Upsala journal of medical sciences最新文献

{"title":"Associations of lower values of peak oxygen uptake and handgrip strength with a smaller liver volume.","authors":"Muhammad Naeem, Marcello Ricardo Paulista Markus, Martin Bahls, Mohammed Mousa, Marcus Dörr, Jens-Peter Kühn, Robin Bülow, Stephan B Felix, Giovanni Targher, Beate Stubbe, Ralf Ewert, Henry Völzke, Till Ittermann","doi":"10.48101/ujms.v130.11924","DOIUrl":"10.48101/ujms.v130.11924","url":null,"abstract":"<p><strong>Background and aims: </strong>The associations between physical fitness markers and liver volume in the general population are unclear. We investigated the associations of peak oxygen uptake (VO_2peak)and handgrip strength with liver volume in a general population sample.</p><p><strong>Methods and results: </strong>Data were taken from 1,531 German adults (51.3% women), aged 20 to 88 years, from two cohorts of the population-based Study of Health in Pomerania (SHIP-START-2 and SHIP-TREND-0). We analysed cross-sectional associations of VO_2peak and handgrip strength with liver volume derived from magnetic resonance imaging (MRI) by using multivariable linear regression models. These models were adjusted for age, sex, body fat mass, pre-existing type 2 diabetes, daily alcohol consumption, smoking status, and use of hypoglycaemic or antihypertensive medications. We observed significant associations of lower VO_2peak and handgrip strength with a smaller liver volume in the whole population, as well as in both men and women. In the whole population, a 1 L/min lower VO_2peak was associated with a 0.15 cm³ (95% confidence interval [CI]: 0.11 to 0.19; <i>P</i> < 0.0001) smaller liver volume for both sexes together. Similarly, a 1 kg lower handgrip strength was associated with a 7.05 cm³ (95% CI: 4.87 to 9.23; <i>P</i> < 0.001) smaller liver volume in the whole population.</p><p><strong>Conclusion: </strong>Our results derived from a large community-based sample showed that lower values of VO_2peak and handgrip strength were associated with a smaller liver volume. These results might explain the possible negative effects of sedentary lifestyle on liver volume - the sedentary liver.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"130 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235362","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":"Cost-effectiveness analysis of transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis at low risk of surgical mortality in Sweden.","authors":"Konrad Nilsson, Stefan James, Oskar Angerås, Jenny Backes, Henrik Bjursten, Pascal Candolfi, Mattias Götberg, Henrik Hagström, Chiara Malmberg, Niels Erik Nielsen, Archita Sarmah, Magnus Settergren, Tom Bromilow","doi":"10.48101/ujms.v130.10741","DOIUrl":"https://doi.org/10.48101/ujms.v130.10741","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve implantation (TAVI) has shown similar or improved clinical outcomes compared with surgical aortic valve replacement (SAVR) in patients with symptomatic severe aortic stenosis at low risk for surgical mortality. This cost-utility analysis compared TAVI with SAPIEN 3 versus SAVR in symptomatic severe aortic stenosis patients at low risk of surgical mortality from the perspective of the Swedish healthcare system.</p><p><strong>Methods: </strong>A published, two-stage, Markov-based cost-utility model that captured clinical outcomes from the <i>Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated according to Recommended Therapies</i> (SWEDEHEART) registry (2018-2020) was adapted from the perspective of the Swedish healthcare system using local general population mortality, utility and costs data. The model had a lifetime horizon. Model outputs included changes in direct healthcare costs and health-related quality of life from using TAVI as compared with SAVR.</p><p><strong>Results: </strong>TAVI with SAPIEN 3 resulted in lifetime costs per patient of 484,142 SEK Swedish krona (SEK) and lifetime quality-adjusted life years (QALYs) per patient of 7.16, whilst SAVR resulted in lifetime costs and QALYs per patient of 457,625 SEK and 6.81 QALYs, respectively. Compared with SAVR, TAVI offered an incremental improvement of +0.35 QALY per patient at an increased cost of +26,517 SEK per patient over a lifetime horizon, resulting in an incremental cost-effectiveness ratio of 76,532 SEK per QALY gained.</p><p><strong>Conclusion: </strong>TAVI with SAPIEN 3 is a cost-effective option versus SAVR for patients with symptomatic severe aortic stenosis at low risk for surgical mortality treated in the Swedish healthcare setting. These findings may inform policy decisions in Sweden for the management of this patient group.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"130 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053337","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":"CORRIGENDUM.","authors":"","doi":"10.48101/ujms.v130.12186","DOIUrl":"https://doi.org/10.48101/ujms.v130.12186","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.48101/ujms.v129.10741.].</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"130 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048454","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":"Elevated levels of aquaporin-4-containing extracellular vesicles in cerebrospinal fluid of patients with bipolar disorder.","authors":"Lennart Wetterberg, Fariborz Mobarrez, Rolf Nybom, Håkan Wallén, Aurimantas Pelanis, Dietrich von Rosen, Mikael Landén","doi":"10.48101/ujms.v130.12006","DOIUrl":"10.48101/ujms.v130.12006","url":null,"abstract":"<p><strong>Objectives: </strong>To examine a hypothetical dysfunction of the brain water channels in bipolar disorder by analyzing aquaporin-4 (AQP4) exposing extracellular vesicles (EVs) in cerebrospinal fluid (CSF) from individuals with bipolar disorder types 1 and 2, and healthy controls.</p><p><strong>Methods: </strong>We analyzed exposure of AQP4 EVs to three different epitopes - the N- and C-terminals, and the epitope containing amino acids 273-291 - in CSF by flow cytometry in 24 individuals with bipolar disorder (type 1, <i>n</i> = 20; type 2, <i>n</i> = 4) and in 14 healthy controls.</p><p><strong>Results: </strong>We observed significantly higher levels of EVs expressing AQP4 in the CSF from individuals with bipolar disorder compared with healthy controls. Specifically, the mean ± SD concentration of AQP4 + EVs per μl CSF for the N-terminal epitope was 346 ± 22 in patients with bipolar disorder type 1, 386 ± 78 in those with bipolar disorder type 2, compared with 39 ± 6.9 in the healthy control group (<i>P</i> < 0.0001). For AQP4+ EVs targeting the C-terminal epitope, the corresponding values were 350 ± 22 for bipolar disorder type 1, 374 ± 46 for bipolar disorder type 2, and 36 ± 6.3 for healthy controls. Similarly, EVs expressing AQP4+ epitopes containing amino acids 273-291 showed concentrations of 344 ± 17 in bipolar disorder type 1, 398 ± 63 in bipolar disorder type 2, and 38 ± 6.4 in the control group (<i>P</i> < 0.0001).</p><p><strong>Conclusion: </strong>Our findings revealed significantly more EVs expressing the three AQP4 epitopes in patients with bipolar disorder compared with healthy controls. This suggests a dysregulated expression of AQP4, implicating a potential disruption in brain water homeostasis as a contributing pathogenic mechanism in bipolar disorder.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"130 ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12292035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733490","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":"Transcatheter aortic valve implantation in Uppsala University Hospital 2009-2023: outcomes and temporal trends.","authors":"Elisa de Wilde, Leonardo Olivetti, Stefan James, Christina Christersson, Sergio Buccheri, Rickard Lindblom, Azad Amin, Giovanna Sarno","doi":"10.48101/ujms.v130.10999","DOIUrl":"https://doi.org/10.48101/ujms.v130.10999","url":null,"abstract":"<p><strong>Background: </strong>In recent years, transcatheter aortic valve implantation (TAVI) has rapidly emerged as a key treatment option for aortic stenosis. TAVI has been performed at Uppsala University Hospital since 2009. Data on TAVI procedures have been collected in a nation-wide all-comer registry, the Swedish Transcatheter Cardiac Intervention Registry (SWENTRY). However, only limited analysis has been conducted on trends in short- and long-term outcomes of TAVI patients in Sweden.</p><p><strong>Methods: </strong>This registry-based cohort study aims to evaluate outcome trends and long-term prognosis in patients who underwent TAVI in a Swedish single center between 2009 and 2023. Survival outcomes were studied using the Kaplan-Meier method. Cox Proportional Hazards models were used to adjust for differences in patient characteristics over time.</p><p><strong>Results: </strong>In total, 1,741 TAVI procedures were performed between 2009 and 2023. Immediate procedural mortality and 1-year mortality averaged at 0.9 and 8.1%, respectively. Both procedural and long-term mortality showed a decreasing trend over time. Similar results were observed when controlling for comorbidities and age.</p><p><strong>Conclusions: </strong>Short-term outcomes and long-term prognosis have been constantly improving for patients undergoing TAVI within this study. Similar mortality and complication trends have been observed in other registry studies. These trends may be attributed to improvements in the quality of care, and the increased use of TAVI in lower risk patients.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"130 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050247","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":"Novel diagnostics for improved treatment of gynecological cancer.","authors":"Ulf Gyllensten","doi":"10.48101/ujms.v130.12111","DOIUrl":"10.48101/ujms.v130.12111","url":null,"abstract":"<p><p>This paper summarizes the efforts to develop novel biomarkers for diagnosis and screening of the three main gynecological cancers, cervical, endometrial, and ovarian cancer, with an emphasis on research performed during the last 20 years in Uppsala. A cervical cancer screening program has existed in Sweden since 1966 using cytology as the primary test. Over the last two decades, research has provided the scientific base for a transition to self-sampling to improve convenience of the woman and achieve higher population coverage, and use of human papillomavirus as the primary test. Also, efficient prophylactic vaccines and more efficient treatment strategies of women with cervical dysplasia have been introduced. Together, these medical tools have the potential to eradicate cervical cancer by 2120, as envisaged by WHO. By contrast, efficient biomarkers for endometrial and ovarian cancer are still lacking. Through the use of high-throughput proteomics, we have identified novel plasma protein biomarkers to be used in the diagnosis of women with adnexal ovarian mass upon transvaginal ultrasound, and possibly also for early detection in population screening. Similarly, novel biomarkers for the diagnosis of endometrial cancer are being evaluated. To establish a population-based screening program requires careful cost-benefit analyses. One alternative would be to broaden the focus of the current cervical cancer screening program to include also the novel biomarkers for ovarian and endometrial cancer, and thereby achieve screening for all three gynecological cancers. A program that screens for all three diseases could increase motivation to participate and thereby population coverage.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"130 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469304","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":"Evaluation of drug delivery vehicles for improved transduction of oncolytic adenoviruses in solid tumor tissue.","authors":"Erik Yngve, Sofie Ingvast, Olle Korsgren, Di Yu","doi":"10.48101/ujms.v130.11217","DOIUrl":"10.48101/ujms.v130.11217","url":null,"abstract":"<p><strong>Background: </strong>Oncolytic viruses are promising tools for immune stimulatory gene therapy of cancer, but their clinical effect on solid tumors have so far been limited. Transduction of the target tumor cells is limited by both extracellular matrix that blocks viral spread within the solid tumor tissue and electrostatic forces that inhibit virus from binding its entry receptor on the cell surface. The enzymes <i>hyaluronidase</i> and <i>collagenase</i> and the polycations diethylaminoethyl (<i>DEAE)-dextran</i>, <i>branched Polyethylenimine (PEI)</i> and <i>protamine sulfate</i> have previously shown potential to improve gene transfer in different forms of viral gene therapy, since they may help the virus to overcome these barriers. In this study, we compared the transduction-enhancing potential of these substances when used as vehicles for adenoviral transduction in solid tumor tissue.</p><p><strong>Methods: </strong>Subcutaneous tumors of pancreatic ductal adenocarcinoma were established in mice and treated with a mix of adenoviral vector Adf35(GFP-Luc) and either one of the selected vehicles. Transduction efficacy was determined by quantification of the viral transgene expression level using live imaging.</p><p><strong>Results: </strong>Addition of hyaluronidase tripled the transgene expression of Adf35(GFP-Luc) when compared to virus alone. No such positive effect was seen for the other tested vehicles.</p><p><strong>Conclusions: </strong>Out of the tested candidates, hyaluronidase showed the best potential to facilitate viral spread in tumor tissue and transduction of tumor cells. Therefore, hyaluronidase may be used as vehicle to improve clinical efficacy of oncolytic virotherapies.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"130 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469303","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":"Special issue: frontiers in recent advances on cancer diagnosis and treatment.","authors":"Bengt Westermark, Carl-Henrik Heldin","doi":"10.48101/ujms.v129.11919","DOIUrl":"https://doi.org/10.48101/ujms.v129.11919","url":null,"abstract":"","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"129 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955751","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":"Determinants of growth differentiation factor 15 plasma levels in outpatients with peripheral arterial disease.","authors":"Emma Skau, Philippe Wagner, Jerzy Leppert, Johan Ärnlöv, Pär Hedberg","doi":"10.48101/ujms.v129.11001","DOIUrl":"https://doi.org/10.48101/ujms.v129.11001","url":null,"abstract":"<p><strong>Background: </strong>Growth differentiation factor 15 (GDF-15) is a robust prognostic biomarker in patients with cardiovascular (CV) disease, and a better understanding of its clinical determinants is desirable. We aimed to study the associations between GDF-15 levels and <i>traditional CV risk factors, indicators of atherosclerotic burden, and cardiac geometry and dysfunction</i> in outpatients with peripheral arterial disease (PAD).</p><p><strong>Methods: </strong>An explorative cross-sectional study (Study of Atherosclerosis in Vastmanland, Västerås, Sweden) included 439 outpatients with carotid or lower extremity PAD. The mean age was 70 years (standard deviation [SD] 7), and 59% of the patients were men. Plasma levels of GDF-15 were obtained along with potential determinants, including medical history, biochemical data, echocardiographic measures of cardiac geometry and function, ankle-brachial index (ABI), and carotid ultrasonographic data on intima-media thickness (IMT) and occurrence of carotid stenosis. The relations between GDF-15 concentrations (transformed with the natural logarithm) and the different determinants were evaluated using uni- and multivariable linear regression models. All pre-specified variables were included in the multivariable models.</p><p><strong>Results: </strong>The multivariable analysis identified independent relations of GDF-15 with several of the included variables (adjusted <i>R</i> ² = 0.48). Diabetes (beta coefficient [β] of 0.37, 95% confidence interval [95% CI] 0.25 to 0.50), low-density lipoprotein (LDL) cholesterol (β = -0.22, 95% confidence interval [CI]: -0.34 to -0.09), and physical activity (β = -0.16, 95% CI: -0.25 to -0.06) had the strongest associations. In contrast, no significant independent associations with GDF-15 level were observed for cardiac geometry and function, ABI, IMT, or carotid stenosis.</p><p><strong>Conclusions: </strong>Circulating GDF-15 is more strongly associated with traditional CV risk factors, especially diabetes, LDL cholesterol, and physical activity than with specific indicators of atherosclerotic burden or cardiac dysfunction. To better understand the pathophysiological role of GDF-15 and its link to clinical outcomes in patients with PAD, future studies should focus on the metabolic processes involved in atherosclerotic disease.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"129 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955750","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":"From early methods for DNA diagnostics to genomes and epigenomes at high resolution during four decades - a personal perspective.","authors":"Ann-Christine Syvänen","doi":"10.48101/ujms.v129.11134","DOIUrl":"10.48101/ujms.v129.11134","url":null,"abstract":"<p><p>In the 1980s, my research career begun with microbial DNA diagnostics at Orion Pharmaceutica in Helsinki, Finland, where I was part of an innovative team that developed novel methods based on the polymerase chain reaction (PCR) and the biotin-avidin interaction. One of our key achievements during this time was the invention of the solid-phase minisequencing method for genotyping single nucleotide polymorphisms (SNPs). In the 1990s, I shifted focus to human genetics, investigating mutations of the 'Finnish disease heritage'. During this period, I also developed quantitative methods using PCR and minisequencing of mitochondrial mutations and for forensic analyses. In the late 1990s and early 2000s, microarray-based SNP genotyping became a major topic for my research, first in Helsinki and later with my research group at Uppsala University in Sweden. By the mid-2000s, I began collaborating with leading clinicians on genetics of autoimmune disease, specifically systemic lupus erythematosus and later worked on the classification and clinical outcome of pediatric acute lymphoblastic leukemia, when large-scale genomics and epigenomics emerged. These collaborations, which focused on integrating genomics into clinical practice, lasted almost two decades until I retired from research in 2022. In parallel with my research activities, I led the SNP/DNA Technology Platform in the Wallenberg Consortium North program from 2001 to 2006. I continued as Director of the SNP&SEQ Technology Platform, which expanded rapidly during the 2010s, and became part of Science for Life Laboratory in 2013. Today (in 2024), the SNP&SEQ Technology Platform is one of the largest units of the Swedish National Genomics Infrastructure hosted by SciLifeLab. The present article provides a personal perspective on nearly four decades of research, highlighting projects and methods I found particularly exciting or important.</p>","PeriodicalId":23458,"journal":{"name":"Upsala journal of medical sciences","volume":"129 ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847764","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}