Nutrition and Cancer-An International Journal最新文献

{"title":"Impact of the Combination of Anamorelin and Rehabilitation on Functional and Nutritional Outcomes in Patients with Cancer Cachexia.","authors":"Makoto Hasegawa, Yohei Sanmoto, Koji Kono","doi":"10.1080/01635581.2024.2397060","DOIUrl":"https://doi.org/10.1080/01635581.2024.2397060","url":null,"abstract":"<p><p>Cancer cachexia, characterized by the progressive loss of skeletal muscle mass, leads to functional impairment and poor prognosis. Anamorelin is approved for treating cancer cachexia in Japan; however, the factors influencing its discontinuation and the impact of combining anamorelin with rehabilitation remain unclear. Therefore, we retrospectively analyzed 82 patients with cancer cachexia to identify factors associated with anamorelin discontinuation and assess changes in nutritional status and motor function using non-dominant handgrip strength after 12 wk. Patients received outpatient rehabilitation, combining resistance and aerobic training every two weeks, alongside anamorelin therapy. Our findings indicate that patients with an ECOG performance status of 1 or 2 were less likely to continue anamorelin therapy for 12 wk compared to those with a performance status of 0 (odds ratio 2.71; 95% CI 1.05 - 7.00; <i>p</i> = 0.040). Significant improvements were observed in body weight (48.8 to 53.7 kg, <i>p</i> < 0.001), skeletal muscle mass (6.4 to 6.9 kg/m², <i>p</i> < 0.001), FAACT score (11.5 to 18.0, <i>p</i> < 0.001), and non-dominant handgrip strength (20.5 to 21.7 kg, <i>p</i> = 0.018) after 12 wk. Early initiation of anamorelin with regular rehabilitation is recommended to enhance nutritional status and motor function in patients with cancer cachexia.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114854","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":"Juzaowan Suppresses Glycolysis in Breast Cancer Cells by Inhibiting the STAT3/C-Myc Axis.","authors":"Yuan Zhou, Liumei Lin, Fei Li, Yuchun Xu, Huatong Peng, Qiang Chen","doi":"10.1080/01635581.2024.2395066","DOIUrl":"https://doi.org/10.1080/01635581.2024.2395066","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer (BC) is characterized by an increasing incidence and mortality rate. Juzaowan inhibits various malignant processes, although its mechanism in BC remains unclear.</p><p><strong>Methods: </strong>To evaluate the impact of Juzaowan on biological functions of BC cells, cellular assays were done to assess proliferation, migration, invasion, and apoptosis. Bioinformatics was used to identify signaling pathways affected by active ingredients of Juzaowan. BC cells were treated with Juzaowan. Western blot assayed lactate production, glucose consumption, and expression of proteins related to glycolytic pathway and STAT3/C-Myc axis.</p><p><strong>Results: </strong>Juzaowan suppressed BC cell proliferation and increased apoptosis. It downregulated anti-apoptotic protein BCL2 while upregulating pro-apoptotic proteins Bax and cleaved caspase 3. Juzaowan significantly inhibited BC cell migration and invasion. Significant upregulation of E-cadherin and significant downregulation of E-cadherin-binding protein ZEB1, N-cadherin, and vimentin were observed. Bioinformatics analysis and cellular experiments confirmed inhibition of Juzaowan on BC cell glucose uptake and glycolytic pathways-related key metabolic enzymes (GLUT1, PKM2, LDH) expressions. Western blot revealed that Juzaowan induced metabolic alterations in BC cells by impeding STAT3/C-Myc axis.</p><p><strong>Conclusion: </strong>This study elucidated molecular mechanisms of Juzaowan inhibiting BC cell glycolysis by repressing STAT3/C-Myc axis, thus suppressing malignant progression. These findings supported clinical applications of Juzaowan.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114855","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":"Early Oral Feeding is Safe and Comfortable in Patients with Gastric Cancer Undergoing Radical Total Gastrectomy.","authors":"Bin Cai, Guangen Xu, Zhenxing Zhang, Kelong Tao, Wei Wang","doi":"10.1080/01635581.2024.2396150","DOIUrl":"https://doi.org/10.1080/01635581.2024.2396150","url":null,"abstract":"<p><p>Data supporting the safety and clinical efficacy of early oral feeding (EOF) after total gastrectomy are limited. The aim of this prospective randomized controlled study was to explore the safety and clinical efficacy of two early enteral nutrition approaches for gastric cancer patients after radical total gastrectomy. The EOF group had faster postoperative recovery of intestinal function than the enteral tube feeding (ETF) group. The times to first flatus and first defecation were shorter in the EOF group (<i>p</i> < 0.05). In addition, the EOF protocol effectively avoided abdominal distension (<i>p</i> < 0.05). The hospitalization cost of the EOF group was lower than that of the ETF group (<i>p</i> < 0.05). Moreover, oral nutrition satisfied the physiological need for oral intake. People were more satisfied with EOF (<i>p</i> < 0.01). Furthermore, it is worth noting that compared with ETF, EOF did not increase the risk of anastomotic complications such as leakage and bleeding. Most obviously, EOF not only avoided the risk of complications during tube insertion, but also avoided the discomfort experience of nasal feeding tube. In summary, compared with ETF, EOF promotes early bowel recovery effectively without increasing the risk of postoperative complications. It is safe and comfortable for gastric cancer patients undergoing radical total gastrectomy.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074600","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":"CT Derived Measurement of Body Composition: Observations from a Comparative Analysis of Patients with Colorectal and Lung Cancer.","authors":"Tanvir Abbass, Ross D Dolan, Paul G Horgan, Nicholas MacLeod, Richard J Skipworth, Barry J Laird, Donald C McMillan","doi":"10.1080/01635581.2024.2392913","DOIUrl":"https://doi.org/10.1080/01635581.2024.2392913","url":null,"abstract":"<p><strong>Background: </strong>CT-derived measures of body composition have been shown to have prognostic value in patients with cancer. However, few studies have compared these observations across tumor types and stages of disease. The aim of the present study was to compare body composition measures between two types of cancers, i.e. colorectal cancer (CRC), which is less inflammatory and patients maintain body composition over a longitudinal study period, whereas lung cancer (LC) is proinflammatory and patients lose more fat and muscle mass using a standard methodology.</p><p><strong>Methods: </strong>Clinicopathological characteristics, including those pertaining to nutritional risk/status and systemic inflammation in patients with colorectal cancer (CRC, <i>n</i> = 1047) and lung cancer (LC, <i>n</i> = 662), were compared. The CT image at L3 was used to assess body composition. Comparison of these cohorts was carried out using the chi-square test. Binary logistic regression analysis was performed to assess the impact of clinico-pathological variables on body composition, and scatter plots were used to examine the relationship between body mass index (BMI) and CT-derived measures of body composition.</p><p><strong>Results: </strong>According to CT-derived body composition, high subcutaneous (SFI) and visceral fat index (VFI) were common (>70%) in both CRC and LC. Also, low skeletal muscle index (SMI) and density (SMD) were approximately 40-50% and 60-70% in both CRC and LC. Compared with CRC, patients with LC had a higher American Society of Anaesthesia (ASA) (<i>P</i> < 0.001), Malnutrition Universal Screening Tool (MUST) (<i>P</i> < 0.001), modified frailty index (mFI) (<i>P</i> < 0.001), modified Glasgow Prognostic Score (mGPS) (<i>P</i> < 0.001), and neutrophil lymphocyte ratio (NLR) (<i>P</i> < 0.001) scores.On binary logistic regression analysis, MUST, mFI, and NLR were predictors of subcutaneous adiposity (<i>P</i> < 0.05); type of cancer, MUST, and mFI were predictors of visceral obesity (<i>P</i> < 0.001); age, type of cancer, MUST, and mGPS were predictors of low SMI (<i>P</i> < 0.001); and age, type of cancer, mFI, and mGPS were predictors of low SMD (<i>P</i> < 0.05). There was a similar relationship between BMI and other measures of CT-derived body composition across two types of cancers.</p><p><strong>Conclusion: </strong>Obesity and low skeletal muscle mass were common in both CRC and LC cohorts despite large differences in comorbidity, nutritional risk, systemic inflammation, and survival, even when normalized for TNM stage. These observations would support the hypothesis that, although prognostic, CT derived body composition analysis primarily reflects patient constitution rather than the effect of tumor stage in patients with cancer. The systemic inflammatory response, as evidenced by mGPS, can be considered as an important therapeutic target and loss of muscle mass in patients with advanced cancer is related to the systemi","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047499","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":"Correction.","authors":"","doi":"10.1080/01635581.2024.2394923","DOIUrl":"https://doi.org/10.1080/01635581.2024.2394923","url":null,"abstract":"","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009905","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":"Association Between Sarcopenia, Clinical Outcomes, and Survival in Patients with Extensive-Stage Small Cell Lung Cancer Treated with First-Line Immunochemotherapy: A Prospective Cohort Study.","authors":"Le Tian, Jia-Xin Huang, Rui Wan, Jie Zhang, Xi Zhang, Ning Li, Na Li, Xin-Qi Liu, Chen-Xin Song, Xin-Yi Wang, Lei Yu, Shao-Ming Wang, Zhi-Jie Wang, Ming-Hua Cong","doi":"10.1080/01635581.2024.2392297","DOIUrl":"https://doi.org/10.1080/01635581.2024.2392297","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between sarcopenia, short-term efficacy, and long-term survival in patients with extensive small-cell lung cancer (SCLC) treated with standard first-line immunochemotherapy.</p><p><strong>Methods: </strong>A total of 63 patients initially diagnosed with extensive-stage small cell lung cancer were enrolled in the prospective study from December 1, 2020 to December 31, 2022. The clinical characteristics, body composition, blood test results, and image data were obtained before treatment. Patients were divided into sarcopenia and non-sarcopenia groups according to the diagnostic criteria of the Asian Sarcopenia Working Group 2019. The primary outcome was overall survival (OS) and comprehensive survival analyses were performed. Secondary outcomes included short-term efficacy and adverse events associated with first-line immunochemotherapy.</p><p><strong>Results: </strong>The median age of the 63 patients enrolled in our study was 63.0 years (40-80 years). The incidence of sarcopenia was 19.0% (12/63) in patients with extensive SCLC. Compared with non-sarcopenia patients, extensive-stage SCLC patients with sarcopenia were significantly older (69.0 vs. 62.0, <i>P</i> = 0.017), and had lower body mass index (BMI) (20.29 vs. 24.27, <i>P</i> < 0.001), hand grip strength (HGS) (20.42 vs. 30.75, <i>P</i> < 0.001), and albumin (35.9 vs. 41.40, <i>P</i> < 0.001). The objective response rate after two cycles of standard first-line immunochemotherapy in the sarcopenia group was lower than in the non-sarcopenia group (30.0 vs. 78.9%, <i>P</i> = 0.012). There was no significant difference in chemotherapy-related hematological toxicity between the two groups. During a median follow-up of 15 months (3-33 months), patients with extensive SCLC had a median OS of 24 months, with 1-year survival of 75% and 2-year survival of 52%, respectively. Compared to non-sarcopenia patients, the median OS in the sarcopenia group was significantly shorter (9 vs. 24 months, <i>P</i> = 0.0014). Multivariate Cox analysis showed that sarcopenia was an independent risk factor for OS in patients with extensive SCLC (HR = 4.993, 95%CI = 1.106-22.538, <i>P</i> = 0.037).</p><p><strong>Conclusions: </strong>Patients with Extensive SCLC and sarcopenia had worse clinical outcomes and shorter OS. Sarcopenia is a prognostic factor affecting first-line treatment efficacy and long-term survival of patients with SCLC in the era of immunotherapy.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005956","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":"Coconut Milk Consumption and Breast Cancer Risk in Thai Women: A Case-Control Study.","authors":"Phornsawan Leechanavanicpan, Pakkapong Phucharoenrak, Phenphop Phansuea, Dunyaporn Trachootham","doi":"10.1080/01635581.2024.2390202","DOIUrl":"https://doi.org/10.1080/01635581.2024.2390202","url":null,"abstract":"<p><p>Coconut milk contains plant-based saturated fat and phytochemicals with antioxidant activities. However, its role in breast cancer risk remains unclear. A case-control study was conducted on 244 participants to study the association. The Case group includes 61 newly diagnosed breast cancer patients receiving < 6 months of therapies. The Control group includes 183 healthy people with matched characteristics. A new questionnaire was developed, validated, and used in this study to estimate the frequency of coconut milk-containing food intake. Results show that the questionnaire has satisfactory content validity, test-retest reliability, and criterion-related validity. From the case-control study, either consuming 1-3 or 4-6 times/week of coconut-milk-containing curry or consuming 4-6 times/week of coconut milk-topped desserts are associated with increased risk of breast cancer (OR = 5.23, 5.6, and 2.6 respectively, <i>p</i> < 0.01). Consuming less than half of coconut milk liquid in desserts correlated with a reduced risk (OR = 0.43, <i>p</i> < 0.05). The findings suggest that moderate (less than half of a serving) and infrequent (less than once a week) consumption of coconut milk may be beneficial for breast cancer prevention. A larger scale study is warranted to confirm the findings and provide evidence for dietary recommendations.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918119","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":"Serum 25-Hydroxyvitamin D and Five-Year Survival in Primary Colon Cancer: A Retrospective Cohort Study.","authors":"Raphael E Cuomo","doi":"10.1080/01635581.2024.2389580","DOIUrl":"https://doi.org/10.1080/01635581.2024.2389580","url":null,"abstract":"<p><p>This study examined the link between serum 25-hydroxyvitamin D (25(OH)D) and mortality in patients with colon cancer. Using a clinical database from the University of California, serum 25(OH)D measures were averaged for the time following diagnosis until either the time of death or 5 years had elapsed. Analytical methods included the use of Generalized Additive Models (GAM), logistic regression, and Cox proportional hazards models to examine non-linear relationships and the impact of 25(OH)D on 5-year mortality. This study assessed 1,602 patients with colon cancer having a median 25(OH)D of 31.8 ng/mL and a 5-year mortality rate of 22.7%. A significant association between higher post-diagnosis vitamin D levels and decreased 5-year mortality was observed. This association persisted after adjusting for disease severity and significant demographic confounders, in both a logistic regression model for 5-year mortality (OR = 0.79, 95% CI: 0.66-0.92, <i>p</i> < 0.001) and a cox proportional hazards model for survival (HR = 0.94, CI: 0.88-0.99, <i>p</i> = 0.048). GAM illustrated a steep increase in survival probability up to a plateau, suggesting a threshold effect beyond roughly 50.0 ng/mL. This study found a potential protective role of vitamin D in the survival of colon cancer patients, supporting the correction of levels below 25 ng/mL but ideally above 50 ng/mL.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914613","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 Antioxidant Dietary Supplement Use upon Response to Cancer Treatment: A Scoping Review of Available Evidence.","authors":"L Susan Wieland, Sydney Shade, Ilana Moffet, Amir Ansari, Ashkan Emadi, Cheryl L Knott, Emily F Gorman, Christopher R D'Adamo","doi":"10.1080/01635581.2024.2385167","DOIUrl":"https://doi.org/10.1080/01635581.2024.2385167","url":null,"abstract":"<p><strong>Introduction: </strong>The effects of antioxidant dietary supplements on response to biological therapies for cancer is unknown. We conducted a scoping review of the available systematic review evidence on this question.</p><p><strong>Methods and analysis: </strong>We searched six databases from inception to August 19, 2022 for systematic reviews of randomized controlled trials of antioxidant dietary supplements used by patients receiving curative chemotherapy, radiotherapy, or other biological therapy for cancer and assessing the impact of supplements on survival, treatment response, or disease progression. We focused on results from reviews at high or moderate AMSTAR-2 quality. Records were selected, data extracted, and AMSTAR-2 ratings assessed independently by two authors.</p><p><strong>Results: </strong>We found 24 systematic reviews with relevant evidence. Reviews were heterogenous in cancers, treatments, and antioxidant dietary supplements assessed. Conclusions across reviews were mixed, ranging from negative to no apparent difference to positive, but always with caveats about the limited size and quality of the evidence. One review was rated 'moderate' on AMSTAR-2; it included one small trial of vitamin C and formed no firm conclusions.</p><p><strong>Conclusions: </strong>We did not find reliable systematic review evidence on the effects of antioxidant dietary supplements upon therapies for cancer. More research is necessary to inform clinical recommendations.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794113","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":"Sarcopenia as a Predictive Factor for Carboplatin Toxicity in Patients with Advanced Non-Small Cell Lung Cancer.","authors":"Jenny G Turcott, Sayako M Miyagui, Salvador Gutiérrez Torres, Daniela Cárdenas-Fernández, Enrique Caballé-Perez, Eduardo Rios-Garcia, Andrés F Cardona, Christian Rolfo, Oscar Arrieta","doi":"10.1080/01635581.2024.2382390","DOIUrl":"https://doi.org/10.1080/01635581.2024.2382390","url":null,"abstract":"<p><p>Sarcopenia in cancer patients often negatively impacts various outcomes. Carboplatin, a first-line chemotherapy for non-small cell lung cancer (NSCLC), is dosed based on body weight, which doesn't account for sarcopenia. This study evaluated the association between sarcopenia and carboplatin-related toxicity in NSCLC patients. Patients with locally advanced or metastatic NSCLC treated with carboplatin were included. Toxicity events during the first two cycles of treatment were recorded. Sarcopenia was assessed using pretreatment computed tomography scans analyzed with Slice-O-Matic V4.2 software, defining sarcopenia as a skeletal muscle index (SMI) of <52.4 cm²/m² for men and <38.5 cm²/m² for women. Among 146 patients, 52% had sarcopenia. Hematological toxicity occurred in 71.2% of all patients and 77.6% of those with sarcopenia. The fat-free mass index (FFMI) was independently associated with hematological toxicity and dose-limiting toxicity (DLT), which was observed in 55.5% of patients. Sarcopenia significantly correlates with hematological toxicity and DLT during carboplatin treatment in NSCLC patients. Given its prevalence and noninvasive detection, further research is needed to understand its impact on treatment outcomes.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141768017","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}