Journal of Pediatric Gastroenterology and Nutrition最新文献

{"title":"Small-intestinal obstruction due to intramural hematoma in a child with hemophilia A.","authors":"Masaki Shinohara, Kenichiro Konishi, Shigemitsu Kojima, Hisashi Kanda, Takeshi Yamaguchi, Taeko Kaburagi, Mayuko Iijima, Junko Hirato, Hirohide Kawasaki, Akira Nishi","doi":"10.1002/jpn3.70184","DOIUrl":"10.1002/jpn3.70184","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"1120-1121"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760386","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":"Endoscopy and noninvasive tests in pediatric disorders of gut-brain interaction: A multicenter retrospective study of the Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition.","authors":"Mattia Spatuzzo, Chiara Imondi, Paola De Angelis, Fortunata Civitelli, Valentina Giorgio, Caterina Strisciuglio, Renato Tambucci, Federica Ferrari, Cosimo Ruggiero, Giuseppina Russo, Danilo A Fegatelli, Salvatore Oliva","doi":"10.1002/jpn3.70167","DOIUrl":"10.1002/jpn3.70167","url":null,"abstract":"<p><strong>Objectives: </strong>Disorders of gut-brain interactions (DGBIs) are highly prevalent in pediatric gastroenterology and often lead to the use of invasive and noninvasive diagnostic tests, despite the guidance provided by the Rome IV criteria. Rome IV promotes a positive diagnostic approach based on the identification of specific symptoms occurring at defined frequencies, unexplained after thorough medical evaluation. This study aimed to evaluate the frequency and diagnostic accuracy of these tests in pediatric DGBIs.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of pediatric patients (aged 2-16 years) evaluated for suspected DGBIs, as defined by the Rome IV criteria, across five national pediatric gastroenterology centers. Patients with known underlying organic gastrointestinal diseases were excluded. Patients were grouped based on the presence or absence of \"red flags\" for organic pathology, including a positive family history for gastrointestinal diseases, persistent pain outside the periumbilical area, nocturnal symptoms, persistent, bilious, or bloody vomiting; presence of blood in stools or anemia; unexplained fever; altered growth parameters, delayed or abnormal puberty; associated gastrointestinal or extraintestinal symptoms; and abnormal physical findings. Clinical data, final diagnoses, and all performed tests were recorded. Statistical analysis assessed the frequency and diagnostic accuracy of each test, and a multivariate model developed to improve diagnostic accuracy.</p><p><strong>Results: </strong>We included 500 patients with suspected DGBIs from five centers: 52.5% were female, and the median age was 9.1 ± 4.5 years. Red flags were present in 45% of patients, showing a higher frequency of positive family history, elevated inflammatory serological markers, and fecal calprotectin (FC) levels. Patients with red flag underwent more endoscopies; however, no significant increase in the detection of organic disease was observed. No single test alone demonstrated sufficient accuracy in predicting organic pathology. A multivariate model combining the presence of red flags, positive family history, elevated serum platelet count, and increased FC achieved the highest accuracy (area under the curve: 0.711, 95% confidence interval: 0.63-0.79).</p><p><strong>Conclusions: </strong>A model combining red flags for organic disease, positive family history, elevated serum platelet count, and increased FC may aid in the identification of organic diseases in children with suspected DGBIs. Prospective studies are needed to validate this model and to support the diagnostic process when Rome IV criteria alone do not distinguish between organic and functional disorders.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"1089-1099"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682753","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":"Gluten-free oats and diet quality in children and youth with celiac disease.","authors":"Diana R Mager, Zhiqian Jiang, Samantha Rashke, Justine M Turner","doi":"10.1002/jpn3.70168","DOIUrl":"10.1002/jpn3.70168","url":null,"abstract":"<p><strong>Objectives: </strong>Celiac disease (CD) requires lifelong adherence to a strict gluten-free diet (GFD). The GFD is associated with higher intakes of fat, added sugars, and glycemic index (GI) and lower diet quality (DQ) in youth with CD. Gluten-free oats (GF-oats) are safe for CD youth, but few studies have studied the nutritional contribution of GF-oats consumption on DQ in children with CD. We hypothesized that youth with CD who consume GF-oats as part of their GFD will have higher DQ, micronutrient and fiber content, and lower GI than a GFD without GF-oats.</p><p><strong>Methods: </strong>A case-control analysis using age-sex matched controls was performed in youth (ages 3-18 years) with CD in a 1:2 (N = 16 GF-oats cases: N = 32 Oat-free cases) ratio to compare differences in macro- and micronutrient (Canadian nutrient file), GI (mixed-method approach), DQ (healthy-eating index) between case-controls using validated methodologies. Dietary adequacy was determined by comparisons to dietary reference intakes (DRI) and to gluten free food guide (GFFG) recommendations.</p><p><strong>Results: </strong>GF-oats did not significantly improve DQ (68.5 ± 16 [cases] vs. 64.3 ± 13 [controls], macro- and micronutrient, fiber intake, or the percentage of children meeting DRIs (p > 0.05). Children consuming GF-oats had lower dietary GI than children not consuming GF-oats (50.6 ± 2.4 [+GF-oats] vs. 56.1 ± 7.4 [-GF-oats]; p = 0.05). No differences in DQ occurred (±GF-oats) when following GFFG recommendations.</p><p><strong>Conclusions: </strong>GF-oats are not a major determining factor of overall DQ in CD youth. Regardless of the oats in the GFD, following the pediatric GFFG was more important to DQ.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"1070-1078"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675086","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":"Pharmacokinetics and safety of intravenous pantoprazole in a hospitalized pediatric population.","authors":"Nancy A Sherman, Kevin D Wolter, Elena Soto","doi":"10.1002/jpn3.70170","DOIUrl":"10.1002/jpn3.70170","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"1010-1013"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659491","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":"Efficacy of probiotics in reducing the duration and severity of acute gastroenteritis in children: A meta-analysis of randomized controlled trials.","authors":"Mohammed Alsabri, Shree Rath, Dina Essam Abo-Elnour, Noha S Shaban, Mayar M Aziz, Amira A Aboali, Mumen Abdalazim Dafallah, Luis L Gamboa","doi":"10.1002/jpn3.70172","DOIUrl":"10.1002/jpn3.70172","url":null,"abstract":"<p><strong>Objectives: </strong>Acute gastroenteritis is a leading global health concern among children, causing significant morbidity and mortality. Despite advances in treatment, effective management remains a challenge. Probiotics aim to restore gut homeostasis by correcting intestinal dysbiosis. This systematic review and meta-analysis aims to assess the efficacy of probiotics in reducing the severity and duration of diarrhea in children with acute gastroenteritis.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across four major databases using the keywords \"acute diarrhea,\" \"pediatric,\" and \"probiotics,\" among others. Only double-arm randomized clinical trials (RCTs) were included, focusing on the efficacy of probiotics in treating pediatric acute diarrhea. Data analysis was performed using Stata 16.0, with a random-effects model applied to account for study variability.</p><p><strong>Results: </strong>Out of 1470 studies screened, 25 RCTs involving 5170 patients (2552 in the probiotic group and 2618 in the placebo group) met the inclusion criteria. Probiotics significantly reduced the overall duration of diarrhea (mean difference [MD]: -7.76; 95% confidence interval [CI]: -14.60 to -0.91; p = 0.03). Diarrhea frequency was notably reduced on Day 2 (MD: -1.03; 95% CI: -2.06 to 0.00; p = 0.05) and Day 5 (MD: -0.51; 95% CI: -0.83 to -0.18; p = 0.002). Probiotics also significantly reduced the duration of vomiting (MD: -0.19; 95% CI: -0.28 to -0.09; p < 0.01), with a nonsignificant trend in fever reduction.</p><p><strong>Conclusion: </strong>This meta-analysis demonstrates the clinical efficacy of probiotics in reducing the duration of diarrhea and vomiting in children with acute gastroenteritis. Future trials are recommended to further explore the role of specific probiotic strains and combinations to enhance treatment outcomes.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"1000-1009"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753641","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":"Lasting reduced motor function affecting quality of life after liver transplantation in children and adolescents.","authors":"Anniken B Østensen, Unn L Jensen, Anne-Britt Skarbø, Pål-Dag Line, Runar Almaas","doi":"10.1002/jpn3.70183","DOIUrl":"10.1002/jpn3.70183","url":null,"abstract":"<p><strong>Objectives: </strong>Assess long-term motor function and quality of life after liver transplantation in children and adolescents.</p><p><strong>Methods: </strong>Data from movement assessment battery for children (MABC-2), neurocognitive testing and quality of life assessments from children receiving a liver transplant at Oslo University Hospital (1995-2020) were retrospectively collected from the structured testing program after transplantation.</p><p><strong>Results: </strong>A total of 77 pediatric patients (3-16 years), of whom 54 had repeated tests, conducted 173 MABC-2 tests. Thirty percent of the liver transplanted children scored ≤16th percentile, at risk of motor problems, and 9% scored ≤5th percentile indicating severe problems. Manual dexterity (MD) and aiming and catching (AC) (15.7% ≤5th percentile) were more affected than balance (4.3% ≤5th percentile). Children scoring ≤16 percentile for AC reported significantly lower score for social pediatric quality of life inventory compared to those with normal motor skills. Parents reported lower quality of life in children scoring ≤16 percentile compared with transplanted children with normal motor scores (p = 0.016). Large blood transfusion requirements perioperatively were associated with low MD score (p = 0.01). Motor skills did not change from the first test, performed at a median age of 6.5 (4.9-11.7) years, to the last test at 12.3 (10-15) years (p = 0.58). MABC-2 correlated with full-scale intelligence quotient (r = 0.37, p = 0.0024) and verbal comprehension index (r = 0.39, p = 0.001).</p><p><strong>Conclusions: </strong>Motor competence is affected in transplanted children and did not improve over time after transplantation. Large blood transfusion requirements were associated with low manual dexterity score. Impaired motor competence affects quality of life after pediatric liver transplantation.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"943-951"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760385","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":"Small intestinal bacterial overgrowth in children: An expert review by the ESPGHAN Gastroenterology Committee.","authors":"Maria Giovanna Puoti, Amit Assa, Marc A Benninga, Ilse Broekaert, Jenej Dolinsek, Matjaž Homan, Javier Martín-deCarpi, Emmanuel Mas, Erasmo Miele, Zrinjka Misak, Caterina Strisciuglio, Christos Tzivinikos, Isabelle Scheers, Sara Sila, Osvaldo Borrelli","doi":"10.1002/jpn3.70156","DOIUrl":"10.1002/jpn3.70156","url":null,"abstract":"<p><p>The aim of this review is to summarize the prevalence, etiology, pathogenesis, diagnosis, and treatments currently available for small intestinal bacterial overgrowth (SIBO) in children. SIBO is a clinical entity characterized by the presence of an excessive number of bacteria in the small bowel leading to several nonspecific gastrointestinal symptoms due to malabsorption and malnutrition, such as bloating, flatulence, belching, diarrhea, abdominal pain, nausea, steatorrhea, fatigue and stunted growth. Initially thought to develop specifically in the context of abnormal or postsurgical gastrointestinal anatomy, it has then been recognized that it can be associated with other nonsurgical conditions, such as gastrointestinal dysmotility, disorders of gut-brain interactions and chronic use of drugs. The uncertainty regarding the exact cut-off of excessive number of bacteria in the small bowel has led to the absence of a universally accepted definition of SIBO making well-designed research to assess the best diagnostic and therapeutic approaches challenging. Current available diagnostic tools includes duodenal/jejunal aspirate with culture and hydrogen breath tests, which all have some limitations and pitfalls that prevent accurate sampling. The treatment goal should be to treat the underlying causes, restore the healthy intestinal microflora, relieve the symptoms and address the associated complications. The use of antibiotics represents the treatment cornerstore. However, they are commonly used despite the scarce published evidence and the absence of agreement on the dose and duration of the treatment. Currently, data on best diagnostic and therapeutic strategies in children remain lacking. Novel diagnostic approaches for SIBO are emerging and may facilitate further research.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"986-999"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742308","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":"Protein intake and insulin-like growth factor-1 at 12 months and associations with growth, body composition, and metabolic syndrome at 8 years.","authors":"Gabriella O Seidal, Jovanna Dahlgren, Stefan Bergman, Gerd A Tangen, Josefine Roswall","doi":"10.1002/jpn3.70179","DOIUrl":"10.1002/jpn3.70179","url":null,"abstract":"<p><strong>Objectives: </strong>Metabolic programming may occur during early life and have long-lasting effects on metabolic health. This study examined what impact early protein intake and levels of insulin-like growth factor (IGF-1) at 1 year of age had on growth, body composition and risk factors for metabolic syndrome at 8 years of age.</p><p><strong>Methods: </strong>This was a prospective, observational, population-based study of 551 healthy, Swedish children. We used food diaries handed in at 1 year of age, and IGF-1 was measured at the same age. At 8 years of age, the children attended a clinical visit, where they underwent a dual X-ray absorptiometry scan, blood sampling, and anthropometry measurements.</p><p><strong>Results: </strong>Protein intake at 1 year of age was associated with high waist circumference and insulin resistance measured as homeostatic model assessment for insulin resistance, at 8 years of age.</p><p><strong>Conclusions: </strong>Protein intake at 1 year of age may have an impact on later metabolic health, mainly in form of insulin resistance and waist circumference.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"1079-1088"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789347","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":"Healthcare resource utilization and cost trends in pediatric inflammatory bowel disease within an accountable care organization.","authors":"Peter F Farmer, Huey-Fen Chen, Jennifer Cooper, Brendan Boyle, Ross M Maltz, Hilary K Michel, Jennifer L Dotson","doi":"10.1002/jpn3.70162","DOIUrl":"10.1002/jpn3.70162","url":null,"abstract":"<p><strong>Objective: </strong>Healthcare utilization and costs for the inflammatory bowel disease (IBD) population continue to rise nationally. We aimed to describe healthcare utilization and cost trends in children and adolescents with IBD within a pediatric Medicaid accountable care organization (ACO).</p><p><strong>Methods: </strong>Cross-sectional analysis of inpatient and outpatient insurance claims of known patients with IBD at a single center, also enrolled in a regional ACO. Healthcare utilization and costs were assessed by the total number of different types of healthcare encounters and associated claims on a per-year basis.</p><p><strong>Results: </strong>We used data from claims incurred by 269 unique patients between October 2015 and December 2020. Total encounters and costs remained stable apart from a notable decrease in encounters in 2020 (likely related to the COVID-19 pandemic). Proportion of outpatient and inpatient encounter types remained stable, with greater than 94% of encounters being outpatient and 1%-2% inpatient. emergency department (ED) encounters decreased significantly from 141 total ED encounters (5% of encounters) in 2016 to 66 (3%) in 2020. Gastrointestinal surgical encounters remained consistent; however, the costs associated more than doubled from $189,970 (8%) in 2016 to $404,793 (19%) in 2020. Total costs from IBD-related infusion encounters increased from $693,440 (29% of total claims costs) in 2016, to $1,241,089 (60%) in 2020 (p < 0.001). Biosimilar use increased rapidly during our study period with a relative decrease in IBD-related infusion costs.</p><p><strong>Conclusions: </strong>Consistent with adult data, IBD-related infusion encounters are a primary driver of healthcare utilization and cost in pediatric IBD. Biosimilars offer an opportunity to decrease these costs.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"1034-1044"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675087","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":"Predictors of antitumor necrosis factor primary nonresponse and drug durability in pediatric inflammatory bowel disease.","authors":"Nicole Davidson, Grant A Morris, Molly A Wright, Guy Brock, Brendan Boyle, Jennifer L Dotson, Hilary K Michel, Ross M Maltz","doi":"10.1002/jpn3.70160","DOIUrl":"10.1002/jpn3.70160","url":null,"abstract":"<p><strong>Objectives: </strong>Antitumor necrosis factor (anti-TNF) therapies are first-line therapies for children with inflammatory bowel disease (IBD) (Crohn's disease [CD], ulcerative colitis [UC] and IBD-unclassified [IBD-U]). Limited studies describing anti-TNFs durability and loss of response in children. This study evaluates predictors of primary Nonresponse and 3-year drug durability in children with IBD.</p><p><strong>Methods: </strong>This was a single-center retrospective review of patients with IBD less than 18 years old who initiated anti-TNF (infliximab or adalimumab) from January 1, 2014, to December 31, 2019. Clinical and laboratory data were recorded at the time of anti-TNF initiation, 14 weeks, 12 months, and 3 years. Predictors of primary nonresponse (discontinuation within 14 weeks) and durability were assessed.</p><p><strong>Results: </strong>A total of 456 patients initiated anti-TNF therapy (183 adalimumab and 273 infliximab). Thirty-seven (8%) patients were primary nonresponders. The 3-year drug durability for both therapies was >70%. Among patients with CD, the 3-year durability was >75% for both therapies. The 3-year durability with UC/IBD-U was 37% for adalimumab and 56% for infliximab. Predictors of primary nonresponse were an erythrocyte sedimentation rate > 55 mm/h in CD on infliximab, and baseline albumin <4 g/dL and <15.6 years at diagnosis in UC/IBD-U.</p><p><strong>Conclusions: </strong>Anti-TNF therapies had a 3-year durability of >75% in patients with CD, while the durability was lower (37%-56%) for patients with UC/IBD-U. Less than 10% of patients were considered primary nonresponders, which lends support to the long-term durability of anti-TNF therapies for pediatric IBD while keeping in mind predictive factors of Nonresponse.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"1024-1033"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675090","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}