Journal of Gastroenterology and Hepatology最新文献

{"title":"cGAS-STING Pathway's Impact on Intestinal Barrier","authors":"Liqi Li,&nbsp;Yingge He,&nbsp;Yu Chen,&nbsp;Xiaoshu Zhou","doi":"10.1111/jgh.16974","DOIUrl":"10.1111/jgh.16974","url":null,"abstract":"<p>Intestinal inflammation and increased permeability have been linked to metabolic dysregulation in patients with compromised intestinal barrier function. Among the pathways, garnering attention is the cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) pathway. Upon binding to double-stranded DNA (dsDNA), cGAS catalyzes the conversion of ATP and GTP into cyclic GMP-AMP (cGAMP). Subsequently, cGAMP binds to STING, triggering the activation of tank-binding kinase 1 (TBK1), which activates interferon regulatory factor 3 (IRF3), thus inducing the production of type I interferon. Activated TBK1 can also induce the activation of nuclear factor κB (NF-κB), thus mediating the production of proinflammatory cytokines. The effects of this process vary among innate and adaptive immune cells, as well as intestinal epithelial cells (IECs). This review aims to elucidate the impact and role of the cGAS-STING pathway on intestinal barrier function.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 6","pages":"1381-1392"},"PeriodicalIF":3.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16974","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078440","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}

{"title":"Real-World Effectiveness and Safety of Vedolizumab in Patients ≥ 70 Versus < 70 Years With Ulcerative Colitis: Multicenter Retrospective Study","authors":"Tadakazu Hisamatsu,&nbsp;Taku Kobayashi,&nbsp;Satoshi Motoya,&nbsp;Toshimitsu Fujii,&nbsp;Reiko Kunisaki,&nbsp;Tomoyoshi Shibuya,&nbsp;Minoru Matsuura,&nbsp;Sakiko Hiraoka,&nbsp;Ken Takeuchi,&nbsp;Hiroshi Yasuda,&nbsp;Kaoru Yokoyama,&nbsp;Noritaka Takatsu,&nbsp;Atsuo Maemoto,&nbsp;Toshiyuki Tahara,&nbsp;Keiichi Tominaga,&nbsp;Masaaki Shimada,&nbsp;Nobuaki Kuno,&nbsp;Jovelle L. Fernandez,&nbsp;Lisa Hirose,&nbsp;Kaori Ishiguro,&nbsp;Mary Cavaliere,&nbsp;Toshifumi Hibi","doi":"10.1111/jgh.16936","DOIUrl":"10.1111/jgh.16936","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Vedolizumab (VDZ) is often used in older patients with ulcerative colitis (UC) in clinical practice; however, real-world evidence is still limited, including in those with late-onset UC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This post hoc analysis of a multicenter, retrospective, observational chart review, enrolling 370 patients with UC receiving VDZ between December 2018 and February 2020, compared effectiveness and safety of VDZ among patients ≥ 70 (<i>n</i> = 40) versus &lt; 70 years (<i>n</i> = 330), and among patients ≥ 70 years with and without late-onset UC (age at disease onset: ≥ 70 [<i>n</i> = 13] versus &lt; 70 years [<i>n</i> = 26]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no differences between patients ≥ 70 and &lt; 70 years in clinical remission rates (week 6: 57.5% vs. 47.6%, <i>p</i> = 0.9174; week 14: 62.5% vs. 54.8%, <i>p</i> = 0.1317; week 54: 47.5% vs. 46.4%, <i>p</i> = 0.8149), primary nonresponse (10.0% vs. 15.5%, <i>p</i> = 0.6248), loss of response (12.5% vs. 9.4%, <i>p</i> = 0.5675), or overall safety. Among patients ≥ 70 years, the incidence of adverse drug reactions was numerically greater in those with concomitant corticosteroids than in those without. For older patients with and without late-onset UC, week 54 remission rates were 23.1% versus 57.7% (<i>p</i> = 0.0544); surgery was reported in 3/13 versus 2/26 patients and hospitalization in 5/13 versus 6/26 patients. One death was reported in patients with late-onset UC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>VDZ effectiveness and safety were similar in patients ≥ 70 and &lt; 70 years; VDZ may be a suitable treatment option for patients ≥ 70 years with UC. Patients with late-onset UC tended to have more frequent surgery/hospitalization and lower effectiveness than those without, possibly necessitating greater caution when using VDZ.</p>\u0000 \u0000 <p><b>Trial Registration:</b> Japanese Registry of Clinical Trials registration number: jRCT-1080225363</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 6","pages":"1435-1445"},"PeriodicalIF":3.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16936","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078441","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}

{"title":"Cumulative Dose of Regorafenib in Patients With Metastatic Colorectal Cancer: A Multicenter Cohort Study.","authors":"Yu-Hsuan Kuo, Chun-Nan Kuo, Chia-Lun Chang, Yu Ko","doi":"10.1111/jgh.17003","DOIUrl":"https://doi.org/10.1111/jgh.17003","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the prognostic effect of the cumulative dose (CD) of regorafenib on survival in patients with metastatic colorectal cancer (mCRC).</p><p><strong>Materials and methods: </strong>This retrospective study utilized the Taipei Medical University Clinical Research Database for analysis. Patients aged ≥ 20 years with mCRC who were prescribed regorafenib between January 2014 and December 2021 were identified and then divided into low- and high-CD groups (≤ 4200 mg vs. > 4200 mg). Overall survival (OS), time-to-treatment discontinuation (TTD), and the incidence of five common adverse events were compared between groups. In addition, natural cubic splines were employed to examine the non-linear relationship between cumulative doses and survival in the multivariate Cox regression model.</p><p><strong>Results: </strong>A total of 259 patients were enrolled, with 130 in the low-CD group and 129 in the high-CD group; the median OS was 4.6 months and 9.8 months, respectively (p < 0.01). The median TTD was 51.5 days for the low-CD group and 72.0 days for the high-CD group (p < 0.01). No significant difference in drug-related adverse events was observed between groups. In the multivariate Cox analysis, a CD ≤ 4200 mg was a negative prognostic factor (hazard ratio 1.41 [95% confidence interval 1.08-1.84], p = 0.01). In addition, patients on a dose range between 4368 and 5376 mg exhibited minimal mortality risk.</p><p><strong>Conclusion: </strong>The cumulative doses of regorafenib > 4200 mg were associated with improved survival. The suggested optimal dose range serves as a reference for dose modification in clinical practice.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013425","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":"Clinical Trials in Disorders of Gut Brain Interaction (DGBI) Overlap Syndrome-The Start of Good Things to Come!","authors":"Benjamin Wei-Rong Tay, Kai Ting Cheryl Chua, Sanjiv Mahadeva","doi":"10.1111/jgh.16994","DOIUrl":"https://doi.org/10.1111/jgh.16994","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022201","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":"Navigating the Paradox of IL-22: Friend or Foe in Hepatic Health?","authors":"Jianqi Qin,&nbsp;Weixiong Zhu,&nbsp;Wence Zhou","doi":"10.1111/jgh.16991","DOIUrl":"10.1111/jgh.16991","url":null,"abstract":"<p>Interleukin-22 (IL-22), a cytokine from the IL-10 family produced by T cells and innate lymphoid cells, plays a crucial role in immune responses and tissue regeneration. Its association with liver disease has garnered significant attention; however, its exact impact remains controversial. This review aims to enhance the current understanding of the dual role of IL-22 in liver disease by exploring its protective and pathogenic effects. First, we provide an overview of IL-22 biology, including its source, receptors, and signaling pathways. Subsequently, we offer a comprehensive overview of the dual function of IL-22 in non-neoplastic liver disease, emphasizing its antiapoptotic and regenerative properties. We also discuss the applicability of the conclusions drawn from studies on nonalcoholic fatty liver disease to metabolic dysfunction-associated steatotic liver disease. Furthermore, we elaborate on the intricate role of IL-22 in hepatocellular carcinoma, particularly its influence on the tumor microenvironment, proliferation, and immune evasion. In conclusion, IL-22 is paradoxical in liver disease, acting as a friend and foe. It is imperative to understand this paradox to develop targeted therapies that capitalize on the beneficial effects of IL-22 while mitigating its detrimental effects.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 6","pages":"1393-1408"},"PeriodicalIF":3.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16991","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995915","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}

{"title":"Outcomes of Endoscopic Papillectomy After an Insulated Plastic Pancreatic Stent Placement: A Retrospective Cohort Study.","authors":"Chang-Young Choi, Sun Ung Youn, Ji Min Kim, Jae Chul Hwang, Byung Moo Yoo, Soon Sun Kim, Jin Hong Kim, Min Jae Yang","doi":"10.1111/jgh.16996","DOIUrl":"https://doi.org/10.1111/jgh.16996","url":null,"abstract":"<p><strong>Background and aim: </strong>Insulated plastic pancreatic stent placement before endoscopic papillectomy (EP) was introduced to prevent post-EP pancreatic stenting difficulties, avoid stent transection during EP, and ensure a safe hemostatic procedure in cases of post-EP bleeding by securing the pancreatic orifice. This study aimed to evaluate the technical efficacy and long-term outcomes of this procedure.</p><p><strong>Methods: </strong>A retrospective analysis of 84 patients who underwent EP for ampullary adenomas between August 2006 and December 2020 was conducted using a 5-Fr polytetrafluoroethylene (PTFE)-insulated handmade pancreatic stent.</p><p><strong>Results: </strong>EP after pancreatic stenting was successfully performed in 73/84 patients (86.9%). En bloc resection was performed in 59/73 patients (80.8%), and complete resection was achieved in 63/73 patients (86.3%). No stent transection was observed. Delayed bleeding was encountered in seven (9.6%) and 24 (32.9%) patients based on consensus guidelines and extended definitions, respectively. The incidence of pancreatitis was less frequent in the pre-EP pancreatic stenting group than in the post-EP pancreatic stenting group but statistically nonsignificant and underpowered (6.8 vs. 18.2%; p = 0.227, 95% confidence interval 0.046-4.030). In complete resection cases, tumor recurrence was encountered in six patients (8.2%) with surveillance for a median of 24 months. In the long term, one case (1.4%) of cholangitis and four cases (5.5%) of papillary structures developed.</p><p><strong>Conclusions: </strong>Insulated PTFE plastic stent placement before EP may serve as an alternative to conventional EP, considering the feasibility of pancreatic stent placement, en bloc resectability, incidence of post-EP pancreatitis, and long-term oncological prognosis.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013428","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":"Correction to \"Gastrointestinal Side Effects of Somatostatin Analogs in Neuroendocrine Tumors: A Focused Review\".","authors":"","doi":"10.1111/jgh.16993","DOIUrl":"https://doi.org/10.1111/jgh.16993","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021947","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":"Performance of the GALAD Model in an Asian Cohort Undergoing Hepatocellular Carcinoma Surveillance: A Prospective Cohort Study.","authors":"Wei-Lun Liou, Si-Yu Tan, Hiroyuki Yamada, Thinesh Krishnamoorthy, Jason Pik-Eu Chang, Chin-Pin Yeo, Chee-Kiat Tan","doi":"10.1111/jgh.16997","DOIUrl":"https://doi.org/10.1111/jgh.16997","url":null,"abstract":"<p><strong>Background and aim: </strong>Current hepatocellular carcinoma (HCC) surveillance strategy has its limitations, consequently delaying early detection. The GALAD model has been validated in retrospective studies, with two published cut-off values yielding different sensitivities for HCCs of different etiologies. We evaluated the performance of GALAD model in HCC surveillance and determined the ideal cut-off value for our cohort.</p><p><strong>Methods: </strong>Patients undergoing 6-monthly HCC surveillance in Singapore General Hospital were recruited between December 2017-October 2018. Study serum specimens were prospectively collected and retrospectively tested using the μTASWako alpha-fetoprotein (AFP), AFP-L3, and protein induced by vitamin K antagonism-II (PIVKA-II) kits. GALAD score was calculated and compared with individual biomarkers using area under the curve (AUC) analysis. Published GALAD cut-offs of -0.63 and -1.95 were compared for their performance in HCC detection.</p><p><strong>Results: </strong>There were 207 patients (median age 59 years, 55.1% males). Hepatitis B was the commonest etiology (72.9%). By February 2023, with a median follow-up of 48.9 months, 20 patients had developed HCC. Eight patients developed HCC within 1 year from specimen collection. For HCC developing within 1 year, GALAD model detected HCC with an AUC of 0.84, greater than AFP (AUC 0.77), AFP-L3 (AUC 0.60), and PIVKA-II (AUC 0.67). GALAD at cut-off -1.95 achieved sensitivity and specificity of 75% and 92.5% for HCCs detected within 1 year, superior to cut-off -0.63 (sensitivity 12.5%, specificity 100%).</p><p><strong>Conclusion: </strong>In this prospective study of HCC surveillance, the GALAD model performed better than individual biomarkers. The cut-off of -1.95 was more useful in our predominantly chronic hepatitis B cohort.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988457","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":"Short and Endurance Squeeze Contractile Integral in High-Resolution Anorectal Manometry Is Correlated With Vaizey Incontinence Score-A Pilot Study.","authors":"Jia-Feng Wu, Tzung-Hsin Chou, Ping-Huei Tseng, I-Jung Tsai, Hui-Chuan Lee, Yao-Kai Yang, Chia-Hsiang Yang","doi":"10.1111/jgh.17001","DOIUrl":"https://doi.org/10.1111/jgh.17001","url":null,"abstract":"<p><strong>Background and aim: </strong>Fecal incontinence severely deteriorates normal social function and quality of life. We investigated the relationship between short squeeze contractile integral (SSCI), endurance squeeze contractile integral (ESCI) of high-resolution anorectal manometry (HRAM), and Vaizey incontinence score in adults.</p><p><strong>Methods: </strong>We performed HRAM in 45 adults (26 females and 19 males), and all subjects completed the Vaizey incontinence score questionnaire after enrollment in this prospective study. The diagnosis of fecal incontinence is defined by Rome IV criteria and a Vaizey incontinence score > 5. The contraction power during short and endurance squeezes was quantified by calculating the SSCI and ESCI in the HRAM study.</p><p><strong>Results: </strong>Patients in the incontinence group (n = 12) had significantly lower maximum pressure at short squeeze, SSCI, and ESCI (p = 0.001 and 0.004, respectively) than patients in the continence group (n = 33). The ROC curve analysis identified the SSCI < 65 000 mmHg·s·cm achieved the highest area under the curve for predicting fecal incontinence than the ESCI and the maximum pressure at short squeeze maneuver (77.30%, 74.00%, and 71.15%, respectively). The logistic regression further confirms the SSCI < 65 000 mmHg·s·cm is associated with fecal incontinence after adjusting age and sex (odds ratio = 7.30, p = 0.009).</p><p><strong>Conclusions: </strong>The novel SSCI indicates the adequacy of contraction power during short squeeze by HRAM in adult patients and correlates with fecal incontinence. The correlation between SSCI and Vaizey incontinence score is higher than the traditional measurement of HRAM in adults with fecal incontinence.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014698","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":"Impact of Frailty on Care Burden of Hospitalized Older Adults Receiving Colonoscopy: A 2016-2020 Nationwide Inpatient Sample Analysis.","authors":"Chao-Ling Cheng, Po-Jui Huang, Shih-Ping Huang","doi":"10.1111/jgh.16998","DOIUrl":"https://doi.org/10.1111/jgh.16998","url":null,"abstract":"<p><strong>Background: </strong>Colonoscopy is a widely used diagnostic and therapeutic procedure. The impact of frailty on outcomes of hospitalized older patients undergoing colonoscopy is unclear. This study aims to evaluate associations between frailty and outcomes of hospitalized older adults undergoing colonoscopy.</p><p><strong>Methods: </strong>Data were extracted from the Nationwide Inpatient Sample (NIS), 2016-2020. Hospitalized patients ≥ 65 years old who underwent colonoscopy were included. Frailty was assessed using a modified frailty index (mFI), and frail was defined as mFI ≥ 0.27. The primary outcomes were in-hospital mortality, nonroutine discharge, prolonged length of stay (LOS) (≥ 75th percentile), postprocedural dysrhythmia, and other postprocedural complications.</p><p><strong>Results: </strong>A total of 142 257 hospitalized older adults were included, with 29 558 categorized as frail. The mean age was 77 years, and 54% were males. Frail patients had significantly higher in-hospital mortality (2.7% vs. 1.7%), nonroutine discharge (27.8% vs. 19.6%), prolonged LOS (33.9% vs. 24.2%), and postprocedural dysrhythmia (46.3% vs. 29.2%) compared to nonfrail patients (all, p < 0.001). After adjusting for covariates, frailty remained significantly associated with increased risks of in-hospital mortality (odds ratio [OR] = 1.60), nonroutine discharge (OR = 1.62), prolonged LOS (OR = 1.62), and postprocedural dysrhythmia (OR = 2.12). Stratified analyses by sex and age obtained the same results across all subgroups.</p><p><strong>Discussion: </strong>Frailty is significantly associated with adverse outcomes in hospitalized older adults undergoing colonoscopy. These findings highlight the importance of increased periprocedural care for frail patients to improve clinical outcomes and optimize resource utilization.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022157","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}