Seminars in arthritis and rheumatism最新文献

{"title":"Estimating the incidence of autoimmune inflammatory arthritis after Lyme disease","authors":"John B Miller ,&nbsp;Brittany L Adler ,&nbsp;Ana-Maria Orbai ,&nbsp;Ami A Shah ,&nbsp;Elizabeth Szymanski ,&nbsp;Laura M Prichett ,&nbsp;John N Aucott","doi":"10.1016/j.semarthrit.2025.152797","DOIUrl":"10.1016/j.semarthrit.2025.152797","url":null,"abstract":"<div><h3>Objective</h3><div>A previous case series described the development of new autoimmune, inflammatory arthritis (IA) developing within 2 years of Lyme disease (LD). This study aimed to estimate the incidence of IA following LD using administrative claims data. Influenza, an infection not typically associated with post-infectious IA, was used for comparison.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the Johns Hopkins Health System administrative claims data from 01/2013–05/2024. Patients with LD and influenza were identified using International Classification of Diseases (ICD) codes, with LD cases further defined by requiring an antibiotic prescription within 30 days of the ICD code. IA cases were identified using 2+ ICD codes for rheumatoid arthritis, psoriatic arthritis or spondyloarthritis. Comparisons between infection groups were conducted using chi-square tests and Z-tests as appropriate. Logistic regression analyses were conducted to estimate the odds of IA development within two years of Lyme or influenza diagnosis, controlling for age and sex.</div></div><div><h3>Results</h3><div>The incidence of IA was significantly higher following LD compared to influenza (1.67 % vs 0.45 %, <em>p</em> &lt; 0.0001), with the highest incidence of IA occurring within the first year after LD. Regression analysis showed LD was associated with increased odds of IA compared to influenza (OR 3.76, 95 % CI: 2.41–5.86, <em>p</em> &lt; 0.001) after adjusting for age and sex.</div></div><div><h3>Conclusion</h3><div>The incidence of IA was higher within a year of LD infection, higher than that expected in the general population. The temporal association and elevated incidence support the need for prospective studies to elucidate mechanisms linking infection and autoimmunity in LD.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152797"},"PeriodicalIF":4.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687438","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":"Weight loss, disease activity, and patient reported outcomes in patients with musculoskeletal and autoimmune diseases taking weight loss medications: a retrospective cohort study","authors":"Thomas R. Riley ,&nbsp;Kristin Wipfler ,&nbsp;Katherine D. Wysham ,&nbsp;Veena K. Ranganath ,&nbsp;Michael D. George ,&nbsp;Kaleb Michaud ,&nbsp;Joshua F. Baker","doi":"10.1016/j.semarthrit.2025.152783","DOIUrl":"10.1016/j.semarthrit.2025.152783","url":null,"abstract":"<div><h3>Introduction</h3><div>Given potential impacts of adiposity on pain and inflammation, we evaluated if weight loss was associated with improvements in disease activity and patient reported outcomes (PROs) in people with rheumatic and musculoskeletal disease (RMD) using weight loss therapies.</div></div><div><h3>Methods</h3><div>Participants with RMDs enrolled in the <em>FORWARD</em> Databank and reporting weight loss medication use were included in this retrospective cohort study. Linear models using generalized estimating equations assessed the association with ≥5 % weight loss and changes in PROs and disease activity over a 6-month period, clustering by participant and adjusting for the prior 6-month PRO, BMI, diabetes status, age, and sex. Testing for effect modification was performed to assess whether the effect of weight loss varied across BMI categories and across condition.</div></div><div><h3>Results</h3><div>We identified 3868 users of weight loss medications with 24,484 discrete observations. Weight loss ≥5 % was reported in 10.5 % (2603) of observations and was associated with improvements in patient activity scale II (PAS-II), patient global assessment, pain, fatigue, polysymptomatic distress, and SF-36 physical component score (PAS-II adjusted: B -0.12, 95 % CI -0.17, -0.067, p &lt; 0.001). Those who lost ≥5 % of weight were more likely to have improvements in PAS-II and PROs if they were obese, independent of diagnosis.</div></div><div><h3>Conclusion</h3><div>Among participants with RMDs that reported weight loss medication use, ≥5 % weight loss was associated with statistically significant improvements in patient-reported disease activity and quality of life PROs. The use of weight loss medications could be considered in trials aimed at improving symptoms of RMDs.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152783"},"PeriodicalIF":4.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703863","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":"Response to: ‘Critical Commentary ‘Infectious complications of Belimumab with standard care in systemic lupus erythematosus: A systematic review and meta-analysis’ by Saketh Sainag Mandiga et al","authors":"Yu Zhao ,&nbsp;Huihe Chen ,&nbsp;Weijie Wang","doi":"10.1016/j.semarthrit.2025.152784","DOIUrl":"10.1016/j.semarthrit.2025.152784","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152784"},"PeriodicalIF":4.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670676","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":"CAR T-cell therapy in SLE: A systematic review","authors":"Alberto Nordmann-Gomes ,&nbsp;Leila Khalili ,&nbsp;Wei Tang ,&nbsp;Laura Geraldino-Pardilla ,&nbsp;Yevgeniya Gartshteyn ,&nbsp;Robert Clancy ,&nbsp;Maya Souvignier ,&nbsp;Stephen Suh ,&nbsp;Michel Sadelain ,&nbsp;Anca Askanase","doi":"10.1016/j.semarthrit.2025.152786","DOIUrl":"10.1016/j.semarthrit.2025.152786","url":null,"abstract":"<div><h3>Introduction</h3><div>CAR T-cell therapy is poised to revolutionize the treatment of SLE. Several publications reported on small numbers of SLE patients treated with CAR-T.</div></div><div><h3>Objective</h3><div>To review and summarize the available clinical evidence published or presented to date on the use of CAR therapy in SLE.</div></div><div><h3>Methods</h3><div>We conducted a systematic review to evaluate all clinical studies assessing safety and efficacy outcomes of CAR therapy in SLE. For this review, we followed PRISMA recommendations. MEDLINE (PubMed), Embase, Scopus, and CENTRAL were consulted.</div></div><div><h3>Results</h3><div>The search strategy yielded 5905 results, of which 16 studies were included, encompassing 145 participants. Pooled analysis of the 102 individual SLEDAI scores available showed the mean baseline SLEDAI of 13.1 (95% CI 12.3–13.9) decreased to 2.3 (95% CI 1.5–3.1) after 6 months, and 1.4 (95% CI 0.3–2.4) after 12 months. DORIS remission was achieved in 45/64 patients (70%) and LLDAS in 50/56 (89%). CRS occurred in 81 (56%) participants, of which 80 (98%) were grade 1 or 2, and 1 (2%) grade 3. ICANS was reported in four patients, 1 grade 1, 1 grade 2, 1 grade 3, and 1 grade 4. Eleven patients (7.6%) developed serious infections, including one case of fatal pneumococcal meningitis.</div></div><div><h3>Conclusion</h3><div>This systematic review evaluated all the available clinical evidence on the use of CAR T-cell therapy in patients with SLE. The findings reinforce the efficacy of this treatment modality and underscore the need for further research to better define its role in SLE management.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152786"},"PeriodicalIF":4.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739406","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":"Developing efficient predictive models for the diagnosis of VEXAS syndrome","authors":"Daniel Montes ,&nbsp;Andrew C. Hanson ,&nbsp;Hannah E. Langenfeld ,&nbsp;Cynthia S. Crowson ,&nbsp;Mrinal M. Patnaik ,&nbsp;Ronald S. Go ,&nbsp;Alexander Hines ,&nbsp;Kambiz Kalantari ,&nbsp;Yael Kusne ,&nbsp;Terra Lasho ,&nbsp;Abhishek Mangaonkar ,&nbsp;Horatiu Olteanu ,&nbsp;Kaaren K. Reichard ,&nbsp;Megan M. Sullivan ,&nbsp;David S. Viswanatha ,&nbsp;Kenneth J. Warrington ,&nbsp;Matthew J. Koster","doi":"10.1016/j.semarthrit.2025.152796","DOIUrl":"10.1016/j.semarthrit.2025.152796","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify clinical and laboratory features associated with the presence of <em>UBA1</em> mutation and develop predictive models to guide efficient diagnosis of VEXAS syndrome.</div></div><div><h3>Methods</h3><div>All patients who underwent <em>UBA1</em> mutation testing were identified. Using a comprehensive list of VEXAS syndrome features, the presence or absence of each feature in each patient was determined for two timepoints: time of first VEXAS symptom onset and the time of <em>UBA1</em> mutation testing. For each timepoint, the presence of each disease feature was compared between <em>UBA1</em> positive and negative patients. The least absolute shrinkage and selection operator (LASSO) method was used to develop multi-feature models to predict the presence of pathogenic <em>UBA1</em> mutations.</div></div><div><h3>Results</h3><div>Overall, 144 patients who underwent <em>UBA1</em> mutation testing were included. Features including skin rash, chondritis, and monocytopenia were significantly associated with the presence of a <em>UBA1</em> mutation at both timepoints. Macrocytosis, uveitis, and pulmonary disease had significant association at time of testing. 12-feature and 5-feature LASSO models at symptom onset demonstrated good discriminatory capacity with areas under receiver operating curves (AUCs) of 0.86 and 0.81, respectively. 16-variable and 5-feature models at time of testing had good-to-excellent performance with AUCs of 0.92 and 0.84, respectively. A single feature model utilizing absolute monocyte count also had fair discriminatory capacity with AUC of 0.78 at both timepoints.</div></div><div><h3>Conclusions</h3><div>Multi-feature models that efficiently separate VEXAS cases from controls were successfully developed. These models have the potential to address existing diagnostic challenges including a lack of consensus regarding key features of VEXAS syndrome.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152796"},"PeriodicalIF":4.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703862","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":"Genome-wide association study for loci associated with positive antinuclear antibodies","authors":"Jing Cui ,&nbsp;Jeong Yee ,&nbsp;Hongshu Guan ,&nbsp;Jack Ellrodt ,&nbsp;Emily G. Oakes ,&nbsp;Liming Liang ,&nbsp;Karen H. Costenbader","doi":"10.1016/j.semarthrit.2025.152794","DOIUrl":"10.1016/j.semarthrit.2025.152794","url":null,"abstract":"<div><h3>Background</h3><div>The genetic basis, heritability, and genetic differences by patterns and titers of antinuclear antibodies (ANA) are still poorly understood.</div></div><div><h3>Methods</h3><div>Within the Mass General Brigham Biobank, containing electronic health records (EHR) and genotyping for &gt;65,000 consented patients, we identified individuals with HEp-2 immunofluorescence ANA results (1989–2022) and genetically predicted European ancestry. We performed genome-wide associated studies for ANA+ ≥ 1:40, ≥ 1:80, all and in speckled and homogeneous ANA patterns, for those only +1:40, and then excluding those with ≥1 of 9 ANA-associated autoimmune diagnoses, each compared to those ANA- and adjusted for age, sex, and 4 genetic principal components. The lability method estimated ANA+ heritability. We investigated HLA alleles using SNP2HLA imputation.</div></div><div><h3>Results</h3><div>7035 subjects were ANA+ at ≥1:40, 4279 at ≥1:80 and 5840 were ANA -. Associations were similar but stronger for ANA ≥1:80 than ≥1:40. Associations were stronger for speckled and homogeneous ANA patterns separately (each vs. all ANA-) and attenuated after excluding those with ≥1 autoimmune disease diagnosis. At both titers, <em>HLA-DQB1:0201</em> had the strongest association, OR 1.3 (95 % CI 1.2–1.5, p 9.1 × 10^–14 for ANA ≥1:80); <em>HLA-B:08, HLA-DRB1:03,</em> and <em>HLA:C:0701</em> alleles also showed significant associations. The strongest non-HLA association was rs34748780 (chromosome 7) near <em>IRF5/TNPO3,</em> OR 1.2 (95 % CI 1.1–1.4, p 1.6 × 10^–8 for ANA ≥1:80). ANA+ ≥1:40 heritability was 12 % (SE 0.03), p 1.0 × 10^–8 and ≥1:80 was 19 % (SE 0.03), p 1.9 × 10^–12.</div></div><div><h3>Conclusion</h3><div><em>HLA-DQB1:0201, HLA-DRB1:03, HLA-B,</em> and <em>HLA-C</em> were strong genetic factors for ANA+ in these European ancestry individuals.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152794"},"PeriodicalIF":4.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687439","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":"Letter to ‘‘Cancer risk in Sjögren's disease: A longitudinal cohort study on incidence, predictors, and mortality impact’’","authors":"Xiaodi Shi,&nbsp;Jiaqing Wang","doi":"10.1016/j.semarthrit.2025.152779","DOIUrl":"10.1016/j.semarthrit.2025.152779","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152779"},"PeriodicalIF":4.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614261","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":"Can we identify axial spondyloarthritis among young adults referred to non-rheumatology specialists? Results from the SHERPAS study","authors":"Benavent D ,&nbsp;Tapia M ,&nbsp;Bernabeu D ,&nbsp;Muley V ,&nbsp;Juárez M ,&nbsp;Balsa A ,&nbsp;Plasencia Ch ,&nbsp;Navarro-Compán V","doi":"10.1016/j.semarthrit.2025.152780","DOIUrl":"10.1016/j.semarthrit.2025.152780","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the prevalence and features associated with axSpA diagnosis in young adults with chronic back pain (CBP) referred to specialists other than rheumatologists, and to evaluate magnetic resonance imaging (MRI) of sacroiliac joints (SIJ) in this population.</div></div><div><h3>Methods</h3><div>A prospective, observational study was conducted from July 2021 to October 2023. Adults aged 18–40 years with CBP referred for spinal MRI by non-rheumatology specialists were included. Participants completed a self-administered questionnaire assessing back pain characteristics and SpA features. The spinal MRI was extended to SIJ. Thereafter, participants were evaluated by a rheumatologist, who established the diagnosis of axSpA based on clinical evaluation and complementary tests.</div></div><div><h3>Results</h3><div>Among 268 patients enrolled, 8 (3.0 %) were diagnosed with definite axSpA, and 14 (5.2 %) suspected axSpA cases, resulting in a total of 8.2 % with definite or suspected axSpA. Buttock pain (54.5 % vs. 24.3 %; p = 0.04), improvement with NSAIDs (68.2 % vs. 36.5 %; p = 0.02), shorter symptom duration (3.5 vs. 5.1 years; p = 0.02), HLA-B27 positivity (27.3 % vs. 3.3 %; p &lt; 0.01), and elevated CRP levels (36.4 % vs. 12.2 %; p = 0.01) were associated with axSpA diagnosis. MRI findings revealed spinal degenerative lesions in most patients, and SIJ abnormalities in almost one third, being more common in patients with axSpA.</div></div><div><h3>Conclusion</h3><div>In our cohort of young adults with CBP referred to non-rheumatology specialists, approximately 8 % were diagnosed with definite or suspected axSpA. MRI spinal lesions were reported in most patients, while SIJ findings were reported in one out of three patients.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152780"},"PeriodicalIF":4.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144597212","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":"Refining RA-ILD screening: Diagnostic limitations and the emerging role of lung ultrasound","authors":"Horacio Matías Castro","doi":"10.1016/j.semarthrit.2025.152775","DOIUrl":"10.1016/j.semarthrit.2025.152775","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152775"},"PeriodicalIF":4.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522767","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":"Discriminating capacity of the ASAS health index in patients with axial spondyloarthritis treated with ixekizumab","authors":"Uta Kiltz ,&nbsp;Anna Moltó ,&nbsp;Désirée van der Heijde ,&nbsp;Louis Bessette ,&nbsp;Annelies Boonen ,&nbsp;Rebecca Bolce ,&nbsp;Christophe Sapin ,&nbsp;Theresa Hunter Gibble ,&nbsp;Boris Janos ,&nbsp;Andris Kronbergs ,&nbsp;Khai Jing Ng ,&nbsp;Jürgen Braun","doi":"10.1016/j.semarthrit.2025.152777","DOIUrl":"10.1016/j.semarthrit.2025.152777","url":null,"abstract":"<div><h3>Objective</h3><div>To test the discriminating capacity of different thresholds of the Assessment of SpondyloArthritis international Society Health Index (ASAS HI) in placebo-controlled trials of patients with axial spondyloarthritis (axSpA), including radiographic (r-axSpA) and non-radiographic (nr-axSpA) subtypes.</div></div><div><h3>Methods</h3><div>The discriminating capacities of absolute (≥2.0–≥4.0 points) and relative (≥20%–≥50%) ASAS HI improvement thresholds were evaluated in patients with axSpA from three COAST trials (COAST-V, COAST-W, and COAST-X) of ixekizumab every 4 weeks (IXE Q4W) vs. placebo. Threshold-based response rates at Week 16 were compared between trial arms using Fisher’s exact test. Odds ratios and phi coefficients were used to evaluate how strongly each improvement threshold was associated with treatment allocation in a given trial. Missing data were handled using non-responder imputation.</div></div><div><h3>Results</h3><div>ASAS HI data were available at baseline and Week 16 for 587 patients in IXE Q4W and placebo arms. The ASAS HI ≥30% improvement threshold effectively discriminated treatment allocation in all trials; significant differences were observed between IXE Q4W and placebo in r-axSpA (COAST-V: p = 0.026; COAST-W: p = 0.023) and nr-axSpA (COAST-X: p = 0.040). Lower absolute (≥2.0–≥3.0 points) and relative (≥20%–≥30%) thresholds discriminated effectively in COAST-W, whereas higher absolute (≥3.5–≥4.0 points) and relative (≥30%–≥50%) thresholds discriminated effectively in COAST-V. In COAST-X, ≥30%, ≥40%, and ≥50% thresholds discriminated effectively. Phi coefficients were small (&lt;0.3) across all trials and thresholds.</div></div><div><h3>Conclusions</h3><div>Several ASAS HI improvement thresholds discriminated axSpA patients in treatment vs. placebo arms at Week 16. The ASAS HI ≥30% improvement threshold discriminated across all three COAST trials.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"74 ","pages":"Article 152777"},"PeriodicalIF":4.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589293","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}