{"title":"Cilostazol for the treatment of distal symmetrical polyneuropathy in diabetes mellitus: Where do we stand?","authors":"Dimitrios Pantazopoulos , Evanthia Gouveri , Manfredi Rizzo , Nikolaos Papanas","doi":"10.1016/j.jdiacomp.2024.108905","DOIUrl":"10.1016/j.jdiacomp.2024.108905","url":null,"abstract":"<div><h3>Introduction</h3><div>Diabetic Neuropathy (DN) is one of the most frequent chronic complications of diabetes mellitus. Its commonest form, distal symmetrical polyneuropathy (DSPN), is characterised by slowly progressing length-dependent nerve damage in the lower limbs, increasing the risk of foot ulcerations and leading to symptoms like tingling, pain, or numbness.</div></div><div><h3>Aim</h3><div>The aim of this review was to discuss the utility of cilostazol, a phosphodiesterase inhibitor with known antiplatelet, vasodilatory, anti-inflammation properties, in the treatment of DSPN.</div></div><div><h3>Results</h3><div>Preclinical studies in animals have demonstrated the ability of cilostazol to improve nerve function and to protect from peripheral nerve disruption and central sensitisation. However, clinical trials in humans are very sparse and have so far not been encouraging.</div></div><div><h3>Conclusions</h3><div>Further research is needed to fully understand the mechanisms and potential efficacy of cilostazol in treating DSPN.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108905"},"PeriodicalIF":2.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christopher M Lawrence , Carmel E Smart , Aleeza Fatima , Bruce R King , Prudence Lopez
{"title":"Increased bolus overrides and lower time in range: Insights into disordered eating revealed by insulin pump metrics and continuous glucose monitor data in Australian adolescents with type 1 diabetes","authors":"Christopher M Lawrence , Carmel E Smart , Aleeza Fatima , Bruce R King , Prudence Lopez","doi":"10.1016/j.jdiacomp.2024.108904","DOIUrl":"10.1016/j.jdiacomp.2024.108904","url":null,"abstract":"<div><h3>Aims</h3><div>To determine the prevalence of disordered eating behaviors (DEB) in a population of Australian adolescents with T1D and to investigate clinical parameters, insulin pump therapy (IPT) and continuous glucose monitor (CGM) data trends, and psychological attributes associated with DEB.</div></div><div><h3>Methods</h3><div>50 participants (27 female, 23 male, average age 15.2 years, average duration of diabetes 6.2 years) were recruited. Diabetes Eating Problem Survey-Revised (DEPS-R) and Strengths and Difficulties Questionnaires were completed. Prevalence of disordered eating was reported, and associations with clinical parameters, insulin pump therapy (IPT) and continuous glucose monitor (CGM) metrics were assessed.</div></div><div><h3>Results</h3><div>Twenty-four participants (48 %) had an elevated DEPS-R score. Participants with elevated DEPS-R were more likely to be female (75 % vs 31.6 %, <em>p</em> = 0.004), have a higher HbA1c (8.2 %/67 mmol/mol vs. 6.9 %/51 mmol/mol, <em>p</em> < 0.002) and BMI <em>Z</em>-score (+1.28 SD vs +0.76 SD, <em>p</em> = 0.040). They had lower time in range, 3.9–10 mmol/L (50.3 % vs. 63.8 %, <em>p</em> = 0.01) and higher mean glucose (10.0 mmol/L vs. 8.3 mmol/L, <em>p</em> = 0.005). Of the 60 % using IPT, participants with elevated DEPS-R had increased meal bolus overrides (7.9 % vs 3.8 %, <em>p</em> = 0.047). Reported difficulties on SDQ were higher in the elevated DEPS-R group (18.3 vs 10.5, <em>p</em> < 0.002).</div></div><div><h3>Conclusions</h3><div>DEB are common in Australian adolescents with T1D and associated with increased dysglycemia. Diabetes technology cannot be solely relied upon for detection of DEB and there remains a need for routine screening.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108904"},"PeriodicalIF":2.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mary R. Rooney , Faye L. Norby , Elsayed Z. Soliman , Lin Yee Chen , Elizabeth Selvin , Justin B. Echouffo-Tcheugui
{"title":"Duration of diabetes, glycemic control, and low heart rate variability: The Atherosclerosis Risk in Communities (ARIC) study","authors":"Mary R. Rooney , Faye L. Norby , Elsayed Z. Soliman , Lin Yee Chen , Elizabeth Selvin , Justin B. Echouffo-Tcheugui","doi":"10.1016/j.jdiacomp.2024.108903","DOIUrl":"10.1016/j.jdiacomp.2024.108903","url":null,"abstract":"<div><div>Persons with long-standing, poorly controlled diabetes or recent hyperglycemia had the highest burden of cardiac autonomic neuropathy. Cardiac autonomic neuropathy contributed to elevated long-term incidence of cardiovascular disease and mortality even in persons with well-controlled diabetes.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108903"},"PeriodicalIF":2.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tomás González-Vidal , Diego Rivas-Otero , Jessica Ares-Blanco , Carmen Lambert , Elías Delgado-Álvarez , Edelmiro Menéndez-Torre
{"title":"Real-life evaluation of consensus recommendations for transition to subcutaneous insulin in hyperosmolar hyperglycemic crises","authors":"Tomás González-Vidal , Diego Rivas-Otero , Jessica Ares-Blanco , Carmen Lambert , Elías Delgado-Álvarez , Edelmiro Menéndez-Torre","doi":"10.1016/j.jdiacomp.2024.108902","DOIUrl":"10.1016/j.jdiacomp.2024.108902","url":null,"abstract":"<div><div>A recent consensus report on hyperglycemic crises included recommendations for calculating the subcutaneous insulin dose when transitioning from intravenous insulin. In 95 patients admitted for hyperosmolar hyperglycemic crisis, there were no significant differences in post-transition glycemic control between patients who met the consensus recommendations and those who did not.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108902"},"PeriodicalIF":2.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ming-Hang Tsai , Wu-Chien Chien , Hsin-Chung Lin , Chi-Hsiang Chung , Lih-Chyang Chen , Kuo-Yang Huang , Hsin-An Lin
{"title":"Pioglitazone increases risk of ischemic heart disease in patients with type 2 diabetes receiving insulin","authors":"Ming-Hang Tsai , Wu-Chien Chien , Hsin-Chung Lin , Chi-Hsiang Chung , Lih-Chyang Chen , Kuo-Yang Huang , Hsin-An Lin","doi":"10.1016/j.jdiacomp.2024.108898","DOIUrl":"10.1016/j.jdiacomp.2024.108898","url":null,"abstract":"<div><h3>Aim</h3><div>Studies evaluating the cardiovascular safety of pioglitazone show inconsistent results and ischemic heart disease (IHD) risks associated with different anti-diabetic drugs added to metformin uncontrolled type 2 diabetes mellitus (T2DM) are not assessed. This study aimed to evaluate IHD risk associated with pioglitazone and/or insulin added to patients with metformin uncontrolled T2DM.</div></div><div><h3>Methods</h3><div>Data were extracted from the National Health Insurance Research Database of Taiwan. A total of 19,952 patients with T2DM uncontrolled on metformin received pioglitazone and/or insulin added to metformin were included.</div></div><div><h3>Results</h3><div>Compared to those who never received pioglitazone and/or insulin, patients receiving both insulin and pioglitazone had higher cumulative risk of IHD (adjusted HR [aHR] = 1.911, 95 % confidence interval [CI]: 1.506–2.351), pioglitazone alone (aHR = 1.446, 95 % CI: 1.111–1.775), and insulin alone (aHR = 1.351, 95 % CI: 1.1052–1.684) (all, <em>p</em> < 0.05). Patients who received both pioglitazone and insulin had a higher cumulative risk of IHD than those who received insulin or pioglitazone as well as a similar result in the cumulative defined daily dose (cDDD) of the drugs.</div></div><div><h3>Conclusion</h3><div>Administering pioglitazone plus insulin to patients with T2DM uncontrolled on metformin may increase the risk of IHD, suggesting that other second-line anti-diabetes drugs may be a better choice for patients with T2DM uncontrolled on metformin.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108898"},"PeriodicalIF":2.9,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evgeny Golbets , Iftach Sagy , Ziv Ribak , Ran Ben David , Alan Jotkowitz , Dan Schwarzfuchs , Leonid Barski
{"title":"Clinical features and outcomes of patients diagnosed with diabetic ketoacidosis (DKA) who were hospitalized for conditions outside of internal medicine","authors":"Evgeny Golbets , Iftach Sagy , Ziv Ribak , Ran Ben David , Alan Jotkowitz , Dan Schwarzfuchs , Leonid Barski","doi":"10.1016/j.jdiacomp.2024.108900","DOIUrl":"10.1016/j.jdiacomp.2024.108900","url":null,"abstract":"<div><h3>Aims</h3><div>To assess the clinical features and outcomes of patients diagnosed with DKA who were hospitalized for conditions outside of internal medicine.</div></div><div><h3>Methods</h3><div>Retrospective analysis of admissions for DKA in adult patients between 2005 and 2022 at a tertiary hospital in Israel. Patients with DKA were stratified into medical vs non-medical groups, the primary outcome was in-hospital mortality.</div></div><div><h3>Results</h3><div>429 patients were included in the study, 385 patients (89.7 %) were treated by an internal medicine team, while 44 patients (10.3 %) were hospitalized with surgical or obstetrical conditions. Patients in the non-internal medicine group were older (52 ± 18.9 vs 43.6 ± 20.4, <em>p</em> < 0.005) and had higher rates of diabetes complications such as chronic ischemic heart disease (20.5 % vs. 4.2 %, <em>p</em> < 0.0001) and chronic kidney disease (50 % vs. 3.4 %, <em>p</em> < 0.001). Glucose level on presentation was lower for non-internal medicine patients (398 ± 221 mg/dL vs 551 ± 180 mg/dL) and outcomes of mechanical ventilation and length of hospitalization were more severe (29.5 % vs. 6 %, <em>p</em> < 0.001 and 8.0 vs. 3.0, p < 0.001). Multivariate analysis demonstrated that composite outcome of in-hospital mortality, ICU admission and longer hospitalization was more likely in the non-internal medicine group (OR 3.99, CI 1.89–8.4, <em>p</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>DKA is a universal pathology that concerns various medical fields. It is essential for every clinician to be familiar with this condition. Patients diagnosed with DKA who were hospitalized for conditions outside of internal medicine may be at high risk and may present with lower glycemic levels. Future research is needed to characterize the unique features of subgroups of patients with DKA.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108900"},"PeriodicalIF":2.9,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elisabeth B. Stougaard , Ninna Hahn Tougaard , Suvanjaa Sivalingam , Christian Stevns Hansen , Joachim Størling , Tine Willum Hansen , Marie Frimodt-Møller , Robert E. Steinert , Soheil Varasteh , Per-Henrik Groop , Hanne Salmenkari , Markku J. Lehto , Frederik Persson , Peter Rossing
{"title":"Effects of probiotics and fibers on markers of nephropathy, inflammation, intestinal barrier dysfunction and endothelial dysfunction in individuals with type 1 diabetes and albuminuria. The ProFOS Study","authors":"Elisabeth B. Stougaard , Ninna Hahn Tougaard , Suvanjaa Sivalingam , Christian Stevns Hansen , Joachim Størling , Tine Willum Hansen , Marie Frimodt-Møller , Robert E. Steinert , Soheil Varasteh , Per-Henrik Groop , Hanne Salmenkari , Markku J. Lehto , Frederik Persson , Peter Rossing","doi":"10.1016/j.jdiacomp.2024.108892","DOIUrl":"10.1016/j.jdiacomp.2024.108892","url":null,"abstract":"<div><h3>Aims</h3><div>To estimate whether a mix of pre- and probiotics would strengthen the gut barrier and protect the kidneys in individuals with type 1 diabetes and albuminuria.</div></div><div><h3>Methods</h3><div>Randomized, placebo-controlled, crossover study. Forty-one participants received synbiotic (pre- and probiotics) mix or placebo for 12 weeks with 6 weeks washout. Primary endpoint was change from baseline to end-of-period in UACR. Secondary endpoints were changes in endothelial glycocalyx thickness, inflammatory and intestinal barrier dysfunction markers, glomerular filtration rate (GFR) and ambulatory systolic blood pressure.</div></div><div><h3>Results</h3><div>Thirty-five participants completed the study. Mean age was 58 (SD 10) years, 73 % (<em>n</em> = 30) were male, median UACR was 134 (IQR 63–293) mg/g, estimated GFR was 75 (30) ml/min/1.73m<sup>2</sup>. There was no significant difference in UACR with a mean relative change (CI 95 %) from baseline to end-of-treatment of −3.0 (−18.4; 15.5) % in the synbiotic group and −12.0 (−29.6; 9.6) % in the placebo group with no significant difference between treatment periods (9.37 (−25.2; 44.0) percentage points; <em>p</em> = 0.60). No significant beneficial difference in the secondary end points was demonstrated.</div></div><div><h3>Conclusion</h3><div>Twelve weeks treatment with synbiotic mix had no effect on UACR or on any of the secondary endpoints in subjects with type 1 diabetes and albuminuria.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108892"},"PeriodicalIF":2.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142537397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Precision diabetology: Where do we stand now?","authors":"Christian Herder , Manfredi Rizzo , Michael Roden","doi":"10.1016/j.jdiacomp.2024.108899","DOIUrl":"10.1016/j.jdiacomp.2024.108899","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108899"},"PeriodicalIF":2.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yike Li , Nan Shen , Enmin Xie , Ziyu Guo , Zixiang Ye , Kun Yang , Xingliang Li , Yanxiang Gao , Jingang Zheng
{"title":"Predicting the impact of stress-induced hyperglycemia on in-hospital mortality in patients with chronic kidney disease and acute coronary syndrome: A retrospective study","authors":"Yike Li , Nan Shen , Enmin Xie , Ziyu Guo , Zixiang Ye , Kun Yang , Xingliang Li , Yanxiang Gao , Jingang Zheng","doi":"10.1016/j.jdiacomp.2024.108895","DOIUrl":"10.1016/j.jdiacomp.2024.108895","url":null,"abstract":"<div><h3>Background</h3><div>Stress hyperglycemia is prevalent in critical illnesses and has been associated with adverse short- and long-term outcomes in individuals with acute coronary syndrome (ACS). However, there is limited evidence for the predictive value of stress hyperglycemia and hospitalization mortality in patients with chronic kidney disease (CKD) and ACS. This study aimed to explore the association between hospitalized mortality, stress hyperglycemia ratio (SHR), and admission blood glucose (ABG) in patients with CKD and ACS.</div></div><div><h3>Methods</h3><div>This study included 655 hospitalized patients who were diagnosed with ACS and CKD. Patients with incomplete data were excluded, resulting in the analysis of 550 patients. The primary outcome measured was in-hospital mortality.</div></div><div><h3>Results</h3><div>The median age of the cohort included in the analysis was 71 years, with a male proportion of 66.2 %, and a mean estimated glomerular filtration rate (eGFR) of 27.8 mL/min/1.73 m<sup>2</sup>. Patients classified as having stage 3, stage 4, and stage 5 chronic kidney disease (CKD) comprised 46.9 %, 17.1 %, and 36.0 % of the population, respectively. The overall in-hospital mortality rate was 10.7 % (<em>n</em> = 59). Both SHR (OR = 2.67; 95 % CI 1.51–4.74; <em>p</em> < 0.001) and ABG (OR = 1.09; 95 % CI 1.04–1.14; p < 0.001) were significantly associated with in-hospital mortality in CKD and ACS patients. SHR and ABG showed a linear relationship with in-hospital mortality, with SHR demonstrating superior reclassification ability over ABG. The inclusion of SHR or ABG, irrespective of diabetes mellitus status, substantially enhanced the predictive performance of the Global Registry of Acute Coronary Events (GRACE) score model.</div></div><div><h3>Conclusions</h3><div>In patients with ACS and CKD, a robust correlation was observed between SHR, ABG, and in-hospital mortality. Both SHR and ABG improved the predictive accuracy of the GRACE score in forecasting inpatient mortality in this population.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108895"},"PeriodicalIF":2.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142530817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R.D.M. Varkevisser , T. Sas , H.J. Aanstoot , Dutch type 1 Biomarker group, B.H.R. Wolffenbuttel , M.M. van der Klauw
{"title":"Residual C-peptide is associated with new and persistent impaired awareness of hypoglycaemia in type 1 diabetes","authors":"R.D.M. Varkevisser , T. Sas , H.J. Aanstoot , Dutch type 1 Biomarker group, B.H.R. Wolffenbuttel , M.M. van der Klauw","doi":"10.1016/j.jdiacomp.2024.108893","DOIUrl":"10.1016/j.jdiacomp.2024.108893","url":null,"abstract":"<div><h3>Aims</h3><div>To describe the change in impaired awareness of hypoglycaemia (IAH) over time and to identify factors associated with this change in the Dutch Type 1 Diabetes biomarkers cohort (<span><span>NCT04977635</span><svg><path></path></svg></span>).</div></div><div><h3>Methods</h3><div>A prospective cohort of type 1 diabetes patients, with C-peptide <300 pmol/L, who had completed the Clarke questionnaire, to determine IAH status, at baseline and after 2 years. Changes in awareness status were defined and compares as follows: unchanged normal awareness (NAH) versus unchanged IAH, new IAH versus reversal of IAH. Multivariate logistic regression models were fitted using forward and backward stepwise selection using a 0.10 <em>P</em>-value cut-off, and stepwise backward selection using AIC criteria.</div></div><div><h3>Results</h3><div>A total of 431 out of 611 participants were included. The baseline prevalence of IAH was 17 % and 20 % after 2 years. The incidence proportion of new IAH and reversal of IAH were, 9.5 % and 31 %, respectively. For every 2.7-fold increase in C-peptide, the odds of IAH decrease by 58 %. A 1-unit increase in BMI over the 2-year follow-up period is associated with a 5.27-fold increase in the odds of reversing IAH.</div></div><div><h3>Conclusions</h3><div>Higher C-peptide levels are protective against new IAH, and an increase in BMI over time is associated with the reversal of IAH.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108893"},"PeriodicalIF":2.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}