Acta Haematologica最新文献

{"title":"Two Novel Heterozygous Mutations (p.γPhe230Val and p.AαAsn839Thr) Cause Hereditary Hypodysfibrinogenemia in Two Chinese Independent Families.","authors":"Shengchen Ge,&nbsp;Yuqing Luo,&nbsp;Rujiao Dong,&nbsp;Xiaoli Guo,&nbsp;Mingshan Wang,&nbsp;Yi Chen","doi":"10.1159/000527952","DOIUrl":"https://doi.org/10.1159/000527952","url":null,"abstract":"<p><p>The objective of this study was to explore the molecular defects in two Chinese families with hypodysfibrinogenemia. The coagulation method and immunoturbidimetric method were used to detect plasma fibrinogen activity and plasma fibrinogen antigen. The fibrinogen genes were amplified by PCR, and suspected mutations were confirmed by reverse sequencing. Bioinformatics and model analysis were used to study the conservatism and harm of the mutations. Study showed that the Fg:C and Fg:Ag of the probands of the two families were reduced, respectively, to 0.80g/L, 0.92g/L and 1.35g/L, 1.42g/L; gene analysis revealed that the proband 1 had a heterozygous missense mutation of c.688T>G (p.γPhe230Val) in exon 7 of the FGG gene; the c.2516A>C (p.AαAsn839Thr) heterozygous missense mutation in exon 6 of the FGA gene was got by the proband 2. These mutations found in this study might be related to the hypodysfibrinogenemia.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":"146 3","pages":"252-258"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9616654","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":"Anemia in Celiac Disease: Multiple Aspects of the Same Coin.","authors":"Styliani Kokoris,&nbsp;Eleni Gavriilaki,&nbsp;Eleni Vrigkou,&nbsp;Konstantinos Triantafyllou,&nbsp;Anna Roumeliotou,&nbsp;Elias Kyriakou,&nbsp;Evangelia Lada,&nbsp;Argyri Gialeraki,&nbsp;Dimitrios Kalantzis,&nbsp;Elisavet Grouzi","doi":"10.1159/000527463","DOIUrl":"https://doi.org/10.1159/000527463","url":null,"abstract":"<p><p>Extraintestinal manifestations of celiac disease (CD) are an integral part of the disease's clinical profile and, frequently, appear as the presenting feature. Given that anemia in CD may be multifactorial, increased awareness is needed on the part of treating physicians, and especially hematologists, to screen for CD. In this study, we highlight anemia as the presenting feature of CD which has remained undiagnosed for several years. In patients with a positive antibody testing or high suspicion of CD, endoscopy with a biopsy of the small intestine is performed, as it is considered the \"gold standard\" for diagnosing CD. Since most of the manifestations of CD are preventable or treatable with a gluten-free diet, an early diagnosis is vital for the prevention of serious and potentially lethal complications.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":"146 1","pages":"82-87"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10671708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Recurrent Atypical e8a2 BCR::ABL1 Transcript with Insertion of an Inverted 55 Base Pair ABL1 Intron 1b Sequence: A Detailed Molecular Analysis.","authors":"Thomas Burmeister,&nbsp;Lars Bullinger,&nbsp;Philipp le Coutre","doi":"10.1159/000531128","DOIUrl":"10.1159/000531128","url":null,"abstract":"<p><p>Atypical BCR::ABL1 transcripts are found in approximately 2% of cases of chronic myeloid leukemia. It is important to detect them since affected patients also benefit from tyrosine kinase inhibitor therapy. In the rare e8a2 atypical BCR::ABL1 transcript, two out-of-frame exons are fused, thus, interposed nucleotides are usually found at the fusion site to restore the reading frame. In approximately half of previously reported e8a2 BCR::ABL1 cases, an inserted 55 bp sequence homologous to an inverted sequence from ABL1 intron 1b was detected. The generation of this recurrent transcript variant is not obvious. This work describes the molecular analysis of such an e8a2 BCR::ABL1 translocation from a CML patient. The genomic chromosomal breakpoint is identified, and the formation of this transcript is theoretically explained. The clinical course of the patient is reported, and recommendations are provided for the molecular analysis of future e8a2 BCR::ABL1 cases.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"413-418"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9522856","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":"An Analysis of Dasatinib Treatment Patterns in Patients with Chronic Myeloid Leukemia after Experiencing Pleural Effusion during Dasatinib Therapy.","authors":"Ali McBride,&nbsp;John Brokars,&nbsp;Sheila Reiss Reddy,&nbsp;Eunice Chang,&nbsp;Marian H Tarbox,&nbsp;Thomas W LeBlanc","doi":"10.1159/000530512","DOIUrl":"https://doi.org/10.1159/000530512","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment with dasatinib for chronic myeloid leukemia (CML) has been associated with development of pleural effusion; however, data regarding its optimal management are limited. We examined treatment patterns and healthcare resource utilization (HCRU) and costs among patients with CML treated with dasatinib who experienced a subsequent pleural effusion.</p><p><strong>Methods: </strong>Adults with CML and ≥1 pharmacy claim for dasatinib in 2015-2018 who experienced pleural effusion after dasatinib were identified using data from claims databases.</p><p><strong>Results: </strong>Overall, 123 patients were eligible. After 1 year, of the 38.2% of patients with a dose modification, 72.3% did not switch treatment; among these patients, 70.6% continued treatment. Among patients with a stable dose after pleural effusion (61.8%), 57.9% later switched to another TKI. The mean (SD) duration of dasatinib treatment after pleural effusion was 262.0 (124.0) days for patients with a dose modification versus 149.1 (155.2) days for those with a stable dose (p &lt; 0.001). HCRU and costs were similar between groups.</p><p><strong>Conclusion: </strong>Dasatinib dose modification after pleural effusion was not always required; however, patients with dose modifications continued therapy for a longer duration with a lower rate of switching to another TKI versus patients who remained on a stable dose.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":"146 4","pages":"259-266"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10038000","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":"Photon Counting Detector Computed Tomography: A New Frontier of Myeloma Bone Disease Evaluation.","authors":"Joselle Cook, Kishore Rajendran, Andrea Ferrero, Preet Dhillon, Shaji Kumar, Francis Baffour","doi":"10.1159/000531461","DOIUrl":"10.1159/000531461","url":null,"abstract":"<p><p>Photon counting detector (PCD) computed tomography (CT) is a paradigm-shifting innovation in CT imaging which was recently granted approval for clinical use by the US Food and Drug Administration. PCD-CT allows the generation of multi-energy images with increased contrast and scanning speed or ultra-high spatial resolution (UHR) images with lower radiation doses, compared to the currently used energy integrating detector (EID) CT. Since the recognition of bone disease related to multiple myeloma is important for the diagnosis and management of patients, the advent of PCD-CT heralds a new era in superior diagnostic evaluation of myeloma bone disease. In a first-in-human pilot study, patients with multiple myeloma were imaged with UHR-PCD-CT to validate and establish the utility of this technology in routine imaging and clinical care. We describe 2 cases from that cohort to highlight the superior imaging performance and diagnostic potential of PCD-CT for multiple myeloma compared to clinical standard EID-CT. We also discuss how the advanced imaging capabilities from PCD-CT enhances clinical diagnostics to improve care and overall outcomes for patients.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"419-423"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10568597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9660911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resolution of Melanoma to Programmed Death-1 Blockade but Simultaneous Rapid Progression of Concomitant Chronic Lymphocytic Leukemia.","authors":"Melinda Burgess,&nbsp;Colm Keane,&nbsp;Joshua Wd Tobin,&nbsp;Soi Cheng Law,&nbsp;Alison Griffin,&nbsp;Devinder Gill,&nbsp;Adam D Ewing,&nbsp;Victoria Atkinson,&nbsp;Peter Mollee,&nbsp;Muhammed B Sabdia,&nbsp;Nicholas Saunders,&nbsp;Maher K Gandhi","doi":"10.1159/000527631","DOIUrl":"https://doi.org/10.1159/000527631","url":null,"abstract":"<p><p>Here, we present a novel case of a patient with chronic lymphocytic leukemia (CLL) who received CTLA-4 and then PD-1 immune-checkpoint blockade (ICB) as treatment for concomitant metastatic melanoma. Whereas the metastatic melanoma was responsive to ICB, the CLL rapidly progressed (but responded to ICB cessation and ibrutinib). There were no new genetic mutational drivers to explain the altered clinical course. PD-1/PD-L1/PD-L2 and CTLA-4/CD80/CD86 expression was not increased in CLL B cells, CD8+ or CD4+ T-cell subsets, or monocytes. The patient's CLL B cells demonstrated strikingly prolonged in vitro survival during PD-1 blockade, which was not observed in samples taken before or after ICB, or with other patients. To our knowledge, a discordant clinical course to ICB coupled with these biological features has not been reported in a patient with dual malignancies.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":"146 2","pages":"166-171"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9243587","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":"Successful Multidisciplinary Management of Aortic Valve Repair in Severe Hemophilia B with Extended Half-Life Recombinant Factor IX Concentrate.","authors":"Giulia Milano,&nbsp;Laura Banov,&nbsp;Johanna Svahn,&nbsp;Marco Gucciardo,&nbsp;Fernando Marotta,&nbsp;Angelo Claudio Molinari","doi":"10.1159/000529056","DOIUrl":"https://doi.org/10.1159/000529056","url":null,"abstract":"<p><p>Successful management of surgery in severe coagulation disorders depends on adequate replacement of the deficient factors from intervention until wound healing. Extended half-life (EHL) recombinant factor IX (rFIX) has been increasingly used in hemophilia B (HB) patients. Monitoring of blood levels of EHL rFIX allows to obtain pharmacokinetic (PK) parameters in order to optimize and personalize therapeutic scheme. We describe a case of a young male with severe HB who successfully underwent aortic valve repair. This is the first reported open-heart surgery in a patient with severe HB using EHL rFIX. The success was based on accurate PK evaluation and on meticulous preoperative planning and close cooperation among surgeons, hemophilia specialists, and laboratory team despite the long distance between hemophilia center and surgical clinic.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":"146 4","pages":"322-325"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10336478","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":"Relevant Clinical Factors in Patients with Myelofibrosis on Ruxolitinib for 5 or More Years.","authors":"Lucia Masarova, Prithviraj Bose, Naveen Pemmaraju, Lingsha Zhou, Sherry Pierce, Zeev Estrov, Hagop Kantarjian, Srdan Verstovsek","doi":"10.1159/000533875","DOIUrl":"10.1159/000533875","url":null,"abstract":"<p><strong>Introduction: </strong>Median duration of therapy with the first JAK1/2 inhibitor ruxolitinib (RUX) approved for patients with intermediate or high-risk myelofibrosis (MF) is about 3 years.</p><p><strong>Methods: </strong>In this retrospective study, we aimed to evaluate clinical features, predictive factors, and outcome of patients presenting to our institution who were able to remain on RUX for ≥5 years (RUX ≥5y, n = 73).</p><p><strong>Results: </strong>Comparing baseline demographics of patients who remained on RUX ≥5y (n = 73) with patients who were on RUX for 6 months to 3 years (n = 203), we confirmed that patients on RUX ≥5y lacked advanced clinical features at the start of therapy, such as anemia, neutropenia, thrombocytopenia, higher blasts or monocytes. Predictive independent factors for staying on RUX ≥5y were hemoglobin &gt;10 g/dL, circulating blasts &lt;1%, platelets &gt;150 × 109/L, neutrophils &gt;70%, and having primary MF. Age over 65 years remained significant for outcome in patients on RUX ≥5y.</p><p><strong>Conclusion: </strong>In this retrospective study, we report on the relevance of absence of advanced clinical features for long RUX therapy and confirm the role of age on outcome despite therapy.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"523-530"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10572112","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":"Contents Vol. 145, 2022","authors":"B. Ramot, I. Ben-bassat","doi":"10.1159/000527908","DOIUrl":"https://doi.org/10.1159/000527908","url":null,"abstract":"Vera Ulrike Bacher – Inselspital, Bern, Switzerland Caterine Bagot – Glasgow Royal Infirmary, Glasgow, UK Barbara Bain – St. Mary’s Hospital, London, UK Gautam Borthakur – University of Texas, Houston, TX, USA Jan A. Burger – The University of Texas, Houston, TX, USA Noel Chan – McMaster University, Hamilton, ON, Canada Morton Coleman – New York Presbyterian Hospital, New York, NY, USA Nicolas C.P. Cross – Salisbury District Hospital, Salisbury, UK Courtney D. DiNardo – The University of Texas, Houston, TX, USA Francesco Di Raimondo – University of Catania, Catania, Italy Dan Douer – University of Southern California, Los Angeles, CA, USA Robert Peter Gale – Los Angeles, CA, USA Morie A. Gertz – Mayo Clinic College of Medicine, Rochester, MN, USA Chaim Hershko – Shaare Zedek Medical Center, Jerusalem, Israel Elias Jabbour – The University of Texas, Houston, TX, USA Tapan M. Kadia – MD Anderson Cancer Center, Houston, TX, USA Hagop Kantarjian – MD Anderson Cancer Center, Houston, TX, USA C. Ola Landgren – Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA Lucia Masarova – MD Anderson Cancer Center, Houston, TX, USA Alison Moskowitz – Memorial Sloan Kettering Cancer Center, New York, NY, USA Arnon Nagler – Chaim Sheba Medical Center, Tel Hashomer, Israel Maro Ohanian – MD Anderson Cancer Center, Houston, TX, USA Guillermo J. Ruiz-Argüelles – Clínica Ruiz, Puebla, Mexico Deborah Rund – Hebrew University, Jerusalem, Israel Koji Sasaki – MD Anderson Cancer Center, Houston, TX, USA Sam Schulman – McMaster Clinic, Hamilton, ON, Canada John F. Seymour – University of Melbourne, Melbourne, VIC, Australia Nicholas Short – The University of Texas, Houston, TX, USA Founded 1948 by E. Meulengracht, K. Rohr, and G. Rosenow Continued by H. Lüdin (1960–1977), U. Bucher (1977–1983), R.S. Hillman (1978–1987), H.R. Marti (1983–1988), E.A. Beck (1984–1988), B. Ramot (1989–1995), B. Ramot and I. Ben-Bassat (1992–1995), and I. Ben-Bassat (1995–2017) Acta Haematologica","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":"145 1","pages":"I - IX"},"PeriodicalIF":2.4,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46745167","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":"PharmaNews","authors":"Sabine M. Rüdesheim, Frechen, Quelle","doi":"10.1159/000526949","DOIUrl":"https://doi.org/10.1159/000526949","url":null,"abstract":"Im Rahmen des diesjährigen Kongresses der Deutschen Gesellschaft für Innere Medizin (DGIM) fand am 30. April 2022 das Symposium «SARS-CoV-2-Varianten & Durchbruchsinfektionen: Aktuelles Update zur Wirksamkeit der zugelassenen COVID-19 Therapieoptionen» statt. Als wissenschaftlicher Vorsitzender gab Prof. Dr. Sebastian Dolff, Essen, den Auftakt mit einem Update zur epidemiologischen Lage von COVID-19 in Deutschland: Im dritten Jahr der Pandemie ist das Virus mit einer (zum Zeitpunkt des DGIM) sinkenden 7-Tage-Inzidenz von 758,5 Neuinfektionen pro 100 000 Einwohnern (EW) in Deutschland weiterhin weit verbreitet (Stand 29. April 2022). Die Rate an Hospitalisierungen liegt bei 5,08/100 000 EW (7-Tage-Inzidenz) und es befinden sich 531 145 COVID-19-Patient*innen im Krankenhaus, davon 1408 in intensivmedizinischer Behandlung (Stand 29. April 2022) [1]. Die Anzahl der Hospitalisierungen ist weiterhin sinkend. Damit belegen COVID-19-Patient*innen in Deutschland (zum Zeitpunkt des Kongresses) 6,4% der betreibbaren Intensivbetten für Erwachsene [1]. PD Dr. Dr. Martin Stürmer, Frankfurt und Kaiserslautern, betonte jedoch: «Die Dunkelziffer ist sehr hoch.» Zum einen nimmt die Anzahl der durchgeführten Tests aktuell deutlich ab, zum anderen schwankt die Positivrate der Tests [2]. In seinem Vortrag ging Stürmer auch auf mögliche Ursprünge des Virus ein: So konnte durch Whole-Genome-Sequencing und Genmarker-Analyse ein phylogenetischer Baum erstellt werden, demzufolge das Fledermaus-Virus RaTG13 und Pangolin-CoV die mit SARS-CoV-2 am nächsten verwandten Virustypen darstellen und als Ursprung infrage kommen [3]. Doch das Virusgenom veränderte sich auch seit Beginn der Pandemie: Eine Vielzahl von Varianten des SARS-CoV-2 ist entstanden, die durch Veränderungen im Erregergenom mit neuen Eigenschaften einhergehen können, z.B. bezüglich Übertragbarkeit oder Immunantwort [4]. Nach der ursprünglichen Alpha-Variante haben sich in Deutschland zu geringen Teilen Beta und Gamma, aber prominent Delta und Omikron verbreitet – die derzeit vorherrschende Variante ist der Subtyp Omikron BA.2 [5]. Alle bisher identifizierten Varianten weisen Mutationen am sogenannten Spike-Protein auf. Dieses Oberflächenprotein ist das Ziel der Anti-SARS-CoV-2-Antikörper, die z.B. durch die Schutzimpfung induziert werden [6]. Doch trotz dieser Mutationen ist die Impfung auch gegen die neueren Varianten wirksam: Nach der Auffrischungsimpfung beträgt die geschätzte Impfeffektivität gegen Hospitalisierung bei den 12–17-Jährigen 62%, bei den 18–59-Jährigen 63% und bei den Erkrankten ≥ 60 Jahre sogar 84% [5]. Auch die Frage nach Therapiemöglichkeiten gegen die aktuell vorherrschenden Varianten wurde auf dem Symposium erörtert. Denn Symptomatik und Schwere des Krankheitsverlaufs können stark variieren – von symptomlosen Infektionen bis hin zu schweren Pneumonien und Tod [4]. Nach der Infektion kommt es früh im Erkrankungsverlauf zur viralen Abwehrphase, in der sich das Virus abhängig von der viralen ","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":"145 1","pages":"572 - 574"},"PeriodicalIF":2.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42646719","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}