Scandinavian Journal of Gastroenterology最新文献

{"title":"Serum ferritin level is associated with liver fibrosis and incident liver-related outcomes independent of <i>HFE</i> genotype in the general population.","authors":"Ville T Männistö, Konsta Hakkarainen, Antti Jula, Annamari Lundqvist, Terhi Vihervaara, Iris Erlund, Fredrik Åberg","doi":"10.1080/00365521.2024.2314707","DOIUrl":"10.1080/00365521.2024.2314707","url":null,"abstract":"<p><strong>Background & aims: </strong>Hyperferritinemia reflects iron accumulation in the body and has been associated with metabolic disturbances and alcohol use, and is also a common finding in individuals diagnosed with liver disease. The major genetic regulator of iron metabolism is the <i>HFE</i> gene.</p><p><strong>Methods: </strong>The aim of this this study was to investigate the association between serum ferritin and liver fibrosis using the enhanced liver fibrosis (ELF) test, and the association between ferritin and liver-related outcomes in a Finnish population-based cohort of 6194 individuals (45% male, mean [± standard deviation] age, 52.9 ± 14.9 years; body mass index 26.9 ± 4.7 kg/m²). The effects of <i>HFE</i> variants on these associations were also evaluated.</p><p><strong>Results: </strong>Serum ferritin levels were significantly associated with liver fibrosis, as estimated by enhanced liver fibrosis (ELF) test in weighted linear regression analysis. Serum ferritin was significantly associated with both all liver-related outcomes (<i>n</i> = 92) and severe liver-related outcomes (<i>n</i> = 54) in weighted Cox regression analysis (hazard ratio [HR] per 1 SD, 1.11 [95% confidence interval (CI) 1.02-1.21]; <i>p</i> = 0.012 and HR 1.11 [95% CI 1.02-1.21]; <i>p</i> = 0.013, respectively). However, there was association neither between <i>HFE</i> risk variants and ELF test nor between <i>HFE</i> risk variants and liver-related outcomes.</p><p><strong>Conclusion: </strong>Serum ferritin levels were associated with liver fibrosis and incident liver disease, independent of <i>HFE</i> genotype in the general population. Furthermore, data demonstrated that metabolic disturbances and alcohol use were major risk factors for hyperferritinemia.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"592-599"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703306","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":"Maternal, obstetrical, and neonatal outcomes in celiac disease.","authors":"Khaled Alsabbagh Alchirazi, Claire Jansson-Knodell, Yazan Abu-Omar, Mohammad Aldiabat, Andrew Ford, Ahmed Telbany, Thabet Qapaja, Osama Hamid, Osama Abu Shawer, Alberto Rubio-Tapia","doi":"10.1080/00365521.2024.2311849","DOIUrl":"10.1080/00365521.2024.2311849","url":null,"abstract":"<p><strong>Objectives: </strong>Some studies have suggested a link between celiac disease (CD) and adverse maternal, obstetrical, and neonatal outcomes. Using a large database, we evaluated the effect of CD on pregnancy outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the National Inpatient Sample (NIS) of all deliveries from 2015 to 2019 in the United States. Using ICD-10 codes, we identified pregnant patients who had CD and those who did not. A multivariate logistic regression was used to generate odds ratios (ORs) with 95% confidence intervals (CIs) for maternal, obstetrical, and neonatal outcomes.</p><p><strong>Results: </strong>Of 12,039,222 deliveries between 2015 and 2019, there were 10,555 births in women with CD. Pregnant women with CD were more likely to be white and older compared to those without CD. Pregnant women with CD were significantly more likely to carry a diagnosis of gestational hypertension (OR 1.26; 95% CI 1.04-1.52), preeclampsia (1.28; 1.08-1.53), and severe preeclampsia (1.62; 1.25-2.09). They were less likely to have a full-term uncomplicated delivery (OR 0.11; 95% CI, 0.05-0.20), while being more likely to require device-assisted delivery (1.25; 1.04-1.50) and sustain 3rd or 4th degree vaginal lacerations (1.56; 1.21-2.02). Babies of pregnant women with CD were more likely to be small for gestational age (SGA) (OR 1.29; 95% CI 1.03-1.61).</p><p><strong>Conclusions: </strong>CD in pregnancy appears to be associated with increased adverse maternal, obstetrical, and neonatal outcomes. Clinicians should discuss these increased risks with CD patients who are planning to conceive.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"547-552"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139692821","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":"Letter to editor: effects of vancomycin in primary sclerosing cholangitis with and without inflammatory bowel disease.","authors":"Sheza Malik, Priyadarshini Loganathan, Babu P Mohan","doi":"10.1080/00365521.2024.2310168","DOIUrl":"10.1080/00365521.2024.2310168","url":null,"abstract":"","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"630"},"PeriodicalIF":1.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139577344","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":"Infliximab desensitization in patients with inflammatory bowel diseases: a safe therapeutic alternative.","authors":"Nassim Hammoudi, Déborah Hassid, Joëlle Bonnet, My-Linh Tran Minh, Clotilde Baudry, Anne Vauthier, Leila Chedouba, Pascal Houzé, Nelson Lourenco, Thomas Aparicio, Jean-Marc Gornet, Matthieu Allez","doi":"10.1080/00365521.2024.2316765","DOIUrl":"10.1080/00365521.2024.2316765","url":null,"abstract":"<p><strong>Background: </strong>Hypersensitivity reactions (HSR) to the administration of infliximab (IFX) in Inflammatory Bowel Diseases (IBD) patients are not rare and usually lead to drug discontinuation. We report data on safety and effectiveness of desensitization to IFX in patients with previous HSR.</p><p><strong>Methods: </strong>We conducted a retrospective monocentric observational study. Patients for whom a desensitization protocol to IFX was realized after a previous HSR were included. Anti-drug antibodies (ADA) and IFX trough levels at both inclusion and six months after desensitization were collected. Clinical outcomes, including recurrence of HSR were evaluated.</p><p><strong>Results: </strong>From 2005 to 2020, 27 patients (Crohn's Disease: 26 (96%) were included). Desensitization after HSR was performed after a median time of 10.4 months (2.9-33.1). Nineteen (70%) patients received immunosuppressants at time of desensitization. Eight (30%) patients presented HSR at first (<i>n</i> = 2), second (<i>n</i> = 4) or third (<i>n</i> = 2) IFX perfusion after desensitization. None led to intensive care unit transfer or death. Thirteen (48%) had clinical response at 6 months and 8 (29%) were still under IFX treatment two years after desensitization. IFX trough levels and ADA were available for 14 patients at time of desensitization. Most patients (12 out of 14) had ADA at a high level. At 6 months, among the 7 patients with long term response to IFX, 4 presented a decrease of ADA titers and 2 had a significant trough level of IFX.</p><p><strong>Conclusion: </strong>IFX desensitization in patients with IBD is a safe therapeutic alternative and represents a potential option for patients refractory to multiple biologics.<b>What is already known?</b> Hypersensitivity reactions to the administration of infliximab is frequent. Occurrence of hypersensitivity reaction, either immediate or delayed, usually leads to permanent drug discontinuation.<b>What is new here?</b> Infliximab desensitization is well tolerated with no hypersensitivity reaction recurrence in 70% of patients. Clinical success at 6 months was of 48% and around a third of patients remained under infliximab therapy two years after desensitization. Antidrug antibodies decreased and infliximab trough levels increased in these patients showing the impact of desensitization on immunogenicity.<b>How can this study help patient care?</b> Infliximab desensitization represents a potential option for patients refractory to multiple biologics who presented hypersensitivity reaction to the drug.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"553-560"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730357","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":"Bioengineering vascularized liver tissue for biomedical research and application.","authors":"Parsa Davoodi, Niloofar Rezaei, Moustapha Hassan, David C Hay, Massoud Vosough","doi":"10.1080/00365521.2024.2310172","DOIUrl":"10.1080/00365521.2024.2310172","url":null,"abstract":"<p><p>The liver performs a wide range of biological functions that are essential to body homeostasis. Damage to liver tissue can result in reduced organ function, and if chronic in nature can lead to organ scarring and progressive disease. Currently, donor liver transplantation is the only longterm treatment for end-stage liver disease. However, orthotopic organ transplantation suffers from several drawbacks that include organ scarcity and lifelong immunosuppression. Therefore, new therapeutic strategies are required. One promising strategy is the engineering of implantable and vascularized liver tissue. This resource could also be used to build the next generation of liver tissue models to better understand human health, disease and aging <i>in vitro</i>. This article reviews recent progress in the field of liver tissue bioengineering, including microfluidic-based systems, bio-printed vascularized tissue, liver spheroids and organoid models, and the induction of angiogenesis <i>in vivo</i>.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"623-629"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139692820","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":"The association of triglyceride-glucose-waist circumference with metabolic associated fatty liver disease and the severity of liver steatosis and fibrosis in American adults: a population-based study.","authors":"Zhouxiao Wu, Kai Huang, Sizeng Bao, Xiangyu Zhang, Jingwen Li, Weiliang Kong, Yanmei Shi, Yilian Xie","doi":"10.1080/00365521.2024.2305268","DOIUrl":"10.1080/00365521.2024.2305268","url":null,"abstract":"<p><strong>Background: </strong>The global obesity pandemic has led to an alarming rise in the prevalence of metabolic-associated fatty liver disease (MAFLD), making it a substantial clinical and economic burden on society. Early detection and effective treatment of MAFLD are imperative to mitigate its impact.</p><p><strong>Methods: </strong>This cross-sectional study was conducted involving 4634 adults from the National Health and Nutrition Examination Surveys (NHANES) 2017-2018 cycle. Transient elastography (TE) was used to diagnose MAFLD and assess the extent of liver steatosis and fibrosis. Multivariate logistic regression models were utilized to examine the association between the triglyceride and glucose index-waist circumference (TyG-WC) and the risk of MAFLD, liver fibrosis, and steatosis.</p><p><strong>Results: </strong>A positive association between TyG-WC and MAFLD persisted across all three models: model1: OR = 8.44, 95% CI: 6.85-10.38 (unadjusted), model2: OR = 8.28, 95% CI: 6.53-10.50 (partially adjusted), and model3: OR = 7.98, 95% CI: 4.11-15.46 (fully adjusted). Further investigation through interaction and stratified analysis revealed that this association was more pronounced in the non-obese and Non-Hispanic White persons groups. Moreover, a non-linear relationship analysis unveiled threshold and saturation effects between TyG-WC and MAFLD. Specifically, a TyG-WC value of approximately 600 may represent the threshold effect for MAFLD risk, while 1200 may signify the saturation effect of MAFLD risk. Finally, a robust correlation between TyG-WC and the severity of liver steatosis and fibrosis was found.</p><p><strong>Conclusions: </strong>The findings suggest that the TyG-WC index exhibits excellent predictive value for MAFLD in the general American population.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"561-569"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139484657","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":"Expert endoscopist assessment of colorectal polyp size using virtual scale endoscopy, visual or snare-based estimation: a prospective video-based study.","authors":"Ioana Popescu Crainic, Roupen Djinbachian, Douglas K Rex, Alan Barkun, Aasma Shaukat, James East, Cesare Hassan, Yuichi Mori, Heiko Pohl, Amit Rastogi, Prateek Sharma, Joseph C Anderson, Mahsa Taghiakbari, Edgard Medawar, Daniel von Renteln","doi":"10.1080/00365521.2024.2308519","DOIUrl":"10.1080/00365521.2024.2308519","url":null,"abstract":"<p><strong>Background and aims: </strong>Accurate polyp size estimation during colonoscopy has an impact on clinical decision-making. A laser-based virtual scale endoscope (VSE) is available to allow measuring polyp size using a virtual adaptive scale. This study evaluates video-based polyp size measurement accuracy among expert endoscopists using either VSE or visual assessment (VA) with either snare as reference size or without any reference size information.</p><p><strong>Methods: </strong>A prospective, video-based study was conducted with 10 expert endoscopists. Video sequences from 90 polyps with known reference size (fresh specimen measured using calipers) were distributed on three different slide sets so that each slide set showed the same polyp only once with either VSE, VA or snare-based information. A slide set was randomly assigned to each endoscopist. Endoscopists were asked to provide size estimation based on video review.</p><p><strong>Results: </strong>Relative accuracies for VSE, VA, and snare-based estimation were 75.1% (95% CI [71.6-78.5]), 65.0% (95% CI [59.5-70.4]) and 62.0% (95% CI [54.8-69.0]), respectively. VSE yielded significantly higher relative accuracy compared to VA (<i>p</i> = 0.002) and to snare (<i>p</i> = 0.001). A significantly lower percentage of polyps 1-5 mm were misclassified as >5 mm using VSE versus VA and snare (6.52% vs. 19.6% and 17.5%, <i>p</i> = 0.004) and a significantly lower percentage of polyps >5 mm were misclassified as 1-5 mm using VSE versus VA and snare (11.4% vs. 31.9% and 14.9%, <i>p</i> = 0.038).</p><p><strong>Conclusions: </strong>Endoscopists estimate polyp size with the highest accuracy when virtual adaptive scale information is displayed. Using a snare to assist sizing did not improve measurement accuracy compared to displaying visual information alone.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"608-614"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139707723","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":"The cckOMA syndrome and its relation to the Zollinger-Ellison syndrome: a diagnostic challenge.","authors":"Jens F Rehfeld","doi":"10.1080/00365521.2024.2308532","DOIUrl":"10.1080/00365521.2024.2308532","url":null,"abstract":"<p><strong>Objective: </strong>Among patients with enteropancreatic neuroendocrine tumor syndromes only one case with a cholecystokinin (CCK) secreting tumor has been reported. She had significant hyperCCKemia leading to a specific syndrome of severe diarrheas, weight loss, repeated duodenal ulcers and a permanently contracted gallbladder with gallstones. There are, however, reasons to believe that further CCKomas exist, for instance among Zollinger-Ellison patients with normal plasma gastrin concentrations. The present review is a call to gastroenterologists for awareness of such CCKoma patients.</p><p><strong>Method: </strong>After a short case report, the normal endocrine and oncological biology of CCK is described. Subsequently, the CCKoma symptoms are discussed with particular reference to the partly overlapping symptoms of the Zollinger-Ellison syndrome. In this context, the diagnostic use of truly specific CCK and gastrin assays are emphasized. The discussion also entails the problem of access to accurate CCK measurements.</p><p><strong>Conclusion: </strong>Obviously, the clinical awareness about the CCKoma syndrome is limited. Moreover, it is also likely that the knowledge about the necessary specificity demands of diagnostic gastrin and CCK assays have obscured proper diagnosis of the CCKoma syndromes in man.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"533-542"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651626","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":"Prevalence, clinical characteristics and treatment outcomes of oxyntic gland neoplasm: a single-center retrospective study.","authors":"Jin-Yan Zhang, Yan-Qing Wang, Zhi-Kun Yin, Xiao-Yi Lei, Wei-Feng Huang, Ji Li, Wei-Lin Yang","doi":"10.1080/00365521.2024.2310183","DOIUrl":"10.1080/00365521.2024.2310183","url":null,"abstract":"<p><strong>Background: </strong>Oxyntic gland neoplasm (OGN) is a rare subtype of gastric cancer. The aim of this study is to evaluate the prevalence, clinicopathological features, effectiveness and safety of endoscopic treatment, as well as the prognosis of OGN.</p><p><strong>Methods: </strong>We retrospectively analyzed the data of patients pathologically diagnosed with OGN at our hospital from November 1, 2019 to May 1, 2023.</p><p><strong>Results: </strong>A total of 36 patients with 45 lesions were identified, resulting in a disease frequency of 0.047% (36/76,832). The mean age was 55.0 ± 7.5 years, with a male-to-female ratio of about 1:1.12. Most lesions were ≤10 mm in size (84.4%), located in the upper third of the stomach (73.3%), exhibited slight elevation (75.5%), appeared whitish (55%), had dilated blood vessels on the surface (75.5%). 16 and 21 lesions were treated by precutting endoscopic mucosal resection (EMR-P) and endoscopic submucosal dissection (ESD), respectively. No significant differences were found between EMR-P and ESD in terms of en bloc resection rate (100% vs 100%, <i>p</i> = 1.000), complete resection rate (100% vs 90.5%, <i>p</i> = 0.495), and curative resection rate (93.8% vs 90.5%, <i>p</i> = 1.000). No complications such as bleeding and perforation were observed. No recurrence or metastasis was observed during the follow-up period.</p><p><strong>Conclusions: </strong>OGN is a rare tumor with unique clinical, endoscopic, and pathological characteristics. EMR-P and ESD are deemed safe and effective for treating OGNs. The relatively faster and easier EMR-P seems at least non-inferior to ESD, especially for removal of smaller OGNs. The overall prognosis is favorable.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"524-532"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139642900","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":"Diarrhoea of unknown cause: medical treatment in a stepwise manner<b>Management of Idiopathic Diarrhoea Based on Experience of Step-Up Medical Treatment</b>.","authors":"Ann-Sofie Jansson-Rehnberg, Asbjørn Mohr Drewes, Jon Sponheim, Christer Borgfelt, Andreas Münch, Wilhelm Graf, Magnus Simrén, Greger Lindberg, Per M Hellström","doi":"10.1080/00365521.2024.2313061","DOIUrl":"10.1080/00365521.2024.2313061","url":null,"abstract":"<p><p>The basic principle for the treatment of idiopathic diarrhoea (functional diarrhoea K59.1) is to delay transit through the gut in order to promote the absorption of electrolytes and water. Under mild conditions, bulking agents may suffice. With increasing severity, antidiarrhoeal pharmaceuticals may be added in a stepwise manner. In diarrhoea of unknown aetiology, peripherally-acting opioid receptor agonists, such as loperamide, are first-line treatment and forms the pharmaceutical basis of antidiarrheal treatment. As second-line treatment opium drops have an approved indication for severe diarrhoea when other treatment options fail. Beyond this, various treatment options are built on experience with more advanced treatments using clonidine, octreotide, as well as GLP-1 and GLP-2 analogs which require specialist knowledge the field.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"543-546"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723956","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}