Contact Lens & Anterior Eye最新文献

{"title":"Does orthokeratology contact lens wear suppress the immune cell response in the human corneal epithelium, while soft contact lens wear enhances it?","authors":"Rabia Mobeen, Fiona Stapleton, Cecilia Chao, Helen Swarbrick, Thomas Naduvilath, Blanka Golebiowski","doi":"10.1016/j.clae.2025.102380","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102380","url":null,"abstract":"<p><strong>Background: </strong>Orthokeratology (OK) contact lenses are increasingly prescribed for myopia control but their impact on corneal epithelial immune cells (CEIC) is unclear. This study compares CEIC in OK wearers to soft contact lens (SCL) wearers and non-wearers.</p><p><strong>Methods: </strong>In vivo confocal microscope images at the corneal central and mid-peripheral subbasal level were evaluated in 18 OK wearers, 18 SCL wearers and 18 non-wearers (mean age 27.6±8.0 years; 65% female). Corneal epithelial immune cell density was manually quantified and morphology was graded using a published system. Statistical significances (p<0.05) were examined using generalised estimating equations.</p><p><strong>Results: </strong>Corneal epithelial immune cell density in OK wearers was lower than in SCL wearers (p=0.03) at the central cornea, but not at the mid-periphery. Compared to SCL wearers, OK wearers had smaller cell bodies, with fewer participants displaying CEIC with dendrites, long and thick dendrites at both corneal locations (p<0.001). Orthokeratology wearers also had smaller CEIC bodies (p=0.01) and fewer participants had CEIC with dendrites (p=0.01) than non-wearers at both locations. Contrarily, SCL wearers had larger CEIC bodies, with a greater proportion of SCL wearers displaying CEIC with dendrites, long and thick dendrites compared to non-wearers (p≤0.04) at both locations. Corneal epithelial immune cell density was higher at the central cornea than at mid-periphery in SCL wearers (p<0.001) and non-wearers (p=0.01), but not in OK wearers (p=0.26).</p><p><strong>Conclusions: </strong>In long-term OK lens wear, immune cells observed in the corneal epithelium are fewer in number and are less likely to present with dendrites, suggesting a suppressed CEIC response in OK lens wear which should be investigated further.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102380"},"PeriodicalIF":4.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068943","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":"Contact lenses for visual rehabilitation in post-keratoplasty eyes: A systematic review.","authors":"Sina Khosravi Mirzaei, Sepehr Feizi, Fatemeh Hatami, Firouze Hatami, Seyed Mohamadmehdi Moshtaghion","doi":"10.1016/j.clae.2025.102374","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102374","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the role of contact lenses (CLs) in visual rehabilitation following keratoplasty.</p><p><strong>Methods: </strong>Four databases, including PubMed, Scopus, Web of Science, and Embase were systematically searched for studies published between January 2010 and July 2023. Visual outcomes, daily wearing duration, subjective comfort, rate and etiology of CL discontinuation, corneal endothelial cell density, central corneal thickness, and complications were extracted.</p><p><strong>Results: </strong>This review included thirteen case series and two chart reviews, analyzing a total of 464 eyes, of which 97% underwent penetrating keratoplasty. Scleral CLs were the most frequently fitted lens (285 eyes, 61%). All studies reported a significant improvement in visual acuity with CL correction. Most post-keratoplasty patients could wear CLs comfortably for 8 to 12 h/day. The rate of CL dropout ranged from 0% to 39%, mainly due to CL intolerance, discomfort, and graft rejection. Corneal graft rejection (18 eyes), conjunctival hyperemia (8 eyes), corneal epithelial trauma (5 eyes), graft edema (4 eyes), and microbial keratitis (3 eyes) were the most frequently reported complications.</p><p><strong>Conclusion: </strong>CLs are effective for improving visual acuity following keratoplasty, with minor complications depending on the type of CL.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102374"},"PeriodicalIF":4.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061231","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":"Interocular astigmatic symmetry: A systematic review.","authors":"Raquel Salvador-Roger, Vicente Micó, José J Esteve-Taboada","doi":"10.1016/j.clae.2025.102377","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102377","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this investigation was to consolidate the extant data pertaining to interocular astigmatic symmetry, with a view to discerning any patterns that may emerge from the research.</p><p><strong>Methods: </strong>A systematic literature review was conducted in accordance with the PICO framework. The search, conducted through September 2024, included three databases (PubMed, Web of Science, and Scopus) and the reference list of the selected articles, which were identified from inception. The articles were selected based on the inclusion criteria of population-based studies with data on interocular astigmatic symmetry.</p><p><strong>Results: </strong>A total of 65 articles were retrieved, of which 13 met the inclusion criteria. The thirteen studies included a total of 329,747 subjects from ten different countries. The prevalence of interocular astigmatic symmetry according to axis orientation was isorule in most of the articles (i.e., both eyes having the same pattern: with-the-rule astigmatism, against-the-rule astigmatism, or oblique astigmatism), except for those pertaining to the geriatric population. Regarding the classification according to axis orientation, mirror symmetry was demonstrated to be the most prevalent pattern in interocular astigmatism. Genetic and individual factors, such as age, sex, and refractive error, did not exhibit a discernible influence on interocular astigmatic symmetry.</p><p><strong>Conclusion: </strong>The findings of this study indicated a clear trend through the isorule pattern and mirror symmetry in a population.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102377"},"PeriodicalIF":4.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014672","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":"Comparison of two-year myopia control efficacy between spectacle lenses with highly aspherical lenslets and orthokeratology lenses.","authors":"Qiming Liu, Yunyun Chen, Yanting Feng, Siang Zhang, Xinjie Mao, Jingjing Xu","doi":"10.1016/j.clae.2025.102376","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102376","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the two-year efficacy of spectacle lenses with highly aspherical lenslets (HAL) and orthokeratology (OK) lenses in managing myopia in children.</p><p><strong>Methods: </strong>This retrospective study examined medical records from the Affiliated Eye Hospital of Wenzhou Medical University, involving 1683 HAL users and 1192 OK users. Participants were children aged 8-13 with a refractive error of -0.50 to -6.00 D. They were divided by age into younger (8-10 years) and older (11-13 years) groups and further divided into low myopia (-0.50 to -3.00 D) and moderate myopia (<-3.00 to -6.00 D) subgroups. The participants were included in either the 1-year or 2-year follow-up group based on the length of their follow-up records. The change in axial length (AL) was compared between the HAL and OK groups using t-tests and multiple linear regression analysis.</p><p><strong>Results: </strong>In the younger group, HALs yielded significantly slower AL elongation than did the OK lenses at both the 1-year (HAL: 0.16 ± 0.19 mm; OK: 0.22 ± 0.17 mm; p < 0.001) and 2-year follow-ups (HAL: 0.32 ± 0.27 mm; OK: 0.37 ± 0.24 mm; p = 0.009). In the older group, the AL changes did not significantly differ by lens at the 1-year (p = 0.782) or 2-year (p = 0.239) follow-up. Among the low myopia subgroup, the HAL users consistently exhibited smaller AL changes than did the OK users across all follow-ups (p < 0.05), except at the 2-year follow-up in the olders (p = 0.414). For the moderate myopia subgroup, the OK lenses yielded significantly slower AL changes at the 2-year follow-up (younger: p = 0.013; older: p = 0.01), although no significant differences were found at the 1-year follow-up (younger: p = 0.635; older: adjusted: p = 0.143).</p><p><strong>Conclusions: </strong>HALs are significantly more effective than OK lenses in controlling AL elongation in younger children with low myopia, while both treatments show similar effectiveness in older children. For moderate myopia, OK lenses are preferred for superior long-term control.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102376"},"PeriodicalIF":4.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014671","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":"Letter to the editor RE “Lid wiper epitheliopathy: Topical review of current identification strategies and future perspectives”","authors":"Marta Vianya-Estopa ,&nbsp;Chris Lievens ,&nbsp;Yvonne Norgett","doi":"10.1016/j.clae.2025.102375","DOIUrl":"10.1016/j.clae.2025.102375","url":null,"abstract":"","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102375"},"PeriodicalIF":4.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980508","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":"Blink completeness and rate in dry eye disease: An investigator-masked, prospective registry-based, cross-sectional, prognostic study.","authors":"Michael T M Wang, Barry Power, Ally L Xue, Jennifer P Craig","doi":"10.1016/j.clae.2025.102369","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102369","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the prognostic ability of blink rate and the proportion of incomplete blinking to predict dry eye disease diagnosis, as defined by the TFOS DEWS II criteria.</p><p><strong>Methods: </strong>A total of 453 community residents (282 females, 171 males; mean ± SD age, 37 ± 19 years) were recruited in an investigator-masked, prospective registry-based, cross-sectional, prognostic study. Dry eye symptomology, tear film quality, and ocular surface characteristics were assessed in a single clinical session, and blink parameters evaluated by an independent masked observer.</p><p><strong>Results: </strong>Overall, 214 (47 %) participants fulfilled the TFOS DEWS II criteria for dry eye disease. Multivariate regression analysis demonstrated that an increased proportion of incomplete blinking was associated with a higher odds of dry eye disease (odds ratio, 1.12 per 10 % increase; 95 % CI, 1.05-1.19; p < 0.001), with the Youden-optimal prognostic threshold proportion being ≥ 40 % incomplete blinking. Higher levels of incomplete blinking were also associated with poorer dry eye symptomology, tear film stability, corneal and lid margin staining, lipid layer thickness, meibography, and meibum quality (all p ≤ 0.03). No significant associations were detected between blink rate and ocular surface parameters (all p > 0.10).</p><p><strong>Conclusions: </strong>The degree of incomplete blinking is a significant predictor of dry eye disease, and the utility of incorporating blink assessment into diagnostic workup algorithms warrants further investigation. The association with meibomian gland dropout, expressed meibum quality, and lipid layer thickness would suggest that incomplete blinking may predispose towards the development of meibomian gland dysfunction.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102369"},"PeriodicalIF":4.1,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972963","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":"Translation and validation of the 8-item contact lens dry eye questionnaire (CLDEQ-8) among Chinese soft contact lens wearers.","authors":"Jiajia Gao, Zhipeng Lai, Yin Hu, Xiao Yang","doi":"10.1016/j.clae.2024.102366","DOIUrl":"https://doi.org/10.1016/j.clae.2024.102366","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a Chinese version of the 8-item Contact Lens Dry Eye Questionnaire (CLDEQ-8) with cross-cultural adaption and clinical validation among soft contact lens wearers (SCL) in China.</p><p><strong>Methods: </strong>The translation and adaptation of the Chinese CLDEQ-8 (C-CLDEQ-8) followed a rigorous methodological process based on cross-cultural research guidelines consisting of three main phases: 1) forward and backward translation of original CLDEQ-8 into Chinese, 2) cross-cultural adaptation performed by medical advising committee, and 3) clinical validation and repeatability test of the translated questionnaire on Chinese SCL wearers. Rasch analysis was also performed to investigate the psychometric properties of C-CLDEQ-8.</p><p><strong>Results: </strong>134 experienced SCL wearers aged 18-45 completed the C-CLDEQ-8. C-CLDEQ-8 score was linearly related to the overall opinion of SCLs (beta = 2.16, p = 0.002), gestalt eye dryness response (beta = 2.90, p < 0.001), and sensitivity response (beta = 1.83, p = 0.001). The questionnaire showed excellent test-retest repeatability with an intra-class correlation coefficient (ICC) of 0.95 and great internal consistency with a Cronbach's alpha of 0.83. The corrected index of homogeneity for each item was more significant than 0.5. In Rasch analysis, the infit and outfit values for eight items were all within 0.6-1.4, suggesting a good fit for the Rasch model. Martin-Löf test result indicated that the Rasch model was unidimensional (p = 1.0). Item characteristics curves suggested combining categories 3-4 and 5-6 in item 5 of C-CLDEQ-8.</p><p><strong>Conclusions: </strong>This study produced a Chinese version of CLDEQ-8 with great validity and reliability and proved capable of evaluating SCL-related symptoms.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102366"},"PeriodicalIF":4.1,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972964","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":"Nanotechnology-based non-invasive strategies in ocular therapeutics: Approaches, limitations to clinical translation, and safety concerns","authors":"Pinal Chaudhari ,&nbsp;Shaila A. Lewis ,&nbsp;Vivek Ghate","doi":"10.1016/j.clae.2025.102367","DOIUrl":"10.1016/j.clae.2025.102367","url":null,"abstract":"<div><div>The eye is a highly sensitive and vital component that significantly affects human quality of life. Diseases that affect the eye are major contributors to visual impairment and blindness and can have a profound effect on an individual’s well-being. Ocular drug delivery is challenging because of physiological and anatomical barriers. Invasive Intravitreal administration is primarily used for the treatment and management of posterior segmental disease. However, frequent intravitreal administration is associated with adverse effects. Furthermore, topical administration results in less than 5% ocular bioavailability, leading to a void in the safe and efficacious management of posterior segment diseases. Nanocarrier-based systems have been well explored as ocular therapeutics to overcome the sub-therapeutic management attributed to conventional eye drops and physiological and anatomical barriers. Since the first report of nanoparticles to date, the nanocarrier system has come a long way with the simplicity and versatility offered by the system. Significant progress has been made in the development of noninvasive nanocarrier systems and their interactions with the ocular surface. The nanocarrier system enhances precorneal retention, limits nontherapeutic absorption, and offers controlled drug release. This review aims to provide an overview of the recent advancements in noninvasive nanocarrier-based topical ocular drug delivery systems, including their interaction with the ocular surface, the barriers to their translation to clinical settings, and the associated scale-up challenges.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 2","pages":"Article 102367"},"PeriodicalIF":4.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967210","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":"Diversity and composition of ocular microbiota in contact lens wearers: Efficacy of liposomal ozonated oil.","authors":"María Carmen Sánchez-González, Inmaculada Gallardo-Real, Estanislao Gutiérrez-Sánchez, Concepción De-Hita-Cantalejo, Raúl Capote-Puente, José-María Sánchez-González","doi":"10.1016/j.clae.2025.102368","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102368","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the ocular surface microbiota in regular contact lens wearers with dry eyes and assess the effectiveness of reducing bacterial load using a liposomal ozonated oil solution.</p><p><strong>Methods: </strong>This prospective, longitudinal, controlled study randomized subjects into two groups. Group A (45 subjects) received hydroxypropylmethylcellulose (HPMC, Artific®), while Group B (41 subjects) received ozonated sunflower seed oil with soybean phospholipids (OSSO, Ozonest®). Microbial communities were analyzed via DNA metabarcoding of the 16S rRNA gene, and statistical analyses (alpha and beta diversity) were performed in R.</p><p><strong>Results: </strong>Both groups predominantly harbored Staphylococcus caprae, Streptococcus oralis, and Corynebacterium spp., with OSSO and HPMC users showing distinct bacterial profiles. Alpha diversity showed no significant differences, but beta diversity revealed differences in bacterial composition between the groups.</p><p><strong>Conclusions: </strong>The results seem to indicate that the use of ozonized oil reduces the bacterial load compared to the solution used as a control.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102368"},"PeriodicalIF":4.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957574","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":"Corneal astigmatism after temporary discontinuation from long-term spherical and toric orthokeratology.","authors":"Bi Yang, Longqian Liu, Pauline Cho","doi":"10.1016/j.clae.2024.102365","DOIUrl":"https://doi.org/10.1016/j.clae.2024.102365","url":null,"abstract":"<p><strong>Objective: </strong>To investigate changes in corneal astigmatism (curvatures and corneal sagittal height difference (C-sagDiff) at 8-mm chord) after temporary discontinuation from long-term spherical and toric orthokeratology (ortho-k) lens wear in a Chinese population.</p><p><strong>Methods: </strong>Relevant data were retrieved from 110 patients (55 wearing spherical ortho-k lenses, 55 wearing toric ortho-k lenses) who have been undergoing ortho-k treatment for at least one year and stopped lens wear temporarily for scheduled lens replacement. The topographic and refraction data at baseline and post-discontinuation was collected for all the patients. Only data from the right eye was used for analysis. Corneal curvature changes and C-sagDiff at 8-mm chord in the two principal meridians within each group and the corneal astigmatism changes between the two groups were analyzed.</p><p><strong>Results: </strong>No significant differences in age, gender, baseline flat K (FK) and steep K (SK), myopia, refractive astigmatism, and duration of lens wear were noted between the two groups (P > 0.05). Baseline corneal astigmatism and C-sagDiff in toric ortho-k group was higher than spherical ortho-k group (P < 0.001). For both ortho-k groups, after treatment discontinuation of about 1-month (30-37 days), FK became flatter, SK remained unchanged, corneal astigmatism and C-sagDiff increased. Changes in corneal astigmatism for spherical and toric groups were 0.24 ± 0.33 and 0.32 ± 0.32 D, respectively. C-sagDiff increased from 22.85 ± 8.41 to 31.37 ± 12.98 μm and from 32.35 ± 12.39 to 45.40 ± 15.01 μm in the spherical and toric ortho-k groups, respectively. No significant between-group difference in corneal astigmatism change was found (P = 0.214). Corneal astigmatism change was affected by wearers' age and duration of ortho-k lens wear. The younger the subject and the longer the duration of ortho-k lens wear, the more significant the corneal astigmatism change after discontinuation of the treatment.</p><p><strong>Conclusion: </strong>After 1-month discontinuation from long-term ortho-k lens wear, corneal flat K became flatter, steep K remained unchanged, the C-sagDiff and the corneal astigmatism increased, irrespective of whether spherical or toric lenses were used. The change of corneal astigmatism was about 0.25D on average, which was not clinically significant. There was no significant difference of corneal and refractive astigmatism change between spherical and toric ortho-k groups.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102365"},"PeriodicalIF":4.1,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928537","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}