American Journal of Hypertension最新文献

{"title":"Elevated blood pressure: a genetically determined risk factor for cerebral artery dissection.","authors":"Xinchun Xu, Qiong Li, Qiuping Chen, Haibo Wang, Chuchu Wu, Xiaohu Chen, Fei Chen, Chaoyan Yue","doi":"10.1093/ajh/hpae102","DOIUrl":"https://doi.org/10.1093/ajh/hpae102","url":null,"abstract":"<p><strong>Background: </strong>We aim to investigate the potential causal link between blood pressure (BP) levels and cerebral artery dissection (CAD) risk employing a two-sample Mendelian randomization (TSMR) framework.</p><p><strong>Methods: </strong>Utilizing large-scale genome-wide association studies (GWAS)-retrieved data, we employed various MR techniques, including inverse variance weighted (IVW), MR-Egger regression, weighted median, and weighted mode, to ascertain BP's causal impact on CAD. The MR-Egger intercept was calculated to assess pleiotropy presence, determining heterogeneity by Cochran's Q statistic.</p><p><strong>Results: </strong>The findings highlighted a significant association between elevated systolic BP (SBP; IVW: OR=3.09, 95% CI: 1.11-8.61, p=0.031) and increased diastolic BP (DBP; IVW: OR=2.17, 95% CI: 1.14-6.21, p=0.023) with CAD risk. Sensitivity analyses reinforced the robustness and reliability of these results.</p><p><strong>Conclusions: </strong>The results from this TSMR study suggest a causal link between high SBP and DBP and the increased likelihood of CAD, which provide genetic evidence for a reduced risk of CAD under blood pressure control.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896515","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":"Another Vital Reason to Treat Hypertension: Preventing Intracranial Artery Dissections.","authors":"Zafer Keser","doi":"10.1093/ajh/hpae104","DOIUrl":"https://doi.org/10.1093/ajh/hpae104","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896514","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":"Dialysate Sodium Levels, Ambulatory Aortic Blood Pressure and Arterial Stiffness in Hemodialysis Patients.","authors":"A Bratsiakou, M Theodorakopoulou, F Iatridi, P Sarafidis, C Davoulos, D S Goumenos, E Papachristou, M Papasotiriou","doi":"10.1093/ajh/hpae094","DOIUrl":"https://doi.org/10.1093/ajh/hpae094","url":null,"abstract":"<p><strong>Background: </strong>Increased aortic blood-pressure(BP) and arterial stiffness are associated with higher cardiovascular risk in hemodialysis. Previous works showed that lower dialysate sodium is associated with lower brachial-BP; data on aortic-BP and arterial stiffness are limited. This study aimed to investigate the effects of different dialysate sodium concentrations on 72-h aortic-BP and arterial stiffness parameters in hemodialysis patients.</p><p><strong>Methods: </strong>This analysis is part of a prospective, non-randomized interventional study. Twenty-five hemodialysis patients underwent a set of three periods of different dialysate sodium concentrations; six sessions with dialysate sodium of 137meq/L, followed consecutively by six sessions with 139meq/L and, finally, six sessions with 141meq/L. At the start of the sixth hemodialysis session on each sodium concentration, 72-h ABPM (Mobil-O-Graph) was performed to evaluate aortic-BP and arterial stiffness indices during the overall 72-h, different 24-h, day-time and night-time periods.</p><p><strong>Results: </strong>Mean 72-h aortic SBP/DBP were higher with increasing dialysate sodium concentrations (137meq/L: 114.2±15.3/77.0±11.8mmHg vs 139meq/L: 115.4±17.3/77.9±14.0mmHg vs 141meq/L: 120.5±18.4/80.5±14.7mmHg, p=0.002/p=0.057, respectively). Wave-reflections parameters (AIx, AIx(75), AP) were not significantly different between the three dialysate sodium concentrations. Ambulatory PWV was significantly higher with increasing dialysate sodium concentrations (137meq/L: 8.5±1.7m/s vs 139meq/L: 8.6±1.6m/s vs 141meq/L: 8.8±1.6m/s, p<0.001). In generalized linear-mixed-models including 72-h brachial SBP as random covariate, the adjusted marginal-means of 72-h PWV were not significantly different between-groups.</p><p><strong>Conclusions: </strong>This study showed that lower dialysate sodium concentrations are associated with significant decreases in ambulatory aortic BP and PWV. This study showed that higher dialysate sodium concentrations are associated with significant increases in ambulatory aortic BP and PWV. These findings further support the need for modification of dialysate sodium concentration in hemodialysis.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888251","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":"Current Status and Future Perspective of Onco-Hypertension.","authors":"Tatsuhiko Azegami, Hidehiro Kaneko, Shintaro Minegishi, Yuta Suzuki, Hiroyuki Morita, Katsuhito Fujiu, Norihiko Takeda, Takashi Yokoo, Yuichiro Yano, Kaori Hayashi, Akira Nishiyama, Koichi Node","doi":"10.1093/ajh/hpae099","DOIUrl":"https://doi.org/10.1093/ajh/hpae099","url":null,"abstract":"<p><p>Hypertension and cancer are both increasing with age. Recently, the new concept of \"Onco-Hypertension\" has been proposed to address the mutual risks posed by hypertension and cancer and to provide comprehensive care for patients with these two conditions in an aging society. Hypertension and cancer share common risk factors and may be interrelated in pathogenesis: hypertension is involved in the development of certain cancers, and cancer survivors have a higher incidence of hypertension. With recent advances in cancer therapy, the number of cancer survivors has increased. Cancer survivors not only have a higher risk of incident hypertension but also an increased risk of future cardiovascular events, highlighting the growing importance of comprehensive care. In this review, we provide an overview of the current status and future perspective of the \"Onco-Hypertension,\" including our research findings.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791675","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":"State-of-the-Art Review for the American Journal of Hypertension Cardio-Rheumatology insights into hypertension: Intersection of inflammation, arteries, and heart.","authors":"Shadi Akhtari, Paula J Harvey, Lihi Eder","doi":"10.1093/ajh/hpae098","DOIUrl":"https://doi.org/10.1093/ajh/hpae098","url":null,"abstract":"<p><p>There is an increased prevalence of atherosclerotic cardiovascular disease (ASCVD) in patients with inflammatory rheumatic diseases (IRD) including rheumatoid arthritis, systemic lupus erythematosus, psoriatic arthritis, and systemic sclerosis. The mechanism for development of ASCVD in these conditions has been linked not only to a higher prevalence and undertreatment of traditional cardiovascular (CV) risk factors, but importantly to chronic inflammation and a dysregulated immune system which contribute to impaired endothelial and microvascular function, factors that may contribute to accelerated atherosclerosis. Accurate ASCVD risk stratification and optimal risk management remains challenging in this population with many barriers that include lack of validated risk calculators, the remitting and relapsing nature of underlying disease, deleterious effect of medications used to manage rheumatic diseases, multimorbidity, decreased mobility due to joint pain, and lack of clarity about who bears the responsibility of performing CV risk assessment and management (rheumatologist vs primary care provider vs cardiologist). Despite recent advances in this field, there remains significant gaps in knowledge regarding the best diagnostic and management approach. The evolving field of Cardio-Rheumatology focuses on optimization of cardiovascular care and research in this patient population through collaboration and coordination of care between rheumatologists, cardiologists, radiologists, and primary care providers. This review aims to provide an overview of current state of knowledge about ASCVD risk stratification in patients with IRD, contributing factors including effect of medications, and review of the current recommendations for cardiovascular risk management in patients with inflammatory disease with a focus on hypertension as a key risk factor.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756566","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":"Assessing the Accuracy of Systolic Aortic Pressure Estimation From a Brachial Cuff Alone: A Comparison With Radial Tonometry.","authors":"Denis Chemla, Davide Agnoletti, Pierre Attal, Sandrine Millasseau, Jacques Blacher, Mathieu Jozwiak","doi":"10.1093/ajh/hpae039","DOIUrl":"10.1093/ajh/hpae039","url":null,"abstract":"<p><strong>Background: </strong>A novel method for estimating central systolic aortic pressure (cSAP) has emerged, relying solely on the peripheral mean (MBP) and diastolic (DBP) blood pressures. We aimed to assess the accuracy of this Direct Central Blood Pressure estimation using cuff alone (DCBPcuff = MBP2/DBP) in comparison to the use of a generalized transfer function to derive cSAP from radial tonometry (cSAPtono).</p><p><strong>Methods: </strong>This retrospective analysis involved the International Database of Central Arterial Properties for Risk Stratification (IDCARS) data (Aparicio et al., Am J Hypertens 2022). The dataset encompassed 10,930 subjects from 13 longitudinal cohort studies worldwide (54.8% women; median age 46.0 years; office hypertension: 40.1%; treated: 61.0%), documenting cSAPtono via SphygmoCor calibrated against brachial systolic BP (SBP) and DBP. Our analysis focused on aggregate group data from 12/13 studies (89% patients) where a full BP dataset was available. A 35% form factor was used to estimate MBP = (DBP + (0.35 × (SBP-DBP)), from which DCBPcuff was derived. The predefined acceptable error for cSAPtono estimation was set at ≤ 5 mm Hg.</p><p><strong>Results: </strong>The cSAPtono values ranged from 103.8-127.0 mm Hg (n = 12). The error between DCBPcuff and cSAPtono was 0.2 ± 1.4 mm Hg, with no influence of the mean. Errors ranged from -1.8 to 2.9 mm Hg across studies. No significant difference in errors was observed between BP measurements obtained via oscillometry (n = 9) vs. auscultation (n = 3) (P = 0.50).</p><p><strong>Conclusions: </strong>Using published aggregate group data and a 35% form factor, DCBPcuff demonstrated remarkable accuracy in estimating cSAPtono, regardless of the BP measurement technique. However, given that individual BP values were unavailable, further documentation is required to establish DCBPcuff's precision.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140183530","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 Association Between Type of Insurance Plan, Out-of-Pocket Cost, and Adherence to Antihypertensive Medications in Medicare Supplement Insurance Enrollees.","authors":"Donglan Zhang, Jianing Xu, Daniel B Hall, Xianyan Chen, Ming Chen, Jasmin Divers, Jingkai Wei, Janani Rajbhandari-Thapa, Davene R Wright, Milla Arabadjian, Henry N Young","doi":"10.1093/ajh/hpae062","DOIUrl":"10.1093/ajh/hpae062","url":null,"abstract":"<p><strong>Background: </strong>Medicare supplement insurance, or Medigap, covers 21% of Medicare beneficiaries. Despite offsetting some out-of-pocket (OOP) expenses, remaining OOP costs may pose a barrier to medication adherence. This study aims to evaluate how OOP costs and insurance plan types influence medication adherence among beneficiaries covered by Medicare supplement plans.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the Merative MarketScan Medicare Supplement Database (2017-2019) in Medigap enrollees (≥65 years) with hypertension. The proportion of days covered (PDC) was a continuous measure of medication adherence and was also dichotomized (PDC ≥0.8) to quantify adequate adherence. Beta-binomial and logistic regression models were used to estimate associations between these outcomes and insurance plan type and log-transformed OOP costs, adjusting for patient characteristics.</p><p><strong>Results: </strong>Among 27,407 patients with hypertension, the average PDC was 0.68 ± 0.31; 47.5% achieved adequate adherence. A mean $1 higher in 30-day OOP costs were associated with a 0.06 (95% confidence intervals [CIs]: -0.09 to -0.03) lower probability of adequate adherence, or a 5% (95% CI: 4%-7%) decrease in PDC. Compared with comprehensive plan enrollees, the odds of adequate adherence were lower among those with point-of-service plans (odds ratio [OR]: 0.69, 95% CI: 0.62-0.77), but higher among those with preferred provider organization (PPO) plans (OR: 1.08, 95% CI: 1.01-1.15). Moreover, the association between OOP costs and PDC was significantly greater for PPO enrollees.</p><p><strong>Conclusions: </strong>While Medicare supplement insurance alleviates some OOP costs, different insurance plans and remaining OOP costs influence medication adherence. Reducing patient cost-sharing may improve medication adherence.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11247132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140896874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sacubitril/Valsartan as an Effective Hypertension Treatment Option in Those With Chronic Type B Aortic Dissection.","authors":"Michael G Buhnerkempe, Stephanie Bitner, John M Flack","doi":"10.1093/ajh/hpae054","DOIUrl":"10.1093/ajh/hpae054","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856301","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":"Efficacy and Safety of Sacubitril/Valsartan in Chronic Type B Aortic Dissection Combined With Mild Hypertension.","authors":"Xuelin Wang, Feier Song, Lujing Jiang, Ziling Huang, Songyuan Luo, Xin Li, Xuyu He","doi":"10.1093/ajh/hpae038","DOIUrl":"10.1093/ajh/hpae038","url":null,"abstract":"<p><strong>Background: </strong>Optimal antihypertensive medication for chronic type B aortic dissection (AD) remains undecided. This study compared the efficacy and safety of sacubitril/valsartan with valsartan to determine suitable antihypertensive drug combinations.</p><p><strong>Methods: </strong>In this single-center, open-label, randomized, controlled trial, patients with chronic Stanford type B AD and mild hypertension were randomized to receive sacubitril/valsartan 100/200 mg or valsartan 80/160 mg. The primary endpoint was the reduction in mean sitting systolic blood pressure (msSBP) at week 8 in patients with sacubitril/valsartan vs. valsartan. Key secondary endpoints included changes in (i) mean sitting diastolic blood pressure (msDBP); (ii) pulse pressure (PP); and (iii) mean ambulatory blood pressure (BP) for 24-hour, daytime, and nighttime. Safety assessments included adverse events (AEs) and serious AEs. This trial was registered with the Chinese Clinical Trial Registry, identifier: ChiCTR2300073399.</p><p><strong>Results: </strong>A total of 315 patients completed the study. Sacubitril/valsartan provided a significantly greater reduction in msSBP than valsartan at week 8 (between-treatment difference: -5.1 mm Hg [95% confidence interval -5.8 to -4.5], P < 0.001). Reductions in msSBP, msDBP, and PP as well as the mean ambulatory BP for 24-hour, daytime, and nighttime, were significantly greater in sacubitril/valsartan compared with valsartan (all P < 0.001). No excessive episodes of AEs occurred in the sacubitril/valsartan group.</p><p><strong>Conclusions: </strong>Sacubitril/valsartan and valsartan reduced BP compared with baseline values. However, sacubitril/valsartan improved BP control to a greater extent than valsartan. It may offer a new treatment option for patients with mild hypertension and chronic type B AD.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334353","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 Role of Notch1 Pathway Regulating CD4+CD25+Foxp3+ T Cells in Renovascular Hypertension","authors":"Dexian Yu, Na Zheng, Lijuan Yin, Yang Chen, Lin Peng, Fajing He, Wenjuan Chen","doi":"10.1093/ajh/hpae053","DOIUrl":"https://doi.org/10.1093/ajh/hpae053","url":null,"abstract":"\u0000 \u0000 \u0000 To explore the role and mechanism of the Notch1 pathway in regulating CD4+CD25+Foxp3+ Treg cells in renal vascular hypertension (RVH).\u0000 \u0000 \u0000 \u0000 According to the diagnostic criteria of RVH in the 8th edition of Internal Medicine, 220 patients treated in the Department of Nephrology of Sichuan Provincial People’s Hospital from January 2019 to January 2022 were enrolled in RVH group, and 220 patients with essential hypertension (EH) in the same period were selected as EH group; another 220 healthy examinees were selected as control group (NC). The proportion of CD4+CD25+ Treg cells in peripheral blood mononuclear cells (PBMCs) and the expression levels of interleukin-10 (IL-10), transforming growth factor-β (TGF-β), and cell proliferation nuclear antigen-67 (Ki-67) in PBMC of the 3 groups were compared by real-time fluorescence quantitative PCR and western blotting; the relative expression levels of Notch1 receptor and ligand mRNA in PBMC of the 3 groups were compared by real-time fluorescence quantitative PCR; the expression of downstream proteins Hes1 and Hes5 of Notch1 signaling pathway, the proportion of CD4+CD25+Foxp3+ Treg cells, and the effect on TGF-β expression were compared by western blotting after adding Notch1 signaling pathway inhibitor (DAPT). Real-time quantitative PCR and western PCR were used. The proportion of CD4+CD25+ Treg cells in PBMCs and the expression levels of IL-10, TGF-β, and cell proliferating nuclear antigen-67 (Ki-67) in PBMC were compared between the 2 groups. Real-time quantitative PCR was used to compare the mRNA expression levels of the Notch1 receptor and ligand in PBMC between the 2 groups.\u0000 \u0000 \u0000 \u0000 Flow cytometry results showed that compared with the NC group, the RVH group had a significantly lower proportion of CD4+CD25+Foxp3+ Treg cells, TGF-β and Ki-67 expression levels, and higher IL-10 expression levels, with significant differences (P < 0.001). Compared with the RVH group, the EH group had a significantly higher proportion of CD4+CD25+Foxp3+ Treg cells, TGF-β and Ki-67 expression levels, and lower IL-10 expression levels, with significant differences (P < 0.001). Real-time quantitative PCR results showed that the RVH group also had significantly higher relative expression levels of Notch receptor Notch1 mRNA, Notch ligand DLL1, DLL4, Jagged1, and Jagged2 mRNA in PBMC than the NC group and EH group, with significant differences (P < 0.001). Western blot results showed that after adding Notch1 signaling pathway inhibitor (DAPT), Hes1 and Hes5 expression in peripheral CD4+CD25+Foxp3+ Treg cells of patients decreased significantly (P < 0.001), while CD4+CD25+Foxp3+ Treg proportion and TGF-β expression level increased significantly (P < 0.001).\u0000 \u0000 \u0000 \u0000 The Notch1 signaling pathway plays an immunoregulatory role in RVH regulated by CD4+CD25+Foxp3+ Treg cells. Regulation of the Notch1 signaling pathway can significantly promote the proliferation of CD4+CD25+Foxp3+ Treg cells and the ability to secrete anti-inf","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141646168","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}