Hormones-International Journal of Endocrinology and Metabolism最新文献

{"title":"A novel pathogenic variant of the glucocorticoid receptor gene, causing generalized glucocorticoid resistance: a case report and review of the literature.","authors":"Özge Güngör, Sena Yeral, Büşra Özcan, Duygu Arıcan, Ilgın Yıldırım Şimşir, Haluk Akın, Ayça Aykut, Asude Durmaz","doi":"10.1007/s42000-025-00659-x","DOIUrl":"10.1007/s42000-025-00659-x","url":null,"abstract":"<p><strong>Purpose: </strong>Generalized glucocorticoid resistance (GGCR) is caused by variants in the NR3C1 gene, which encodes the human glucocorticoid receptor (hGR). To date, 39 pathogenic variants of NR3C1 have been reported, primarily in the ligand-binding domain (LBD). This study presents a novel case of the NR3C1 variant located in the N-terminal domain (NTD) of hGR, highlighting its clinical and molecular significance in glucocorticoid resistance.</p><p><strong>Case presentation: </strong>The patient was a 21-year-old woman presenting with chronic fatigue, irregular menstrual cycles, and osteopenia, though without any clinical signs of Cushing's syndrome. She underwent a standard evaluation of the hypothalamic-pituitary-adrenal (HPA) axis. Endocrinological tests revealed elevated levels of ACTH, morning serum cortisol, aldosterone, DHEAS, 11-deoxycortisol, pregnenolone, and corticosterone, as well as increased urinary-free cortisol excretion. The low-dose dexamethasone suppression test (LDDST) showed suppression of cortisol levels. Molecular analysis via Whole Exome Sequencing (WES) identified a novel heterozygous pathogenic variant, c.220 C > T (p.Gln74Ter), in the NR3C1 gene. This confirmed the diagnosis of glucocorticoid resistance syndrome.</p><p><strong>Conclusion: </strong>This case contributes to expanding the mutational spectrum of NR3C1 in glucocorticoid resistance syndrome, supporting more accurate diagnosis and genetic counseling for affected individuals.</p>","PeriodicalId":50399,"journal":{"name":"Hormones-International Journal of Endocrinology and Metabolism","volume":" ","pages":"835-841"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune checkpoint inhibitor-related diabetes mellitus associated with high signal intensity in diffusion-weighted magnetic resonance imaging of the pancreas at an early clinical stage.","authors":"Masaki Suzuki, Yushi Hirota, Shin Urai, Masaaki Yamamoto, Keitaro Sofue, Wataru Ogawa","doi":"10.1007/s42000-025-00629-3","DOIUrl":"10.1007/s42000-025-00629-3","url":null,"abstract":"<p><strong>Introduction: </strong>Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment but can give rise to immune-related adverse events such as ICI-related diabetes mellitus (DM).</p><p><strong>Case presentation: </strong>We herein present the case of a 59-year-old Japanese man with malignant melanoma who developed ICI-related DM after 18 months of nivolumab treatment. He experienced marked hyperglycemia and diabetic ketoacidosis without a personal or family history of diabetes. Laboratory findings revealed initial preservation of insulin secretion but a rapid decline in C-peptide levels in the absence of islet autoantibodies. He was therefore diagnosed with ICI-related DM. This case fulfilled the criteria for fulminant type 1 DM but lacked the typical human leukocyte antigen alleles associated with conventional type 1 diabetes. No metastasis or morphological changes were apparent on CT scans of the pancreas, and magnetic resonance cholangiopancreatography did not show dilation or interruption of the main pancreatic duct. However, diffusion-weighted magnetic resonance imaging revealed high signal intensity with low apparent diffusion coefficient values in the pancreas, likely indicative of fibrosis or infiltration of inflammatory cells.</p><p><strong>Discussion: </strong>This case underscores that ICI-related DM should be considered a potential immune-related adverse event as well as pointing to the benefit of diffusion-weighted imaging for assessment of pancreatic involvement at an early stage of the disease.</p>","PeriodicalId":50399,"journal":{"name":"Hormones-International Journal of Endocrinology and Metabolism","volume":" ","pages":"569-574"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic evidence links hyperthyroidism to knee osteoarthritis.","authors":"Tianli Xu, Limin Shen, Xiaojun Cao, Jincheng Song, Mengjie Tang, Chaoyan Yue","doi":"10.1007/s42000-025-00648-0","DOIUrl":"10.1007/s42000-025-00648-0","url":null,"abstract":"<p><strong>Purpose: </strong>The causal relationship between hyperthyroidism and knee osteoarthritis (KOA) remains to date unknown. We aimed to examine the potential causal relationship between hyperthyroidism status and the risk of developing KOA via a bidirectional two-sample Mendelian randomization (MR) approach.</p><p><strong>Methods: </strong>Single-nucleotide polymorphism (SNP) data related to hyperthyroidism and KOA were obtained from a genome-wide association study (GWAS) in Europe. KOA was used as the outcome variable and hyperthyroidism was used as the exposure factor. The inverse-variance weighted (IVW) method served as the primary analytic tool and heterogeneity and pleiotropy were evaluated via sensitivity analysis.</p><p><strong>Results: </strong>The IVW method indicated that hyperthyroidism status has a causative influence on the risk of developing KOA [OR, 1.046; 95% confidence interval (CI), 1.013-1.080; P = 0.006]. No significant reverse causality was detected. Sensitivity analyses validated the robustness of these findings.</p><p><strong>Conclusions: </strong>Hyperthyroidism status can causally increase the risk of developing KOA. This result indicated that the risk of developing KOA may be decreased by controlling hyperthyroidism.</p>","PeriodicalId":50399,"journal":{"name":"Hormones-International Journal of Endocrinology and Metabolism","volume":" ","pages":"359-365"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1RAs in patients with psoriasis.","authors":"Ioanna A Paschou, Evangelia Sali, Stavroula A Paschou, Theodora Psaltopoulou, Electra Nicolaidou, Alexander J Stratigos","doi":"10.1007/s42000-025-00635-5","DOIUrl":"10.1007/s42000-025-00635-5","url":null,"abstract":"","PeriodicalId":50399,"journal":{"name":"Hormones-International Journal of Endocrinology and Metabolism","volume":" ","pages":"291-293"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hereditary disorders of vitamin-D metabolism and its receptor.","authors":"Vasileios Lainis, Olga Katsouli, Sοusana Gazi, Evanthia Kassi, Efstathios Chronopoulos, Symeon Tournis","doi":"10.1007/s42000-025-00630-w","DOIUrl":"10.1007/s42000-025-00630-w","url":null,"abstract":"<p><strong>Purpose: </strong>Hereditary disorders of vitamin D metabolism are rare diseases. This review summarizes the current knowledge in this field and highlights the complicated metabolism of vitamin D.</p><p><strong>Methods: </strong>PubMed and Google Scholar databases were searched in English. The keywords rickets, VDDR, vitamin D, metabolism, hypercalcemia, CYP2R1, CYP3A4, CYP24A1, and receptor were used and original and review articles were retrieved.</p><p><strong>Results: </strong>Vitamin D is produced in the skin following the action of ultraviolet light on 7-dehydrocholesterol or is taken up by food. The active form of the hormone 1,25(OH)₂D is produced after two-step hydroxylations. The first hydroxylation takes place in the liver, in which 25(OH)D is produced by the enzyme CYP2R1. The second hydroxylation occurs in the kidneys where 1,25(OH)₂D is produced by CYP27B1. Mutations in the genes encoding these enzymes can lead to vitamin D-dependent rickets type 1B (VDDR1B) and VDDR1A, respectively. CYP24A1 is the main catabolic enzyme of vitamin D. Loss-of-function mutations of the CYP24A1 gene can lead to idiopathic infantile hypercalcemia (IIH). Moreover, loss-of-function mutations of the vitamin D receptor (VDR) gene can cause VDDR2. Recently, gain-of-function mutations of the CYP3A4 gene have been found to be responsible for a distinct form of rickets, VDDR 3, characterized by accelerated clearance of 1,25(OH)₂D.</p><p><strong>Conclusions: </strong>Based on the evidence in the current literature, this article thoroughly reviews the metabolism of vitamin D, clinical symptoms, imaging findings, and available treatments for the different types of hereditary disorders related to vitamin D metabolism and action.</p>","PeriodicalId":50399,"journal":{"name":"Hormones-International Journal of Endocrinology and Metabolism","volume":" ","pages":"335-346"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the essentials of the recent guidelines for managing patients with metabolic dysfunction-associated steatotic liver disease.","authors":"Dimitrios S Karagiannakis, Katerina Stefanaki, Stavroula A Paschou, Margarita Papatheodoridi, Sotirios Tsiodras, Nikolaos Papanas","doi":"10.1007/s42000-024-00625-z","DOIUrl":"10.1007/s42000-024-00625-z","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of end-stage liver disease and liver transplantation in the Western world, with an approximate prevalence of 30% worldwide which is continuously rising. It is characterized by intrahepatic fat deposition along with at least one cardiometabolic risk factor, such as diabetes mellitus, obesity, hypertriglyceridemia, and hypertension. MASLD consists of a spectrum of liver diseases ranging from simple liver steatosis to steatohepatitis, liver fibrosis, and cirrhosis. Recently, the European Association for the Study of the Liver (EASL), the European Association for the Study of Diabetes (EASD), and the European Association for the Study of Obesity (EASO) released the latest guidelines regarding the management of patients with MASLD. This article highlights the critical points of these guidelines and emphasizes problematic issues that need further evaluation.</p>","PeriodicalId":50399,"journal":{"name":"Hormones-International Journal of Endocrinology and Metabolism","volume":" ","pages":"487-494"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in diabetes management: transformative potential, challenges, and opportunities in healthcare.","authors":"Arnabjyoti Deva Sarma, Moitrayee Devi","doi":"10.1007/s42000-025-00644-4","DOIUrl":"10.1007/s42000-025-00644-4","url":null,"abstract":"<p><strong>Background: </strong>Diabetes, a chronic metabolic disorder characterized by ineffective blood sugar regulation, affects millions of people worldwide, with its prevalence projected to more than double in the next 30 years. Diabetes-related complications are severe and sometimes life-threatening, including cardiovascular disease, kidney failure, and blindness, this posing a significant challenge, especially in low- and middle-income countries. This study explored the integration of artificial intelligence (AI) into diabetes management, emphasizing its transformative potential in healthcare.</p><p><strong>Objectives: </strong>To evaluate the role of AI in enhancing diabetes management and to identify the challenges and opportunities associated with its implementation.</p><p><strong>Methods: </strong>A systematic review following the PRISMA guidelines was conducted by analyzing the literature published from January 2020 to May 2024. This review focused on the application of AI in diabetes diagnosis, personalization of treatment, and predictive analytics.</p><p><strong>Results: </strong>The ability of AI to analyze large datasets and identify complex patterns shows promise in improving diabetes management. AI-assisted diagnostic tools enhance diagnostic accuracy, enable early detection, and support personalized treatment plans, thereby reducing human error. AI has also facilitated research breakthroughs in genomics and drug discovery. Furthermore, AI-powered predictive analytics enhances clinical decision-making and supports precision medicine. Despite these advancements, challenges remain in such issues as data quality, technical infrastructure, and ethical considerations, emphasizing the need for responsible AI development that focuses on patient privacy and transparency.</p><p><strong>Conclusions: </strong>AI has significant potential to revolutionize diabetes management and healthcare delivery. Combining AI's analytical processes with clinical expertise can substantially improve the quality of care. Addressing data, technology, and ethical challenges is crucial for fully harnessing AI's potential, thereby enhancing patient well-being and healthcare outcomes.</p>","PeriodicalId":50399,"journal":{"name":"Hormones-International Journal of Endocrinology and Metabolism","volume":" ","pages":"307-322"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a new diagnostic prediction model for NAFLD based on machine learning algorithms in NHANES 2017-2020.3.","authors":"Yazhi Wang, Peng Wang","doi":"10.1007/s42000-025-00634-6","DOIUrl":"10.1007/s42000-025-00634-6","url":null,"abstract":"<p><strong>Aims: </strong>Nonalcoholic fatty liver disease (NAFLD) is a multisystem disease that can trigger the metabolic syndrome. Early prevention and treatment of NAFLD is still a huge challenge for patients and clinicians. The aim of this study was to develop and validate machine learning (ML)-based predictive models. The model with optimal performance would be developed as a set of simple arithmetic tools for predicting the risk of NAFLD individually.</p><p><strong>Methods: </strong>Statistical analyses were performed in 2428 individuals extracted from the National Health and Nutrition Examination Survey (NHANES, cycle 2017-2020.3) database. Feature variables were selected by the least absolute shrinkage and selection operator (LASSO) regression. Seven ML algorithms, including logistic regression (LR), decision tree (DT), random forest (RF), extreme gradient boosting (XGB), K-nearest neighbor (KNN), light gradient boosting machine (LightGBM), and multilayer perceptron (MLP), were used to construct models based on the feature variables and evaluate their performance. The model with the best performance was transformed into a diagnostic predictive nomogram (DPN). The DPN was developed into an online calculator and an Excel algorithm tool. Receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and subgroup analyses were used to compare and assess the predictive abilities of the DPN and six existing NAFLD predictive models, including the ZJU index, the hepatic steatosis index (HSI), the triglyceride-glucose index (TyG), the Framingham steatosis index (FSI), the fatty liver index (FLI), and the visceral adiposity index (VAI).</p><p><strong>Results: </strong>Among the 2428 participants, the prevalence of NAFLD was 47.45%. LASSO regression identified eight variables from 39 variables, including body mass index (BMI), waist circumference (WC), alanine aminotransferase (ALT), triglyceride (TG), diabetes, hypertension, uric acid (UA), and race. Among the models constructed by the seven algorithms mentioned above, the LR-based model performed the best, demonstrating outstanding performance in terms of area under the curve (AUC, 0.823), accuracy (0.754), precision (0.768), specificity (0.804), and positive predictive value (0.768). It was then transformed into the DPN, which was successfully developed as an online calculator and an Excel algorithm tool. The diagnostic accuracy (AUC 0.856, 95% confidence interval (CI) 0.839-0.874, and AUC 0.823, 95% CI 0.793-0.854, respectively) and net clinical benefit of DPN in the training and validation sets were superior to those of the ZJU, HSI, TyG, FSI, FLI, and VAI. The results were maintained in subgroup analyses.</p><p><strong>Conclusions: </strong>The LR model based on ML was developed, exhibiting good performance. DPN can be used as an individualized tool for rapid detection of NAFLD.</p>","PeriodicalId":50399,"journal":{"name":"Hormones-International Journal of Endocrinology and Metabolism","volume":" ","pages":"461-476"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of aqueous extract from Cyathula prostrata (Linn.) Blume (Amaranthaceae) on puberty onset and some reproductive parameters in immature female Wistar rats.","authors":"Landry Lienou Lienou, Marie Stephanie Chekem Goka, Richard Tagne Simo, Fabrice Fabien Dongmo Dongho, Rosalie Annie Ngane Ngono, Ana Paula Ribeiro Rodrigues, Phélix Bruno Telefo","doi":"10.1007/s42000-025-00633-7","DOIUrl":"10.1007/s42000-025-00633-7","url":null,"abstract":"<p><strong>Purpose: </strong>Cyathula prostrata (C. prostrata) a medicinal plant from tropical Africa, is traditionally used in Western Cameroon to treat female infertility. This study investigated the hormone-like effects of the aqueous extract of C. prostrata (AECp) leaves and stems on the onset of puberty and various reproductive parameters in immature female Wistar rats.</p><p><strong>Methods: </strong>Five groups of immature female rats received daily oral doses of AECp for 20 consecutive days. Post-treatment body, ovarian, and uterine weights were recorded, along with uterine and ovarian protein levels, ovarian cholesterol levels, and blood hormone concentrations (FSH, LH, estradiol, and progesterone).</p><p><strong>Results: </strong>AECp increased the growth rate in all treated animals. It reduced the age at vaginal opening by 2 to 6 days compared to controls. Secondary and tertiary follicles increased by 32.7% and 37.7%, respectively, in AECp-treated rats (96 mg/kg and 64 mg/kg). AECp significantly reduced uterine and ovarian protein levels by 21.3% and 27.8% at 64 mg/kg dosage. Regardless of dose, AECp lowered ovarian cholesterol and serum FSH levels (p < 0.001). Serum progesterone, estradiol, and LH levels increased significantly at 64 mg/kg compared to controls.</p><p><strong>Conclusion: </strong>This study demonstrates AECp's positive effects on the onset of puberty and ovarian folliculogenesis in immature female rats.</p>","PeriodicalId":50399,"journal":{"name":"Hormones-International Journal of Endocrinology and Metabolism","volume":" ","pages":"507-516"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The deleterious effect of bisphenol S on early embryo development of mice.","authors":"Christina Mantzouki, Despoina Mavrogianni, Maria Papagianni, George Konomos, George Creatsas, Peter Drakakis, George Mastorakos","doi":"10.1007/s42000-025-00638-2","DOIUrl":"10.1007/s42000-025-00638-2","url":null,"abstract":"<p><strong>Purpose: </strong>Increasing levels of infertility in Western countries has drawn ever more scientific attention to the role in this trend of endocrine disruptors, such as bisphenol A, a substance now banned in some cases and some countries. Because this substance has been replaced by the structurally similar bisphenol S (BPS), this study focused on the effects of the latter on early mice embryo development.</p><p><strong>Methods: </strong>Cultures of CD1 mice embryos with varying concentrations of BPS were compared with control blank cultures in order to examine the survival rate of embryos according to BPS concentration and culture day.</p><p><strong>Results: </strong>The administration of BPS at any dose (1, 10, and 100 pg/ml) in cultures of mice embryos led to a significant decrease in their survival rate. The negative effect of BPS was seen to start early (day 1 of experiment), even with the lowest employed dose (1 pg/ml).</p><p><strong>Conclusions: </strong>This is, to the best of our knowledge, the first study to investigate the impact of BPS on the survival rate of mice embryos. In this study, potential adverse effects of BPS on early CD1 mice embryo development with regard to survival rate have been identified. Dose of BPS, timing of BPS administration, and time duration of exposure play a critical role in the decrease of mice embryo survival rate as compared to control cultures. These findings raise concerns regarding the safety of BPS and highlight the need for further research into the effect of this substance on human embryos.</p>","PeriodicalId":50399,"journal":{"name":"Hormones-International Journal of Endocrinology and Metabolism","volume":" ","pages":"533-542"},"PeriodicalIF":2.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}