Journal of periodontal research最新文献

{"title":"Herpesvirus Simplex Virus-1 Exploits Inflammation to Infect Periodontal Stem Cells and Disrupt Lineage Commitment.","authors":"Araceli Valverde, Raza Ali Naqvi, Yinghua Chen, Alireza Moshaverinia, Anne George, Deepak Shukla, Gloria Martinez, Gabriella Chapa, Salvador Nares, Afsar R Naqvi","doi":"10.1111/jre.70022","DOIUrl":"https://doi.org/10.1111/jre.70022","url":null,"abstract":"<p><strong>Aims: </strong>Elevated levels of Herpes Simplex Virus 1 (HSV-1) have been reported in periodontitis, however, the tropism and relationship with periodontal inflammation are poorly characterized. This study investigated how inflammation affects viral tropism toward human periodontal ligament stem cells (hPDLSCs).</p><p><strong>Methods: </strong>HSV-1 gB and gD transcripts in healthy and diseased human gingiva were measured by RT-qPCR and confirmed in HSV-1-infected murine gingiva. HSV-1 infection in hPDLSCs was analyzed by imaging and flow cytometry. hPDLSCs were individually treated with IL-6, TNF-α, GMCSF, IL-10, or PgLPS, and HSV-1 replication was assessed by infecting with the 17 GFP strain. Lineage markers in virally infected hPDLSCs during osteogenic differentiation were measured by RT-qPCR and immunofluorescence in vitro and validated in vivo. Mice subjected to ligature-induced periodontitis (LIP) and infected with HSV-1 were examined for gingival histology, inflammatory cytokines, and alveolar bone loss.</p><p><strong>Results: </strong>Inflamed human gingiva showed higher expression of viral transcripts compared to healthy controls. In mouse oral HSV-1 infection, gB and gD expression increased over time, with higher levels in mice with ligature-induced periodontitis. Virus infected hPDLSCs challenged with inflammatory mediators or PgLPS showed higher GFP, while IL-10 treatment attenuated GFP levels. Importantly, HSV-1 17 GFP infection affected osteoblast lineage commitment by promoting the expression of key transcription factors in vitro and in vivo. Compared to the LIP alone group, higher levels of inflammatory markers and bone loss were evident in HSV-1 infected with LIP.</p><p><strong>Conclusion: </strong>hPDLSCs are trophic to HSV-1 in vitro and in vivo, with periodontal inflammation playing a significant role in viral tropism.</p>","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731900","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":"Soft-Tissue Phenotype Modification as an Adjunct to the Treatment of Peri-Implant Mucositis-A Quasi-Randomized Clinical Trial.","authors":"Zeynep Aksu, Sila Cagri Isler, Berrin Unsal, Andrea Roccuzzo, Mario Romandini","doi":"10.1111/jre.70014","DOIUrl":"https://doi.org/10.1111/jre.70014","url":null,"abstract":"<p><strong>Aim: </strong>This quasi-randomized clinical trial evaluated the additional benefit of soft-tissue phenotype modification via free palatal graft (FPG) as an adjunct to non-surgical therapy for peri-implant mucositis. A secondary objective was to determine whether any observed effects were mediated by improved plaque control.</p><p><strong>Methods: </strong>Forty-three patients (55 implants) with peri-implant mucositis and keratinized tissue width (KTW) < 2 mm were enrolled. One month after oral hygiene instructions and non-surgical treatment, participants were quasi-randomly allocated to either an FPG procedure (test group, n = 22) or no additional intervention (control group, n = 21). The primary outcome was bleeding on probing (BoP) extent at 6 months (i.e., number of bleeding sites per implant). Secondary outcomes included peri-implant phenotype parameters (KTW, tissue thickness, and vestibular depth), plaque extent, and other peri-implant health measures (BoP severity, probing pocket depth [PPD], peri-implant soft-tissue dehiscence [PISTD], and treatment success). Intergroup comparisons were performed using regression analyses, and a mediation analysis assessed whether treatment effects were mediated by improved plaque control.</p><p><strong>Results: </strong>At 6 months, FPG significantly increased KTW (mean difference [MD] = 2.36 mm; p < 0.001) and tissue thickness (MD = 0.97 mm; p < 0.001), while reducing plaque extent (MD = -1.49; p < 0.001), compared with the control group. BoP extent was significantly lower in the test group (0.75 ± 1.07) than in controls (1.83 ± 1.20) (MD = -1.06; 95% CI: -1.67 to -0.44; p = 0.001). Additionally, the test group exhibited lower BoP severity (MD = -0.50; p < 0.001) and higher treatment success (OR = 8.44; p = 0.001). No significant differences were observed in PPD and PISTD. Mediation analysis suggested that the observed benefits of FPG on peri-implant health were largely independent of improved plaque control.</p><p><strong>Conclusion: </strong>FPG effectively modified the peri-implant soft-tissue phenotype and, as an adjunct to non-surgical therapy, provided additional benefits in managing peri-implant mucositis. The effects on peri-implant health were not attributable to improved plaque control.</p>","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731901","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":"Limosilactobacillus reuteri-Fusobacterium nucleatum Interactions Modulate Biofilm Composition and Immunogenicity.","authors":"Luming Yang, Gopu Sriram, Ren Jie Jacob Chew, Kai Soo Tan","doi":"10.1111/jre.70021","DOIUrl":"https://doi.org/10.1111/jre.70021","url":null,"abstract":"<p><strong>Aim: </strong>The interactions between Limosilactobacillus reuteri and oral bacteria are poorly understood. This study seeks to characterize how two strains of L. reuteri coaggregate with Fusobacterium nucleatum, determining the impact on the biofilm composition and immunogenicity.</p><p><strong>Methods: </strong>A series of in vitro experiments was conducted using L. reuteri DSM 17938 and ATCC PTA 5289, Fusobacterium nucleatum ATCC 25586, and Porphyromonas gingivalis W50. The coaggregation between individual strains of L. reuteri, F. nucleatum, and P. gingivalis was evaluated using the tube coaggregation assay and confocal microscopy. Biofilm compositions were determined by confocal microscopy and culture. The effect of coaggregation on the immunogenicity of L. reuteri-F. nucleatum aggregates were evaluated using periodontal ligament fibroblasts, oral epithelial cells, and monocytes.</p><p><strong>Results: </strong>Both L. reuteri DSM and PTA strains demonstrated coaggregation with F. nucleatum. This interaction reduced the amount of F. nucleatum in biofilm by 1000-fold. Additionally, the coaggregation between L. reuteri and F. nucleatum lowered its immunogenicity. Furthermore, the coaggregation of L. reuteri with F. nucleatum led to a 50% reduction in the amount of P. gingivalis present in the biofilm.</p><p><strong>Conclusion: </strong>This study demonstrates novel mechanisms through which L. reuteri can exert its effects as a probiotic. The coaggregation with L. reuteri modulates the immunogenicity of F. nucleatum and impairs its ability to serve as the bridging species, altering the biofilm composition, thus limiting the extent of dysbiosis.</p>","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707748","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":"Peri-Implantitis and Soft Tissue Dehiscence in a Turkish Population: Risk Indicators, Diagnostic Parameters and Biomarkers Discovery.","authors":"Sila Cagri Isler, Gulcin Akca, Berrin Unsal, Georgios Romanos, Anton Sculean, Mario Romandini","doi":"10.1111/jre.13422","DOIUrl":"https://doi.org/10.1111/jre.13422","url":null,"abstract":"<p><strong>Aim: </strong>To assess (i) the risk indicators of peri-implantitis and peri-implant soft-tissue dehiscence (PISTD), and (ii) the accuracy of clinical parameters and peri-implant crevicular fluid (PICF) immunological markers in diagnosing peri-implantitis, within a Turkish university population.</p><p><strong>Methods: </strong>A total of 324 implants in 112 patients were included. The outcomes for the risk indicators analysis were the presence of peri-implantitis and PISTD, with peri-implantitis also serving as the reference standard for the diagnostic accuracy analysis. Several potential risk indicators-including demographic, medical, and dental history, clinical and radiographic parameters, and dental chart data-were assessed using multilevel logistic regressions. The diagnostic performance of clinical parameters and PICF immunological markers was evaluated using logistic regressions and reporting sensitivity, specificity, positive/negative predictive values, and area under the curve (AUC) values.</p><p><strong>Results: </strong>In the final multilevel logistic regression, the following indicators were associated with peri-implantitis: stage III-IV periodontitis (OR = 5.67), irregular maintenance (SPIC) compliance (OR = 7.71), history of implant loss (OR = 14.44), implant system, absence of keratinized mucosa (KM) (OR = 8.41), and clinical attachment loss in adjacent teeth (OR = 3.75). Risk indicators for PISTD included: mandibular location (OR = 0.22), implant system, absence of KM (OR = 5.95), and mucosal thickness < 2 mm (OR = 197.01). Peri-implant bleeding on probing (BoP) at 2 or more sites had the highest sensitivity for peri-implantitis (98.0%), while the highest specificity was observed for BoP severity (modified Bleeding Index 2-3 = 96.4%). The highest AUC was found for peri-implant probing pocket depth (PPD) ≥ 6 mm (0.88). Among PICF immunological markers, IL-2 and IL-10 exhibited the highest sensitivity (100.0%), while TNF-α had the highest specificity (92.9%). IL-8 and TNF-α had the highest AUC values (0.80).</p><p><strong>Conclusion: </strong>In this Turkish university cohort, several risk indicators were identified for peri-implantitis and PISTD. Among clinical parameters, only PPD ≥ 6 mm demonstrated strong diagnostic accuracy for peri-implantitis. Several PICF immunological markers, particularly IL-8 and TNF-α, showed promising diagnostic potential.</p>","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707749","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":"Periodontal Prognosis: The Past, the Present, the Future.","authors":"Jack G Caton","doi":"10.1111/jre.70020","DOIUrl":"https://doi.org/10.1111/jre.70020","url":null,"abstract":"","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690580","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":"Role of Keratinized Mucosa on the Risk of Peri-Implant Diseases and Soft Tissue Dehiscence in the Posterior Mandible-A 20-Year Prospective Cohort Study.","authors":"Andrea Roccuzzo, Jean-Claude Imber, Alexandra Stähli, Mario Romandini, Anton Sculean, Giovanni E Salvi, Mario Roccuzzo","doi":"10.1111/jre.70018","DOIUrl":"https://doi.org/10.1111/jre.70018","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the 20-year outcomes of tissue-level implants placed in the posterior mandible, comparing implants surrounded by keratinized tissue (KT) or alveolar mucosa (AM).</p><p><strong>Methods: </strong>At baseline, 128 patients (128 implants) were rehabilitated with implant-supported fixed dental prostheses in the posterior mandible and enrolled in a supportive periodontal/peri-implant care (SPC) program. Patients were categorized based on the presence (KT) or absence (AM) of keratinized mucosa. During the first 10 years of SPC, 11 AM patients underwent free gingival grafting (FGG), identifying a third group (AM + FGG). At the 20-year follow-up, peri-implant health status and soft-tissue dehiscence were assessed according to the 2018 Case Definitions. The need for additional treatment between the 10- and 20-year examinations was also recorded.</p><p><strong>Results: </strong>Of the 98 patients evaluated at the 10-year follow-up, 64 (KT = 42; AM = 16; AM + FGG = 6; drop-out rate: 35%) attended the 20-year examination. Additional treatment was required in 11 AM patients (50%) versus 2 KT patients (5%) (p < 0.01). AM implants exhibited significantly greater marginal bone loss, bleeding on probing, and soft tissue recession compared to KT implants (p < 0.01). The application of an FGG (AM + FGG = 6) had a protective effect on peri-implant health status at 20 years. Peri-implantitis was diagnosed in 4.2% of implants surrounded by keratinized mucosa (KT or AM + FGG) versus 25% in the AM group (OR = 6.67; 95% CI: 1.09-40.9; p = 0.041).</p><p><strong>Conclusion: </strong>Tissue level implants placed in the posterior mandible without KT showed greater marginal bone loss, bleeding on probing, soft tissue recession, and peri-implant diseases compared to implants with KT at 20 years.</p>","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675092","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":"Stem Cells From Dental Pulp, Periodontal Tissues, and Other Oral Sources: Biological Concepts and Regenerative Potential.","authors":"Karim M Fawzy El-Sayed, Sara El Moshy, Israa Ahmed Radwan, Dina Rady, Aiah A El-Rashidy, Marwa M S Abbass, Christof E Dörfer","doi":"10.1111/jre.70015","DOIUrl":"https://doi.org/10.1111/jre.70015","url":null,"abstract":"<p><p>The dental pulp and the periodontal tissues are crucial for maintaining oral health through supporting the structure, function, and integrity of teeth and surrounding tissues. The potential to regenerate these tissues (in case of their damage) represents a significant advancement in dental medicine. A functional regeneration could profoundly impact the quality of life for individuals with dental and periodontal diseases through offering new solutions to tissue loss and dental functional impairment, beyond what conventional dental therapies would provide. Studies on tissue engineering-based dentin-pulpal and periodontal regeneration have demonstrated promising results, using mesenchymal stromal cells (MSCs) from sources like bone marrow, adipose tissue, and cord blood. Nevertheless, MSCs derived directly from dental and periodontal tissues exhibit unique biological properties, with the potential to specifically address dental and periodontal regeneration, holding distinctive regenerative and immunomodulatory properties that may allow them to become valuable tools in clinical regenerative procedures. Their use in therapies could greatly benefit patients with oral and periodontal diseases, potentially enhancing life quality. Despite these promising findings, the distinct regenerative capacity of these cells, their mechanisms, and their potential clinical translational applications remain not fully elucidated. This review article aims to consolidate current knowledge about the biological characteristics and regenerative capabilities of dental and periodontal MSCs. By exploring the biology, isolation, and functional capacities of these cells, this work seeks to offer a deeper understanding of their potential and limitations, guiding future research and clinical strategies.</p>","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667855","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":"The Role of Oxidative Stress in Periodontitis.","authors":"Pedro Bullon, Francesca Giampieri, Beatriz Bullon, Maurizio Battino","doi":"10.1111/jre.70016","DOIUrl":"https://doi.org/10.1111/jre.70016","url":null,"abstract":"<p><p>Periodontitis and noncommunicable diseases share an overall inflammatory state often sustained by concomitant oxidative stress as one of the main processes involved. A huge amount of literature supports such a main pathogenic process, which is also considered the therapeutic target. The attempt to control inflammation by acting on oxidative stress has given largely unsatisfactory results, either as preventive or as treatment approaches. To propose new ideas that will help in this field, the paper reviewed all physiological processes involved in oxidative stress in periodontitis. The discussion considers all of them, considering whether they come from endogenous sources, that is, all the intracellular physiological devices and/or processes that are involved in oxidative stress, such as mitochondria, rough endoplasmic reticulum, peroxisomes, autophagy, and aging, or from exogenous sources, that is, the external factors that affect oxidative stress, such as nutrition, physical activity, psychological status, environmental conditions, microbiome, and drugs. The most important conclusion is that all of them should be taken into consideration in future research since we need to address oxidative stress as part of a specific biological and metabolic cellular state in a multicellular organism. To understand the cellular physiology that underlies oxidative stress and consider this point in treating each of our periodontal patients according to a specific oxidative state could be called personalized/precise oxidative stress therapy (POST) and should include the following points: (1) environmental conditions, (2) individual characteristics, and (3) oxidative state of different intracellular organelles.</p>","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649792","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":"Surgical Versus Non-Surgical Treatment of Periodontitis: The Past, the Present, the Future","authors":"Bruce L. Pihlstrom","doi":"10.1111/jre.70017","DOIUrl":"10.1111/jre.70017","url":null,"abstract":"&lt;p&gt;Overall, the goal of periodontal therapy is to maintain the natural dentition in health, comfort, and function. For decades, dentists have considered, discussed, and debated the fundamental question of whether to use surgical or non-surgical therapy to treat periodontitis [&lt;span&gt;1, 2&lt;/span&gt;]. Historically, decisions for or against using various treatments were based on anecdotal evidence and clinical experience. Over the last 50 years or so, clinical research has provided objective data to support both methods of therapy. This led to the current management of periodontitis, which involves a combination of both non-surgical and surgical interventions. One of the main questions facing clinicians today is how to monitor the stability of periodontitis following treatment so they can intervene to prevent or reverse further loss of periodontal support. While future treatment strategies cannot be predicted, advances in periodontal diagnosis, new technology, cost-effectiveness, precision care, artificial intelligence, and new ways to control periodontal inflammation are likely to influence future methods of periodontal treatment.&lt;/p&gt;&lt;p&gt;It should be noted that these studies used practitioner-measured outcomes of probing depth and CAL rather than the patient-centered outcome of tooth retention. This was necessary because tooth loss from periodontitis occurs over many years, making it impractical to use as an outcome measure in shorter studies. However, CAL is generally accepted as a valid measure of periodontal support and, importantly, CAL loss ≥ 2 mm has been validated as an informative surrogate for tooth loss in a large 26-year population study [&lt;span&gt;20&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In the past, surgical and non-surgical treatment for periodontitis were often viewed as distinct and separate treatment strategies. Today there is more emphasis on integrating non-surgical and surgical treatment into a continuum of therapy. Depending on specific diagnoses, systemic health, risk factors, and other considerations, both are frequently used and have been endorsed by the American Academy of Periodontology [&lt;span&gt;23&lt;/span&gt;] and the European Federation of Periodontology [&lt;span&gt;24&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;It is impossible to predict the future of any discipline, but current trends can provide some insight into what may transpire in coming years. Regardless of future treatment methods, controlling periodontal inflammation and the oral biofilm will remain essential for successful surgical and non-surgical periodontal therapy. New developments in helping patients improve oral hygiene and comply with supportive care and new ways to change harmful behaviors such as substance and tobacco use could have profound effects on periodontal treatment methods. Rather than using a periodontal probe and laborious methods of physical clinical measurement (i.e., CAL, probing depth, BOP), future clinicians will likely use improved diagnostic methods and biomarkers that will allow precise identification o","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":"60 6","pages":"519-523"},"PeriodicalIF":3.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jre.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637360","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":"Sixty Years of Osseointegration: The Past, the Present, the Future.","authors":"Tomas Albrektsson","doi":"10.1111/jre.13397","DOIUrl":"https://doi.org/10.1111/jre.13397","url":null,"abstract":"","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637359","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}