Journal of Rheumatology最新文献

{"title":"Scleritis in Systemic Sclerosis Treated With Infliximab Biosimilar.","authors":"Huda Alfaris, Marissa Sit, Sindhu R Johnson","doi":"10.3899/jrheum.2024-0496","DOIUrl":"10.3899/jrheum.2024-0496","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1148-1149"},"PeriodicalIF":3.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anifrolumab in Refractory Systemic Lupus Erythematosus: A Real-World, Multicenter Study.","authors":"Chiara Tani, Chiara Cardelli, Margherita Zen, Luca Moroni, Matteo Piga, Fulvia Ceccarelli, Serena Fasano, Ginevra De Marchi, Laura Coladonato, Giacomo Emmi, Mariele Gatto, Francesca Trentin, Giuseppe A Ramirez, Elisabetta Chessa, Gabriele Gallina, Licia Picciariello, Martina Patrone, Maria L Urban, Edoardo Biancalana, Luca Quartuccio, Francesco Ciccia, Fabrizio Conti, Alberto Cauli, Lorenzo Dagna, Andrea Doria, Marta Mosca","doi":"10.3899/jrheum.2024-0053","DOIUrl":"10.3899/jrheum.2024-0053","url":null,"abstract":"<p><strong>Objective: </strong>To report real-world experience on the use of anifrolumab (ANI) in refractory systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>The present study is a multicenter, retrospective study involving 9 Italian SLE referral centers participating in a compassionate use program for the use of ANI in adult patients with active SLE in whom all the available treatment choices failed, were not tolerated, or were contraindicated. At baseline and 1, 3, 6, 9, and 12 months of treatment, overall and organ-specific disease activity, flares, daily glucocorticoid (GC) dose, and adverse events were recorded.</p><p><strong>Results: </strong>A total of 26 patients were enrolled. At 4 weeks after starting ANI, a significant decrease in the Systemic Lupus Erythematosus Disease Activity Index 2000 (<i>P</i> = 0.01), Systemic Lupus Erythematosus-Disease Activity Score (<i>P</i> = 0.01), and physician global assessment (<i>P</i> = 0.001) was recorded, and the same trend was maintained over time. A significant reduction in Cutaneous Lupus Erythematosus Disease Area and Severity Index-activity (<i>P</i> < 0.001) and in tender (<i>P</i> = 0.03) and swollen (<i>P</i> = 0.02) joint counts was also recorded. At 3 months of follow-up, 33% of patients already achieved a remission state, whereas 46% were in Lupus Low Disease Activity State (LLDAS); at 6 months, 50% were in remission and 80% were in LLDAS. A significant reduction in the mean GC daily dose was observed, starting from week 4 (<i>P</i> = 0.04). A total of 4 disease flares according to the Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index were recorded (3 mild-moderate and 1 severe). Overall, 4/20 patients with at least 24 weeks of follow-up (20%) were considered nonresponders.</p><p><strong>Conclusion: </strong>This study provides real-world experience on the use of ANI in patients with refractory SLE, confirming its rapid effectiveness and an overall acceptable safety profile.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1096-1101"},"PeriodicalIF":3.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scleroderma Renal Crisis: Clues From the Physical Exam.","authors":"Aakash V Patel, Alex M Tinianow, Phillip V Petrasko, John H Stone","doi":"10.3899/jrheum.2024-0173","DOIUrl":"10.3899/jrheum.2024-0173","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1142-1143"},"PeriodicalIF":3.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Absence of Glucocorticoids Concomitant With Avacopan and Subsequent Liver Injury in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis.","authors":"Tomohisa Uchida, Shoichi Fukui, Naoki Iwamoto, Ayaka Umetsu, Momoko Okamoto, Keita Fujikawa, Akinari Mizokami, Takuya Tomokawa, Kazusato Hara, Yoshiro Horai, Atsushi Kawakami","doi":"10.3899/jrheum.2024-0340","DOIUrl":"10.3899/jrheum.2024-0340","url":null,"abstract":"","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1146-1148"},"PeriodicalIF":3.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Pneumocystis jirovecii Pneumonia and Prophylaxis-Associated Adverse Events Among Patients with Systemic Lupus Erythematosus.","authors":"Yiran Jiang, Alí Duarte-García, Michael Putman, David Gazeley","doi":"10.3899/jrheum.2023-1038","DOIUrl":"https://doi.org/10.3899/jrheum.2023-1038","url":null,"abstract":"<p><strong>Objective: </strong>Pneumocystis jirovecii Pneumonia (PJP) is an opportunistic infection that may affect patients with systemic lupus erythematosus (SLE). The objective of this project was to describe the incidence of PJP among patients with SLE.</p><p><strong>Methods: </strong>A retrospective cohort analysis of the TriNetX database. Included patients had ≥2 ICD9- CM/ICD10-CM codes for SLE separated by at least 30 days and were new users of mycophenolate mofetil or cyclophosphamide. The incidence of PJP over the first six months of therapy was calculated; adverse events were assessed using incident rate ratios (IRR) and Cox proportional hazards regressions.</p><p><strong>Results: </strong>A total of 6,017 patients with SLE were identified. Most were female (5,176, 86%) and Black or African American (2,138, 35.5%). Induction medications included mycophenolate mofetil (5,208, 86.6%), cyclophosphamide (505, 8.4%), or both (304, 5.1%); the most common PJP prophylaxis was trimethoprim/sulfamethoxazole (1,126, 18.7%). Five PJP cases were identified over 2,752 person years, one of whom received PJP prophylaxis, for an incidence rate of 1.8 cases per 1000 person years. In adjusted analysis, patients who received prophylaxis had a higher risk of neutropenia (hazard ratio (HR) 2.5, CI 1.4-4.4), leukopenia (HR 1.9, CI 1.3-2.8), nephropathy (HR 1.7, CI 1.4-2.1), and hyperkalemia (HR 1.4, CI 0.9-2.0).</p><p><strong>Conclusion: </strong>PJP rarely affects patients with SLE undergoing therapy with mycophenolate mofetil or cyclophosphamide; prophylaxis against PJP is associated with adverse events. The majority of patients with SLE and PJP had structural lung disease. These data do not support universal prescribing of PJP prophylaxis for patients with SLE without lung disease.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Lived Experiences of Older Adults with Systemic Lupus Erythematosus: Patient Perspectives.","authors":"Sarah B Lieber, Sarah R Young, Yvonne Shea, Sarah P Gottesman, Robyn Lipschultz, Dongmei Sun, M Carrington Reid, Lisa A Mandl, Iris Navarro-Millán","doi":"10.3899/jrheum.2024-0478","DOIUrl":"10.3899/jrheum.2024-0478","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about perceptions of aging among individuals living with systemic lupus erythematosus (SLE). Gaining this knowledge could help to identify targets for future behavioral interventions aimed at successful aging with SLE. This qualitative study sought to elicit the lived experiences, and essence, of aging from older adults with SLE.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with adults ≥65 years of age with SLE seen at a single tertiary center. Qualitative data were analyzed thematically using a phenomenological approach. We collected data on sociodemographic characteristics and disease features prior to each qualitative interview.</p><p><strong>Results: </strong>Among 30 participants with mean age of 71.3 years and mean SLE duration of 26.3 years (range 5 to 62 years), four overarching themes emerged to describe the essence of aging with SLE: SLE and comorbid conditions, cumulative impact of SLE symptoms, SLE disease trajectory, and self-perceptions of aging. Older adults with SLE shared variable aging experiences, including perspectives on multimorbidity and disease trajectory and self-perceptions of aging.</p><p><strong>Conclusion: </strong>We identified both positive and negative self-perceptions of aging, often informed by participants' lived experiences of cumulative impact of SLE symptoms and SLE disease trajectory and underscoring the diversity of their experiences. Understanding self-perceptions of aging in this population could inform development of evidence-based strategies to empower older adults with SLE to harness their positivity and resilience and thus improve health-related outcomes, including health-related quality of life.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interstitial Lung Disease in Patients With Rheumatoid Arthritis or Psoriatic Arthritis Initiating Biologics and Controls: Data From 5 Nordic Registries.","authors":"Sella Aarrestad Provan, Lotta Ljung, Eirik Klami Kristianslund, Brigitte Michelsen, Till Uhlig, Thorarinn Jonmundsson, Joe Sexton, Bjorn Gudbjornsson, Daniela Di Giuseppe, Merete Lund Hetland, Gudrun Bjork Reynisdottir, Bente Glintborg, Heikki Relas, Kalle Aaltonen, Tore Kristian Kvien, Johan Askling","doi":"10.3899/jrheum.2024-0252","DOIUrl":"10.3899/jrheum.2024-0252","url":null,"abstract":"<p><strong>Objective: </strong>Interstitial lung disease (ILD) is one of the most common pulmonary manifestations of rheumatoid arthritis (RA), but its prevalence has not been investigated in psoriatic arthritis (PsA). The role of methotrexate (MTX) in ILD development remains under debate. This study (1) compares the incidences of ILD in patients with RA or PsA initiating a first biologic disease-modifying antirheumatic drug (bDMARD) to that in the general population, and (2) investigates the role of MTX comedication on ILD incidence.</p><p><strong>Methods: </strong>Patients were identified in 5 rheumatology registries. Demographics, MTX use, and disease activity were retrieved. Matched subjects from the general population were available from 4 countries. Incidence of ILD during follow-up of up to 5 years was assessed through national patient registries. Subjects with prior ILD were excluded. Adjusted hazard ratios (HRs) were calculated for ILD incidence in patients vs the general population, and for MTX users vs nonusers.</p><p><strong>Results: </strong>During follow-up of 29,478 patients with RA and 10,919 patients with PsA initiating a first bDMARD and 362,087 population subjects, 225, 23, and 251 cases of ILD were identified, respectively. HRs for ILD (vs population subjects) were 9.7 (95% CI 7.97-11.91) in RA and 4.4 (95% CI 2.83-6.97) in PsA. HRs for ILD with MTX comedication (vs nonuse) were 1.0 (95% CI 0.72-1.25) in RA and 0.9 (95% CI 0.38-2.05) in PsA.</p><p><strong>Conclusion: </strong>Among patients with RA and PsA initiating a bDMARD, the risk of ILD was higher than in the general population, and was highest in RA. MTX comedication was not a risk determinant for ILD.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1111-1118"},"PeriodicalIF":3.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Gout Remission Definitions in a Randomized Controlled Trial of Colchicine Prophylaxis for People With Gout Initiating Allopurinol.","authors":"Adwoa Dansoa Tabi-Amponsah, Lisa K Stamp, Anne Horne, Jill Drake, Sarah Stewart, Greg Gamble, Keith J Petrie, Nicola Dalbeth","doi":"10.3899/jrheum.2024-0400","DOIUrl":"10.3899/jrheum.2024-0400","url":null,"abstract":"<p><strong>Objective: </strong>To investigate (1) the effect of colchicine prophylaxis on gout remission when commencing urate-lowering therapy (ULT), and (2) illness perceptions of people in remission using 2 definitions of gout remission.</p><p><strong>Methods: </strong>Data from a 12-month double-blind placebo-controlled trial of 200 people with gout commencing allopurinol were analyzed. Participants were randomly assigned to prophylaxis with 0.5 mg daily colchicine or placebo for 6 months, followed by 6 months of additional follow-up. Gout remission was assessed using the 2016 preliminary definition or simplified definition without patient-reported outcomes. Illness perceptions were assessed using a gout-specific version of the Brief Illness Perception Questionnaire.</p><p><strong>Results: </strong>In the first 6 months, few participants were in remission according to either the 2016 preliminary definition (3% for colchicine and 4% for placebo) or the simplified definition (7% for colchicine and 12% for placebo). In the second 6 months, after study drug (colchicine or placebo) discontinuation, fewer participants in the colchicine group than in the placebo group were in remission according to the 2016 preliminary definition (4% vs 14%, <i>P</i> = 0.03), and the simplified definition (14% vs 28%, <i>P</i> = 0.02). Participants fulfilling remission using either definition had more favorable perceptions about their gout symptoms and illness concerns, as well as consequences, when using the simplified definition.</p><p><strong>Conclusion: </strong>Using either definition, 6 months of colchicine prophylaxis when initiating ULT does not provide an advantage in the fulfillment of gout remission. People fulfilling either definition report fewer symptoms, less concern about their gout, and, when using the simplified definition, are less affected by gout.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1135-1140"},"PeriodicalIF":3.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous Golimumab in Children With Polyarticular-Course Juvenile Idiopathic Arthritis: Long-Term Extension of an Open-Label Phase III Study.","authors":"Hermine I Brunner, César Pacheco-Tena, Ingrid Louw, Gabriel Vega-Cornejo, Ekaterina Alexeeva, Simone Appenzeller, Vyacheslav Chasnyk, Thomas Griffin, Carmen Navarrete Suarez, Sheila Knupp-Oliveira, Andrew Zeft, Yonatan Butbul Aviel, Deirdre De Ranieri, Beth S Gottlieb, Deborah M Levy, C Egla Rabinovich, Clóvis Artur Silva, Yury Spivakovsky, Yosef Uziel, Sarah Ringold, Xie L Xu, Jocelyn H Leu, Edwin Lam, Yuhua Wang, Daniel J Lovell, Alberto Martini, Nicolino Ruperto","doi":"10.3899/jrheum.2024-0298","DOIUrl":"10.3899/jrheum.2024-0298","url":null,"abstract":"<p><strong>Objective: </strong>To report pharmacokinetics (PK), immunogenicity, clinical effect, and safety of intravenous (IV) golimumab in children with active polyarticular-course juvenile idiopathic arthritis (pcJIA) who participated in A Study to Evaluate the Pharmacokinetics, Efficacy and Safety of Intravenous Golimumab in Pediatric Participants With Active Polyarticular Course Juvenile Idiopathic Arthritis Despite Methotrexate Therapy (GO-VIVA)'s open-label, long-term extension (LTE) through week 252.</p><p><strong>Methods: </strong>GO-VIVA participants who continued IV golimumab (80 mg/m² every 8 weeks) after week 52 were included. PK and safety were assessed through week 244 (last dose) and week 252, respectively, and clinical response through week 116. Clinical outcomes included JIA-American College of Rheumatology (ACR) responses and clinical Juvenile Arthritis Disease Activity Score in 10 joints (cJADAS10). Binary outcomes used nonresponder imputation, and other descriptive analyses used observed data.</p><p><strong>Results: </strong>Of 112/127 (88.2%) participants entering the LTE, 69 completed the week 252 visit. Median steady-state trough golimumab concentrations were generally maintained from week 52 through week 244 (range 0.3-0.6 μg/mL). Antigolimumab antibody rates were consistent through week 52 (39.2% [49/125]) and week 244 (44.8% [56/125]). Week 52 JIA-ACR 30/50/70/90 response rates (75.6% [96/127], 74% [94/127], 65.4% [83/127], and 48.8% [62/127], respectively) were generally maintained through week 116 (72.4% [92/127], 71.7% [91/127], 63.8% [81/127], and 50.4% [64/127], respectively), when the median cJADAS10 was 1.6 and 56.7% (72/127) of participants achieved cJADAS10 ≤ 5 (minimal disease activity). Rates (per 100 patient-years) of serious adverse events and serious infections through week 252 were 7.7 and 3.9, respectively.</p><p><strong>Conclusion: </strong>GO-VIVA LTE participants experienced adequate PK exposure and stable safety and immunogenicity. The majority of participants experienced no more than minimal residual disease activity. Data suggest IV golimumab treatment provided durable clinical response through week 116, with an acceptable risk-benefit profile.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":"1125-1134"},"PeriodicalIF":3.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obese Patients With Polymyalgia Rheumatica Experience More Pain And Disability At Disease Onset And Require Higher Doses Of Glucocorticoids.","authors":"Marco A Cimmino, Cynthia S Crowson, Bhaskar Dasgupta, Michael Schirmer, Christian Dejaco, Carlo Salvarani, Eric L Matteson, Dario Camellino","doi":"10.3899/jrheum.2024-0353","DOIUrl":"https://doi.org/10.3899/jrheum.2024-0353","url":null,"abstract":"<p><strong>Objective: </strong>polymyalgia rheumatica (PMR) is an inflammatory disorder of the elderly characterized by girdle pain and stiffness. Obesity has an influence on disease activity and outcome in rheumatic diseases like osteoarthritis and rheumatoid arthritis, but its relationship to the severity and outcome of PMR is unknown.</p><p><strong>Methods: </strong>In a post-hoc analysis, 83 patients with recent-onset PMR were studied over six months with clinical examination, laboratory evaluation, and girdle ultrasound. MHAQ, Short Form 36 (SF36), and PMR-VAS, as well as prednisone (PDN) therapy were recorded. Patients were divided according to their body mass index (BMI).</p><p><strong>Results: </strong>at baseline, the 12 obese patients had significantly more shoulder pain (p=0.03), global pain (p=0.03), PMR VAS (p<0.01), and fatigue (p=0.03), higher MHAQ (p=0.01), and lower physical component summary on SF36 (p=0.048), SF36 social functioning index (p=0.05) and SF36 pain index (p<0.001). The mean initial PDN dose was similar among groups, but obese patients received a lower dose per kg weight (1.9±0.7 mg vs. 2.2±0.7 mg; p<0.01). At six months, obese patients were being treated with higher mean daily PDN doses (8.5±3.2 mg/day vs. 6.2±5.2 mg/day, p=0.02); 40% of them were receiving higher daily PDN dose than per-protocol, vs. 14% non-obese patients (p=0.048). Clinical features, laboratory and ultrasound results were similar.</p><p><strong>Conclusion: </strong>obesity affects both symptoms severity and PDN utilization in patients with PMR. The reason thereof may relate to different subjective pain perception rather than increased inflammation in obese patients. BMI should be considered when interpreting symptoms in PMR patients and deciding their PDN doses.</p>","PeriodicalId":50064,"journal":{"name":"Journal of Rheumatology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}