American Journal of Nephrology最新文献

{"title":"Integrated Analysis of the αKlotho-FGF23-FGFR Genetic Axis Reveals Determinants of Cardiovascular Risk in Chronic Kidney Disease.","authors":"Vanessa Nobles, Virginia Díaz-Acevedo, Laura González-Rodríguez, Bárbara Cancho, Raquel Gil-Lozano, Álvaro Álvarez, Nicolás Roberto Robles, Guillermo Gervasini","doi":"10.1159/ajn/ablag018","DOIUrl":"10.1159/ajn/ablag018","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) is associated with a markedly increased cardiovascular (CV) risk. The disruption of the αKlotho-Fibroblast Growth Factor 23 (FGF23)-FGF receptors (FGFRs) axis has been implicated in chronic diseases and CV complications. We aimed to evaluate the impact of genetic variability across this pathway on renal function and CV outcomes in CKD patients.</p><p><strong>Methods: </strong>A total of 829 patients with CKD stages 1-5D were genotyped for 54 tag-single nucleotide polymorphisms (SNPs) and functional variants in KL, FGF23, FGFR1, and FGFR4. Associations with renal function, parameters of blood pressure (BP) and mineral and bone disorder and CV events (CVE) were assessed using single- and multiple-marker approaches adjusting for clinical covariates.</p><p><strong>Results: </strong>FGF23 rs13312770 and KL rs211239 were associated with impaired [odds ratio (OR) = 1.77 (0.99-3.17), p = 0.047] and preserved [OR = 0.55 (0.31-0.98), p = 0.035] renal function, respectively. Four KL SNPs were associated with BP traits, namely rs385564 and rs2283368 with diastolic BP [mean difference: -2.43 (-4.56-0.29), p = 0.026 and 2.73 (0.21-5.25), p = 0.034] and rs78425544 and rs9536314 with pulse pressure [5.07 (0.16-9.98), p = 0.043 and 3.50 (0.06-6.93), p = 0.047]. Six FGFR1 SNPs were associated with vitamin D levels, with rs2978083 showing the strongest association (p < 0.0001). Seventy-three (8.8%) patients experienced CVE during follow-up. Carriers of FGFR4 rs351855 had improved CVE-free survival [hazard ratio (HR) = 0.52 (0.28-0.96), p = 0.037], whilst KL rs2283368, KL rs575536, and FGFR1 rs2956724 were associated with increased risk [HR = 2.02 (1.09-3.78), p = 0.022, HR = 2.38 (1.25-4.50), p = 0.007, and HR = 2.18 (1.03-4.63), p = 0.041, respectively]. The inclusion of these four SNPs in a clinical-only Cox model improved Harrell's C-index from 0.739 to 0.79 (ΔC = 0.056, 7.6%). Haplotypes based on sliding-windows identified several 3-SNP and 2-SNP combinations with a relevant effect on CV risk. Finally, epistasis analysis showed that FGFR1 rs3758101 combined with three different KL variants in SNP pairs significantly impacted CV risk (p < 0.001 in all instances).</p><p><strong>Conclusion: </strong>Genetic variability within the αKlotho-FGF23-FGFR axis is significantly associated with renal function and CV outcomes in CKD. Multi-locus approaches reveal combined and interactive effects that enhance risk stratification beyond single-variant analyses.</p>","PeriodicalId":7570,"journal":{"name":"American Journal of Nephrology","volume":" ","pages":"1"},"PeriodicalIF":3.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179069","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":"Response to the Letter to the Editor Entitled \"Additive Obinutuzumab Achieves High Remission Rates in Rituximab-Refractory Membranous Nephropathy: Caution in effect Attribution\".","authors":"Huixian Li, Wanhong Lu","doi":"10.1159/ajn/ablag028","DOIUrl":"https://doi.org/10.1159/ajn/ablag028","url":null,"abstract":"","PeriodicalId":7570,"journal":{"name":"American Journal of Nephrology","volume":" ","pages":"1"},"PeriodicalIF":3.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163439","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 of Hemoglobin Levels with Progression to End-Stage Kidney Disease in IgA Nephropathy: A Sex-Specific Analysis.","authors":"Ji-Eun Yoo, Kyu Yeun Kim, Man-Hoon Han, Yong-Jin Kim, Yu Jin Seo, Junyoung Park, Min-Gyu Kim, Youn-Sik Oh, You Hyun Jeon, Hee-Yeon Jung, Ji-Young Choi, Jang-Hee Cho, Chan-Duck Kim, Yong-Lim Kim, Jeong-Hoon Lim, Sun-Hee Park","doi":"10.1159/ajn/ablag012","DOIUrl":"10.1159/ajn/ablag012","url":null,"abstract":"<p><strong>Introduction: </strong>The prognostic significance of hemoglobin (Hb) levels in immunoglobulin A nephropathy (IgAN) remains uncertain, particularly regarding potential sex-specific differences. We investigated the association between Hb levels and progression to end-stage kidney disease (ESKD) in patients with biopsy-proven IgAN.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study included 788 adults with biopsy-proven IgAN diagnosed between 2002 and 2021. Patients were categorized by Hb levels at biopsy (<11.0, 11.0-11.9, 12.0-12.9 [reference], 13.0-13.9, and ≥14.0 g/dL). The primary outcome was progression to ESKD. Multivariable Cox proportional hazards models and sex-stratified analyses were performed.</p><p><strong>Results: </strong>During a median follow-up of 70 months, 66 patients (8.4%) progressed to ESKD. In multivariable analysis, Hb < 11.0 g/dL was independently associated with a higher risk of ESKD compared with the reference group (adjusted hazard ratio [aHR], 2.88; 95% confidence interval [CI], 1.24-6.68; p = 0.014). Restricted cubic spline analysis demonstrated a nonlinear relationship between Hb levels and ESKD risk, with a marked increase below approximately 12 g/dL. In women, low Hb levels remained significantly associated with ESKD (Hb < 11.0 g/dL: aHR, 5.10; 95% CI, 1.35-19.29; p = 0.016; Hb 11.0-11.9 g/dL: aHR, 4.66; 95% CI, 1.26-17.19; p = 0.021), whereas no significant association was observed in men. Lower Hb levels were also associated with more severe tubular atrophy/interstitial fibrosis and endocapillary hypercellularity.</p><p><strong>Conclusions: </strong>Low Hb levels at diagnosis were independently associated with progression to ESKD in patients with IgAN, particularly among women. Hb may serve as a simple and clinically useful prognostic marker for risk stratification in IgAN.</p>","PeriodicalId":7570,"journal":{"name":"American Journal of Nephrology","volume":" ","pages":"1"},"PeriodicalIF":3.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164296","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":"The Solitary Functioning Kidney: From Pathophysiology to Long-Term Management.","authors":"Ranhao Li, Hongxia Mai, Wenjun Zhang","doi":"10.1159/ajn/ablag029","DOIUrl":"https://doi.org/10.1159/ajn/ablag029","url":null,"abstract":"<p><p>Solitary functioning kidney (SFK) is a clinical condition characterized by the presence of a single functioning kidney, arising from either congenital anomalies or acquired causes. It is recognized as an important risk factor for chronic kidney disease (CKD) and, in some patients, for progression to end-stage kidney disease (ESKD). Congenital solitary functioning kidney is commonly associated with renal hypoplasia or dysplasia, genetic abnormalities, and congenital anomalies of the kidney and urinary tract, whereas acquired solitary functioning kidney is often secondary to unilateral nephrectomy for renal tumors, trauma, tuberculosis, severe infection, or living kidney donation. The principal pathophysiological mechanisms underlying the progression from SFK to CKD are compensatory renal hypertrophy and glomerular hyperfiltration in the remnant kidney. Although these adaptive responses may initially maintain renal function, sustained compensation can lead to glomerular injury, proteinuria, tubulointerstitial damage, and renal fibrosis. Early diagnosis relies primarily on imaging modalities, such as ultrasonography and magnetic resonance imaging, together with assessment of renal function and emerging biomarkers, including neutrophil gelatinase-associated lipocalin and cystatin C. Prognostic evaluation of patients with SFK should comprehensively consider etiology, age, compensatory renal growth, associated urinary tract anomalies, comorbidities, and markers of kidney injury. Effective long-term management is essential to prevent or delay progression to CKD and ESKD, with particular emphasis on individualized follow-up, lifestyle modification, blood pressure control, reduction of proteinuria, and avoidance of additional nephrotoxic insults. Previous publications have often addressed pediatric congenital solitary functioning kidney (CSFK), living kidney donors, and disease-related nephrectomy cohorts separately, limiting the translation of heterogeneous evidence into a common clinical approach. This review integrates congenital and acquired SFK across the life course, distinguishes shared markers of established kidney injury from etiology-specific determinants of renal reserve, and proposes an evidence-informed framework for dynamic risk stratification and risk-adapted follow-up and management. This framework is conceptual and requires prospective validation.</p>","PeriodicalId":7570,"journal":{"name":"American Journal of Nephrology","volume":" ","pages":"1"},"PeriodicalIF":3.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163801","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":"Mesenchymal stromal cell derived membrane particles improve metabolic activity and functional performance during porcine kidney normothermic machine perfusion.","authors":"Shengbing Li, Yitian Fang, Robert C Minnee, Ron de Bruin, Martin J Hoogduijn","doi":"10.1159/ajn/ablag010","DOIUrl":"https://doi.org/10.1159/ajn/ablag010","url":null,"abstract":"<p><p>Introduction Kidneys from donation after circulatory death (DCD) donors are increasingly used to alleviate organ shortage but highly vulnerable to ischemia-reperfusion injury, leading to poor graft outcomes. Normothermic machine perfusion (NMP) enables targeted intervention during donor kidney preservation. Membrane particles (MPs) derived from mesenchymal stromal cells (MSCs) have shown regenerative potential. We aimed to investigate MPs as a potential therapeutic strategy to improve metabolism and function in porcine DCD kidneys during NMP. Methods Six pairs of porcine kidneys underwent 4-hour NMP. Within each pair, one kidney received perfusate containing MPs derived from 1.0×107 MSCs, while the contralateral kidney served as a control. Hemodynamics, sodium reabsorption, oxygen consumption, and injury markers were monitored. Gene expression related to inflammation and metabolism were analyzed. Results MP administration did not affect renal blood flow or intrarenal resistance. Injury markers (AST, LDH, IL-6) were increased over time in both groups, without significant difference between MP-treated and control kidneys. In contrast, MP-treated kidneys showed significantly higher expression of metabolic genes (PDHB, ATP6V0D2, NDUFS8). Functionally, MP administration enhanced sodium reabsorption, urinary creatinine excretion, and oxygen utilization efficiency compared with controls. Conclusion MSC-derived MPs can be safely delivered to porcine kidneys and promote kidney functional performance and metabolic activity. These findings support MPs as a promising cell-free therapeutic strategy to improve the quality of kidneys during NMP.</p>","PeriodicalId":7570,"journal":{"name":"American Journal of Nephrology","volume":" ","pages":"1"},"PeriodicalIF":3.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164403","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":"The Cardiorenal Protective Effects of Low-Dose Tolvaptan in Peritoneal Dialysis Patients with Volume Overload.","authors":"Xinyang Li, Panpan Chao, Chongyu Zhang, Wenpeng Cui","doi":"10.1159/ajn/ablag013","DOIUrl":"10.1159/ajn/ablag013","url":null,"abstract":"<p><strong>Introduction: </strong>The aims of the study were to compare the efficacy and safety of low-dose tolvaptan versus conventional therapy in peritoneal dialysis (PD) patients with volume overload and to evaluate its effects on cardiac and renal functions.</p><p><strong>Methods: </strong>The control group received conventional therapy, while the tolvaptan group received oral tolvaptan (15 mg) every other day for 6 months. Clinical and safety data were collected at baseline, 3, 6, and 9 months (3 months post-discontinuation). Primary outcomes included changes in volume status, residual renal function, and cardiac function.</p><p><strong>Results: </strong>Sixty patients with PD who underwent regular follow-up at the Second Hospital of Jilin University between May 1, 2023, and December 31, 2025, were randomized 1:1 to tolvaptan or control (n = 30 each); 56 completed follow-up (28 per group). Overhydration decreased in both groups, with a greater reduction in the tolvaptan group (linear trend test, p = 0.033). A 24-h urine volume in the tolvaptan group increased during the first week (p = 0.02) and remained higher throughout the treatment period (all p < 0.05), although total water removal (urine volume plus peritoneal ultrafiltration volume) did not differ between the 2 groups at any follow-up time point (all p > 0.05). A 24-h peritoneal ultrafiltration in the tolvaptan group showed an initial decrease, followed by an increase. Residual renal glomerular filtration rate (GFR) in the tolvaptan group remained stable at 3 and 6 months (p = 0.695, p = 0.178), but decreased after discontinuation (p < 0.001), whereas in the control group, residual renal GFR was lower than baseline at all time points (p < 0.05). Ln (BNP) levels declined in both groups (p = 0.392). The left ventricular ejection fraction in the tolvaptan group increased during the first 6 months (p = 0.019) but decreased at 9 months, with no change in controls. Ln (LVMI) decreased in the tolvaptan group but increased in the control group, with a significant difference in trends (p < 0.001). One patient had hypernatremia, which resolved, no other adverse events. During the follow-up period, no episodes of PD-related peritonitis, PD technique failure, or all-cause mortality were observed in either group.</p><p><strong>Conclusion: </strong>With strict sodium monitoring, low-dose tolvaptan safely improved volume status and delayed residual renal function decline. It also showed potential cardioprotective effects, primarily reflected by a reduction in LVMI. However, the long-term effects on hard clinical outcomes, including mortality and technique survival, require further investigation.</p>","PeriodicalId":7570,"journal":{"name":"American Journal of Nephrology","volume":" ","pages":"1"},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134803","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":"A new beating heart model of cardiopulmonary bypass-induced acute kidney injury demonstrates heme protein toxicity and ferroptosis.","authors":"Kathryn Smedlund, Dulat Bekbolsynov, Mustafa Azizi, Apurva Lad, Sareeta Manandhar, William T Gunning, Sebastian V Jansen, Lasse J Strudthoff, David E Leaf, Stanislaw Stepkowski, Rajesh Gupta","doi":"10.1159/ajn/ablag022","DOIUrl":"https://doi.org/10.1159/ajn/ablag022","url":null,"abstract":"<p><strong>Background: </strong>Cardiac surgery-associated acute kidney injury (CSA-AKI) occurs in 20-30% of patients after heart surgery with cardiopulmonary bypass (CPB). AKI rates are even higher in VA ECMO treated patients. The pathogenesis of CSA-AKI is incompletely understood, and preventative therapies are lacking. We hypothesize that CSA-AKI occurs due to pump related RBC hemolysis and accumulation of cell-free hemoglobin (CFH) and hemopexin in the kidneys.</p><p><strong>Methods: </strong>A new beating heart model of CPB was developed. Rats were used for CPB experiments; blood pressure (BP) was measured by Millar invasive BP catheters, and Glomerular Filtration Rate (GFR) was measured at 24 hours after CPB using the FITC-Sinistrin (FITC-S) method. Western immunoblots were performed to measure hemopexin (Hpx), glutathione peroxidase 4 (GPX4), and β-actin. Urine KIM-1 was measured by ELISA method. KIM-1 and TATA-box Binding Protein 1 (TBP1) mRNA expression were quantified by qRT-PCR. Plasma levels of cell-free hemoglobin (CFH), Hpx, haptoglobin, and IL-6 were measured by ELISA. Immunofluorescence labeling was used to detect hemoglobin (Hb), Hpx, megalin, and KIM-1 in kidneys. Lipid peroxidation was assessed with 4-hydroxynonenal (4-HNE) staining.</p><p><strong>Results: </strong>Compared with sham controls, GFR was reduced 24 hours after CPB and histological kidney sections had higher scores, indicating CPB-induced AKI. Urine KIM-1 protein level and kidney KIM-1 mRNA were increased after CPB. Immunofluorescence staining also showed tubular KIM-1 staining after CPB. Plasma IL-6 levels were increased after CPB, and plasma Hpx increased 24 hours after CPB. Immunofluorescence staining demonstrated colocalized Hpx and megalin in proximal tubules in kidneys, with hemoglobin staining in kidneys after CPB. Finally, ferroptosis was induced by CPB, as evidenced by decreased GPX4 protein and increased 4-HNE staining at 24 hrs. after CPB.</p><p><strong>Conclusion: </strong>CPB induces AKI with evidence of hemoglobin and Hpx deposition in the proximal tubules and ferroptosis.</p>","PeriodicalId":7570,"journal":{"name":"American Journal of Nephrology","volume":" ","pages":"1"},"PeriodicalIF":3.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079160","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":"Viewpoint: Microvascular Failure at the Cardiorenal Crossroads: Rethinking Congestion in HFpEF and CKD.","authors":"Carmine Zoccali, Francesca Mallamaci, Raffaele De Caterina","doi":"10.1159/ajn/ablag014","DOIUrl":"https://doi.org/10.1159/ajn/ablag014","url":null,"abstract":"","PeriodicalId":7570,"journal":{"name":"American Journal of Nephrology","volume":" ","pages":"1"},"PeriodicalIF":3.8,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987711","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":"Orforglipron and the Kidney: A Promise or Disappointment? The Need for Trials Examining Renal Outcomes.","authors":"Joel Shah, Eder Luna-Ceron, Fernanda Payan-Schober, Lisa Aimee Hechanova, Deborah J Clegg, Biff F Palmer","doi":"10.1159/ajn/ablag011","DOIUrl":"10.1159/ajn/ablag011","url":null,"abstract":"<p><strong>Background: </strong>Orforglipron, the first oral non-peptide GLP-1 receptor agonist, has a pharmacokinetic and formulation profile that may be theoretically attractive for patients with chronic kidney disease (CKD) including hepatic metabolism with minimal renal excretion and removal of potential barriers associated with current injectable and other oral formulations.</p><p><strong>Summary: </strong>We utilized a literature search utilizing PubMed/MEDLINE and ClinicalTrials.gov from their respective inceptions through May 2026 to synthesize a review on orforglipron. Phase 3 trials demonstrated significant reductions in hemoglobin A1c, body weight, and cardiovascular risk markers with stable eGFR and no indications of significant renal toxicity. These trials however were not designed or powered to evaluate renal outcomes including eGFR, albuminuria, and kidney failure progression. Additionally, previous trials were noted to have underrepresented or excluded populations of patients with advanced CKD; thus, renal effects are inferential barring further clinical investigation, though a current trial examining kidney and cardiovascular outcomes in patients with both atherosclerosis and CKD is underway.</p><p><strong>Key message: </strong>Future CKD-specific trials are necessary to determine the safety, efficacy, and potential integration of orforglipron into nephrology treatment algorithms.</p>","PeriodicalId":7570,"journal":{"name":"American Journal of Nephrology","volume":" ","pages":"1"},"PeriodicalIF":3.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918105","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":"Additive Obinutuzumab in Rituximab-refractory Membraneous Nephropathy: Caution in Effect Attribution.","authors":"Emre Cankaya, Burak Aslum, Ezgi Çoskun Yenigun","doi":"10.1159/ajn/ablag009","DOIUrl":"10.1159/ajn/ablag009","url":null,"abstract":"","PeriodicalId":7570,"journal":{"name":"American Journal of Nephrology","volume":" ","pages":"1"},"PeriodicalIF":3.8,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896436","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}