Inflammatory Bowel Diseases最新文献

{"title":"Response to letter to the editor: \"GLP-1RAs for pouchitis in obesity: what the current study does not tell us\".","authors":"Hany Habib, Aakash Desai","doi":"10.1093/ibd/izag128","DOIUrl":"10.1093/ibd/izag128","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1868-1869"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420861","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":"Socioeconomic disparities in biologic persistence among patients with inflammatory bowel disease are associated with increased health care utilization.","authors":"Jessica L Sheehan, Dala Eloubeidi, Kira L Newman, Laura A Johnson, Ariel A Jordan, Shirley Cohen-Mekelburg, Jeffrey A Berinstein, Renuka Tipirneni, Peter D R Higgins","doi":"10.1093/ibd/izag062","DOIUrl":"10.1093/ibd/izag062","url":null,"abstract":"<p><strong>Introduction: </strong>Biologic persistence, defined as the total uninterrupted time on a biologic agent, is associated with improved outcomes in inflammatory bowel disease (IBD). However, social determinants of health (SDOH), such as socioeconomic status, may influence a patient's ability to access these medications. We aimed to better understand the relationship between socioeconomic status and biologic persistence in patients with IBD and to determine whether patients with poor biologic persistence had higher health care utilization.</p><p><strong>Methods: </strong>We identified patients with IBD seen at the University of Michigan during 2015-2022. Using the Centers for Disease Control Social Vulnerability Index (SVI), we examined the relationship between socioeconomic status and biologic persistence, defined as an active biologic prescription for 365 days or longer, while controlling a priori for IBD type, age, sex, race, comorbidities, IBD severity, and insurance type. Secondarily, we examined the relationship between biologic persistence and unplanned health care utilization.</p><p><strong>Results: </strong>In this cohort of 3067 patients with IBD who were prescribed biologics, 20% (n = 620) did not achieve biologic persistence. Low socioeconomic status (odds ratio [OR] 0.56; P = .003) was associated with a lower likelihood of achieving biologic persistence. Biologic persistence was associated with lower risk of IBD-related hospitalization (incidence rate ratio [IRR], 0.48; P < .001), readmission (IRR, 0.52; P < .001), and surgery (IRR, 0.33; P < .001).</p><p><strong>Conclusions: </strong>Low socioeconomic status was associated with lower likelihood of biologic persistence and patients who lacked biologic persistence had greater IBD-related unplanned health care utilization.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":"1741-1749"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770617","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":"Beyond calprotectin: where leucine-rich α2-glycoprotein may fit in small bowel Crohn's disease monitoring.","authors":"Tatsuya Kawamura, Takeshi Yamamura, Masanao Nakamura","doi":"10.1093/ibd/izag175","DOIUrl":"10.1093/ibd/izag175","url":null,"abstract":"","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864802","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":"Comparative assessment of nutritional status and energy expenditure in relation to dietary intake in hospitalized and outpatient patients with inflammatory bowel disease across disease phases.","authors":"Tessa C Oude Vrielink, Peter B F Mensink, Inge Oude Meijers, Marita Klein Jäger, Job van der Palen, Henri Braat, Wouter Tobias van Haaften","doi":"10.1093/ibd/izag171","DOIUrl":"https://doi.org/10.1093/ibd/izag171","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition is a common problem in inflammatory bowel diseases (IBD) and is associated with poorer outcomes and reduced quality of life. Body mass index (BMI) is commonly used to assess nutritional status but does not reflect body composition. Data on nutritional status and energy requirements in IBD are limited. The aim of our study was to evaluate nutritional status and energy requirements in hospitalized and outpatient patients with active IBD, and in patients with IBD in remission, in relation to caloric and protein intake.</p><p><strong>Methods: </strong>This single-center prospective cohort study assessed nutritional status using the fat-free mass index (FFMI), derived from bioelectrical impedance vector analysis (BIVA). Energy requirements were measured by indirect calorimetry (Q-NRG). Protein requirements and caloric and protein intake were evaluated. Active IBD patients were evaluated longitudinally at baseline and 12 weeks and compared cross-sectionally with patients in remission.</p><p><strong>Results: </strong>Following remission, FFMI increased by 1.1 kg/m² in hospitalized patients (n = 14), significantly greater than the 0.4 kg/m² increase in outpatients (n = 12) (P = .026). No significant differences were observed between groups in BMI change (P = .45) or resting energy expenditure reduction (P = .53). Once in remission, the caloric balance of hospitalized and outpatient patients were comparable to patients with IBD in remission (n = 11) (P = .66).</p><p><strong>Conclusions: </strong>Hospitalized patients with active IBD showed greater improvement in BIVA-derived nutritional status during remission than outpatients, despite similar BMI changes and stable energy expenditure. BIVA-derived FFMI may be useful for nutritional assessment of patients with IBD. Given the small sample size and exploratory design, these results should be interpreted as hypothesis-generating.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860407","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":"Wearable perspiration sensor for continuous inflammation tracking in inflammatory bowel disease.","authors":"Sarah Shahub, Kai-Chun Lin, Natalie K Choi, Nicole M Garcia, Sriram Muthukumar, David T Rubin, Shalini Prasad","doi":"10.1093/ibd/izag173","DOIUrl":"https://doi.org/10.1093/ibd/izag173","url":null,"abstract":"<p><strong>Background: </strong>Wearable sensors present an opportunity to monitor inflammation via noninvasive media such as perspiration, which may be sampled continuously to track biomarkers in inflammatory bowel disease (IBD). Here we demonstrate the use of a perspiration sensor for C-reactive protein (CRP) and calprotectin and their clinical significance.</p><p><strong>Methods: </strong>Thirty-three patients with IBD were enrolled in a cross-sectional study of CRP and calprotectin perspiration expression compared to expression in serum and stool, respectively. Perspiration on-body measurements were obtained every minute using a wearable sensor worn for 40-130 minutes during standard of care assessment. Synchronously collected serum levels were measured, as was fecal calprotectin from a subcohort.</p><p><strong>Results: </strong>Principal component analysis of demographic data identified age, disease activity, and diagnosis as the major contributors to variance in the dataset. When endoscopic scores were incorporated into the PCA, both disease activity and endoscopy score were identified as contributing most strongly to the primary variance. In perspiration and serum, median CRP was observed to be elevated in patients with Crohn's disease (CD) compared to ulcerative colitis, while median calprotectin was elevated in UC compared to CD. Median calprotectin across perspiration, serum, and stool was observed to be elevated in IBD of the colon over isolated ileal IBD. Furthermore, median perspiration and serum CRP were elevated in patients under 40 years of age compared to those 40 and older, whereas median perspiration, serum, and fecal calprotectin were elevated in patients 40 and older compared to the younger cohort.</p><p><strong>Conclusions: </strong>We report the use of a noninvasive perspiration sensor for tracking inflammatory markers in patients with IBD and demonstrate consistency of perspiration CRP and calprotectin measurements with corresponding serum and stool measurements.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850522","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":"Reporting and representation of participant race, ethnicity, and sex in pediatric IBD clinical trials.","authors":"Yunlin Jiang, Jiaying Tan, Long Qin, Mingye Zhao, Zhenyi Wang","doi":"10.1093/ibd/izag169","DOIUrl":"https://doi.org/10.1093/ibd/izag169","url":null,"abstract":"<p><strong>Background and aims: </strong>Pediatric inflammatory bowel disease (IBD) incidence is rising among racial and ethnic minority children, yet to our knowledge no comprehensive evaluation of demographic representation in pediatric IBD trials exists. We systematically evaluated the reporting and representation of race, ethnicity, and sex in pediatric IBD clinical trials, stratified by Crohn disease (CD) and ulcerative colitis (UC).</p><p><strong>Methods: </strong>We performed a cross-sectional study of pediatric IBD trials identified in PubMed and EMBASE through March 2026. Reference distributions were derived from the National Patient-Centered Clinical Research Network (race/ethnicity, United States) and the Global Burden of Disease Study 2023 (sex, global). Enrollment incidence ratios (EIRs) were used to compare trial enrollment to expected disease burden. Comparisons were performed with random-effects meta-analyses that pooled trial-level estimates, with subgroup analyses, sensitivity analyses, and meta-regression analyses.</p><p><strong>Results: </strong>Of 145 trials enrolling 8273 children, sex and race were consistently reported; ethnicity reporting rose from 0% before 2000 to 87.5% after 2020. Female participants were underrepresented (EIR, 0.91; 95% CI, 0.87-0.95), most markedly in CD trials (EIR, 0.82; 95% CI, 0.78-0.88). Black (EIR, 0.55; 95% CI, 0.42-0.71) and Hispanic (EIR, 0.46; 95% CI, 0.28-0.76) participants were underrepresented. Asian/Pacific Islander participants were overrepresented (EIR, 1.78; 95% CI, 1.37-2.30), while White and non-Hispanic participants were proportionally represented. Meta-regression showed gains over time for Asian/Pacific Islander, female, and Hispanic participants, but a slight decline for Black participants.</p><p><strong>Conclusions: </strong>Female and Black children remain persistently underrepresented in pediatric IBD trials relative to disease burden; findings for Hispanic children were similar but based on a small number of trials. Enforceable diversity action plans and standardized demographic reporting are urgently needed to ensure equitable therapeutic benefit.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839496","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":"Targeting the TL1A pathway in inflammatory bowel disease: mechanistic insights and emerging therapeutic pipeline.","authors":"Mohammed Nabil Quraishi, Vipul Jairath, Badr Al-Bawardy","doi":"10.1093/ibd/izag172","DOIUrl":"https://doi.org/10.1093/ibd/izag172","url":null,"abstract":"<p><p>Tumor necrosis factor-like ligand 1A (TL1A), encoded by TNFSF15, signals through death receptor 3 on effector T cells, innate lymphoid cells, and intestinal myofibroblasts, driving both chronic intestinal inflammation and tissue fibrosis. In this narrative review, we provide a contemporary appraisal of TL1A-directed therapeutics in inflammatory bowel disease based on electronic searches through May 2026. Three anti-TL1A monoclonal antibodies (tulisokibart, afimkibart, and duvakitug) have advanced to phase 3 trials across multiple global programs, with phase 2 clinical remission rates of 26%-48% in ulcerative colitis (placebo-adjusted differences 15-26 percentage points) and endoscopic response rates of 26%-48% in Crohn's disease, alongside favorable safety profiles. Mucosal transcriptomic and serum proteomic analyses from phase 2 trials, including DDW 2026 readouts from ARTEMIS-UC and TUSCANY-2, provide the first human-tissue confirmation of class antifibrotic activity through the suppression of Th17, myeloid, and extracellular matrix pathways. TNFSF15 risk-variant companion diagnostics are advancing, although their incremental utility remains modest and will be definitively tested in phase 3. The pipeline has expanded to at least 19 development programs, including extended half-life antibodies (XmAb942, SPY002, and BCD-261), bispecifics combining TL1A with IL-23 or α4β7 (RO7837195, XmAb412, LQ080, and ALX001), a first-in-class oral anti-TL1A nanobody, and a first-in-class DR3 receptor antagonist (SL-325). We discuss therapeutic positioning and timing, the opportunity in acute severe UC, and the unusual standing of IBD as the lead indication for this mechanism class. Phase 3 results anticipated in 2026-2027 will be particularly informative for fibrostenotic phenotypes and biologic-refractory patients.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839726","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":"Clinical and endoscopic features of checkpoint inhibitor-induced colitis and their association with selective immunosuppressive therapy use.","authors":"Myrthe R Naber, Mick J M van Eijs, Jildou S Huitema, Jacco J de Haan, Karijn P M Suijkerbuijk, Marijn C Visschedijk, Fiona D M van Schaik","doi":"10.1093/ibd/izag104","DOIUrl":"10.1093/ibd/izag104","url":null,"abstract":"<p><strong>Background and aims: </strong>Immune checkpoint-inhibitor (ICI) colitis is a common adverse event that is primarily treated with corticosteroids but may require selective immunosuppressive therapy (SIT). Although endoscopic features have been associated with SIT use, it remains unclear whether these associations differ by ICI type.</p><p><strong>Methods: </strong>We conducted a 2-center retrospective cohort study and included patients with histologically confirmed ICI colitis. Endoscopic images were reviewed by gastroenterologists specialized in inflammatory bowel disease (IBD) and scored using the Mayo score and the Immune-Mediated Colitis Endoscopic Score (IMCES). Early SIT use was defined as SIT use within 3 weeks after the start of colitis treatment. Features associated with SIT use were stratified by ICI type, and discriminative performance was evaluated using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Among 255 included patients, 38% required SIT. Biochemical parameters associated with early SIT use were C-reactive protein (CRP) (odds ratio (OR), 1.41; P = .005), and albumin (OR, 0.92; P = .020). Endoscopic features associated with SIT use included erythema (OR, 4.09; P = .006) and exudate (OR, 3.24; P = .012), which were limited to patients treated with anti-cytotoxic T-lymphocyte-associated antigen 4-based (aCTLA-4-based) therapy. In multivariable analysis, ICI type remained the only variable associated with early SIT use (OR, 12.8; P < .001). The IMCES demonstrated areas under the curves (AUCs) of 0.57 (95% CI, 0.50-0.65) for overall and 0.61 (95% CI, 0.53-0.69) for early SIT use.</p><p><strong>Conclusions: </strong>In patients with ICI colitis, escalation to SIT use was primarily associated with ICI type, with limited additional value of biochemical or endoscopic features. The IMCES showed poor predictive performance in this external validation cohort.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792320","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":"GLP-1 receptor agonist therapy is associated with increased symptomatic remission in ulcerative colitis: a matched cohort study.","authors":"Budoor Alqinai, Swapna Gayam, Jennifer Hadam-Veverka","doi":"10.1093/ibd/izag167","DOIUrl":"10.1093/ibd/izag167","url":null,"abstract":"<p><strong>Background: </strong>Ulcerative colitis (UC) remains associated with significant morbidity despite therapeutic advances. The impact of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on UC disease activity is not well defined.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using electronic health records from a single tertiary academic health system (2022-2024). Adults with UC initiating liraglutide or semaglutide for metabolic indications and maintained on therapy ≥ 12 weeks were included. A 1:1 matched cohort of UC patients not receiving GLP-1 RAs served as controls. The primary outcome was symptomatic remission at 12 weeks (partial Mayo ≤ 2 with rectal bleeding subscore 0). Multivariable logistic regression assessed adjusted odds of remission.</p><p><strong>Results: </strong>A total of 150 GLP-1 RA patients were matched to 150 controls with comparable baseline characteristics. GLP-1 RA use was associated with higher remission rates at 4 weeks (34.7% vs 15.3%, P = .001), 8 weeks (54.7% vs 18.0%, P < .001), and 12 weeks (66.7% vs 25.3%, P < .001). Mean partial Mayo scores improved from 5.8 at baseline to 2.1 at 12 weeks in the GLP-1 RA group vs 4.6 in controls (P < .01). GLP-1 RA use remained independently associated with remission (adjusted OR 5.90, 95% CI 3.52-9.86; P < .001). Weight loss was not associated with remission. Semaglutide demonstrated higher remission rates than liraglutide (72.5% vs 60%; OR 1.77, P = .04). Endoscopic outcomes in a subset showed higher remission (58% vs 38%) and improvement (69% vs 47%).</p><p><strong>Conclusion: </strong>GLP-1 RA therapy was associated with significantly improved UC disease activity and higher remission rates compared to matched controls, with a modest advantage observed for semaglutide. These findings support a potential adjunctive role for GLP-1 RAs in UC, particularly in patients with metabolic comorbidities.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792577","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":"Novel proteomic signatures of stricturing Crohn disease using a treatment-naive cohort.","authors":"Zishan Liu, Xiaomin Wu, Weidong Huang, Jinshen He, Yu Wang, Tingting Gu, Baili Chen, Yao He, Zhirong Zeng, Yao Zhang, Qian Cao, Yael Haberman, Minhu Chen, Rui Feng, Shixian Hu, Guibin Wang, Ren Mao","doi":"10.1093/ibd/izag160","DOIUrl":"https://doi.org/10.1093/ibd/izag160","url":null,"abstract":"<p><strong>Background: </strong>Crohn disease (CD) is frequently complicated by intestinal strictures, which require early recognition and management. This study aimed to identify biomarkers associated with CD-related strictures by use of serum and intestinal proteomics and to develop diagnostic and predictive models for potential clinical application.</p><p><strong>Methods: </strong>Serum samples from treatment-naive CD patients and paired intestinal samples from stricturing intestine were subjected to proteomic analysis. Machine learning approaches were employed to select stricture-related biomarkers and develop models. The candidate protein was validated using external cohorts and molecular experiments.</p><p><strong>Results: </strong>The discovery cohort included 62 patients. A diagnostic model for intestinal stricture was developed using serum levels of 5 proteins from 30 nonstricturing, nonpenetrating (B1) phenotype and 20 stricturing (B2) phenotype patients, achieving an area under the curve of 0.754. A predictive model for stricture progression, based on another set of 5 proteins in 10 B1 progressors, achieved an AUC of 0.947 internally. Serum enzyme-linked immunoassay (ELISA) validation in the First Affiliated Hospital of Sun Yat-sen University (FAH-SYSU) and Sir Run Run Shaw Hospital (SRRSH) cohorts (n = 62) confirmed elevated glypican-6 (GPC6) levels in the stricturing (B2) group, with a similar trend observed in intestinal tissue in the progression group of the RISK cohort (n = 237). Single-cell transcriptomic analysis and immunofluorescence staining further confirmed higher GPC6 expression and protein levels in the fibrostenotic mucosa and submucosa, particularly in fibroblasts.</p><p><strong>Conclusions: </strong>We developed serum-based diagnostic and predictive models for intestinal strictures in CD, which may be suitable for clinical use once externally adequately validated. GPC6 emerged as a candidate biomarker closely associated with intestinal fibrosis, offering promising implications for its diagnosis and prognosis.</p>","PeriodicalId":13623,"journal":{"name":"Inflammatory Bowel Diseases","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792569","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}