Journal of Gastroenterology最新文献

{"title":"Evidence-based clinical practice guidelines for peptic ulcer disease 2026.","authors":"Mitsushige Sugimoto, Tomoari Kamada, Masanori Ito, Junichi Iwamoto, Tadayoshi Okimoto, Shoko Ono, Takeshi Kanno, Toshimi Chiba, Kengo Tokunaga, Sachiyo Nomura, Takahisa Murao, Toshio Watanabe, Daisuke Asaoka, Eri Iwata, Ting Wang, Hideki Ono, Ryo Katsumata, Satoshi Kikuchi, Naoki Konishi, Satoshi Sato, Aya Sunago, Hiromi Sekiguchi, Hourin Cho, Daisuke Chinda, Osamu Dohi, Akinobu Nakata, Akira Higashimori, Yuka Hirashita, Keigo Misawa, Kazuhiro Mizukami, Daisuke Miyamori, Junko Mukohyama, Hideki Mori, Shuhei Yoshida, Jun Watanabe, Kiichi Satoh, Yuji Mizokami, Atsushi Takagi, Yoshifumi Takeyama, Susumu Eguchi, Sumio Watanabe, Hajime Isomoto, Takao Itoi, Satoshi Mochida","doi":"10.1007/s00535-026-02504-3","DOIUrl":"10.1007/s00535-026-02504-3","url":null,"abstract":"<p><p>In 2026, the fourth edition of the evidence-based clinical practice guidelines for peptic ulcer disease by the Japanese Society of Gastroenterology (JSGE) was revised. These revised guidelines cover epidemiology, hemorrhagic peptic ulcers, Helicobacter pylori eradication therapy, non-eradication therapy, drug-induced ulcers, non-H. pylori, and nonsteroidal anti-inflammatory drug (NSAID) ulcers, remnant gastric ulcers, surgical treatment, and conservative therapy for perforation and stenosis. Although H. pylori infection and NSAIDs use remain two major causes of peptic ulcers, the prevalence and mortality rates of peptic ulcer have been declining due to the widespread use of eradication therapy and development of potent acid-inhibitory drugs in recent years. However, an increasing trend in idiopathic ulcers and ulcers caused by non-H. pylori Helicobacter (NHPH) infection has attracted attention. In this revised edition, therapeutic algorithms for the treatment of peptic ulcers based on H. pylori infection, low-dose aspirin (LDA) or NSAID use, ulcer history, and ulcer complications (e.g., hemorrhage) remain largely unchanged. This edition shows options for H. pylori eradication in various situations compared with the previous edition, and recommends the most effective regimens, regardless of Japanese insurance coverage. In addition, a new flowchart outlining the eradication treatment process has been presented. Compared with the previous version, the main changes in pharmacological treatment have been made: due to its acid-inhibitory characteristics compared with proton pump inhibitors and increased evidence of its efficacy and safety, vonoprazan has now been selected as the first-line treatment for peptic ulcers and NSAID- and LDA-induced ulcers.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":"1361-1381"},"PeriodicalIF":5.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813045","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":"Clinical characteristics and outcomes of bacterial and viral gastrointestinal infection by pathogen: a large-scale observational study in United States.","authors":"Taito Kitano, Daisuke Kitagawa, Sayaka Yoshida","doi":"10.1007/s00535-026-02523-0","DOIUrl":"https://doi.org/10.1007/s00535-026-02523-0","url":null,"abstract":"<p><strong>Background: </strong>The evaluations of clinical characteristics and outcomes by specific gastrointestinal (GI) pathogen are critical. This study aimed to evaluate GI pathogen-specific clinical characteristics and outcomes using a large-scale database.</p><p><strong>Methods: </strong>This retrospective cohort study used a database (TriNetX) of multicenter electronic health records to evaluate clinical characteristics and outcomes of GI infection by 14 bacterial and viral pathogen groups. Evaluated clinical outcomes were all-cause 30-day ward admission, critical care admission and mortality.</p><p><strong>Results: </strong>The number of patients with GI infection by pathogen ranged from Vibrio (N = 373) to norovirus (N = 24,100). For all-cause 30-day mortality, norovirus had the higher mortality rate (1.7%) than other viruses, including 0.4% for rotavirus, 0.9% for adenovirus, 0.5% for astrovirus, and 0.5% for sapovirus. The comparative trends by pathogen were maintained for the all-cause 30-day critical care admission rate and hospitalization rate. The elderly had the highest mortality rate across investigated GI pathogens. For the critical care admission rate by age group, Shiga toxin-producing E. coli (7.2%) and norovirus (5.0%) had relatively high critical care admission rates in children <5 years.</p><p><strong>Conclusion: </strong>Severe clinical outcomes following GI infection were not rare across investigated pathogens with the elderly having the highest mortality rate. A limitation of this study was that it assessed only all-cause outcome events. The study findings may guide future development and allocation of preventive and therapeutic interventions.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110572","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":"Correction: Evaluation of endoscopic submucosal dissection as a treatment option for duodenal tumors ≥ 20 mm: a systematic review and meta-analysis by lesion size.","authors":"Daisuke Minezaki, Yusaku Takatori, Motohiko Kato, Yasunori Sato, Kohei Takizawa, Koichi Kurahara, Naomi Kakushima, Nobutsugu Abe, Osamu Dohi, Satoru Nonaka, Seiichiro Fukuhara, Shoichi Yoshimizu, Shu Hoteya, Yasushi Yamasaki, Naohisa Yahagi","doi":"10.1007/s00535-026-02519-w","DOIUrl":"https://doi.org/10.1007/s00535-026-02519-w","url":null,"abstract":"","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110569","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":"Prior vedolizumab exposure and fibroblast-derived MMP13 are associated with ustekinumab nonresponse in ulcerative colitis.","authors":"Yuiko Tsuruta, Yoki Furuta, Masatoshi Nakashima, Cheng Pan, Shota Takano, Koichi Sakurai, Hideki Kitada, Kana Omoto, Taichi Matsuyama, Yoshinari Sakai, Suguru Chiyonaga, Kotaro Fukubayashi, Takashi Shono, Masakuni Tateyama, Kotaro Waki, Munenori Honda, Kenshi Matsuno, Akira Yamasaki, Hideaki Miyamoto, Ryosuke Gushima, Takehisa Watanabe, Katsuya Nagaoka, Hideaki Naoe, Yoshihiro Komohara, Yasuhito Tanaka","doi":"10.1007/s00535-026-02506-1","DOIUrl":"https://doi.org/10.1007/s00535-026-02506-1","url":null,"abstract":"<p><strong>Background: </strong>As therapeutic options for ulcerative colitis increase, optimizing the sequencing of advanced therapies has become an important challenge. We examined whether baseline clinical characteristics influence the effectiveness of ustekinumab and investigated molecular signatures associated with ustekinumab resistance.</p><p><strong>Methods: </strong>This multicenter, retrospective study enrolled 102 patients with ulcerative colitis who initiated ustekinumab at 11 institutions. Clinical response and remission were assessed at 2, 6, and 12 months. Ustekinumab persistence was evaluated by Kaplan-Meier analysis. Predictive factors of nonresponse at 6 months were analyzed by logistic regression. To explore the molecular determinants of ustekinumab nonresponse, colonic tissue analyses were performed to identify candidate genes and their cellular sources. Cytokine stimulation experiments using intestinal fibroblasts were conducted to investigate upstream regulatory pathways.</p><p><strong>Results: </strong>The 6-month clinical response and remission rates were 69.6% and 42.2%, respectively, with a 1-year ustekinumab persistence rate of 72.5%. Prior vedolizumab exposure was independently associated with ustekinumab nonresponse (odds ratio = 3.956; 95% confidence interval = 1.085-14.429). Transcriptomic profiling demonstrated enrichment of extracellular matrix-related pathways in nonresponders, and quantitative polymerase chain reaction confirmed significantly elevated matrix metalloproteinase 13 expression. In vitro stimulation assays demonstrated that interleukin-1β robustly induced matrix metalloproteinase 13 expression in intestinal fibroblasts.</p><p><strong>Conclusions: </strong>Prior vedolizumab exposure was associated with lower ustekinumab effectiveness, suggesting that treatment history may be important when determining therapeutic sequencing in ulcerative colitis. Fibroblast-derived matrix metalloproteinase 13 represents a promising molecular marker associated with nonresponse to ustekinumab and may reflect an interleukin-1β-driven inflammatory fibroblast program linked to diminished treatment responsiveness.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074934","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":"NOTCH-mediated glial CXCL9:SPP1 polarization by GSK3β exacerbates postnatal enteric nervous system dysfunction in Hirschsprung disease.","authors":"Yanyi Li, Yuanli Wang, Chengyan Tang, Xinrong Xia, Yuan Gong, Qing Du, Bo Wang, Shengying He, Yuanmei Liu, Zhu Jin, Zebing Zheng","doi":"10.1007/s00535-026-02500-7","DOIUrl":"https://doi.org/10.1007/s00535-026-02500-7","url":null,"abstract":"<p><strong>Background: </strong>Current surgical treatment of Hirschsprung disease (HSCR), a rare congenital intestinal disorder, is frequently complicated by defecation dysfunction. The role of glycogen synthase kinase 3 beta (GSK3β), aberrantly highly expressed in HSCR tissues, in the HSCR pathogenesis remains unclear.</p><p><strong>Methods: </strong>Publicly available scRNA-seq data of HSCR were analyzed. Histopathological characteristics of clinical samples were observed from HSCR children using Hematoxylin-Eosin staining. Regulation of the CXCL9:SPP1 (CS) polarization of glial cells by the GSK3β-NOTCH axis was assessed in both clinical samples and Schwann cells through immunofluorescence (IF), qRT-PCR, and Western blot. Regulation of neuronal development by the CS polarization was assessed in a co-culture system of Schwann cells and mouse dorsal root ganglion neurons using TUNEL staining, ELISA, IF, and patch-clamp techniques. In an Ednrb knockout mouse model, we verified in vivo that GSK3β regulated CS polarization of enteric glial cells via the NOTCH signaling pathway, which exacerbated developmental abnormalities of the enteric nervous system (ENS) and accelerated the progression of HSCR in vivo.</p><p><strong>Results: </strong>Enteric glial cells were significantly increased in HSCR mouse samples, mainly as an SPP1⁺ subpopulation where GSK3β was highly expressed and the NOTCH signaling pathway was significantly enriched. GSK3β knockdown significantly attenuated CS polarization and blocked the NOTCH pathway. Mechanistically, GSK3β promoted enteric glial cell CS polarization by activating the NOTCH signaling pathway and aggravated the developmental abnormalities of the ENS, ultimately exacerbating postnatal ENS dysfunction and thereby potentially worsening HSCR-associated complications.</p><p><strong>Conclusion: </strong>GSK3β upregulation promotes NOTCH signaling pathway activation, which in turn regulates CS polarization and potentially exacerbates postnatal ENS dysfunction and aggravates HSCR-associated complications.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976809","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":"The evolving landscape of chronic pancreatitis in Japan: findings from a nationwide epidemiological survey in 2021.","authors":"Atsushi Masamune, Ryotaro Matsumoto, Tetsuya Takikawa, Yasuhisa Sekino, Yuichi Tanaka, Yu Tanaka, Takanori Sano, Yoshifumi Takeyama, Kazuhiro Kikuta","doi":"10.1007/s00535-026-02518-x","DOIUrl":"https://doi.org/10.1007/s00535-026-02518-x","url":null,"abstract":"<p><strong>Background: </strong>To reassess the clinico-epidemiological characteristics of chronic pancreatitis (CP) in Japan, we conducted a nationwide epidemiological survey.</p><p><strong>Methods: </strong>A two-stage nationwide survey was performed targeting patients with CP treated at participating hospitals in 2021. The first-stage survey estimated the number of patients, and the second-stage survey collected detailed clinical information.</p><p><strong>Results: </strong>The estimated number of patients with definite or probable CP in 2021 was 73,590 (prevalence, 58.6 per 100,000 population), representing a 30% increase from 2016. The estimated number of newly diagnosed patients was 17,490, corresponding to an annual incidence of 13.9 per 100,000 population. Detailed clinical data were available for 4633 patients. The male-to-female ratio was 4.15:1, the mean age in 2021 was 64.4 years, and the mean age at diagnosis was 58.7 years. Alcohol was the leading etiology (69.6%), followed by idiopathic CP (24.3%). Notably, alcohol-related CP accounted for 39.5% of female cases. Diabetes mellitus and pancreatic exocrine insufficiency were present in 45.8% and 36.6% of patients, respectively. Endoscopic treatment was the initial intervention in 92.8% of patients undergoing treatment for pancreatic stones and/or pancreatic duct strictures. Malignancies were identified up to the time of the survey in 18.0% of patients, including pancreatic cancer in 89 patients.</p><p><strong>Conclusions: </strong>The prevalence of CP in Japan continues to increase. The aging CP population, the increasing proportion of alcohol-related CP among women, and the substantial burden of diabetes, exocrine insufficiency, and malignancy underscore the growing healthcare impact of CP and the need for effective prevention and long-term management strategies.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945036","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":"A PRK-armed oncolytic adenovirus drives calreticulin exposure for dendritic cell licensing to prime antitumor CD8⁺ T cells and synergizes with anti-PD-1 or CAR-T therapy in colorectal cancer.","authors":"Yan Liu, Beibei Ran, Lingkai Kong, Dan Zhou, Yan Zhuang, Ciliang Guo, Xuanqi Ren, Jiazhen Li, Xiaoqi Yang, Huawei Cui, Qilei Xin, Lingjun Xiao, Xiaosong Gu, Junhua Wu, Chunping Jiang","doi":"10.1007/s00535-026-02513-2","DOIUrl":"https://doi.org/10.1007/s00535-026-02513-2","url":null,"abstract":"<p><strong>Background: </strong>The therapeutic potential of oncolytic adenoviruses (ADVs) in colorectal cancer is constrained by a counterproductive host response: virus-triggered hyperactivation of the pro-survival AKT pathway, which fosters an immunosuppressive tumor microenvironment.</p><p><strong>Methods: </strong>We engineered a novel oncolytic adenovirus, ADV-PRK, designed to co-express the AKT-inhibitory peptide PRK. Its antitumor efficacy and mechanisms were evaluated in syngeneic (MC38, CT26) and humanized mouse models. Molecular analyses (Western blot, immunofluorescence, and qPCR) elucidated signaling pathways. Immunological outcomes were assessed via flow cytometry and in vitro co-culture assays. Combination therapies with anti-PD-1 or CAR-T cells were tested in vivo.</p><p><strong>Results: </strong>We demonstrate that ADV-PRK abrogates phosphorylation of both AKT and its downstream effector, the ER calcium channel IP3R3. This suppression drives ER calcium efflux, inducing calreticulin (CRT) translocation to the cell surface. Surface-exposed CRT acts as a potent \"eat-me\" signal, licensing dendritic cells to prime and activate tumor-specific CD8⁺ T cells, which are essential for efficacy. In vivo, ADV-PRK monotherapy achieved superior tumor control. It demonstrated potent synergy with both anti-PD-1 and CAR-T cell therapy, by remodeling the immune landscape to expand activatable T cells and support adoptive cellular therapy. Its activity in a humanized model confirms translational relevance.</p><p><strong>Conclusions: </strong>Our work delineates a distinct immunomodulatory axis, AKT-IP3R3-Ca²⁺-CRT, to reverse adenovirus-induced immunosuppression. This provides a translatable, mechanism-based strategy to convert immunologically \"cold\" tumors into environments receptive to immunotherapy, thereby offering a rational combinatorial approach to overcome resistance and significantly broaden the applicability of current immunotherapies.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906367","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":"Young age or surgical selection? Interpreting lymph-node metastasis risk in T1 colorectal cancer.","authors":"Gökhan Köker, Galip Egemen Atar","doi":"10.1007/s00535-026-02516-z","DOIUrl":"https://doi.org/10.1007/s00535-026-02516-z","url":null,"abstract":"","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900758","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":"Clinical practice guidelines for duodenal cancer 2025.","authors":"Satoshi Yasuda, Kenji Nakagawa, Mitsuhiro Fujishiro, Naomi Kakushima, Takahiro Horimatsu, Ken-Ichi Okada, Motohiko Kato, Osamu Dohi, Satoru Nonaka, Takashi Hirose, Shingo Kanaji, Shinji Kuroda, Takuro Saito, Chie Takishita, Chie Tanaka, Shunsuke Doi, Souya Nunobe, Tsutomu Fujii, Yukiya Narita, Saori Mishima, Kei Muro, Tetsuo Ushiku, Yasuo Ejima, Hiroki Yamaue, Yasuhiro Kodera, Masayuki Sho","doi":"10.1007/s00535-026-02514-1","DOIUrl":"https://doi.org/10.1007/s00535-026-02514-1","url":null,"abstract":"<p><p>Although duodenal cancer is a rare malignancy, its detection has been increasing with the widespread use of upper gastrointestinal endoscopy and advances in diagnostic modalities, and interest in its diagnosis and treatment is growing. Four years after the publication of the first edition of the clinical practice guidelines for duodenal cancer (2021 edition), we have prepared a revised edition that reflects the new findings accumulated during this period. In the field of diagnosis and endoscopic therapy, we further clarified the indications for treatment of non-ampullary duodenal epithelial tumors and provided specific recommendations for biopsy indications. For endoscopic treatment, the indication criteria for endoscopic submucosal dissection (ESD) were stratified according to lesion size and institutional experience, and specific techniques for the prevention of adverse events were presented. In surgical treatment, a new clinical question on minimally invasive surgery was established, and the current status and challenges of laparoscopic and robot-assisted surgery were summarized. In chemotherapy, we emphasized the importance of personalized medicine based on gene panel testing and biomarkers, and incorporated the latest treatment strategies, including immune checkpoint inhibitors. This revised edition is intended to serve as a practical reference in daily clinical practice and to contribute to further improving outcomes for patients with duodenal cancer.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897072","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":"Protective sufficiency versus mechanistic mediation of 4-hydroxybenzoic acid in DSS colitis.","authors":"Huanhuan Li, Bin Wei","doi":"10.1007/s00535-026-02517-y","DOIUrl":"https://doi.org/10.1007/s00535-026-02517-y","url":null,"abstract":"","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891899","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}