Vascular Medicine最新文献

{"title":"Lack of diversity in patients undergoing carotid artery stenting: Implications for the Distressed Community Index.","authors":"Carmen Pajarillo, Gaëlle Romain, Jacob Cleman, Lindsey Scierka, Scott Grubman, Christopher Schenck, Jonathan Kluger, Kim G Smolderen, Carlos Mena-Hurtado","doi":"10.1177/1358863X241292545","DOIUrl":"10.1177/1358863X241292545","url":null,"abstract":"<p><strong>Introduction: </strong>As the role of social determinants in carotid artery stenting (CAS) outcomes remains unclear, we investigated the association between the Distressed Community Index (DCI) (zip-code based) and post-CAS mortality/stroke outcomes.</p><p><strong>Methods: </strong>We analyzed patients undergoing CAS from 2015 to 2019 using the Medicare claims-linked Vascular Quality Initiative database. Patients were grouped based on high (DCI ⩾ 60) and low (DCI < 60) community distress. We analyzed 36-month mortality using Kaplan-Meier survival curves and hierarchical Cox regression, and 36-month stroke using cumulative incidence function curves and Fine-Gray models.</p><p><strong>Results: </strong>The final cohort included 8717 patients (3032 DCI ⩾ 60), with a mean DCI score of 46.2 (± 28.5) and mean age of 74.7 (± 7.8) years. Most participants were men (64.3%), White (92.7%), and non-Hispanic/Latino (97.7%). There was no significant difference in the 36-month mortality incidence between high and low community distress groups (25.6% vs 23.5%, <i>p</i> = 0.22), and no significant association between high community distress and mortality (unadjusted HR: 1.04; 95% CI 0.90-1.21; adjusted HR: 1.02; 95% CI 0.89-1.17). The high community distress group experienced an elevated 36-month stroke incidence (26.8% vs 22.4%, <i>p</i> = 0.048), but no significant association with stroke was observed (unadjusted sub-HR: 1.12; 95% CI 1.00-1.24; adjusted sub-HR: 1.03; 95% CI 0.92-1.16).</p><p><strong>Conclusion: </strong>Our cohort showed underrepresentation in terms of sex, race, and ethnicity, with a skewed DCI distribution towards lower community distress. Contrary to what we know about community distress, no independent association between higher community distress and post-CAS stroke/mortality risk was found. Future work must examine whether accessibility barriers and selective CAS allocation explain our results.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"27-37"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¹⁸F-NaF uptake on vascular PET imaging in symptomatic versus asymptomatic atherosclerotic disease: A meta-analysis.","authors":"Shiv Bhakta, Mohammed M Chowdhury, Jason M Tarkin, James Hf Rudd, Elizabeth A Warburton, Nicholas R Evans","doi":"10.1177/1358863X241287692","DOIUrl":"10.1177/1358863X241287692","url":null,"abstract":"<p><strong>Introduction: </strong>¹⁸F-sodium fluoride (NaF) positron-emission tomography (PET) is increasingly being used to measure microcalcification in atherosclerotic disease in vivo. Correlations have been drawn between sodium fluoride uptake and the presence of high-risk plaque features, as well as its association with clinical atherosclerotic sequelae. The aim of this study was to perform a meta-analysis of NaF uptake on PET imaging and its relation to symptomatic and asymptomatic disease.</p><p><strong>Methods: </strong>A systematic review was performed according to PRISMA guidelines, via searching the Ovid MEDLINE, Ovid Embase, Cochrane Library, PubMed, Scopus, and Web of Science Core Collection databases up to May 2024. The search strategy included the terms 'NaF', 'PET', and 'plaque', and all studies with data regarding the degree of microcalcification, as measured by ¹⁸F-NaF uptake in symptomatic and asymptomatic atherosclerotic plaques, were included. Analysis involved calculating mean differences between uptake values and comparison using a random-effects model.</p><p><strong>Results: </strong>A total of 16 articles, involving 423 participants, were included in the meta-analysis (10 carotid artery studies, five coronary artery studies, and one in peripheral vascular disease). Comparing ¹⁸F-NaF uptake in symptomatic versus asymptomatic atherosclerotic plaques, a mean difference of 0.43 (95% CI 0.29 to 0.57; <i>p</i> < 0.0001, <i>I</i>² = 65%) was noted in studies comparing symptomatic and asymptomatic plaques in the same participant, with a significant difference in effect based on arterial territory studied (χ² = 12.68, <i>p</i> = 0.0018). In studies of participants with and without symptomatic disease, there was no significant difference between symptomatic and asymptomatic plaques (mean difference 0.27, 95% CI -0.26 to 0.80, <i>p</i> = 0.28, <i>I</i>² = 85%).</p><p><strong>Conclusions: </strong>PET imaging using ¹⁸F-NaF can detect differences in microcalcification between symptomatic and asymptomatic atherosclerotic plaques within, but not between, individuals, and thus, is a marker of symptomatic disease. The standardization of ¹⁸F-NaF PET imaging protocols, and its future use as a risk stratification tool or outcome measure, requires further study. <b>(PROSPERO Registration ID: CRD42023451363)</b>.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"10-19"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475941","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":"Carotid web: Pathophysiology, diagnostic, and therapeutic options. A narrative review.","authors":"Emeraude Rivoire, Nellie Della Schiava, Olivier Rouvière, Gaele Pagnoux, Tae-Hee Cho, Antoine Millon, Anne Long","doi":"10.1177/1358863X241282635","DOIUrl":"10.1177/1358863X241282635","url":null,"abstract":"<p><p>A carotid web (CaWeb), otherwise known as a carotid bulb diaphragm, is a spur of intimal fibrous tissue extending into the carotid bulb. It is a rare, underdiagnosed cause of ischemic strokes in young people. The purpose of this narrative review was to provide an update on CaWebs, highlighting recent evolutions in their management. We undertook a comprehensive literature search on main electronic databases - MEDLINE/PubMed, Cochrane Library, Web of Science, and EMBASE - using a dedicated equation to include studies up to February 13, 2024. We also searched for the most recent guidelines about carotid disease or stroke including CaWeb management. A CaWeb is found in up to 10% of young patients, particularly young women, with severe anterior stroke due to an arterial-arterial embolism from the intra-nidus thrombus. Most patients with a CaWeb have less than 50% stenosis on duplex ultrasound, and diagnosis is mostly obtained by computed tomography angiography. When applying traditional stenosis criteria for symptomatic disease (> 50% stenosis), this highly morbid condition is easily overlooked, leading to recurrent strokes. Antithrombotic treatment is associated with a high recurrence rate of stroke after the index event. The first-line treatment of symptomatic CaWebs is increasingly based on endarterectomy or stenting. The lack of recommendations before 2021 and recent discordant guidelines make CaWeb management complex. No guidelines are available to manage patients with asymptomatic CaWebs. Results from ongoing multicenter registries will be useful in guiding management decisions.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"82-92"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in treatment strategies for pulmonary embolism in older adults: The SERIOUS-PE study of RIETE participants and US Medicare beneficiaries.","authors":"Behnood Bikdeli, Hannah Leyva, Alfonso Muriel, Zhenqiu Lin, Gregory Piazza, Candrika D Khairani, Rachel P Rosovsky, Ghazaleh Mehdipour, Michelle L O'Donoghue, Olga Madridano, Juan Bosco Lopez-Saez, Meritxell Mellado, Ana Maria Diaz Brasero, Elvira Grandone, Primavera A Spagnolo, Yuan Lu, Laurent Bertoletti, Luciano López-Jiménez, Manuel Jesús Núñez, Ángeles Blanco-Molina, Marie Gerhard-Herman, Samuel Z Goldhaber, Shannon M Bates, David Jimenez, Harlan M Krumholz, Manuel Monreal","doi":"10.1177/1358863X241292023","DOIUrl":"10.1177/1358863X241292023","url":null,"abstract":"<p><strong>Introduction: </strong>Sex differences exist in risk factors and comorbidities of older adults (aged ⩾ 65 years) with pulmonary embolism (PE). Clinically relevant sex-based treatment disparities for PE have not been adequately addressed. The few existing show conflicting results due to small sample size (type II error) and suboptimal methods (overreliance on <i>p</i>-value, which may detect differences of small clinical relevance).</p><p><strong>Methods: </strong>We assessed sex differences in anticoagulation and advanced therapies for PE in older adults, utilizing data from Registro Informatizado Enfermedad TromboEmbolica (RIETE), a large PE registry with predominant participation from Europe, and data from US Medicare beneficiaries. We prespecified a standardized difference (SRD) > 10% as clinically relevant. RIETE included 33,462 (57.7% female) and Medicare included 102,391 (55.0% female) older adults with PE.</p><p><strong>Results: </strong>In RIETE, there were no overall sex differences in the use of anticoagulation (median: 181 vs 180 days, SRD < 1%), fibrinolysis (SRD < 3%), thrombectomy (SRD < 2%), or inferior vena cava (IVC) filters (SRD: 4.4%). However, fibrinolytic therapy (systemic or catheter-based) was less often used in female than male patients with intermediate-risk PE (8.0% vs 12.1%, SRD: 13.6%). No sex differences were noted with advanced PE therapies in Medicare beneficiaries. In unadjusted analyses, fibrinolysis and IVC filter placement were more frequent in Medicare than RIETE participants regardless of sex (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>In a predominantly European PE registry and a US study of older adults, there were no overall sex differences in anticoagulation patterns or advanced therapy utilization. Future studies should determine if sex disparities in fibrinolytic therapy for intermediate-risk PE and greater use of advanced therapies in US older adults correlate with clinical outcomes.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"58-66"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Death certificate documentation is inaccurate for most patients with acute pulmonary embolism.","authors":"Firas Hentati, Milan Kaushik, Shantum Misra, Brett J Carroll, William B Earle, Eric A Secemsky","doi":"10.1177/1358863X241287691","DOIUrl":"10.1177/1358863X241287691","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"79-81"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early combination lipid-lowering therapy is associated with greater achievement of goal LDL-C: Insights from the OPTIMIZE PAD-1 trial.","authors":"Connie N Hess, Ashley Daffron, Mark R Nehler, Michael Szarek, Christopher P Cannon, Judith Hsia, Joseph J Saseen, Marc P Bonaca","doi":"10.1177/1358863X241309839","DOIUrl":"https://doi.org/10.1177/1358863X241309839","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"1358863X241309839"},"PeriodicalIF":3.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil-to-lymphocyte ratio as a prognostic biomarker in patients with peripheral artery disease: A systematic review and meta-analysis.","authors":"Roy B Kurniawan, Paulus P Siahaan, Pandit Bt Saputra, Jannatin N Arnindita, Cornelia G Savitri, Novia N Faizah, Luqman H Andira, Mario D'Oria, J Nugroho Eko Putranto, Firas F Alkaff","doi":"10.1177/1358863X241281699","DOIUrl":"10.1177/1358863X241281699","url":null,"abstract":"<p><strong>Background: </strong>The neutrophil-to-lymphocyte ratio (NLR) is a simple and routinely obtained parameter reflecting systemic inflammation, including in peripheral artery disease (PAD).</p><p><strong>Methods: </strong>This systematic review aimed to assess the role of NLR as a prognostic biomarker in patients with PAD. A systematic search was conducted across PubMed, ScienceDirect, Web of Science, Scopus, ProQuest, EBSCO, and Cochrane. Random-effects meta-analysis was used to pool risk ratios, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). A bivariate model was used to generate summary receiver operating characteristics with the corresponding area under the curve (AUC).</p><p><strong>Results: </strong>This review included 5243 patients with PAD from nine eligible studies. High NLR corresponded to at least a twofold increased risk of all-cause mortality (ACM), major adverse limb events (MALE), and major adverse cardiovascular events (MACE). NLR's performance was good for predicting 1-year ACM (AUC 0.71 [95% CI: 0.59-0.79], sensitivity 58.2% [95% CI: 45.3-71.0], specificity 72.6% [95% CI: 65.6-79.62], PPV 41.0% [95% CI: 31.2-50.7], NPV 82.7% [95% CI: 74.1-91.3]) and 1-year MALE (AUC 0.78 [95% CI: 0.75-0.80], sensitivity 65.4% [95% CI: 41.6-89.2], specificity 77.7% [95% CI: 71.0-84.3], PPV 53.7% [95% CI: 47.3-60.1], NPV 83.91% [95% CI: 73.2-94.6]). However, these values tended to decrease as the follow-up duration extended, except for the pooled specificities, which exhibited the opposite pattern.</p><p><strong>Conclusion: </strong>NLR emerges as a simple and cost-effective prognostic biomarker with decent performance for poor outcomes in patients with PAD <b>(PROSPERO Registration No.: CRD42023486607)</b>.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"687-699"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476010","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":"Clinical outcomes in patients with chronic limb-threatening ischemia and infected ulcers following endovascular therapy are pathogen dependent: A single-center experience from 2012 to 2021.","authors":"Jonas Salm, Franziska Ikker, Tanja Böhme, Elias Noory, Ulrich Beschorner, Tobias Siegfried Kramer, Siegbert Rieg, Dirk Westermann, Thomas Zeller","doi":"10.1177/1358863X241268692","DOIUrl":"10.1177/1358863X241268692","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic limb-threatening ischemia (CLTI) and infected leg ulcers are at risk of amputation and postinterventional sepsis.</p><p><strong>Methods: </strong>This retrospective, single-center study included patients with CLTI and infected leg ulcers who underwent endovascular treatment (EVT) between 2012 and 2021.</p><p><strong>Results: </strong>The study included 712 patients, 286 (40.2%) of whom underwent amputation (minor, <i>n</i> = 212; major, <i>n</i> = 74). Gram-negative bacteria (GNB) were significantly more prevalent in amputees (36.4% vs 30.9%, <i>p</i> < 0.05). Patients with gram-positive bacteria (GPB) had a 4-year freedom from any amputation rate of 72% (95% CI 64-81%) compared to 52% (95% CI 42-66%) in patients with GNB identification (<i>p</i> < 0.05). Cox proportional regression analysis showed that GNB, male sex, mean Wound, Ischemia, and foot Infection (WIfI) score, diabetes mellitus, and end-stage renal disease were independently and positively associated with amputation (<i>p</i> < 0.05). The mean WIfI score and end-stage renal disease were independently and positively associated with death from any cause (<i>p</i> < 0.05). <i>Staphylococcus aureus</i> or GNB, end-stage renal disease, and diabetes mellitus were independent risk factors for sepsis after EVT (<i>p</i> < 0.05). Inpatient-administered antibiotic regimes had significantly higher microbiological activity in cases of GPB identification compared to GNB identification (28% vs 9%, <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Although the isolation of both GNB and <i>S. aureus</i> is a risk factor for sepsis following EVT, the isolation of GNB is independently associated with higher rates of amputation, demonstrating the importance of identifying pathogens to recognize patients at high risk.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"700-706"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of incident stroke among individuals without coronary artery calcification: A pooled cohort analysis from the Multi-Ethnic Study of Atherosclerosis, Jackson Heart Study, and Framingham Heart Study.","authors":"Aliza Hussain, Michelle C Johansen, Michael J Blaha, Mouaz H Al-Mallah, Miguel Cainzos-Achirica, Vijay Nambi, Jerome I Rotter, Xiuqing Guo, Jie Yao, Stephen S Rich, Jaideep Patel, John W McEvoy, Khurram Nasir, Rebecca Gottesman, Roger S Blumenthal, Christie M Ballantyne, Salim S Virani, Mahmoud Al Rifai","doi":"10.1177/1358863X241270911","DOIUrl":"10.1177/1358863X241270911","url":null,"abstract":"<p><strong>Introduction: </strong>The absence of coronary artery calcium (CAC = 0) is associated with low risk of stroke events; however, predictors of incident stroke among those with CAC = 0 are not known.</p><p><strong>Methods: </strong>Individual participant-level data were pooled from three prospective cohorts (Multi-Ethnic Study of Atherosclerosis [MESA], Jackson Heart Study, and Framingham Heart Study). Multivariable-adjusted Cox proportional hazards models were used to study the association between cardiovascular risk factors and incident adjudicated stroke among individuals with CAC = 0 who were free of clinical atherosclerotic cardiovascular disease at baseline.</p><p><strong>Results: </strong>Among 6180 participants (mean age 53 [SD 11] years, 62% women, and 44% White, 36% Black, and 20% other individuals), over a median (IQR) follow up of 15 (12-16) years, there were 122 strokes (95 ischemic, 27 hemorrhagic) with an overall unadjusted event rate of 2.0 per 1000 person-years. After multivariable adjustment, risk factors associated with overall stroke included (hazard ratio [95% CI]) systolic blood pressure (SBP): 1.19 (1.05-1.36) per 10-mmHg increase and carotid intima-media thickness (CIMT): 1.21 (1.04-1.42) per 0.1-mm increment. Current cigarette smoking: 2.68 (1.11-6.50), SBP: 1.23 (1.06-1.42) per 10-mmHg increase, and CIMT: 1.25 (1.04-1.49) per 0.1-mm increment were associated with ischemic stroke, whereas C-reactive protein was associated with hemorrhagic stroke risk (0.49, 0.25-0.93).</p><p><strong>Conclusion: </strong>In a large cohort of individuals with CAC = 0, the rate for incident stroke was low (2.0 per 1000-person years) and was associated with modifiable risk factors.</p>","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"632-639"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subclinical coronary artery disease and perioperative cardiac events in patients undergoing peripheral artery bypass surgery.","authors":"Abiah Pritchard, Nichole Brunton, Swapna Sharma, Michael N Young, Stanislav Henkin","doi":"10.1177/1358863X241280070","DOIUrl":"10.1177/1358863X241280070","url":null,"abstract":"","PeriodicalId":23604,"journal":{"name":"Vascular Medicine","volume":" ","pages":"720-722"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}