Hypertension Research最新文献

{"title":"JSH2024 Fukuoka Declaration \"NEO-HYPERTENSION harmonized with society\".","authors":"Koichi Node, Atsushi Tanaka, Akira Nishiyama, Kazuomi Kario","doi":"10.1038/s41440-024-01926-x","DOIUrl":"https://doi.org/10.1038/s41440-024-01926-x","url":null,"abstract":"","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smartphone application-based intervention to lower blood pressure: a systematic review and meta-analysis.","authors":"Makiko Abe, Tetsuo Hirata, Natsumi Morito, Megumi Kawashima, Sumiko Yoshida, Yoichi Takami, Taku Fujimoto, Shin Kawasoe, Takeshi Shibukawa, Hiroyoshi Segawa, Toshitaka Yamanokuchi, Shintaro Ishida, Koji Takahashi, Kazuhiro Tada, Yoshifumi Kato, Atsushi Sakima, Hisatomi Arima","doi":"10.1038/s41440-024-01939-6","DOIUrl":"10.1038/s41440-024-01939-6","url":null,"abstract":"<p><p>Nowadays, the mHealth market is flooded with smartphone applications (apps) lacking validation for blood pressure (BP)-lowering effects and BP measurement accuracy. This systematic review for Guidelines for BP control using digital technologies of the Japanese Society of Hypertension aimed to assess the validation studies of apps. We searched eligible studies in Ovid MEDLINE, Cochrane Library, and Ichushi, focusing on randomized controlled trials and observational studies comparing the effects of smartphone app-based interventions with non-digital healthcare. Random effects models of meta-analysis were employed to estimate the pooled effects of mean BP change and 95% confidence intervals (CIs). Out of 7385 studies screened, 76 studies with 46,459 participants were included. The interventions were significantly associated with a reduction in office systolic and diastolic BP at six months (systolic BP, -2.76 mmHg, 95% CI: -3.94 to -1.58; diastolic BP, -1.23 mmHg, -1.80 to -0.67). Normotensives saw a significant reduction in office systolic BP at three-month (-4.44 mmHg, -6.96 to -1.92), diminishing afterward (six-month, 0.86 mmHg, -2.81 to 4.52; twelve-month, 0.86 mmHg, -2.81 to 4.52). Conversely, hypertensive participants experienced a significant reduction in office systolic BP at both three- and six-month (three-month, -7.71 mmHg, -10.63 to -4.79; six-month, -1.88 mmHg, -3.41 to -0.35), albeit with limited evidence thereafter. A larger BP reduction was observed among participants using apps with wireless transmission of BP measurements (P = 0.047 for interaction), while there was no clear difference in BP reduction according to the presence of other functions. Smartphone app-based interventions may hold the potential to improve BP levels.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-hospital systolic blood pressure lowering patterns and risk of rehospitalization for angina in patients with hypertension and coronary artery disease.","authors":"Chi Wang, Yanjie Li, Lu Tian, Zekun Feng, Cuijuan Yun, Sijin Zhang, Yizhen Sun, Ziwei Hou, Siyu Yao, Miao Wang, Maoxiang Zhao, Lihua Lan, Jianxiang Huang, Zhen Ge, Hao Xue","doi":"10.1038/s41440-024-01942-x","DOIUrl":"https://doi.org/10.1038/s41440-024-01942-x","url":null,"abstract":"<p><p>This study aimed to examine the association between in-hospital systolic blood pressure (SBP) lowering patterns and rehospitalization for angina in patients with hypertension and coronary artery disease (HT-CAD). This prospective cohort study was conducted in Chinese PLA General Hospital, Beijing, China. We included 730 patients with HT-CAD, who were hospitalized between August 2020 and September 2022. The in-hospital SBP lowering patterns were identified according to SBP level at admission, SBP level at discharge, and the difference between them: normal-stable SBP, more-intensive SBP reduction, less-intensive SBP reduction, and non-reduced SBP. We used Cox proportional hazards regression to estimate the risk of rehospitalization for angina according to SBP lowering patterns. We identified 121 cases of rehospitalization for angina in a median follow-up of 28.2 months. Patients with more-intensive SBP reduction had the lowest incidence rate of rehospitalization for angina, followed by those with normal-stable SBP, less-intensive SBP reduction, and non-reduced SBP. After adjusting for potential confounders, we found that compared with patients with more-intensive SBP reduction, the hazard ratios and 95% confidence intervals of rehospitalization for angina were 1.35 (0.78-2.35) for patients with normal-stable SBP, 2.17 (1.14-4.14) for patients with less-intensive SBP reduction, and 2.99 (1.57-5.68) for patients with non-reduced SBP. This association was more pronounced in patients with multi-vessel stenosis than in patients with single-vessel stenosis. In conclusion, in-hospital SBP lowering patterns were associated with risk of rehospitalization for angina. These results highlighted the importance of intensive in-hospital SBP control in patients with HT-CAD.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does casual urine Na/K ratio predict 24 h urine Na/K ratio in treated hypertensive patients? Comparison between casual urine voided in the morning vs. 24 h urine collected on the previous day.","authors":"Kimika Arakawa, Mitsuhiro Tominaga, Satoko Sakata, Takuya Tsuchihashi","doi":"10.1038/s41440-024-01945-8","DOIUrl":"https://doi.org/10.1038/s41440-024-01945-8","url":null,"abstract":"<p><p>The urine sodium-to-potassium (Na/K) ratio is associated with blood pressure and cardiovascular diseases. A single urine sample is preferable for determining the Na/K ratio in clinical practice. We evaluated whether the Na/K ratio measured using morning casual urine samples predicts the ratio measured using the preceding 24 h urine sample in patients with hypertension. The study included 187 hypertensive patients (mean age 66.1 years, 52.4% female) whose Na and K concentrations were measured both in 24 h (24Na/K) and casual urine the next morning (CNa/K). The Na/K ratios were 3.54 ± 1.5 in 24NaK and 2.63 ± 1.9 in CNa/K. The two estimates showed a significant positive correlation (r = 0.49, p < 0.0001), and (CNa/K-24Na/K)/24Na/K was -23.5 ± 44.4%. In the Bland-Altman plot, the mean difference was -0.91. When CNa/K was divided into three groups, <2 (low), 2-4 (medium), and ≥4 (high), the overall agreement with 24Na/K was 46.0% (86 of 187). The low group had 24.4% agreement and 75.6% underestimation (24Na/K > CNa/K); the medium group had 60.8% agreement, 30.5% underestimation, and 8.7% overestimation (24Na/K < CNa/K); and the high group had 71.8% agreement and 28.2% overestimation. These results indicate that CNa/K and 24Na/K were significantly correlated; however, CNa/K was generally lower than 24Na/K, particularly at Na/K levels < 2. Further efforts should be made to address the validity of using casual urine Na/K ratios in hypertension management practices.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concept, study design, and baseline nighttime blood pressure control status of the WISDOM-Night Study using a wrist-type oscillometric home blood pressure monitoring device.","authors":"Kazuomi Kario, Naoko Tomitani, Koki Haimoto, Keisuke Narita, Ryosuke Komi, Shinji Koba, Hidekazu Shimizu, Hiroyuki Ohbayashi, Takeshi Fujiwara, Tomoyuki Kabutoya, Hajime Kihara, Hiromitsu Sekizuka, Hiroyuki Mizuno, Yasuhisa Abe, Hajime Haimoto, Kenji Harada, Satoshi Hoshide","doi":"10.1038/s41440-024-01930-1","DOIUrl":"10.1038/s41440-024-01930-1","url":null,"abstract":"<p><p>There is growing evidence that nocturnal hypertension is an independent risk factor for cardiovascular diseases, including heart failure. However, brachial blood pressure (BP) measurements during sleep might themselves disturb sleep quality. We initiated a nationwide, multicenter observational prospective study using a wrist-type oscillometric nighttime BP monitoring device with new algorithms to measure supine BP accurately without sleep disturbance. This study, named the Wrist ICT-based Sleep and Circadian Blood Pressure Monitoring Program-Night BP Study (WISDOM-Night Study), was designed to clarify the impact of wrist-measured daily nighttime BPs on cardiovascular prognosis (stroke, coronary artery disease, heart failure, etc.) using 7 days of BP measurements at 2:00 a.m., 3:00 a.m., 4:00 a.m., and 4 h after bedtime. A total of 2751 patients with one or more cardiovascular risk factors were recruited between March 2021 and March 2024 and are currently being followed up for 7 years. Additionally, 1416 of the WISDOM-Night Study-enrolled patients who also agreed to participate in the WISDOM-Hypertension-Mediated Organ Damage (HMOD) Study underwent echocardiography to evaluate the association between wrist-measured BP and left ventricular structure. Data from this WISDOM-Night Study should provide the prospective association between nighttime BP and cardiovascular disease and reveal the indexes of nighttime BP with clinical pathological relevance. This first report of the WISDOM-Night Study describes the study design, baseline characteristics, and BP control status.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital therapeutic for hypertension improves physician-patient communication and clinical inertia: a survey of physicians who implemented CureApp HT in clinical practice.","authors":"Tomohiro Katsuya, Fumi Hisaki, Mitsuharu Aga, Yumi Hirayama, Yusuke Takagi, Yuko Ichikihara, Tomoyuki Tanigawa","doi":"10.1038/s41440-024-01899-x","DOIUrl":"10.1038/s41440-024-01899-x","url":null,"abstract":"<p><p>In the 2019 Guidelines for the Management of Hypertension by the Japanese Society for Hypertension, lifestyle modification is recommended for all individuals except those with normal blood pressure. However, no detailed methods have been established to achieve the target blood pressure and resolve clinical inertia. CureApp HT, a digital therapeutic for hypertension that contributes to blood pressure reduction through lifestyle modification, was approved as software as a medical device for reimbursement by Japanese national health insurance in September 2022. This study aimed to survey physicians who implemented CureApp HT to assess how it changes physician-patient communication and contributes to clinical inertia resolution. A questionnaire survey was conducted at three time points: before the first prescription (first survey), 3 months (second survey), and 6 months (third survey) after the first prescription for physicians who had implemented CureApp HT. The primary outcome was the total score of five items on a Likert scale related to physician-patient communication, and it was analyzed based on the 47 physicians who responded to all three questionnaires. The total score of physician-patient communication significantly improved after 6 months of the introduction of CureApp HT, reflecting that physicians observed positive changes in patients' knowledge and attitudes regarding hypertension treatment. Furthermore, the number of physicians who set a target home blood pressure of 125/75 mmHg for their patients significantly increased. CureApp HT allows physicians to recognize changes in patients' disease knowledge and treatment attitudes, enabling them to set more stringent blood pressure targets and addressing clinical inertia. Physicians who implemented CureApp HT recognized changes in the patients' stages of behavioral change through improvements in patients' knowledge of the disease and their attitudes towards treatment, and by experiencing more effective communication, they set stricter blood pressure targets.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home blood pressure stability score is associated with better cardiovascular prognosis: data from the nationwide prospective J-HOP study.","authors":"Kazuomi Kario, Hiroshi Kanegae, Satoshi Hoshide","doi":"10.1038/s41440-024-01940-z","DOIUrl":"10.1038/s41440-024-01940-z","url":null,"abstract":"<p><p>A home blood pressure (BP)-centered strategy is emerging as the optimal approach to achieve adequate BP control in individuals with hypertension, but a simple cardiovascular risk score based on home BP level and variability is lacking. This study used prospective data from the Japan Morning Surge-Home Blood Pressure (J-HOP) extended study to develop a simple home BP stability score for the prediction of cardiovascular risk. The J-HOP extended study included 4070 participants (mean age 64.9 years) who measured home BP three times in the morning and evening for 14 days at baseline. During the mean 6.3-year follow-up, there were 260 cardiovascular events. A home BP stability score was calculated based on the average of morning and evening systolic BP (SBP; MEave), and three home BP variability metrics: average real variability (average absolute difference between successive measurements); average peak (average of the highest three SBP values for each individual), and time in therapeutic range (proportion of time spent with MEave home SBP 100-135 mmHg). There was a curvilinear association between the home BP stability score and the risk of cardiovascular events. Compared with individuals in the optimal home SBP stability score group (9-10 points), those in the very high-risk group (0 points) had significantly higher cardiovascular event risk during follow-up (adjusted hazard ratio 3.97, 95% confidence interval 2.22-7.09; p < 0.001), independent of age, sex, medication, cardiovascular risk factors, and office BP. These data show the potential for a simple home BP-based score to predict cardiovascular event risk in people with hypertension.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning assists early-detection of hypertension-mediated heart change on ECG signals.","authors":"Chengwei Liang, Fan Yang, Xiaobing Huang, Lijuan Zhang, Ying Wang","doi":"10.1038/s41440-024-01938-7","DOIUrl":"https://doi.org/10.1038/s41440-024-01938-7","url":null,"abstract":"<p><p>Arterial hypertension is a major risk factor for cardiovascular diseases. While cardiac ultrasound is a typical way to diagnose hypertension-mediated heart change, it often fails to detect early subtle structural changes. Electrocardiogram(ECG) represents electrical activity of heart muscle, affected by the changes in heart's structure. It is crucial to explore whether ECG can capture slight signals of hypertension-mediated heart change. However, reading ECG records is complex and some signals are too subtle to be captured by cardiologist's visual inspection. In this study, we designed a deep learning model to predict hypertension on ECG signals and then to identify hypertension-associated ECG segments. From The First Affiliated Hospital of Xiamen University, we collected 210,120 10-s 12-lead ECGs using the FX-8322 manufactured by FUKUDA and 812 ECGs using the RAGE-12 manufactured by NALONG. We proposed a deep learning framework, including MML-Net, a multi-branch, multi-scale LSTM neural network to evaluate the potential of ECG signals to detect hypertension, and ECG-XAI, an ECG-oriented wave-alignment AI explanation pipeline to identify hypertension-associated ECG segments. MML-Net achieved an 82% recall and an 87% precision in the testing, and an 80% recall and an 82% precision in the independent testing. In contrast, experienced clinical cardiologists typically attain recall rates ranging from 30 to 50% by visual inspection. The experiments demonstrate that ECG signals are sensitive to slight changes in heart structure caused by hypertension. ECG-XAI detects that R-wave and P-wave are the hypertension-associated ECG segments. The proposed framework has the potential to facilitate early diagnosis of heart change.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An investigation of the association between atrial fibrillation and the liver fibrosis-4 index in patients who underwent coronary computed tomography angiography.","authors":"Tetsuo Hirata, Yuhei Shiga, Kohei Tashiro, Sara Higashi, Tetsuro Tachibana, Yuto Kawahira, Yasunori Suematsu, Takashi Kuwano, Makoto Sugihara, Masahiro Ogawa, Shin-Ichiro Miura","doi":"10.1038/s41440-024-01917-y","DOIUrl":"https://doi.org/10.1038/s41440-024-01917-y","url":null,"abstract":"<p><p>Liver fibrosis scores, such as the fibrosis-4 index (FIB-4I), a representative index of liver fibrosis, have recently been linked to heart failure, coronary artery disease (CAD), and atrial fibrillation (AF). We investigated the association between FIB-4I and AF in patients who underwent coronary computed tomography angiography (CCTA). This study included 1525 patients clinically suspected of having CAD or about to undergo treatment for AF, such as catheter ablation. FIB-4I and the presence or absence of AF were the primary endpoints. FIB-4I was higher in the AF group than in the sinus rhythm group (1.93 ± 0.94 versus [vs.] 1.75 ± 1.03, p = 0.001). No significant difference was observed in the FIB-4I between the paroxysmal AF and persistent AF groups (1.93 ± 0.99 vs. 1.94 ± 0.78, p = 0.922). Furthermore, FIB-4I was higher in the hypertension (HTN) group than in the non-HTN group (1.84 ± 1.04 vs. 1.62 ± 0.91, p < 0.001). Low FIB-4I (≤1.29) was proven to be a contributing factor for the absence of AF in all patients (odds ratio [OR]: 0.55, 95% confidence interval [CI]: 0.39-0.78, p < 0.001) as well as the HTN and non-HTN (OR: 0.53, 95% CI: 0.37-0.78, p < 0.001 and OR: 0.39, 95% CI: 0.23-0.68, p < 0.001, respectively) groups. Thus, FIB-4I may serve as a diagnostic indicator of the absence of AF in patients undergoing CCTA. The liver fibrosis-4 index as a diagnostic indicator of the absence of atrial fibrillation in patients undergoing coronary computed tomography angiography.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated uric acid levels as a risk factor for new-onset hypertension in newly enrolled Japanese university students (JSH46-0100).","authors":"Hiroyuki Terawaki, Ryuichi Yoshimura, Hitomi Ueda, Satoko Tajirika, Minako Kawamoto, Ryo Horita, Taku Fukao, Yasuko Ito, Takafumi Ito, Mayumi Yamamoto","doi":"10.1038/s41440-024-01941-y","DOIUrl":"10.1038/s41440-024-01941-y","url":null,"abstract":"<p><p>This study aimed to determine the association between serum uric acid (UA) levels and new-onset hypertension (HTN) in newly enrolled students (aged 18 to 20 years) at a university in Gifu, Japan. We analyzed data collected over a 12-year period from April 2010 to March 2022. From this dataset, we selected individuals who were normotensive at admission and underwent a follow-up examination four years later, at the time of their progression to a master's course (n = 2859). Among these participants, 75 (2.6%) developed HTN by the second visit. Their serum UA levels (mg/dL) were significantly higher compared to those who remained HTN-free, both at baseline (6.02 ± 1.06 vs. 5.42 ± 1.17) and at the second visit (6.10 ± 1.20 vs 5.46 ± 1.22). Logistic regression analysis revealed that the odds of developing HTN were higher when considering the mean UA level across both visits (odds ratio: 1.63 per 1 mg/dL increase) compared to either the first or second visit alone. Further analysis of the relationship between elevated mean UA levels (above the cutoff value of 5.7 mg/dL) and the risk of new-onset HTN demonstrated a significant odds ratio of 3.39, which remained significant after adjusting for body mass index and sex. In summary, elevated UA levels are an independent risk factor for future HTN in young adults.</p>","PeriodicalId":13029,"journal":{"name":"Hypertension Research","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}