Annals of hepatology最新文献

{"title":"Comment on \"Role of waist circumference, body mass index and high-sensitivity C-reactive protein in pediatric steatotic liver disease: A cross-sectional study\".","authors":"Xiaohan Zhou, Yani Wang","doi":"10.1016/j.aohep.2025.101934","DOIUrl":"https://doi.org/10.1016/j.aohep.2025.101934","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101934"},"PeriodicalIF":3.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293230","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":"Improvement in renal function after switching from entecavir to tenofovir alafenamide in chronic hepatitis B patients with low estimated glomerular filtration rates.","authors":"Liang Wang, Shipeng Ma, Lajpat Rai Malhi, Xiaoping Wu, Liping Liu, Xin Wan, Yuliang Zhang, Xiaopeng Li, Shanfei Ge","doi":"10.1016/j.aohep.2025.101925","DOIUrl":"https://doi.org/10.1016/j.aohep.2025.101925","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Tenofovir alafenamide (TAF) and entecavir (ETV) are both considered renal-friendly nucleoside/nucleotide analogs (NAs). However, the difference between ETV and TAF in terms of renal function remains unclear. This study aims to compare the renal safety profiles of two antiviral medications directly and evaluate the impact of switching from ETV to TAF treatment on renal function in chronic hepatitis B (CHB) patients with low estimated glomerular filtration rates (eGFR).</p><p><strong>Patients and methods: </strong>A total of 179 CHB patients who received TAF (n=84) or ETV (n = 95) between 2019 and 2023 were included in the study. Changes in eGFR levels between two treatment groups from baseline to 72 weeks were compared to measure the influence of these NAs on renal function.</p><p><strong>Results: </strong>At baseline, 84 patients were included in each treatment group after a 1:1 propensity score matching process. At week 48, a notable different changes in eGFR were observed between the two groups. Gender, baseline eGFR, and medication (TAF/ETV) were significantly correlated with eGFR abnormalities. Furthermore, eGFR abnormalities at week 48 led to the transition of 6 patients in the ETV group to TAF. eGFR significantly increased (83.60 ± 5.45 vs. 93.39 ± 9.88 mL/min/1.73 m²; p=0.031) and serum creatinine significantly decreased (81.47±11.36 vs. 74.9±10.67 μmol/L; p=0.046) from week 48 to 60. At week 48, the incidence of low-level viremia (LLV) was 19.0% in the ETV group and 16.7% in the TAF group, respectively (p>0.05). Pairwise comparisons revealed no significant difference in the percentage of LLV between the ETV continued group and the TAF continued group at week 48, 60, and 72. Additionally, there was also no significant difference in the proportion of LLV between the ETV+TAF combination group and the TAF+ETV combination group at week 48, 60, and 72.</p><p><strong>Conclusions: </strong>There was a substantial difference in eGFR between ETV and TAF treatments at week 48. Gender, baseline eGFR, and medication (TAF/ETV) were all remarkably positive indicators of eGFR abnormalities. In patients receiving ETV, an early switch to TAF may result in the reversal of early-stage renal damage.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101925"},"PeriodicalIF":3.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293231","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":"Data mining reveals novel gene drivers of lenvatinib resistance in hepatocellular carcinoma.","authors":"Cyrollah Disoma, Claudio Tiribelli, Caecilia Sukowati","doi":"10.1016/j.aohep.2025.101932","DOIUrl":"10.1016/j.aohep.2025.101932","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Liver cancer is the sixth most common malignancy and the third leading cause of cancer-related deaths globally. Hepatocellular carcinoma (HCC) is the most prevalent type, accounting for nearly 90 % of all liver cancer cases. The first-line systemic therapy for advanced HCC includes lenvatinib, an oral multi-kinase tyrosine inhibitor. However, many HCC patients exhibit resistance to lenvatinib, leading to treatment failure. Recent studies suggest that lenvatinib resistance is multi-factorial.</p><p><strong>Materials and methods: </strong>Four public RNA-seq datasets were retrieved from Gene Expression Omnibus (GEO) database and further analyzed to identify novel gene drivers of lenvatinib resistance. Bioinformatics analyses were performed in differentially expressed genes. In vitro validation was conducted in HCC cell lines after acute lenvatinib treatment.</p><p><strong>Results: </strong>After applying several filtering conditions, Gene Ontology (GO) and pathway enrichment analyses using Kyoto Encyclopaedia of Genes and Genome (KEGG) databases to identify significantly enriched pathways, a total of five genes emerged as good novel candidate genes which are likely to be associated with lenvatinib resistance: SEZ6L2, SECTM1, FBLN7, IFI6, and NPC1L1. The association of these five genes with patient's prognosis was based on TCGA database. Our validation using Huh7 and Hep3B HCC cells treated with lenvatinib showed increased consistent mRNA expressions of SECTM1 and IFI6.</p><p><strong>Conclusions: </strong>This study showed the relevance of finding new genes associated with lenvatinib resistance. .</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101932"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214703","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":"Identifying patients with undiagnosed primary biliary cholangitis using a clinical management process.","authors":"Agustin Castiella, Maria José Sánchez-Iturri, Jon Stampa, Beatriz Fernandez, Iñigo Garaizabal, Alvaro Prada, Silvia Torrente, Leire Aburruza, Eva Zapata","doi":"10.1016/j.aohep.2025.101933","DOIUrl":"10.1016/j.aohep.2025.101933","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Early diagnosis of primary biliary cholangitis (PBC) is fundamental, as treatment with ursodeoxycholic acid (UDCA) prevents its progression. The aim of our study is to investigate undiagnosed patients in our region and to treat retrieved patients.</p><p><strong>Patients and methods: </strong>Analysis of databases (immunology, biochemistry and other data from their medical records) was performed between January 2019 and December 2021. PBC was diagnosed if anti-mitochondrial antibodies were positive (>1:80) and alkaline phosphatase (AP) was chronically elevated in the absence of other liver disease. Identified patients were contacted.</p><p><strong>Results: </strong>A total of 306 patients were identified and 221 had previously been diagnosed with PBC and were undergoing treatment. Fifty-one patients did not meet the current criteria for diagnosis and treatment at their last blood test. Six patients had died by the time the study started. Finally, we found 28 patients with a probable diagnosis of PBC who could benefit from treatment (9.6%). We contacted all 28 patients and 16 (57.14%) of them agreed to come to our hospital for diagnosis confirmation, ultrasound and fibroscan. All of them were women, aged between 46 and 74 years (mean 61.18, SD 9.19). Laboratory analysis showed a mean AP of 144.25 (SD 71.03) and mean GGPT of 115.62 (SD 98.42). Mean bilirubin was 0.55 (SD 0.22). Fibroscan showed a mean value of 6.05 kPa. UDCA was initiated in 14 patients; two patients refused treatment.</p><p><strong>Conclusions: </strong>The use of hospital databases enabled us to diagnose and treat 16 (57.14%) of the 28 detected patients.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101933"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214704","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 global comparison of hepatitis B & C drug pricing.","authors":"Leah Yao, Xiaohan Ying, Getan Malik, Catherine Tsai, Arun B Jesudian, Robert S Brown, Stephen E Congly","doi":"10.1016/j.aohep.2025.101928","DOIUrl":"10.1016/j.aohep.2025.101928","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Drug pricing is a major driver of healthcare spending in the United States (US) and the cost of medications in the US is up to three time higher than other countries. This cross-sectional study aims to investigate the current price differences between hepatitis B (HBV) and hepatitis C (HCV) antiviral therapies in the US as compared to peer high-income countries.</p><p><strong>Materials and methods: </strong>Publicly available drug formularies for Canada, UK, Japan, France, Germany, Italy, and Australia were used to collect 2024 prices for seven HBV medications (lamivudine, adefovir, tenofovir disoproxil fumarate (TDF), tenofovir alafenamide fumarate, entecavir, peginterferon alfa-2a, emtricitabine/TDF) and seven HCV medications (sofosbuvir/velpatasvir, sofosbuvir/ledipasvir, sofosbuvir, ribavirin, elbasvir/grazoprevir, glecaprevir/pibrentasvir, sofosbuvir/velpatasvir/voxilaprevir). US prices were obtained from UpToDate®'s listed representative average wholesale price and Medicare Part D 2022 drug prices.</p><p><strong>Results: </strong>US prices for HBV originator medications were on average 4.71x (range 1.99-6.17x) the prices in the peer countries. US generic HBV drug prices for TDF, entecavir, and emtricitabine/TDF were on average 45% cheaper or 0.55x less than the average generic prices in peer countries (range 0.48-0.66x). US originator prices for HCV medications were on average 1.83x the prices in peer countries (range 0.63-2.66x).</p><p><strong>Conclusions: </strong>HBV and HCV originator medications cost significantly more in the US compared to seven other major industrial countries. However, the introduction of HBV generic medications has lowered the cost of treatment for patients in the US. Future adoption of international reference pricing may help bridge remaining pricing disparities.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101928"},"PeriodicalIF":3.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141283","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":"Acute kidney injury incidence and clinical features: Refractory versus non-refractory ascites.","authors":"Neha Tiwari, Chinmay Bera, Nazia Selzner, Cynthia Tsien, Florence Wong","doi":"10.1016/j.aohep.2025.101922","DOIUrl":"10.1016/j.aohep.2025.101922","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Outpatients with cirrhosis, ascites and minor acute serum creatinine (sCr) changes could have been missed as having acute kidney injury (AKI). This study aims to assess the incidence, clinical features of all AKI stages amongst patients with cirrhosis and various ascites severities.</p><p><strong>Materials and methods: </strong>Retrospective study of patients with cirrhosis and ascites from April 2020 to March 2021. Data collected included demographics, clinical features, medications, AKI development, and 6-month follow-up outcomes. Multivariate analysis for factors predicting AKI development and resolution was done.</p><p><strong>Results: </strong>115 (38 % of 306) with refractory ascites (RA) were compared to 191 with non-refractory ascites (n-RA), 86 % were outpatients. RA patients had higher baseline MELD-Na (18.1 ± 4.7 vs. 17.2 ± 6.8 in n-RA, p = 0.01) but had similar cirrhosis complications. 98 % RA patients required regular large volume paracenteses (LVP) (p < 0.001 vs. n-RA). AKI occurred in 39 % of RA and 19 % of n-RA patients (p<0.001). Most were stage 1 AKI, treated with albumin ± vasoconstrictor with similar response. 27 % of AKI in n-RA were classified as type 1 HRS (vs.20 % in RA, p < 0.001). Baseline MELD-Na (p = 0.01) predicted AKI development; lower peak sCr predicted AKI resolution (p = 0008). 11 (3.6 %) n-RA and 22 (19 %) RA patients developed acute-on-chronic liver failure (ACLF), with 86 % RA patients having renal failure as part of the ACLF syndrome (p < 0.001 vs. n-RA patients). Both groups had similar 6-month survival.</p><p><strong>Conclusions: </strong>AKI occurs not infrequently in n-RA patients who are mostly treated as outpatients. Therefore, patients with n-RA need to be monitored closely so to allow prompt diagnosis and treatment of AKI.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101922"},"PeriodicalIF":3.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141287","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":"Non-alcoholic fatty liver disease, in contrast to alcoholic liver disease, is associated with lower socio-economic status: results from a German referral center.","authors":"Semjon Bugaichuk, Verena Wilkens, Karoline Horvatits, Samuel Huber, Ansgar W Lohse, Johannes Kluwe, Sven Pischke, Thorben Fründt","doi":"10.1016/j.aohep.2025.101926","DOIUrl":"10.1016/j.aohep.2025.101926","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Elevated liver enzymes (ELE) are a common finding in the general population, often caused by undiagnosed chronic liver disease. But little is known to what extent socioeconomic status (SES) influences the occurrence of various liver diseases.</p><p><strong>Material and methods: </strong>Retrospective study of outpatients presenting with ELE. All patients received a structured work-up including abdominal ultrasound and serological testing. SES was assessed for patients from the Hamburg area using the social monitoring database of the Hamburg City Housing Department. SES was rated as high (SES-H), medium (SES-M), and low (SES-L).</p><p><strong>Results: </strong>Out of n=859 patients analysed, SES was assessable for n = 310 (53%) patients: SES-H/-M/-L [n; %]: 31 (10%), 223 (72%), 56 (18%). The most prevalent liver diseases were NAFLD (n=125; 40.3%), drug-induced liver injury (n=16; 5.2%) and alcoholic liver disease (ALD, n=13; 4.2%). Prevalence of NAFLD differed significantly between SES-subgroups (SES-H/-M/-L [n; %]: 6 (19%) vs. 88 (39%) vs. 32 (55%); p= .004), the distribution of ALD was similar between the SES subgroups (1(3.2%) vs. 11 (4.9%) vs. 1 (2%); p= .55). Median body mass index (BMI) increased from SES-H to SES-VL (SES-H/-M/-L [kg/m2]: 24.4 vs. 26.2 vs. 28.6; p= .001).</p><p><strong>Conclusions: </strong>NAFLD is the most prevalent liver disease in patients presenting with unexplained ELE, with a significantly higher occurrence in individuals from lower SES groups. Furthermore, BMI increases among patients with lower SES, highlighting the potential role of socioeconomic factors in NAFLD development. These findings underscore the need for targeted public health interventions, particularly in socioeconomically disadvantaged population.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101926"},"PeriodicalIF":3.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092664","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":"Hepatic arterioportal fistula after biopsy conditioning portal hypertension: first case in primary biliary cholangitis and a systematic literature review.","authors":"Camilla Gallo, Pietro Invernizzi","doi":"10.1016/j.aohep.2025.101924","DOIUrl":"10.1016/j.aohep.2025.101924","url":null,"abstract":"<p><p>Hepatic arterioportal fistulas (HAPFs) are aberrant shunts between the portal venous and the hepatic arterial systems leading to portal hypertension (PH). Acquired post-biopsy HAPFs are rare and most of them resolve spontaneously with no clinical manifestations. If symptomatic, they should be treated, and endovascular embolization represents the standard of care. We present the first case of an acquired high-flow post-biopsy HAPF causing clinically significant PH and PH-related bleeding in a 26-year-old female patient affected by early-stage primary biliary cholangitis (PBC). The HAPF was safely and successfully treated with selective arterial embolization through spring steel coils and liquid embolizing agents. In fact, no peri-procedural complications were reported, and final result showed the complete closure of the shunt at control abdominal Doppler ultrasound, with almost complete regression of PH-related endoscopic signs. Despite the possibility of developing PH even in early histologic stages of PBC, we attributed the most significant proportion of PH to the high-flow HAPF and we proved that its embolization was needed to be prioritized in the therapeutic management of the case.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101924"},"PeriodicalIF":3.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092663","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":"Alcoholic cirrhosis-associated immune dysfunction: What does it imply for us?","authors":"Mingyu Sun, Ziyi Yang, Fei Tang, Fenghui Li, Qing Ye, Chao Sun, Jing Liang","doi":"10.1016/j.aohep.2025.101927","DOIUrl":"10.1016/j.aohep.2025.101927","url":null,"abstract":"<p><p>Alcoholic cirrhosis is a leading cause of chronic advanced liver disease. With the gradual eradication of viral hepatitis and the rising levels of alcohol consumption, the incidence of alcoholic cirrhosis is expected to increase steadily. Alcohol is primarily metabolized in the gastrointestinal tract, producing toxic metabolites that enter the portal vein circulation and are subsequently transported to the liver. Excessive alcohol intake activates the microsomal ethanol oxidation system and disrupts the intestinal microbiota-driven microenvironment dictated by intestinal microbiota, and increase intestinal permeability, all of which trigger severe systemic inflammatory responses and impaired immune function. This phenomenon, known as cirrhosis-associated immune dysfunction (CAID), is closely linked to the severity of cirrhosis and can significantly influence disease progression, potentially leading to multi-organ failure. This narrative review sheds light on the relationship between alcoholic cirrhosis and CAID, focusing on tailored interventions to modify immune response and modulate gut microbiota composition in hopes of mitigating the development and deterioration of alcoholic cirrhosis.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101927"},"PeriodicalIF":3.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a prediction index for persistent acute kidney injury following orthotopic liver transplant.","authors":"Noemi Del Toro-Cisneros, Francisco Javier Antiga-López, Karina C Felix-Bauer, Adela Uribe-Pérez, Luis Angel Rivas-Sánchez, Nayelli C Flores-García, Ignacio García-Juárez, Olynka Vega-Vega","doi":"10.1016/j.aohep.2025.101923","DOIUrl":"10.1016/j.aohep.2025.101923","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Acute kidney injury (AKI) is a common complication of orthotopic liver transplantation (OLT). This study aimed to identify factors associated with persistent AKI (pAKI) and to develop a risk index. The impact of pAKI on mortality and renal function over a 5-year period was also assessed.</p><p><strong>Materials and methods: </strong>In this retrospective cohort study, adult OLT recipients were included. pAKI was defined as AKI lasting >72 hours. Logistic regression identified pAKI-associated factors, which were used to create a risk index. Long-term renal function was then evaluated.</p><p><strong>Results: </strong>Among 305 patients, 23 % developed pAKI. The median MELD (Model for End-stage Liver Disease) score was 17. Multivariate analysis identified male sex, reoperation, transfusion of >6 units of red blood cells, anhepatic time >50 minutes, and norepinephrine use >0.25 mcg/kg/min as significant risk factors. The risk index assigned 3 points each to male sex and norepinephrine use, and 5 points to the remaining factors. A score ≥11 had moderate performance (AUC 0.70) and a negative predictive value of 90 %. Patients with pAKI had longer ICU and hospital stays and higher in-hospital mortality. At 5 years, overall mortality did not differ significantly, but those with pAKI had a 10 ml/min/1.73m² lower eGFR.</p><p><strong>Conclusions: </strong>pAKI is a frequent OLT complication, negatively affecting short-term outcomes and long-term renal function. The proposed risk index effectively identifies patients at low risk, supporting targeted monitoring and prevention.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101923"},"PeriodicalIF":3.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961861","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}