International heart journal最新文献

{"title":"Validity of Diagnoses of Aortic Dissection and Pulmonary Embolism in Hospitalized Patients Using the Japanese DPC Database.","authors":"Risa Kishikawa, Satoshi Kodera, Kohei Abe, Shinnosuke Sawano, Hiroshi Shinohara, Junichi Ishida, Hiroyuki Morita, Norihiko Takeda","doi":"10.1536/ihj.25-444","DOIUrl":"https://doi.org/10.1536/ihj.25-444","url":null,"abstract":"<p><p>Acute aortic dissection (AD) and pulmonary thromboembolism (PE) are life-threatening conditions requiring timely diagnosis. In Japan, large-scale validation studies of administrative data for these diagnoses are limited. It is required to validate the accuracy of International Classification of Diseases, 10th Revision (ICD-10) codes for acute AD and PE in the Diagnosis Procedure Combination (DPC) database using medical chart review as the reference standard.We reviewed DPC data from the University of Tokyo Hospital (April 2018-March 2024). Patients with I710 (AD) or I260/I269 (PE) listed in key diagnosis fields were identified. Chart reviews confirmed diagnoses, and 199 randomly selected patients without AD/PE codes served as negative controls. Sensitivity, specificity, and positive predictive value (PPV) were calculated.Among 10,483 records, 54 had DPC-coded AD and 71 had PE. Chart review confirmed 47 cases of acute AD and 48 of acute PE. No false negatives were found among controls. For acute AD, sensitivity was 100.0% (95% CI: 92.5-100.0), specificity 96.6% (93.1-98.6), and PPV 87.0% (75.1-94.6). For acute PE, sensitivity was 100.0% (92.6-100.0), specificity 89.6% (84.9-93.3), and PPV 67.6% (55.5-78.2).ICD-10 codes in the DPC database accurately identify acute AD and PE, with particularly high sensitivity. While PPV for acute PE is lower, likely due to inclusion of chronic conditions, DPC data can be cautiously used for research and surveillance in academic hospital settings. Multicenter validation is needed to ensure broader generalizability.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"67 1","pages":"61-64"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and Outcomes of Mechanical Support Use in Surgical Repair of Ventricular Septal Defect after Myocardial Infarction.","authors":"Masanobu Miura, Yuta Kagaya, Hiroki Saito, Kenjiro Sato, Masanori Kanazawa, Masateru Kondo, Yoko Sumita, Koshiro Kanaoka, Hideaki Endo, Akihiro Nakamura","doi":"10.1536/ihj.25-318","DOIUrl":"https://doi.org/10.1536/ihj.25-318","url":null,"abstract":"<p><p>Ventricular septal defect after myocardial infarction (MI-VSD) is a rare but fatal complication. This real-world database study reports the patient characteristics and outcomes after surgical repair of MI-VSD based on the Japanese Registry of All Cardiac and Vascular Diseases Diagnosis Procedure Combination (JROAD-DPC), especially considering the popularity of percutaneous ventricular assist device (PVAD) use.This retrospective study used data from the JROAD-DPC, a nationwide administrative claims database in Japan, covering the period from April 2012 to March 2022. In the JROAD-DPC database, among 487,178 patients with acute myocardial infarction across 1,124 institutions, the present study analyzed 1,763 patients (49.7% female, 74.8 ± 9.1 years old) who underwent surgical repair of MI-VSD, with in-hospital death as the primary outcome.More than 60% of the patients were Killip III or IV, and most were receiving inotropes. Perioperatively, 87.4%, 13.2%, and 4.7% received support with an intra-aortic balloon pump (IABP), extracorporeal membrane oxygenation (ECMO), and PVAD, respectively. ECMO and PVAD were used in combination in 15 patients. The time from device placement to surgical repair tended to be longer in patients using PVAD. Since 2018, the number of cases using PVAD in the perioperative period has increased, but the in-hospital mortality consistently exceeds 30% with no improvement in prognosis. Furthermore, there was a significant trend toward increased perioperative bleeding.PVAD are still used infrequently and the mortality rate of MI-VSD remains significantly high.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"67 2","pages":"107-113"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between Indoor Environment and Seasonal Variation in Home Blood Pressure among Residents of Houses with Different Insulation, Ventilation, and Air Conditioning Systems.","authors":"Hironori Nakagami, Keiko Sekiya, Daisuke Umemoto, Koichi Yamamoto","doi":"10.1536/ihj.25-637","DOIUrl":"https://doi.org/10.1536/ihj.25-637","url":null,"abstract":"","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"67 1","pages":"98-100"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dampened Reactive Hematopoiesis and Systemic Inflammatory Response Following Early Recurrent Myocardial Infarction in Mice.","authors":"Yunhang Zhang, Haiju He, Xue Li, Chunhong Cui","doi":"10.1536/ihj.25-037","DOIUrl":"https://doi.org/10.1536/ihj.25-037","url":null,"abstract":"<p><p>Acute myocardial infarction (AMI) impacts the regenerative capacity of hematopoietic stem and progenitor cells (HSPCs) following injury, but it remains unclear if these functional alterations persist beyond the initial ischemic event.A minimally invasive mouse model of recurrent myocardial infarction was established using echocardiography-guided coronary interventions. Bone marrow HSPCs were quantified and analyzed for proliferation by flow cytometry and BrdU incorporation. Peripheral blood leukocytes and inflammatory cytokines (IL-6, G-CSF) were measured by flow cytometry and ELISA. Bone marrow extracellular TGF-β1 was assessed by ELISA, and its functional role was evaluated through antibody-mediated inhibition.The minimally invasive infarction model was validated through electrocardiography, cardiac biomarkers, echocardiography, and cardiac pathology staining. Fourteen days post-I/R or sham treatment, bone marrow hematopoiesis returned to a steady state with no significant differences in Lin^-Sca-1⁺c-Kit⁺ (LSK), hematopoietic stem cell (HSC), multipotent progenitor (MPP), and granulocyte/macrophage progenitor (GMP) cell numbers. However, after a secondary ischemic challenge, there was a dampened reactive hematopoiesis indicated by reduced HSPCs, compared to the first ischemic event. BrdU incorporation analysis showed decreased HSPC proliferation activity during the reparative phase after initial ischemic challenge, linking dampened hematopoiesis to decreased HSPCs proliferation. Additionally, early recurrent infarct mice had fewer neutrophils released in peripheral blood and lower serum IL-6 and G-CSF levels. Elevated TGF-β1 levels were detected in bone marrow extracellular fluid during the reparative phase of cardiac-ischemic injury, and inhibiting TGF-β1 reversed the dampened reactive hematopoiesis of HSPCs in an early recurrent MI setting.Our data suggest that initial myocardial ischemia challenges blunt bone marrow reactive hematopoiesis to subsequent ischemic stress, with decreased HSPC proliferation contributing to diminished regenerative capacity. TGF-β1 in bone marrow extracellular fluid may mediate this decreased HSPC proliferation.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"67 1","pages":"77-86"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of Acute Vasodilator Challenge with Inhaled Nitric Oxide to Predict Pulmonary Hemodynamic Reversibility in Patients with Pulmonary Hypertension due to Left Heart Disease Referred for Heart Transplantation.","authors":"Kei Morishita, Satoshi Ishii, Hisataka Maki, Masaru Hatano, Shun Minatsuki, Kazutoshi Hirose, Shun Kitamura, Saki Kaneko, Satoru Ando, Takahiro Kurihara, Yoshitaka Isotani, Chie Bujo, Masaki Tsuji, Hiroki Yagi, Katsura Soma, Junichi Ishida, Eisuke Amiya, Masahiko Ando, Minoru Ono, Norihiko Takeda","doi":"10.1536/ihj.25-683","DOIUrl":"https://doi.org/10.1536/ihj.25-683","url":null,"abstract":"<p><p>Pulmonary hypertension due to left heart disease (PH-LHD) in heart transplantation (HTx) candidates is associated with increased post-transplant mortality. Although guidelines recommend acute vasodilator challenge (AVC) with nitroprusside or milrinone, the safety and utility of inhaled nitric oxide (iNO) for AVC in this setting remain unclear.We retrospectively reviewed 18 patients with PH-LHD referred for HTx who underwent AVC with iNO. While arterial oxygen saturation decreased after AVC (95.4 ± 2.6 to 94.1 ± 2.7%, P = 0.013), there were no significant changes in mean aortic pressure (74.5 ± 9.8 versus 74.0 ± 8.0 mmHg, P = 0.680), and no respiratory or circulatory adverse events occurred. Both mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) significantly decreased (mPAP: 36.1 ± 8.0 to 33.2 ± 7.5 mmHg, P = 0.007; PVR: 5.2 ± 2.9 to 2.9 ± 1.3 Wood Units [WU], P < 0.001). Nine patients subsequently underwent left ventricular assist device (LVAD) implantation. At 1 month after implantation, PVR decreased from pre-AVC levels (4.0 ± 1.6 to 2.9 ± 1.3 WU, P = 0.049). The percent change in PVR from pre-AVC to post-LVAD correlated with the percent change from pre-AVC to post-AVC (r = 0.76, P = 0.029).Our preliminary findings suggest that AVC with iNO may be a useful method for evaluating the reversibility of elevated PVR and could indicate the hemodynamic response to LVAD implantation in patients with PH-LHD.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"67 2","pages":"150-155"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Hydrophilic Polymer Embolism after Transcatheter Aortic Valve Replacement.","authors":"Yuya Kobayashi, Satoshi Kawaguchi, Yuya Kitani, Akiho Minoshima, Chiaki Takahashi, Toshiharu Takeuchi, Hiroyuki Kamiya, Naoki Nakagawa","doi":"10.1536/ihj.25-564","DOIUrl":"https://doi.org/10.1536/ihj.25-564","url":null,"abstract":"<p><p>Recently, endovascular catheter-based interventions have become an established therapeutic option for severe valvular heart disease. Although cholesterol crystal embolism is a well-recognized complication of endovascular treatment, the hydrophilic polymer coating of catheter devices may also induce embolic events. Herein, we reported a rare case of hydrophilic polymer embolism (HPE) after transcatheter aortic valve replacement for severe aortic stenosis. At present, there are no specific treatment options for HPE, but early diagnosis and corticosteroid therapy may be effective. This report highlighted the characteristics and successful management of HPE based on a patient we treated and previous literature.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"67 2","pages":"186-190"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation and Comparison of ASCVD Risk Score and SCORE2-Diabetes in Japanese Patients with Diabetes Mellitus.","authors":"Yu Suresvar Singh, Yutaka Nakamura, Yuya Matsue, Hanako Inoue, Yuka Akama, Yudai Fujimoto, Taishi Dotare, Taisuke Nakade, Tadao Aikawa, Daichi Maeda, Hirohisa Endo, Akihiro Mochida, Mika Kurita, Fuki Ikeda, Hirotaka Watada, Tohru Minamino","doi":"10.1536/ihj.25-627","DOIUrl":"https://doi.org/10.1536/ihj.25-627","url":null,"abstract":"<p><p>Diabetes mellitus is a major risk factor for cardiovascular disease (CVD), and prediction models are recommended to identify patients with diabetes mellitus at high CVD risk. However, no risk prediction models have been developed for Japanese patients with diabetes mellitus. Therefore, we aimed to validate the Atherosclerotic Cardiovascular Disease (ASCVD) risk score and Systematic Coronary Risk Evaluation 2-Diabetes (SCORE2-Diabetes) model in Japanese patients with diabetes mellitus.We retrospectively collected data from all patients admitted to our hospital for diabetes education between January 2011 and December 2022. The primary endpoint is a composite of myocardial infarction and stroke. Patients who had a history of CVD at admission were excluded. Model performance was evaluated using area under the receiver-operating-characteristics curve (AUROC).We evaluated 1,186 patients (mean age, 59 ± 13 years; males, 65%; mean glycohemoglobin, 8.5%). During a median follow-up of 3.2 years, 30 patients (2.5%) experienced the primary endpoint. Both ASCVD risk score (hazard ratio [HR]: 1.03, 95% confidence interval [CI]: 1.01-1.06, P = 0.002) and SCORE2-Diabetes (HR: 1.09, 95% CI: 1.05-1.14, P < 0.001) were significantly associated with the primary endpoint. SCORE2-Diabetes showed superior discrimination ability (AUROC: 0.688, 95% CI: 0.585-0.791) compared to ASCVD score (AUROC: 0.639, 95% CI: 0.534-0.744) (P = 0.008).Both ASCVD risk score and SCORE2-Diabetes were validated in Japanese patients with diabetes mellitus. The SCORE2-Diabetes model demonstrated superior predictive performance compared to the ASCVD risk score.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"67 2","pages":"170-177"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population-Based Incidence and Outcomes of Acute Aortic Dissection in Rural Areas of Japan.","authors":"Fumihiko Takahashi, Yasuaki Saijo, Hiroyuki Kamiya, Naoki Nakagawa","doi":"10.1536/ihj.25-619","DOIUrl":"https://doi.org/10.1536/ihj.25-619","url":null,"abstract":"<p><p>Acute aortic dissection (AAD) is a life-threatening cardiovascular disease. Although various nationwide registries have investigated the clinical characteristics of AAD, data on its incidence and outcomes, particularly in rural areas of Japan, remain limited. We conducted a population-based review of patients with AAD in the Rumoi medical area, a well-defined rural region of Hokkaido. Data were retrospectively collected for patients diagnosed with AAD between January 2014 and December 2023. A total of 67 cases of AAD were identified (type A, 59.7%; n = 40), and 32.8% of patients were dead on hospital arrival. The mean patient age was 75.7 ± 13.1 years, and 59.7% (40/67) were male. The age-adjusted incidence and mortality rates of AAD were 17.3 and 6.45 per 100,000 inhabitants per year, respectively. Of the 45 patients who arrived at the hospital alive, 14 with type A AAD and 10 with type B AAD were transferred to tertiary referral hospitals for emergency surgery or conservative treatment. All transferred patients with type A AAD underwent emergency open aortic surgery, and one patient with type B AAD underwent emergency endovascular surgery. This study demonstrated a higher incidence of AAD than that reported in several previous studies in Japan. In contrast, the 30-day mortality among patients who were alive on arrival was lower than in prior reports. These findings suggest that prompt diagnosis and early transfer to tertiary referral hospitals can reduce the mortality rate even in rural settings.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"67 2","pages":"164-169"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Periaortic Adipose Tissue on Computed Tomography and Aortic Vulnerable Plaques Evaluated by Non-Obstructive General Angioscopy.","authors":"Yutaka Koyama, Keisuke Kojima, Yuta Hotsubo, Yuki Nakajima, Saki Mizobuchi, Yudai Tanaka, Shohei Migita, Masatsugu Miyagawa, Katsunori Fukumoto, Yasunari Ebuchi, Riku Arai, Suguru Migita, Ryuta Watanabe, Mitsumasa Sudo, Daisuke Fukamachi, Yasuo Okumura","doi":"10.1536/ihj.25-672","DOIUrl":"https://doi.org/10.1536/ihj.25-672","url":null,"abstract":"<p><p>Periaortic adipose tissue (PAAT) is known to promote atherosclerosis and has been linked to cardiovascular disease (CVD). However, its association with aortic plaque instability remains unclear. This study aimed to assess whether PAAT is associated with aortic vulnerable plaques (VPs) as identified by non-obstructive general angioscopy (NOGA) in patients with CVD.We investigated 117 patients who underwent both aortic NOGA and computed tomography (CT). On CT images, adipose tissue was defined by Hounsfield unit values ranging from -190 to -30, from the level of the tracheal bifurcation to the diaphragm. The PAAT volume index (PAAT-I) was calculated by dividing PAAT volume by the body surface area. The number of VPs in the whole aorta was assessed using NOGA.The number of VPs in both the thoracic and the whole aorta was significantly correlated with PAAT-I (thoracic: r = 0.40, P < 0.0001; whole: r = 0.33, P = 0.007). In univariate Poisson regression, PAAT-I was significantly associated with the number of VPs in the thoracic aorta (β = 0.04, P < 0.0001). This association remained significant in multivariate analysis adjusted for age, sex, body mass index, smoking history, hypertension, dyslipidemia, diabetes mellitus, chronic kidney disease, peripheral artery disease, stroke, and epicardial adipose tissue volume index (β = 0.04, P = 0.005).PAAT in the thoracic aorta was related to the number of NOGA-derived aortic VPs in patients with CVD. PAAT may play a crucial role in the development of aortic plaque instability.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"67 2","pages":"178-185"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparisons of Left Ventricular Hypertrophy due to Essential Hypertension and Hypertrophic Non-Obstructive Cardiomyopathy.","authors":"Mareomi Hamada, Sayuri Uga-Yamabe, Shuntaro Ikeda, Akiyoshi Ogimoto","doi":"10.1536/ihj.25-272","DOIUrl":"10.1536/ihj.25-272","url":null,"abstract":"<p><p>Essential hypertension (EH) and hypertrophic non-obstructive cardiomyopathy (HNCM) are representative conditions associated with left ventricular hypertrophy (LVH). We compared the severity and distribution of LVH between these two conditions.This study included 44 patients with EH and 79 with HNCM exhibiting precordial negative T-waves (NTs) without LV heart failure. Electrocardiographic assessments included measurements of SV1 + RV5 and the maximum depth of NTs, and routine echocardiographic indices were measured.The SV1 + RV5 and maximum depth of NTs were greater in HNCM than in EH. A correlation was found between these two indices in both groups, with the correlation slope being 4.8 times steeper in the HNCM group. The difference in correlation slopes was considered to reflect the degree of myocardial ischemia. The maximum depth of NTs was predoinantly recorded in the V6 lead in EH, and the V4 and V5 leads in HNCM. Interventricular septal thickness (IVST) was greater in HNCM, whereas LV posterior wall thickness (PWT) was higher in EH. The IVST/PWT ratios were calculated as 0.91 ± 0.10 in EH and 1.20 ± 0.35 in HNCM (P< 0.0001). No significant difference was found in the LV mass index between the two groups. The areas under the receiver operating characteristic curve for the maximum depth of precordial NT and the maximum depth of precordial NT/SV1 + RV5 ratio were 0.967 and 0.952, respectively.LVH was similar between EH and HNCM; however, myocardial ischemia was more severe in HNCM than in EH. The distribution pattern of LVH differed markedly between these two conditions.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":" ","pages":"961-967"},"PeriodicalIF":1.3,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145503517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}