Platelets最新文献

{"title":"Branched endovascular aortic aneurysm repair decreases platelet reactivity and platelet-rich thrombus formation - a prospective, cohort study.","authors":"Aleksandra Gąsecka, Ewelina Błażejowska, Agata Konieczka, Mateusz Leśniewski, Magdalena Ostaszewska, Michał Łomiak, Magdalena Gajewska, Sylwester Rogula, Łukasz Szarpak, Krzysztof J Filipiak, Mateusz Zawadka, Katarzyna Jama, Paweł Andruszkiewicz, Marcin Grabowski, Tomasz Jakimowicz","doi":"10.1080/09537104.2025.2458622","DOIUrl":"10.1080/09537104.2025.2458622","url":null,"abstract":"<p><p>Appropriate platelet function determines both the perioperative haemostasis and the risk of postoperative thrombotic complications in patients undergoing branched endovascular repair (bEVAR) of thoracoabdominal aortic aneurysm (TAAA). We aimed to assess the effect of bEVAR on platelet function and the predictive value of preoperative platelet function for postoperative bleeding. We measured platelet function using impedance aggregometry and total thrombus-formation analysis system in 50 consecutive patients, with TAAA undergoing elective bEVAR. After bEVAR, platelet reactivity was assessed using ASPI test, ADP test and TRAP test and thrombus size decreased, whereas time to clot formation increased, compared to baseline (<i>p</i> ≤ .042 for all). Preoperative platelet reactivity in the TRAP test was lower in patients who experienced post-operative bleeding, defined as ≥3 red blood cell units transfusion, compared to those who did not (<i>p</i> = .038). Baseline hemoglobin level <13 g/dl and TRAP test result ≤29.5 AUC increased the odds of bleeding by 5.4-fold and 6.8-fold, respectively, independent of other clinical variables. We conclude that in patients with TAAA undergoing bEVAR, platelet reactivity and platelet-rich thrombus formation decreased directly after the operation. Preoperative hemoglobin level and platelet reactivity in the TRAP test were independent predictors of postoperative bleeding complications.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"36 1","pages":"2458622"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of thromboxane generation with the bleeding events in aspirin users.","authors":"Yawen Liu, Yijie Liu, Feiqing Liang, Lu Lin, Zhipeng Xie, Jinxia Mai, Zhuoyi Wu, Min Huang, Shilong Zhong","doi":"10.1080/09537104.2025.2473953","DOIUrl":"10.1080/09537104.2025.2473953","url":null,"abstract":"<p><p>Coronary artery disease is among the leading causes of morbidity and mortality worldwide, posing a significant threat to human health and life. Aspirin is widely used in the treatment of coronary artery disease, however, long-term use may increase the risk of bleeding. Urinary 11-dehydro-TXB2, a biomarker indicative of platelet activation, has been associated with thrombotic events, but its association with bleeding events remains unexplored. This study aimed to assess the predictive value of TXB2-M levels for bleeding events in patients with coronary artery disease undergoing aspirin therapy. Multifactorial logistic regression analysis was employed to evaluate the potential of TXB2-M levels as a reliable marker for bleeding risk following aspirin use. Among patients with coronary artery disease treated with aspirin, those with lower TXB2-M levels exhibited an increased risk of bleeding events within three years (Hazard Ratio: 0.46; 95% Confidence Interval: 0.26-0.79; <i>P</i> < 0.05). Additionally, variations in TXB2-M levels were observed across different demographic groups. This study reinforces the validity of TXB2-M levels as a biomarker for identifying patients at elevated risk of bleeding, thus facilitating the implementation of personalized treatment strategies to minimize bleeding risks while preserving the efficacy of antithrombotic therapy.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"36 1","pages":"2473953"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multi-color flow cytometric method for characterizing murine reticulated platelets using SYTO 13.","authors":"Muataz Ali Hamad, Krystin Krauel, Nancy Schanze, Mark Zurek, Christoph B Olivier, Peter Kohl, Thomas G Nührenberg, Daniel Duerschmied","doi":"10.1080/09537104.2025.2489020","DOIUrl":"https://doi.org/10.1080/09537104.2025.2489020","url":null,"abstract":"<p><p>Reticulated platelets (RP) are immature platelets with heightened RNA content. An increased level of RP in the circulation is associated with various pathological conditions. In this study, we employed a novel flow cytometry approach for RP detection in mice, utilizing the nucleic acid dye SYTO 13 in conjunction with a platelet-specific marker (anti-mouse CD42b-DyLight 649). The efficacy of SYTO 13 for RP identification was confirmed by higher circulating RP levels in platelet-depleted mice during the recovery phase (35% ± 13%) compared to untreated mice (11% ± 1%, <i>n</i> = 9, <i>p</i> < .0001). We further characterized murine RP by exploring the surface expression of the platelet activation marker P-selectin. While there was no preactivation at baseline, stimulation with a thrombin receptor agonist (PAR-4) resulted in a higher increase in the percentage of P-selectin-positive platelets in RP (93% ± 6%) compared to non-RP (77% ± 14%, <i>n</i> = 6, <i>p</i> = .0065). In addition, RP exhibited higher geometric mean fluorescence intensity levels than non-RP (1874 ± 1278 <i>versus</i> 859 ± 549, <i>n</i> = 6, <i>p</i> = .02). Our proof-of-principle study demonstrates the efficacy of SYTO 13 in combination with platelet (activation) markers for identifying RP in both resting and activated states. This method holds promise for simultaneously monitoring RP levels and platelet activation in murine models of human disease.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"36 1","pages":"2489020"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case with a novel GATA1 variant mimicking immune thrombocytopenia attacks.","authors":"Elif Habibe Aktekin, Serdar Ceylaner, Şeyda Beşen, Ayşe Erbay, Nalan Yazıcı","doi":"10.1080/09537104.2025.2500499","DOIUrl":"10.1080/09537104.2025.2500499","url":null,"abstract":"<p><p>One of the leading thrombocytopenia occasions in childhood is immune thrombocytopenia (ITP). Small number of these patients do not respond to treatment methods known to be effective for ITP such as corticosteroids, intravenous immunoglobulin and thrombopoietin receptor agonists (eltrombopag, romiplostim, etc.) and have serious bleeding symptoms. We present a case in which a molecular genetic analysis was performed due to challenging responses to medical treatment for severe systemic bleeding symptoms which were similar to ITP. A hemizygous variant was detected in the <i>GATA1</i> gene and a homozygous variant in the <i>ATP2A1</i> gene for Brody myopathy. Eltrombopag, romiplostim, IVIG and corticosteroid were applied to resistant thrombocytopenia of the patient without knowing the cause. Patient had response in platelet counts in some occasions. This situation attracted our attention after the detection of this GATA variant in the etiopathogenesis of thrombocytopenia. Further investigations should be performed for much more rare causes of thrombocytopenia in patients with refractory thrombocytopenia attacks.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"36 1","pages":"2500499"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of a twin pregnancy patient with Glanzmann thrombasthenia might be caused by a novel <i>ITGA2B</i> gene mutation (c.2822G>A): a case report and family investigation.","authors":"Xiangcheng Liao, Ruikai Zhu, Zhigang Yang, Aiqiu Qin, Yucong Huang, Ping Li, Liling Liu, Zhuning Mo","doi":"10.1080/09537104.2025.2470758","DOIUrl":"10.1080/09537104.2025.2470758","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Mutations in the ITGA2B or ITGB3 gene that encodes for the αIIbβ3 platelet integrin usually cause Glanzmann thrombasthenia (GT). This study aims to investigate the clinical characteristics of a pedigree exhibiting an inherited hemorrhagic disorder resembling GT, elucidate its molecular pathogenesis and evaluate the efficacy of blood management strategies for a proband who is pregnant with twins. The clinical data of the pedigree with inherited hemorrhagic disorder were collected, including the assessment of clinical, laboratory and thromboelastography (TEG) profiles. DNA samples were obtained for next-generation sequencing, encompassing the exons and flanking sequences of the ITGA2B and ITGB3 genes, as well as other genes associated with blood and immune deficiency. Bioinformatics software tools, such as PolyPhen-2, SIFT and MutationTaster, were employed to analyze the functional impact of mutations. Protein structural models for the new mutation type were generated using PyMOL. The phenotype of the proband in this pedigree with inherited platelet dysfunction and bleeding disorder was in accordance with GT. The proband shows persistent blood accumulation in the uterine cavity. Laboratory findings indicate normal PLT morphology, PLT count, MPV, and PDW. However, there is a decreased PLT aggregation induced by agonists ADP, collagen, and AA while maintaining a normal response to ristocetin. The initial TEG examination results indicated that the patient presented with a hypocoagulable state, characterize d by a reduction in α angle (46.9), an extended K value (4.6) and a decreased maximum amplitude (35.1). The younger sister demonstrated comparable TEG performance to that of the proband and has a documented history of abnormal bleeding. A novel heterozygous mutation of &lt;i&gt;ITGA2B&lt;/i&gt; at position c.2822 G&gt;A (p.Trp941*) was identified in the proband and her familial counterparts-father, brother and sister. MutationTaster software predicted the new mutation to be pathogenic; however, PolyPhen-2 and SIFT software did not provide correlated predictions. The p.Trp941* mutation resulted in the premature termination of translation at residue 940Trp, leading to impaired protein function. Successful management was achieved during the perioperative period by administration of human immunoglobulin, platelets and antifibrinolytic drugs, followed by recombinant factor VIIa (rFVIIa), according to the thromboelastography tracings. The laboratory findings of the proband are consistent with GT, and a novel mutation in the ITGA2B gene at position c.2822 G&gt;A (p.Trp941*) has been identified as a potential cause of GT. However, since GT is a recessive disorder and both the proband and her family members are heterozygous, it cannot be excluded that they may possess additional bleeding risk factors, including the presence of other undetected variants. This study also illustrates the significance of multidisciplinary planning, TEG analysis and judicious utilization of ","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"36 1","pages":"2470758"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From reticulated platelets to immature platelet fraction: structure, function, and clinical applications.","authors":"Yuxin Zhang, Ziyun Wang, Pan Zhou, Hongwei Zhang","doi":"10.1080/09537104.2025.2467383","DOIUrl":"10.1080/09537104.2025.2467383","url":null,"abstract":"<p><p>In comparison to mature platelets, reticulated platelets (RPs) are newly released from the bone marrow and exhibit a larger size, higher reactivity, and a greater quantity of RNA, and can be an agile indicator of platelet turnover. The transcriptome associated with platelet function is significantly upregulated in RPs, which is a possible explanation for RPs intrinsic hyper-reactivity. We presented a comprehensive overview of the detection techniques for RPs. Current methods to quantify RPs in clinical routine are flow cytometry and fully automated hematology analyzers (Sysmex-XE/XN, Abbott, ADVIA, Mindray), which make the detection of RPs simpler, faster and more affordable. The proportion of RPs increased in the circulation has potential diagnostic and prognostic values in multiple clinical settings (risk stratification in cardiovascular diseases, the effect on antiplatelet drugs, differential diagnosis of thrombocytopenia, monitor platelet recovery after bone marrow or stem cell transplantation, and other diseases). There have been several studies focusing on RPs in recent years, particularly in cardiovascular disease and thrombocytopenia. In this review we summarizes the current study with regard to RPs and discuss their likely contribution in clinical routine.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"36 1","pages":"2467383"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-derived extracellular vesicles promote hair follicle growth through β-catenin signaling pathway.","authors":"Lei Wang, Yiwen Huang, Yajuan Wu, Yuanbo Huang, Zhou Lu, Panyu Wu, Shuo Meng, Tian Tian, Lei Cao","doi":"10.1080/09537104.2025.2498353","DOIUrl":"https://doi.org/10.1080/09537104.2025.2498353","url":null,"abstract":"<p><p>The application of platelet concentrates such as platelet-rich plasma (PRP) for the treatment of hair loss is impeded by the absence of standardized preparation protocols and storage conditions. Providing off-the-shelf controlled product methods and inheriting regenerative function of platelets, platelet-derived extracellular vesicles (PEVs) can be a promising alternative to surpass platelet concentrates limitations. This study aimed to investigate the effects of PEVs on cultured dermal papilla cells (DPCs) and hair follicles (HFs) in animal model. PEVs were prepared from fresh apheresis platelets and characterized. Their impact on the proliferation and migration of DPCs was explored. After subcutaneous administration of PEVs in a mouse model of depilation-induced hair regeneration, we observed the accelerated transition of HFs from the telogen to the anagen phase, and found the β-catenin signaling pathway was involved. These results indicate that PEVs activate DPCs and promote HF growth effectively. The PEVs from apheresis platelets offer a robust alternative for the treatment of hair loss.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"36 1","pages":"2498353"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiometabolic risk factor burden associates with an immature platelet profile.","authors":"Carine E Hamo, Matthew Muller, Emily Rosenfeld, Yuhe Xia, Adedoyin Akinlonu, Elliot Luttrell-Williams, Tessa J Barrett, Jeffrey S Berger","doi":"10.1080/09537104.2025.2459800","DOIUrl":"10.1080/09537104.2025.2459800","url":null,"abstract":"<p><p>Cardiometabolic risk factors, obesity, diabetes and hyperlipidemia contribute to cardiovascular disease (CVD). While platelets are involved in CVD pathogenesis, the relationship between risk factor burden on platelet indices and the platelet transcriptome remains uncertain. Blood was collected from CVD-free adults, measuring platelet count, mean platelet volume (MPV), immature platelet fraction (IPF), and absolute immature platelet fraction (AIPF) by hemogram. Platelets were isolated and analyzed via RNA sequencing. Participants were stratified by number of cardiometabolic risk factors (diabetes, obesity, hyperlipidemia). We calculated median (IQR) values of platelet indices and p-for-trend via linear regression across risk factor burden. To evaluate the association between risk factor burden and platelet transcripts, we performed multivariable linear regression adjusting for age, sex, and race/ethnicity. Among 141 participants, (50.5 ± 14.8 years, 42% male, 26% Black) risk factor burden was associated with increasing platelet size, IPF, and AIPF but not platelet count. Platelet RNA sequencing identified 100 differentially expressed transcripts (<i>p</i> < .01; 66 upregulated, 34 downregulated). Gene ontology enrichment analysis demonstrated upregulated pathways of secondary metabolic processes (NES = 1.96, <i>p</i> < .01), and hematopoietic stem cell proliferation (NES = 1.95, <i>p</i> < .01). Greater cardiometabolic risk factor burden is associated with increased platelet size and immaturity and suggesting novel platelet-mediated mechanisms linking risk factor burden with CVD.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"36 1","pages":"2459800"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"miR-28-5p targeted Rap1b attenuates splenic inflammation infiltration in immune thrombocytopenia.","authors":"Rongqing Yu, Lizhen Cen, Xinyu Wu, Huaiyuan Liu, Xuejun Zhai, Qiong Bin","doi":"10.1080/09537104.2025.2487756","DOIUrl":"10.1080/09537104.2025.2487756","url":null,"abstract":"<p><p>Immune thrombocytopenia (ITP) is an autoimmune disease with isolated platelet count decrease. A subset of patients responds inferiorly to the first-line therapies including glucocorticoid and intravenous immunoglobulins (IVIG), of which the underlying mechanisms have not been fully elucidated. We first found that expression of miR-28-5p was obviously increased in complete responders, and decreased to substantially low levels in partial or non-responders. In the passive ITP model, upregulation of miR-28-5p by injecting agomir slightly improved thrombocytopenia, and obviously inhibited the <i>Rap1b</i> gene expression. Luciferase reporter assay demonstrated there was significant decrease of luciferase activity in 293T cells co-transfected with miR-28-5p mimics and plasmids with <i>Rap1b</i> wide-type sequence. Upregulation of miR-28-5p, and downregulation of <i>Rap1b</i> played a favorable role in reducing B cell infiltration in the marginal zone of spleen in mice. However, miR-28-5p exhibited no significant influence on megakaryocyte maturation in ITP both in vitro and in vivo studies. Finally, we confirmed that miR-28-5p upregulation was associated with superior early treatment response in ITP, and possibly functioned by targeting <i>Rap1b</i> gene to inhibit humoral immunity.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"36 1","pages":"2487756"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracellular thiol isomerase ERp5 regulates integrin αIIbβ3 activation by inhibition of fibrinogen binding.","authors":"Kaifei Sun, Yaqiong Zhang, Aizhen Yang, Yuxin Zhang, Zhenzhen Zhao, Xiaofeng Yan, Yi Lu, Yue Han, Depei Wu, Freda Passam, Jingyu Zhang, Yi Wu","doi":"10.1080/09537104.2025.2455743","DOIUrl":"10.1080/09537104.2025.2455743","url":null,"abstract":"<p><p>Recent studies have shown that anti-ERp5 antibodies inhibit platelet activation and thrombus formation; Moreover, ERp5-deficient platelets exhibit enhanced platelet reactivity via regulation of endoplasmic reticulum (ER) stress. In this study, we used a new ERp5-knockout mouse model as well as recombinant ERp5 (rERp5) protein, to examine the role of ERp5 in platelet function and thrombosis. Although platelet-specific ERp5-deficient mice had decreased platelet count, the mice had shortened tail-bleeding times and enhanced platelet accumulation in FeCl₃-induced mesenteric artery injury, compared with wild-type mice. Using platelet-specific ERp5-deficient mice, we found that ERp5 deficiency increased platelet aggregation, granule secretion, and integrin αIIbβ3 activation. Wild-type recombinant ERp5 protein (rERp5-wt) and inactive mutant ERp5 protein (rERp5-mut) both inhibited human platelet aggregation and the binding of fibrinogen to human platelets, indicating that ERp5 protein interferes with the interaction between integrin αIIbβ3 and its ligand fibrinogen, and its enzymatic activity is not required for this process. Consistently, wild-type mice injected with rERp5-wt or rERp5-mut protein had prolonged tail-bleeding times. Our results provide important evidence that platelet ERp5 negatively regulates platelet activation and thrombus formation, via steric hindrance interfering with integrin αIIbβ3 ligation.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"36 1","pages":"2455743"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}