International Urology and Nephrology最新文献

{"title":"Initial clinical experience with RADA16 as a novel therapeutic for severe haemorrhagic radiation cystitis: a preliminary feasibility case series.","authors":"Petre Cristian Ilie, Anne Carrie, Yacine Touati, Robert Mills, Croitoru Radu, Claudiu Tanase, Ruth Doherty, Will Finch, David Manson-Bahr, Fiona Richardson, Tom Dymond, Lee Smith","doi":"10.1007/s11255-026-05219-9","DOIUrl":"10.1007/s11255-026-05219-9","url":null,"abstract":"<p><strong>Background: </strong>Haemorrhagic radiation cystitis (HRC) is a challenging complication of pelvic radiotherapy, often resistant to conventional treatments.</p><p><strong>Aims: </strong>To evaluate the clinical efficacy and safety of RADA16, a self-assembling peptide, in managing severe HRC.</p><p><strong>Methods: </strong>A preliminary feasibility case series of five consecutive patients treated at two UK hospitals. All patients had persistent haematuria despite standard interventions and received RADA16 via flexible or rigid cystoscopy.</p><p><strong>Results: </strong>The findings from the cases suggest that all patients have experienced at least a partial or early resolution of haematuria and no adverse effects were reported. In most cases, two applications of RADA16 were sufficient. The longest patient followed up was still symptom free at 3 years.</p><p><strong>Discussion: </strong>This preliminary feasibility case series has demonstrated early efficacy for RADA16 in the management of HRC.</p><p><strong>Conclusions: </strong>RADA16 is a potentially promising minimally invasive treatment for refractory HRC. Further trials are warranted to confirm these findings.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4751-4755"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053890","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":"Secreted frizzled-related protein 1 augments vascular smooth muscle cell calcification via activating the Wnt/β-catenin/Runx2 axis.","authors":"Huihui Chen, Guolei Zhang, Jingjing Jin, Mei Juan Cheng, Dongxue Zhang, Zhezhe Niu, Rongfang Zhu, Yuetong Qian, Xiangnan Liang, Lei He, Wei Zhou, Shenglei Zhang, Yaling Bai, Jin Sheng Xu","doi":"10.1007/s11255-026-05167-4","DOIUrl":"10.1007/s11255-026-05167-4","url":null,"abstract":"<p><strong>Purpose: </strong>Vascular calcification (VC) is highly prevalent and a significant cardiovascular risk factor in patients with chronic kidney disease (CKD). Secreted frizzled-related protein 1 (SFRP1) is a secreted glycoprotein closely associated with the Wnt/β-catenin pathway which plays a crucial role in bone formation, but its function and mechanism in VC remain unknown.</p><p><strong>Methods: </strong>Serum and radial artery tissues were collected from CKD patients with or without VC. The cellular model of VSMCs' calcification was established under high-phosphate conditions in vitro. Western blot, qRT-PCR, and immunofluorescence were used to detect SFRP1 expression. The function of SFRP1 was identified by transfection with sh-SFRP1 and pCMV3-SFRP1 plasmid.</p><p><strong>Results: </strong>Initially, bioinformatics analysis showed that SFRP1 expression was significantly elevated in high-phosphate-stimulated rat VSMCs. Subsequently, we discovered that the expression of SFRP1 was dramatically increased in the calcified arteries of CKD patients. Functionally, when SFRP1 was knocked down, the calcification process and the expression of Runx2 were attenuated. In contrast, SFRP1 overexpression exacerbated the β-GP-induced VSMCs' calcification. Mechanistically, we confirmed the activation of Wnt/β-catenin signaling in the in vitro calcification model and this activation was inhibited by SFRP1 knockdown. Furthermore, when the Wnt/β-catenin signaling was enhanced with LiCl, the suppressing effect of SFRP1 knockdown on β-GP-induced osteogenic transdifferentiation of VSMCs was reversed, and calcification was promoted.</p><p><strong>Conclusion: </strong>We identified that SFRP1 promoted vascular calcification in CKD partly by regulating the Wnt/β-catenin/Runx2 axis, suggesting that SFRP1 may be a potential biomarker and therapeutic target for VC in CKD.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4949-4964"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863929","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":"Percutaneous nephrolithotomy among patients with upper urinary system anomalies: evaluating the prevalence, types, characteristics and comparing its outcomes with other patients: a prospective, comparative study of 1485 patients.","authors":"Anahita Ansari Djafari, Babak Javanmard, Mohammad Seifipoor, Sina Samenezhad","doi":"10.1007/s11255-026-05202-4","DOIUrl":"10.1007/s11255-026-05202-4","url":null,"abstract":"<p><strong>Background and purpose: </strong>PCNL plays an important role in the treatment of kidney stones, but since it is less defined for patients with anomalous urinary system, their management is challenging. This study attempts to resolve this issue to help the urologist to properly assess the patients before, during, and after surgery.</p><p><strong>Materials and methods: </strong>A prospective study data were collected for 1485 PCNL candidates treated over 3 years (Sep 2022-Dec 2025). According to preoperative and intraoperative imaging, the samples were divided into two groups: abnormal (n = 121) and normal (n = 1364) groups and compared.</p><p><strong>Results: </strong>The prevalence of anomalies was 8.1%, with bifid or trifid pelvis 4.5%, mal-rotation 1.3%, duplex system 1.1%, infundibulum stenosis 0.5%, and horseshoe kidney 0.4% being the most common, and others being rare. In the anomaly group, the stones were mostly mixed (73.5%) with a dominant calcium component. Uric acid and struvite types were slightly more common than in the normal group. There was no statistically significant gender difference between the two groups. (P = 0.54) The mean age of the normal group was 40.8 ± 8.6 years and the anomaly group was 37.9 ± 8.8 years. The mean length of hospitalization in the anomaly group was 3.60 ± 0.89 days which was significantly longer than the normal group (P < 0.0001). There was no difference in body mass index (BMI) between the groups (P = 0.144). In the anomaly group, 84.3% had a history of related procedures. Number of access in the anomaly group was more than in the normal group (1.09 ± 0.28 vs. 1.18 ± 0.39 and P = 0.01). There were more upper access and puncture sites. In the anomaly group, the surgical duration was 66.5 ± 28.1 min, which was more than in the normal group. (P = 0.0003) In the anomaly group, 73.6% were stone-free in the first operation, compared to 82.2% in the normal group. (P = 0.019) Postoperative complications in the anomaly group occurred in 47.1% and more than in normal individuals, but major complications in the anomaly group were comparable to the normal group. (P = 0.43).</p><p><strong>Conclusion: </strong>Types of urinary system anomalies and their prevalence in PCNL candidate patients and postoperative outcomes indicate the importance of the subject. It seems necessary to achieve appropriate criteria for comparison and correct understanding of future studies. Ultimately, PCNL in patients with upper urinary tract anomalies is associated with increased technical complexity, reduced stone-free rates, and higher overall complication rates. Although it remains a viable treatment modality, these outcomes should be carefully considered during preoperative counseling and surgical planning.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4729-4737"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015496","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":"Development and validation of a machine learning-based prediction model for malnutrition risk in peritoneal dialysis patients: a multi‑center retrospective study.","authors":"Na Li, Min Xu, Xiaodan Wei, Yao Qu, Huimin Zhang, Ying Liu","doi":"10.1007/s11255-026-05223-z","DOIUrl":"10.1007/s11255-026-05223-z","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and validate a machine learning (ML)‑based model for predicting malnutrition risk in patients undergoing maintenance peritoneal dialysis (PD) using routinely available clinical and laboratory data.</p><p><strong>Methods: </strong>A multicenter retrospective cohort study was conducted. Adults with end-stage renal disease who received PD for at least 90 days were enrolled from two tertiary hospitals. Malnutrition was defined by a 35-point Modified Quantitative Subjective Global Assessment (mSGA) score > 7 at 3-month post-enrollment. Candidate predictors included demographics, laboratory indices, dialysis parameters, comorbidities, and psychosocial scores. After feature selection via LASSO regression, three models-logistic regression (LR), Random Forest (RF), and eXtreme Gradient Boosting (XGBoost)-were trained and optimized. Model performance was evaluated on an internal and an independent external validation set using discrimination (AUC), calibration, and decision curve analysis (DCA). Model interpretability was enhanced with SHAP analysis and a clinical nomogram.</p><p><strong>Results: </strong>Among 497 included patients, 29.8% were malnourished. Nine predictors were selected by LASSO: age, dialysis vintage, serum albumin, high‑sensitivity C‑reactive protein (hs‑CRP), hemoglobin, total weekly Kt/V, depression score (SDS), anxiety score (SAS), and diabetic nephropathy as the primary cause. XGBoost achieved the highest discrimination, with an AUC of 0.868 (95% CI 0.792-0.944) on internal validation and 0.857 (95% CI 0.805-0.909) on external validation, significantly outperforming LR (p = 0.023). Calibration was excellent (confirmed by calibration intercept, slope, and Brier score), and DCA demonstrated superior net benefit across clinically relevant risk thresholds. Serum albumin, hs‑CRP, and total weekly Kt/V were consistently the most influential predictors across all models.</p><p><strong>Conclusions: </strong>An XGBoost‑based ML model effectively predicts malnutrition risk in PD patients using readily available clinical data. With robust validation, interpretable outputs (SHAP, nomogram), and confirmed clinical utility, this tool holds promise for early identification and targeted intervention in high‑risk patients.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"5087-5106"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative analysis of variant histology and urothelial bladder cancer following radical cystectomy.","authors":"Thomas McMaster, Gabrielle Hoskin, David Homewood, Abigail Attwell-Heap, Joanna Perry-Keene, Vanessa Harrison, Chandrasekhar Perumalla, Sam Chopra","doi":"10.1007/s11255-026-05234-w","DOIUrl":"10.1007/s11255-026-05234-w","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the prevalence of variant histology bladder cancer subtypes and compare survival and oncological outcomes following radical cystectomy, in urothelial and variant histology cohorts, at a high-volume Australian center.</p><p><strong>Method: </strong>A five-year retrospective cohort study, including 82 patients at a tertiary center in Queensland, Australia. Inclusion criteria comprised patients over 18 years old with localized high-risk bladder cancer and who underwent open cystectomy plus ileal conduit, with curative intent. Exclusion criteria included metastatic disease, an indication other than malignancy and treatment with palliative intent. Statistical analysis was performed using R version 4.4.1, with statistical significance reported at p < 0.05.</p><p><strong>Results: </strong>Variant histology comprised 26% of the study cohort with a greater proportion of highly aggressive VH subtypes observed in the data compared to current literature. On multivariable analysis, VH was not associated with a higher risk of mortality. However, muscle-invasive disease and positive lymph nodes were independently associated with a significant risk of mortality (P = 0.009 and P = 0.048, respectively). Within the VH bladder cancer group, there was a greater proportion (62%) found to be stage > T1 post-cystectomy, compared to the urothelial group (41%).</p><p><strong>Conclusion: </strong>This is the only Australian study examining outcomes post-radical cystectomy across multiple VH subtypes. Highly aggressive subtypes (micropapillary, plasmacytoid, sarcomatoid) were over-represented in our cohort. Improved recognition of VH guides multidisciplinary decision-making while a standard of care is yet to be established. Multicentered Australian registries with long-term follow-up are needed to enhance statistical analysis and evaluate the impact of variant histology on treatment outcomes.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4791-4798"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217586","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":"Charting the unseen: 3D mapping of latent prostate cancer infers its likely origin and growth patterns.","authors":"Shijie Jin, Zhiyuan Yang, Zhipeng Mai, Yuliang Chen, Miao Ren, Yi Zhou, Wenze Wang, Yu Xiao, Zhien Zhou, Weigang Yan","doi":"10.1007/s11255-026-05230-0","DOIUrl":"10.1007/s11255-026-05230-0","url":null,"abstract":"<p><strong>Purpose: </strong>Latent prostate cancers discovered at autopsy may represent the earliest, subclinical stage of the disease. This study aimed to construct three-dimensional (3D) spatial distribution maps of these tumors to infer their likely origin and growth patterns.</p><p><strong>Methods: </strong>A total of 161 tumor lesions from 230 cadaver donors were stratified by volume (V1: 0-0.05 ml; V2: 0.05-0.1 ml; V3: 0.1-0.5 ml; V4: > 0.5 ml) and registered to a standardized MRI-based reference prostate model using Advanced Normalization Tools. Two-dimensional frequency maps were generated per axial layer and stacked into a 3D map.</p><p><strong>Results: </strong>The smallest tumors (V1) originated almost exclusively in the peripheral zone (83.5%), concentrated in the apical two-thirds of the gland (95.9%), with a uniform distribution across the anterior-posterior and left-right axes. As tumor volume increased (V2 to V4), three distinct growth patterns emerged: (1) increased invasion into the transition zone; (2) horizontal convergence into three \"hotspots\"-the anterior midline and bilateral posterolateral regions; and (3) vertical concentration within layers III to IX. A compact \"susceptible region\" occupying only 9.8% of the gland volume harbored 88.2% of the largest (V4) tumors.</p><p><strong>Conclusion: </strong>Latent prostate cancers appear to originate predominantly within the apical-to-mid peripheral zone with an initially uniform spatial distribution. Their growth is anisotropic, favoring the anterior midline and bilateral posterolateral zones while concentrating vertically within the central 20-40% of the prostatic height. These spatial patterns point to target areas that may improve biopsy strategies and focal therapy planning.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4775-4782"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175835","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 global, regional, and Chinese disease burden of acute glomerulonephritis from 1990 to 2021 and future trends up to 2039 based on the 2021 Global Burden of Disease Database.","authors":"Xiangjin Li, Huijuan Ma, Hui Xu","doi":"10.1007/s11255-026-05226-w","DOIUrl":"10.1007/s11255-026-05226-w","url":null,"abstract":"<p><strong>Purpose: </strong>Acute glomerulonephritis (AGN) is a non-infectious inflammation of the glomeruli. Severe AGN can lead to acute renal failure, imposing substantial economic burdens on society. GBD database provided comprehensive data for analyzing global disease trends. Therefore, a thorough assessment of AGN-related burden is essential to inform mitigation strategies.</p><p><strong>Methods: </strong>In this study, the incidence, mortality, disability-adjusted life years (DALYs), their rates, and corresponding age-standardised rates (ASR) from 1990 to 2021 were systematically described. Trends in the disease burden of AGN across different age groups and genders were further analyzed at the global, regional, and Chinese levels. Additionally, an age-period-cohort model (APCM) was constructed to predict potential future trends.</p><p><strong>Results: </strong>In 2021, the incidence, mortality, DALYs, and their corresponding rates of AGN diseases declined significantly globally compared to 1990, yet China maintained relatively high levels of these indicators. Age-stratified analysis showed that individuals aged 0-14 had substantially higher AGN disease burden rates than other age groups. Projections for 2022-2039 indicate rising AGN incidence and age-standardized incidence rate (ASIR), but decreasing mortality/age-standardized mortality rate (ASMR) and DALYs/age-standardized DALYs rate (ASDR). This study highlights the need for increased attention to AGN disease burden in children aged 0-14, China, and regions with medium SDI.</p><p><strong>Conclusion: </strong>This study systematically described the trends of AGN disease at the global, regional, and Chinese levels from 1990 to 2021 and predicted possible future trends. The findings provided valuable tools for assessing the disease burden of AGN.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"5071-5085"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138016","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":"Conceptual and interpretive considerations in MRI-based characterisation of urethral biomechanics during voiding.","authors":"Ayesha Rizwan, Syeda Maryam Batool, Syeda Erum Batool, Syed Muhammad Adil Rasheed Zaidi, Aisha Miral Imran Afzal, Muhammad Hassan Saeed","doi":"10.1007/s11255-026-05242-w","DOIUrl":"10.1007/s11255-026-05242-w","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4841-4842"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294997","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":"Prediction is not decision: why frailty must guide clinical choices in hemodialysis.","authors":"Fabrizio Cristiano","doi":"10.1007/s11255-026-05170-9","DOIUrl":"10.1007/s11255-026-05170-9","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"5115-5116"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837762","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":"Meta-analysis of the impact of serum phosphorus reduction on the prognosis of non-dialysis CKD patients: evidence based on clinical outcomes.","authors":"Yizhe Xin, Rujia Wang, Ying Guo, Yue Qiu, Bin Fu","doi":"10.1007/s11255-026-05165-6","DOIUrl":"10.1007/s11255-026-05165-6","url":null,"abstract":"<p><strong>Background: </strong>Existing research on phosphorus-lowering in CKD predominantly focuses on dialysis patients and intermediate biomarkers like serum phosphorus and PTH, lacking evidence on hard clinical outcomes such as ESRD progression or mortality in non-dialysis CKD. With limited supporting evidence in KDIGO guidelines, this study systematically evaluates active phosphate-lowering on mortality and renal progression in this population.</p><p><strong>Methods: </strong>This study identified and included eligible RCTs from Chinese and English databases up to August 2025, including CNKI, Wanfang, VIP, CBM, Cochrane, Embase, Medline, and PubMed. Methodologically, it innovatively categorized subjects into \"greater reduction\" and \"smaller reduction\" groups based on actual achieved serum phosphate reduction, rather than by intervention type, to directly evaluate the relationship between phosphorus-lowering efficacy and clinical outcomes (mortality and dialysis).</p><p><strong>Results: </strong>A total of 27 randomized controlled trials were included, involving 3149 non-dialysis CKD patients. Meta-analysis shows that actively reducing serum phosphorus can significantly delay the progression of renal function in non-dialysis CKD patients, reduce their all-cause mortality rate (RR, 0.52; 95% CI 0.35-0.75; heterogeneity I² = 0%), and lower the risk of entering dialysis (RR, 0.60; 95% CI 0.48-0.75; heterogeneity I² = 0%).</p><p><strong>Conclusion: </strong>The results of the meta-analysis suggest that for non-dialysis CKD patients, actively intensifying phosphate-lowering therapy can effectively delay disease progression, delay dialysis initiation, and reduce the risk of death. The research results provide important basis for individualized phosphorus management strategies for non-dialysis CKD patients, and provide strong data support for the recommendations of controlling serum phosphorus in the KDIGO guidelines.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4843-4856"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863990","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}