Ocular Immunology and Inflammation最新文献

{"title":"Exogenous Methicillin-Resistant <i>Staphylococcus aureus</i> Endophthalmitis is Caused by Multidrug-Resistant Lineages that are Associated with Poor Outcomes.","authors":"Fatma Z A Ali, Camille Andre, Lucia Sobrin, Jie Sun, Rick Boody, James Cadorette, Paulo J M Bispo","doi":"10.1080/09273948.2024.2417797","DOIUrl":"10.1080/09273948.2024.2417797","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the genomic epidemiology of methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) endophthalmitis and correlate it with the presenting clinical features and outcomes.</p><p><strong>Methods: </strong>Nine patients presenting with MRSA endophthalmitis from 2014 to 2022 were included. Phenotypic and genomic tests were used for strain characterization. Demographics, clinical presentation, treatment and outcomes were reviewed.</p><p><strong>Results: </strong>The MRSA population was dominated by multidrug-resistant (MDR) strains within the clonal complex 5 (CC5) carrying an SCC<i>mec</i> type II genetic element (USA100-like strains). These strains carried genes that confer resistance to five antibiotic classes, in addition to mutations in topoisomerase genes (<i>gyrA</i> and <i>parC</i>) that resulted in resistance to all fluoroquinolones tested. Patients were mostly male (56%), with a median age of 82.7 years, and most had no recent history of extensive healthcare exposure. All cases were exogenous following ocular surgery (67%) or intravitreal injection (33%). The main exam findings were visual acuity ≤ hand motion, hypopyon (89%), and vitreous opacity (89%). Five patients (56%) showed improvement in visual acuity at 1 month following presentation, three (33%) at 3 months, and two (22%) at 6 months. Complications included evisceration (<i>n</i> = 1) and phthisis (<i>n</i> = 1). Patients who had pars plana vitrectomy within 48 hours of presentation had better clinical outcomes compared to those who did not.</p><p><strong>Conclusion: </strong>Exogenous MRSA endophthalmitis is caused by MDR strains that resemble the hospital-acquired lineage USA100. These strains cause severe endophthalmitis in patients with no recent hospital/healthcare exposure.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"446-456"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505031","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":"Online Patient Resources for Birdshot Uveitis: How Readable are These Resources?","authors":"Eric L Wan, Sofia Akhtar, Christine Griffith, Alice T Gasch","doi":"10.1080/09273948.2024.2413904","DOIUrl":"10.1080/09273948.2024.2413904","url":null,"abstract":"<p><strong>Purpose: </strong>Birdshot uveitis is a rare ophthalmic condition that can be challenging to control. The readability of online patient resources may impact the management of patients with birdshot. Thus, we examined the readability of online patient resources and identified differences in readability among sources and sections of websites.</p><p><strong>Methods: </strong>We queried 3 search engines (Google, Yahoo, Bing) for search results based on a series of terms related to birdshot uveitis. One hundred and twenty results were retrieved and 17 articles were assessed for readability analysis using validated readability and grade-level metrics. Articles were scored based on their entire textual content and, when feasible, also based on sections (e.g. background, diagnosis, treatment). Statistical analyses were conducted using ANOVA and Tukey's honestly significant difference.</p><p><strong>Results: </strong>The websites analyzed were from hospitals and academic centers (5), private practices (3), patient advocacy organizations (4), and other non-profits (5). On average, online patient resources are too difficult to read according to readability scores and grade levels ranging from late high school to college graduate. Articles written by non-profits other than advocacy organizations had an average of 6.5% more complex words than articles written by hospitals and academic centers (<i>p</i> < 0.05). Multiple metrics revealed that the treatment sections were less readable than the causes and symptoms sections.</p><p><strong>Conclusion: </strong>The readability of online patient resources for birdshot far exceeds reading levels recommended by the AMA, NIH, and patient safety organizations. Efforts should be made to improve the readability of patient education materials and patient understanding of their disease.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"396-402"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471169","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":"Real-World Efficacy and Safety of Escalation to Weekly Adalimumab for Chronic Non-Infectious Uveitis: A Multicenter Study Involving Pediatric and Adult Patients.","authors":"Murat Oklar, Merve İnanç Tekin, Kübra Özdemir Yalçınsoy, Nilüfer Zorlutuna Kaymak, Burak Tanyildiz, Pınar Çakar Özdal","doi":"10.1080/09273948.2025.2456637","DOIUrl":"10.1080/09273948.2025.2456637","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety of weekly adalimumab (ADA) treatment in non-infectious uveitis (NIU) patients, including both pediatric and adult populations, and identify factors influencing treatment efficacy.</p><p><strong>Methods: </strong>A retrospective cohort study at two hospitals in Türkiye included 51 NIU patients (29 children, 22 adults) who escalated from bi-weekly to weekly ADA due to inadequate disease control. Data on six clinical parameters (anterior chamber reaction, vitreous haze, visual acuity, central macular thickness [CMT], prednisone use, uveitis flare-up frequency), adverse effects, and treatment-related factors were collected. Statistical analyses involved non-parametric tests and regression models.</p><p><strong>Results: </strong>Weekly ADA led to clinical improvement in 88.2% of patients, with uveitis control achieved in 76.4% by the 6th month. Escalation to weekly dosing significantly improved all clinical parameters compared to the 6-month period before ADA initiation (<i>p</i> < 0.001). Patients on combined weekly ADA and DMARD therapy experienced fewer uveitis attacks (B = - 2.272, 95% CI = [-4.289, -0.254], <i>p</i> = 0.028). Starting ADA as first-line treatment reduced uveitis attacks (<i>p</i> = 0.002) and increased the likelihood of inactive uveitis (OR = 10.349, 95% CI = [1.379, 77.687], <i>p</i> = 0.023). Patients resistant to multiple biologics had worse preADA visual acuity (<i>p</i> = 0.011).</p><p><strong>Conclusion: </strong>Weekly ADA is effective and safe for controlling NIU when bi-weekly dosing is insufficient. Combining ADA with DMARDs enhances outcomes and reduce uveitis attacks. Poor preADA visual acuity may suggest resistance to biologics. Prospective studies should validate these findings, explore anti-ADA antibody development, and assess how DMARD addition affects immunological parameters and treatment efficacy.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"367-376"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046787","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":"Star Reviewing Editors in 2024.","authors":"","doi":"10.1080/09273948.2025.2479382","DOIUrl":"https://doi.org/10.1080/09273948.2025.2479382","url":null,"abstract":"","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":"33 3","pages":"499"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730875","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":"Anti-Adalimumab Antibodies in Patients with Noninfectious Uveitis Who Use Adalimumab Weekly or Every Other Week.","authors":"Leman Ismayilova, Hilal Eser-Ozturk, Asuman Birinci, Yuksel Sullu","doi":"10.1080/09273948.2025.2487164","DOIUrl":"https://doi.org/10.1080/09273948.2025.2487164","url":null,"abstract":"<p><strong>Purpose: </strong>Adalimumab (ADA) is the only biologic agent approved for treating non-infectious uveitis (NIU). Anti-drug antibodies (AAA) may be an essential factor associated with treatment failure. We conducted a study to determine the clinical response to ADA treatment in patients with NIU. We also aimed to determine AAA's frequency and clinical importance in these patients.</p><p><strong>Methods: </strong>This cross-sectional study included 60 NIU patients who used ADA therapy every other week or weekly for at least three months. The clinical findings recorded before starting ADA and on the day included in the study were compared. Serum AAA formation was evaluated. AAA-positive and AAA-negative patients were compared in terms of etiology, duration, and localization of uveitis, duration of ADA treatment, and additional IMT.</p><p><strong>Results: </strong>The increase in visual acuity, decrease in central macular thickness, improvement in the number of attacks/year, and decrease in need for CS were statistically significant with ADA treatment. AAA was positive in 15 (25%) patients. The improvement in median visual acuity, CMT, and number of attacks/year was statistically significant in both ADA-positive and negative patients. The effect of disease etiology, disease duration, uveitis localization, ADA treatment duration, and additional IMT use on serum AAA formation could not be demonstrated.</p><p><strong>Conclusion: </strong>ADA is mostly associated with favorable clinical response in treating NIU. In insufficient clinical response, the dose escalation method may increase treatment success. AAA formation may not be the only factor in the ineffectiveness of treatment.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-6"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764523","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":"Three-Year Results of XEN-45 Implantation for Glaucoma Secondary to Fuchs Uveitis Syndrome, Intermediate Uveitis, and Juvenile Idiopathic Arthritis-Related Anterior Uveitis.","authors":"Emil Nasyrov, David A Merle, Deshka Doycheva, Caroline J Gassel, Bogomil Voykov","doi":"10.1080/09273948.2024.2423197","DOIUrl":"10.1080/09273948.2024.2423197","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the long-term outcomes of XEN-45 implantation for glaucoma secondary to Fuchs uveitis syndrome (FUS), juvenile idiopathic arthritis (JIA)-related anterior uveitis and intermediate uveitis (IU).</p><p><strong>Methods: </strong>This retrospective study evaluated 19 eyes with FUS, 10 eyes with JIA, and nine eyes with IU that underwent XEN-45 Gel Stent implantation. The primary outcome measure was 3-year surgical success, defined as a ≥20% reduction in intraocular pressure (IOP), with a target IOP of 6-21 mmHg. Success was considered complete when IOP control was achieved without glaucoma medication or surgery other than needling and qualified when medication and/or incisional bleb revision were allowed for IOP control. The secondary outcome measures included IOP changes and revision and complication rates.</p><p><strong>Results: </strong>The 3-year complete success rate was 49% and 67% in the FUS and IU groups, respectively, both significantly higher than the 20% rate in the JIA group (<i>p</i> = 0.01 and 0.02, respectively, log-rank test). The qualified success rate was also significantly higher in the FUS and IU groups than in the JIA group. Significantly more medications were reintroduced in the JIA group within the first year, and the JIA group did not achieve a significantly lower median IOP at the 2- and 3-year visits, contrary to the FUS and IU groups. The bleb revision and secondary glaucoma surgery rates were similar among all groups.</p><p><strong>Conclusion: </strong>XEN-45 demonstrates a favourable safety and efficacy profile for glaucoma secondary to FUS and IU. However, its efficacy is significantly poor for JIA-related uveitic glaucoma.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"463-473"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605401","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":"Polymerase Chain Reaction for Detection of <i>Mycobacterium tuberculosis</i> in Granulomatous Anterior Uveitis - An Analysis of 51 Eyes.","authors":"Anshukita Anshukita, L Dhanurekha, A R Anand, Jyotirmay Biswas","doi":"10.1080/09273948.2024.2420661","DOIUrl":"10.1080/09273948.2024.2420661","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the role of polymerase chain reaction (PCR) in detecting <i>Mycobacterium tuberculosis (MTb)</i> in granulomatous anterior uveitis and comparing the results with those of Mantoux test, QuantiFERON-TB Gold test, and High-Resolution Computed Tomography of Chest (HRCT-chest).</p><p><strong>Methods: </strong>Data of 51 eyes of 38 patients with clinical features of granulomatous anterior uveitis undergoing anterior chamber fluid aspiration for PCR for MTb targeting IS6110 and MPB64 were studied.</p><p><strong>Results: </strong>Out of 38 patients, 25 (65.8%) were positive for MTb genome on PCR. 24 patients were tested for Mantoux, out of which 12 patients (50%) were positive and 12 patients (50%) were negative. 22 out of 38 patients had undergone QuantiFERON-TB Gold (QFT) test, out of which 10 (45.5%) were positive and 12 (54.5%) were negative. 36 out of 38 patients had undergone HRCT. Eight out of 38 (21.1%) patients had significant findings in HRCT-chest, as well as PCR positivity for MTb genome while 12 (31.6%) patients did not have any significant findings on HRCT-chest, but were positive for PCR.</p><p><strong>Conclusion: </strong>PCR for MTb is a valuable tool in the diagnosis of tubercular anterior uveitis. PCR can be positive even in cases of negative Mantoux test, QFT, and HRCT-chest in granulomatous anterior uveitis.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"457-462"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522570","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":"Treatment Options in Bilateral Diffuse Uveal Melanocytic Proliferation (BDUMP): Case Presentation and Review of the Literature.","authors":"Katerina Lazari, Anna Dastiridou, Konstantina Riri, Victoria Toumanidou, Athanasia Plakopiti, Sofia Androudi","doi":"10.1080/09273948.2024.2413909","DOIUrl":"10.1080/09273948.2024.2413909","url":null,"abstract":"<p><strong>Purpose: </strong>To outline the therapeutic approach for a rare case of Bilateral Diffuse Uveal Melanocytic Proliferation (BDUMP) and examine the current management recommendations of this uncommon condition.</p><p><strong>Methods-results: </strong>Literature review on the current treatment options in BDUMP cases. An 82-year-old woman was referred to our clinic due to bilateral visual loss. She was treated elsewhere with anti-vascular endothelial growth factors (anti-VEGF) in both eyes for presumed choroidal neovascularization (CNV) without improvement. Her past medical history (PMH) entailed colon cancer, treated with surgical resection and adjuvant chemotherapy 15 years ago. The patient presented with low visual acuity in both eyes, multiple oval orange patches in the fundus with striking hyperfluorescent pattern in fluorescein angiography (FA), giraffe pattern in fundus autofluorescence (FAF) and rapidly progressive cataracts. Intravitreal dexamethasone implants were administered with mild improvement and subretinal fluid absorption.</p><p><strong>Conclusions: </strong>The management strategy in BDUMP should focus on the systemic, often occult malignancy. There is no standard treatment protocol for BDUMP; however, plasmapheresis in combination with primary malignancy treatment seems to yield promising results in current literature reports. Anti-VEGF injections failed to control BDUMP sequelae, however intravitreal dexamethasone implants may offer temporary relief.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"403-408"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392190","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":"Cytomegalovirus Corneal Endotheliitis After Acanthamoeba Keratitis: A Case Report.","authors":"Lusheng Ma, Yingyu Li, Xinjuan Wang, Jing Hong","doi":"10.1080/09273948.2024.2400617","DOIUrl":"10.1080/09273948.2024.2400617","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to present a unique case of acanthamoeba keratitis (AK) with a delayed diagnosis and prolonged usage of glucocorticoid eye drops. Subsequently, the patient developed cytomegalovirus corneal endotheliitis (CMVCE), leading to severe ocular complications. To the best of our knowledge, this is the first documented case of confirmed CMVCE subsequent to AK.</p><p><strong>Methods: </strong>A 32-year-old male patient with a history of contact lens usage and extended administration of glucocorticoid eye drops for keratitis underwent deep anterior lamellar keratoplasty (DALK) in the left eye. The diagnosis of AK was delayed by 4 months. Following corneal endothelial decompensation, penetrating keratoplasty (PKP) was performed 5-month post-DALK. Intraoperatively, the presence of CMV in aqueous humor and corneal tissue was confirmed using multiplex qPCR, validating the diagnosis of CMVCE. Despite aggressive antiviral therapy, the patient's left-eye condition continued to worsen, leading to a combined phacoemulsification and trabeculectomy in the left eye, as well as supplementary Ahmed valve drainage.</p><p><strong>Results: </strong>Following four surgical procedures and subsequent follow-up, the patient's left-corneal graft remained clear, intraocular pressure was well-regulated, the eye was preserved, and some degree of vision was retained.</p><p><strong>Conclusion: </strong>CMVCE subsequent to AK represents a severe form of infectious corneal keratopathy. In AK patients experiencing unexplained corneal endothelial decompensation, mydriasis, iris atrophy, concurrent cataract, and secondary glaucoma post-keratoplasty, a reoccurrence of AK should not be considered in isolation. CMV infection should also be suspected, and an aqueous humor test should be conducted to confirm the diagnosis.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"474-477"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483742","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":"Long-Term Outcomes of Adalimumab Treatment in Conventional Treatment-Resistant Serpiginous Choroiditis.","authors":"Berru Yargi-Ozkocak, Cigdem Altan, Burcu Kemer-Atik, Ali Safa Balci, Berna Basarir","doi":"10.1080/09273948.2024.2359002","DOIUrl":"10.1080/09273948.2024.2359002","url":null,"abstract":"<p><strong>Background/objectives: </strong>To investigate the long-term efficacy and safety of adalimumab(ADA) in the treatment of patients with serpiginous choroiditis (SC) refractory to conventional therapy through quantitative parameters.</p><p><strong>Subjects/methods: </strong>A retrospective analysis was conducted on patients diagnosed with SC clinically and through fundus autofluorescence(FAF). Patients receiving ADA treatment were included. Demographic and clinical characteristics of the patients, association with tuberculosis (TB) infection, number of immunosuppressive therapies, recurrences, best corrected visual acuity (BCVA) change, and ADA-related side effects were recorded. The progression rate before and after ADA was calculated based on the area involved by FAF.</p><p><strong>Results: </strong>Sixteen eyes of 8 patients (3 female/5 male) were enrolled to the study. The median (IQR) age was 53.5 (16.5) years. Diagnosis was SC in 4, ampiginous choroiditis in 3, and TB-related serpiginous-like choroiditis in 1 patient. Peripapillary involvement was present in 10 of 16 eyes. The area involved by FAF continued to progress under ADA treatment, however the progression rate was decreased (<i>p</i> = 0.143).The BCVA was preserved (<i>p</i> = 0.772). The number of systemic and local treatments decreased with ADA (<i>p</i> = 0.025 and 0.019, respectively). Additionally, the number of recurrences was reduced with ADA (<i>p</i> = 0.002). Median (IQR) follow-up was 45(28.75) months. Two patients experienced ADA-related side effects (pulmonary TBand rash).</p><p><strong>Conclusions: </strong>Our findings suggest a promising role for ADA in halting the progression of SC and have implications for improving outcomes. Despite the evidence in the literature at the level of case reports, ADA can be used effectively with close monitoring for potential risks.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"358-366"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238367","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}