Pancreas最新文献

{"title":"Asymptomatic Lipase Elevation After Immune Checkpoint Inhibitors Reflects Pancreatic Injury With Volume Loss but Minimal Clinical Sequelae.","authors":"Hamza A Chaudhry, Yinghong Wang, Suresh T Chari","doi":"10.1097/MPA.0000000000002687","DOIUrl":"10.1097/MPA.0000000000002687","url":null,"abstract":"<p><strong>Objectives: </strong>Asymptomatic lipase elevation (ALE) after immune checkpoint inhibitor therapy (ICI-℞) is considered a laboratory abnormality distinct from clinical pancreatitis. We hypothesized that ALE indicates pancreatic injury defined as imaging evidence of pancreatitis on CT/PET scans and/or volume loss on CT pancreatic volumetry (PV). We examined the safety of continued ICI-℞ in ALE.</p><p><strong>Methods: </strong>We identified 1146 ICI-treated patients with PET/CT and lipase measurement within 1 month. Asymptomatic patients (n=1123) were stratified by lipase levels: normal (n=837), 1-3× (n=222), or ≥3× (n=64) upper limit of normal (ULN). We compared pancreas volume (baseline vs. 1 year and % with ≥20% volume loss) in 98 patients across these strata. Clinical sequelae (pancreatitis, endocrine/exocrine insufficiency) were recorded for patients continuing ICI-℞.</p><p><strong>Results: </strong>Normal lipase cohort showed no evidence of pancreatic injury. In ALE with lipase 1-3×ULN, CT/PET rarely showed pancreatitis (0.5%/2%); ≥20% volume loss occurred in 28%. In ALE with lipase ≥3×ULN, CT+/PET+/≥20% volume loss was seen in 9%/16%/57%, respectively ( P <0.0001 for each feature vs. 1-3x ULN). Pancreas volume (median) decreased significantly in lipase ≥3× ( P <0.0001). Continuing ICI-℞ in patients with ALE (n=33) and symptomatic pancreatitis (n=5) resulted in minimal to no clinical sequelae.</p><p><strong>Conclusions: </strong>ALE after ICI-℞ indicates pancreatic injury characterized best by volume loss. Despite this, therapy continuation is well tolerated with minimal clinical sequelae. Although our data do not change current management, they do suggest that ALE and ICI-P represent a clinical spectrum of a shared pathophysiology.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e1006-e1013"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204982","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":"Commentary on \"High Rate of Exocrine Pancreatic Dysfunction in Pediatric Patients With Diabetes Mellitus\".","authors":"Zheng Zhang, Xiang Chen","doi":"10.1097/MPA.0000000000002691","DOIUrl":"10.1097/MPA.0000000000002691","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e1047"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353041","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":"Primary Hyperparathyroidism-Induced Acute Pancreatitis: Case Report and Systematic Review.","authors":"Fei Che, Dongfeng Lv, YaDong Liu, Yangpeng Wu","doi":"10.1097/MPA.0000000000002693","DOIUrl":"10.1097/MPA.0000000000002693","url":null,"abstract":"<p><strong>Background: </strong>Primary hyperparathyroidism (PHPT) is a rare but notable metabolic cause of acute pancreatitis (AP). Early diagnosis and surgical intervention are crucial to prevent recurrence and improve prognosis.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data of a 61-year-old male presenting with AP and severe hypercalcemia (3.54 μmol/L) as the initial manifestation of PHPT. In addition, a systematic review of 83 studies published between 1958 and May 2026 was performed in accordance with PRISMA guidelines. Individual patient data (IPD) on demographics, total serum calcium levels, treatment modalities, and clinical outcomes were extracted.</p><p><strong>Results: </strong>The patient's total serum calcium was 3.54 μmol/L (14.16 mg/dL) with a parathyroid hormone (PTH) of 640.5 pg/mL. Unenhanced abdominal computed tomography (CT) confirmed acute pancreatitis (AP; moderately severe acute pancreatitis according to the Revised Atlanta 2012 classification), and a left inferior parathyroid adenoma was identified through cervical ultrasonography and 99mTc-MIBI scintigraphy. Total serum calcium normalized following parathyroidectomy (PTX), with resolution of symptoms. A systematic review of 107 patients with primary hyperparathyroidism-associated pancreatitis (PHPT-AP) showed a median age of 38 years (IQR 26-56, range: 11-88), 41.1% male, and a median peak total calcium was 3.25 μmol/L (IQR 2.98-3.82, range: 2.55-5.36). PTX was performed in 88.8% of the cases.</p><p><strong>Conclusion: </strong>PHPT is a treatable cause of acute pancreatitis and should be considered in cases of idiopathic or recurrent pancreatitis. Routine screening of total serum calcium and PTH levels is recommended for idiopathic or recurrent AP. For PHPT-AP patients with hypercalcemic crisis (>3.75 μmol/L or >15 mg/dL), early parathyroidectomy after medical stabilization (traditionally recommended within 72 h, although modern evidence supports optimization over 48 h-1 wk) is safe and curative. For severe but noncrisis PHPT-AP (such as our index case with peak calcium 3.54 μmol/L), definitive parathyroidectomy should be scheduled during the same hospitalization or within 2-4 weeks after pancreatitis resolution. Among 99 survivors, 75 had explicit follow-up records with no pancreatitis recurrence reported; quantifiable follow-up duration was available for 36 of these patients (median: 18 mo, IQR 6-36).</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e1034-e1046"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670038","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":"Outcomes of Surveillance Program for Individuals at High-Risk of Pancreatic Adenocarcinoma.","authors":"Leena S Penumalee, Yangruijue Ma, Ruohui Chen, Katherine Hanley, Charles Muller, Brittany Degreef, Rajesh N Keswani","doi":"10.1097/MPA.0000000000002696","DOIUrl":"10.1097/MPA.0000000000002696","url":null,"abstract":"<p><strong>Objectives: </strong>Individuals at high-risk (HRI) of developing pancreatic adenocarcinoma (PDAC) are offered intensive screening to detect PDAC at an early, curable stage. There are scant data on how HRI PDAC screening programs perform in clinical practice outside of large, prospective cohort studies. This study assessed the screening patterns, outcomes, and adherence of HRIs participating in a structured PDAC screening program.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of HRIs at a single, quaternary-care referral center between 2009 and 2025. Based on risk factors, patients were offered structured testing with noninvasive imaging [most commonly magnetic resonance imaging (MRI)] and/or endoscopic ultrasound (EUS). Demographic and clinical information were obtained through chart review. Adherence rates were calculated, and a multivariable analysis was conducted to identify factors associated with adherence.</p><p><strong>Results: </strong>A total of 316 patients met high-risk criteria and underwent screening. Seven PDACs were detected during a mean cohort follow-up of 2.5 years; 6 early-stage PDACs (4 stage I, 2 stage II) were detected during surveillance, and 1 stage III PDAC was diagnosed due to symptoms in a patient nonadherent to screening. Seven patients underwent surgical resection, including 4 with PDAC and 3 with worrisome lesions on imaging or endoscopic ultrasound (2 high-risk cystic lesions and 1 PanIN-IB). There was 1 death from PDAC in a patient with stage IA disease who did not undergo resection. The mean adherence rate for the cohort was 76.5% over 3.8 years. Individuals with pathogenic germline variants demonstrated higher adherence ( P =0.02).</p><p><strong>Conclusion: </strong>A PDAC screening program for HRIs identified early-stage PDAC in an important proportion of patients. While overall adherence rates are high, additional research is needed to identify barriers affecting patient adherence.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e1048-e1054"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382627","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":"The Association Between Serum Uric Acid to Creatinine Ratio and the Severity of Acute Pancreatitis.","authors":"Chun-Mei Li, Xian Feng","doi":"10.1097/MPA.0000000000002695","DOIUrl":"10.1097/MPA.0000000000002695","url":null,"abstract":"","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e1055"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550185","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":"AI-Driven Test-Free Prediction of ICU Admission, Insulin Dependence, and Exocrine Dysfunction After Acute Pancreatitis.","authors":"Ishanu Chattopadhyay, Dmytro Onishchenko, Philip A Kern, Darwin L Conwell","doi":"10.1097/MPA.0000000000002697","DOIUrl":"10.1097/MPA.0000000000002697","url":null,"abstract":"<p><strong>Objectives: </strong>Acute pancreatitis (AP) has heterogeneous trajectories: some patients deteriorate rapidly and require ICU care, whereas others develop delayed sequelae such as exocrine pancreatic dysfunction (EPD) and pancreatogenic diabetes. Existing scoring systems are burdensome, not available at first presentation, and poorly suited for forecasting longer-term outcomes.</p><p><strong>Methods: </strong>Our AI platform operating exclusively on routinely collected EHR predicts 3 outcomes after a first recorded AP diagnosis: (1) ICU admission (same-day, within 1 wk, within 2 wk); (2) incident EPD; and (3) incident insulin dependence among patients without prior diabetes diagnosis or antihyperglycemic prescriptions. Models were trained and validated using a US administrative claims database comprising > 164 million individuals.</p><p><strong>Results: </strong>We demonstrate area under the receiver operating curves (AUCs) of 0.986 (same-day ICU), 0.933 (ICU within 1 wk), and 0.927 (ICU within 2 wk). For longer-term outcomes, AUCs were 0.913 (male) and 0.901 (female) for incident EPD, and 0.861 (male) and 0.884 (female) for incident insulin dependence. Established chronic pancreatitis risk factors (eg, obesity, tobacco dependence) are recovered with large effect sizes and high significance, supporting epidemiologic plausibility. Negative associations were consistent with etiologic subtypes, competing risks, and health care utilization patterns.</p><p><strong>Conclusions: </strong>Using only existing coded longitudinal history from a US administrative claims environment, ZeBRA enables simultaneous, test-free prediction of early deterioration and delayed pancreatic sequelae after AP, providing a scalable and interpretable basis for early risk stratification and targeted follow-up across the AP-chronic pancreatitis continuum. Broader clinical adoption will require external validation, especially in non-US health systems and data sets with different coding and care-delivery structures.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e1026-e1033"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148361995","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":"Changes in Activity of Heat Shock Protein-70 Family Genes Is Associated With Early Acute Pancreatitis Severity.","authors":"Aiste Kielaite-Gulla, Justina Gaizevska, Agne Sestokaite, Rasa Sabaliauskaite, Kristina Snipaitiene, Ryte Damaseviciute, Kestutis Strupas, Sonata Jarmalaite","doi":"10.1097/MPA.0000000000002686","DOIUrl":"10.1097/MPA.0000000000002686","url":null,"abstract":"<p><strong>Objectives: </strong>Acute pancreatitis (AP) is a painful and potentially life-threatening disorder, with no effective therapy available to date. Genome assessment shows promise as a potential method for predicting AP severity. We hypothesized that single-nucleotide polymorphisms (SNPs) and expression changes in heat shock protein 70 (HSP70) family genes may play a role in early prediction of AP severity.</p><p><strong>Methods: </strong>A total of 44 AP patients and 47 age- and sex-matched healthy controls were studied. Leukocyte-extracted total RNA and genomic DNA were used for HSPA1A and HSPA1L gene expression and genotyping in promoter regions ( HSPA1A : rs1008438 and HSPA1L : rs2227956) analyses, respectively.</p><p><strong>Results: </strong>No statistically significant differences were found between the genotypes of AP patients and controls; however, HSPA1A expression was 2-fold lower in AP. The decrease in expression was more evident in the mild and mild/moderate AP groups versus controls ( P =0.024 and 0.008, respectively). HSPA1L expression in AG versus AA carriers was higher in the entire cohort ( P =0.014) and markedly differed between AP patients ( P =0.001). Also, HSPA1L expression was the highest in severe AG cases and significantly differed from AA genotype carriers ( P =0.005).</p><p><strong>Conclusions: </strong>We suggest that HSP70 family gene expression may be a valuable marker for predicting disease severity in AP.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e973-e979"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865682","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":"Usefulness of Apparent Diffusion Coefficient Values on Diffusion-weighted Magnetic Resonance Imaging in Small Pancreatic Neuroendocrine Neoplasms.","authors":"Ryo Muranushi, Kazuto Shibuya, Nana Kimura, Mina Fukasawa, Norihito Naruto, Toru Watanabe, Katsuhisa Hirano, Isaku Yoshioka, Kyo Noguchi, Tsutomu Fujii","doi":"10.1097/MPA.0000000000002713","DOIUrl":"10.1097/MPA.0000000000002713","url":null,"abstract":"<p><strong>Objectives: </strong>Whether lymph node dissection is necessary for pancreatic neuroendocrine neoplasms (pan-NEN) smaller than 20 mm in diameter remains controversial. We aimed to investigate the usefulness of apparent diffusion coefficient (ADC) values on diffusion-weighted magnetic resonance imaging (DW-MRI) in predicting lymph node metastasis (LNM) in pan-NENs.</p><p><strong>Methods: </strong>Data concerning 44 patients with pan-NENs who had undergone radical pancreatectomy in our department between January 2008 and December 2023 were retrospectively reviewed. ADC values of the tumor area on DW-MRI were measured and analyzed in relation to clinicopathologic factors.</p><p><strong>Results: </strong>Thirty-three patients had pan-NENs smaller than 20 mm in diameter. Six patients with LNM showed significantly lower ADC values than those without ( P = 0.0105). Of the patients with pan-NENs smaller than 20 mm in diameter, 4 patients with LNM had significantly lower ADC values ( P = 0.0010). Regarding vascular invasion, the patient group positive for lymphatic, venous, and neural invasion had significantly lower ADC values than those in the negative group ( P = 0.018, 0.036, and 0.033, respectively).</p><p><strong>Conclusion: </strong>In cases of pan-NENs smaller than 20 mm in diameter, low ADC values may predict LNM and vascular invasion.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e967-e972"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930462","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 Role of MET Gene as a Potential Biomarker and Therapeutic Target in Ampullary Cancer.","authors":"Apurva, Arun Kumar, Abhay K Sharma, Nimisha, Ejaj Ahmad, Vineeta V Batra, Seneha Santoshi, Sundeep S Saluja","doi":"10.1097/MPA.0000000000002692","DOIUrl":"10.1097/MPA.0000000000002692","url":null,"abstract":"<p><strong>Background: </strong>The incidence of ampullary carcinoma (AC) has dramatically increased. Nearly 50% of patients develop recurrence, indicating the need for additional prognostic markers and treatment options. Emerging evidence suggests that mesenchymal epithelial transition (MET) genes play a role in tumorigenesis and can be a useful therapeutic target; however, their role in AC remains unexplored.</p><p><strong>Methods: </strong>This study investigated the methylation status using methylation-specific PCR, mRNA expression using quantitative PCR, and protein expression using immunohistochemistry of the MET proto-oncogene in 61 surgically resected AC specimens and further examined its coexpression with HER2.</p><p><strong>Results: </strong>Our findings revealed MET promoter hypomethylation (68.85%), increased expression of MET at the mRNA (67.21%) and protein level (54%) in AC patients. Significant correlation was observed between hypomethylation and increased mRNA expression ( P =0.026; <0.000), and MET mRNA and protein expression ( P =0.037). Further, MET expression was notably higher in early stage ( P =0.003) and intestinal type (84.21%) than pancreatobiliary type (PB type) (61.76%) ( P =0.199). In addition, coexpression of MET and HER2 receptors occurred in a significant subset of cases in AC, suggesting receptor tyrosine kinase convergence ( P =0.014). In silico analysis of the GSE60979 data set corroborated these findings, showing increased MET and ERBB2 (HER2) expression in tumor samples compared with normal tissues. At a median follow-up of 34 months, the mean survival of AC patients was 37.3±2.5 months.</p><p><strong>Conclusions: </strong>These findings demonstrate that MET dysregulation is a recurrent molecular event in ampullary carcinoma and support further investigation of MET and HER2 coexpression as a basis for future mechanistic and therapeutic studies.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e980-e994"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148331979","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":"Comparative Analysis of Outcomes and Readmissions Trends in Adult and Pediatric Acute Biliary Pancreatitis: A Nationwide Analysis.","authors":"Umer Farooq, Zahid I Tarar, Sagar Pathak, Abdullah Abbasi, Faisal Kamal, Kambiz Kadkhodayan, Dennis Yang, Natalie Cosgrove, Maham Hayat, Deepanshu Jain, John George, Muhammad K Hasan, Mustafa Arain","doi":"10.1097/MPA.0000000000002682","DOIUrl":"10.1097/MPA.0000000000002682","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the comparative outcomes, resource utilization, and overall impact of same-admission cholecystectomy in pediatric patients with acute biliary pancreatitis (ABP) relative to adults.</p><p><strong>Methods: </strong>Using the 2016-2020 National Readmission Database, we identified ABP patients through ICD-10 codes and compared local and systemic complications in adults (≥18) versus pediatric (<18) patients. Proportions were analyzed using the Fisher exact test, and multivariate logistic regression was performed, adjusting for age, sex, comorbidities, procedure volume, and patient and hospital factors. Readmission trends were assessed with the Mantel-Haenszel test. Analyses used Stata 14.2; P <0.05 was significant.</p><p><strong>Results: </strong>Among 194,441 ABP patients, 1.54% (n=2999) were pediatric. Systemic complications of acute pancreatitis were similar, except sepsis was higher in adults (1.72% vs. 0.41%, P <0.01). Local complications, including pseudocyst, pancreatic necrosis, and walled-off necrosis, were comparable. Mortality was 0% versus 0.71% ( P =0.22). Same-admission cholecystectomy (CCY) was more common in pediatric cases; ERCP in adults. CCY reduced 30-day readmissions in both groups (11.81%→5.55% pediatric; 11.99%→4.44% adults, P <0.05). Pediatric CCY rates were stable longitudinally during the study period; adult rates slightly increased (56.51%→57.23%, trend P =0.01).</p><p><strong>Conclusion: </strong>Despite higher comorbidities in adults, ABP-specific local and systemic complications and mortality were similar between adults and pediatric patients. Same-admission cholecystectomy (CCY) was associated with a significant reduction in 30-day readmissions in both groups, highlighting its importance as a key intervention across age groups in acute biliary pancreatitis (ABP) cases.</p>","PeriodicalId":19733,"journal":{"name":"Pancreas","volume":" ","pages":"e1020-e1025"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988604","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}