Therapeutics and Clinical Risk Management最新文献

{"title":"Left Bundle Branch Area Pacing Improves Left Atrial Outcomes in Pacemaker-Dependent Patients: A Prospective Cohort Study Using Speckle Tracking and Three-Dimensional Echocardiography.","authors":"Yingchen Mei, Rui Han, Liting Cheng, Zefeng Wang, Yihua He, Wei Liu, Yongquan Wu","doi":"10.2147/TCRM.S481237","DOIUrl":"10.2147/TCRM.S481237","url":null,"abstract":"<p><strong>Purpose: </strong>Evidence that left bundle branch area pacing (LBBAP) is more effective than conventional right ventricular (RV) pacing in enhancing left atrial (LA) outcomes is lacking. The aim of this study was to investigate LA outcomes using 2-dimensional speckle tracking echocardiography (2D-STE) and real-time 3-dimensional echocardiography (RT-3DE) at 6-months of follow-up in patients that received LBBAP, RV septal pacing (RVSP), or RV apical pacing (RVAP).</p><p><strong>Methods: </strong>A total of 90 patients with normal left ventricular ejection fraction (LVEF) underwent dual-chamber pacemaker implantation for bradycardia at Beijing Anzhen Hospital between January 2021 and July 2021. Patients were divided into three groups based on the pacing site: LBBAP, RVSP, or RVAP.</p><p><strong>Results: </strong>There were no significant differences in baseline characteristics and echocardiographic findings among patients that received LBBAP, RVSP, or RVAP. At 6-months of follow-up, left atrial volume index (LAVI), LA reservoir strain (LASr), LA contractile strain (LASct), global longitudinal strain (GLS), global circumferential strain (GCS), and synchronization parameters (Tmsv-16SD, Tmsv-12SD, Tmsv-6SD, longitudinal Tε-dif, circumferential Tε-dif) were significantly improved in patients that received LBBAP, while they had significantly worsened with RVSP and RVAP. Compared to baseline, at 6-months of follow-up, patients that received LBBAP had significantly improved LASr (28.17±10.12% vs 35.4±17.17%, <i>P</i>=0.024), LASct (-12.03±2.15% vs -17.53±7.37%, <i>P</i>=0.045), E/e' ratio(12.61±3.8 vs 10.85±3.75,P=0.014) and LVEF (65.74±7.90% vs 68.81±5.92%, <i>P</i>=0.023). The 6-minute walking distance significantly increased at 6-months of follow-up compared to baseline in all patients, but the increase was most prominent for LBBAP (403.00±98.46 m vs. 469.34±59.32m, <i>P</i>=0.015). LBBAP was associated with a lower risk of new-onset atrial fibrillation.</p><p><strong>Conclusion: </strong>In pacemaker-dependent patients, LBBAP achieved better LA strain, LV strain, and LV synchronization than RVSP or RVAP at 6-months of follow-up.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1343-1358"},"PeriodicalIF":2.8,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087411","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":"Low-Dose Sulfamethoxazole-Trimethoprim Could Prevent <i>Pneumocystis jiroveci</i> Pneumonia in Kidney Transplant Recipients: A Retrospective, Observational Study.","authors":"Rongrong Wang, Xiuhua Wu, Xishao Xie, Chunchun Wei, Jianyong Wu, Kuifen Ma","doi":"10.2147/TCRM.S528627","DOIUrl":"10.2147/TCRM.S528627","url":null,"abstract":"<p><strong>Objective: </strong>Emerging evidence suggests that low doses of sulfamethoxazole-trimethoprim (TMP-SMX) may offer protection against <i>Pneumocystis jiroveci</i> pneumonia (PJP) in kidney transplant recipients. However, cases of PJP following the withdrawal of prophylaxis have been documented. This study aimed to investigate the relationship between the occurrence of PJP and different regimes of low-dose TMP-SMX prophylaxis.</p><p><strong>Methods: </strong>This retrospective observational study was conducted in the First Affiliated Hospital of Zhejiang University in China. Recipients diagnosed with PJP were included, and four controls were matched for each case based on transplantation time, age, and sex. Multivariate conditional logistic regression was employed to compare the odds of PJP occurrence among different TMP-SMX regimens.</p><p><strong>Results: </strong>From January 1, 2017, to December 31, 2020, 1763 patients underwent kidney transplantation at our center. Thirty-one patients developed PJP post-transplantation, and 124 patients without PJP were included as controls. One patient developed PJP during the prophylaxis period, and the others occurred after TMP-SMX discontinuation, resulting in a PJP incidence rate of 1.36% over the follow-up period. Compared to controls, the PJP group received a significantly lower cumulative TMP-SMX dose (median: 57 single-strength dose [SSD] tablets <i>vs</i> 100 tablets; <i>p = 0.001</i>) and had a shorter prophylaxis duration (median: 6.00 months <i>vs</i> 10.00 months; <i>p = 0.004</i>). They also exhibited higher CMV infection rates (29.0% vs 4.8%, <i>p</i> < 0.001), elevated serum creatinine levels at discharge (174.80μmol/L vs 134.58 μmol/L, <i>p</i> = 0.018), and reduced CD 4⁺ cell counts (354.12/L vs 542.58/L, <i>p</i> = 0.05). Multivariate analysis revealed that a higher cumulative TMP-SMX dose was significantly associated with a lower risk of PJP (<i>p</i> = 0.005). Subgroup analysis indicated that at least 6 months of TMP-SMX prophylaxis is necessary for PJP prevention in recipients on quarter-strength daily (SMX/TMP 100/20 mg, <i>p</i> = 0.022) or half-single strength daily (SMX/TMP 200/40 to 400/80 mg, <i>p</i> = 0.005) regimens.</p><p><strong>Conclusion: </strong>An adequate prophylactic duration of either quarter-strength daily TMP-SMX or half-single strength daily TMP-SMX may protect kidney transplant recipients from PJP.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1333-1342"},"PeriodicalIF":2.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040845","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":"Therapeutic Potential of Lumbrokinase in Acute Ischemic Stroke: A Meta-Analysis of Efficacy and Safety.","authors":"Elvan Wiyarta, Rakhmad Hidayat, Mohammad Kurniawan, Bryanna Infinita Laviashna Saputro, Indira Laksmi Maharani, Derren David Christian Homenta Rampengan, Lucia Callista Tanudharma, Raymond Rubianto Tjandrawinata","doi":"10.2147/TCRM.S537232","DOIUrl":"10.2147/TCRM.S537232","url":null,"abstract":"<p><strong>Background: </strong>Acute ischemic stroke (AIS) requires rapid treatment. Although alteplase is a standard thrombolytic therapy, its limited availability in low-resource settings presents a challenge. Lumbrokinase, a fibrinolytic enzyme isolated from earthworms, has been proposed as an adjunct treatment option. This meta-analysis evaluated efficacy and safety in addition to supportive care.</p><p><strong>Methods: </strong>A systematic review of randomized controlled trials (RCTs) was conducted using multiple databases through July 2024 following PRISMA guidelines. The risk of bias was assessed using RoB 2.0, and evidence quality was graded using GRADE. Publication bias was evaluated using funnel plots. Meta-analyses employed a random-effects model and reported odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals. Primary outcomes included the Barthel Index and NIHSS scores, and secondary outcomes included adverse events and laboratory results.</p><p><strong>Results: </strong>A total of 35 RCTs published between 2010 and 2024 were included. Compared with supportive care alone, lumbrokinase adjunct therapy significantly improved Barthel Index scores (MD = 15.17; 95% CI: 14.60 to 15.74) and reduced NIHSS scores (MD = -2.01; 95% CI: -2.06 to -1.97). Safety analyses revealed no significant increase in adverse events including gastrointestinal discomfort (OR = 1.00; 95% CI: 0.32 to 3.16) and GI bleeding (OR = 1.42; 95% CI: 0.55 to 3.67). Laboratory assessments indicated improvements in aPTT (MD = 1.93; 95% CI: 1.58 to 2.28), platelet aggregation rate (MD = -205.86; 95% CI, -206.77 to -204.96), and D-dimer levels (MD = -0.04; 95% CI: -0.05 to -0.03).</p><p><strong>Conclusion: </strong>Lumbrokinase may safely improve stroke outcomes; however, limited evidence warrants cautious use and further high-quality trials.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1319-1331"},"PeriodicalIF":2.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040857","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":"Efficacy and Clinical Significance of Postoperative Transcutaneous Electrical Acupoint Stimulation [Response to Letter].","authors":"Zhihu Zhou, Xiang Yang, Min Shi, Liqiao Huang, Danping Wu, Huailong Yang, Xu Zhang","doi":"10.2147/TCRM.S563046","DOIUrl":"10.2147/TCRM.S563046","url":null,"abstract":"","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1317-1318"},"PeriodicalIF":2.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024300","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":"Evaluating the Efficacy of High-Intensity Focused Electromagnetic (HIFEM) Therapy for Postprostatectomy Incontinence in Men.","authors":"Halil Tosun, Emre Can Akinsal, Unsal Bas, Gokhan Sonmez, Numan Baydilli, Deniz Demirci","doi":"10.2147/TCRM.S534674","DOIUrl":"10.2147/TCRM.S534674","url":null,"abstract":"<p><strong>Purpose: </strong>Urinary incontinence (UI) is a common complication after radical prostatectomy (RP), adversely affecting patients' quality of life. This study aimed to evaluate the efficacy and safety of high-intensity focused electromagnetic (HIFEM) therapy as a non-invasive treatment for post-prostatectomy UI.</p><p><strong>Patients and methods: </strong>Twenty-seven men (mean age ± SD: 67.9 ± 3.4 years) with persistent UI after RP underwent six HIFEM sessions (28 min, twice weekly) using the BTL EMSELLA^® chair. Outcomes were assessed after the sixth session and at one-month follow-up. Primary endpoints were changes in International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) scores and daily pad use.</p><p><strong>Results: </strong>Baseline mean ICIQ-SF score was 10.58 ± 4.15. This decreased to 5.43 ± 3.85 after treatment and to 4.16 ± 3.97 at one month, representing improvements of 53.1% and 60.6%, respectively (both p < 0.005). Daily pad use declined from baseline to 1.45 ± 1.54 after treatment and 1.13 ± 1.81 at follow-up (both p < 0.001). No adverse events were reported.</p><p><strong>Conclusion: </strong>HIFEM therapy significantly improved UI severity and reduced pad dependence in men with post-prostatectomy incontinence, with effects sustained for at least one month and no observed side effects. These findings support HIFEM as a safe, non-invasive treatment option warranting further study in larger, long-term trials.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1309-1315"},"PeriodicalIF":2.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12407011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001468","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":"Determining Effect of Postoperative Transcutaneous Electrical Acupoint Stimulation on Recovery Quality After Gynecological Laparoscopic Surgery [Letter].","authors":"Zhi-Bin Huang, Yong-Bao Lin, Fu-Shan Xue","doi":"10.2147/TCRM.S559827","DOIUrl":"10.2147/TCRM.S559827","url":null,"abstract":"","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1307-1308"},"PeriodicalIF":2.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993508","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":"Knowledge, Attitude, and Practice of Nurses in Preventing Complications in Patients with Nephrotic Syndrome: A Cross-Sectional Study.","authors":"Nannan Wang, Xueqin Deng, Ting Zhang, Yonglin Tao, Qing Feng","doi":"10.2147/TCRM.S538455","DOIUrl":"10.2147/TCRM.S538455","url":null,"abstract":"<p><strong>Background and aim: </strong>Nephrotic syndrome (NS) is frequently accompanied by serious complications such as edema-related infections, thromboembolism, and acute kidney injury, which can significantly impact prognosis. Nurses are essential in early identification, patient education, and implementation of preventive measures. This study explores the knowledge, attitude, and practice (KAP) levels of nurses concerning complication prevention in nephrotic syndrome and identifies relevant influencing factors.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted from January to December 2023 across Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine and Shanghai Baoshan Medical Emergency Center in China, targeting nurses working in nephrology-related units. A total of 246 valid responses were obtained using a structured and pre-validated KAP questionnaire. The instrument included domains assessing factual understanding, behavioral attitudes, and routine clinical practices. Data were analyzed using descriptive statistics, Pearson's correlation, and logistic regression to determine relationships between demographic variables and KAP outcomes.</p><p><strong>Results: </strong>The mean knowledge score among respondents was 5.12±2.67, attitude score was 18.76±5.02, and practice score was 30.45±11.07. Correlational analysis revealed significant positive associations between knowledge and practice (r = 0.421, p < 0.001), and between attitude and practice (r = 0.336, p = 0.015). Regression analysis identified prior nephrology education, years of clinical experience, and academic qualifications as independent predictors of higher practice scores.</p><p><strong>Conclusion: </strong>While nurses generally hold positive attitudes towards complication prevention in nephrotic syndrome (NS), there are significant gaps in their knowledge and inconsistencies in the application of preventive practices. These findings emphasize the need for targeted training programs to enhance nurses' practical competencies in managing NS complications. By improving nurses' knowledge and clinical practices, especially in early detection and prevention, patient outcomes can be significantly improved, leading to more effective management of NS-related complications.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1295-1305"},"PeriodicalIF":2.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970127","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":"Neoadjuvant Therapy for Organ Preservation in Locally Advanced Rectal Cancer: A Review.","authors":"Liangting Qiu, Jianjun Li","doi":"10.2147/TCRM.S518959","DOIUrl":"10.2147/TCRM.S518959","url":null,"abstract":"<p><p>Preoperative chemoradiotherapy (CRT) and sphincter-preserving total mesorectal excision (TME) effectively control tumor growth in locally advanced rectal cancer (LARC). However, associated complications can impair the quality of life (QoL) of the patients. Neoadjuvant therapies, such as consolidation neoadjuvant therapy and total neoadjuvant therapy (TNT), can improve tumor regression, potentially achieving a complete response and allowing organ preservation. Emerging clinical data suggest that these approaches can promote long-term cancer control in patients with LARC.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1289-1293"},"PeriodicalIF":2.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12375309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970132","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":"Erratum: Impact of Isotretinoin on Blood Lipids and Liver Enzymes: A Retrospective Cohort Study in Saudi Arabia [Corrigendum].","authors":"","doi":"10.2147/TCRM.S561428","DOIUrl":"10.2147/TCRM.S561428","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2147/TCRM.S466113.].</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1287-1288"},"PeriodicalIF":2.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12375507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970337","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":"The Predictive Value of the Combination of Serum RBP4, ALP, IL-1β for Postoperative Recurrence of Intrahepatic Bile Duct Stones.","authors":"Wenjie Tang, Xin Kang, Changhong Zhou, Chao Chen","doi":"10.2147/TCRM.S529277","DOIUrl":"10.2147/TCRM.S529277","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the predictive value of serum retinol-binding protein (RBP4), alkaline phosphatase (ALP), and interleukin (IL)-1β for postoperative recurrence of intrahepatic bile duct stones (IBDS).</p><p><strong>Methods: </strong>This retrospective study included 320 patients with intrahepatic bile duct stones (IBDS) admitted to our hospital from May 2020 to May 2022, all of whom underwent laparoscopic choledocholithotomy combined with choledochoscopy. Patients were divided into a recurrence group and a non-recurrence group based on their postoperative status. Serum levels of RBP4 and IL-1β were measured by ELISA; liver function indicators including ALP were analyzed using a biochemical analyzer; levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were also detected by ELISA; toll-like receptor 4 (TLR4) and thyroid-stimulating hormone (TSH) were measured by radioimmunoassay.Pearson correlation analysis was performed to assess the relationships between serum RBP4, ALP, IL-1β and laboratory indicators. Multivariate logistic regression analysis was used to identify factors influencing postoperative recurrence of IBDS. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of serum RBP4, ALP, and IL-1β for IBDS recurrence after surgery.</p><p><strong>Results: </strong>The levels of serum RBP4, ALP, IL-1β, TNF-α, TLR4, and TSH in the recurrence group were significantly higher than those in the non-recurrence group (P < 0.05). Pearson correlation analysis showed that serum RBP4, ALP, and IL-1β were all positively correlated with TNF-α, TLR4, and TSH (P < 0.05). Multivariate logistic regression analysis identified RBP4, ALP, IL-1β, TNF-α, TLR4, and TSH as independent risk factors for postoperative recurrence of IBDS (P < 0.05).According to ROC curve analysis showed that the area under the curve (AUC) for serum RBP4 in predicting postoperative recurrence of IBDS was 0.844, for serum ALP was 0.822, and for serum IL-1β was 0.732. The combined detection of RBP4, ALP, and IL-1β yielded an AUC of 0.892, which was superior to the predictive performance of each marker alone (Z = 2.654, Z = 2.668, Z = 2.650; all P < 0.05).</p><p><strong>Conclusion: </strong>Serum levels of RBP4, ALP, and IL-1β are significantly elevated in patients with IBDS, and their combined detection can enhance the predictive value for postoperative recurrence of IBDS.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1277-1285"},"PeriodicalIF":2.8,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970085","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}