International Journal of Rheumatic Diseases最新文献

{"title":"Anti-GP210 Antibodies as a Primary Driver of Pruritus: A Hypothetical Two-Hit Model Beyond PBC","authors":"Claudio Karsulovic, Ka Joo, Lía Hojman","doi":"10.1111/1756-185x.70380","DOIUrl":"https://doi.org/10.1111/1756-185x.70380","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767884","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":"Vitamin D Is Associated With Susceptibility and Disease Severity in Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis","authors":"Shovit Ranjan,&nbsp;Bidyut K. Das,&nbsp;Rina Tripathy,&nbsp;Sarit S. Pattanaik,&nbsp;Manoj Parida,&nbsp;Saumya Ranjan Tripathy,&nbsp;Aditya K. Panda","doi":"10.1111/1756-185x.70379","DOIUrl":"https://doi.org/10.1111/1756-185x.70379","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Vitamin D, recognized for its immunomodulatory properties, is potentially associated with autoimmune diseases like systemic lupus erythematosus (SLE). This systematic review and meta-analysis assessed the relationship between Vitamin D levels and SLE, highlighting its role in modulating disease activity and immunological markers like anti-dsDNA, C3, and C4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Case–control studies reporting Vitamin D, disease activity indices, C3, C4, and anti-dsDNA antibody levels in SLE patients and healthy controls were evaluated. Systematic searches in PubMed, Scopus, ScienceDirect, Web of Science, and Embase were last updated on April 6, 2024. Inclusion criteria targeted studies on SLE patients and healthy controls reporting these specific markers. Study quality was assessed with the Newcastle-Ottawa Scale (NOS), and publication bias was checked using Egger's test and Begg's funnel plot. The meta-analyses were conducted with CMAv4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analysis of 43 studies with 2940 SLE patients and 2458 healthy controls showed significantly lower Vitamin D levels in SLE patients (mean difference: −10.070 ng/mL; 95% CI: −12.85 to −7.28; <i>p</i> &lt; 0.001). Vitamin D levels negatively correlated with SLEDAI scores (correlation: −0.427; 95% CI: −0.541 to −0.298; <i>p</i> &lt; 0.001) and anti-dsDNA antibodies (correlation: −0.397; 95% CI: −0.611 to −0.130; <i>p</i> = 0.004), and positively correlated with complement components C3 (correlation: 0.268; 95% CI: 0.077–0.440; <i>p</i> = 0.006) and C4 (correlation: 0.299; 95% CI: 0.192–0.400; <i>p</i> &lt; 0.001). Sensitivity analyses confirmed these findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings revealed a strong association between low Vitamin D levels and increased SLE severity. However, limitations like some inconsistency, small-study biases, and possible language restrictions in study inclusion necessitate cautious interpretation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751505","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 APLAR Recommendations for the Management of Psoriatic Arthritis","authors":"Ying-Ying Leung,&nbsp;Paul Bird,&nbsp;Muhammad Haroon,&nbsp;Mitsumasa Kishimoto,&nbsp;Kichul Shin,&nbsp;Ashish Jacob Mathew,&nbsp;Heizel Reyes,&nbsp;Jeffrey Chau,&nbsp;Dennis Neuen,&nbsp;Praveena Chiowchanwisawakit,&nbsp;Asal Adnan Ridha,&nbsp;Chuanhui Xu,&nbsp;William Taylor,&nbsp;Fariz Yahya,&nbsp;Ho So,&nbsp;Sho Fukui,&nbsp;Nguyen Van Hung,&nbsp;Soosan G. Soroosh,&nbsp;Cesarius Singgih Wahono,&nbsp;Lydia Say Lee Pok,&nbsp;Juan Raphael Gonzales,&nbsp;Yi Wei Yeo,&nbsp;Chathurika Dandeniya,&nbsp;Akimichi Morita,&nbsp;Perdana Aditya Rahman,&nbsp;Shahlaa Basim,&nbsp;Kalum Deshapriya,&nbsp;Eman Satti,&nbsp;Nguyen Duc Phong,&nbsp;Min Jung Kim,&nbsp;Avanish Jha,&nbsp;Priyanka Moovara Cackamvalli,&nbsp;Ahmed Rafique,&nbsp;Md. Nazrul Islam,&nbsp;Lai-Shan Tam","doi":"10.1111/1756-185x.70372","DOIUrl":"https://doi.org/10.1111/1756-185x.70372","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Under the auspices of the Asia-Pacific League of Associations for Rheumatology (APLAR), we aimed to develop broad, evidence- and consensus-based guidelines to aid health professionals managing patients with psoriatic arthritis (PsA) in the region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A working group of 35 members comprising rheumatologists, dermatologists, and patient research partners from 18 APLAR countries was convened. The working group conducted systematic literature reviews to derive the quality of evidence via GRADE methods in supporting the efficacy and safety of classes of therapeutic agents for the management of active PsA, its comorbidities, and screening for specific infection concerns in the region. Recommendation statements on the principles of management and the best use of therapeutic drugs were developed. Consensus within the working group was achieved. An external voting panel, five from each of the 18 APLAR countries, was convened to confirm further agreement on the recommendation statements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The main literature review included 178 articles from clinical trials for PsA. Additional articles on the evidence for managing comorbidities, uveitis, inflammatory bowel disease, and screening for chronic hepatitis B and latent tuberculosis were reviewed. The working group discussed and reached consensus on eight management principles and 16 recommendation statements for managing PsA. Endorsement from an external voting panel (<i>n</i> = 90, response rate 80%) was achieved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These first recommendations for the management of PsA patients in the APLAR regions were developed based on the best available evidence and region-specific considerations through discussion among rheumatologists, dermatologists, and patients, with strong agreement from an external expert panel.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 8","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144716549","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":"Exploring the Targets of Gulao Yukang Pill in Rheumatoid Arthritis via the Hippo Signaling Pathway: An Integrated Network Pharmacology and Experimental Validation Study","authors":"Tao Wang,&nbsp;Gang Wang,&nbsp;Jia Wang,&nbsp;Ganggang Jiang,&nbsp;Hailong Liu,&nbsp;Ganggang Jiang","doi":"10.1111/1756-185x.70367","DOIUrl":"https://doi.org/10.1111/1756-185x.70367","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Investigating the Mechanism of Gulao Yukang Pill (GLYK) in Treating Rheumatoid Arthritis (RA) via the Hippo signaling pathway and Its Regulatory Effects on <i>Th17</i>/<i>Treg</i> Cell Balance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Network pharmacology was applied to construct a network mapping the interactions between drug active ingredients and target genes, pinpointing the crucial active components and genetic targets through which GLYK exerts its effects on RA. Using Gene Set Variation Analysis (GSVA) in R4.2.2, we predicted the pathway activity scores of 7 Hippo pathways between the disease and control groups and selected those with significant differences. Key genes were correlated with the selected pathways, and target genes related to the Hippo pathway were screened. The binding capacity of crucial active components and their corresponding target genes was predicted using the Deep Purpose algorithm framework. Targets acting on RA were screened, and a CIA (Collagen-Induced Arthritis) animal model was developed for the purpose of further demonstrating the therapeutic impact of GLYK on RA and to verify the results of network pharmacology through histopathological observation, ELISA method detection, flow cytometry detection, Western blot detection, and qRT-PCR detection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Network pharmacology has identified nine key targets in the Hippo pathway associated with rheumatoid arthritis (RA) treatment, including Mst1 and TAZ, which are critical for GLYK's therapeutic effects as they are linked to its core effective ingredients that mediate the treatment of RA. Animal experiments validated the network pharmacology predictions, confirming that Mst1 and TAZ in the Hippo pathway are pivotal therapeutic targets for RA. GLYK suppresses inflammation and bone destruction by inhibiting the Hippo pathway components Mst1/TAZ, thereby reducing the <i>Th17</i>/<i>Treg</i> ratio.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>GLYK can influence the expression of upstream core molecules Mst1 and downstream effector molecules TAZ in the Hippo pathway, which can reduce the swelling and arthritis index of CIA rats, lower the proportion of <i>Th17</i>/<i>Treg</i> cells, inhibit inflammation, and bone destruction. The Hippo pathway is a goal of GLYK in the intervention of RA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 8","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144716819","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":"Case(s) Report: Clinical, Laboratory, and Histopathological Profile of Kikuchi–Fujimoto Disease in Young Adults","authors":"Rahul Kumar,&nbsp;Tanvi Batra,&nbsp;Atul Kakar","doi":"10.1111/1756-185x.70381","DOIUrl":"https://doi.org/10.1111/1756-185x.70381","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 8","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144716544","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":"Diagnostic Utility of Biomarkers in Anaphylaxis: A Systematic Review and MetaAnalysis—Correspondence","authors":"Fu-Tang Lin,&nbsp;Huai-An Yin,&nbsp;Yan-Ru Xiao,&nbsp;Chin-Yuan Yii,&nbsp;Chia-Jung Li,&nbsp;Su-Boon Yong","doi":"10.1111/1756-185x.70371","DOIUrl":"https://doi.org/10.1111/1756-185x.70371","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681170","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":"Adalimumab Versus JAK Inhibitors in Juvenile Idiopathic Arthritis","authors":"Tsai-Yi Hung,&nbsp;Yung-Heng Lee,&nbsp;Brian Shiian Chen,&nbsp;Chen Dong,&nbsp;An-Ping Huo","doi":"10.1111/1756-185x.70368","DOIUrl":"https://doi.org/10.1111/1756-185x.70368","url":null,"abstract":"&lt;p&gt;Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease that begins in childhood and is characterized by persistent joint inflammation. It includes a diverse and heterogeneous group of conditions categorized into seven subtypes based on clinical manifestations, genetic, and serological factors [&lt;span&gt;1&lt;/span&gt;]. If left untreated, JIA can lead to a poor health-related quality of life (HRQoL), significant functional impairment, and disability. According to the American College of Rheumatology (ACR) guidelines, first-line treatment for JIA typically involves nonsteroidal anti-inflammatory drugs (NSAIDs), intra-articular glucocorticoids, and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). If the response is inadequate, biological DMARDs (bDMARDs), such as tumor necrosis factor inhibitors (TNFi), may be considered as a second-line treatment [&lt;span&gt;2&lt;/span&gt;]. With ongoing advances in pharmacotherapy, Janus kinase inhibitors (JAKi) have also emerged as a treatment option.&lt;/p&gt;&lt;p&gt;TNFi effectively manages JIA by targeting and neutralizing TNF-α, a key cytokine driving inflammation in immune-mediated conditions. Currently, the TNFi available for treating JIA include adalimumab, etanercept, golimumab, and infliximab. A systematic review found limited evidence of differences in the efficacy and safety of TNFi across various JIA categories [&lt;span&gt;3&lt;/span&gt;], although a 2017 review noted variable responses to biologics by JIA category and underrepresentation of specific categories in studies [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;A randomized controlled trial (RCT) indicates that adalimumab, either alone or in combination with methotrexate, is an effective treatment for children with JIA. It significantly reduces joint inflammation and swelling [&lt;span&gt;5&lt;/span&gt;]. Additional research has also evaluated the long-term safety and efficacy of adalimumab for JIA patients, finding that it is well tolerated and leads to significant clinical improvements. However, its retention rate is relatively low, mainly due to non-treatment-related factors [&lt;span&gt;6&lt;/span&gt;]. Despite significant advancements in treatment over the past two decades, approximately one-quarter of patients with JIA remain resistant to these therapies [&lt;span&gt;7&lt;/span&gt;]. This underscores the need to develop new medications explicitly targeting these challenging cases.&lt;/p&gt;&lt;p&gt;JAKi is a novel class of small-molecule medications. In contrast to the injectable options required for bDMARDs, their oral formulation may improve medication adherence. This is particularly beneficial for children, adolescents, and individuals with needle aversion. JAKi reduces inflammation and modulates immune responses by inhibiting Janus kinase activity, which blocks cytokine signaling—a key driver of various inflammatory processes. Different JAKis target distinct JAK enzymes, resulting in varied clinical applications in JIA subtypes. According to phase 3 clinical trials, tofacitinib is approved for polyart","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185x.70368","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Practice Consensus Statement 2025: Management of Hyperuricemia and Gout in Adolescents","authors":"Changgui Li,&nbsp;Jie Lu,&nbsp;Zhaohui Lyu,&nbsp;Haibing Chen,&nbsp;Benli Su,&nbsp;Bo Ban,&nbsp;Jianhua Mao,&nbsp;Ping Liu,&nbsp;Zhifeng Cheng,&nbsp;Jun Zhu,&nbsp;Naijun Wan,&nbsp;Xiaobo Chen,&nbsp;Chunxiu Gong,&nbsp;Peiyu Ye,&nbsp;Mingshu Sun,&nbsp;Wenyan Sun,&nbsp;Hui Zhang,&nbsp;Han Yin,&nbsp;Xiaoyun Jiang,&nbsp;Qing Wang,&nbsp;Yaolong Chen,&nbsp;Hsiao-Yi Lin,&nbsp;Jie Mi,&nbsp;Jiajun Zhao","doi":"10.1111/1756-185x.70378","DOIUrl":"https://doi.org/10.1111/1756-185x.70378","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In response to the increasing global prevalence of gout, there is a concerning shift towards a younger demographic, with China at the forefront of this trend. Hyperuricemia, a central factor in the pathogenesis of gout, is becoming increasingly common among adolescents, particularly males, and is associated with various health risks, including joint pain, CKD, metabolic disorders, and premature death. Despite the seriousness of this issue, there is a lack of specific guidelines addressing adolescent and hyperuricemia gout management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The working comprising 26 clinician pediatricians, rheumatologists, and endocrinologists, all experienced in the clinical presentation and management of gout and hyperuricemia, was convened to develop a consensus. A systematic literature search was conducted in PubMed, the Cochrane Library, and EMBASE published from 1 January 1960 to 31 May 2024. Two rounds of Delphi surveys for each recommendation were conducted among all group members via electronic questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Adolescent-onset gout is characterized by a pronounced genetic predisposition and distinct environmental influences, with a significant number of cases reporting a positive family history. We issued three consensus statements with five recommendations including the criteria, the urate-lowering treatment, and flare therapy principles for hyperuricemia and gout in adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This consensus statement comprehensively delves into the critical clinical challenges associated with gout and hyperuricemia in the adolescent population, emphasizing the pressing requirement for improved detection and management strategies to support a demographic that may be underserved by the healthcare system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185x.70378","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Sacroiliitis in Familial Mediterranean Fever Mimicking Septic Arthritis—A Diagnostic Challenge","authors":"Mert Tokatlı,&nbsp;Büşra Fırlatan Yazgan,&nbsp;Buğu Bulat,&nbsp;Ahmet Gürkan Erdemir,&nbsp;Levent Kılıç","doi":"10.1111/1756-185x.70369","DOIUrl":"https://doi.org/10.1111/1756-185x.70369","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673132","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":"Bibliometric Analysis of Juvenile Idiopathic Arthritis From 2012 to 2023","authors":"Shuolan Jing,&nbsp;Shihao Li,&nbsp;Liqun Dong","doi":"10.1111/1756-185x.70359","DOIUrl":"https://doi.org/10.1111/1756-185x.70359","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666482","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}