Open Forum Infectious Diseases最新文献

{"title":"Correction to: Association Between the Need to Change Initial Antifungal Therapy and Treatment Costs in Patients With Invasive Aspergillosis.","authors":"","doi":"10.1093/ofid/ofaf161","DOIUrl":"https://doi.org/10.1093/ofid/ofaf161","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ofid/ofae747.].</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf161"},"PeriodicalIF":3.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658078","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":"Correction to: Let's Have a Chat: How Well Does an Artificial Intelligence Chatbot Answer Clinical Infectious Diseases Pharmacotherapy Questions?","authors":"","doi":"10.1093/ofid/ofaf162","DOIUrl":"https://doi.org/10.1093/ofid/ofaf162","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ofid/ofae641.].</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf162"},"PeriodicalIF":3.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658079","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":"Urogenital Schistosomiasis Mimicking IgG4-RD in a Patient With HIV.","authors":"Guillemette Gagey, Didier Sorial, Camille Rasmussen, Frédéric Mechai, Lionel Galicier, Jérôme Vérine, Eric Oksenhendler, Rémi Bertinchamp, Elsa Poullot, David Boutboul","doi":"10.1093/ofid/ofaf136","DOIUrl":"10.1093/ofid/ofaf136","url":null,"abstract":"<p><p>This article reports a case of urogenital schistosomiasis mimicking IgG4-related disease (IgG4-RD) in a 47-year-old immunocompromised man with HIV. Initially diagnosed with IgG4-RD, further biopsies revealed schistosoma eggs. Elevated IgG4 levels indicated a Th2 immune response, highlighting its complex role in antischistosomal immunity and the need for careful differential diagnosis.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 4","pages":"ofaf136"},"PeriodicalIF":3.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753803","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":"Impact of Antibiotic Duration on Gut Microbiome Composition and Antimicrobial Resistance: A Substudy of the BALANCE Randomized Controlled Trial.","authors":"Eric Armstrong, Maria Kulikova, Noelle Yee, Asgar Rishu, John Muscedere, Stephanie Sibley, David Maslove, J Gordon Boyd, Gerald Evans, Michael Detsky, John Marshall, Linda R Taggart, Jan O Friedrich, Jennifer L Y Tsang, Erick Duan, Karim Ali Firdous, David McCullagh, Aidan Findlater, Rob Fowler, Nick Daneman, Bryan Coburn","doi":"10.1093/ofid/ofaf137","DOIUrl":"10.1093/ofid/ofaf137","url":null,"abstract":"<p><strong>Background: </strong>Maintaining a diverse gut microbiome and minimizing antimicrobial resistance gene (ARG) carriage through reduced antibiotic utilization may decrease antimicrobial resistance. We compared gut microbiome disruption and ARG carriage following 7 or 14 days of antibiotics for treatment of bacteremia in a substudy of the BALANCE randomized controlled trial.</p><p><strong>Methods: </strong>The BALANCE randomized controlled trial enrolled 3631 participants with bacteremia, who were randomized 1:1 to receive 7 or 14 days of antibiotics. Rectal swabs were collected from 131 participants and analyzed with metagenomic sequencing to characterize the gut microbiome and ARGs. The primary outcome was change in gut microbiome diversity at day 7 vs 14.</p><p><strong>Results: </strong>Forty-one participants (n = 28 in the 14-day group, n = 13 in the 7-day group) had samples available for the primary analysis, with an imbalance in piperacillin-tazobactam exposure between groups. Change in gut microbiome diversity at day 7 vs 14 was comparable between the 14-day group (median, 0.07; IQR, -0.46 to +0.51) and 7-day group (median, 0.19; IQR, -0.77 to +0.22; <i>P</i> = .49). Change in ARG abundance at day 7 vs 14 did not differ by treatment duration, nor did the abundance of individual ARGs. We did not observe any change in gut microbiome diversity or ARG carriage at enrollment vs day 7.</p><p><strong>Conclusions: </strong>In this subset of patients from the BALANCE randomized controlled trial, we did not detect greater gut microbiome disruption or ARG carriage among participants who received 14 vs 7 days of antibiotics, but we were limited by small sample size and imbalances between groups.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf137"},"PeriodicalIF":3.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11935739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710902","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":"Outcomes of Fecal Microbiota Transplantation for <i>Clostridioides difficile</i> Infection in South Australia.","authors":"Emily C Tucker, Bianca Angelica, Ryan M Mathias, Louisa Edwards, Robert V Bryant, Samuel P Costello","doi":"10.1093/ofid/ofaf149","DOIUrl":"10.1093/ofid/ofaf149","url":null,"abstract":"<p><strong>Background: </strong>Fecal microbiota transplantation (FMT) sourced from a bank of prescreened anaerobically processed frozen donor stool has been available in South Australia since 2013. This study aimed to evaluate the real-world clinical and safety outcomes of FMT for recurrent, refractory, and/or severe or fulminant <i>Clostridioides difficile</i> infection (CDI) facilitated via this centralized facility.</p><p><strong>Methods: </strong>Donor screening test data were prospectively collected on all donors who passed prescreening evaluations between April 2013 and August 2023. The South Australian FMT for CDI database prospectively recorded outcomes for consecutive patients who underwent FMT for CDI from August 2013 to May 2023 in South Australia.</p><p><strong>Results: </strong>An overall 98 potential donors passed prescreening assessments and underwent laboratory screening tests: 32 (33%) had tests that failed, 5 (5%) had incomplete screening, and 61 (62%) passed. Detection of an extended-spectrum β-lactamase-producing organism (9/65, 14%) was the common reason for ineligibility following completion of screening tests. In total 220 cases of CDI were recorded, and follow-up data were available in 216. Primary cure occurred in 84% of cases (182/216): 88% (132/150) for recurrent CDI, 76% (50/66) for refractory CDI, 85% (51/60) for severe disease, and 65% (17/26) for fulminant disease. Repeat FMT was delivered in 23 of 34 cases (68%), with secondary cure in 74% (17/23 cases). Serious adverse events were observed in 6 patients overall (3%). No deaths were directly attributable to FMT.</p><p><strong>Conclusions: </strong>FMT was safe and efficacious for management of recurrent and refractory CDI over a 10-year period in a real-world prospective Australian cohort. Further studies to optimize the use of FMT for severe and fulminant CDI are warranted.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 4","pages":"ofaf149"},"PeriodicalIF":3.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753764","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":"Evaluation of the 2023 Duke-International Society of Cardiovascular Infectious Diseases Criteria in a Multicenter Cohort of Patients With Intravenous Drug Use: A Retrospective Study.","authors":"Q Joyce Han, David M Henson, Evin Yucel, Talal S Alnabelsi, Sami A El-Dalati, Molly L Paras","doi":"10.1093/ofid/ofaf126","DOIUrl":"10.1093/ofid/ofaf126","url":null,"abstract":"<p><strong>Background: </strong>Intravenous drug use (IVDU) significantly increases the risk of infective endocarditis (IE). This study evaluates the 2023 Duke-International Society of Cardiovascular Infectious Diseases (ISCVID) criteria for diagnosing IE in patients with a history of IVDU.</p><p><strong>Methods: </strong>This multicenter retrospective study evaluates these criteria in a cohort of 205 patients with intravenous drug use (IVDU) history, comparing outcomes with the 2000 modified Duke criteria. At 2 academic centers, patient records were reviewed for clinical, microbiologic, and imaging data to assess diagnostic classifications.</p><p><strong>Results: </strong>The 2023 Duke-ISCVID criteria reclassified 11 patients (5.3%), primarily due to updates in microbiological criteria, including the inclusion of various streptococcal species and <i>Staphylococcus epidermidis</i> in patients with cardiovascular implantable electronic devices (CIEDs). Notably, an unexpected prevalence of <i>Streptococcus pyogenes</i> as a causative agent was identified in 6 of 20 cases at 1 site.</p><p><strong>Conclusions: </strong>The 2023 Duke-ISCVID criteria reclassified 5% of IE cases in patients with IVDU due to expanded microbiological definitions. The unexpected prevalence of <i>S. pyogenes</i> highlights the need to consider atypical pathogens in high-risk groups.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf126"},"PeriodicalIF":3.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691755","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":"Factors Associated With Measles Infection in Afghanistan Surrounding the 2021 Outbreak: A Multivariable Analysis.","authors":"Mohamed Mostafa Tahoun, Mohammad Haris Abdianwall, Mohammad Omar Mashal, Abdul Wahid Amiri, Samad Ali Shah, Jennifer Pigoga Hart, Fazal Alizai, Jamshed Tanoli, Alaa Abou Zeid","doi":"10.1093/ofid/ofaf153","DOIUrl":"https://doi.org/10.1093/ofid/ofaf153","url":null,"abstract":"<p><strong>Background: </strong>Despite development of a safe and effective vaccine, measles remains a risk in many low-income countries where vaccination is less available. Afghanistan's recent measles epidemic remains understudied, and data are needed to inform the public health response. This study investigated the demographic and epidemiologic characteristics associated with suspected and laboratory-confirmed measles infections surrounding the 2021 outbreak in Afghanistan.</p><p><strong>Methods: </strong>We conducted a multivariable retrospective analysis of historical measles case data in Afghanistan from July 2019 to June 2023.</p><p><strong>Results: </strong>Confirmed measles infections in Afghanistan increased by >200% since July 2021, and the majority of cases during the recent outbreak were laboratory-confirmed. Early infancy was a risk factor for confirmed measles during the recent outbreak, as compared with pre-outbreak (<i>P</i> < .001). Epidemiologic linkage was identified as protective (<i>P</i> < .001), while sex (<i>P</i> = .796) and travel history (<i>P</i> = .615) were not predictive of risk.</p><p><strong>Conclusions: </strong>Routinely collected measles surveillance data suggest that infancy and unknown travel status posed greater risk to those with confirmed measles infection in Afghanistan during the 2021 epidemic as compared with pre-epidemic, and known exposure may lead to lower rates of formal laboratory diagnosis. The results also highlight the geographic shift in cases before vs during the outbreak, as well as differences in distribution of suspected and laboratory-confirmed cases throughout the epidemic.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 4","pages":"ofaf153"},"PeriodicalIF":3.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773061","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":"Prevalence of the Antibiotic Resistance of <i>Salmonella typhi</i> and <i>Salmonella paratyphi</i> in Pakistan: A Systematic Review and Meta-analysis.","authors":"Aftab Ullah, Muhammad Shabil, Saud A Abdulsamad, Asif Jan, Abdulghani A Naeem, Haseen Ullah, Mudassir Khattak, Zakiullah","doi":"10.1093/ofid/ofaf131","DOIUrl":"https://doi.org/10.1093/ofid/ofaf131","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic resistance to <i>Salmonella</i> is a significant threat to public health globally, particularly in low- and middle-income countries such as Pakistan. This study reviews the existing literature to determine the pooled prevalence of antibiotic resistance among <i>Salmonella typhi</i> and <i>Salmonella paratyphi</i> strains across Pakistan in the past decade, including the emergence of extended-spectrum β-lactamase.</p><p><strong>Methods: </strong>Six databases were searched for studies published from January 2014 to December 2024. Studies were screened for relevance, and data were extracted on antibiotic susceptibility among human <i>S typhi</i> and <i>S paratyphi</i> isolates. Their quality was assessed per the Joanna Briggs Institute checklist. A random effects model was employed by R statistical software (version 4.4) to calculate the pooled resistance rates.</p><p><strong>Results: </strong>Thirty-one studies met the inclusion criteria after full-text screening. The analysis revealed significant resistance rates to commonly used antibiotics for <i>S typhi</i>, including nalidixic acid (92%; 95% CI, 88%-95%), ampicillin (80%; 95% CI, 66%-89%), ciprofloxacin (64%; 95% CI, 48%-77%), azithromycin (7%; 95% CI, 3%-16%), and meropenem (2%; 95% CI, 1%-3%), with notable variations across cities, and for <i>S paratyphi</i>, such as nalidixic acid (91%; 95% CI, 82%-96%), ampicillin (34%; 95% CI, 21%-50%), ciprofloxacin (51%; 95% CI, 25%-77%), azithromycin (4%; 95% CI, 1%-12%), and meropenem (2%; 95% CI, 1%-5%). In <i>S typhi</i>, 29% and 25% of patients had multidrug resistance (95% CI, 21%-41%) and extensive drug resistance (95% CI, 12%-44%), respectively; corresponding rates for <i>S paratyphi</i> were 9% (95% CI, 2%-28%) and 2% (95% CI, 1%-7%).</p><p><strong>Conclusions: </strong>The findings revealed the alarming prevalence of antibiotic-resistant <i>Salmonella</i> in Pakistan and the need for updated treatment guidelines. Public health strategies must focus on improving antibiotic use and developing alternative treatment options to mitigate the rising threat of resistant <i>Salmonella</i> strains. Continued research, policy intervention, and national and international cooperation are essential to safeguard public health and ensure effective management of enteric fever.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 4","pages":"ofaf131"},"PeriodicalIF":3.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772031","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":"Impact of <i>Strongyloides stercoralis</i> Coinfection on Disease Severity and Treatment Outcomes in Pulmonary Tuberculosis.","authors":"Nathella Pavan Kumar, Saravanan Munisankar, Bindu Dasan, Arul Nancy, Kannan Thiruvengadam, Kadar Moideen, Sujatha Nott, Vijay Viswanathan, Shanmugam Sivakumar, Syed Hissar, Hardy Kornfeld, Subash Babu","doi":"10.1093/ofid/ofaf009","DOIUrl":"10.1093/ofid/ofaf009","url":null,"abstract":"<p><strong>Background: </strong>This study investigates how <i>Strongyloides stercoralis</i> (Ss) infection impacts pulmonary tuberculosis (PTB) treatment outcomes, disease severity, and bacterial burdens in PTB patients with Ss coinfection.</p><p><strong>Methods: </strong>We used chest x-rays and sputum smear grades to assess lung conditions and bacterial loads in 483 PTB patients. Ss infection was confirmed by seropositivity, and cytokine and profibrotic factor levels were analyzed using multiplex enzyme-linked immunosorbent assay. Treatment outcomes were categorized as favorable (cure without recurrence) or unfavorable (treatment failure or TB recurrence) during treatment or within 12 months postcure.</p><p><strong>Results: </strong>PTB patients coinfected with Ss had significantly higher bacterial loads, increased risk of bilateral lung lesions, and greater likelihood of cavitary disease compared with those without Ss infection. The coinfected individuals exhibit significantly increased levels of cytokines (interleukin [IL]-4, IL-5, IL-13, interferon [IFN]-α, and IFN-β) and profibrotic factors (vascular endothelial growth factor, epidermal growth factor [EGF], fibroblast growth factor 2 [FGF-2], and PDGF-AB/BB [platelet-derived growth factor]) and significantly diminished levels of cytokines (IFN-γ and IL-2).</p><p><strong>Conclusions: </strong>This study underscores the exacerbating impact of Ss coinfection on PTB severity and treatment outcomes, emphasizing the need for integrated management strategies for affected patients.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 3","pages":"ofaf009"},"PeriodicalIF":3.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605817","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":"Rapid Point-of-care Testing to Inform Intrapartum Treatment of Group B <i>Streptococcus</i>-Colonized Women in Uganda.","authors":"Juliet Nsimire Sendagala, Melanie Etti, Rose Azuba, Joseph Peacock, Kirsty Le Doare","doi":"10.1093/ofid/ofae605","DOIUrl":"10.1093/ofid/ofae605","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal Group B <i>Streptococcus</i> (GBS) rectovaginal colonization is an important risk factor for invasive disease in neonates, yet availability of culture-based methods for detection is limited in low-resource settings. We evaluated the diagnostic performance of the HiberGene (HG) GBS loop-mediated isothermal amplification (LAMP) assay for the rapid detection of GBS in rectal/vaginal swabs collected from women in Uganda. This work forms a part of the PROGRESS GBS study.</p><p><strong>Methods: </strong>In phase 1, 1294 rectal and vaginal swabs were collected from pregnant women and inoculated in enrichment (Lim) broth, which was then tested using the HG GBS LAMP assay (<i>sip</i> gene target) and culture on chromogenic agar. In phase 2, 166 swabs from nonpregnant women were tested directly (without the enrichment step). For samples with discordant results, an additional method of testing against multiplex real-time polymerase chain reaction assay was used.</p><p><strong>Results: </strong>Overall, the HG GBS LAMP assay detected more GBS-positive samples (31.3%; 452/1445) than culture-based methods (13.3%; 192/1445). Multiplex polymerase chain reaction-tested results were concordant with LAMP results in 96.3% of cases. The sensitivity and specificity of the LAMP assay, after adjusting for the tiebreaker results of discordant samples, were 94.4% (95% confidence interval, 86.2-99.4) and 99.0% (95% confidence interval, 94.3-100), respectively.</p><p><strong>Conclusions: </strong>The results of this study demonstrate high sensitivity and specificity of the HG GBS LAMP assay for the detection of GBS rectovaginal colonization in our setting. Given its rapid turnaround time, the HG GBS LAMP assay could appropriately be used to screen women for GBS rectovaginal colonization during labor to enable provision of intrapartum antibiotic prophylaxis.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 Suppl 3","pages":"S182-S186"},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605869","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}