Journal of Hypertension最新文献

{"title":"Development of the European Society of Hypertension guidelines for the management of arterial hypertension: comparison of the helpfulness of ESH 2013, 2018, and 2023 guidelines.","authors":"Akos Koller, Zoltán Járai, Johanna Takács","doi":"10.1097/HJH.0000000000003985","DOIUrl":"10.1097/HJH.0000000000003985","url":null,"abstract":"<p><strong>Objective: </strong>Over the last decade, the European Society of Hypertension (ESH) published several guidelines (GLs) for the Management of Arterial Hypertension (2013, 2018, and 2023). We hypothesized that the GL has been improved because of the publications of new evidence. Thus, we aimed to examine the development of ESH guidelines (ESH GLs) by comparing their helpfulness regarding the diagnosis and treatment of hypertension.</p><p><strong>Methods: </strong>A novel mathematical analysis was used to compare ESH GLs. Not only the frequency of Classes of Recommendations (CLASS) and the Levels of Evidence (LEVEL) were examined but a newly developed certainty index (CI) was calculated. This CI allows the CLASS and LEVEL to be assessed together, providing a less biased assessment of GLs, than examining the CLASS and LEVEL independently or related to each other.</p><p><strong>Results: </strong>The number of recommendations showed continuous and significant increases from 2013 ( N  = 110) to 2018 ( N  = 169), and 2023 ( N  = 269). Examining the frequency of CLASS and/or LEVEL led to biased results, showing both improvements and/or worsening comparing years. However, based on the new analysis, a continuous improvement was shown in the percentage of certainty from 2013 to 2023 (2013: 60.5%, 2018: 72.1%, 2023: 75.3%). Accordingly, the CI was also significantly increased from 2013 (CI: 0.21), to 2018 (CI: 0.44), and to 2023 (CI: 0.51).</p><p><strong>Conclusion: </strong>The analysis shows that compared to previous GLs, the structure of the ESH 2023 GL has been rearranged and simplified. The higher number of Recommendations indicates a continuously accumulating knowledge regarding the mechanisms, clinical findings, and epidemiology of hypertension. Moreover, the ESH 2023 GL shows a higher degree of certainty and CI, corresponding to a higher level of helpfulness of the ESH 2023 GL for healthcare professionals to diagnose, prevent, and treat hypertension.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"852-858"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreased adenosine 3',5'-cyclic monophosphate is a driving factor of P300/SIRT1-mediated histone hyperacetylation in obesity-related hypertension.","authors":"Yuting Wang, Qin Zhang, Chen Shen, Hui Wang, Yaqi Li, Haojie Wu, Xiaodong Sun, Lin Shi","doi":"10.1097/HJH.0000000000003981","DOIUrl":"10.1097/HJH.0000000000003981","url":null,"abstract":"<p><strong>Background: </strong>Obesity is the most significant risk factor associated with primary hypertension. A high-fat diet may lead to obesity-related hypertension, with evidence indicating that individuals with this condition exhibit a diminished adenosine 3',5'-cyclic monophosphate (cAMP) signaling pathway, although the exact mechanisms remain unclear. This study aimed to investigate the regulatory role of the cAMP signaling pathway in obesity-related hypertension.</p><p><strong>Methods: </strong>A rat model of obesity-related hypertension was established by feeding with a high-fat diet for 16 weeks. Changes in the cAMP signaling pathway and SIRT1 in rat renal tissues were explored using immunohistochemistry, immunofluorescence, and RT-qPCR. The effects and mechanisms of the cAMP signaling pathway on histone 3 lysine 27 acetylation and ACE1 were investigated by intervening in human renal tubular epithelial cells with P300, cAMP activators, SIRT1, cAMP inhibitors, and oleic acid.</p><p><strong>Results: </strong>The cAMP signaling pathway was found to be suppressed in rat renal tissue after feeding a high-fat diet, and a simultaneous decrease in histone deacetylase was observed. Furthermore, we identified that the inhibition of cAMP leads to the reduction of SIRT1 and the induction of P300. In addition, vitro experiments suggested that oleic acid suppressed the cAMP signaling pathway, which subsequently upregulated histone 3 lysine 27 acetylation and angiotensin converting enzyme 1 (ACE1) by increasing the expression of P300 and decreasing the expression of SIRT1.</p><p><strong>Conclusion: </strong>The reduced cAMP signaling pathway in obesity could promote histone 3 lysine 27 acetylation modification and upregulate ACE1 expression by regulating P300 and SIRT1 levels, which may have important implications in the management of obesity-related hypertension.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"841-851"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the heart rate dipping pattern associated with sleep quality during an ambulatory blood pressure monitoring? A cross-sectional study.","authors":"Carlos E Leiva Sisnieguez, Ricardo D Olano, Rodolfo N Stavile, Julián Minetto, Gustavo Cerri, Walter G Espeche, Horacio A Carbajal, Martín R Salazar","doi":"10.1097/HJH.0000000000003971","DOIUrl":"10.1097/HJH.0000000000003971","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to characterize individuals with nondipping heart rate (HR) and to assess the association between that pattern and sleep quality during the night of an ambulatory blood pressure monitoring (ABPM).</p><p><strong>Methods: </strong>Individuals who attended our Unit to perform an ABPM, from February 2022 to May 2024, were asked about clinical and epidemiological antecedents and responded two validated surveys, about sleep quality during the night of the ABPM and in the prior 30 days. Then, they were categorized according to the presence of a dipping in nocturnal HR (defined as a decline in average HR at night equal or higher than 10% compared with daytime values) as HR dippers or HR nondippers (drop in mean nighttime HR lower than 10% of diurnal mean) in order to compare the mentioned variables.</p><p><strong>Results: </strong>One thousand two hundred and nine individuals were included. They were predominantly female (61.8%), middle-aged (median 50 years, IQR 36-60), overweight (median BMI 29, IQR 25.3-33.5) and had median ABPM estimates within normal ranges. In individuals without beta-blockers ( n  = 1107), HR nondippers had an adverse cardiovascular disease (CVD) risk profile, and no differences were found between HR dippers and HR nondippers concerning perceived good rest during the ABPM night (63.5 vs. 59.7%, P  = 0.211) and usual sleep quality. The sensitivity analysis including beta-blockers' users ( n  = 102) was consistent.</p><p><strong>Conclusion: </strong>A blunted dipping in mean nighttime HR identifies individuals with a high CVD risk profile and is not associated with bad sleep quality during the night of an ABPM.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"790-796"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure phenotypes and day-night variability in acute ischemic stroke: is there any cardiovascular mortality link 10 years after?","authors":"Christina Antza, Vasilios Kotsis","doi":"10.1097/HJH.0000000000003976","DOIUrl":"10.1097/HJH.0000000000003976","url":null,"abstract":"<p><strong>Objective: </strong>Blood pressure (BP) phenotypes and day-night variability have been associated with acute ischemic stroke (AISTR). The aim of this study was to analyze the BP phenotypes and day-night variability during the first 3 days of an AISTR and their correlation with 10-year cardiovascular death (CVD).</p><p><strong>Methods: </strong>Eighty-five volunteers (49.9% men, 77.3 ± 6 years), diagnosed for AISTR, were included in the study. Twenty-four hour ABPM was performed during the first 3 days of AISTR symptoms. A follow-up visit was performed through phone call, 10 years after the AISTR event.</p><p><strong>Results: </strong>There is a reproducible nocturnal circadiac rhythm, with the nondipping status to be the most prevalent (89.3%, 89.2%, 88.3% for Days 1, 2, 3 accordingly, P  > 0.05), compared to dipping status ( P  < 0.05), but not a reproducible BP phenotype, except the hypertensive one (50%, 45.8%, 51.6% for Days 1, 2 and 3 accordingly, P  > 0.05). The mean follow-up was 509.6 ± 10 weeks. 37.1% had died (41.2% from MACE). Cox regression analysis revealed that age [odds ratio (OR):1.15, confidence interval (CI): 1.01-1.17, P  < 0.05], sex (male, OR: 1.92, CI: 1.07-3.82, P  < 0.05), diabetes mellitus (OR: 1.55, CI: 1.06-3.14, P  < 0.05), early vascular ageing (OR: 2.01, CI: 1.19-3.74, P  < 0.05), transient ischemic attack (OR: 2.32, CI: 1.02-5.34, P  < 0.05), sustained hypertension (OR: 2.78, CI: 1.13-6.83, P  < 0.05), day-night SBP ratio (OR: 0.98, CI: 0.96-0.99, P  < 0.05) and day-night DBP ratio (OR: 0.96, CI: 0.94-0.99, P  < 0.05) were significant predictors for CVD.</p><p><strong>Conclusion: </strong>Hence, patients with AISTR present a reproducible nocturnal circadian rhythm, but not a reproducible BP phenotype, except sustained hypertension. These parameters found also to be determinants for 10-year CVD.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"807-813"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased arterial stiffness and left ventricular remodelling as markers of masked hypertension: findings from the PAMELA population.","authors":"Cesare Cuspidi, Rita Facchetti, Elisa Gherbesi, Fosca Quarti-Trevano, Jennifer Vanoli, Giuseppe Mancia, Guido Grassi","doi":"10.1097/HJH.0000000000003970","DOIUrl":"10.1097/HJH.0000000000003970","url":null,"abstract":"<p><strong>Background: </strong>The value of the association of arterial stiffness with left ventricular concentric remodelling/left ventricular hypertrophy (LVH) assessed by echocardiography, for prediction of masked hypertension defined by office and ambulatory blood pressure monitoring (ABPM) in the general population is largely undefined. We investigated this topic in the participants to the Pressioni Monitorate E Loro Associazioni (PAMELA) study.</p><p><strong>Methods: </strong>The study included 272 participants (153 normotensives and 119 with masked hypertension) who attended the second and third survey of the PAMELA study performed after 10 and 25 years from the initial evaluation. Data collection included medical history, physical examination, blood tests, office, ABPM, echocardiographic and Cardio-Ankle Vascular Index (CAVI) measurements.</p><p><strong>Results: </strong>Compared to normotensive individuals, participants with masked hypertension were younger, had significantly higher office, home, mean 24-h, day-time, night-time SBP/DBP and heart rate. The likelihood of having masked hypertension, was approximately more than two-fold higher [odds ratio (OR) = 2.29, confidence interval (CI): 1.01-5.31, P  = 0.04] in participants with increased CAVI and left ventricular remodelling/LVH compared to their counterparts without organ damage. This association showed a unique value in identifying masked hypertension compared to both isolated markers of organ damage (OR = 1.69, P  = 0.15 for increased CAVI and OR = 0.82, P  = 0.80 for left ventricular remodelling/LVH), after adjusting for age, sex, office SBP/DBP, antihypertensive treatment and diabetes.</p><p><strong>Conclusion: </strong>The present study offers a new piece of evidence of the key value of looking for both vascular and cardiac organ damage to unmask MH and improve its clinical management in the general population.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"781-789"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe neurovascular hypertension in a 17-year-old girl cured by microvascular decompression.","authors":"Maximilian Middelkamp, Paula-Sophie Steffens, Valentina Vogelsang, Raphael Schild, Jens Gempt, Ania C Muntau, Lasse Dührsen","doi":"10.1097/HJH.0000000000003986","DOIUrl":"10.1097/HJH.0000000000003986","url":null,"abstract":"<p><p>We report a rare case of centrally caused hypertension in a 17-year-old adolescent due to neurovascular compression of the root entry/exit zone of the ninth/tenth cranial nerves of the rostral ventrolateral medulla oblongata on the left side. The patient underwent a comprehensive diagnostic workup to exclude other causes of secondary hypertension. A cranial magnetic resonance imaging (cMRI) indicated a neurovascular compression. The patient underwent microvascular decompression (MVD) twice. After the first MVD, blood pressure values significantly decreased to normotensive levels without any antihypertensive medication. After one year without clinical symptoms, the patient experienced recurrent hypertension and underwent a second MVD. Again, the blood pressure normalized without any medication or clinical symptoms within six-month follow-up. This case report highlights neurovascular compression at brainstem level as an important differential diagnosis of centrally caused hypertension, even in the absence of specific cranial nerve deficits. MVD is an effective treatment option.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"904-908"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"KAT7 contributes to ponatinib-induced hypertension by promoting endothelial senescence and inflammatory responses through activating NF-κB signaling pathway.","authors":"Liang-Liang Tang, Xin-Yu Xu, Mei Zhang, Qi Qin, Rong Xue, Shuai Jiang, Xu Yang, Chen Liang, Qiu-Shi Wang, Chang-Jiang Yu, Zhi-Ren Zhang","doi":"10.1097/HJH.0000000000003979","DOIUrl":"10.1097/HJH.0000000000003979","url":null,"abstract":"<p><strong>Background and purpose: </strong>Ponatinib, a tyrosine kinase inhibitor (TKI) leads to hypertension; however, the mechanisms remain elusive. We aimed to investigate whether lysine acetyltransferase 7 (KAT7), a key regulator of cellular senescence that is closely associated with cardiovascular diseases, involves in ponatinib-induced hypertension.</p><p><strong>Methods and results: </strong>After administering ponatinib to Sprague-Dawley (SD) rats for 8 days, we measured blood pressure, vasodilation, and endothelial function using tail-cuff plethysmography, isometric myography, and the Total NO Assay kit, respectively. The results indicated that ponatinib increased blood pressure, impaired endothelium-dependent relaxation (EDR), and caused injury to endothelial cells in SD rats. Furthermore, PCR and Western blot experiments demonstrated an upregulation of KAT7 expression in rat mesenteric artery endothelial cells (MAECs) following ponatinib treatment. To further study the role of KAT7 in ponatinib-induced hypertension, we divided the SD rats into four groups: control, ponatinib, WM-3835 (a KAT7 inhibitor), and ponatinib plus WM-3835. Notably, WM-3835 administration significantly improved ponatinib-induced hypertension and EDR dysfunction in SD rats. Mechanistically, over-expression of KAT7 (OE-KAT7) in MAECs led to cellular senescence and inflammation, phenomena that were also observed in the mesenteric arteries of ponatinib-treated rats and in MAECs exposed to ponatinib. However, WM-3835 mitigated these detrimental effects in both in vivo and in vitro experiments. Additionally, both OE-KAT7 and ponatinib treatment induced H3K14 acetylation (H3K14ac), with OE-KAT7 also elevating the recruitment of the H3K14ac to the p21 promoter. Moreover, BAY 11-7085, a nuclear factor (NF)-κB inhibitor, potently alleviated the accumulation of IL-6 and IL-8, as well as endothelial cell senescence induced by ponatinib and KAT7 overexpression.</p><p><strong>Conclusion: </strong>Our data indicate that ponatinib-induced elevation of KAT7 led to endothelial cells senescence and inflammatory responses through H3K14 acetylation and NF-κB signaling pathway, subsequently caused vasotoxicity and hypertension.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"827-840"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chill factor: effect of thermoneutrality on thoracic perivascular adipose tissue and vascular reactivity.","authors":"Sophie N Saxton","doi":"10.1097/HJH.0000000000003983","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003983","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"43 5","pages":"750-751"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma renin activity: blood pressure steps or salt-sensitivity slopes - or both?","authors":"Peter Bie","doi":"10.1097/HJH.0000000000003991","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003991","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"43 5","pages":"747-749"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic and prognostic value of ECG-predicted hypertension-mediated left ventricular hypertrophy using machine learning.","authors":"Hafiz Naderi, Julia Ramírez, Stefan Van Duijvenboden, Esmeralda Ruiz Pujadas, Nay Aung, Lin Wang, Bishwas Chamling, Marcus Dörr, Marcello R P Markus, Choudhary Anwar A Chahal, Karim Lekadir, Steffen E Petersen, Patricia B Munroe","doi":"10.1097/HJH.0000000000004034","DOIUrl":"https://doi.org/10.1097/HJH.0000000000004034","url":null,"abstract":"<p><strong>Objective: </strong>Four hypertension-mediated left ventricular hypertrophy (LVH) phenotypes have been reported using cardiac magnetic resonance (CMR): normal LV, LV remodelling, eccentric and concentric LVH, with varying prognostic implications. The electrocardiogram (ECG) is routinely used to detect LVH; however, its capacity to differentiate between LVH phenotypes is unknown. This study aimed to classify hypertension-mediated LVH from the ECG using machine learning and test for associations of ECG-predicted phenotypes with incident cardiovascular outcomes.</p><p><strong>Methods: </strong>ECG biomarkers were extracted from the 12-lead ECG of 20 439 hypertensive patients in UK Biobank (UKB). Classification models integrating ECG and clinical variables were built using logistic regression, support vector machine (SVM), and random forest. The models were trained in 80% of the participants, and the remaining 20% formed the test set. External validation was sought in 877 hypertensive participants from the Study of Health in Pomerania (SHIP). In the UKB test set, we tested for associations between ECG-predicted LVH phenotypes and incident major adverse cardiovascular events (MACE) and heart failure.</p><p><strong>Results: </strong>Among UKB participants 19 408 had normal LV, 758 LV remodelling, 181 eccentric and 92 concentric LVH. Classification performance of the three models was comparable in UKB. SVM (accuracy 0.79, sensitivity 0.59, specificity 0.87, AUC 0.69) was taken forward for external validation with similar results in SHIP. There was superior prediction of eccentric LVH in both cohorts. In the UKB test set, ECG-predicted eccentric LVH was associated with heart failure (hazard ratio 3.42, 95% CI 1.06-9.86).</p><p><strong>Conclusion: </strong>ECG-based ML classifiers represent a potentially accessible screening strategy for the early detection of hypertension-mediated LVH phenotypes.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}