International Journal of Rheumatic Diseases最新文献

{"title":"Mechanistic Breakthroughs and Clinical Value of Upadacitinib in Enthesitis Management","authors":"Li Yang, Lu Wang, Qinghua Zou, Chen Li","doi":"10.1111/1756-185X.70317","DOIUrl":"https://doi.org/10.1111/1756-185X.70317","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256273","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":"Paeoniflorin Alleviates Immune Inflammation in Submandibular Gland Epithelial Cells in Sjögren's Syndrome Through Multiple Signaling Pathways","authors":"Zou Xudan, Chen Yueyue, Wu Suling","doi":"10.1111/1756-185X.70297","DOIUrl":"https://doi.org/10.1111/1756-185X.70297","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255937","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":"Acrometastasis of the Third Finger in Widespread Radiation-Induced Angiosarcoma","authors":"Etienne Rivière, Pierre Germain","doi":"10.1111/1756-185X.70324","DOIUrl":"https://doi.org/10.1111/1756-185X.70324","url":null,"abstract":"<p>An 88-year-old woman with dementia, who previously underwent tumorectomy and radiation for left breast cancer in 2007, developed extensive ulcerated purplish nodular lesions of the left breast (Figure 1A) 5 years later. These lesions were identified as angiosarcoma located in the radiotherapy field. Despite receiving four courses of palliative chemotherapy with taxol, she experienced painful swelling in the third phalanx of her left middle finger, initially treated with rifampicin and ofloxacin for 3 weeks. Distal purplish nodular cutaneous lesions (Figure 1B) and radiological evidence of erosion and destruction of the distal phalanx (Figure 1C) persisted. A biopsy confirmed the presence of angiosarcoma acrometastasis, and the patient was provided with best supportive care but passed away 1 month later.</p><p>Acrometastases of the hand are exceptionally rare, comprising less than 0.1% of malignant bone lesions and up to 0.6% in autopsy series [<span>1</span>]. These lesions primarily occur in patients around 60 years of age, often with a history of lung carcinoma, and they carry a poor prognosis, typically averaging around 6 months [<span>2</span>]. In the hand, both metacarpals and phalanges can be affected, with the distal phalanx of the thumb being most commonly involved [<span>3</span>]. These lesions can mimic inflammatory or benign conditions, such as gout or infections, which may lead to misdiagnosis, underreporting, and delayed treatment. Additionally, some patients might overlook their condition due to denial, addiction, or cognitive impairment, resulting in presentation at advanced stages with widespread disease and a poor prognosis, as seen in the patient.</p><p>There are several other complications that can occur after chemotherapy or radiotherapy for breast cancer, including localized pain or skin lesions [<span>4</span>], breast lymphedema [<span>5</span>], radiation-induced fibrosis of the breast [<span>6</span>], skeletal muscle dysfunction [<span>7</span>], osteoporosis [<span>8</span>], neuropathic pain [<span>9</span>], valvular heart disease [<span>10</span>] or cardiovascular toxicity [<span>11</span>], amenorrhea and infertility in younger women [<span>12</span>], metabolic alterations [<span>13</span>] or diabetes and cancer-related fatigue [<span>14</span>], cognitive impairment [<span>15</span>] with or without sleep disturbance [<span>16</span>], anxiety or depression [<span>17</span>], radiation-induced pulmonary fibrosis [<span>18</span>] or bronchiolitis obliterans with organizing pneumonia [<span>19</span>], and second malignancies such as leukemia [<span>20</span>].</p><p>Radiation-induced angiosarcoma of the breast is a very rare and severe complication of radiotherapy, primarily observed in older women, with an estimated incidence of 0.05%–0.3% [<span>21</span>]. The aggressive nature of this tumor and its propensity for metastasis, although unlikely to the finger, might be attributed to dysregulation of angiog","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185X.70324","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256274","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":"Risk Factors for Pneumocystis jirovecii Pneumonia in Rheumatoid Arthritis: The Protective Potential of Salazosulfapyridine","authors":"Yuki Hara,&nbsp;Takuro Nii,&nbsp;Takanori Matsuki,&nbsp;Kazuyuki Tsujino,&nbsp;Keisuke Miki,&nbsp;Akira Miyama,&nbsp;Koichiro Takahi,&nbsp;Hiroshi Kida","doi":"10.1111/1756-185X.70318","DOIUrl":"https://doi.org/10.1111/1756-185X.70318","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this study was to identify the risk factors for <i>Pneumocystis jirovecii</i> pneumonia (PCP) in patients with rheumatoid arthritis (RA) and to recommend appropriate disease-modifying antirheumatic drug (DMARD) selection for those at high risk of developing PCP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective review of patients with RA who were treated with methotrexate or biologic and targeted synthetic DMARDs (b/tsDMARDs). Patients with no chest computed tomography data or those receiving prophylactic sulfamethoxazole–trimethoprim, atovaquone, or inhaled pentamidine were excluded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 554 patients who met the inclusion and exclusion criteria, 16 developed PCP. Multivariate logistic analysis revealed interstitial pneumonia as a significant risk factor for PCP (odds ratio: 4.53, 95% confidence interval: 1.51–13.12), whereas salazosulfapyridine (SASP) use was associated with a reduced risk (odds ratio: 0.11, 95% confidence interval: 0.00–0.81). A Kaplan–Meier analysis comparing the cumulative incidence of PCP between propensity score-matched SASP users and nonusers further demonstrated that SASP use reduced the risk of developing PCP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with RA complicated by interstitial pneumonia are at a higher risk of developing PCP. Although methotrexate and b/tsDMARDs do not increase the risk of developing PCP, SASP may potentially reduce the risk. A prospective study is warranted to investigate the efficacy and safety of SASP in patients with RA at high risk for PCP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185X.70318","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244584","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":"mCRP as a Biomarker of ANCA-Associated Vasculitis","authors":"Chitose Fujita,&nbsp;Yasuo Sakurai,&nbsp;Yuki Yasuda,&nbsp;Masaaki Fujita","doi":"10.1111/1756-185X.70321","DOIUrl":"https://doi.org/10.1111/1756-185X.70321","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244585","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":"Outlook of Future AI-Supported All-Around Rheumatic Disease Management: An Example of Knee Osteoarthritis","authors":"Chih-Wei Chen,&nbsp;Jenny Lin-Hong Shi,&nbsp;Yung-Heng Lee,&nbsp;James Cheng-Chung Wei","doi":"10.1111/1756-185X.70309","DOIUrl":"https://doi.org/10.1111/1756-185X.70309","url":null,"abstract":"&lt;p&gt;Artificial Intelligence (AI) has emerged as a transformative force across various industries, and health care is no exception. In rheumatic disease management, AI holds tremendous potential to revolutionize how we diagnose, predict, and treat this debilitating condition [&lt;span&gt;1, 2&lt;/span&gt;]. Published research has shed light on the transformative potential of AI applications in addressing key aspects of patient care, specifically focusing on pain management. By leveraging AI algorithms and machine learning techniques, healthcare professionals can tap into a wealth of patient-specific data, enabling accurate diagnosis, personalized treatment plans, and enhanced rehabilitation strategies [&lt;span&gt;3&lt;/span&gt;]. Furthermore, the development of intelligent assistive devices and wearables propelled by AI promises to empower individual rheumatic patients to take control of their condition [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Knee osteoarthritis (KOA) is considered the most common form of arthritis that causes disability, which is associated with morphological changes in the subchondral bone, functional restrictions, articular cartilage degeneration, and damage to the surrounding soft tissue [&lt;span&gt;5-7&lt;/span&gt;]. KOA has significant impacts on quality of life, which is also associated with gender, mental health, body weight, and other factors of patients [&lt;span&gt;6&lt;/span&gt;]. This Editorial article takes KOA as an example of remarkable ways AI can contribute to rheumatology disease management.&lt;/p&gt;&lt;p&gt;One of the key challenges in KOA management is the timely and accurate diagnosis of the condition. AI algorithms excel in analyzing medical images, such as X-ray and magnetic resonance imaging (MRI), to detect and assess the severity of KOA. Today, many methods have been developed to diagnose KOA, but problems exist in automatic analysis and transparent diagnostic methods. Farooq et al. [&lt;span&gt;8&lt;/span&gt;] developed a semi-supervised, multitask deep learning model that enhances KL-grade classification (KL-grade refers to Kellgren-Lawrence grade, a common method of classifying the severity of osteoarthritis) of KOA by integrating leg side identification as an auxiliary task, effectively leveraging additional unlabelled data to boost feature learning and achieving high accuracy (75.53%) and robustness across two major public datasets. Gornale et al. [&lt;span&gt;9&lt;/span&gt;] compared the effectiveness of using k-nearest neighbors (KNN) and decision trees in detecting KOA from X-ray images and found that KNN performed better with a high accuracy of 99.80%, showing strong clinical relevance as a reliable computer-aided tool for early diagnosis and grading of osteoarthritis. Tiulpin et al. [&lt;span&gt;10&lt;/span&gt;] introduced a Siamese convolutional neural network (CNN) to automatically diagnose and classify KOA from X-ray images, achieving high accuracy and strong agreement with expert evaluations (agreement with expert annotations on test dataset: 0.83). By incorporating attention maps and probabilistic","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185X.70309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244578","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 Series: Spinal Malalignment and Total Hip Arthroplasty Dislocation in Rheumatoid Arthritis","authors":"Koichi Murata,&nbsp;Takayuki Fujii,&nbsp;Hiromu Ito,&nbsp;Shuichi Matsuda","doi":"10.1111/1756-185X.70319","DOIUrl":"https://doi.org/10.1111/1756-185X.70319","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244579","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":"Application of a Growth-Rate Model to Enhance Subgroup Identification in Heterogeneous Clinical Courses of the Idiopathic Inflammatory Myopathy-Associated Interstitial Lung Disease and Its Prognostic Implication","authors":"Jiahao Tian,&nbsp;You-Jung Ha,&nbsp;Jeong Seok Lee,&nbsp;Eun Young Lee,&nbsp;Jonathan G. Goldin,&nbsp;Grace-Hyun J. Kim","doi":"10.1111/1756-185X.70320","DOIUrl":"https://doi.org/10.1111/1756-185X.70320","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Analyzing longitudinal real-world data with nonuniform study-time intervals is challenging. This study aimed to identify subgroups in heterogeneous clinical courses of idiopathic inflammatory myopathies-associated interstitial lung disease (IIM-ILD) using a growth rate model and to assess their prognostic significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective cohort study, 243 chest high-resolution computed tomography (HRCT) scans from 80 patients with IIM-ILD were analyzed using a computer-aided quantification system to estimate quantitative lung fibrosis (QLF) scores. Longitudinal patterns were identified through a growth-rate model, and a landmark survival analysis was performed using the last HRCT date as an anchor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Using the growth-rate model, we identified five different patterns in the serial QLF scores: progressive (<i>n</i> = 19), improving (<i>n</i> = 20), convex (<i>n</i> = 10), others (mostly concave, <i>n</i> = 22), and stable (<i>n</i> = 9). When the group with the progressive pattern was divided into the rapid progression and slow progression by the median progression rate (<b><i>g</i></b> = 1.029%/month), the rapid progressive group was significantly associated with mortality (Hazard ratio 15.926, 95% confidence interval 1.079–548.324, <i>p</i> = 0.043), compared to the reference group. However, the intensity of immunosuppression or QLF scores at landmark time were not associated with mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Combined volumetric measurement of lung fibrosis and application of growth-rate model had the potential to identify subgroups in analyzing complex, dynamic real-world data of IIMs-ILD. This approach may help extrapolate the future course and provide useful information about prognosis in patients with ILD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244580","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":"Potentially Elevated Rheumatoid Arthritis Risk due to Chemotherapy-Induced Inflammation in Prostate Cancer With Bone Metastasis","authors":"Jide He,&nbsp;Zenan Liu,&nbsp;Qianyang Ni,&nbsp;Jialong Wu,&nbsp;Zhenkun Zhao,&nbsp;Lei Qiu,&nbsp;Zi'ang Li,&nbsp;Hongyin Wang,&nbsp;Sijie Li,&nbsp;Xiushi Lin,&nbsp;Hongsheng Sun,&nbsp;Jian Lu","doi":"10.1111/1756-185X.70315","DOIUrl":"https://doi.org/10.1111/1756-185X.70315","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic inflammation plays a crucial role in the development and progression of rheumatoid arthritis (RA). Prostate cancer with bone metastasis (PCa-BM) is the most common metastatic form of advanced prostate cancer in the elderly, significantly affecting prognosis and quality of life Although chemotherapy is commonly used for PCa-BM, the chronic inflammation it causes may exacerbate the risk of joint injuries to induce RA and related complications. Therefore, exploring the risk of chemotherapy-induced chronic inflammation on RA risk in PCa-BM patients holds critical importance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In vitro and in vivo experiments were used to evaluate the inflammatory response triggered by chemotherapy and its potential impact on RA in PCa-BM. Anti-inflammatory interventions were introduced to assess their effects on cytokine modulation. In vivo, the inflammatory and immunological alterations within the tumor microenvironment of PCa-BM were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Chemotherapy significantly activated inflammatory factors within the tumor microenvironment of PCa-BM. Elevated levels of inflammatory biomarkers, including TNF-α, IL-6, IL-10, IL-17A, and p-STAT3, were observed. Anti-inflammatory intervention resulted in a significant reduction in these chronic inflammatory cytokines induced by chemotherapy, which were associated with RA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Combining anti-inflammatory therapy with chemotherapy effectively reduced inflammatory factors in the tumor microenvironment, which not only delayed tumor progression but also alleviated the chronic inflammatory injury on joints. It is suggested that combining chemotherapy with anti-inflammatory therapy could play a crucial role in managing RA risk in PCa-BM patients, particularly among the elderly with musculoskeletal disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244577","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":"Immunophenotypic Profiling Reveals Circulating Lymphocyte Dysregulation in Primary Sjögren's Syndrome","authors":"Xianghui Wen,&nbsp;Yanli Zhang,&nbsp;Xinyu Wu,&nbsp;Xuqi Zheng,&nbsp;Mingcan Yang,&nbsp;Dong Liu,&nbsp;Budian Liu,&nbsp;Qiujing Wei,&nbsp;Xiehui Chen,&nbsp;Peng Zhang,&nbsp;Jieruo Gu","doi":"10.1111/1756-185X.70276","DOIUrl":"https://doi.org/10.1111/1756-185X.70276","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate peripheral T and B cell subset alterations in primary Sjögren's syndrome (pSS) and their associations with disease activity (ESSDAI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study enrolled 43 patients with pSS and 46 healthy controls (HCs). Demographic data and clinical manifestations were collected for all participants. Flow cytometry was utilized to detect the frequencies of T and B cell subsets in peripheral blood mononuclear cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Primary Sjögren's syndrome patients exhibited elevated naïve CD4+ T cells, central memory CD4+ T cells, virus-specific CD8+ T cells, Th2/Th17 cells, total B cells, and CD21−/low B cells. Conversely, terminally differentiated/exhausted CD4+ T cells, Th1/Tc1 cells, and plasma cells were reduced. ESSDAI correlated positively with Tc cells and CD21−/low B cells and inversely with plasma cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>T and B cell dysregulation may drive immune dysfunction in pSS, with specific subsets linked to disease severity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245051","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}