Journal of Clinical Periodontology最新文献

{"title":"Diagnostic Accuracy of a Point-Of-Care aMMP-8 Test for Discriminating Periodontal Health Status in Adults: Validation Trials and Updated Meta-Analysis.","authors":"Yuan Li, Julie Choi Ka Kung, Junyu Shi, Xinyu Wu, Steve Lut Ting Lam, Ke Deng, Xiao Zhang, Hongchang Lai, George Pelekos, Lijian Jin, Maurizio S Tonetti","doi":"10.1111/jcpe.14119","DOIUrl":"https://doi.org/10.1111/jcpe.14119","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the diagnostic accuracy of an active matrix metalloproteinase-8 (aMMP-8) point-of-care oral rinse test (POC-ORT) for predicting periodontitis in treatment-naïve subjects in two independent studies and update a recent meta-analysis.</p><p><strong>Methods: </strong>The aMMP-8 POC-ORT index test was performed in a representative population in Hong Kong, China, and a consecutive convenience sample in Shanghai, China. The reference standard was the 2017 World Workshop classification of periodontal diseases. Sensitivity, specificity, and the area under the receiver operating characteristic (AUROC) curve were assessed. The original data were used to update a recent Bayesian meta-analysis following the current Cochrane guideline for diagnostic trials. The GRADE framework was used to interpret the strength and certainty of the evidence.</p><p><strong>Results: </strong>Three-hundred and eighty-four and 390 subjects were enrolled in the Hong Kong and Shanghai studies, respectively; 74.5% and 67.2% had periodontitis. An aMMP-8-positive test predicted periodontitis with an AUROC of 0.661 and 0.669 in the two studies. The updated systematic review and meta-analysis included eight studies and 2048 subjects. After considering the risk of bias, indirectness, inconsistency, imprecision and publication bias, it showed moderate certainty of a sensitivity of 0.59 (95% CrI: 0.42-0.75), a specificity of 0.82 (95% CrI: 0.68-0.93) and a hierarchical summary AUROC of 0.77 (95% CrI: 0.74-0.81).</p><p><strong>Conclusion: </strong>There is moderate certainty that the aMMP-8 POC-ORT test predicts periodontitis with low to moderate sensitivity, moderate to high specificity, and moderate accuracy. Its high false-negative rate does not allow the replacement of clinical examinations when available. The moderate to high positive predictive value shows the potential utility of a positive test for self-detection or co-management of periodontitis in a medical setting and its incorporation in multi-test diagnostics. Further investigations are highly warranted.</p>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting circFOXO3 to Modulate Integrin β6 Expression in Periodontitis: A Potential Therapeutic Approach","authors":"Mingyan Xu, Feixiang Zhu, Yifan Guo, Fan Liu, Songlin Shi, Ling Yang, Rui Huang, Xiaoling Deng","doi":"10.1111/jcpe.14124","DOIUrl":"https://doi.org/10.1111/jcpe.14124","url":null,"abstract":"AimsCircular RNA forkhead box O3 (circFOXO3) is crucial in regulating inflammation in lung and heart injuries. However, its role in periodontitis remains unclear. We sought to elucidate the effects of circFOXO3 on periodontitis progression and related molecular mechanisms.MethodsReverse‐transcription quantitative polymerase chain reaction and fluorescence in situ hybridization were used to quantify and localize circFOXO3 expression. The mechanism by which circFOXO3 promotes inflammation in periodontitis was investigated using epithelial cells, human gingival epithelium and a rat model of ligature‐induced periodontitis.ResultscircFOXO3 expression was abnormally high in the gingival epithelial tissues of patients with periodontitis. Elevated circFOXO3 levels down‐regulated microRNA (miR)‐141‐3p, leading to increased FOXO3 expression. FOXO3 interacted with JunB to form a transcriptional‐repression complex that inhibited the integrin β6 (ITGβ6)‐mediated activation of transforming growth factor β (TGF‐β) in epithelial cells. Through the miR‐141‐3p/FOXO3/JunB axis, circFOXO3 suppressed TGF‐β signalling, thereby exacerbating periodontal inflammation. Finally, circFOXO3 inhibition hindered disease progression and restored TGF‐β activity in vivo via the FOXO3/JunB/ITGβ6 pathway.ConclusionOur study identified a novel mechanism by which circFOXO3 contributes to periodontal inflammation through a complex transcriptional regulatory network involving miR‐141‐3p, FOXO3, JunB and ITGβ6. These findings highlight potential therapeutic targets for the development of effective treatments for this debilitating disease.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"14 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142968233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Chewing Capacity and Mortality Risk: The Role of Diet and Ageing","authors":"Mi Du, Ke Deng, Jiawei Yin, Chenkai Wu, Shixian Hu, Linxu Guo, Zhixin Luo, Maurizio Tonetti, Geerten‐Has E. Tjakkes, Anita Visser, Shaohua Ge, An Li","doi":"10.1111/jcpe.14122","DOIUrl":"https://doi.org/10.1111/jcpe.14122","url":null,"abstract":"AimMasticatory dysfunction due to tooth loss is a potentially modifiable risk for mortality, but the pathway behind that remains to be investigated. This prospective study aimed to examine the role of diet and ageing in the associations between chewing capacity and long‐term mortality.MethodsData were obtained from participants (aged ≥ 20) in the National Health Nutritional and Health Survey (NHANES 1999–2010, <jats:italic>n</jats:italic> = 22,900). The mortality follow‐up ended on 31 December 2019. Chewing capacity was determined by the number of functional tooth units (FTUs). Diet information in NHANES was collected using a 24‐h‐recall questionnaire, and diet quality was measured by three index‐based dietary patterns, namely the nutrition index (NI), energy‐adjusted dietary inflammatory index (E‐DII) and healthy eating index‐2015 (HEI‐2015). The biological ageing process was reflected using phenotypic age acceleration (PhenoAgeAccel) and frailty index. Mediation analyses were conducted to assess the role of diet quality in the association between FTUs and ageing, as well as the role of ageing in the association between impaired chewing capacity (ICC) and mortality.ResultsParticipants with more FTUs were found to have a slower biological ageing process. Diet quality scores were estimated to mediate 9.0%–23.0% of the association between chewing capacity and biological ageing. Multivariable Cox proportional hazards regression models found a positive association between ICC and all‐cause mortality (hazard ratio = 1.282 [95% confidence interval: 1.189–1.382]). Also, ICC was significantly associated with a 28.9% higher risk of mortality due to cardiovascular disease (CVD) and a 32.7% higher risk of mortality due to cancer. Mediation analyses indicated that PhenoAgeAccel mediated the effect of ICC on all‐cause, CVD and cancer mortality with proportions of 18.1%, 17.3% and 12.5%, respectively. Similar mediating proportions were observed in the frailty index (range: 11.6%–23.5%).ConclusionsICC was associated with poorer diet quality and accelerated ageing, resulting in higher mortality risk. Therefore, it is plausible that dietary interventions and oral rehabilitation would promote healthy longevity, although further investigations are needed.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"27 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142968234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Serum Levels of Perfluoroalkyl and Polyfluoroalkyl Substances and Dental Floss Use: The Double-Edged Sword of Dental Floss Use-A Cross-Sectional Study.","authors":"Yan Jiao, Zhuo Fu, Xiaofei Ni","doi":"10.1111/jcpe.14126","DOIUrl":"https://doi.org/10.1111/jcpe.14126","url":null,"abstract":"<p><strong>Background: </strong>Although evidence suggests that dental floss contains perfluoroalkyl and polyfluoroalkyl substances (PFASs), it is still uncertain whether the use of dental floss contributes to an increased risk of PFAS exposure.</p><p><strong>Methods: </strong>We analysed data on serum PFAS concentrations and dental floss usage in a cohort of 6750 adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2020. In our study, we used logistic regression, a survey-weighted linear model, item response theory (IRT) scores, inverse probability weights (IPWs) and sensitivity analysis to assess the potential impact of dental floss usage on human serum PFAS levels.</p><p><strong>Results: </strong>The analysis of six PFASs revealed that dental floss users had higher serum concentrations of perfluorooctanoic acid (PFOA) compared with non-users, while serum concentrations of other PFASs were lower. Dental floss users recorded a lower level of overall PFAS burden score compared with non-users. Sensitivity analysis showed a statistically significant increase in serum PFOA concentration among dental floss users.</p><p><strong>Conclusion: </strong>Our findings suggest that the use of dental floss may be associated differently with serum concentrations of specific PFASs. Among a large representative sample of U.S. adults, individuals reporting the use of dental floss had lower levels of serum PFASs overall, with the exception of PFOA, which was slightly elevated. Dental floss is an important oral hygiene tool, and further research is needed to clarify its role in PFAS exposure.</p>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periodontitis Increases Gingival, Serum and Hippocampus β‐Amyloid Expressions but Reduces Neurovascular Coupling in Basilar Artery of Rats","authors":"Earl Fu, Kuo‐Feng Huang, Hsi‐Hsien Chang, Hui‐Hwa Tseng, Stephen Shei‐Dei Yang","doi":"10.1111/jcpe.14110","DOIUrl":"https://doi.org/10.1111/jcpe.14110","url":null,"abstract":"AimNeurodegenerative diseases are characterized by early increased beta‐amyloid (Aβ) and decreased cerebrovascular reactivity. We investigated Aβ in gingiva, serum or hippocampus and neurovascular reactivity in basilar artery (BA) of periodontitis rats, to test the impact of Aβ on BA vasoreactivity ex vivo.Materials and MethodsPeriodontitis was induced in 32 rats using silk‐ligation. Rats were sacrificed at weeks 0, 1, 2 and 4. Gingival TNF‐α, IL‐1β and Aβ were quantified via immunoblotting. Alveolar bone destruction was examined by micro‐computed tomography. Serum and hippocampus Aβ values were measured by enzyme‐linked immunosorbent assay and fluorescence staining, respectively. Vasoreactivity was measured by myography on isolated BA.ResultsFrom Week 1, gingival TNF‐α and IL‐1β and bone destruction increased. Gingiva, serum and hippocampus Aβ values increased from Week 2. Nicotine‐induced BA relaxation declined from Week 2, while acetylcholine‐induced relaxation decreased by Week 4. Bone loss correlated with Aβ and nicotine‐induced relaxation. Correlations were observed between Aβs in tissues, between two induced BA relaxations and between Aβ expressions and the induced relaxations. Ex vivo, Aβ reduced nicotine‐ and isoproterenol‐induced relaxations but not electrical stimulated relaxation.ConclusionsPeriodontitis may increase Aβ expressions and reduce BA neurovascular reactivity, with Aβ contributing to this abnormal neurovascular coupling.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"84 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142939914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Gingival Recessions in Adolescent Orthodontic Patients Treated With Fixed Appliances and Lingual Retainer","authors":"Beatriz Celis, Javier Sanz‐Esporrin, Carina Verdasco, Rosa‐Maria Yañez‐Vico, Conchita Martin","doi":"10.1111/jcpe.14097","DOIUrl":"https://doi.org/10.1111/jcpe.14097","url":null,"abstract":"AimTo evaluate risk indicators for gingival recessions (GRs) in the lower anterior teeth of orthodontic patients post treatment and during a retention period of at least 5 years, compared to non‐treated controls.Material and MethodsEighty‐nine orthodontically treated patients who were recession‐free before treatment were recruited. Demographic, cephalometric and occlusal records were retrieved before (T1) and after treatment (T2), and periodontal outcomes were clinically evaluated at least 5 years post retention (T3). Eighty‐eight non‐treated patients served as controls. Recession areas were digitally assessed and compared using <jats:italic>t</jats:italic>‐test and chi‐square tests, and a multiple linear regression model was built.ResultsIn the treated group, recession incidence was 11.24% at T2 and 67.42% at T3, all classified as type 1, class A (−). Among controls, recession prevalence was 15.91%, similar to the incidence at T2, but significantly lower than at T3. GR was most common in canines (1.85 mm<jats:sup>2</jats:sup>; 95% CI: 2.61–7.70; <jats:italic>p</jats:italic> &lt; 0.005). Regression analysis identified higher incidence of recessions in female patients and in those with thin phenotype, high angle skeletal pattern, increased final inclination of lower incisors and greater probing depth.ConclusionsGR incidence after orthodontic treatment was comparable to controls but increased significantly post retention. Several risk indicators may predict GR occurrence.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"92 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142939912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Socioeconomic, Spatial and Educational Factors and Midlife Periodontal Disease Risk: Evidence From ‘High School and Beyond’","authors":"John Robert Warren, Jessie Himmelstern, Chandra Muller, Eric Grodsky, Ryan Demmer","doi":"10.1111/jcpe.14113","DOIUrl":"https://doi.org/10.1111/jcpe.14113","url":null,"abstract":"BackgroundPeriodontal disease (PD) is a prevalent, preventable and treatable oral infection associated with substantial morbidity globally. There is little information from population‐representative cohort studies about the sociodemographic, educational and other early life factors that stratify PD risk.MethodsWe used data from the U.S. ‘High School and Beyond’ (HS&amp;B:80) study, which has followed a nationally representative sample of 26,820 people from high school in 1980 through midlife in 2021. Data from the 1980s include information about education, early life circumstances, spatial location and demographic attributes. Data from 13,080 sample members who responded in 2021 include indicators of self‐reported PD diagnosis.ResultsPeople with higher degrees and course grades have a lower risk of midlife PD. Rural adolescents and those who attended private schools are also at lower risk. We find little evidence of heterogeneity in correlates of midlife PD by gender or race/ethnicity.ConclusionsThe quantity and characteristics of people's schooling and their location of residence are associated with midlife PD.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"28 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Host‐Derived Diagnostic Markers Related to Soft Tissue Destruction and Bone Degradation in Periodontitis”","authors":"","doi":"10.1111/jcpe.14114","DOIUrl":"https://doi.org/10.1111/jcpe.14114","url":null,"abstract":"","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"23 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamin‐Related Protein 1 Orchestrates Inflammatory Responses in Periodontal Macrophages via Interaction With Hexokinase 1","authors":"Yiming Jiang, Zihan Wang, Kaige Zhang, Yue Hu, Dehao Shang, Lulu Jiang, Minghao Huang, Biyao Wang, Xiaomin He, Zhou Wu, Xu Yan, Xinwen Zhang","doi":"10.1111/jcpe.14111","DOIUrl":"https://doi.org/10.1111/jcpe.14111","url":null,"abstract":"AimTo explore the potential roles of mitochondrial dysfunction in the initiation of inflammation in periodontal macrophages and to determine the mechanism underlying the involvement of dynamin‐related protein 1 (Drp1) in macrophage inflammatory responses through its interaction with hexokinase 1 (HK1).Materials and MethodsGingival tissues were collected from patients diagnosed with periodontitis or from healthy volunteers. Drp1 tetramer formation and phosphorylation were analysed using western blot. THP‐1 macrophages and RAW264.7 cells were stimulated with <jats:styled-content style=\"fixed-case\"><jats:italic>Porphyromonas gingivalis</jats:italic></jats:styled-content> (<jats:italic>Pg</jats:italic>) or <jats:italic>Pg</jats:italic> lipopolysaccharide (<jats:italic>Pg</jats:italic> LPS), respectively. Alterations in proteins associated with mitochondrial dynamics were scrutinized via western blot. Immunofluorescence was used to evaluate mitochondrial damage and mitochondrial permeability transition pore (mPTP) opening. Western blot was used to examine the inflammatory markers NLRP3, caspase‐1, IL‐1β and GSDMD. Protein interactions involving Drp1 were verified through immunoprecipitation.ResultsIn periodontitis patient samples, <jats:italic>Pg</jats:italic> LPS‐treated RAW264.7 cells, and <jats:italic>Pg</jats:italic>‐stimulated THP‐1 macrophages, over‐activated Drp1 was able to drive NLRP3 inflammasome activation and the subsequent release of inflammatory factors. A direct interaction between Drp1 and HK1 was observed, facilitating excessive mPTP opening and subsequent mitochondrial dysfunction.ConclusionIn the inflammatory milieu of periodontal tissues, Drp1 hyperactivation in the macrophages is implicated in inflammation induction. Modulation of the inflammatory response in periodontal macrophages by Drp1 appears to facilitate mPTP opening.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"5 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142935144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periodontal Care Is Associated With a Lower Risk of Dialysis Initiation in Middle‐Aged Patients With Type 2 Diabetes Mellitus: A 6‐Year Follow‐Up Cohort Study Based on a Nationwide Healthcare Database","authors":"Taro Kusama, Yudai Tamada, Ken Osaka, Kenji Takeuch","doi":"10.1111/jcpe.14105","DOIUrl":"https://doi.org/10.1111/jcpe.14105","url":null,"abstract":"ObjectiveTo investigate the association between dental attendance with periodontal care and the risk of dialysis initiation in patients with type 2 diabetes mellitus (T2D).MethodsThis retrospective cohort study used data from the Japan Medical Data Center (JMDC) claims database (January 2015 to August 2022). Patients with T2D, aged 40–74, were included. Dental attendance with periodontal care and initiation of dialysis were used as the exposure and outcome variables, respectively. We fitted the Cox proportional hazards model, including potential confounders, to estimate hazard ratios (HRs) and 95% confidence intervals (95%CIs).ResultsAmong 99,273 participants (mean age = 54.4 years [SD = 7.8], male = 71.9%), the incidence rate of dialysis initiation was 0.92 per 1000 person‐years. After adjusting for all covariates, those with periodontal care (HR = 0.68 [95%CI = 0.51–0.91] for ≥ 1 time/year and HR = 0.56 [95%CI = 0.41–0.77] for ≥ 1 time/6 months) had a significantly lower risk of dialysis initiation compared to those without dental attendance.ConclusionPeriodontal disease care in patients with T2D is associated with a reduced risk of dialysis initiation by 32%–44%. This suggests that integrating periodontal care into diabetes management may help prevent the progression of diabetic nephropathy and improve patient outcomes.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"203 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142929096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}