commissioned by the BSG and developed by a multidisciplinary group. The aim of this guideline is to review and summarise the current evidence, in order to inform and guide diagnosis and management of patients with AIH and its variant syndromes. The main focus is on AIH in adults, but the guidelines should also be relevant to older children and adolescents.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"9 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143758153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ETV5-S100A9 feed-forward loop connecting HCC and MDSCs to shape the immunosuppressive tumour microenvironment","authors":"Carmen Chak-Lui Wong, Chun Ming Wong","doi":"10.1136/gutjnl-2025-335078","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-335078","url":null,"abstract":"Hepatocellular carcinoma (HCC), the most common form of primary liver cancer, is a leading cause of cancer-related deaths worldwide, accounting for approximately 800 000 deaths annually. Treatment options for unresectable, advanced-stage HCC are very limited. For decades, tyrosine kinase inhibitors such as sorafenib and lenvatinib have been the only first-line treatments for advanced HCC. These inhibitors primarily target the signal transduction pathways in cancer cells to slow cancer cell proliferation and induce apoptosis. However, growing evidence suggests that the interaction between cancer cells and immune cells within the tumour immune microenvironment (TIME) is crucial for cancer cells to evade immunosurveillance. Blocking this crosstalk has emerged as a promising therapeutic strategy for HCC treatment. For example, immune checkpoint inhibitors (ICIs) like nivolumab (anti-programmed death 1 (PD1)) and atezolizumab (anti-programmed death-ligand (PD-L1)) have demonstrated survival benefits in clinical trials and are now standard treatments for advanced HCC.1 Erythroblast transformation specific (ETS) variant transcription factor 5 (ETV5) is a member of the ETS family of transcription factors, characterised by a conserved ETS domain that binds to the GGAA/T DNA sequence. ETV5 modulates gene expression by interacting with various transcription activators or repressors, thereby regulating cellular differentiation and development. Recent studies have shown that ETV5 is overexpressed in several human cancers. However, its role in HCC has not been thoroughly investigated. In Gut , research led by Xia L elegantly revealed the oncogenic roles of ETV5 in HCC.2 The authors confirmed in multiple cohorts that ETV5 is …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"22 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introducing ‘borderline observable’ intraductal papillary mucinous neoplasms: between pancreatic cancer risk and discontinuation of extended surveillance","authors":"Giampaolo Perri, Giovanni Marchegiani","doi":"10.1136/gutjnl-2025-334807","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-334807","url":null,"abstract":"Epidemiologically, intraductal papillary mucinous neoplasms (IPMNs) are increasingly detected due to advances in imaging, with a prevalence of up to 25% of the general population in modern prospective studies.1 Conceptually, IPMNs are the only radiographically identifiable precursors of pancreatic cancer. However, opportunities for early cancer detection and surgical resection must be considered within the framework of cost-effective strategies that healthcare systems can sustainably support. The American Gastroenterology Guidelines (AGA) were the first suggesting against continued surveillance of asymptomatic pancreatic cysts, in the absence of significant change in their characteristics after 5 years of surveillance, or once the patient was no longer a surgical candidate.2 Back in 2015, this recommendation was deemed ‘conditional’ and based on ‘very low-quality evidence’ by its authors2 themselves, and it could appropriately be considered scientifically premature. However, 10 years later, several seminal longitudinal studies have confirmed that the risk of developing pancreatic cancer in vast IPMN cohorts is indeed minimal after an adequate period of surveillance.3–6 Indeed, the most recent evidence-based guidelines are now timidly following the pioneer example of AGA in suggesting discontinuation for specific patients.7 A landmark study included patients with branch duct …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"57 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143713054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic resection after downstaging of oesophageal carcinoma by neoadjuvant chemoimmunotherapy: – a new multimodal concept?","authors":"Mingyan Cai, Baohui Song, Dongli He, Chen Xu, Rongkui Luo, Yang Qian, Sikei Kam, Xucheng Huo, Jian Wang, Michael Vieth, Yunshi Zhong","doi":"10.1136/gutjnl-2024-333337","DOIUrl":"https://doi.org/10.1136/gutjnl-2024-333337","url":null,"abstract":"Oesophageal surgery is the current standard for advanced oesophageal cancer within multimodal protocols involving perioperative chemoimmunotherapy and/or radiotherapy. However, oesophagectomy is afflicted with significant morbidity and mortality so that organ-preserving strategies would be worthwhile to develop. We report a case of advanced oesophageal squamous cell cancer (cT2) treated by neoadjuvant therapy and presumably downstaged to a superficial lesion. Semicircumferential endoscopic full-thickness resection (EFTR) was performed, followed by implantation of a metallic stent. Histology showed residual intramucosal high-grade dysplasia. Three months postoperation, the wound healed well, with no occurrence of oesophageal stenosis. The patient received immunotherapy until 24 months post-EFTR and has been followed for 26 months without the recurrence of the disease. Further studies have to show the oncological success, but also oncological risks associated with such an innovative approach. Radical surgery is the standard treatment for advanced-stage oesophageal cancer without metastases.1 Yet, the radical surgery, which involves extensive resection, is associated with a substantial mortality and a high morbidity rate, significantly impacting the quality of life for patients.2 Existing evidence indicated that the implementation of neoadjuvant chemotherapy and immune checkpoint inhibitors in patients with esophageal squamous cell carcinoma (ESCC) yields a complete pathological response rate ranging from 35.3% to 43.2%,3–5 accompanied by a high major pathological response rate ranging from 44% to 82%.6 The integration of immune checkpoint inhibitors into systemic therapy, in conjunction with radiochemotherapy, has rendered technically unresectable advanced oesophageal cancer surgically resectable lesions in most cases.7 Inspired by this approach, we attempted conversion therapy for patient ineligible for surgery and endoscopic resection. Through neoadjuvant chemotherapy in combination with immune checkpoint inhibitor, the endoscopically unresectable ESCC was converted into endoscopically resectable lesion. Subsequently, by employing EFTR, the oesophageal lesion was successfully removed, achieving oesophagus preservation. A 68-year-old male patient with a history …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"10 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143713056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"24-Nor-ursodeoxycholic acid: a novel treatment targeting T-cell-mediated immune dysregulation in primary sclerosing cholangitis and beyond","authors":"Likai Tan, William Ka Kei Wu","doi":"10.1136/gutjnl-2025-334966","DOIUrl":"https://doi.org/10.1136/gutjnl-2025-334966","url":null,"abstract":"Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease characterised by progressive inflammation and fibrosis of the bile ducts, leading to biliary cirrhosis and an increased risk of cholangiocarcinoma. PSC is commonly associated with inflammatory bowel disease (IBD). The pathogenesis of PSC is complex and not fully understood, but immune-mediated mechanisms, particularly T cell involvement, are believed to play a central role. Genetic studies have identified associations between PSC susceptibility and specific human leucocyte antigen (HLA) haplotypes, suggesting a role for T cell-mediated autoimmunity.1 Gut and liver resident T cells from PSC patients with concurrent IBD exhibit heightened responses to shared antigens, indicating a related pathogenesis between PSC and IBD.2 Peripheral blood mononuclear cells from PSC patients show increased frequencies of T helper 17 (Th17) and Th1/Th17 cells on pathogen stimulation.3 Within the liver, there is an accumulation of tissue-resident naïve-like CD4+ T cells predisposed to differentiate into Th17 cells. These tissue-resident T cells produce interleukin (IL)−17 and IL-22, contributing to local inflammation by recruiting neutrophils via CXCL8.4 Therefore, restoring immune balance in PSC represents a promising therapeutic approach. However, while existing immune-modulating therapies showed some improvement in cholestasis markers, particularly in PSC patients with worse liver function, the overall clinical benefits were limited. 24-Nor-ursodeoxycholic acid (NorUDCA) is …","PeriodicalId":12825,"journal":{"name":"Gut","volume":"25 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143713055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stressed hepatocyte sustains alcohol-associated hepatitis progression by producing leukocyte cell-derived chemotaxin 2","authors":"Honghai Xu, Zihao Wu, Jiangfeng Qin, Xutong Li, Feng Xu, Wei Wang, Hui Zhang, HeHe Yin, Shiwei Zhu, Wenzhe Zhang, Yuanru Yang, Yuanyuan Wei, Long Gao, Jiatao Liu, Yufeng Gao, Ming-Hua Zheng, Haoxiong Zhou, Tingting Qi, Jinjun Chen, Yanhang Gao, Li Zuo, Jiong Chen, Suthat Liangpunsakul, Jiabin Li, Hua Wang","doi":"10.1136/gutjnl-2024-334318","DOIUrl":"https://doi.org/10.1136/gutjnl-2024-334318","url":null,"abstract":"Background Neutrophil infiltration and hepatocyte damage are indispensable hallmarks in alcohol-associated hepatitis (AH), yet the underlying crosstalk between neutrophils and hepatocytes and its role in AH pathogenesis remain unclear. Objective We investigate the regulatory role of leucocyte cell-derived chemotaxin 2 (LECT2) in hepatocyte–neutrophil interaction and its impact on AH progression. Design We used bulk and single-cell RNA sequencing to identify hepatocyte-secreted factors targeting neutrophils. We analysed serum and liver samples from AH patients and employed genetically modified mice alongside in vitro studies. Results RNA-sequencing analysis identified several neutrophil chemokines that are elevated in hepatocytes from AH patients, including LECT2 whose role in AH remains largely unknown. AH patients exhibited increased levels of LECT2 in hepatocytes, positively correlating with the severity of AH. Ethanol-fed mice also exhibited elevated liver LECT2, which was abolished by inhibiting endoplasmic reticulum stress. Functional studies revealed that ethanol-induced liver injury was ameliorated in Lect2 -deficient mice but was exacerbated in mice with hepatic overexpression of Lect2 . Furthermore, LECT2 exacerbated ethanol-induced liver injury by promoting reactive oxygen species (ROS) through its interaction with prohibitin 2 (PHB2), a neutrophil membrane protein. By directly binding to PHB2, LECT2 disrupts the stable structure of PHB1/PHB2 heterodimerisation, consequently leading to PHB2 degradation, ROS accumulation, neutrophil activation and neutrophil extracellular trap formation. Moreover, therapeutic intervention of LECT2 via Lect2 shRNA ameliorated ethanol-induced liver injury. Conclusion Our studies identified a novel vicious cycle between neutrophils and hepatocytes through the LECT2–PHB2 interaction, presenting a promising therapeutic intervention by targeting LECT2 to mitigate AH in patients. Data are available upon reasonable request. The data that support the findings of this study are available on request from the corresponding authors.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"11 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143713401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining faecal haemoglobin, iron deficiency anaemia status and age can improve colorectal cancer risk prediction in patients attending primary care with bowel symptoms: a retrospective observational study","authors":"Jayne Digby, Jennifer Nobes, Judith A Strachan, Rebecca McCann, Christopher Hall, Callum G Fraser, Craig Mowat","doi":"10.1136/gutjnl-2024-334248","DOIUrl":"https://doi.org/10.1136/gutjnl-2024-334248","url":null,"abstract":"Background In primary care, National Institute for Health and Care Excellence suspected cancer guidelines recommend measuring faecal haemoglobin (f-Hb) if colorectal cancer (CRC) is suspected, with a referral threshold of ≥10 µg Hb/g faeces defining a 3% risk, but most have a normal colonoscopy. Objective Examine whether combining f-Hb, patient age and iron-deficient anaemia (IDA) status improves risk prediction. Design Retrospective single-centre observational study of symptomatic patients who submitted contemporaneous f-Hb and full blood count (FBC) samples between December 2015 and December 2019. f-Hb was estimated using HM-JACKarc (Hitachi Chemical Diagnostics Systems). Patients were categorised by presence/absence of IDA. Incident CRC was identified via record linkage to the Scottish Cancer Registry. Kaplan-Meier estimates determined cumulative 1-year CRC risk by patient age, f-Hb result and presence of IDA. Results Of 34 647 valid f-Hb results retrieved; 7889 (22.8%) had f-Hb≥10 µg Hb/g. Of these, 33 285 samples (96.1%) had associated FBC results of which 3000 (9.0%) had IDA. Overall, 571 incident CRC were recorded. The risk of CRC breached 3% in patients with f-Hb>99 µg Hb/g aged >40 years and reached 30% (19.4–41.0) with f-Hb>99 µg Hb/g in age >55 years plus IDA. 2029 f-Hb results (25.7%) were in the 10–19 µg Hb/g range of which 27 (1.3%) had CRC. In this subgroup, CRC risk did not exceed 3% in patients <85 years and no IDA. Conclusion Combining f-Hb, patient age and IDA status improves CRC risk prediction, identifies a low-risk group with f-Hb<20 µg Hb/g and no IDA and could inform revised referral guidance. Data are available upon reasonable request. Data are available on request.","PeriodicalId":12825,"journal":{"name":"Gut","volume":"37 1","pages":""},"PeriodicalIF":24.5,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143713052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}