中华肝脏病杂志最新文献

{"title":"[Recent advances in epidemiology, prevention and treatment of hepatitis C in China].","authors":"J J Yu, L Zhao, G W Ding, S D Ye, J Han, Z F Liu, W J Yan, J Li","doi":"10.3760/cma.j.cn501113-20260330-00126","DOIUrl":"10.3760/cma.j.cn501113-20260330-00126","url":null,"abstract":"<p><p>Hepatitis C is a liver disease caused by the hepatitis C virus (HCV) that can lead to chronic hepatitis, cirrhosis, and hepatocellular carcinoma, and it is one of the main causes of liver disease-related deaths globally and in China. The prevention and control of hepatitis C have consistently been priorities in China. A national seroepidemiological survey conducted in 2020 showed that the weighted prevalence of anti-HCV positivity among individuals aged 1-69 years in China was 0.28%, while the weighted prevalence of HCV RNA positivity was 0.15%, corresponding to an estimated 5.54 million individuals with anti-HCV positivity and 3.22 million individuals with HCV RNA positivity. Compared with the 2006 survey, the weighted prevalence of anti-HCV positivity decreased by 35%, indicating that substantial progress has been made in hepatitis C prevention and control in China. However, due to the large population size, the absolute number of infected individuals remains considerable. The introduction of direct-acting antiviral agents (DAAs) has transformed hepatitis C into a curable disease. In recent years, the inclusion of multiple DAAs in the National Medical Insurance Drug List has improved patients' access to antiviral therapy.The National Health Commission and nine other departments jointly issued the Work Plan for the Action to Eliminate the Public Health Hazard of Hepatitis C (2021-2030) in 2021, and the National Disease Control and Prevention Administration and nine other departments jointly released the Action Plan for Viral Hepatitis Prevention and Care (2025-2030) in 2025, providing policy support and planning for hepatitis C elimination in China. This article systematically reviews the current epidemiological status, disease burden characteristics, progress in prevention and treatment, and major challenges faced, providing a reference for advancing efforts to eliminate the public health threat posed by hepatitis C based on updated epidemiological data and recent developments in prevention and treatment in China.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 9","pages":"912-916"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Novel therapeutic strategies for liver metastases driven by the common microenvironment].","authors":"L X Shen, W J Fang, Z Tong","doi":"10.3760/cma.j.cn501113-20260531-00222","DOIUrl":"10.3760/cma.j.cn501113-20260531-00222","url":null,"abstract":"<p><p>The liver is one of the most common target organs for distant metastasis from various malignant tumors. Once liver metastases develop, they often indicate a poor prognosis and may be accompanied with reduced therapeutic responses.Whether cancer cells originating from different primary sites can further colonize, survive, and form metastatic lesions after entering the liver is closely related to the liver's unique immune-tolerant state and alterations in vascular structures and metabolic microenvironment. Although different tumors have distinct tissue origins and molecular characteristics, they are often influenced by similar microenvironmental factors during intrahepatic progression and exhibit certain functional convergence. Based on this characteristic, different diseases treated with the same method aimed at liver cancer metastases possess certain theoretical and practical significance. Herein, the main characteristics of the liver's immune microenvironment are organized and discussed, with a focus on immunotherapy, anti-angiogenic therapy, and convergent therapy strategies involving emerging targets such as human epidermal growth factor receptor 2 and claudin-18.2, with the aim of providing a reference for the comprehensive treatment approaches for metastatic liver cancer.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 9","pages":"836-844"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Noninvasive scores for predicting liver-related events in patients with metabolic dysfunction-associated fatty liver disease].","authors":"Y K Gao, S Y Chen, X Han, C L Sun, X N Wu, H You, Y M Sun","doi":"10.3760/cma.j.cn501113-20251015-00435","DOIUrl":"10.3760/cma.j.cn501113-20251015-00435","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To evaluate the predictive value of noninvasive fibrosis scores for liver-related events (LREs) in metabolic dysfunction-associated fatty liver disease (MAFLD). &lt;b&gt;Methods:&lt;/b&gt; Patients with biopsy-confirmed MAFLD who were treated at Beijing Friendship Hospital between 2018 and 2024 were prospectively enrolled and followed up. Demographic and laboratory data were collected. The noninvasive measures and fibrosis scores evaluated in this study included liver stiffness measurement (LSM) based on transient elastography, the aspartate aminotransferase-to-platelet ratio index (APRI), Fibrosis-4 (FIB-4) index, NAFLD fibrosis score (NFS), Agile3+, Agile4, and FibroScan-AST (FAST) score. LREs were defined as the first occurrence of decompensated cirrhosis, hepatocellular carcinoma, liver disease-related death, liver transplantation, or clinically significant portal hypertension (noninvasively according to the Baveno VII consensus criteria). Continuous variables were compared between the two groups using the Wilcoxon rank-sum test. Risk stratification was performed based on the cutoff values for each baseline noninvasive score. Kaplan-Meier analysis was used to compare cumulative incidences of LREs across risk strata. Cox regression analysis was used to assess the predictive value of each score for LREs, while receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to evaluate the predictive performance of each noninvasive score for 3-year LREs. &lt;b&gt;Results:&lt;/b&gt; Data from 226 biopsy-confirmed MAFLD patients were included. Among them, 70 (31.0%) were male, and the median age was 54 (41, 61) years. The median follow-up duration was 36 months. A total of 22 (9.7%) LRE occurred. The LRE group exhibited higher baseline levels of total bilirubin, creatinine, LSM, and all noninvasive scores, as well as a higher prevalence of diabetes but lower platelet counts (&lt;i&gt;P&lt;/i&gt;&lt;0.01). The median values of LSM and all noninvasive scores were consistently higher at various time points during follow-up in the LRE group than in the non-LRE group. Risk stratification results showed that the high-risk groups for each noninvasive score had the highest 3-year cumulative incidence of liver-related events (LREs) (LSM ≥15.0:39.4%; APRI≥1.5:27.3%; FIB-4&gt;2.67:31.6%; NAFLD fibrosis score &gt;0.676:37.8%; FAST≥0.67:22.1%; Agile3+≥0.679:27.3%; Agile4≥0.565:35.9%), all of which were significantly higher than those in the low- and intermediate-risk groups (&lt;i&gt;P&lt;/i&gt;&lt;0.01). Univariate Cox regression analysis indicated that LSM and all non-invasive scores were significantly associated with an increased risk of LREs [LSM: hazard ratio (&lt;i&gt;HR&lt;/i&gt;)=2.44, 95% confidence interval (&lt;i&gt;CI&lt;/i&gt;): 1.88-3.17; APRI: &lt;i&gt;HR&lt;/i&gt;=1.74, 95%&lt;i&gt;CI&lt;/i&gt;:1.30-2.33; FIB-4: &lt;i&gt;HR&lt;/i&gt;=1.80, 95%&lt;i&gt;CI&lt;/i&gt;:1.45-2.24; NAFLD fibrosis score: &lt;i&gt;HR&lt;/i&gt;=3.79, 95%&lt;i&gt;CI&lt;/i&gt;:2.44-5.89; Agile3+:&lt;i&gt;HR&lt;/i&gt;=17.66, 95%&lt;i&gt;CI&lt;/i&gt;:4.79-65.07; Agile4:&lt;i&gt;HR&lt;/i&gt;=3.39, 95% &lt;i&gt;CI&lt;/i&gt;: ","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 9","pages":"893-902"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research advances on the role of eosinophils in acute liver injury].","authors":"M Y Zhu, X L Fu, J B Chang","doi":"10.3760/cma.j.cn501113-20260519-00194","DOIUrl":"10.3760/cma.j.cn501113-20260519-00194","url":null,"abstract":"<p><p>The role of eosinophils (Eos) has attracted considerable attention in acute liver injury. Animal studies have validated that eosinophils recruited to the liver through the positive feedback loop of interleukin (IL)-4/chemokine (C-C motif) ligand 24 alleviate inflammation by inhibiting interferon-γ production via IL-4/IL-13 signaling and promotes hepatocyte proliferation through heparin-binding epidermal growth factor-like growth factor/epidermal growth factor receptor. Clinical study results suggest that drug-induced liver injury and drug-induced hypersensitivity syndrome often accompany elevated Eos levels, whereas the absence of Eos elevation predicts poor prognosis. The hypotheses of \"conditional transition\" and \"exhaustion\" have been proposed based on cases where liver failure reversed after the depletion of Eos with benralizumab monoclonal antibody, suggesting that Eos may exert a protective role in the early stages of disease but become overactivated in later stages, shifting to a pathogenic role and eventually leading to functional exhaustion.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 9","pages":"917-921"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The role of hepatocyte programmed cell death in liver fibrosis].","authors":"M Zhou, Z J Zeng, X K Yang, H Li","doi":"10.3760/cma.j.cn501113-20250918-00393","DOIUrl":"10.3760/cma.j.cn501113-20250918-00393","url":null,"abstract":"<p><p>Liver fibrosis is a key link in the occurrence and development of chronic liver disease. Therefore, liver fibrosis inhibition has important significance in the prevention and treatment of chronic liver diseases. With the deepening of research on hepatocytes, researchers have discovered that distinct stimuli to hepatocytes induce corresponding programmed cell death through different molecular mechanisms (including apoptosis, necroptosis, pyroptosis, panaptosis, ferroptosis, cuproptosis, and autophagy), thereby effecting promotion or inhibition in liver fibrosis. Notably, hepatocyte programmed cell death regulation can alleviate or exacerbate the fibrosis progression. This paper elucidates the different role types, the related inducing mechanisms, and corresponding regulatory intervention measures in hepatocyte programmed cell death to provide a new theoretical basis for the prevention and treatment of liver fibrosis.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 9","pages":"922-929"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pathogenic mechanisms and advances in the diagnosis and treatment of co-occurring psychiatric and psychological symptoms in patients with liver cirrhosis].","authors":"H Gong, Y R Li, F N Zhang, T T Zhao, M Huang, C C Liu, N He","doi":"10.3760/cma.j.cn501113-20250920-00401","DOIUrl":"10.3760/cma.j.cn501113-20250920-00401","url":null,"abstract":"<p><p>Patients with liver cirrhosis commonly have psychiatric and psychological symptoms, particularly depression, which substantially impairs quality of life and may increase all-cause mortality. However, the pathogenic mechanisms of co-occurring psychiatric and psychological symptoms in cirrhosis remain unclear and may involve multiple factors, including neurobiological alterations, liver dysfunction, primary liver disease, and treatment-related factors. Psychiatric and psychological symptoms can be assessed using diverse scales and managed with pharmacological and non-pharmacological interventions in patients with cirrhosis. This review summarizes the epidemiology, potential pathogenic mechanisms, diagnostic criteria, treatment, and intervention strategies for co-occurring psychiatric and psychological symptoms in patients with cirrhosis, with the aim of providing references for clinical practice.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 9","pages":"930-937"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Alcoholic liver disease: new insights into an undeniable challenge and strategies for prevention and treatment].","authors":"C W Tang","doi":"10.3760/cma.j.cn501113-20260715-00275","DOIUrl":"10.3760/cma.j.cn501113-20260715-00275","url":null,"abstract":"<p><p>Long-term and excessive alcohol consumption is metabolized in the liver while simultaneously causing liver injury, ultimately leading to alcoholic liver disease (ALD). With the increasing consumption of alcoholic beverages among the general population, ALD has become one of the major liver diseases in China. The progression of ALD encompasses stages including hepatic steatosis, hepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. In the absence of effective pharmacotherapies for ALD, current management strategies should prioritize early diagnosis and timely reinforcement of alcohol abstinence to prevent disease progression to cirrhosis and hepatocellular carcinoma. Overlooked drinking history frequently results in missed diagnosis of ALD; therefore, greater attention should be paid to the systematic collection of long-term drinking history in clinical practice. ALD is closely associated with lifestyle factors, and its prevention and control require not only professional medical guidance and governmental public health support, but also rely on public dissemination of medical knowledge and gradual shifts in drinking culture. Furthermore, existing research achievements in ALD should be accelerated in their translation into clinical diagnostic and therapeutic strategies as well as related health industry applications, so as to promote disease prevention, early recognition, and standardized management.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 8","pages":"715-717"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Characteristics and predictive factors of recompensation in patients with hepatitis B-related decompensated cirrhosis: a retrospective cohort study].","authors":"Y J Li, Z L Yan, J H Deng, L P Yang, Y Lu, Z L Wang, Q Lu, J T Chen, X E Xin, H M Zu","doi":"10.3760/cma.j.cn501113-20260111-00019","DOIUrl":"10.3760/cma.j.cn501113-20260111-00019","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate and evaluate the incidence rate, time distribution, related factors, and prediction model discriminative ability for recompensation in patients with hepatitis B-related decompensated cirrhosis. &lt;b&gt;Methods:&lt;/b&gt; Four hundred and five patients hospitalized for the first time due to hepatitis B-related decompensated cirrhosis were retrospectively enrolled, using the date of initial hospitalization for decompensation as the follow-up initial point. Recompensation was defined as the resolution condition of decompensation complications, lasting for at least 12 months without specific maintenance therapy, with reference to the Baveno Ⅶ consensus in combination with real-world clinical practice. A statistical analysis was performed on the recompensation occurrence time in patients who achieved recompensation. Patients followed up for≥12 months (&lt;i&gt;n&lt;/i&gt;=382) were included, with 12 months as the cutoff. Univariate and multivariate logistic regression analyses were used to analyze related factors, with recompensation (primary event time of occurrence &gt;12 months) as the endpoint. A recompensation prediction model was constructed based on key variables. The discriminative ability was evaluated using the area under the receiver operating characteristic curve (AUC), and tertile risk stratification was performed. The baseline and recompensated indicators were compared pairwise for patients with recompensation. &lt;b&gt;Results:&lt;/b&gt; Recompensation occurred in 94 out of 405 cases, with an overall incidence of 23.2%. The recompensation incidence was 22.7% (92/405) when \"time to recompensation &gt;12 months\" was used as the primary event criterion. The median time to recompensation was 22.9 (16.0, 35.4) months, mainly concentrated between 12 and &lt;24 months. Multivariate logistic regression showed that persistent virological suppression was independently associated with recompensation (&lt;i&gt;OR&lt;/i&gt;=2.387, 95%&lt;i&gt;CI&lt;/i&gt; 1.395-4.082, &lt;i&gt;P&lt;/i&gt;=0.001). The independent adverse factors for recompensation were initial decompensated complications ≥2(&lt;i&gt;OR&lt;/i&gt;=0.525, 95%&lt;i&gt;CI&lt;/i&gt; 0.288-0.957, &lt;i&gt;P&lt;/i&gt;=0.036) and portal vein thrombosis (&lt;i&gt;OR&lt;/i&gt;=0.296, 95%&lt;i&gt;CI&lt;/i&gt; 0.108-0.806, &lt;i&gt;P&lt;/i&gt;=0.017). There was no statistically significant difference in the composition of the initial decompensation complication types, but the complication burden was closely related to recompensation, with a significantly lower recompensation rate in patients with ≥2 complications [18.2% (25/137) &lt;i&gt;vs&lt;/i&gt;. 28.2% (69/245), &lt;i&gt;P&lt;/i&gt;=0.031]. The model for end-stage liver disease (MELD), complication burden, portal vein thrombosis, sustained virological suppression, and non-selective β receptor blockers had better discrimination in Model B than Model A (AUC 0.670 &lt;i&gt;vs&lt;/i&gt;. 0.532). The actual recompensation rates following tripartite risk stratification were 15.4% (18/117), 19.7% (23/117), and 35.9% (42/117), respectively. Alanine aminotransferase (ALT) and aspartate aminotrans","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 8","pages":"769-777"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Exploration of antiviral regimens for patients with chronic hepatitis B virus infection in the indeterminate phase].","authors":"J Zheng, X W Li, L Long, X Liu, S Yuan, S P Wang, L C Cheng, X Wang, G Y Long","doi":"10.3760/cma.j.cn501113-20250903-00363","DOIUrl":"10.3760/cma.j.cn501113-20250903-00363","url":null,"abstract":"","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 8","pages":"794-800"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Alcohol liver disease: immunoregulatory mechanisms and precision therapeutic targets].","authors":"H Y Shen, L M Wei, L Zuo, H Wang","doi":"10.3760/cma.j.cn501113-20260319-00117","DOIUrl":"10.3760/cma.j.cn501113-20260319-00117","url":null,"abstract":"<p><p>Alcohol liver disease (ALD) represents a major health challenge worldwide, with particularly high mortality in severe alcohol-associated hepatitis. Inflammation plays a central role in ALD progression, and immune cells along with their inflammatory mediators contribute to disease development through actions in both the liver and extrahepatic organs. Currently, there is a lack of targeted therapies that can effectively block chronic ALD progression or intervene in alcohol-related acute liver failure. This article elucidates the core mechanisms by which immune heterogeneity drives the development and progression of ALD and influences treatment responses, summarizes current clinical research progress in anti-inflammatory therapies, and highlights promising future directions, particularly biomarker-guided precision therapy.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"34 8","pages":"723-731"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}