Acta Diabetologica最新文献

{"title":"Non-invasive biomarkers for diabetic complications: insights from corneal and retinal imaging.","authors":"Meichun Xiao, Yunhan Chen, Xiaoxin Yan, Li Wang, Huiqin Cheng, Wenqu Chen","doi":"10.1007/s00592-025-02588-y","DOIUrl":"https://doi.org/10.1007/s00592-025-02588-y","url":null,"abstract":"<p><strong>Background: </strong>Diabetes-related complications, such as diabetic peripheral neuropathy (DPN) and chronic kidney disease (CKD), severely affect quality of life. Early detection is crucial. This study investigates ocular imaging parameters as potential biomarkers for these conditions using corneal confocal microscopy (CCM) and optical coherence tomography angiography (OCTA).</p><p><strong>Methods: </strong>This cross-sectional study included 76 type 2 diabetes patients (139 eyes) from Fujian Medical University Union Hospital. Participants underwent CCM to assess corneal nerve fiber density (CNFD), branching density (CNBD), and nerve fiber length (CNFL). OCTA and OCT were used to evaluate macular and peripapillary retinal vascular densities (VD) and retinal nerve fiber layer (RNFL) thickness. Laboratory tests measured sural nerve conduction velocity (SSNCV), urine albumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR). DPN and CKD were categorized using Toronto consensus criteria and UACR thresholds, respectively. Statistical analyses included Spearman correlation and ROC curve evaluations.</p><p><strong>Results: </strong>Significant reductions in CNFD, CNBD, and CNFL were observed in the DPN + group compared to DPN- (P < 0.001, P = 0.005, P < 0.001). Corneal nerve parameters correlated positively with SSNCV (r = 0.419-0.430, P < 0.001). ROC analysis demonstrated CNFD as the most sensitive marker for detecting DPN (AUC = 0.7179, 95% CI: 0.6328-0.8031). Retinal superficial VD in the superior macular region showed the highest diagnostic performance for CKD (AUC = 0.7140, 95% CI: 0.6057-0.8223), with significant correlations between retinal VD parameters and UACR.</p><p><strong>Conclusions: </strong>Corneal nerve parameters measured by CCM and retinal vascular parameters assessed by OCTA are promising non-invasive biomarkers for early detection and monitoring of diabetic neuropathic and microvascular disorders.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231225","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":"Italian guidelines for the treatment of type 1 diabetes.","authors":"Basilio Pintaudi, Daniela Bruttomesso, Angela Girelli, Liliana Indelicato, Edoardo Mannucci, Andrea Pizzini, Valentina Anelli, Elisabetta L Romeo, Riccardo Schiaffini, Federico Spandonaro, Antonio Migliore, Massimiliano Orso, Daniela D'Angela, Barbara Polistena, Katja Speese, Rita Stara, Giovanni Targher, Marilena Vitale, Riccardo Candido","doi":"10.1007/s00592-025-02569-1","DOIUrl":"https://doi.org/10.1007/s00592-025-02569-1","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231235","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":"Metrics in pregnancy: is it the time for new glycaemic goals for pregnant women with type 1 diabetes? An experience with advanced hybrid closed loop.","authors":"O Bitterman, R Fresa, A Napoli","doi":"10.1007/s00592-025-02590-4","DOIUrl":"https://doi.org/10.1007/s00592-025-02590-4","url":null,"abstract":"<p><strong>Introduction: </strong>Recommended pregnancy specific Time in Range (TIR) 63-140 mg/dl is a quite wide range and, even if the goal of > 70% is achieved, the specific targets for fasting and mean glycaemia, which are much lower than 140 mg/dl, could not be complied. This case series aimed to explore the performance of an Advanced Hybrid closed Loop (AHCL) in pregnancy on a stricter glycaemic range.</p><p><strong>Methods: </strong>We collected retrospective data about recommended glucose metrics and an hypothetic TITR 63-95 mg/dl, more suitable for fasting periods, from 11 type 1 diabetes patients, using Medtronic MiniMed™ 780G, with glucose target 100 mg/dl and Active Insulin Time 2 h, from preconceptional phase until delivery.</p><p><strong>Results: </strong>TIR 63-140 mg/dl quickly improved throughout pregnancy, with progressively improving HbA1c and no significant changes in Time Below Range (TBR). TITR 63-95 mg/dl was 26% in the 1st trimester, 20% in the 2nd and 30% in the 3rd, corresponding to 6, 5 and 7 h per day, less than the hypothetic 8/24 hours of fasting. TAR > 140 reduced more compared to TAR > 95, reflecting a greater improve in postprandial values than in fasting.</p><p><strong>Conclusions: </strong>Although the AHCL Medtronic MiniMed™ 780G helped improving glycaemic control during pregnancy, our patients spent very few hours in the range 63-95 mg/dl, probably because they did not reach fasting glucose goals. A stricter TIR may be hypothesized for pregnant women too, as an additional goal along with TIR 63-140 mg/dl, but studies are needed to explore the consequences on maternal and fetal outcomes.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231286","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":"Preliminary real-world observational data on A8 TouchCare use in adults with type 1 diabetes.","authors":"Nicolò Diego Borella, Anna Corsi, Cristiana Scaranna, Roberto Trevisan, Giuseppe Lepore","doi":"10.1007/s00592-025-02589-x","DOIUrl":"https://doi.org/10.1007/s00592-025-02589-x","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231282","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":"Development and validation of a risk predictive nomogram for carotid intima-media thickening in patients with type 2 diabetes.","authors":"Yongqi Zheng, Luni Tuo, Jie Xiao, Runzi Ling, Lei Yan","doi":"10.1007/s00592-025-02584-2","DOIUrl":"https://doi.org/10.1007/s00592-025-02584-2","url":null,"abstract":"<p><strong>Aim: </strong>Carotid intima-media thickness (CIMT) serves as a valuable cardiovascular risk marker in type 2 diabetes mellitus (T2DM). We aimed to develop and validate a nomogram incorporating novel indicators, including the triglyceride-glucose (TyG) index, to predict CIMT thickening in T2DM.</p><p><strong>Methods: </strong>In this retrospective study of 804 patients with T2DM, we employed least absolute shrinkage and selection operator regression followed by stepwise regression for predictor selection. Six machine learning models were evaluated, with model selection based on the area under the receiver operating characteristic curve (AUROC). The optimal model was used to develop the nomogram, assessed using AUROC, calibration curves, decision curve analysis (DCA), and SHapley Additive exPlanations (SHAP) for feature importance.</p><p><strong>Results: </strong>Independent predictors of CIMT thickening in T2DM included age, body mass index, current smoking status, regular exercise habits, glycated hemoglobin, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and TyG index. Logistic regression demonstrated excellent predictive performance and was selected for nomogram development. The predictive model showed strong discriminative ability and good calibration in both the training and testing datasets. DCA confirmed its clinical utility across relevant risk thresholds, with SHAP analysis identifying age as the most influential predictor.</p><p><strong>Conclusions: </strong>This study developed and validated a nomogram integrating routine clinical parameters and novel indicators, including the TyG index, to assess the risk of CIMT thickening in T2DM patients. This nomogram provides an evidence-based tool to help clinicians identify high-risk patients and guide early therapeutic interventions.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079377","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":"Modified cut-off value of the urine albumin-to-creatinine ratio is helpful for identifying patients at high risk for chronic kidney disease in prediabetes.","authors":"Jing Liu, Liu Yang, Jinli Wu, Lili You, Li Yan, Meng Ren","doi":"10.1007/s00592-025-02518-y","DOIUrl":"https://doi.org/10.1007/s00592-025-02518-y","url":null,"abstract":"<p><strong>Background: </strong>Prediabetes is associated with higher risk of chronic kidney disease (CKD), however studies investigating the prognostic index for incident CKD in patients with prediabetes are lacking. Thus, the present study aims to find the risk factors for CKD in prediabetic population.</p><p><strong>Methods: </strong>We included 1220 prediabetic participants without CKD in the REACTION study and examined the associations of clinical indicators with CKD incidence with 3.6 years of follow-up using logistic regression analyses. To explore the nonlinear relationship between the Urine Albumin-To-Creatinine Ratio (UACR) and the hazard ratio (HR) of CKD, a Restricted Cubic Spline (RCS) analysis was conducted. Logistic regression analysis was employed to assess the association between UACR categories and the risk of CKD incidence.</p><p><strong>Results: </strong>There were 78 (6.4%) individuals developed CKD, and elevated UACR was observed in patients who developed CKD. UACR was an independent risk factor of CKD after adjusting for covariates and RCS presented an association between elevated UACR and higher risk of CKD incidence. UACR cutoff points of 7.54 mg/g overall was associated with the risk of CKD progression. In comparison to a UACR range of 0-7.54 mg/g (B1), those who falling within the ranges of 7.54-14.95 (B2), 14.95-22.36 (B3), and 22.36-30 (B4), exhibited a significantly increased risk of CKD development. eGFR below the threshold of 81.64 mL/min/1.73m² was significantly associated with an increased risk of CKD characterized by impaired glomerular filtration.</p><p><strong>Conclusion: </strong>In conclusion, the novel UACR cutoff of 7.54 mg/g serves as an effective tool to identify individuals at high risk of developing CKD-ACR during the prediabetes stage.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074044","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":"Low bone morphogenic protein-2 in diabetes patients with peripheral neuropathy is a correlated risk factor for the development of Charcot arthropathy.","authors":"Jean Cassuto, Agnetha Folestad, Martin Ålund, Susanne Asteberg, Jan Göthlin","doi":"10.1007/s00592-025-02573-5","DOIUrl":"https://doi.org/10.1007/s00592-025-02573-5","url":null,"abstract":"<p><strong>Aims: </strong>Diabetes patients with peripheral neuropathy run increased risk of developing Charcot arthropathy (Charcot), often associated with foot fractures. Bone morphogenic proteins (BMPs) are among the most important regulators of bone homeostasis and fracture repair but have not been investigated in the pathophysiology of Charcot. The current study aims to address this issue.</p><p><strong>Methods: </strong>Sixteen patients diagnosed with active Charcot were treated with total contact cast (TCC) and monitored during 24 months (M) with repeated plain radiographs and magnetic resonance imaging (MRI). Plasma was sampled at 9 occasions and analyzed for BMP-1, BMP-2, BMP-3, BMP-4, BMP-6, BMP-7 and BMP-9 as well as for basal laboratory data. Fifteen diabetes patients with peripheral neuropathy and fifteen healthy participants without diabetes served as controls.</p><p><strong>Results: </strong>All Charcot patients had pathologically low BMP-2 level at inclusion which remained suppressed throughout the 2-year follow-up as defined by being lower than 2 standard deviations (SD) of BMP-2 in healthy controls (p < 0.001) and in diabetes patients with neuropathy without Charcot (p < 0.002). BMP-2 did not differ between the control groups. BMP-7 in Charcot patients increased significantly 6-12 months following TCC treatment. Other BMPs showed no significant differences between the groups at any point during the follow-up.</p><p><strong>Conclusions: </strong>Low BMP-2 in diabetes patients with neuropathy is associated with increased risk of developing Charcot fractures due to the critical role of BMP-2 for the initiation of bone repair. BMP-7 appears to partly compensate for the lack of response by other osteogenic BMPs during fracture repair in Charcot patients.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074058","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":"Retinopathy and nephropathy in type 1 diabetes: role of HbA1c and blood pressure variability.","authors":"Pavel Fatulla, Johnny Ludvigsson, Henrik Imberg, Thomas Nyström, Marcus Lind","doi":"10.1007/s00592-025-02575-3","DOIUrl":"https://doi.org/10.1007/s00592-025-02575-3","url":null,"abstract":"<p><strong>Aims: </strong>To examine the association between within-person variability in glycated hemoglobin A1c (HbA1c) and blood pressure (BP) with retinopathy and nephropathy in type 1 diabetes (T1D).</p><p><strong>Methods: </strong>This nationwide cohort included 9,358 individuals from the Swedish National Diabetes Register with T1D <5 years at inclusion (1998-2017) and ≥8 years follow-up. Variability in HbA1c, systolic BP (SBP), and diastolic BP (DBP) was calculated as updated SDs. Associations with microvascular complications were analyzed using logistic regression with generalized estimating equations, adjusted for demographic and clinical covariates.</p><p><strong>Results: </strong>Mean age at inclusion was 14.2 years, mean diabetes duration 1.2 years, and 44% were female. Over 10.7 years' follow-up, retinopathy developed in 33% and nephropathy in 9.3%. SBP variability was significantly associated with pre-proliferative or proliferative retinopathy (aOR 1.13, 95% CI 1.00-1.27) and proliferative retinopathy/ laser photocoagulation (1.23, 1.04-1.45), as well as with any albuminuria (1.15, 1.08-1.23) and macroalbuminuria (1.29, 1.15-1.45). DBP variability was associated with any albuminuria (1.11, 1.03-1.19) and macroalbuminuria (1.28, 1.10-1.50). HbA1c variability was associated with any retinopathy (1.14, 1.08-1.20) and any albuminuria (1.12, 1.03-1.21).</p><p><strong>Conclusions: </strong>Beyond mean levels, higher variability in HbA1c and BP is associated with retinopathy and nephropathy. Stable BP control in patients with established retinopathy may be important to prevent progression to sight-threatening stages.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074118","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":"Expression of long non-coding RNAs MALAT1, MEG3, and XIST in gestational diabetes mellitus: a cross-sectional study.","authors":"Bishal Kumar Dey, Sudipta Banerjee, Pieu Adhikary, Subhankar Chowdhury, Sanchita Roy, Subesha Basu Roy, Rana Bhattacharjee","doi":"10.1007/s00592-025-02581-5","DOIUrl":"https://doi.org/10.1007/s00592-025-02581-5","url":null,"abstract":"<p><strong>Background and aims: </strong>Gestational diabetes mellitus (GDM) is defined as glucose intolerance first identified during pregnancy that does not meet the criteria for overt diabetes. Its pathophysiology shares key features with type 2 diabetes mellitus (T2D), including insulin resistance and inflammation. Emerging evidence suggests that long non-coding RNAs (lncRNAs) are implicated in T2D. This study investigates the gene expression of lncRNAs in GDM and explores their association with insulin resistance and proinflammatory cytokines.</p><p><strong>Materials and methods: </strong>This cross-sectional study included 25 GDM and 36 non-GDM (NGDM) participants from a tertiary care antenatal clinic. GDM was diagnosed using a 75 g oral glucose tolerance test (OGTT) based on the International Association of Diabetes and Pregnancy Study Groups criteria. MALAT1, MEG3, and XIST were selected for analysis due to their reported involvement in T2D. Their gene expression levels were quantified using real-time PCR, while serum concentrations of proinflammatory cytokines (TNF-α, IL-6, IL-1β) and glycemic markers (C-peptide, fasting insulin) were measured using ELISA.</p><p><strong>Results: </strong>MALAT1, MEG3, and XIST were significantly downregulated in the GDM group compared to the NGDM group (p < 0.01). In the GDM group, all three lncRNAs showed a significant negative correlation with Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) (MALAT1: r = -0.44, p = 0.03; MEG3: r = -0.46, p = 0.04; XIST: r = -0.45, p = 0.04). Additionally, MALAT1 gene expression negatively correlated with IL-6 (r = -0.49, p = 0.03) and TNF-α (r = -0.48, p = 0.04). MEG3 and XIST gene expression negatively correlated with IL-1β (r = -0.51 and - 0.50, p = 0.03 for both) and TNF-α (r = -0.47 and - 0.52, p = 0.04 and 0.03, respectively).</p><p><strong>Conclusion: </strong>MALAT1, MEG3, and XIST are downregulated in GDM, and their gene expression levels are negatively correlated with insulin resistance and select proinflammatory cytokines. These findings suggest a potential role for lncRNA downregulation in GDM pathogenesis, warranting further investigation.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028796","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":"Incidence and causes of major amputation in patients with diabetic foot ulcers: data from a retrospective study.","authors":"Marco Meloni, Luigi Uccioli, Aikaterini Andreadi, Laura Giurato, Valeria Ruotolo, Maria Romano, Alessandro Minasi, Ermanno Bellizzi, Federico Rolando Bonanni, Martina Salvi, Alfonso Bellia, Davide Lauro","doi":"10.1007/s00592-025-02577-1","DOIUrl":"https://doi.org/10.1007/s00592-025-02577-1","url":null,"abstract":"<p><strong>Aim: </strong>The study aimed to evaluate the rate and causes of major amputation in patients with diabetic foot syndrome.</p><p><strong>Methods: </strong>The current study is a retrospective observational study including consecutive patients referred to a tertiary-level diabetic foot service from January 2020 to November 2023 due to a new diabetic foot problem requiring hospital admission. All patients had been managed by a multi-disciplinary diabetic foot team (MDFT) through a pre-set limb salvage protocol including the management of peripheral arterial disease, infection, foot offloading, and comorbidities. At 1 year of follow-up, the following outcomes measures were evaluated: rate of major amputation, clinical characteristics of amputees, and causes of major amputation.</p><p><strong>Results: </strong>Overall, 1226 patients referring for a diabetic foot problem and requiring hospitalization were screened for the study. Among them, 30 (2.4%) patients experienced major amputation. Amputees had 69.9±10.7 years, the majority were male (73.3%) with a prevalence of type 2 diabetes (93.3%) and a long diabetes duration (25.2±9.8 years). They showed several comorbidities such as ischaemic heart disease (83.3%), heart failure (46.7%), end-stage-renal-disease (26.7%), and in addition high rate of peripheral arterial disease (PAD) (86.7%), infected wounds (98.3%), and osteomyelitis (90%). Major amputation was mainly related to untreatable limb ischemia (failure of revascularization procedure) in 56.7% of cases, calcaneus osteomyelitis and necrotizing fasciitis in 16.7% of cases, and tarsal osteomyelitis in 10% of cases.</p><p><strong>Conclusions: </strong>The rate of major amputation was very low in this population managed by a MDFT. PAD was the main cause of major amputation.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991257","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}