Nephron最新文献

{"title":"Preferences for Advance Care Planning in Patients with End-Stage Kidney Disease: A Cross-Sectional Survey among Nephrology Healthcare Providers in a Tertiary Care Center in India.","authors":"Bharathi Naik, Arun Ghoshal, Anuja Damani, Pankaj Singhai, Ravindra Prabhu Attur, Naveen Salins, Ajith M Nayak, Shankar Prasad Nagaraju","doi":"10.1159/000541347","DOIUrl":"10.1159/000541347","url":null,"abstract":"<p><strong>Introduction: </strong>Advance care planning (ACP) is essential in managing patients with end-stage kidney disease (ESKD), yet its integration into clinical practice remains limited, particularly in low- and middle-income countries. This study explores the preferences, attitudes and perceived barriers of nephrology healthcare providers toward ACP for patients with ESKD in a tertiary care center in India.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among nephrology healthcare providers at a tertiary care center in India. The survey, developed from literature reviews and pretested, covered demographics, ACP knowledge and attitudes, current practices, and perceived barriers and facilitators. Data collection occurred from September 2022 to March 2023. Quantitative data were analyzed descriptively, and qualitative data through thematic analysis.</p><p><strong>Results: </strong>A total of 50 healthcare providers participated. While 36% acknowledged the importance of ACP, only 8% routinely engaged in ACP discussions. Major barriers included inadequate training (22%), lack of awareness about the importance of discussing ACP among stakeholders (20%), cultural barriers (18%), lack of time (14%), and the absence of institutional protocols for discussion on ACP (14%). Additional barriers included instances where families withhold health information from patients due to fear of losing hope (16%) and patient/family discomfort in discussing ACP (12%). Providers expressed a need for structured ACP protocols and educational programs.</p><p><strong>Conclusion: </strong>Despite recognizing its importance, ACP is underutilized in the care of patients with ESKD in India. Addressing the identified barriers through targeted interventions may enhance ACP practices and improve patient outcomes.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"48-56"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of complete remission of glucocorticoid-dependent nephrotic syndrome after TRF-budesonide treatment in a patient with mild mesangial proliferative IgA nephropathy.","authors":"Efstathios Mitsopoulos, Panagiotis Pateinakis, Christodoulos Keskinis, Dorothea Papadopoulou","doi":"10.1159/000543271","DOIUrl":"https://doi.org/10.1159/000543271","url":null,"abstract":"<p><p>The combination of nephrotic syndrome with mild histopathological lesions of IgA nephropathy is considered by some as a special form of IgA nephropathy with superimposed minimal change disease (MCD) while by others as coincidental deposition of IgA in patients with MCD (MCD-IgAN). We present the first case of complete remission of nephrotic syndrome in a 55-year-old man with MCD-IgAN after the administration of targeted-release formulation of budesonide (TRF-budesonide). The patient's treatment with TRF-budesonide, even though methylprednisolone, mycophenolate mofetil, and cyclophosphamide had been previously tried, is of particular importance because it not only suggests that TRF-budesonide appears to be a promising treatment for MCD-IgAN but may also provide a new therapeutic option for patients with podocytopathies.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-16"},"PeriodicalIF":2.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic syndrome, non-alcoholic fatty liver disease and graft inflammation: an unaddressed pathogenic link after kidney transplantation.","authors":"Arminda Fariña-Hernández, Ana González-Rinne, Alberto Hernández-Bustabad, Rita María Guerra-Rodríguez, Ana Paola Saiz-Udaeta, Juana Alonso-Titos, Domingo Marrero, Antonio Rivero-González, Cristo Adonay Santana-Quintana, Pedro Ruíz-Esteban, Domingo Hernández","doi":"10.1159/000543276","DOIUrl":"https://doi.org/10.1159/000543276","url":null,"abstract":"<p><p>Kidney transplantation (KT) is the treatment of choice for chronic kidney disease (CKD) patients, but there is a continued loss of grafts in the long-term (50% at 10 years) due to either patient 's death or chronic allograft dysfunction. Metabolic syndrome (MS) is very prevalent after KT (30-40%) and its components contribute to the appearance of non-alcoholic fatty liver disease/metabolic dysfunction-associated fatty liver disease (NAFLD/MAFLD) and non-alcoholic steatohepatitis (NASH), which represents the hepatic component of MS. Furthermore, about 20-40% of KT recipients present early graft inflammation, including subclinical inflammation. Thus, the relationship between NAFLD-MAFLD/NASH and graft inflammation may be in a bidirectional, though no definite link between NAFLD-NASH and graft inflammation is currently known. Additionally, MS-related risk factors are associated with modern immunosuppressants and negative synergistic effect on graft and patient survival seems plausible. Indeed, pro-inflammatory cytokines and adipokines released by adipose tissue can generate a low-grade inflammatory state and endothelial dysfunction both involved in the appearance of CVD, and these disorders are associated with worsening liver lesions and subclinical and clinical atheromatosis. In this review, we show the recent clinical evidence regarding the prevalence and risk factors of MS and NAFLD/MAFLD following KT. Additionally, we propose the potential mechanism link between NAFLD/MAFLD-NASH and graft inflammation post-KT, as well as alternatives therapies for NAFLD after KT. Prevention of long-term life-threatening complications in this particular population rests upon better understanding and management of these severe clinical complications.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-18"},"PeriodicalIF":2.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between metabolic disorders and impaired kidney function thereafter in the Japanese general population.","authors":"Fumihiko Kin, Hiroyuki Takase, Naomi Kawakatsu, Kazusa Hayashi, Takeru Isogaki, Yasuaki Dohi","doi":"10.1159/000543267","DOIUrl":"https://doi.org/10.1159/000543267","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic syndrome (MetS) and chronic kidney disease are both important risk factors for cardiovascular disease and are closely related to each other. We retrospectively investigated whether MetS or its components increase the risk of development of impaired kidney function in the Japanese general population.</p><p><strong>Methods: </strong>This is a retrospective cohort study　which enrolled 14917 participants who visited our hospital for physical checkups from 2008 to 2018 and had normal estimated glomerular filtration rate (eGFR≥60 mL/min/1.73 m2) during the baseline examination. Participants were followed up for the median of 1847 days until 2019 with the development of impaired kidney function (eGFR<60 mL/min/1.73 m2) as the endpoint. The definition of MetS was based on Japanese diagnostic criteria (2005).</p><p><strong>Results: </strong>Throughout the study, 2150 participants (25.9 per 1000 person-year) developed impaired kidney function after their baseline checkup. The incidence of impaired kidney function was more frequent in participants with MetS (39.3 per 1000 person-year) than without (24.2 per 1000 person-year, p<0.001). Moreover, each metabolic syndrome component was positively associated with the incidence of impaired kidney function, where the incidence of impaired kidney function increased with the number of MetS components at baseline (0, 1, 2 and ≥3 component(s); 17.3, 26.9, 32.9 and 39.7 per 1000 person-year, respectively). Multivariate Cox hazard analysis revealed that MetS was an independent risk factor for impaired kidney function after adjusting for known risk factors (hazard ratio, 1.29; 95% confidence interval, 1.15-1.45).</p><p><strong>Conclusions: </strong>Testing for MetS and its components can help evaluate the risk of developing impaired kidney function in the general population.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-13"},"PeriodicalIF":2.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multimethod International Mapping Exercise of Arts Interventions in Renal Units: The PAINT Project.","authors":"Trisha Forbes, Anna Wilson, Clare McKeaveney, Claire Carswell, Christopher Bailey, Jenny Baxley Lee, Mayleen Laico, Claire Meaney, Helen Noble","doi":"10.1159/000542878","DOIUrl":"10.1159/000542878","url":null,"abstract":"<p><strong>Introduction: </strong>Due to the chronic nature of kidney disease, the challenges of symptom burden, and reduced mortality and comorbidity, individuals living with the condition experience substantial anxiety and depression. Incorporating the arts into clinical practice is encouraged to promote and support mental health and well-being. The aim of the PAINT project was to undertake an international mapping exercise to identify the current provision of arts programmes in kidney centres for people living with kidney disease.</p><p><strong>Methods: </strong>A multimethod approach was employed, involving a cross-sectional online survey and semi-structured qualitative interviews, which employed qualitative description research design. Healthcare staff working in kidney centres or organisations providing arts activities to individuals living with kidney disease were recruited into the study.</p><p><strong>Results: </strong>One hundred and nineteen participants from 29 countries responded to the survey, with 39 of the respondents reporting arts activities in their renal unit. There was a wide range of respondents in terms of role, and the types of arts activities included visual arts activities, music, literature/creative writing, film, movement/dance, and craft. Individuals with chronic kidney disease who had taken part in arts activities were mostly adults (64%), and most were undergoing haemodialysis (82%). Sixteen respondents participated in the semi-structured interviews and encouraged the adoption of arts activities for people living with kidney disease. Three themes were identified: enhanced well-being and positive outcomes for individuals living with kidney disease; staff engagement and enthusiasm; and barriers to participation.</p><p><strong>Conclusions: </strong>This overview of arts activities being offered globally to people living with kidney disease and experiences of renal healthcare staff who provide activities in their units are encouraging in terms of arts in healthcare. These practitioners have observed the benefits of this person-centred arts approach in action, predominantly in terms of the positive impact on the well-being of individuals with kidney disease and improved relationships with staff in dialysis units. Further attention and funding should be focused on arts activities within renal centres.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-14"},"PeriodicalIF":2.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium Retention in Liver Disease: Is ENaC Activation Independent of the Renin-Angiotensin-Aldosterone System a Therapeutic Target?","authors":"Daniel Batlle, Mohammed Z Rehman, Thomas Brannon, Robert Rosa","doi":"10.1159/000542883","DOIUrl":"10.1159/000542883","url":null,"abstract":"","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-4"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diosgenin improves lipid metabolism in diabetic nephropathy via regulation of miR-148b-3p/DNMT1/FOXO1 axis.","authors":"Min Luo, Zongren Hu, Jichang Yang, Jinhan Yang, Wen Sheng, Chengxiong Lin, Dian Li, Qinghu He","doi":"10.1159/000541690","DOIUrl":"https://doi.org/10.1159/000541690","url":null,"abstract":"<p><strong>Background: </strong>The progression of diabetic nephropathy (DN) is closely associated with lipid accumulation. Diosgenin (Dio) plays a beneficial role in the lipid metabolism associated with multiple diseases. Thus, the mechanism underlying Dio's function in DN associated with aberrant lipid accumulation warrants further investigation.</p><p><strong>Methods: </strong>To model DN in vitro, HK-2 cells were treated with high glucose (HG) and palmitic acid. Cell viability was evaluated using MTT assay. The triglyceride (TG) content in HK-2 cells was measured using a commercial assay kit. The formation of lipid droplets in HK-2 cells was observed using Oil Red O staining. The expression levels of mRNA and protein were detected using RT-qPCR and western blot, respectively. The DNA methylation of FOXO1 was assessed using MSP. The interaction between DNMT1 and the FOXO1 promoter was confirmed by ChIP assay.</p><p><strong>Results: </strong>Dio treatment reduced TG levels and lipid droplet formation in HK-2 cells co-treated with HG and palmitic acid. Simultaneously, the levels of miR-148b-3p and FOXO1 were increased by Dio, while Dio decreased the expression levels of DNMT1 and SREBP-2. Meanwhile, miR-148b-3p can bind to DNMT1, which in turn inhibits the expression of FOXO1 by mediating the DNA methylation of FOXO1. In addition, FOXO1 negatively regulates the expression of SREBP-2 by interacting with the SREBP-2 promoter. MiR-148b-3p inhibition or silencing of FOXO1 abolished the inhibitory effect of Dio on TG production and lipid droplet formation. This effect was further exacerbated by the downregulation of DNMT1. FOXO1 overexpression may counteract the promotive effects of miR-148b-3p inhibitor on lipid accumulation.</p><p><strong>Conclusion: </strong>Dio treatment reduced TG production and lipid droplet formation in HK-2 cells during the progression of DN by modulating the miR-148b-3p/DNMT1/FOXO1/SREBP-2 axis. This finding provides new evidence supporting the therapeutic potential of Dio for DN.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-23"},"PeriodicalIF":2.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urine miR-340-5p Predicts the Adverse Prognosis of Sepsis-Associated Acute Kidney Injury and Regulates Renal Tubular Epithelial Cell Injury by Targeting KDM4C.","authors":"Mengmeng Pu, Huanhuan Zhao, Silei Xu, Xiaohui Gu, Qiang Feng, Peng Huang","doi":"10.1159/000541348","DOIUrl":"10.1159/000541348","url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis-associated acute kidney injury (SA-AKI) is a common complication of sepsis. miR-340-5p has been identified as an effective biomarker of various human diseases. As the downstream target, the involvement of lysine (K)-specific demethylase 4C (KDM4C) in SA-AKI would help interpret the regulatory mechanism of miR-340-5p. The significance of miR-340-5p in the onset and progression of SA-AKI was evaluated to provide a potential therapeutic target for SA-AKI.</p><p><strong>Methods: </strong>This study enrolled 64 healthy individuals (control) and 159 sepsis patients (92 SA-AKI and 67 non-AKI) and collected urine samples. The urine level of miR-340-5p was analyzed by PCR, and a series of statistical analyses were conducted to assess the clinical significance of miR-340-5p in the occurrence and development of SA-AKI. The injured renal tubular epithelial cells were established with LPS induction. The roles of miR-340-5p in cellular processes were evaluated.</p><p><strong>Results: </strong>Increasing urine miR-340-5p discriminated SA-AKI patients from healthy individuals (AUC = 0.934) and non-AKI sepsis patients (AUC = 0.806) sensitively. Additionally, elevated miR-340-5p could predict the adverse prognosis (HR = 5.128, 95% CI = 1.259-20.892) and malignant development of SA-AKI patients. In vitro, lipopolysaccharide (LPS) also induced an increased level of miR-340-5p and significant cell injury in the renal tubular epithelial cell; silencing miR-340-5p could alleviate the suppressed proliferation, migration, and invasion caused by LPS. In mechanism, miR-340-5p negatively regulated KDM4C, which mediated the function of miR-340-5p.</p><p><strong>Conclusion: </strong>miR-340-5p served as a diagnostic and prognostic biomarker of SA-AKI and regulated renal tubular epithelial cell injury via modulating KDM4C.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-10"},"PeriodicalIF":2.3,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Critical Role of Tight Junction Proteins in Kidney Disease Pathogenesis.","authors":"David Jayne, Corentin Herbert, Vincent Anquetil, Geoffrey Teixeira","doi":"10.1159/000542498","DOIUrl":"10.1159/000542498","url":null,"abstract":"<p><strong>Background: </strong>Kidney disease poses a significant global health challenge, marked by a rapid decline in renal function due to a variety of causative factors. A crucial element in the pathophysiology of kidney disease is the dysregulation of epithelial cells, which are vital components of renal tissue architecture. The integrity and functionality of these cells are largely dependent on tight junctions (TJ) proteins, complex molecular structures that link adjacent epithelial cells. These TJ not only confer cellular polarity and maintain essential barrier functions but also regulate epithelial permeability.</p><p><strong>Summary: </strong>TJ proteins are pivotal in their traditional role at cell junctions and in their non-junctional capacities. Recent research has shifted the perception of these proteins from mere structural elements to dynamic mediators of kidney disease, playing significant roles in various renal pathologies. This review explores the multifaceted roles of TJ proteins, focusing on their functions both within and external to the renal epithelial junctions. It highlights how these proteins contribute to mechanisms underlying kidney disease, emphasizing their impact on disease progression and outcomes.</p><p><strong>Key messages: </strong>TJ proteins have emerged as significant players in the field of nephrology, not only for their structural role but also for their regulatory functions in disease pathology. Their dual roles in maintaining epithelial integrity and mediating pathological processes make them promising therapeutic targets for kidney disease. Understanding the intricate contributions of TJ proteins in kidney pathology offers potential for novel therapeutic strategies, aiming to modulate these proteins to halt or reverse the progression of kidney disease.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Serum Ferritin Levels with Short-Term Mortality Risk in Sepsis-Associated Acute Kidney Injury: A Retrospective Cohort Study.","authors":"Jie Sun, Ying Qi, Yan Wang, Wenxin Wang, Pengpeng Meng, Changjin Han, Bing Chen","doi":"10.1159/000542410","DOIUrl":"10.1159/000542410","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the prognostic significance of serum ferritin levels in sepsis-associated acute kidney injury (SA-AKI) and their correlation with short-term mortality. Despite the established predictive value of serum ferritin in various serious diseases, its specific prognostic relevance in SA-AKI remains unexplored. Therefore, this study seeks to fill this research gap by investigating the association between serum ferritin levels and short-term mortality in patients with SA-AKI.</p><p><strong>Methods: </strong>This retrospective cohort study utilized clinical data from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database, including all patients with SA-AKI admitted to the intensive care unit for the first time. The relationship between serum ferritin levels and 28-day mortality was explored using restricted cubic splines. Kaplan-Meier curves and Cox regression models were employed to evaluate the association between serum ferritin levels and mortality. Subgroup and sensitivity analyses were performed to verify the robustness of the results.</p><p><strong>Results: </strong>In this study, a total of 878 patients (486 males and 392 females) with a median age of 63.7 years were enrolled. The results indicated that increasing serum ferritin levels were linearly associated with a gradual increase in 28-day mortality rates. Specifically, patients in the highest quartile of serum ferritin had significantly higher 28-day mortality compared to those in the reference group (the first quartile of ferritin levels). After adjusting for various factors, the fully adjusted hazard ratio was 1.92 (95% CI: 1.24-2.96, p = 0.003).</p><p><strong>Conclusion: </strong>In patients with SA-AKI, higher serum ferritin levels are associated with an increased 28-day mortality rate.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-12"},"PeriodicalIF":2.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}