Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi最新文献

{"title":"[Delayed physical growth and related factors in pediatric patients with transfusion-dependent thalassemia].","authors":"Z X Kuang, J Y Zhao, X Yu, J Xu, Z Gao, Y J Liu, A N Wang, J Dong, H Pan, L L Zhang, L W Fang, G B Wu, X L Li, J Shi, L Xu, W J Xie","doi":"10.3760/cma.j.cn121090-20240903-00333","DOIUrl":"10.3760/cma.j.cn121090-20240903-00333","url":null,"abstract":"<p><p><b>Objectives:</b> To investigate the physical growth status of pediatric patients with transfusion-dependent thalassemia (TDT) and analyze the effects of treatment-related and socioeconomic factors on physical growth. <b>Methods:</b> Based on the specialized thalassemia database from gene therapy clinical research at the Institute of Hematology & Hospital of Blood Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, we collected data on height and weight development, family economic status, and medical records of 338 pediatric patients with TDT from October 2023 to May 2024. The length/height-for-age and body mass index (BMI) -for-age were classified based on the Growth Standard for Children under 7 Years of Age, Standard for Height Level Classification among Children and Adolescents Aged 7-18 Years, and Dietary Guidelines for Chinese Residents. Logistic regression analysis was conducted to assess the effects of family economic status and disease-related treatment on length/height-for-age and BMI-for-age. <b>Results:</b> Among the 338 patients, 118 were children and 220 were adolescents (192 males and 146 females), with a median age of 12 years (range: 0.8-18) and a median diagnosis duration of 10.3 years (range: 0.5-17.9). Subtypes included α-thalassemia [21 cases (6.2%) ], β-thalassemia [288 cases (85.2%) ], and combined αβ-thalassemia[29 cases (8.6%) ]. The monthly household income of patients was concentrated in 3 000-5 000 yuan (39.9%) and 5 001-10 000 yuan (34.9%), whereas 67.2% of the families had monthly medical expenses of <3 000 yuan. Of the patients, 75.5% received their first transfusion before 1 year of age. The proportions of children and adolescents with pretransfusion hemoglobin (HGB) of ≤70 g/L were 4.2% and 6.4%, respectively. Adolescents demonstrated significantly higher rates of transfusion frequency of <4 weeks/session, monthly red blood cell infusion of >2 U, serum ferritin (SF) of ≥5 000 μg/L, iron chelation therapy, and splenectomy compared with children (all <i>P</i><0.05). Of the 338 patients, 26.0%, 22.8%, and 8.9% demonstrated stunted growth, underweight, and concurrent stunted growth with underweight, respectively. No significant difference was observed in the stunted growth rates between children (22.9%) and adolescents (27.7%) (<i>P</i>=0.402). However, the underweight rate in adolescents (26.8%) was significantly higher than that in children (15.3%) (<i>P</i>=0.023). The multivariate analysis determined the following risk factors for stunted growth: monthly household income of <10 000 yuan (5 001-10 000 yuan: <i>OR</i>=5.49, 95% <i>CI</i>: 1.48-35.76; 3 000-5 000 yuan: <i>OR</i>=6.87, 95% <i>CI</i>: 1.88-44.60; <3 000 yuan: <i>OR</i>=9.29, 95% <i>CI</i>: 2.20-64.77), pretransfusion HGB of ≤70 g/L (<i>OR</i>=3.25, 95% <i>CI</i>: 1.07-10.18), and SF of ≥5 000 μg/L (<i>OR</i> = 3.04, 95% <i>CI</i>: 1.20-7.70). Longer diagnostic duration was associated with underweight (<i>OR</i>=1.10, 9","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 4","pages":"328-335"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162636","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":"[Chinese expert consensus on standard procedures for the outpatient management of patients with multiple myeloma (2025)].","authors":"","doi":"10.3760/cma.j.cn121090-20250123-00044","DOIUrl":"10.3760/cma.j.cn121090-20250123-00044","url":null,"abstract":"<p><p>With the development of new drugs and treatments, the survival of patients with multiple myeloma (MM) is significantly prolonged, and MM treatment has entered the stage of chronic disease management. To assist in MM management, the Plasma Cell Disease Group of the Chinese Society of Hematology and the Hematology Committee of the Chinese Medicine Education Association prepared this expert consensus. It provides recommendations on the conditions of establishing outpatient management, standards and processes of patient treatment, outpatient follow-up management, and patient education. This consensus aims to establish and optimize the outpatient management model of MM treatment, enhance the efficacy of patient management and follow-up, and thereby to establish a more convenient diagnosis and treatment model.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 4","pages":"284-288"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162594","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":"[Nonspecific peripheral T cell lymphoma combined with pure red cell aplasia: a case report and literature review].","authors":"X Y Zhang, Y Y Zheng, D G Fan, J F Zhong, S X Wu","doi":"10.3760/cma.j.cn121090-20240809-00297","DOIUrl":"10.3760/cma.j.cn121090-20240809-00297","url":null,"abstract":"<p><p>Nonspecific peripheral T-cell lymphoma (PTCL-NOS) combined with pure red cell aplasia (PRCA) is reported by only few in China. This article described a patient with PTCL-NOS who presented with severe anemia as the initial symptom, accompanied by multiple lymphadenopathy. Laboratory tests confirmed decreased red blood cell count and reticulocyte proportion, markedly reduced bone marrow red blood cell proliferation, and markedly increased proportion of bone marrow CD3(+)CD8(+) T lymphocytes. On lymph node pathology examination, immunohistochemistry was consistent with PTCL-NOS, with positive TCRβ gene rearrangement. First-line chemotherapy with four courses of ECHOP regimen led to significant reductions in lymph node size, partial remission on whole-body computed tomography evaluation, normalization of hemoglobin and bone marrow hematopoietic erythroid proliferation, and absence of CD3(+)CD8(+) T lymphocytes in bone marrow. Currently, the patient remains to have good prognosis with maintenance oral lenalidomide.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 4","pages":"359-362"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161155","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":"[Correlation between complement deposition levels on blood cells and clinical biomarkers in patients with paroxysmal nocturnal hemoglobinuria].","authors":"M L Zhang, X Wang, C Yang, M Chen, B Han","doi":"10.3760/cma.j.cn121090-20240717-00265","DOIUrl":"10.3760/cma.j.cn121090-20240717-00265","url":null,"abstract":"<p><p><b>Objective:</b> To explore the complement deposition levels on blood cell surfaces in patients with paroxysmal nocturnal hemoglobinuria (PNH) and evaluate their association with clinical manifestations. <b>Methods:</b> This study enrolled patients with PNH, who had not been treated with complement inhibitors and appeared at Peking Union Medical College Hospital from February 2021 to February 2023. The clinical information of participants was retrospectively recorded, and peripheral blood samples were collected. Gender- and age-matched normal controls (NC) were recruited accordingly. C5b-9, C3, C4b, and factor B (FB) deposition levels on peripheral red blood cells, white blood cells, and platelets were detected with flow cytometry. The correlation between complement deposition levels and clinical symptoms was analyzed. <b>Results:</b> This study involved 73 patients with PNH, including 42 (57.5%) males, with a median age of 36 (range: 14-76) years. 16 matched NC were collected. Among patients with PNH, 36 (49.3%) had classical PNH and 37 (50.7%) had aplastic anemia-PNH syndrome. Thromboembolic events (TEE) occurred in 18 (24.7%) patients. The median HGB, absolute reticulocyte count (Ret), and lactate dehydrogenase of PNH patients were 76 (37-116) g/L, 181.0 (45.9-495.8) ×10(9)/L, and 1 875 (377 - 5 509) U/L, respectively. The median number of Flaer-negative white blood cells was 94.0% (13.0% - 99.9%) ; the median CD59 negative red blood cells was 46.7% (9.0% - 93.0%). The deposition of C5b-9, C3, C4b, and FB on red blood cells, white blood cells, and platelets in patients with PNH was significantly higher than that in NC (all <i>P</i><0.05). C5b-9 deposition level was significantly higher than that of C3, C4b, and FB on all three blood cell lineages in PNH patients (all <i>P</i><0.01). The deposition of all complement fragments on red blood cells was significantly lower than that on white blood cells and platelets (all <i>P</i><0.01). C5b-9 deposition on red blood cells was positively correlated with Ret in PNH patients (<i>P</i>=0.005). C3 (<i>P</i>=0.001) and C4b (<i>P</i>=0.017) deposition levels on white blood cells and C3 deposition on platelets (<i>P</i>=0.002) in patients with TEE history were lower than those without. <b>Conclusions:</b> C5b-9, C3, C4b, and FB deposition levels on all three blood cells in patients with PNH were higher than NC. Increased C5b-9 on red blood cells may indicate active hemolysis. Reduced C3 and C4b levels on white blood cells and low C3 deposition on platelets may indicate TEE risk.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 4","pages":"314-320"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162633","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":"[Treatment challenges and optimal management of classical Hodgkin's lymphoma].","authors":"J Q Mi, Y Fang, W Y Yu, Q Q Cai","doi":"10.3760/cma.j.cn121090-20240906-00338","DOIUrl":"10.3760/cma.j.cn121090-20240906-00338","url":null,"abstract":"<p><p>The cure rate of patients with classical Hodgkin's lymphoma (cHL) has significantly improved and the mortality rate has decreased with the advancement of chemotherapy and radiotherapy, especially the application of combined radio-chemotherapy. However, some patients still face relapse or refractory issues, as well as the risk of death due to treatment-related adverse reaction. Treatment has fully entered the era of targeted therapy in recent years, with the deepening research on cHL. Novel drugs, represented by targeted CD30 antibody-drug conjugates and immune checkpoint inhibitors, have further improved the prognosis of patients with newly diagnosed and relapsed/refractory cHL. This study aims to determine the mechanism of achieving comprehensive optimization management of cHL in the new era of drugs, improve patient prognosis, enhance therapeutic efficacy, and reduce the occurence of adverse reactions.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 4","pages":"364-371"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161194","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":"[Primary cutaneous CD8(+) infiltrating ectodermal lymphocytic T-cell lymphoma: a case report].","authors":"K T Long, Z H Pu, W X Yang","doi":"10.3760/cma.j.cn121090-20241125-00478","DOIUrl":"10.3760/cma.j.cn121090-20241125-00478","url":null,"abstract":"","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 4","pages":"363"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161188","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":"[Screening of MLL fusion genes and rare breakpoint cases in patients with acute myeloid leukemia].","authors":"S Li, H C Cheng, Z Y Wang, W P Hao, H Liang, J Ma","doi":"10.3760/cma.j.cn121090-20240407-00125","DOIUrl":"10.3760/cma.j.cn121090-20240407-00125","url":null,"abstract":"<p><p><b>Objective:</b> To screen for patients with mixed-lineage leukemia (MLL) fusion gene-positive with acute myeloid leukemia (AML), analyze the clinical characteristics and prognosis of patients with AML with positive fusion genes, and report two cases with rare breakpoint sites. <b>Methods:</b> This study included 287 patients with AML (non-acute promyelocytic leukemia) admitted to the Hematology and Oncology Research Center of Harbin First Hospital from October 2021 to October 2023. The cohort involved 157 males and 130 females, with a median age of 48 years (range: 19-80 years). All 287 patients underwent screening for 56 fusion genes and chromosome karyotyping analysis. Fluorescence in situ hybridization (FISH) and RNA seq were further performed on patients with negative fusion genes but positive 11q23.3 chromosomal translocation. Patient observation indicators included remission, recurrence, and others. <b>Results:</b> Among the 287 patients with AML, 15 were positive for the MLL fusion gene, with a positivity rate of 5.2%. Among the 11 types of MLL fusion genes detected, the most prevalent fusion types were MLL-ENL (4 cases), MLL-ELL (4 cases), MLL-AF9 (3 cases), and MLL-AF6 (3 cases). Of the 15 patients with positive MLL fusion gene, 2 demonstrated negative fusion gene while exhibiting positive chromosome and FISH. RNA-seq testing in these two patients revealed an uncommon breakpoint in the MLL fusion gene and a novel breakpoint fusion site, respectively. Complete remission (CR) was achieved in 6 patients with positive MLL fusion genes during the first chemotherapy cycle. After two cycles, eight patients achieved CR, with 50% of them experiencing recurrence within 2 months. <b>Conclusion:</b> RNA seq technology is useful for screening fusion genes with unconventional or novel cleavage sites, and patients with positive MLL fusion genes demonstrated a poorer prognosis.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 4","pages":"349-354"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161192","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":"[Effects of donor T cell stat3 deficiency on acute intestinal graft-versus-host disease in mice].","authors":"Y X Xu, X Q Wang, S J Yang, Q X Song, J Wei, X Zhang","doi":"10.3760/cma.j.cn121090-20250107-00011","DOIUrl":"10.3760/cma.j.cn121090-20250107-00011","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the effects and underlying mechanisms of Stat3 knockout in donor T cells on acute gastrointestinal graft-versus-host disease (GI-aGVHD) . <b>Methods:</b> BALB/c mice were exposed to lethal irradiation and transplanted with bone marrow and spleen cells from BALB/c mice (syngeneic control group), C57BL/6 mice (wild-type T cell group, WT group), or C57BL/6J-Stat3(em1cyagen) mice (Stat3 gene knockout T cell group, Stat3-KO group) via tail vein injection to establish the aGVHD model. The survival rate, body weight changes, and clinical scores of mice were monitored. Cytometric bead array (CBA) was used to detect the concentrations of serum cytokines. Lymphocytes were isolated from tissues for flow cytometric analysis. H&E staining was performed to observe intestinal pathological changes. FITC-dextran assay was conducted to assess intestinal permeability. Immunohistochemistry was used to evaluate the expression of Ki67 and Muc2. Real-Time Quantitative Reverse Transcription PCR (qRT-PCR) was employed to analyze the gene expression levels of Olfm4, Lysozyme, and Muc2 in the small intestine. Metabolomics was conducted to detect metabolites in serum and intestinal tissues. An in vitro GI-aGVHD organoid model was established by coculturing intestinal organoids with allogeneic T cells, where the number and area of small intestinal organoids were recorded. The GVL effect was assessed using luciferase-transfected ALL cells (ALL/Luc) and bioluminescent imaging. <b>Results:</b> Compared with the WT group, Stat3 knockout T cells alleviated body weight loss, reduced symptoms-such as hunchback and diarrhea-in mice, improved survival rate (<i>P</i><0.05), and reduced serum interleukin (IL) -2, IL-6, interferon-γ, tumor necrosis factor-α, IL-17A, and IL-10 levels (all <i>P</i><0.05), intestinal inflammatory cell infiltration (<i>P</i><0.05), and intestinal mucosal permeability. Further, Muc2 and Ki67 expression levels in the small intestine of the Stat3 knockout group were markedly increased, and Olfm4, Lysozyme, and Muc2 gene expression levels were significantly increased (all <i>P</i><0.05). In vitro, the Stat3 knockout group demonstrated better organoid development than the WT group. Metabolomic analyses indicated that Stat3 knockout in T cells may affect the pathways associated with bile acid secretion and unsaturated fatty acids. ALL/Luc cells in the GVL mouse model proliferated rapidly in the TCD-BM group; however, 80% of the mice in the Stat3-KO group survived tumor-free for >100 days (<i>P</i><0.05) . <b>Conclusion:</b> Knocking out Stat3 in graft T cells reduces T cell damage to intestinal stem cells, thereby ultimately alleviating GI-aGVHD while maintaining a stable GVL effect.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 4","pages":"302-313"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162643","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":"[Keeping up with the trends and improving the hierarchical system for the diagnosis and treatment of hemophilia in China].","authors":"R C Yang","doi":"10.3760/cma.j.cn121090-20250108-00017","DOIUrl":"10.3760/cma.j.cn121090-20250108-00017","url":null,"abstract":"<p><p>As a rare disease, hemophilia is the optimal one for hierarchical diagnosis and treatment. Under the guidance and support of National Health Commission of the People's Republic of China and related organization, Hemophilia Treatment Center Collaborative Network of China has explored the establishment of the hierarchical system for the diagnosis and treatment of hemophilia in China, which contributed to the improvement of hemophilia care in China and in the meantime, shared the experience for other diseases and disciplines.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 4","pages":"281-283"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162658","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":"[Chinese expert consensus on screening and clinical application of monoclonal immunoglobulins(2025)].","authors":"","doi":"10.3760/cma.j.cn121090-20250108-00016","DOIUrl":"10.3760/cma.j.cn121090-20250108-00016","url":null,"abstract":"<p><p>Monoclonal immunoglobulins (M proteins) are homogeneous immunoglobulins or their fragments (such as light chains) secreted by clonal B cells or plasma cells. M protein-related diseases are a group of disorders characterized by the presence of M proteins in the blood and/or urine. M protein screening helps in early M protein-related disease detection. To enhance the early detection of M protein-related diseases, domestic hematologists have developed this consensus, which systematically introduces the current screening methods for M proteins and their clinical application scenarios to guide clinical practice.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 4","pages":"289-294"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162553","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}