International heart journal最新文献

{"title":"Comparison of Organ Congestion Between the Lung and Intestine.","authors":"Kousuke Akao, Teruhiko Imamura, Koichiro Kinugawa","doi":"10.1536/ihj.25-280","DOIUrl":"https://doi.org/10.1536/ihj.25-280","url":null,"abstract":"<p><p>Pulmonary congestion can be quantitatively assessed using the remote dielectric sensing (ReDS) system, whereas intestinal congestion is evaluated based on the colon wall thickness (CWT) as measured by abdominal computed tomography. However, the relationship between pulmonary and intestinal congestion (i.e., inter-organ congestion) remains poorly understood.ReDS and CWT values were simultaneously obtained from patients hospitalized for cardiovascular diseases. The association between congestion in these two organs and its prognostic significance for a composite endpoint-including heart failure hospitalization and all-cause mortality-was investigated.A total of 111 patients (median age: 79 years; 60 males) were analyzed. Patients with high ReDS values and high CWT exhibited a larger left atrial size and lower prescription rates of loop diuretics compared with patients in the Normal group (P < 0.05 for both). Individuals with elevated ReDS values but low CWTs had larger left atrial dimensions, whereas those with high CWTs but low ReDS values had a higher prevalence of chronic kidney disease (P < 0.05 for both). The cumulative incidence of the composite endpoint was significantly stratified by the ReDS values (P = 0.037); in contrast, the CWT values did not demonstrate significant stratification (P = 0.71).Pulmonary and intestinal congestion reflect distinct pathophysiological processes in patients with cardiovascular diseases. The simultaneous evaluation of ReDS and CWT values may provide valuable insights to guide personalized therapeutic strategies in this patient population.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 5","pages":"794-804"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206221","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":"MiR-411-5p Alleviates Angiotensin II-Induced Fibrosis in H9c2 Cells by Inhibiting HCN1.","authors":"Chengnan Tian, Peijun Li, Xuehong Zhong, Wentong Li, Junjian Yu, Ziyou Liu","doi":"10.1536/ihj.24-772","DOIUrl":"https://doi.org/10.1536/ihj.24-772","url":null,"abstract":"<p><p>Myocardial fibrosis (MF) is closely related to various cardiovascular diseases, especially heart failure. However, the mechanisms related to the treatment of MF are not entirely clear. Therefore, this study investigated the effects of miR-411-5p and HCN1 on MF alleviation.RT-qPCR and Western blotting were used to determine Ang II-induced fibrosis of H9c2 cells and alterations in miR-411-5p and HCN1 expression. CCK-8, EdU staining, Transwell assay, immunofluorescence staining, and Western blot were used to determine the effects of the corresponding transfectants on H9c2 cell viability, cell proliferation, migration, and fibrosis. Meanwhile, the dual-luciferase report, RNA binding protein immunoprecipitation assay, RT-qPCR, and Western blot were collectively employed to investigate the targetability between miR-411-5p and HCN1.In this study, the optimal concentration of Ang II used to establish fibrosis of H9c2 cells was 10 ng/mL, under which the expression level of miR-411-5p was downregulated but the expression level of HCN1 was upregulated. Enhanced miR-411-5p or HCN1 silencing downregulated the elevation of cell viability, proliferation, migration, and fibrosis of H9c2 cells and primary CFs caused by Ang II. MiR-411-5p inhibitors reversed the decline in the viability, proliferation, migration, and fibrosis of H9c2 cells and primary CFs induced by sh-HCN1 transfection. In addition, miR-411-5p targets and negatively regulates HCN1 expression.In conclusion, miR-411-5p alleviated Ang II-induced fibrosis of H9c2 cells and primary CFs by inhibiting HCN1.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 5","pages":"852-861"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206321","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":"Successful Cryoballoon Ablation in Paroxysmal Atrial Fibrillation Patient Post-Esophageal Cancer Surgery.","authors":"Yuji Miyoshi, Shota Tokuno, Yasuko Tanabe, Yuichiro Kawamura, Naoki Nakagawa","doi":"10.1536/ihj.24-541","DOIUrl":"10.1536/ihj.24-541","url":null,"abstract":"<p><p>In conventional radiofrequency ablation for symptomatic paroxysmal atrial fibrillation, there are concerns regarding the risk of esophageal thermal injury (ETI), such as esophageal ulcers and left atrioesophageal fistulas. While the incidence of ETI is generally considered low with cryoballoon ablation, some cases of esophageal ulcers and gastric hypoperistalsis have been reported. In this report, we present the case of a 77-year-old male patient with atrial fibrillation after esophageal surgery who had successfully undergone cryoballoon ablation without esophageal complications, despite the close proximity of the left atrium and gastric tube. Cryoballoon ablation achieved pulmonary vein isolation without complications in the upper alimentary tract.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 1","pages":"183-186"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079434","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":"Concomitant Mitral Valve Surgery in a Modified Morrow Procedure in Patients with Hypertrophic Obstructive Cardiomyopathy.","authors":"Chunshui Liang, Mingwen Li, Ruiyan Ma, Zhao Jian","doi":"10.1536/ihj.24-155","DOIUrl":"10.1536/ihj.24-155","url":null,"abstract":"<p><p>Ventricular septal myectomy (modified Morrow procedure) is the gold standard surgical intervention for hypertrophic obstructive cardiomyopathy (HOCM). However, the indications for a concomitant mitral valve (MV) procedure to relieve mitral regurgitation (MR) or intrinsic MV pathological changes remain controversial. We aimed to retrospectively analyze this series of patients to evaluate the safety and efficiency of the procedure at our center.We retrospectively reviewed a total of 56 consecutive patients with HOCM who underwent concomitant MV surgery with modified Morrow procedures at our center between January 2019 and December 2021. The baseline characteristics, perioperative data, and postoperative outcomes were examined.The operative mortality rate was 0% among all 56 patients. Two patients had complete atrioventricular block, two patients experienced renal failure, and one patient required reoperation for bleeding. The peak gradient of the left ventricular outflow tract decreased from 93.6 ± 34.4 mm Hg to 20.5 ± 13.0 mm Hg. MR was significantly relieved, and the systolic anterior motion of the MV resolved completely after concomitant MV surgery. During a mean follow-up of 13.8 ± 7.1 months, no patient required cardiac reoperation.Concomitant surgery of the MV during the modified Morrow procedure was performed safely and effectively in the treatment of most types of HOCM in our practice.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 2","pages":"252-256"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752614","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":"Coronary Microvascular Dysfunction and Adverse Outcomes in the Spectrum of Dilated Cardiomyopathy.","authors":"Hisanori Kosuge, Masatake Kobayashi, Shoko Hachiya, Yasuhiro Fujita, Satoshi Hida, Kazuhiro Satomi","doi":"10.1536/ihj.24-744","DOIUrl":"10.1536/ihj.24-744","url":null,"abstract":"<p><p>Hypokinetic non-dilated cardiomyopathy (HNDC), a preclinical state of dilated cardiomyopathy (DCM), is characterized by left ventricular (LV) dysfunction without LV dilatation. Although myocardial fibrosis and microvascular dysfunction in DCM are associated with LV remodeling and poor outcome, these characteristics concerning HNDC remain unclear. We compared DCM and HNDC with regard to their clinical characteristics and prognosis.We retrospectively enrolled 100 patients with DCM (n = 64) or HNDC (n = 36) who underwent cardiac magnetic resonance (CMR). DCM and HNDC were classified based on an LV end-diastolic diameter index (LVEDDI). The association of LVEDDI with the composite outcome of all-cause mortality, heart failure hospitalization, or ventricular arrhythmia occurrence was assessed. Phase-contrast cine imaging was performed in a subset of 17 patients (12 with DCM and 5 with HNDC) and 7 control subjects to assess coronary flow reserve (CFR).During the follow-up period (median: 22.0 months; interquartile range: 9.0-33.8 months), patients with DCM showed higher risk of the primary outcome than those with HNDC (P = 0.026). A higher LVEDDI was significantly associated with clinical outcomes even after adjusting for covariates (i.e., brain natriuretic peptide, the presence of late gadolinium enhancement, and LV ejection fraction; adjusted hazard ratio, 1.350; 95% confidence interval, 1.008-1.808; P = 0.044). CFR in HNDC was significantly higher than that in DCM (P < 0.05) and comparable to that in the control group.LV dilatation is an independent predictor of adverse events in DCM and HNDC.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 2","pages":"257-263"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752616","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":"Clinical Courses of Elderly Patients with Heart Failure Managed by Local Partnership Clinical Pathway and Multidisciplinary Care.","authors":"Yuki Yamamoto, Noboru Watanabe, Satoru Hasegawa, Chieko Tanaka, Chie Takano, Takahiro Shimizu, Hirohiko Motoki, Mitsuaki Isobe, Koichiro Kuwahara","doi":"10.1536/ihj.24-467","DOIUrl":"https://doi.org/10.1536/ihj.24-467","url":null,"abstract":"<p><p>Heart failure (HF) is the most critical issue in the medical and long-term care for the elderly because HF is an economic and social burden due to its high prevalence and poor prognosis. General practitioners (GPs) have recently managed patients with chronic HF (CHF) in collaboration with hospital cardiologists. However, little is known about how to collaborate and its outcomes.We have operated a local partnership program using clinical pathway (LPCP) for CHF to facilitate medical and nursing care teamwork in the local community since June 2009. The hospital's multidisciplinary teams evaluate and share patient information periodically. Among 500 patients with available follow-up data as of December 2020, we defined patients who withdrew from the LPCP for reasons other than death as path-dropout (n = 164) and the remaining as path-continue patients (n = 336). The Kaplan-Meier method considering time co-variability of path-dropout, showed a significantly higher hazard ratio of all-cause death in the path-dropout group than in the path-continue group (HR: 5.09; 95% CI: 3.54-7.30, P < 0.001).LPCP provides integrated disease management for CHF by cardiologists and multidisciplinary professionals in the hospital collaborating with local GPs and home care teams. A multivariate analysis identified LPCP as the most important independent predictor of clinical outcome. LPCP may work as an observational tool to distinguish HF patient clinical outcomes.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 3","pages":"352-362"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199001","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":"Risk Factors and Construction of a Predictive Model for Postoperative Early Cognitive Dysfunction in Aortic Dissecting Aneurysms.","authors":"Lu Ding, Yinhuan Xu, Guangpu Fan","doi":"10.1536/ihj.24-686","DOIUrl":"https://doi.org/10.1536/ihj.24-686","url":null,"abstract":"<p><p>This study aimed to investigate the factors influencing cognitive dysfunction in patients with aortic dissection after surgery and to construct a risk prediction model for it.This retrospective study analyzed 122 patients with aortic dissection who were admitted to our hospital between January 1, 2015, and February 29, 2024. First, we grouped the patients based on the early occurrence of postoperative cognitive dysfunction (POCD) after surgery into the POCD and non-POCD groups. We subsequently compared the general clinical data and relevant surgical information between the two groups. Multivariate binary logistic regression analysis was performed to identify the factors influencing early POCD in patients with aortic dissection. Then, the risk prediction model was constructed. Receiver operating characteristic (ROC) curves were used to analyze each factor's predictive effectiveness.Multivariate binary logistic regression analysis revealed that age at surgery (P = 0.042), intensive care unit (ICU) stay duration (P = 0.003), mechanical ventilation time (P = 0.020), and aortic cross-clamping time (P = 0.010) were independent risk factors for early POCD in patients with aortic dissection, while postoperative oxygen saturation (P < 0.001) acted as an independent protective factor. A predictive model was established, achieving a ROC curve, area under the curve of 0.955, 95% confidence interval (0.917, 0.993), sensitivity of 0.878, and specificity of 0.926.Age at surgery, ICU stay duration, mechanical ventilation time, aortic cross-clamping time, and postoperative oxygen saturation were independent influencing factors for predicting early POCD.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 3","pages":"456-462"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199008","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":"METTL3 Modulates Autophagy by Targeting TFEB in Myocardial Hypertrophy.","authors":"Yanan Xie, Wei Jiao, Hongchao Wang, Shaowei Kang, Jie Hao, Jinming Liu, Yongjun Li, Bingyan Guo","doi":"10.1536/ihj.24-683","DOIUrl":"https://doi.org/10.1536/ihj.24-683","url":null,"abstract":"<p><p>The aim of this study was to investigate the mechanism of m6A methylation in pathological myocardial hypertrophy (PMH), focusing on whether the methyltransferase METTL3 regulates the expression and nuclear translocation of the transcription factor EB (TFEB), thereby affecting autophagic activity and exacerbating the development of myocardial hypertrophy.An in vivo PMH model was established in mice via transverse aortic constriction (TAC), and an in vitro hypertrophy model was established using H9C2 cells stimulated with angiotensin II (AngII). HE staining, Western blotting, qRT-PCR, immunofluorescence, and dual-color autophagy flux analyses were employed to detect the expression of autophagy-related proteins (LC3, Beclin-1, P62, ATG5) and apoptosis levels. Changes in TFEB and key m6A-related enzymes (METTL3, ALKBH5, heterogeneous nuclear ribonucleoprotein D [HNRNPD]) were examined, and gene overexpression or knockdown experiments were performed to clarify their roles in regulating autophagy and myocardial hypertrophy. Finally, m6A MeRIP-qPCR and RIP-qPCR were conducted to explore the effect of METTL3 on m6A modification and the stability of TFEB transcripts, verifying the interplay between METTL3 and TFEB and its impact on autophagy.In both the in vivo and in vitro hypertrophy models, autophagy was significantly impaired and apoptosis was elevated, while TFEB mRNA and protein expression and its nuclear localization were clearly reduced. At the same time, global m6A methylation was markedly increased, accompanied by upregulation of METTL3 and HNRNPD, as well as downregulation of ALKBH5. Functional assays indicated that METTL3 overexpression further inhibited autophagy-related protein expression and autophagic flux, whereas METTL3 knockdown partially restored autophagy. Mechanistic studies revealed that METTL3 modulates TFEB pre-mRNA stability by influencing the binding efficiencies of ALKBH5 and HNRNPD, resulting in decreased TFEB expression. Conversely, overexpression of TFEB could partly counteract the autophagy impairment caused by METTL3 overexpression and reciprocally regulate the expression of METTL3, ALKBH5, and HNRNPD.METTL3 mediates the inhibition of TFEB via m6A modification, thereby impairing autophagy and aggravating myocardial hypertrophy. These findings suggest that the m6A-TFEB axis may serve as a novel therapeutic target for preventing and treating myocardial hypertrophy and heart failure, offering new insights into the intervention of cardiac remodeling-related diseases.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 4","pages":"615-627"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753251","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":"The Influence of Lifestyle Factors on the Occurrence of Wild-Type Transthyretin Cardiac Amyloidosis.","authors":"Yuichi Baba, Masahiko Sakaguchi, Yuri Ochi, Toru Kubo, Kei Kawada, Takayoshi Hirota, Naohito Yamasaki, Hiroaki Kitaoka","doi":"10.1536/ihj.25-068","DOIUrl":"https://doi.org/10.1536/ihj.25-068","url":null,"abstract":"<p><p>Wild-type transthyretin cardiac amyloidosis (ATTRwt-CA) is a life-threatening condition caused by the deposition of amyloid fibrils from misfolded transthyretin in the myocardium. While protein misfolding underlies its pathogenesis, the triggers and factors driving disease progression remain unclear. This study explores the relationship between lifestyle factors, particularly oxidative stress, and the incidence of ATTRwt-CA. A lifestyle questionnaire survey was conducted among patients with and without ATTRwt-CA at Kochi Medical School Hospital, Japan. Multivariate regression models were used to assess the odds of ATTRwt-CA occurrence in individuals with identified risk factors. The mean ages of patients in the ATTRwt-CA group (n = 65) and the non-ATTRwt-CA group (n = 65) were 77.9 ± 6.5 years and 78.5 ± 7.4 years, respectively. Multiple logistic regression analysis identified male sex (adjusted odds ratio, 4.35; 95% confidence interval, 1.39-14.29; P = 0.01) as an independent risk factor for ATTRwt-CA. Past sunlight exposure of ≥ 1 hour per day (adjusted odds ratio, 3.21; 95% confidence interval, 0.87-11.88; P = 0.08) showed a tendency towards a positive association with ATTRwt-CA occurrence. In contrast, past black tea consumption (adjusted odds ratio, 0.13; 95% confidence interval, 0.01-1.28; P = 0.08) and past smoking (adjusted odds ratio, 0.29; 95% confidence interval, 0.12-0.72; P < 0.01) were tentatively or significantly associated with ATTRwt-CA occurrence. Lifestyle factors may be linked to the occurrence of ATTRwt-CA, potentially through mechanisms involving oxidative stress.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 4","pages":"577-584"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753257","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":"Difference in the Association between Growth Differentiation Factor 15 and Coronary Calcified Plaque According to Chronic Kidney Disease.","authors":"Hayato Shimizu, Satoshi Hoshide, Hiroshi Funayama, Kazuomi Kario","doi":"10.1536/ihj.24-712","DOIUrl":"https://doi.org/10.1536/ihj.24-712","url":null,"abstract":"<p><p>Growth differentiation factor-15 (GDF-15), a member of the TGF-beta superfamily, is upregulated in response to tissue ischemia and proinflammatory cytokines that promote the onset and progression of atherosclerosis. Given that GDF-15 is also elevated in individuals with kidney dysfunction compared to those without, GDF-15 levels may contribute to pathways that play a role in chronic kidney disease-associated atherosclerosis.In 338 patients with coronary artery disease, we investigated the association between GDF-15 and plaque morphology assessed by intravascular ultrasound. No association was found between log-transformed GDF-15 levels and the percentage of calcified plaque volume in chronic kidney disease (CKD) stages G1-G2 (r = 0.077, P = 0.328) or G3a (r = 0.012, P = 0.910). In contrast, a significant association was observed in stages G3b-G5 (r = 0.275, P < 0.001).Multiple linear regression analysis showed that the highest GDF-15 tertile (≥ 2,567 ng/L) as a categorical variable and GDF-15 levels were associated with the calcified plaque percentage in the CKD stages G3b-G5 (n = 82, Estimate [95% confidence interval], 0.0038 [0.0004, 0.0071]; P = 0.0027). This association was also observed with GDF-15 as a continuous variable (estimate per 2-fold higher, 0.0128 [0.0028, 0.2281]; P = 0.0013). No association was found for other CKD stages.A significant association was found between elevated GDF-15 levels and the presence of calcified coronary plaques, as assessed by intravascular ultrasound, in patients with coronary artery disease and CKD.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 4","pages":"540-546"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753281","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}