RMD Open最新文献

{"title":"Correction: Efficacy and safety of jaktinib hydrochloride tablets in active axial spondyloarthritis: a multicentre, randomised, double-blind, placebo-controlled phase II clinical trial.","authors":"","doi":"10.1136/rmdopen-2024-004865corr1","DOIUrl":"https://doi.org/10.1136/rmdopen-2024-004865corr1","url":null,"abstract":"","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Efficacy and safety of filgotinib in patients with rheumatoid arthritis: week 156 interim results from a long- term extension study.","authors":"","doi":"10.1136/rmdopen-2024-004476corr1","DOIUrl":"https://doi.org/10.1136/rmdopen-2024-004476corr1","url":null,"abstract":"","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct clinical outcomes based on multiple serum cytokine and chemokine profiles rather than autoantibody profiles and ultrasound findings in rheumatoid arthritis: a prospective ultrasound cohort study.","authors":"Shoichi Fukui, Tohru Michitsuji, Yushiro Endo, Ayako Nishino, Kaori Furukawa, Shimpei Morimoto, Toshimasa Shimizu, Masataka Umeda, Remi Sumiyoshi, Tomohiro Koga, Naoki Iwamoto, Mami Tamai, Tomoki Origuchi, Karin A J van Schie, Yukitaka Ueki, Nobutaka Eiraku, Tamami Yoshitama, Naoki Matsuoka, Takahisa Suzuki, Akitomo Okada, Hiroaki Hamada, Masahiro Ayano, Toshihiko Hidaka, Tomomi Tsuru, Takahiro Maeda, Tom W J Huizinga, René E M Toes, Atsushi Kawakami, Shin-Ya Kawashiri","doi":"10.1136/rmdopen-2024-005163","DOIUrl":"https://doi.org/10.1136/rmdopen-2024-005163","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the potential of clinical factors, ultrasound findings, serum autoantibodies, and serum cytokine and chemokine profiles as predictors of clinical outcomes in rheumatoid arthritis (RA).</p><p><strong>Patients and methods: </strong>We included 200 patients with RA treated with biological and targeted synthetic disease-modifying antirheumatic drugs in a prospective multicentre ultrasound cohort study. Their serum levels of multiple cytokines and chemokines, rheumatoid factors, and serum autoantibodies (anti-cyclic citrullinated peptide-2 (anti-CCP2) and anti-carbamylated protein antibodies) were measured at baseline, 3 months and 12 months.</p><p><strong>Results: </strong>Dimensionality reduction using 38 cytokines and chemokines demonstrated four distinct clusters that differed significantly regarding the frequencies of remission defined by clinical composite measures and ultrasound evaluations. Prominent differences in IL-1β, IL-5, IL-7, IL-10, IFNγ, GRO, IP-10, MCP-1 and MIP-1β characterised the between-cluster differences. Two distinct groups made of four clusters showed a significant difference in IgM-anti-CCP2 positivity. The least absolute shrinkage and selection operator regression of 38 cytokines and chemokines for Clinical Disease Activity Index (CDAI) remission at 12 months resulted in the selection of MIP-1β. Logistic regression using baseline levels of anti-citrullinated protein antibody, IgM-anti-CCP2 positivity, the CDAI, the total power Doppler score, the cluster by cytokines and chemokines, MIP-1β, methotrexate dose and mechanisms of action revealed that cluster by cytokines and chemokines was the sole significant factor for CDAI remission at 12 months.</p><p><strong>Conclusions: </strong>Specific patterns of cytokines and chemokines-no other clinical factors and autoantibody profiles-were important to distinguish patients with RA achieving remission at 12 months.</p><p><strong>Trial registration number: </strong>UMIN000012524.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in work participation among patients with inflammatory rheumatic musculoskeletal diseases (iRMDs): Data from the German National Database (2010-2022).","authors":"Carlo Veltri, Katinka Albrecht, Uta Kiltz, Dirk Meyer-Olson, Susanna Späthling, Anja Strangfeld, Katja Thiele, Johanna Callhoff","doi":"10.1136/rmdopen-2024-004980","DOIUrl":"https://doi.org/10.1136/rmdopen-2024-004980","url":null,"abstract":"<p><strong>Objective: </strong>To analyse work participation among patients with inflammatory rheumatic musculoskeletal diseases (iRMDs), namely rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and ANCA-associated vasculitis (AAV).</p><p><strong>Methods: </strong>A cross-sectional sample of 16 421 patients from the National Database of the German Collaborative Arthritis Centers, aged <65 years were analysed. For each diagnosis, yearly rates of absenteeism, employment and disability pensions were analysed from 2010 to 2022. Population data were used to calculate standardised employment ratios (SERs), adjusted for age, sex, federal state and vocational qualification. The analysis was additionally stratified by sex, adjusting for other factors.</p><p><strong>Results: </strong>Over the observed time span, large employment increases were found across all diagnoses, namely in RA (54%-68%), PsA (58%-72%), SSc (47%-66%), AAV (43%-61%), SLE (48%-60%) and axSpA (65%-73%). SERs were for RA 0.88 (95% CI 0.86 to 0.90), axSpA (0.88 (0.84 to 0.91)), PsA (0.88 (0.85 to 0.91)), SSc (0.83 (0.75 to 0.91)), SLE (0.76 (0.72 to 0.80)) and AAV (0.73 (0.63 to 0.83)). In RA, axSpA, PsA and AAV, SERs were higher in men while in SLE and SSc men had lower SER. Median of yearly absenteeism due to the disease decreased by 5 (RA), 1 (axSpA), 6 (PsA), 11 (SLE), 4 (SSc) and 10 days (AAV) in the time span. Except for SSc, the proportion of disability pension receivers decreased for all diagnoses.</p><p><strong>Conclusion: </strong>Since 2010, work participation has improved for patients with iRMDs, as reflected in higher employment, reduced absenteeism and less disability retirement. However, patients have not reached population employment rates.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of pharmacological treatments in inclusion body myositis: a systematic review.","authors":"Eduardo José Ferreira Santos, Bayram Farisogullari, Nicholas Yapp, Hermaleigh Townsley, Pedro Sousa, Pedro M Machado","doi":"10.1136/rmdopen-2024-005176","DOIUrl":"10.1136/rmdopen-2024-005176","url":null,"abstract":"<p><strong>Objective: </strong>To identify the best evidence on the efficacy of treatment interventions for inclusion body myositis (IBM) and to describe their safety.</p><p><strong>Methods: </strong>Systematic review of randomised controlled trials (RCTs) of pharmacological treatments of adults with IBM, conducted according to the Cochrane Handbook, updating a previous Cochrane review. The search strategy was run on Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE and EMBASE, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. Assessment of risk of bias, data extraction and synthesis were performed independently by two reviewers. Data pooled in statistical meta-analyses, if possible.</p><p><strong>Results: </strong>From a total of 487 records, 48 were selected for full-text review, 14 fulfilled the inclusion criteria, but only 2 RCTs were included in meta-analyses due to clinical heterogeneity (different drug interventions or dosages). Treatments included various immunosuppressive and immunomodulatory agents, alongside interventions modulating muscle growth and protein homoeostasis. Efficacy was assessed across multiple outcomes, namely muscle strength, physical function, mobility and muscle trophicity. Trials of methotrexate (MTX), intravenous immunoglobulin, interferon beta-1a and MTX, MTX and anti-T-lymphocyte immunoglobulin, oxandrolone, MTX and azathioprine, bimagrumab, arimoclomol, and sirolimus provided low-quality to high-quality evidence of having no effect on the progression of IBM.</p><p><strong>Conclusions: </strong>Drug interventions for IBM were not effective for most of the outcomes of interest. We observed inconsistency of outcome measures across trials. More RCTs are needed, of adequate size and duration, and using a standardised set of outcome measures.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New guidelines on glucocorticoid-induced adrenal insufficiency: the end of short synacthen test in rheumatology?","authors":"Paul Ornetti, Benjamin Bouillet, Damien Denimal","doi":"10.1136/rmdopen-2024-005251","DOIUrl":"10.1136/rmdopen-2024-005251","url":null,"abstract":"","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic disease activity measured with ESSDAI varies largely over 5 years in a prospective, longitudinal cohort of patients with Sjögren's disease.","authors":"Liseth de Wolff, Gwenny Verstappen, Alja Stel, Greetje van Zuiden, Jolien van Nimwegen, Arjan Vissink, Frans Kroese, Suzanne Arends, Hendrika Bootsma","doi":"10.1136/rmdopen-2024-004753","DOIUrl":"10.1136/rmdopen-2024-004753","url":null,"abstract":"<p><strong>Objectives: </strong>The objectives are to evaluate variation in systemic disease activity (European Alliance of Associations For Rheumatology (EULAR) Sjögren's Syndrome Disease Activity Index (ESSDAI)) over time at group and individual patient level and to assess associations of ESSDAI low disease activity (LDA) with other outcome measures in a standard-of-care cohort of patients with Sjögren's disease (SjD).</p><p><strong>Methods: </strong>Patients with SjD participating in a prospective longitudinal study (REgistry of Sjögren Syndrome LongiTudinal cohort) fulfilling the 2016 American College of Rheumatology/EULAR classification criteria with ≥2 years of follow-up were included. ESSDAI was assessed at least yearly, up to 5 years. Patient-reported, objective glandular and laboratory outcomes were compared between patients with ESSDAI LDA (score<5) for <75% vs ≥75% of time.</p><p><strong>Results: </strong>Of 265 included patients with SjD, 236 (89%) were women, median disease duration was 6 years (IQR 2-10) and 114 (43%) received immunosuppressive treatment at some point during follow-up. At group level, median ESSDAI decreased slightly, from 4 (IQR 2-7) at baseline to 3 (IQR 2-5) at year 5, with a concomitant decrease in variation, indicating regression to the mean. At the individual patient level, ESSDAI varied in the majority of patients: 50/102 (49%) untreated patients with ESSDAI<5 at baseline changed to ESSDAI≥5 at least once during follow-up. Of the untreated patients with ESSDAI≥5 at baseline, 41/45 (91%) changed to ESSDAI<5. Patients with ESSDAI LDA for ≥75% of time showed better outcomes on saliva production.</p><p><strong>Conclusions: </strong>In this cohort of patients with SjD, overall ESSDAI slightly decreased during 5 years of follow-up, whereas at individual patient level, large variation was seen over time for the majority of patients. Longer time in ESSDAI LDA was associated with better salivary gland outcomes.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistently different patterns of patient's global assessment of health in rheumatoid arthritis are associated with pain and impaired function more than with inflammation: an inception cohort study over 15 years.","authors":"Valentina Bala, Ingiäld Hafström, Björn Svensson, Sofia Ajeganova","doi":"10.1136/rmdopen-2024-004744","DOIUrl":"https://doi.org/10.1136/rmdopen-2024-004744","url":null,"abstract":"<p><strong>Objective: </strong>To assess patient's self-reported global assessment of health (PGA) in relation to inflammation, pain and disability in patients with rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>Data were obtained from the Better Anti-Rheumatic PharmacOTherapy early RA cohort, in which patients were scheduled for follow-up of 15 years. Longitudinal PGA trajectories were identified using hierarchical agglomerative clustering procedure with Wards methods, based on PGA assessments during the first 2 years. Multivariate linear regression and mixed models were used to evaluate associations between PGA, inflammation, pain and disability.</p><p><strong>Results: </strong>Totally 2238 patients were included in 1991-2006. Three PGA trajectories were identified, low, medium and high, including 34%, 48% and 18% of the patients, respectively. The similar PGA patterns were shown for the inclusion periods before and after 1999. The patients in the low PGA group were less often women, had lower body mass index, lower levels of inflammatory variables, visual analogue scale (VAS) pain and Health Assessment Questionnaire (HAQ) scores at baseline than patients in the higher PGA groups. After adjustments, smoking and antibodies to cyclic citrullinated peptide status differentiated between being in low and high PGA groups. During the first year, all PGA groups showed improved outcomes, most pronounced in low PGA group. Fewer patients in high PGA group achieved remission, independent of remission criteria used. The outcomes were consistently different between the PGA groups from 6 months and onwards. The PGA levels from baseline over 15 years were best explained by VAS pain, followed by HAQ score, Disease Activity Score on 28 joints-3 and tender joint count, adjusted R² up to 77%, 41%, 27% and 26%, respectively.</p><p><strong>Conclusion: </strong>Persistently higher PGA levels in RA were mostly related to pain and disability.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Switching to biological DMARDs versus cycling among JAK inhibitors in patients with rheumatoid arthritis and with inadequate response to JAK inhibitors: from FIRST registry.","authors":"Yusuke Miyazaki, Shingo Nakayamada, Hiroaki Tanaka, Kentaro Hanami, Shunsuke Fukuyo, Satoshi Kubo, Ayako Yamaguchi, Ippei Miyagawa, Yurie Satoh-Kanda, Yasuyuki Todoroki, Yoshino Inoue, Masanobu Ueno, Yoshiya Tanaka","doi":"10.1136/rmdopen-2024-004987","DOIUrl":"10.1136/rmdopen-2024-004987","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify characteristics of patients with rheumatoid arthritis (RA) with an inadequate response to Janus kinase inhibitors (JAKi-IR) and evaluate the efficacy and safety of subsequent treatments.</p><p><strong>Methods: </strong>This study included 434 patients with RA who started JAKi treatment. JAKi-IR patients were those who switched to another drug due to inadequate response or did not reach low disease activity within 26 weeks of beginning JAKi. The efficacy and safety of switched biological disease-modifying anti-rheumatic drugs (bDMARDs) or cycled targeted synthetic disease-modifying anti-rheumatic drugs were analysed 26 weeks after switching treatment in JAKi-IR patients.</p><p><strong>Results: </strong>Patients with JAKi-IR RA accounted for 31.8% (n=138/434). Multiple logistic regression identified factors contributing to JAKi-IR, such as the prior use of multiple ineffective bDMARDs and suboptimal JAKi dosing. There were no differences in patient background when comparing patients with RA with JAKi-IR who cycled to another JAKi (n=31) versus those who switched to bDMARDs (n=45). Among those cycling to another JAKi, the Clinical Disease Activity Index (CDAI) scores improved by week 26, with higher remission rates, while retention and adverse events remained similar. Trajectory analysis identified three CDAI response patterns, with the 'treatment response' group showing rapid and sustained improvement when cycling to another JAKi. Multiple logistic regression in this group identified another JAKi cycle as the critical factor for the treatment response.</p><p><strong>Conclusions: </strong>Cycling JAKis is more effective than switching to bDMARDs in JAKi-IR RA, with no differences in safety or retention. This study suggests that cycling to another JAKi may be appropriate for patients with RA with JAKi-IR.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 Sjögren's disease on quality of sexual life using the Qualisex score.","authors":"Alexandra Kachaner, Raphaele Seror, Véronique Le Guern, Philippe Dieudé, Jacques-Eric Gottenberg, Eric Hachulla, Valérie Devauchelle-Pensec, Aleth Perdriger, Emanuelle Dernis, Marion Couderc, Sophie Berville, Xavier Mariette, Rakiba Belkhir, Gaetane Nocturne","doi":"10.1136/rmdopen-2024-004693","DOIUrl":"https://doi.org/10.1136/rmdopen-2024-004693","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the impact of Sjögren disease (SjD) on the quality of sexual life and its determinants using the Qualisex questionnaire.</p><p><strong>Methods: </strong>The Qualisex questionnaire was administered to participants within the ASSESS cohort, a French national multicentric prospective cohort of individuals with SjD. Patients' characteristics and psychometric evaluations were also collected.</p><p><strong>Results: </strong>Among the 395 patients of the cohort, 92 (23%) completed the questionnaire, with a median age of 56 (44-59) years and a female ratio of 92% (85/92). The median Qualisex score was 3.4 (1.1-5.9).Comparing the first and last quartiles of the Qualisex score, a worst sexual satisfaction was associated with older age (median (IQR) 58 (52-65) vs 52 (41-56) years, p=0.005), higher EULAR Sjögren's disease Patient Reported Index (ESSPRI) (6.8 (5.7-7.7) vs 4.3 (2.8-5.3), p<0.0001) lower SF-36 mental and physical scores (respectively, 43 (38-46) vs 49 (47-53), p=0.0035 and 31 (29-35) vs 35 (30-37), p=0.035), higher Depression and Anxiety scores (HADS) (respectively, 9 (7-11) vs 2 (1-4), p<0.0001 and 11 (8-14) vs 7 (4-10), p=0.006). Interestingly, EULAR Sjögren's disease Disease Activity Index (ESSDAI) score did not differ significantly (4 (1-10) vs 2.5 (1.8-4), p=0.35). In a multivariable analysis, the Qualisex score remained strongly associated with a higher HADS depression score and, to a lesser extent, with a higher ESSPRI. The inability to obtain a score was associated with older age.</p><p><strong>Conclusion: </strong>In SjD patients, sexual satisfaction assessed with the Qualisex score, was strongly associated with depression and, to lesser extent, with ESSPRI, but not with systemic activity.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}