Liver International最新文献

{"title":"Optimising Maralixibat in ALGS Management: Key Considerations for Clinical Implementation","authors":"Xinzhuo Tu, Yunpeng Liu, Kui Wang","doi":"10.1111/liv.70159","DOIUrl":"https://doi.org/10.1111/liv.70159","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144140694","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 Relationship Between TNF-α Inhibitor Potency and HBV Reactivation in Patients With Rheumatic Disorders","authors":"Meng Hsuan Kuo,&nbsp;Chih-Wei Tseng,&nbsp;Kuo-Chih Tseng,&nbsp;Ming-Chi Lu,&nbsp;Chien-Hsueh Tung,&nbsp;Nai-Tzu Chen,&nbsp;Kuang-Yung Huang,&nbsp;Ning-Sheng Lai","doi":"10.1111/liv.70152","DOIUrl":"https://doi.org/10.1111/liv.70152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rheumatologic patients who test positive for hepatitis B surface antigen (HBsAg) or core antibody (HBcAb) are at risk of HBV reactivation when treated with TNF-α inhibitors. The effect of TNF-α inhibitor potency on this risk remains unclear, despite guidelines advising potency-based risk stratification. This study examines how TNF-α inhibitor potency influences the risk of HBV reactivation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From January 2008 to June 2023, 711 new TNF-α inhibitor users with rheumatic diseases were identified, including 39 HBsAg+ patients with antiviral prophylaxis, 72 HBsAg+ patients without antiviral prophylaxis, and 600 HBsAg−/HBcAb+ patients without prophylaxis. A Cox proportional hazards model assessed factors associated with HBV reactivation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over 2526 person-years of follow-up, HBsAg+ patients without antiviral prophylaxis had the highest HBV reactivation rate at 104.1 per 1000 person-years, followed by HBsAg−/HBcAb+ patients at 12.9, and HBsAg+ patients with antiviral prophylaxis at 12.6 per 1000 person-years. Multivariate Cox regression revealed that high-potency TNF-α inhibitors significantly increased HBV reactivation risk in HBsAg+ patients without antiviral prophylaxis (aHR 3.24, 95% CI: 1.09–9.67, <i>p</i> = 0.04). Adalimumab had a higher reactivation risk compared to etanercept (aHR 3.23, 95% CI: 1.02–10.17, <i>p</i> = 0.04), followed by golimumab (aHR 3.27, 95% CI: 0.91–11.64, <i>p</i> = 0.07). For HBsAg−/HBcAb+ patients, TNF-α inhibitor potency did not significantly impact HBV reactivation risk; instead, age over 65 was the only significant risk factor (aHR 3.37, 95% CI: 1.30–8.70, <i>p</i> = 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>High-potency TNF-α inhibitors significantly increase HBV reactivation risk in HBsAg+ patients, while HBsAg−/HBcAb+ patients have a uniformly low risk across all inhibitors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135599","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":"Metabolic Dysfunction-Associated Steatotic Liver Disease in the MENA Region: Setting a Research and Action Priority Agenda","authors":"Mohamed El-Kassas,&nbsp;Marcela Villota-Rivas,&nbsp;Khalid A. Alswat,&nbsp;Khalid M. AlNaamani,&nbsp;Yusuf Yilmaz,&nbsp;Asma Labidi,&nbsp;Faisal M. Sanai,&nbsp;Abeer Awad,&nbsp;Maisam W. I. Akroush,&nbsp;Saleh A. Alqahtani,&nbsp;Mohamed Elbadry,&nbsp;Nermeen Abdeen,&nbsp;Linda Henry,&nbsp;Zobair M. Younossi,&nbsp;Jeffrey V. Lazarus,&nbsp;Abdel-Naser Elzouki,&nbsp;the Steatotic Liver Disease Study Foundation in Middle East and North Africa (SLMENA) Collaborators","doi":"10.1111/liv.70108","DOIUrl":"https://doi.org/10.1111/liv.70108","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background &amp; Aims</h3>\u0000 \u0000 <p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing health challenge, particularly in Middle East and North Africa (MENA) countries. This study aimed to establish a consensus-driven research and action agenda to address MASLD within the MENA region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following a global MASLD research and action agenda setting study, over two Delphi rounds (Rs), MENA region experts (R1 <i>n</i> = 112, R2 <i>n</i> = 104) indicated their level of agreement with and provided feedback on MASLD research and action priorities via Qualtrics XM. In R2, panellists also ranked the priorities, which were categorised across six domains: (1) the human and economic burden, (2) defining and implementing care models, (3) disease management, (4) education and awareness, (5) patient and community perspectives, and (6) leadership and policies for the MASLD public health agenda.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The consensus-built MASLD research and action priority agenda for the MENA region comprises 52 priorities. Combined agreement (i.e., ‘agree’ + ‘somewhat agree’) increased from 97.6% and 98.1% in R1 to 98.2% and 98.5% in R2 with the research (<i>n</i> = 30) and action (<i>n</i> = 22) priorities, respectively. The highest ranked research priorities included developing regional MASLD databases and validating non-invasive diagnostic tools. The highest ranked action priorities included taking steps to enhance the adoption of lifestyle interventions among people living with MASLD and improving disease knowledge among healthcare providers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This region-specific agenda can help to guide research and optimise clinical practice, thereby improving the understanding, prevention, and management of MASLD, enhancing health outcomes and reducing its burden within the MENA region.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125886","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":"Noninvasive Evaluation of Prolonged-Release Pirfenidone in Compensated Liver Cirrhosis. ODISEA Study, a Randomised Trial","authors":"Linda E. Muñoz-Espinosa,&nbsp;Aldo Torre,&nbsp;Laura Cisneros,&nbsp;Iaarah Montalvo,&nbsp;René Malé,&nbsp;Scherezada Mejía,&nbsp;Juan Ramón Aguilar,&nbsp;Javier Lizardi,&nbsp;Jaime Zuñiga-Noriega,&nbsp;María Eugenia Icaza,&nbsp;Frida Gasca-Díaz,&nbsp;Larissa Hernández-Hernández,&nbsp;Paula Cordero-Pérez,&nbsp;Luis Chi,&nbsp;Lilian Torres,&nbsp;Fátima Rodríguez-Alvarez,&nbsp;Graciela Tapia,&nbsp;Jorge Luis Poo","doi":"10.1111/liv.70131","DOIUrl":"https://doi.org/10.1111/liv.70131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Advanced liver fibrosis (ALF) predicts an adverse prognosis in chronic liver disease. In addition to etiological treatment, a new approach to stop or reverse residual fibrosis is desirable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the efficacy and safety of prolonged-release pirfenidone (PR-PFD) versus placebo in compensated cirrhosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>180 patients with ALF (F4) were randomly assigned to: placebo, 1200 mg/d, and 1800 mg/d PR-PFD, plus standardised care, for 24mo. Frequency of lab tests: (3mo), liver stiffness measurement (LSM), FibroTest, ultrasound (US) (6mo), and endoscopy (annually).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fibrosis evolution estimated from LSM was significantly lower only in the 1200 compared to placebo and 1800 groups (24.2 ± 2.4 vs. 15.4 ± 2.4; 27.6 ± 2.4 vs. 24.6 ± 2.4; 24.4 ± 2.3 vs. 23.3 ± 2.3 kPa, respectively, <i>p</i> &lt; 0.001), in intergroup analysis, meeting the primary endpoint. Fibrotest was significantly lower only in the 1200 mg/d group, compared to baseline values (0.86 ± 0.02 vs. 0.83 ± 0.02 units, <i>p</i> &lt; 0.001). Liver function test (LFT's) also improved as well as Model for End-Stage Liver Disease (MELD) score and quality of life (QoL). Decompensations occurred in 19 patients: 12 ascites (more frequent in placebo, <i>p</i> = 0.003), 5 variceal bleeding, 4 encephalopathies, 4 hepatocarcinomas. Adverse events were mainly mild gastrointestinal (<i>n</i> = 35, 48 and 46, <i>p</i> = 0.010) and cutaneous (<i>n</i> = 12, 15, and 22, <i>p</i> = 0.0001) in placebo, 1200 and 1800 mg/day, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PR-PFD at a dose of 1200 mg significantly decreased non-invasive liver fibrosis markers at 24 months and induced improvement in LFT's, MELD, and QoL in compensated cirrhosis, without safety concerns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT01046474</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108692","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":"“Liver-Related Mortality in Type 2 Diabetes: Important Insights and Methodological Considerations”","authors":"Asım Gurbanov,&nbsp;Sezen Genç Uluçeçen,&nbsp;Aslı Çifçibaşi Örmeci","doi":"10.1111/liv.70147","DOIUrl":"https://doi.org/10.1111/liv.70147","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144100502","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":"NSBBs, EBL or Combined Therapy for High-Risk Varices: Systematic Review and Meta-Analysis","authors":"Sreeram Pannala,&nbsp;Anjali Byale,&nbsp;Tan yu Bin,&nbsp;Priyadarshini Loganathan,&nbsp;Viknesh Baskar,&nbsp;Adil Mir,&nbsp;Daniel Yan Zheng Lim,&nbsp;Ravishankar Asokkumar,&nbsp;Arvind Murali,&nbsp;Babu P. Mohan","doi":"10.1111/liv.70145","DOIUrl":"https://doi.org/10.1111/liv.70145","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Non-selective beta blocker (NSBB) is the preferred treatment option for primary prophylaxis of high-risk oesophageal varices, and endoscopic band ligation (EBL) is reserved for those intolerant to NSBB. In this meta-analysis, we aim to compare the outcomes of NSBB, EBL and combined therapy for primary prophylaxis of high-risk oesophageal varices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Major databases, such as MedLine, Embase and Cochrane Library were searched in October 2024 to identify studies comparing clinical outcomes between combined approaches versus NSBB versus EBL only. Only randomised trials were included. Meta-analysis was performed using the random-effects model, and heterogeneity was assessed by <i>I</i>²% statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six randomised trials were included, which consisted of 1011 participants (NSBB 302, EBL 300 and 409 combined) (75.27% males), with an average age of 51.06 years. The NSBBs used were propranolol, nadolol and carvedilol, with an average follow-up of 17.54 months. The combined approach significantly reduced the first episode of variceal bleeding compared to NSBB alone (pooled RR 0.39 [95% CI 0.19–0.76], <i>p</i> = 0.009) and EBL alone (RR 0.46, 0.29–0.74; <i>p</i> = 0.002). The pooled rate of bleeding with the combined approach was 9.4% [95% CI 6%–14.3%], with NSBB being 28.2% [95% CI 12.9%–51%] and with EBL being 13.9% [6%–17%]. Pooled ratios for bleeding-related mortality were significantly better with the combined approach when compared to NSBB alone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Primary prophylaxis of high-grade varices by combined therapy demonstrated a significantly lower risk of variceal bleeding than NSBB or EBL alone. We recommend these findings be incorporated into forthcoming guidelines.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144100500","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":"Bacterial Infections in Severe Alcohol-Associated Hepatitis: Methodological Considerations","authors":"Zongyu Yang,&nbsp;Huan Luo,&nbsp;Jiayi Huang,&nbsp;Songjie Liao","doi":"10.1111/liv.70149","DOIUrl":"https://doi.org/10.1111/liv.70149","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144100501","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":"Hepatocyte Nuclear Factor 4 Alpha: A Key Regulator of Liver Disease Pathology and Haemostatic Disorders","authors":"Subhadip Choudhuri,&nbsp;Nisha Jain Garg","doi":"10.1111/liv.16245","DOIUrl":"https://doi.org/10.1111/liv.16245","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Hepatocyte nuclear factor 4 alpha (HNF4α) is a master regulator of hepatocyte differentiation in fetal and adult liver and exerts its transcriptional role in determining physiological functions of the liver. The objective of this review is to address the current knowledge of molecular mechanisms involved in HNF4α regulation in multiple aspects of liver disease pathogenesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Based on available literature, this review summarises the current state of knowledge onthe mechanism of HNF4α dysregulation, and the role of HNF4α activity inregulating early to advanced stages of various liver diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with deranged HNF4α expression are at higher risk for the development of liver diseases such as viral hepatitis, alcoholic/nonalcoholic fatty liver disease, hepatocellular carcinoma, and haematological disorders such as coagulopathy and bleeding disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>HNF4α interactions with nuclear receptors and target genes promote liver disease pathology by regulating various metabolic pathways. The strong correlation between deranged HNF4α expression and the severity of liver diseases suggests that targeting HNF4α expression can offer potential therapeutic strategy in the prevention of liver disease pathology and haemostatic disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.16245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085396","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":"Author Response to Letter to the Editor “Strengthening Alcohol Risk Reduction Strategies Through Integrated Approaches: A Critical Appraisal”","authors":"Claire Delacôte,&nbsp;Line Carolle Ntandja Wandji,&nbsp;Sylvie Deuffic-Burban,&nbsp;Philippe Mathurin","doi":"10.1111/liv.70144","DOIUrl":"https://doi.org/10.1111/liv.70144","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085397","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":"Natural History of Idiosyncratic Drug-Induced Liver Injury and Prognostic Models","authors":"Harshad C. Devarbhavi,&nbsp;Raúl J. Andrade","doi":"10.1111/liv.70138","DOIUrl":"https://doi.org/10.1111/liv.70138","url":null,"abstract":"<p>Background and Aims: Drug-induced liver injury (DILI) remains a leading cause of acute liver failure worldwide. Drugs such as isoniazid, alone or in combination with other anti-tuberculosis drugs, as well as a growing number of herbal and complementary medicines, have been implicated in most cases of acute liver failure in registry studies. Methods: This review summarizes current knowdledge on the acute and chronic outcomes in patients with idiosyncratic DILI and discusses several of the existing prognostic models. Results and Conclusions: The reasons why some individuals progress from DILI to end-stage liver disease are still largely unknown. However, collaborative efforts over the past few decades have provided figures on the relative incidence of drug-induced acute liver failure and allowed the development of prognostic models to predict this worse outcome at the onset of the event. The outcome of chronic DILI is less well characterised due to the lack of sufficient follow-up in cohort studies, but several phenotypes of DILI can progress to chronicity, and specific drugs such as nitrofurantoin or amiodarone are classic examples of agents leading to chronic forms of DILI. Therapy for drug-induced acute liver failure and chronic DILI is mainly supportive, although some randomised clinical trials have shown beneficial effects of N-acetylcysteine and corticosteroids.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143944641","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}