Hepatobiliary & Pancreatic Diseases International最新文献

{"title":"Mitochondrial dysfunction in the pathogenesis of acute pancreatitis","authors":"Xia Chen ,&nbsp;Rui Zhong ,&nbsp;Bing Hu","doi":"10.1016/j.hbpd.2023.12.008","DOIUrl":"10.1016/j.hbpd.2023.12.008","url":null,"abstract":"<div><div><span><span>The mechanism of cell damage during acute pancreatitis (AP) has not been fully elucidated, and there is still a lack of specific or effective treatments. Increasing evidence has implicated mitochondrial dysfunction as a key event in the </span>pathophysiology of AP. Mitochondrial dysfunction is closely related to calcium (Ca</span>²⁺<span><span><span>) overload, intracellular adenosine triphosphate depletion, mitochondrial permeability transition pore openings, loss of </span>mitochondrial membrane potential<span>, mitophagy damage and inflammatory responses. Mitochondrial dysfunction is an early triggering event in the initiation and development of AP, and this organelle damage may precede the release of </span></span>inflammatory cytokines<span><span>, intracellular trypsin activation and vacuole formation of pancreatic </span>acinar cells. This review provides further insight into the role of mitochondria in both physiological and pathophysiological aspects of AP, aiming to improve our understanding of the underlying mechanism which may lead to the development of therapeutic and preventive strategies for AP.</span></span></div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 1","pages":"Pages 76-83"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139061852","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":"Predictive value of postoperative serum lipase level for postoperative pancreatic fistula after pancreaticoduodenectomy.","authors":"Bing-Jun Tang, Si-Jia Li, Peng-Fei Wang, Can-Hong Xiang, Jian-Ping Zeng, Jun Shi, Jia-Hong Dong, Xue-Dong Wang","doi":"10.1016/j.hbpd.2025.01.002","DOIUrl":"https://doi.org/10.1016/j.hbpd.2025.01.002","url":null,"abstract":"<p><strong>Background: </strong>The prediction of postoperative pancreatic fistula (POPF) is important. This study aimed to investigate the role of postoperative serum lipase level in predicting POPF.</p><p><strong>Methods: </strong>Data from 234 consecutive patients who underwent pancreaticoduodenectomy (PD) were collected. The predictive values of serum amylase and serum lipase during postoperative days (PODs) 1 to 3 for POPF were compared. Subgroup analyses were performed to determine the prognostic value of different levels and durations of elevated serum lipase.</p><p><strong>Results: </strong>Fifty-six patients developed POPF. The POPF group exhibited increased levels of serum amylase and lipase from PODs 1 to 3 (all P < 0.001). Compared with serum amylase, serum lipase has greater predictive value for POPF. Specifically, serum lipase had the highest area under the receiver operating characteristic curve (AUC) at POD 1 (0.791). Body mass index > 24 kg/m² [odds ratio (OR) = 2.431, 95 % confidence interval (CI): 1.094-5.404, P = 0.029), soft pancreatic texture (OR = 3.189, 95 % CI: 1.263-8.056, P = 0.014), serum lipase > 60 U/L at POD 1 (OR = 5.135, 95 % CI: 1.257-20.982, P = 0.023), and C-reactive protein > 167 mg/dL at POD 3 (OR = 3.607, 95 % CI: 1.431-9.090, P = 0.007) were identified as independent risk factors for POPF. Patients with serum lipase ≤ 60 U/L at POD 1 (n = 104) exhibited lower rates of POPF (3.8 % vs. 40.0 %, P < 0.001) and severe complications (Clavien-Dindo ≥ IIIa) (4.8 % vs. 25.4 %, P < 0.001) than those with serum lipase > 60 U/L at POD 1. Moreover, no additional elevation or duration of serum lipase offered any further prognostic value.</p><p><strong>Conclusions: </strong>Postoperative serum lipase outperformed serum amylase in the prediction of POPF, and patients with normal serum lipase level at POD 1 had favorable outcomes. A sustained increase in the serum lipase level offers no additional prognostic value.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371276","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":"Application of extended criteria donor liver grafts in liver transplantation.","authors":"Dan Shi","doi":"10.1016/j.hbpd.2025.01.001","DOIUrl":"https://doi.org/10.1016/j.hbpd.2025.01.001","url":null,"abstract":"","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042338","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":"Serum exosome-derived ALDH1A1 can greatly predict the prognosis of patients with hepatitis E virus-related acute liver failure.","authors":"An-Quan Shang, Hong Yan, Ze Xiang, Jia-Qi Chen, Bin Jiang, Chun Jiang, Bai Ling, Jian Wu","doi":"10.1016/j.hbpd.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.hbpd.2024.12.007","url":null,"abstract":"<p><strong>Background: </strong>Despite the insights into the role of aldehyde dehydrogenase 1 family member A1 (ALDH1A1) in various liver diseases, the expression and its prognostic significance in patients with hepatitis E virus-related acute liver failure (HEV-ALF) remain unclear. This study delved into the assessment of serum exosome-derived ALDH1A1 expression and its prognostic implications for HEV-ALF patients.</p><p><strong>Methods: </strong>Between January 2018 and December 2023, a total of 226 individuals with acute hepatitis E (AHE) and 210 patients with HEV-ALF were recruited from member units of Chinese Consortium for the Study of Hepatitis E. According to the number of organ failure, we categorized 210 HEV-ALF patients into three groups: two organs failure (n = 131), three organs failure (n = 46), and more than three organs failure (n = 33). In addition, 200 health controls from Suzhou Municipal Hospital were included.</p><p><strong>Results: </strong>The levels of serum exosome-derived ALDH1A1 in HEV-ALF patients were significantly higher than those in AHE patients and health controls (both P < 0.05). Furthermore, the levels of serum exosome-derived ALDH1A1 were the highest in more than three organs failure group, followed by three organs failure group and two organs failure group (all P < 0.001). Moreover, serum exosome-derived ALDH1A1 was positively correlated with total bilirubin in HEV-ALF patients (r = 0.315, P < 0.001). The comparisons of serum exosome-derived ALDH1A1 levels in treatment response showed that serum exosome-derived ALDH1A1 levels were decreased in the improvement group, while increased in the fluctuation and deterioration groups (all P < 0.001). Moreover, serum exosome-derived ALDH1A1 was an independent risk factor for predicting the 30-day mortality (P < 0.001). Furthermore, the area under the receiver operating characteristic curve was 0.943, with the sensitivity of 94.87 % and specificity of 87.72 %, indicating the robust decision-making ability. However, no significant differences were found in serum exosome-derived ALDH1A1 levels between patients aged < 60 and ≥ 60 years old (P = 0.131).</p><p><strong>Conclusions: </strong>Serum exosome-derived ALDH1A1 can greatly predict the prognosis of HEV-ALF patients.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928847","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":"Microbiota-related metabolites correlated with the severity of COVID-19 patients.","authors":"Xiao-Sen Wang, Jing-Yu Wang, Fei Yu, Ding Shi, Jiao-Jiao Xie, Lan-Juan Li, Bao-Hong Wang","doi":"10.1016/j.hbpd.2024.12.006","DOIUrl":"https://doi.org/10.1016/j.hbpd.2024.12.006","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) is a global pandemic with high mortality, and the treatment options for the severe patients remain limited. Previous studies reported the altered gut microbiota in severe COVID-19. But there are no comprehensive data on the role of microbial metabolites in COVID-19 patients.</p><p><strong>Methods: </strong>We identified 153 serum microbial metabolites and assessed the changes in 72 COVID-19 patients upon admission and one-month after their discharge, comparing these changes to those in 133 healthy control individuals from the outpatient department during the same period.</p><p><strong>Results: </strong>Our study revealed that microbial metabolites varied across different stages and severity of COVID-19 patients. These altered microbial metabolites included tryptophan, bile acids, fatty acids, amino acids, vitamins and those containing benzene. A total of 13 distinct microbial metabolites were identified in COVID-19 patients compared to healthy controls. Notably, correlations were found among these disrupted metabolites and organ injury and inflammatory responses related to COVID-19. Furthermore, these metabolites did not restore to the normal levels one month after discharge. Importantly, two microbial metabolites were the core microbial metabolites related to the severity of COVID-19 patients.</p><p><strong>Conclusions: </strong>The microbial metabolites were altered in the acute and recovery stage, correlating with disease severity of COVID-19. These results indicated the important role of gut microbiota in the progression of COVID-19, and facilitated the potential therapeutic microbial target for severe COVID-19 patients.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904019","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":"Circulating tumor cell dynamic detecting to optimize neoadjuvant chemotherapy combined with liver transplantation in perihilar cholangiocarcinoma.","authors":"Wen-Jin Liang, Chen Liang, Zhi-Gao Xu, Shao-Jun Ye, Zi-Biao Zhong, Qi-Fa Ye","doi":"10.1016/j.hbpd.2024.12.002","DOIUrl":"https://doi.org/10.1016/j.hbpd.2024.12.002","url":null,"abstract":"","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928844","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":"Diagnostic value and immune infiltration characterization of WTAP as a critical m6A regulator in liver transplantation.","authors":"Shan-Shan Li, Deng-Liang Lei, Hua-Rong Yu, Song Xiang, Yi-Hua Wang, Zhong-Jun Wu, Li Jiang, Zuo-Tian Huang","doi":"10.1016/j.hbpd.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.hbpd.2024.12.004","url":null,"abstract":"<p><strong>Background: </strong>RNA N6-methyladenosine (m6A) regulators are essential for numerous biological processes and are implicated in various diseases. However, the comprehensive role of m6A regulators in the context of liver transplantation (LT) remains poorly understood. This study aimed to illustrate the relationship between m6A regulators and ischemia-reperfusion injury (IRI) following LT.</p><p><strong>Methods: </strong>Datasets were acquired from the Gene Expression Omnibus database. Differential analysis of the merged data identified the differentially expressed m6A regulators. Random forest (RF) models and nomograms were used to forecast the incidence and assess the IRI risk following LT. m6A regulators were classified into distinct subgroups using cluster analysis. The differential gene expression was validated using immunohistochemistry, immunofluorescence, and Western blotting.</p><p><strong>Results: </strong>We found significant disparities in the gene expression levels of the three m6A regulators between patients with and without LT. Wilms' tumor 1-associating protein (WTAP) expression was upregulated following LT. The RF models exhibited a high degree of accuracy in predicting IRI risk. Immune infiltration analysis showed that WTAP was an immune-associated m6A regulator that was closely associated with T and B cells. WTAP expression in the rat LT model was upregulated after 24 h of reperfusion, which was consistent with the results of the bioinformatics analysis.</p><p><strong>Conclusion: </strong>WTAP has a high diagnostic value for IRI in LT and influences the immune status of patients. Hence, WTAP, as a significant regulator of m6A, is a potential biomarker for the detection and implementation of immunotherapy for IRI following LT.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900452","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":"Effect of duodenal papilla morphology on biliary cannulation and complications in patients with common bile duct stones.","authors":"Cong Chen, Rui Tao, Qi-Hui Hu, Zhong-Jun Wu","doi":"10.1016/j.hbpd.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.hbpd.2024.12.001","url":null,"abstract":"<p><strong>Background: </strong>The endoscopic appearance of the major duodenal papilla influences biliary cannulation and complications. This study aimed to investigate the role of major duodenal papillae in the endoscopic treatment of common bile duct (CBD) stones.</p><p><strong>Methods: </strong>This retrospective study was conducted at Bishan Hospital of Chongqing Medical University between January 2018 and August 2022. Patients with native papillae who underwent endoscopic treatment for CBD stones were recruited and divided into four groups according to Haraldsson's classification of papillae (types I-IV). Univariate and multivariate logistic regression analyses were used to identify risk factors for difficult cannulation and post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).</p><p><strong>Results: </strong>A total of 596 patients with CBD stones were enrolled. The proportion of patients with type I papilla was the highest (n = 231, 38.8 %), followed by type III papilla (n = 175, 29.4 %), type IV papilla (n = 101, 16.9 %) and type II papilla (n = 89, 14.9 %). Difficult cannulation occurred in 188 of 596 patients (31.5 %), with most cases occurring in those with type III papilla (71/175, 40.6 %, P = 0.020). Multivariate analysis revealed that age [odds ratio (OR) = 1.034, 95 % confidence interval (CI): 1.021-1.047, P < 0.001], type III papilla (OR = 2.255, 95 % CI: 1.439-3.535, P < 0.001), gallbladder in situ (OR = 2.486, 95 % CI: 1.346-4.590, P = 0.004), and CBD diameter < 10 mm (OR = 1.600, 95 % CI: 1.049-2.441, P = 0.029) were risk factors for difficult cannulation. The total incidence of PEP was 10.9 %. Compared with the other types of papillae, the rate of PEP was the highest in those with type I papilla (15.2 %, P = 0.030). Multivariate analysis demonstrated that PEP was associated with difficult cannulation (OR = 1.811, 95 % CI: 1.044-3.143, P = 0.035) and white blood cells (WBCs) < 10 × 10⁹/L (OR = 2.199, 95 % CI: 1.051-4.600, P = 0.036).</p><p><strong>Conclusions: </strong>The endoscopic appearance of the major papilla is an important factor that influences both biliary cannulation and outcomes. Type III papilla is more frequently difficult to cannulate in the endoscopic treatment of CBD stones.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824880","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":"Survival benefit of adjuvant treatment for ampullary cancer with lymph nodal involvement: A systematic review and meta-analysis","authors":"Min Kyu Kim ,&nbsp;Jin Ho Choi ,&nbsp;In Rae Cho ,&nbsp;Sang Hyub Lee ,&nbsp;Ji Kon Ryu ,&nbsp;Yong-Tae Kim ,&nbsp;Woo Hyun Paik","doi":"10.1016/j.hbpd.2024.07.002","DOIUrl":"10.1016/j.hbpd.2024.07.002","url":null,"abstract":"<div><h3>Background</h3><div>The efficacy of adjuvant treatment (AT) in ampullary cancer (AmC) remains controversial. This systematic review and meta-analysis aimed to evaluate the role of AT for AmC.</div></div><div><h3>Data sources</h3><div>A comprehensive systematic search was performed in PubMed, EMBASE, Cochrane Library, and Web of Science databases. Studies comparing overall survival (OS) and recurrence-free survival (RFS) of patients who underwent AT or not following AmC resection were included.</div></div><div><h3>Results</h3><div>A total of 3971 patients in 21 studies were analyzed. Overall pooled data showed no significant difference in effect on the OS by AT [hazard ratio (HR) = 0.998, 95% confidence interval (CI): 0.768–1.297]. No significant difference in recurrence between the AT and non-AT (nAT) groups was noted (HR = 1.158, 95% CI: 0.764–1.755). In subgroup analysis, patients who received AT showed favorable outcomes in the OS compared with those who received nAT in nodal-positive AmC (HR = 0.627, 95% CI: 0.451–0.870). Neither AT consisted of adjuvant chemotherapy with radiotherapy (HR = 0.804, 95% CI: 0.563–1.149) nor AT with adjuvant chemotherapy (HR = 0.883, 95% CI: 0.642–1.214) showed any significant effect on the OS.</div></div><div><h3>Conclusions</h3><div>The effect of AT in AmC on survival and recurrence did not show a significant benefit. Furthermore, effectiveness according to AT strategies did not show enhancement in survival. AT had an advantage in survival compared with nAT strategy in nodal-positive AmC. In cases of AmC with positive lymph nodal involvement, AT may be warranted regardless of detailed strategies.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"23 6","pages":"Pages 559-565"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602205","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":"Short-term postoperative bacteriobilia or fungibilia in liver transplantation patients with donation after circulatory death allografts associated with a longer hospital stay: A single-center retrospective observational study in China","authors":"Chen-Xue Guo ,&nbsp;Jian-Hua Li ,&nbsp;Zheng-Xin Wang ,&nbsp;Wan-Zhen Li ,&nbsp;Jing Zhang ,&nbsp;Hao Xing ,&nbsp;Su Liu ,&nbsp;Tian Wei ,&nbsp;Li Li ,&nbsp;Rui-Dong Li","doi":"10.1016/j.hbpd.2024.04.001","DOIUrl":"10.1016/j.hbpd.2024.04.001","url":null,"abstract":"<div><h3>Background</h3><div><span><span>Normal bile is sterile. Studies have shown that cholangitis after </span>liver transplantation (LT) was associated with a relatively poor prognosis. It remains unclear whether the bacteriobilia or fungibilia impact the patient outcomes in LT recipients, especially with donation after circulatory death (DCD) </span>allografts, which was correlated with a higher risk of allograft failure.</div></div><div><h3>Methods</h3><div>This retrospective study included 139 LT recipients of DCD grafts from 2019 to 2021. All patients were divided into two groups according to the presence or absence of bacteriobilia or fungibilia. The prevalence and microbial spectrum of postoperative bacteriobilia or fungibilia and its possible association with outcomes, especially hospital stay were analyzed.</div></div><div><h3>Results</h3><div>Totally 135 and 171 organisms were isolated at weeks 1 and 2, respectively. Among all patients included in this analysis, 83 (59.7%) developed bacteriobilia or fungibilia within 2 weeks post-transplantation. The occurrence of bacteriobilia or fungibilia [β = 7.43, 95% CI (confidence interval): 0.02 to 14.82, <em>P</em> = 0.049], particularly the detection of <span><span>Pseudomonas</span></span> (β = 18.84, 95% CI: 6.51 to 31.07, <em>P</em> = 0.003) within 2 weeks post-transplantation was associated with a longer hospital stay. However, it did not affect the graft and patient survival.</div></div><div><h3>Conclusions</h3><div>The occurrence of bacteriobilia or fungibilia, particularly <em>Pseudomonas</em> within 2 weeks post-transplantation, could influence the recovery of liver function and was associated with prolonged hospital stay but not the graft and patient survival.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"23 6","pages":"Pages 566-572"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140841266","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}