Acta Diabetologica最新文献

{"title":"Association between stress hyperglycemia ratio and acute kidney injury in patients with chronic cardiovascular-kidney disorder: a multi-center retrospective cohort study from China.","authors":"Yihang Ling, Yibo He, Tian Chang, Xianlin Ruan, Huangtao Ruan, Zeliang Li, Jin Liu, Yong Liu, Jiyan Chen","doi":"10.1007/s00592-025-02493-4","DOIUrl":"https://doi.org/10.1007/s00592-025-02493-4","url":null,"abstract":"<p><strong>Aim: </strong>Stress hyperglycemia ratio (SHR) is associated with acute kidney injury (AKI) among patients with myocardial infarction. However, the relationship between SHR and AKI in chronic cardiovascular-kidney disorder (CCV-KD) patients are still unknown. This study aimed to clarify the association of SHR with adverse renal outcomes in CCV-KD patients.</p><p><strong>Method: </strong>6,359 CCV-KD patients from the Chinese multi-center registry cohort Cardiorenal ImprovemeNt II (CIN-II) were included in this study. We categorized SHR into distinct groups and conducted logistic analyses to evaluate its association with AKI and progression to end-stage kidney disease (ESKD) or in-hospital dialysis. We also calculated the incidence of these adverse renal outcomes, stratified by estimated glomerular filtration rate (eGFR). Additionally, restricted cubic spline (RCS) was performed to understand the relationship between SHR and adverse renal outcomes.</p><p><strong>Result: </strong>In this study, 13.7% patients experienced AKI and 4.3% patients progressed to ESKD or in-hospital dialysis. Both low SHR (< 0.7) and high SHR (≥ 1.1) were associated with a significantly increased risk of AKI. In addition, high SHR was strongly correlated with an increasing risk of progression to ESKD/dialysis during hospitalization. The incidence of AKI was lowest when the SHR was between 0.9 and 1.1, while the incidence of ESKD was highest when the SHR was ≥ 1.1, across all eGFR subgroups.</p><p><strong>Conclusion: </strong>In patients with CCV-KD, both low and high SHR are associated with an increased risk of AKI development, and elevated SHR is associated with the risk of ESKD/dialysis as well.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959314","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":"Enhancing self-care management in diabetic patients: a randomized controlled trial exploring the interplay of social support, self-efficacy, and empowerment.","authors":"Nevin F Ibrahim, Hanaa A Nofal, Hossam Tharwat Ali, Dina S El-Rafey, Noura Almadani, Rasha Mahfouz, Reda M Khodary","doi":"10.1007/s00592-025-02498-z","DOIUrl":"https://doi.org/10.1007/s00592-025-02498-z","url":null,"abstract":"<p><strong>Background: </strong>Despite the significant global and Egyptian prevalence of Type 2 Diabetes Mellitus (T2DM), with the recognized importance of self-care and social support in enhancing glycemic control, there is a scarcity of studies on this topic within Egypt's especially interventional studies and role of enhancement program on diabetic self-management practice. Our objective is to evaluate the effect of a health education program on the enhancement of self-care management compared to the usual care and explore factors affecting self-care management as social support, self-efficacy, and empowerment among patients with T2DM.</p><p><strong>Methods: </strong>A randomized control trial was conducted on 330 (165:165) T2DM patients confirmed more than one year and had regular visits to the diabetic patient clinic in our hospital. The study outcomes include diabetes knowledge, self-management practice, social support, self-efficacy, and empowerment along with body mass index (BMI), glycated hemoglobin (HbA1c), and fasting blood glucose (FBG).</p><p><strong>Results: </strong>The intervention group had significant improvements in knowledge and self-practice with post-intervention adequate values (80.0% and 87.8%) compared to the control (40% and 55.1%) respectively (p-value < 0.001). Furthermore, a significant increase in patients with controlled FBG and HbA1c occurred in both groups (p-value < 0.001) with a significantly higher increase in the intervention group (p-value < 0.001). In total, 60.9%, 58.8%, and 25.7% of the patients had satisfactory social support, self-efficacy, and empowerment, respectively.</p><p><strong>Conclusion: </strong>The results indicated that a diabetes self-care management education program was proven to be effective in improving patients' self-care management. Social support, self-efficacy, and empowerment could have positive roles.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952578","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":"Primary cutaneous B-cell lymphoma in a woman with type 2 diabetes: a case report.","authors":"Enzo de Araujo Melo, Sarah Lopes Salomão, Bruna Pinheiro Lourente, Carlos Antonio Negrato","doi":"10.1007/s00592-025-02489-0","DOIUrl":"https://doi.org/10.1007/s00592-025-02489-0","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959292","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":"Glial fibrillary acidic protein: a potential biomarker for small fiber neuropathy?","authors":"Claus Vinter Bødker Hviid, Nicklas Højgaard-Hessellund Rasmussen, Johan Røikjer","doi":"10.1007/s00592-025-02500-8","DOIUrl":"https://doi.org/10.1007/s00592-025-02500-8","url":null,"abstract":"<p><strong>Background: </strong>Objective and easily applicable biomarkers for diabetic polyneuropathy (DPN) are warranted. Circulating nerve-specific proteins have emerged as valuable biomarkers for central nervous system disease but few of these have been tested in peripheral neuropathy. Glial Fibrillary Acidic Protein (GFAP) is highly expressed in non-myelinating Schwann cells while UCH-L1 is a neuron expressed stress protein not previous analyzed in DPN. In this pilot study, we explore serum GFAP and UCH-L1 levels in patients with/without DPN and controls.</p><p><strong>Methods: </strong>Persons with DPN (n = 28), without DPN (n = 31), and controls (n = 30) were evaluated in a cross-sectional design. Sural nerve conduction (velocity and amplitude) was evaluated by NC-stat DPNCheck™ and quantitative sensory testing of cold detection and pain was performed. GFAP and UCH-L1 levels were compared across study groups and the unadjusted correlation with nerve assessments evaluated.</p><p><strong>Results: </strong>Serum GFAP were lower in persons with DPN (20.9 ± 10.9 pg/ml) than in persons without DPN (26.2 ± 14.1 pg/ml) (p = 0.04) or controls (31.7 ± 26.0 pg/ml) (p = 0.02). GFAP levels were not different in persons without DPN and controls (p = 0.61). UCH-L1 levels were not different between study groups (p = 0.48). GFAP levels correlated with cold pain threshold (Rho= - 0.320, p = 0.02) but failed to reach significance for cold detection (Rho= - 0.236, p = 0.09). No correlation was observed between GFAP and nerve amplitude (p = 0.58) or conductivity (p = 0.86).</p><p><strong>Conclusion: </strong>Serum GFAP levels are reduced in persons with DPN compared to persons without DPN and controls. Reduced serum GFAP levels may be associated with reduced markers of small nerve fiber damage obtained from quantitative sensory testing in people with diabetes.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794334","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":"Increasing HbA1c in children and youth with a first-degree relative with type 1 diabetes predicts progression to diabetes: a single-centre 10-year screening experience.","authors":"Claudia Piona, Giovanna Contreas, Susanna Gobbi, Erika Caiazza, Costantini Silvia, Elisa Morotti, Marco Marigliano, Claudio Maffeis","doi":"10.1007/s00592-025-02477-4","DOIUrl":"https://doi.org/10.1007/s00592-025-02477-4","url":null,"abstract":"","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778641","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":"Association between the triglyceride glucose-body roundness index and the incidence of cardiovascular disease among Chinese middle and old-aged adults: a nationwide prospective cohort study.","authors":"Wangyang Bai, Hangqi Chen, Huiqin Wan, Xiaofei Ye, Yi Ling, Jinfang Xu, Xiaojing Guo, Jia He","doi":"10.1007/s00592-025-02499-y","DOIUrl":"https://doi.org/10.1007/s00592-025-02499-y","url":null,"abstract":"<p><strong>Aim: </strong>Previous studies have suggested that the triglyceride glucose (TyG) index and body roundness index (BRI) are indicators of insulin resistance (IR) and are associated with the incidence of cardiovascular disease (CVD) among middle and old-aged adults. BRI is considered a more accurate indicator of the proportion of body fat and visceral fat than body mass index (BMI). However, it remains unclear whether the combined use of the TyG index and BRI, specifically the triglyceride glucose-body roundness index (TyG-BRI), is associated with the incidence of CVD among Chinese middle and old-aged adults.</p><p><strong>Methods: </strong>Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). The TyG-BRI index was computed using baseline measurements of triglycerides, fasting blood glucose, waist circumference, and height. Cox proportional hazards regression and restricted cubic spline (RCS) regression analyses were applied to assess the association between the TyG-BRI index and incident CVD (defined as cardiac events or stroke).</p><p><strong>Results: </strong>A total of 8,113 Chinese adults participated in this study, with a median age of 58 years, including 56.3% males. The fully adjusted Cox regression analysis revealed that individuals in the highest quartile (Q4) of the TyG-BRI index had a 59.1% increased risk of developing incident CVD compared to those in the lowest quartile (HR, 1.591 [95% CI, 1.330-1.902]). The TyG-BRI index showed a significant linear association with CVD incidence (P for nonlinearity = 0.447, P < 0.001). This association persisted after conducting subgroup and sensitivity analyses.</p><p><strong>Conclusions: </strong>This study introduced a novel TyG-BRI index, which integrated IR and body roundness as a comprehensive indicator, demonstrating its strong and independent association with increased CVD risk in a Chinese nationwide cohort. Our findings provide new insights into the interaction between metabolic dysfunction and cardiovascular risk, suggesting that the TyG-BRI index could serve as a practical tool for targeted preventive interventions.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750224","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":"Early prediction of gestational diabetes mellitus: the role of the pregnancy-specific triglycerides-glucose index and other fasting parameters in combination with dynamic testing.","authors":"Christian S Göbl, Tina Linder, Daniel Eppel, Grammata Kotzaeridi, Laura Weidinger, Sophie Zarotti, Thorsten Fischer, Monya Todesco Bernasconi, Mirjam Kunze, Nicole Ochsenbein-Koelble, Bettina Winzeler, Irene Hoesli, Evelyn A Huhn, Andrea Tura","doi":"10.1007/s00592-025-02490-7","DOIUrl":"https://doi.org/10.1007/s00592-025-02490-7","url":null,"abstract":"<p><p>The identification of mothers at risk for gestational diabetes mellitus (GDM) at start of pregnancy may be beneficial to improve perinatal outcomes. This study aims evaluating the predictive performance of fasting and dynamic indices of glucose metabolism at first trimester and their association with later GDM development. A cohort of 198 women received detailed metabolic assessment at median gestational age (13 weeks) including 75-g oral glucose tolerance test (OGTT) with assessment of glucose, insulin and C-peptide, and biochemical markers (including triglycerides) to calculate different indices of insulin sensitivity either at fasting and in the OGTT dynamic conditions. Moreover, parameters of β-cell function were assessed. A second OGTT was performed between 24 and 28 gestational weeks (GW) to identify women with GDM. We found that 28 women developed GDM, and, in univariable analysis, this was fairly predicted by several first trimester indices, both at fasting and in dynamic conditions. However, fasting indices containing maternal triglycerides showed better accuracy as compared to traditional indices (even the dynamic ones). In multivariable analysis, the best predictive model of GDM development included fasting and OGTT glucose values, HbA1c, and an insulin sensitivity marker that includes triglycerides (e.g. the improved triglyceride-glucose index, TyGIS). β-Cell function was not included in such predictive model, but at 24-28 GW it showed remarkable impairment in women with GDM. In conclusion, both fasting and dynamic parameters of glucose homeostasis at early pregnancy showed fair predictive accuracy for later GDM, with TyGIS showing excellent performance. β-Cell dysfunction role needs being further elucidated.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750405","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":"Machine learning-based models to predict type 2 diabetes combined with coronary heart disease and feature analysis-based on interpretable SHAP.","authors":"Yijian Ji, Hongyan Shang, Jing Yi, Wenhui Zang, Wenjun Cao","doi":"10.1007/s00592-025-02496-1","DOIUrl":"https://doi.org/10.1007/s00592-025-02496-1","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes and coronary heart disease exhibit heightened prevalence in the Chinese population, posing as leading causes of mortality. The combination of diabetes and coronary heart disease, due to its challenging diagnosis and poor prognosis, imposes a significant disease burden. In recent years, machine learning has frequently been employed in diagnostic applications within medical fields; however, predictive models for type 2 diabetes complicated by coronary heart disease have been confronted with issues such as lower predictive performance and interference from other comorbidities during prediction.</p><p><strong>Methods: </strong>This study enhances the predictive accuracy, sensitivity, specificity, F1 score, and AUC of models forecasting the coexistence of diabetes and coronary heart disease. We developed an advanced prediction model using XGBoost combined with SHAP for feature analysis. Through comparative feature selection, hyperparameter optimization, and computational efficiency analysis, we identified optimal conditions for model performance. External validation with independent datasets confirmed the model's robustness and generalizability, supporting its potential implementation in clinical practice.</p><p><strong>Results: </strong>This study compared three models-Random Forest, LightGBM, and XGBoost-and found that XGBoost exhibited superior performance in both efficacy and computational efficiency. The accuracy (Acc) of the XGBoost model was 0.8910, which improved to 0.8942 after hyperparameter tuning. External validation using datasets from Pingyang Hospital and Heji Hospital in Shanxi Province, China, yielded an AUC of 0.7897, demonstrating robust generalizability. By integrating SHAP (SHapley Additive exPlanations) for interpretability, our study identified bilirubin levels, basophil count, cholesterol levels, and age as key features for predicting the coexistence of type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD). These findings are seamlessly consistent with the feature importance rankings determined by the XGBoost algorithm. The model demonstrates moderate predictive performance (AUC = 0.7879 in external validation) with practical interpretability, offering potential utility in improving diagnostic efficiency for T2DM-CHD comorbidity in resource-limited settings. However, its clinical implementation requires further validation in diverse populations.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750481","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":"Triglyceride-glucose index is a significant predictor of hospital mortality in non-diabetic critically ill patients with ischemic stroke: a retrospective cohort study of the MIMIC-IV database.","authors":"Ronghui Zhu, Qian He, Rui Wang, Yaoyong Tai, Chi Peng, Cheng Wu","doi":"10.1007/s00592-025-02502-6","DOIUrl":"https://doi.org/10.1007/s00592-025-02502-6","url":null,"abstract":"<p><strong>Background and aims: </strong>The relationship between the TyG index and outcomes in non-diabetic patients with ischemic stroke admitted to intensive care unit (ICU) has not been validated. This study aims to investigate the correlation between the TyG index and mortality in non-diabetic ICU patients with ischemic stroke.</p><p><strong>Methods: </strong>We collected data from ICU patients (≥ 18 years) with ischemic stroke and no diabetes. The primary outcome was hospital mortality, and the secondary outcomes were 30-day mortality following admission, hospital length of stay (LOS) and ICU LOS. Cox proportional hazards models and generalized linear models were employed to evaluate association between the TyG index and mortality and LOS, respectively. Nonlinear associations between the TyG index and outcomes were assessed using restricted cubic spline regression models.</p><p><strong>Results: </strong>A total of 1122 eligible patients were included in this study. The hospital mortality was 10.61%, and 30-day mortality was 16.93%. Multivariate Cox proportional hazards models and generalized linear models revealed the higher of TyG was significantly associated with increased hospital mortality [adjusted HR (95% CI) 1.22 (1.02-1.46), P = 0.0264], 30-day mortality [adjusted HR (95% CI) 1.26 (1.10-1.44), P = 0.0011] and prolonged hospital LOS [adjusted difference (95% CI) 0.52 (0.06-0.97), P = 0.0276].</p><p><strong>Conclusions: </strong>TyG index is a significant predictor of hospital mortality, 30-day mortality, and LOS in non-diabetic ICU patients with ischemic stroke, which could aid clinical decision-making in managing ischemic stroke.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750615","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 association between the γ-glutamyltransferase-high-density lipoprotein cholesterol ratio and all-cause mortality in the Korean genome and epidemiology study: health examinees cohort.","authors":"Hee Youn Han, Dong Hyuk Jung, Seok-Jae Heo, Yong Jae Lee","doi":"10.1007/s00592-025-02495-2","DOIUrl":"10.1007/s00592-025-02495-2","url":null,"abstract":"<p><strong>Objective: </strong>The ratio of γ-glutamyl transferase (GGT) and high-density lipoprotein cholesterol (HDL-C) is a novel noninsulin-based marker for assessing the risk of nonalcoholic fatty liver disease and type 2 diabetes mellitus. However, it is unclear whether the GGT/HDL-C ratio is related to all-cause mortality. Therefore, we aimed to investigate the longitudinal association of GGT/HDL-C on all-cause mortality in a large cohort of Korean adults.</p><p><strong>Methods: </strong>Data were assessed for 87,668 participants (25,767 men and 61,901 women) from the Korean Genome and Epidemiology Study-Health Examinees cohort. These data were combined with the death certificate database from the National Statistical Office. The participants were divided into four groups according to GGT/HDL-C quartiles. We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for all-cause mortality in the 11.7 years following the baseline survey using multivariate Cox proportional hazard regression models including age, BMI, smoking status, and drinking habits, which are known to be major confounders.</p><p><strong>Results: </strong>During the follow-up period, 3,214 individuals (3.6%; 1,728 men and 1,486 women) died. The respective HRs (95% CIs) of mortality for GGT/HDL-C quartiles 2-4 were 1.15 (0.99-1.33), 1.48 (1.28-1.71), and 1.97 (1.70-2.29) in men and 1.22 (1.02-1.45), 1.36 (1.15-1.61), and 1.69 (1.42-2.00) in women after adjusting for confounders.</p><p><strong>Conclusions: </strong>GGT/HDL-C may be a useful predictive marker for all-cause mortality in men and women. We believe that GGT/HDL-C ratio will provide a complementary tool to help clinicians make decisions about prevention and disease management to improve survival.</p>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750498","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}