International Journal of Colorectal Disease最新文献

{"title":"The efficacy and safety of suvemcitug, envafolimab, and FOLFIRI in microsatellite-stable or mismatch repair-proficient colorectal cancer: preliminary results of a phase 2 study.","authors":"Ying Liu, Jufeng Wang, Yong Fang, Yanhong Deng, Changlu Hu, Qingxia Fan, Kangsheng Gu, Yu Zhang, Chen Yang, Zhenru Liu, Ji Tian, Xiyang Sun, Shuguang Sun, Ying Cheng","doi":"10.1007/s00384-025-04806-z","DOIUrl":"10.1007/s00384-025-04806-z","url":null,"abstract":"<p><strong>Purpose: </strong>This phase II study is designed to evaluate the combination therapy involving suvemcitug and envafolimab with FOLFIRI in microsatellite-stable or mismatch repair-proficient (MSS/pMMR) colorectal cancer (CRC) in the second-line treatment setting.</p><p><strong>Methods: </strong>This study is a non-randomized, open-label prospective study comprising multiple cohorts (NCT05148195). Here, we only report the data from the CRC cohort. Participants received envafolimab, suvemcitug, and FOLFIRI until disease progression, unacceptable toxicity, or voluntary withdrawal. The recommended dose (RD) and objective response rate (ORR) by investigator assessment were primary endpoints. Secondary endpoints comprised progression-free survival (PFS) and duration of response (DoR). Disease control rate (DCR), overall survival (OS), and safety were also analyzed.</p><p><strong>Results: </strong>At the data cutoff, no dose-limiting toxicity event was observed in the safety run-in stage, and 2 mg/kg Q2W was declared as RD for suvemcitug combined with envafolimab and FORFIRI. Among 20 patients, 50.0% and 10.0% had been treated with prior antiangiogenic agents and anti-EGFR agents, respectively. ORR and DCR were 25.0% (95% CI 8.7-49.1%) and 90.0% (95% CI 68.3-98.8%), and DoR was 4.1 months (95% CI 3.02, NE). The median PFS and median OS were 5.6 months (95% CI 4.0-8.3) and not reached (95% CI 8.5, NE) by the time of study closure. Neutrophil count decreased, white blood cell count decreased, and hypertension were the most common grade ≥3 treatment-related adverse events (TRAE).</p><p><strong>Conclusions: </strong>The safety profile was manageable and the preliminary anti-tumor efficacy was observed in patients with MSS/pMMR CRC in this study, who had failed prior to one line of therapy.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"20"},"PeriodicalIF":2.5,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disregarding C-reactive protein in an inflammation-based nomogram?","authors":"Pablo Ortega-Deballon","doi":"10.1007/s00384-025-04812-1","DOIUrl":"10.1007/s00384-025-04812-1","url":null,"abstract":"","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"18"},"PeriodicalIF":2.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning algorithms for predicting pathological complete response in MRI of rectal cancer patients undergoing neoadjuvant chemoradiotherapy: a systematic review.","authors":"Bor-Kang Jong, Zhen-Hao Yu, Yu-Jen Hsu, Sum-Fu Chiang, Jeng-Fu You, Yih-Jong Chern","doi":"10.1007/s00384-025-04809-w","DOIUrl":"10.1007/s00384-025-04809-w","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review examines the utility of deep learning algorithms in predicting pathological complete response (pCR) in rectal cancer patients undergoing neoadjuvant chemoradiotherapy (nCRT). The primary goal is to evaluate the performance of MRI-based artificial intelligence (AI) models and explore factors affecting their diagnostic accuracy.</p><p><strong>Methods: </strong>The review followed PRISMA guidelines and is registered with PROSPERO (CRD42024628017). Literature searches were conducted in PubMed, Embase, and Cochrane Library using keywords such as \"artificial intelligence,\" \"rectal cancer,\" \"MRI,\" and \"pathological complete response.\" Articles involving deep learning models applied to MRI for predicting pCR were included, excluding non-MRI data and studies without AI applications. Data on study characteristics, MRI sequences, AI model details, and performance metrics were extracted. Quality assessment was performed using the PROBAST tool.</p><p><strong>Results: </strong>Out of 512 initial records, 26 studies met the inclusion criteria. Most studies demonstrated promising diagnostic performance, with AUC values for external validation typically exceeding 0.8. The use of T2W and diffusion-weighted imaging (DWI) MRI phases enhanced model accuracy compared to T2W alone. Larger datasets generally correlated with improved model performance. However, heterogeneity in model designs, MRI protocols, and the limited integration of clinical data were noted as challenges.</p><p><strong>Conclusion: </strong>AI-enhanced MRI demonstrates significant potential in predicting pCR in rectal cancer, particularly with T2W + DWI sequences and larger datasets. While integrating clinical data remains controversial, standardizing methodologies and expanding datasets will further enhance model robustness and clinical utility.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"19"},"PeriodicalIF":2.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The global, regional, and national disease burden of colorectal cancer attributable to low physical activity from 1990 to 2021: an analysis of the Global Burden of Disease Study 2021.","authors":"Yanxue Lian, Alwaleed M Alruwaili, Pincheng Luo","doi":"10.1007/s00384-025-04811-2","DOIUrl":"10.1007/s00384-025-04811-2","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to estimate the spatiotemporal variation in the burden of colorectal cancer (CRC) attributable to low physical activity (LPA) at global, regional, and national levels from 1990 to 2021.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>Annual data on deaths of CRC related to LPA, age-standardized mortality rate (ASMR), disability-adjusted life years (DALYs), and the age-standardized DALYs rate (ASDR) for 204 countries and territories from 1990 to 2021 was extracted from the Global Health Data Exchange website. They were retrieved by age (5-year age groups from 25 to 94 years, and 95+ years), gender (male and female), and Socio-demographic Index (SDI). The association between age-standardized rates and SDI values was assessed by Spearman's correlation.</p><p><strong>Results: </strong>Between 1990 and 2021, there was nearly a twofold increase in DALYs and mortality globally for CRC related to LPA, despite decreases in ASMR and ASDR (EAPC: -0.82% and -0.83%, respectively). However, on a national scale, ASMR and ASDR increased in more than half of the world's countries and territories. Moreover, a greater burden of CRC related to LPA was observed in older populations, females, and those residing in regions with an SDI near 0.77.</p><p><strong>Conclusion: </strong>These findings indicate the critical need to raise awareness about the preventive role of physical activity in CRC. Policymakers should prioritize developing and implementing strategies that ensure equitable access to sports resources, enabling more people to meet the World Health Organization guidelines.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"17"},"PeriodicalIF":2.5,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to multi-target stool DNA testing for colorectal cancer screening in the United States.","authors":"Quang A Le, Mallik Greene, Shrey Gohil, A Burak Ozbay, Michael Dore, A Mark Fendrick, Paul Limburg","doi":"10.1007/s00384-025-04805-0","DOIUrl":"10.1007/s00384-025-04805-0","url":null,"abstract":"<p><strong>Purpose: </strong>Colorectal cancer (CRC) is the second leading cause of cancer mortality in the USA and is highly preventable, with early screening vital for improving outcomes. This study aimed to evaluate adherence rates of multi-target stool DNA (mt-sDNA) testing, following updated guidelines recommending screening starting at age 45.</p><p><strong>Methods: </strong>This retrospective cohort study used aggregated data from Exact Sciences Laboratories LLC, examining new users (first-time testers) aged 45-85 with commercial, Medicare, or Medicaid insurance who received mt-sDNA test kits (point-of-care) between January 1, 2023, and June 1, 2023. Adherence was defined as the percentage of eligible participants returning a valid non-empty test kit within 365 days of initial shipment date. Descriptive statistics and logistic regression were used to analyze adherence.</p><p><strong>Results: </strong>Among 1,557,915 patients, the overall adherence rate to mt-sDNA testing was 71.3% (commercial insurance 72.3%, Medicare Advantage 70.2%, Medicare 69.9%, Medicaid 52.0%) (p < 0.001). Females had slightly higher adherence than males, except for commercial insurance (72.2% vs. 72.6%, p < 0.001). Adherence was highest in commercial insurance for individuals aged 76-85 (79.2%, p < 0.001), gastroenterology patients (82.5%, p < 0.001), and rural residents (73.2%, p < 0.001), along with those in Medicare Advantage earning $200 K + (78.5%, p < 0.001).</p><p><strong>Conclusions: </strong>Adherence to mt-sDNA testing was robust, particularly among individuals with commercial insurance, older adults, gastroenterology patients, higher income groups, and rural residents. With a 71% adherence rate, the test demonstrates substantial engagement and value in colorectal cancer screening. Future research should assess its long-term impact and address disparities to optimize its benefits.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"16"},"PeriodicalIF":2.5,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Laparoscopic surgery is associated with increased risk of postoperative peritoneal metastases in T4 colon cancer: a propensity score analysis.","authors":"Shu-Yuan Li, Ye-Wang, Cheng-Xin, Li-Qiang Ji, Shi-Hao Li, Wen-Di Jiang, Chen-Ming Zhang, Wei Zhang, Zheng Lou","doi":"10.1007/s00384-025-04810-3","DOIUrl":"https://doi.org/10.1007/s00384-025-04810-3","url":null,"abstract":"","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"15"},"PeriodicalIF":2.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of post-operative anaemia in patients undergoing surgery for colorectal cancer: a qualitative focus group-based study.","authors":"Samuel Lawday, Susannah Williams, Elizabeth James, Emma L Court, Fiona Carter, Francesca Rushton, Cat Dampier, E J O'Malley, M Barrington, Rob Bethune, Nader Francis","doi":"10.1007/s00384-024-04794-6","DOIUrl":"10.1007/s00384-024-04794-6","url":null,"abstract":"<p><strong>Background: </strong>Optimal management of anaemia following surgery for colorectal cancer remains unclear. Peri-operative anaemia is common in patients undergoing resectional surgery for colorectal cancer. A significant amount of research has been conducted into the management of pre-operative anaemia; however, little work has investigated post-operative anaemia. We intended to investigate the facilitators of and barriers against the standardised correction of post-operative anaemia. These can aid in identifying optimum treatment for patients following surgery for colorectal cancer.</p><p><strong>Methods: </strong>Four focus groups were held with 29 participants from a multidisciplinary panel of healthcare professionals from two different NHS hospital sites in the UK. The discussions were audio recorded and underwent professional transcription. Transcripts were checked against recordings before undergoing thematic analysis using a realist approach.</p><p><strong>Results: </strong>Four themes were identified. The key barriers to standardised post-operative anaemia correction were a lack of protocoled guidelines or a defined pathway, insufficient education and training, and systemic barriers, such as financial drivers and drug availability. The key facilitator identified was collaboration and communication.</p><p><strong>Discussion: </strong>This study has identified several key barriers and thresholds which can be used in future studies to improve the standardised management of post-operative anaemia.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"14"},"PeriodicalIF":2.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current evidence on powered versus manual circular staplers in colorectal surgery: a systematic review and meta-analysis.","authors":"José Martín-Arévalo, David Moro-Valdezate, Leticia Pérez-Santiago, Fernando López-Mozos, Carlos Javier Peña, Juan Antonio Carbonell Asins, David Casado Rodrigo, Stephanie García-Botello, Claudia Gil-Alfosea, Vicente Pla-Martí","doi":"10.1007/s00384-025-04807-y","DOIUrl":"10.1007/s00384-025-04807-y","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis aims to evaluate the efficacy of powered circular staplers (PCS) compared to manual circular staplers (MCS) in reducing anastomotic leakage (AL) and postoperative bleeding (AB) in colorectal surgery.</p><p><strong>Methods: </strong>Extensive searches were performed in the Embase, PubMed, and SCOPUS electronic bibliographic databases. Most studies were of an observational nature, and only one randomized clinical trial was identified.</p><p><strong>Results: </strong>Twelve studies met the inclusion criteria for anastomotic leakage and five for anastomotic hemorrhage. The number of patients included for AL analysis was 4524. The leakage rate was 4.6% (208 cases). The number of patients with AB was 2868 with a bleeding rate of 4.99% (143 patients). After identifying outliers and studies with possible selection bias, the odds ratio (OR) for leaks and PCS was 0.38 (95% CI 0.26-0.55), the relative risk was - 0.05 (95% CI - 0.07 to 0.03), and the number needed to treat to prevent one leak was 20. For bleeding, the PCS OR for PCS was 0.20 (95% CI 0.0772-0.5177).</p><p><strong>Conclusion: </strong>Powered circular staplers could be associated with a significantly lower risk of leakage and anastomotic bleeding than two-row manual circular staplers. Further prospective randomized trials are needed to validate these findings.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"13"},"PeriodicalIF":2.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The fate of the rectum in ulcerative colitis at index surgery and beyond-a contemporary cohort.","authors":"Ian J B Stephens, Brenda Murphy, Niamh McCawley, Deborah A McNamara, John P Burke","doi":"10.1007/s00384-024-04779-5","DOIUrl":"10.1007/s00384-024-04779-5","url":null,"abstract":"<p><strong>Purpose: </strong>Proctectomy is frequently deferred at index colectomy for ulcerative colitis due to acuity or immunosuppressive treatments. The retained rectum remains symptomatic in over 50% with associated cancer risk. Management options include index or delayed proctectomy with or without restoration of continuity or surveillance. Comparative studies of perioperative outcomes and reasons for retaining the rectum are lacking.</p><p><strong>Methods: </strong>This 13-year retrospective cohort assesses the fate of the rectum in 168 ulcerative colitis patients by analysing index proctectomy, staged proctectomy and retained rectal remnant determinants and outcomes. The primary outcome was the fate of the rectum. Secondary analysis included perioperative morbidity, length of stay and decision-making determinants.</p><p><strong>Results: </strong>Proctectomy was performed in 69% of patients, with 16.1% at index surgery. Restorative surgery rate was 44%. Index proctectomy patients were older (54 vs 37 years, p < 0.01), more co-morbid (59.3% vs 38.2%, p = 0.04) and likely to have elective surgery (81.5% vs 21.3%, p < 0.01) or neoplasia (33.3% vs 1.1%, p < 0.01). Outcomes after staged proctectomy were comparable, with age influencing restoration of continuity (33.5 vs 46 years, p < 0.01). Younger patients were indecisive on proctectomy, while those opting for endoscopic surveillance were older (median 65 years, p < 0.01), had more complications (64.3%, p = 0.23) and prolonged hospitalisation (median 15 days, p = 0.02) at colectomy.</p><p><strong>Conclusions: </strong>Index proctocolectomy for ulcerative colitis is infrequently performed. Perioperative outcomes of restorative and non-restorative staged proctectomy are comparable. Perioperative experience at colectomy may influence patient decisions regarding future management of their rectum.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"12"},"PeriodicalIF":2.5,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic impact and risk factors of severe neutropenia in the early phase of treatment with trifluridine-tipiracil for metastatic colorectal cancer patients: a single-center retrospective study.","authors":"Yoshiro Omori, Satoshi Matsukuma, Mikiko Kawa, Kazuki Ishimitsu, Toru Kawaoka, Norio Akiyama, Kazuhisa Tokuno, Yuji Fujita, Shinya Sato, Shigeru Yamamoto","doi":"10.1007/s00384-024-04798-2","DOIUrl":"10.1007/s00384-024-04798-2","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to identify the risk factors for severe neutropenia in the early phase of trifluridine-tipiracil (FTD/TPI) treatment, and their impact on overall survival (OS).</p><p><strong>Methods: </strong>This single-center retrospective study included patients with unresectable metastatic colorectal cancer who were treated with FTD/TPI. The primary endpoint was OS, and the secondary endpoint was severe neutropenia during the first and second cycles of FTD/TPI. We assessed the association between outcomes and potential confounders using multivariate analysis.</p><p><strong>Results: </strong>Of the 77 total patients, 33 developed severe neutropenia during the first and second treatment cycles. In Cox hazard analysis, the independent factors associated with OS were neutropenia ≥ grade 1 during cycles 1 and 2 (adjusted hazard ratio 0.43; 95% confidence interval (CI) 0.21-0.87), combined treatment with bevacizumab (0.47; 95% CI 0.27-0.83), number of metastatic organs ≥ 3 (2.15; 95% CI 1.22-3.82), and time since diagnosis of metastasis until commencement of FTD/TPI < 18 months (1.94; 95% CI 1.13-3.33). Severe neutropenia during cycles 1 and 2 was not associated with OS (0.75; 0.44-1.27). The risk of severe neutropenia adjusted for initial dose reduction was defined as renal impairment with creatinine clearance (Ccr) of < 60 ml/min (adjusted odds ratio, 4.67; 95% CI, 1.38-15.80) and absolute neutrophil count (per 1000/μl, 0.47; 0.27-0.81).</p><p><strong>Conclusion: </strong>The neutropenia ≥ grade 1 during cycles 1 and 2 of FTD/TPI is a predictor of favorable outcomes; however, the effect of severe neutropenia on OS was not clear. Renal impairment was also associated with severe neutropenia.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"11"},"PeriodicalIF":2.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}