Inflammatory Bowel Diseases最新文献

{"title":"Not All Transmural Healing is Equal in Crohn's Disease: Magnetic Resonance Enterography and Intestinal Ultrasound for Stricture Assessment in the STRIDENT Trial.","authors":"Kenneth Ernest-Suárez, Nurulamin M Noor","doi":"10.1093/ibd/izaf093","DOIUrl":"https://doi.org/10.1093/ibd/izaf093","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: Extraintestinal Manifestations in Patients With Ulcerative Colitis Post-Restorative Proctocolectomy and Ileal Pouch-Anal Anastomosis.","authors":"Alex Barenboim, Nitsan Maharshak","doi":"10.1093/ibd/izaf091","DOIUrl":"https://doi.org/10.1093/ibd/izaf091","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biofeedback-Enhanced Cognitive-Behavioral Therapy Delivered Virtually to Youth With Inflammatory Bowel Disease: A Randomized Controlled Trial.","authors":"Kelly Rea, Abigail Robbertz, Adrianna Westbrook, Jessica Buzenski, Bonney Reed","doi":"10.1093/ibd/izaf061","DOIUrl":"https://doi.org/10.1093/ibd/izaf061","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel diseases (IBDs) are increasingly recognized as products of the brain-gut axis associated with dysfunctions of the chronic stress response systems. The objectives of this study were to evaluate the feasibility, acceptability, and preliminary efficacy of a virtual, group-based heart rate variability (HRV) biofeedback-enhanced coping skills intervention for youth with IBD. Treatment targets included symptoms of anxiety, depression, gastrointestinal (GI) symptoms, and perceived stress.</p><p><strong>Methods: </strong>Youth with IBD (ages 13-18) and their caregivers were randomized to either immediate treatment or waitlist control groups. The intervention consisted of 6 virtually delivered, weekly group sessions combining cognitive-behavioral therapy (CBT) with HRV biofeedback training. Outcomes included measures of anxiety, depression, GI symptoms, perceived stress, and HRV parameters. Assessments were conducted at baseline and post-intervention.</p><p><strong>Results: </strong>Of the 53 youth randomized, 50 participated in their assigned group. The intervention demonstrated strong feasibility with 84% of participants attending at least 4 of 6 sessions. Both adolescents and parents reported strong satisfaction. Following treatment, parents reported significant decreases in adolescent depressive symptoms, anxiety symptoms, and GI symptoms compared to controls. Adolescents reported reductions in GI symptoms and perceived stress compared to controls and reductions in symptoms of anxiety within the treatment group. No changes were observed in HRV parameters.</p><p><strong>Conclusions: </strong>This pilot study supports the feasibility and acceptability of a virtual, group-based HRV biofeedback-enhanced coping skills intervention for youth with IBD. Preliminary efficacy was demonstrated for reducing psychological and physical symptoms. Future research should evaluate efficacy in a larger, more diverse sample with elevated baseline psychological symptoms.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Fecal Microbiome of IBD Patients Is Less Divertible by Bowel Preparation Compared to Healthy Controls: Results From a Prospective Study.","authors":"Andreas Blesl, Lukas Binder, Bettina Halwachs, Franziska Baumann-Durchschein, Stefan Fürst, Patrizia Constantini-Kump, Heimo Wenzl, Gregor Gorkiewicz, Christoph Högenauer","doi":"10.1093/ibd/izaf053","DOIUrl":"https://doi.org/10.1093/ibd/izaf053","url":null,"abstract":"<p><strong>Background: </strong>The fecal microbiome of patients with inflammatory bowel diseases (IBD) is characterized by longitudinal variability. It remains unknown if this is caused by decreased resilience of the microbiome to external factors. We investigated the influence of osmotic diarrhea induced by bowel preparation as a disruptive factor on the fecal microbiome in IBD patients and healthy comparators.</p><p><strong>Methods: </strong>We conducted a prospective, single-center study including IBD patients and healthy controls scheduled for colonoscopy with uniform bowel preparation. Fecal samples were collected at 7 time points prior, during, and until 3 months after the intervention. 16S rRNA was isolated from stool and sequenced using the Illumina technique.</p><p><strong>Results: </strong>Twenty-two IBD patients and 17 healthy controls were included in the study. Baseline diversity was higher in healthy controls. Bowel preparation longitudinally decreased alpha diversity and altered beta diversity and taxonomic composition in both groups. Alterations were more pronounced in healthy controls, and the microbial composition converged between the 2 groups. Bowel preparation resulted in an increased relative abundance of Anaerostipes and Coprococcus in both groups and in decreased relative abundance of Bifidobacterium and Clostridium sensu stricto in IBD patients and of Eubacterium hallii group and Ruminococcus in healthy controls. Changes largely restored to baseline composition within 1 week in both groups and remained stable thereafter.</p><p><strong>Conclusions: </strong>Bowel preparation induced reversible short-term microbial perturbations which were less pronounced in IBD patients than in healthy comparators suggesting that a single external disruptive factor may have less impact on an already altered fecal microbiome.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extraintestinal Manifestations in Patients With Ulcerative Colitis Post-Restorative Proctocolectomy and Ileal Pouch-Anal Anastomosis.","authors":"Cong Dai, Yu-Hong Huang","doi":"10.1093/ibd/izaf080","DOIUrl":"https://doi.org/10.1093/ibd/izaf080","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fecal Microbiome Reflects Disease State and Prognosis in Inflammatory Bowel Disease in an Adult Population-Based Inception Cohort.","authors":"Simen Hyll Hansen, Maria Gjerstad Maseng, Olle Grännö, Marie V Vestergaard, Corinna Bang, Bjørn C Olsen, Charlotte Lund, Christine Olbjørn, Emma E Løvlund, Florin B Vikskjold, Gert Huppertz-Hauss, Gøri Perminow, Hussain Yassin, Jørgen Valeur, Kristina I Aass Holten, Magne Henriksen, May-Bente Bengtson, Petr Ricanek, Randi Opheim, Raziye Boyar, Roald Torp, Svein O Frigstad, Tone Bergene Aabrekk, Trond Espen Detlie, Vendel A Kristensen, Vibeke Strande, Øistein Hovde, Øyvind Asak, Tine Jess, Andre Franke, Jonas Halfvarsson, Marte L Høivik, Johannes R Hov","doi":"10.1093/ibd/izaf060","DOIUrl":"https://doi.org/10.1093/ibd/izaf060","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to determine the diagnostic and prognostic potential of baseline microbiome profiling in inflammatory bowel disease (IBD).</p><p><strong>Methods: </strong>Participants with ulcerative colitis (UC), Crohn's disease (CD), suspected IBD, and non-IBD symptomatic controls were included in the prospective population-based cohort Inflammatory Bowel Disease in South-Eastern Norway III (third iteration) based on suspicion of IBD. The participants donated fecal samples that were analyzed with 16S rRNA sequencing. Disease course severity was evaluated at the 1-year follow-up. A stringent statistical consensus approach for differential abundance analysis with 3 different tools was applied, together with machine learning modeling.</p><p><strong>Results: </strong>A total of 1404 individuals were included, where n = 1229 samples from adults were used in the main analyses (n = 658 UC, n = 324 CD, n = 36 IBD-U, n = 67 suspected IBD, and n = 144 non-IBD symptomatic controls). Microbiome profiles were compared with biochemical markers in machine learning models to differentiate IBD from non-IBD symptomatic controls (area under the receiver operating curve [AUC] 0.75-0.79). For UC vs controls, integrating microbiome data with biochemical markers like fecal calprotectin mildly improved classification (AUC 0.83 to 0.86, P < .0001). Extensive differences in microbiome composition between UC and CD were identified, which could be quantified as an index of differentially abundant genera. This index was validated across published datasets from 3 continents. The UC-CD index discriminated between ileal and colonic CD (linear regression, P = .008) and between colonic CD and UC (P = .005), suggesting a location-dependent gradient. Microbiome profiles outperformed biochemical markers in predicting a severe disease course in UC (AUC 0.72 vs 0.65, P < .0001), even in those with a mild disease at baseline (AUC 0.66 vs 0.59, P < .0001).</p><p><strong>Conclusions: </strong>Fecal microbiome profiling at baseline held limited potential to diagnose IBD from non-IBD compared with standard-of-care. However, microbiome shows promise for predicting future disease courses in UC.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transmural Healing Assessed by Combination of Fecal Calprotectin and Intestinal Ultrasonography Is Associated With Reduced Risk of Bowel Damage Progression in Patients With Crohn's Disease.","authors":"Julie Huet, Kelly Mathieu, Marie Dodel, Dilek Coban, Maëva Bazoge, Bruno Pereira, Anthony Buisson","doi":"10.1093/ibd/izaf068","DOIUrl":"https://doi.org/10.1093/ibd/izaf068","url":null,"abstract":"<p><strong>Background: </strong>Fecal calprotectin (Fcal) and intestinal ultrasonography (IUS) could be used as noninvasive tools to monitor mucosal and transmural healing, respectively, in Crohn's disease (CD). We assessed the agreement between Fcal and IUS to detect active CD and investigated their complementary to predict long-term CD outcomes.</p><p><strong>Methods: </strong>In this prospective study, we consecutively included CD patients with concomitant IUS and Fcal testing within 7 days. Patients were divided into 4 groups: Transmural healing (TH; both normal), IUS healing (Fcal > 100 µg/g but normal IUS), biochemical remission reflecting mucosal healing (MH; Fcal < 100 µg/g but abnormal IUS), and no healing (abnormal Fcal and IUS). The primary endpoint was active CD. The secondary endpoints were time to bowel damage progression, time to relapse-related drug discontinuation, and patients' acceptability (10-points acceptability numerical scale).</p><p><strong>Results: </strong>Among the included 112 patients, 44.6% (50/112), 12.5% (14/112),16.1% (18/112), and 26.8% (30/122) achieved TH, IUS healing, biochemical remission, and no healing, respectively. The agreement between IUS and Fcal to detect an active CD was poor (71.4%, κ-coefficient = 0.41 ± 0.09). Transmural healing was associated with a reduced risk of bowel damage progression compared to no healing (P < .0001) contrary to IUS healing (P = .15) or biochemical remission (P = .84). Transmural healing was associated with a lower risk of relapse-related drug discontinuation than MH (hazard ratio [HR] = 0.09 [0.02-0.45], P = .003), IUS healing (HR = 0.10 [0.02-0.60], P = .001), or no healing (HR = 0.09 [0.018-0.04], P = .002). IUS was better accepted than Fcal testing (9.6 ± 0.8 vs 7.9 ± 2.3; P < .0001, 10-points range-acceptability numerical scale).</p><p><strong>Conclusions: </strong>Transmural healing, evaluated by the combination of noninvasive and well-accepted tools such as Fcal and IUS, is associated with improved long-term outcomes and could be used to monitor patients with CD in daily practice.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Chronic Kidney Disease in Patients With Crohn's Disease.","authors":"Andres Rodriguez, Maria Alejandra Quintero, Hajar Hazime, Rose Killian, Gloria Michelle Ducasa, Katerina M Faust, Maria T Abreu","doi":"10.1093/ibd/izaf039","DOIUrl":"https://doi.org/10.1093/ibd/izaf039","url":null,"abstract":"<p><strong>Background: </strong>Patients with inflammatory bowel diseases (IBD), including Crohn's disease (CD), are at risk of complications, including kidney disease. It is important to identify IBD patients at higher risk of chronic kidney disease (CKD) to improve prevention and treatment. Here, we investigated the clinical and metabolomic characteristics of CD patients who develop CKD.</p><p><strong>Methods: </strong>We identified adult CD patients with (CD + CKD, n = 87) and selected CD patients without CKD (CD controls) matched by age, race, and gender. We collected data on demographic characteristics (age, smoking status, ethnicity, gender), IBD characteristics (diagnosis, Montreal classification, medication use, IBD-related surgeries, perianal disease), and kidney-related factors (primary sclerosing cholangitis, end-stage renal disease, hypertension, diabetes, organ transplantation, and nephrolithiasis). Univariate and multivariate analyses were conducted and odds ratios were calculated to identify risk factors for CKD. Serum samples were collected for untargeted metabolomic analysis.</p><p><strong>Results: </strong>Chronic kidney disease was far more common in CD patients than UC patients. Crohn's disease patients with kidney stones had a 10-fold higher risk of developing CKD than those without kidney stones. Crohn's disease patients with more than 2 IBD-related surgeries had a 7.3-fold higher risk of developing CKD than those who had not undergone surgery. There was no relationship between the number of biologics used or mesalamine use and the risk of CKD. The serum of CD + CKD patients had elevated levels of pro-inflammatory metabolites and those linked to kidney injury.</p><p><strong>Conclusions: </strong>We recommend regular kidney function monitoring and ensuring proper hydration to prevent or manage potential kidney-related complications in CD patients. Patients with resections and kidney stones are particularly vulnerable.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Expression of SARS-CoV-2 Host Cell Entry Genes in the Intestinal Mucosa of IBD Patients With Quiescent or Mildly Active Disease.","authors":"Laura Francesca Pisani, Gugliemo Albertini Petroni, Giorgia Crespi, Silvia Mola, Maria Laura Annunziata, Flavio Andrea Caprioli, Chiara Porta, Luca Pastorelli","doi":"10.1093/ibd/izaf079","DOIUrl":"https://doi.org/10.1093/ibd/izaf079","url":null,"abstract":"<p><strong>Background: </strong>Long-term immunosuppressive therapy typically increases the risk of viral infection, yet during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, inflammatory bowel disease (IBD) patients showed reduced severe coronavirus disease 2019 (COVID-19) susceptibility. This suggests potential overlapping molecular mechanisms between IBD and COVID-19 that warrant investigation.</p><p><strong>Methods: </strong>From April 2020 to April 2022, we enrolled 363 IBD patients and 146 healthy donors. Serum samples were analyzed by enzyme-linked immunoadsorption assay to determine the presence of anti-SARS-CoV-2 antibodies and to measure concentrations of the host-soluble factors sACE2 and mannose-binding lectin (MBL), which have SARS-CoV-2 neutralizing activity. Furthermore, colonic mucosa biopsies were analyzed by real-time PCR to confirm the upregulation of MBL2 as well as to assess the expression of genes encoding SARS-CoV-2 entry molecules (ie, ACE2, TMPRSS2, TMPRSS4, ADAM17, AGTR1).</p><p><strong>Results: </strong>Intestinal mucosa expression of ACE2, TMPRSS2, and TMPRSS4 genes was significantly lower in IBD than in healthy individuals, regardless of the type of medication, while ADAM17 and AGT1R were similar across groups. Serum sACE2 levels changed minimally, whereas circulating MBL levels were significantly higher in CD and somewhat elevated in UC patients versus controls. Parallel trends in MBL2 gene expression were observed in IBD patients' intestinal mucosa.</p><p><strong>Conclusions: </strong>Overall, our study indicates that the presence of higher basal circulating levels of MBL in CD patients and the decreased intestinal mucosa expression of the SARS-CoV-2 receptor ACE2 and the host cell priming proteases TMPRSS2 and TMPRSS4 in both CD and UC patients may reduce COVID-19 risk, underscoring the potential protective role of these biomarkers in IBD populations against SARS-CoV-2 infection.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statin Use is Associated with a Less Severe Disease Course In Inflammatory Bowel Disease: A Nationwide Cohort Study 2006-2020.","authors":"Hamed Khalili, Anders Forss, Jonas Söderling, Gabriella Bröms, Carl Eriksson, Jiangwei Sun, Jonas F Ludvigsson, Ola Olén","doi":"10.1093/ibd/izaf077","DOIUrl":"https://doi.org/10.1093/ibd/izaf077","url":null,"abstract":"<p><strong>Background: </strong>Statins reduce the risk of inflammatory bowel disease (IBD), however their effect on IBD disease progression is largely unknown.</p><p><strong>Methods: </strong>We linked Swedish healthcare registers and performed a nationwide cohort study (2006-2020) of 19 788 adults (≥18 years) with ulcerative colitis (UC) and 12 582 with Crohn's disease (CD). Of these, 1733 with UC and 962 with CD were identified as incident statin users after UC or CD diagnosis. After 1:1 propensity score matching, we compared statin users with non-users to estimate the risk of IBD-related surgery, hospitalizations, and disease flares expressed as incidence rates (IRs) and multivariable-adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs). For outcomes with statistically significant estimates, we calculated the numbers needed to treat (NNT).</p><p><strong>Results: </strong>During a median follow-up of 3.4 years we observed a reduced risk of IBD-related surgery in statin users (UC, IR: 3.4 [95%CI: 2.1-4.8] per 1000 person-years; CD, IR: 9.2 [6.2-12.2]) compared with non-users in UC (IR: 6.3 [4.2-8.5]; aHR: 0.55 [0.31-0.97]) and CD (IR: 15.4 [11.0-19.7]; aHR: 0.54 [0.33-0.88]). The NNT to avoid one IBD-related surgical event per year of statin treatment were 345 (UC) and 161 (CD). For statin users, the risks of hospitalizations (IR: 17.0 [13.9-20.2]; aHR: 0.68 [0.51-0.91]) and disease flares (IR: 207.4 [193.2-221.6]; aHR: 0.86 [0.77-0.97]) were reduced in UC, but not in CD (IR: 20.3 [15.8-24.9]; aHR: 0.78 [0.56-1.09] and IR: 245.5 [223.9-267.1]; aHR: 1.02 [0.88-1.19]). In UC, NNT for hospitalizations and disease flares were 145 and 15.</p><p><strong>Conclusions: </strong>Statins were associated with a reduced risk of IBD-related surgery, hospitalizations, and disease flares in patients with UC, and with a reduced risk of IBD-related surgery in patients with CD.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}