Transfusion Medicine最新文献

{"title":"Ferritin-guided management of blood donors with a marginally low pre-donation haemoglobin and its effect on the number of donations in the following 3 years.","authors":"Sandra Cutajar, George Galea, Monique A Debattista, Monique Borg Inguanez","doi":"10.1111/tme.13149","DOIUrl":"https://doi.org/10.1111/tme.13149","url":null,"abstract":"<p><strong>Background: </strong>The handling of donors with a marginally low haemoglobin is difficult and problematic and various methodologies have been applied to address this issue.</p><p><strong>Aims: </strong>The aim of this study was to assess whether measurement of serum ferritin and subsequent management of donors with a marginally low haemoglobin had any impact on the number of subsequent donations.</p><p><strong>Materials and methods: </strong>Such donors were prospectively randomised into an intervention group whereby their serum ferritin was measured and those in the control group where routine assessments were done as per current SOPs. In the intervention group, action was taken depending on how low the serum ferritin was. The comparator in both study arms was the number of donations that were given during the follow-up period of 3 years.</p><p><strong>Results: </strong>We could not find any significant consequence due to this intervention.</p><p><strong>Discussion and conclusion: </strong>The potential reasons are discussed, and we are proposing further studies on subsets of donors who are more prone to iron deficiency.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151835","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":"Evaluating the appropriateness of fresh frozen plasma transfusions in two tertiary teaching hospitals.","authors":"Jongmin Kim, Kae Lyang Koo, Hyun-Ji Lee, Hyung-Hoi Kim","doi":"10.1111/tme.13142","DOIUrl":"https://doi.org/10.1111/tme.13142","url":null,"abstract":"<p><strong>Background: </strong>Despite efforts to standardise practice using evidence-based guidelines, fresh frozen plasma (FFP) remains the blood component most frequently prescribed inappropriately. This study assessed the appropriateness of FFP transfusion in two tertiary teaching hospitals and analysed the characteristics of appropriate and inappropriate transfusions.</p><p><strong>Methods: </strong>Patients who had undergone FFP transfusion between October and December 2022 at two tertiary teaching hospitals were retrospectively analysed. Only the initial FFP transfusion data were analysed for each patient. Patient characteristics; laboratory test results, including prothrombin time, international normalised ratio, and activated partial thromboplastin time; and the association of FFP transfusion with various factors were examined. Sub-therapeutic dosing was defined as the transfusion of ≤2 units of FFP. FFP transfusions were classified into eight groups based on a classification algorithm to determine their appropriateness.</p><p><strong>Results: </strong>In total, 584 FFP transfusions (2301 units) were analysed, with 42.1% involving subtherapeutic dosing. FFP transfusions were performed in the intensive care unit (ICU; 30.5%), general ward (24.8%), operating room (21.1%), and emergency room (22.9%). Overall, 51.5% of FFP transfusions were deemed appropriate, with significant variations being observed between the hospitals (Hospital B vs. Hospital A: 73.2% vs. 35.3%). Inappropriate FFP transfusions were associated with a higher INR, with 73.4% of them being associated with severe bleeding and/or surgery.</p><p><strong>Conclusions: </strong>In conclusion, 40.6% of FFP transfusions were deemed inappropriate in the present study owing to failure to meet laboratory criteria. The present study provides valuable insights into the optimisation of plasma transfusion practices and emphasises the requirement for institution-specific management.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161199","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":"Transfusion training for haematology registrars: Results of a UK-wide survey.","authors":"Lorna Cain, Lucy Neave, Shubha Allard, Dora Foukaneli, Suzy Morton, Shruthi Narayan","doi":"10.1111/tme.13146","DOIUrl":"https://doi.org/10.1111/tme.13146","url":null,"abstract":"<p><strong>Objectives: </strong>To understand the current status of transfusion training for haematology specialty registrars in the UK and identify potential solutions for improvement.</p><p><strong>Background: </strong>Transfusion knowledge and experience are essential for all haematologists. There are concerns regarding inconsistencies with the delivery of transfusion training.</p><p><strong>Methods: </strong>A 30-question online survey was distributed using the SurveyMonkey platform to UK haematology specialty trainees in June-July 2023.</p><p><strong>Results: </strong>A total of 150 responses (response rate 24%) were received from trainees at different stages of training in 17 training regions. Forty-four percent (66/150) trainees had undertaken or were expected to undertake a dedicated transfusion post during their training; these were deemed to be educationally useful. Ninety-nine percent (149/150) trainees had managed transfusion queries at work. Most trainees (69%, 103/150) had received teaching in hospitals outside of a dedicated transfusion post. A high proportion (87%, 131/150) had attended a transfusion course provided by a national blood service. Levels of overall satisfaction with the transfusion training provided varied: very satisfied/satisfied (30%), neutral (31%), dissatisfied/very dissatisfied (39%). The most common barriers to training selected were lack of exposure to the transfusion laboratory (75%), clashing clinical commitments taking priority (74%), and lack of provision of dedicated transfusion training (70%).</p><p><strong>Conclusion: </strong>There is mixed satisfaction with the transfusion training received by UK haematology registrars, evident from this survey. Protected time for transfusion training in dedicated transfusion posts and in other hospital posts, including laboratory time, is needed for all haematology trainees.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095045","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":"Evaluating a blood warming device for packed red blood cell transfusions to decrease hypothermia in very preterm infants: A randomised control trial protocol.","authors":"Kayla C Everhart, Michael D Wirth, Victor N Iskersky, Robin B Dail","doi":"10.1111/tme.13143","DOIUrl":"https://doi.org/10.1111/tme.13143","url":null,"abstract":"<p><strong>Background: </strong>This protocol describes a study to test a commercial blood warming device in warming blood transfusions to prevent hypothermia associated with packed red blood cell (PRBC) transfusions in very preterm infants.</p><p><strong>Objectives: </strong>Very preterm infants receiving blood transfusions warmed by a commercial blood warmer will have less central body hypothermia post transfusion (abdominal temperatures <36.5°C) and/or a higher mean abdominal temperature for the hour after the transfusion is complete compared to those receiving blood transfusions by standard of care. This trial has been registered with Clinicaltrials.gov (trial number NCT05170633).</p><p><strong>Methods: </strong>In this trial, which is funded by The Gerber Foundation and adhered to the SPIRIT2013 checklist, 140 very preterm infants with an order to receive PRBCs will be randomised into a standard of care group to receive one PRBC transfusion over 3 h with blood in a syringe at room temperature or into the intervention group to receive one PRBC transfusion over 3 h using a Hotline® Blood and Fluid Warmer. Abdominal skin temperatures will be measured every minute through a blood transfusion using a skin thermistor and datalogger.</p><p><strong>Data analysis: </strong>Descriptive statistics will be computed for each group to compare demographics and all infant pre-, during, and post-transfusion body temperatures. A student t-test will be used to compare the groups on mean post-transfusion temperatures as a primary outcome variable. To examine thermal change over time between the two groups, linear mixed models with a random intercept will be utilised.</p><p><strong>Results: </strong>This trial began in January 2022, in a South Carolina neonatal intensive care unit and is ongoing.</p><p><strong>Discussion: </strong>This RCT will determine if warming PRBC transfusions will prevent hypothermia in preterm infants during and after blood transfusions. Results from this trial will be used to design national standards for blood transfusions in preterm infants to decrease morbidity and mortality.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080503","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":"Knowledge and practices in transfusion regarding bedside compatibility test: Insights from a monocentric observational study.","authors":"Ikbel Ghachem, Dorra Baccouche, Mohamed Yassine Kaabar, Ichrak Ghachem, Haifa Tounsi, Asma Bachali","doi":"10.1111/tme.13145","DOIUrl":"https://doi.org/10.1111/tme.13145","url":null,"abstract":"<p><strong>Background: </strong>The bedside compatibility test (BCT) is the final barrier to transfusion safety, aiming to prevent ABO-incompatible incidents. This study evaluated the knowledge and practices of BCT and assessed the impact of a training session introducing a new technique of BCT based on Serafol ABO card.</p><p><strong>Methods: </strong>This is an observational study targeting transfusion-qualified staff working at the MTM hospital in Nabeul. It involved an initial knowledge assessment, a training session on BCT principles, and post-assessment using an anonymous questionnaire that included the interpretation of Serafol ABO card examples.</p><p><strong>Results: </strong>Among 93 participants, 18% frequently performed transfusions, and 31% had prior training. Incorrect BCT practices, including unsafe serum methods, were noted in 46%. Only 7.5% completed necessary pre-transfusion checks. The frequency of overall scores (≥50/100) increased significantly from 43% to 90% (p = 0.000) after the training session. Correct interpretation of the Serafol ABO card was achieved by 86% and 81% of participants in isogroup and non-isogroup compatible situations, respectively. However, 20.5% of participants would have transfused an incompatible unit. A significant difference was observed between doctors and paramedics in interpreting non-isogroup compatible and incompatible situations (p = 0.03). The overall mean interpretation score was 7.7/9, with a 77% compatibility accuracy rate. Professional profile parameters did not significantly influence correct responses.</p><p><strong>Conclusion: </strong>This study revealed gaps in BCT practices, significantly improved through training and the introduction of the Serafol ABO card. Continuous training, medical assessments, and procedure monitoring are vital to enhance transfusion safety.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035855","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 impact of pressure and temperature on the quality of suspended red blood cells: An ex vivo simulation study.","authors":"Chunyu Feng, Rui Fan, Haimei Ma, Huan Zhang","doi":"10.1111/tme.13141","DOIUrl":"https://doi.org/10.1111/tme.13141","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the impact of pressurisation and simultaneous warming at a combination of 50 kPa and 46°C on the quality of suspended red blood cells in an ex vivo environment.</p><p><strong>Background: </strong>During massive rapid blood transfusion, pressure and temperature-controlled blood warming devices are often used to prevent hypothermia caused by the infusion of large amounts of cold blood. If the pressure and temperature are not properly applied during this process, it can endanger the patient's life safety.</p><p><strong>Methods/materials: </strong>400 mL of human suspended red blood cells stored at 2-6°C were subjected to pressure and simultaneous warming at a combination of 50 kPa and 46°C. Changes in blood temperature and blood quality-related indicators before and after warming under pressure were detected, with the procedure repeated six times.</p><p><strong>Results: </strong>In the ex vivo simulated test environment, there were no statistically significant differences in routine blood indicators, biochemical indicators, and hemolysis rates of suspended red blood cells before and after pressure and warming transfusion at 50 kPa pressure and 46°C temperature (P>0.05). There were no significant changes in osmotic fragility after pressure and warming transfusion, and no obvious hemolysis was observed in the morphology of suspended red blood cells under an electron microscope.</p><p><strong>Conclusion: </strong>In the ex vivo simulated test environment, pressure and warming transfusion at 50 kPa pressure and 46°C temperature had no significant impact on blood quality, and the blood quality met the standards for the use of blood products.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035868","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":"Serological and genetic analysis of a B3 phenotype caused by c.259G > T in the ABO gene.","authors":"Min Zhang, Hongjun Gao, Yu Jiang, Fengxia Liu, Xisha Huan, Zhen Huang, Fen Yuan, Ping Lei","doi":"10.1111/tme.13140","DOIUrl":"https://doi.org/10.1111/tme.13140","url":null,"abstract":"<p><strong>Background: </strong>Mixed agglutination is a serological pattern in some ambiguous ABO blood type identification. This study focused on the serological and molecular genetic characteristics of a B3 phenotype induced by a c.259G > T mutation in the ABO gene.</p><p><strong>Study design and methods: </strong>Serological methods such as gel cards and tubes were used to identify the ABO blood type of the patient, with fluorescent PCR for ABO genotyping and Sanger sequencing for analysing the ABO exons. Protein 3D Structure was simulated and further analysed using SWISS-MODLE and PyMOL. Both the wild-type (VAL-87, ABO*B.01) and the mutant (p.Val87Leu) plasmids were transfected into Hela cells to assess the agglutination intensity of the transfected cells with anti-B antibodies.</p><p><strong>Results: </strong>Serological testing showed weak expression of the B antigen and mixed agglutination with anti-B antibodies. ABO genotyping indicated the presence of a B allele, but exon sequencing revealed an additional c.259G > T mutation in exon 6 based on the ABO*B.01 allele. The simulated three-dimensional structures of the proteins showed increased steric hindrance with mutations, leading to a relatively loose structure. The transfected Hela cells with the mutant (p.Val87Leu) plasmid exhibited a significantly reduced agglutination intensity with anti-B antibodies.</p><p><strong>Conclusion: </strong>Based on comprehensive serological, genetic, and simulation analyses, it is concluded that the c.259G > T mutation in exon 6 of the ABO*B.01 allele results in an amino acid change within the enzymatic active site. This alteration likely impacts protein stability and reduces B antigen expression, leading to the B3 subtype phenotype.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025293","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":"Antigen masking indirect antiglobulin test can mitigate the interference of Mezagitamab, a novel anti-CD38 antibody, in serological pre-transfusion testing.","authors":"Cora P Habicht, Clemens Schneeweiss","doi":"10.1111/tme.13139","DOIUrl":"https://doi.org/10.1111/tme.13139","url":null,"abstract":"<p><strong>Objectives: </strong>Investigation of the interference of mezagitamab in serological pre-transfusion testing and the use of DaraEx to overcome it.</p><p><strong>Background: </strong>Administration of anti-CD38 antibodies is a state-of-the-art therapy for patients diagnosed with multiple myeloma. However, treatment with the currently approved anti-CD38 antibodies regularly results in widespread agglutination of red blood cells in serological pre-transfusion testing, making the determination of irregular antibodies and timely transfusion of compatible blood a challenge. Mezagitamab, a novel monoclonal anti-CD38 antibody, is currently under clinical investigation, not only for the treatment of multiple myeloma but also for other indications such as generalised myasthenia gravis.</p><p><strong>Methods/materials: </strong>Mezagitamab or daratumumab spiked plasmas, with or without irregular antibodies, were tested in column agglutination technique cards. DaraEx was used to mitigate occurring interferences.</p><p><strong>Results: </strong>Mezagitamab interferes with the indirect antiglobulin test, with comparable titers but weaker reaction strengths than daratumumab. DaraEx, a reagent containing Fab fragments of an anti-CD38 antibody, is able to completely overcome this interference in the antigen masking indirect antiglobulin test (AMIAT). DaraEx treatment does not interfere with tested irregular antibodies.</p><p><strong>Conclusion: </strong>All novel anti-CD38 antibodies, such as mezagitamab, have the potential to interfere in serological pre-transfusion testing. While masking only one epitope, DaraEx has so far been an effective mitigation for all clinical anti-CD38 antibodies.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024924","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":"Understanding hepcidin for iron management in pregnancy.","authors":"Sarah Rosson, Sue Pavord","doi":"10.1111/tme.13125","DOIUrl":"10.1111/tme.13125","url":null,"abstract":"<p><p>Iron deficiency anaemia (IDA) poses a significant health challenge during pregnancy, affecting up to 30% of pregnant women in the UK. It has been linked to poor health outcomes for the mother, foetus, and the infant. Despite its prevalence and impact, current diagnostic and therapeutic approaches are limited. Ensuring an adequate iron status in pregnancy requires prompt investigation and treatment whilst avoiding excessive iron supplementation and its associated side effects. Hepcidin, a key regulator of iron trafficking in the body, has emerged as a promising candidate for tailoring iron supplementation to individual needs and responsiveness. However, current research on hepcidin-based approaches yields mixed findings, necessitating a comprehensive review to elucidate its potential utility in guiding iron therapy for pregnant women with IDA. This literature review seeks to synthesise existing evidence to explore the role of hepcidin in personalised iron supplementation for pregnant women with IDA and to identify avenues for future research to pave the way for improved management of IDA in pregnancy.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"109-115"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of Asian-Indian criteria for higher body mass index and preservative solutions on haemolysis of stored red blood cells: A prospective observational study.","authors":"Somnath Mukherjee, Stephy Varghese K, Satya Prakash, Debasish Mishra, Ansuman Sahu","doi":"10.1111/tme.13120","DOIUrl":"10.1111/tme.13120","url":null,"abstract":"<p><strong>Introduction: </strong>The quality of packed red blood cells (PRBC) is influenced by various factors such as the collection and processing method, storage conditions, type of bag materials used, anticoagulant properties, and donor characteristics. Studies have indicated that haemolysis in stored RBC bags is linked to male sex, older age, high haemoglobin count, and increased body mass index (BMI). The study's primary objective was to investigate whether a high BMI, as per Asian Pacific criteria among donors, is associated with an elevated haemolysis rate in stored RBC. Additionally, the study aimed to examine any protective effects of different types of preservatives added to blood bags against RBC haemolysis during storage.</p><p><strong>Methods: </strong>Stored RBCs from 100 blood donors with different BMI are analysed for haemolysis on 0, 21, and last day (35/42 days) of storage. A BMI cut-off of 23 was taken for healthy and overweight consideration in blood donors. The blood bags selected for storage were either with additive solution (SAGM) or without additive along with an anticoagulant. The association of the percentage of haemolysis with different variables like age, BMI, and Haemoglobin of the donor were analysed. The correlation between the haematocrit of the bag and haemolysis was determined.</p><p><strong>Results: </strong>This study did not find any significant increase in the percentage of haemolysis in blood bags with higher BMI on the last day of storage (p = 0.424). The haemolysis percentage was higher in bags without SAGM than in bags with an additive solution (p = 0.000). The high haematocrit of the bag has a significant positive correlation with the percentage of haemolysis (p = 0.002). Significantly higher haemolysis in CPDA-1 bags of donor RBC units of BMI >23 groups was observed (p = 0.000) compared to those stored in CPD-SAGM bags.</p><p><strong>Conclusion: </strong>Indian population for higher BMI, as per Asia Pacific cut-off criteria, did not significantly impact the haemolysis of blood bags. Stored RBCs with SAGM, especially of donors having BMI > 23, had a protective effect against haemolysis in blood bags. The percentage of haemolysis was positively correlated with the haematocrit of stored RBC in bags.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"144-150"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906924","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}