Annals of hepatology最新文献

{"title":"Pathophysiology of Ascites: The importance of the intestine. A surgical contribution to the understanding of a medical problem","authors":"Gabriel E. Gondolesi ,&nbsp;Carolina Rumbo ,&nbsp;Leonardo Montes ,&nbsp;Lucia Novellis ,&nbsp;Diego Ramisch ,&nbsp;Ariel Riquelme Henríquez ,&nbsp;Mariana Ortega ,&nbsp;Federico Viano ,&nbsp;Thomas Schiano ,&nbsp;Valeria Descalzi ,&nbsp;Claudio Tiribelli ,&nbsp;Mihai Oltean ,&nbsp;Pablo Barros-Schelotto ,&nbsp;Héctor Solar","doi":"10.1016/j.aohep.2024.101498","DOIUrl":"10.1016/j.aohep.2024.101498","url":null,"abstract":"<div><p>The understanding of the mechanisms for the development of ascites has evolved over the years, involving the liver, peritoneum, heart, and kidneys as key responsible for its formation. In this article, we review the pathophysiology of ascites formation, introducing the role of the intestine as a major responsible for ascites production through “a game changer” case.</p></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 3","pages":"Article 101498"},"PeriodicalIF":3.8,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124002928/pdfft?md5=a39ff7915a81ebd829d874328a873027&pid=1-s2.0-S1665268124002928-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140118594","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":"Neurofilament light chain but not glial fibrillary acidic protein is a potential biomarker of overt hepatic encephalopathy in patients with cirrhosis","authors":"Koos de Wit ,&nbsp;Diederick J. van Doorn ,&nbsp;Bregje Mol ,&nbsp;Lonneke A. van Vught ,&nbsp;Frederik Nevens ,&nbsp;Ulrich Beuers ,&nbsp;Cyriel Y. Ponsioen ,&nbsp;Charlotte E. Teunissen ,&nbsp;R. Bart Takkenberg","doi":"10.1016/j.aohep.2024.101496","DOIUrl":"10.1016/j.aohep.2024.101496","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>Hepatic encephalopathy (HE) is a frequent complication of cirrhosis and may cause cerebral damage. Neurodegenerative diseases can induce the release of neuroproteins like neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) in body fluids, including blood plasma. We investigated whether NfL and GFAP could serve as potential diagnostic plasma biomarkers for overt HE (oHE).</p></div><div><h3>Materials and Methods</h3><p>We included 85 patients from three prospective cohorts with different stages of liver disease and HE severity. The following patients were included: 1) 34 patients with primary sclerosing cholangitis (PSC) with compensated disease; 2) 17 patients with advanced liver disease without oHE before elective transjugular intrahepatic portosystemic shunt (TIPS) placement; 3) 17 intensive care unit (ICU) patients with oHE and 17 ICU patients without cirrhosis or oHE. Plasma NfL and GFAP were measured using single molecule assays.</p></div><div><h3>Results</h3><p>ICU oHE patients had higher NfL concentrations compared to pre-TIPS patients or ICU controls (<em>p &lt; 0.05, each</em>). Median GFAP concentrations were equal in the ICU oHE and pre-TIPS patients or ICU controls. Plasma NfL and GFAP concentrations correlated with Model for End-Stage Liver Disease (MELD) scores (<em>R</em> = 0.58 and <em>R</em> = 0.40, <em>p &lt; 0.001, each</em>).</p></div><div><h3>Conclusions</h3><p>Plasma NfL deserves further evaluation as potential diagnostic biomarker for oHE and correlates with the MELD score.</p></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 3","pages":"Article 101496"},"PeriodicalIF":3.8,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124002904/pdfft?md5=425f580dc8659bc53e456d0ac4043a71&pid=1-s2.0-S1665268124002904-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140068084","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":"Clinical, biochemical and histological features related to treatment response and prognosis in autoimmune hepatitis","authors":"Ludmila Resende Guedes ,&nbsp;Guilherme Grossi Lopes Cançado ,&nbsp;Bruno Campos Santos ,&nbsp;Luma dos Santos Jacomassi ,&nbsp;Mateus Jorge Nardelli ,&nbsp;Fernanda Maria Farage Osório ,&nbsp;Luciana Costa Faria ,&nbsp;Cláudia Alves Couto","doi":"10.1016/j.aohep.2024.101497","DOIUrl":"10.1016/j.aohep.2024.101497","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>Autoimmune hepatitis (AIH) is a rare disease with a complex and not fully understood pathogenesis. Prognostic factors that might influence treatment response, relapse rates, and transplant-free survival are not well established. This study investigates clinical and biochemical markers associated with response to immunosuppression in patients with AIH.</p></div><div><h3>Materials and Methods</h3><p>This retrospective cohort study included 102 patients with AIH treated with immunosuppressants and followed at the Federal University of Minas Gerais, Brazil, from 1990 to 2018. Pretreatment data such as clinical profiles, laboratory, and histological exams were analyzed regarding biochemical response at one year, histological remission, relapse, and death/transplantation rates.</p></div><div><h3>Results</h3><p>Cirrhosis was present in 59 % of cases at diagnosis. One-year biochemical remission was observed in 55.7 % of the patients and was found to be a protective factor for liver transplant. Overall survival was 89 %. Patients with ascites at disease onset showed a higher aspartate aminotransferase (AST)/ alanine aminotransferase (ALT) ratio and elevated Model of end-stage liver disease (MELD) score. The presence of ascites was significantly associated with a 20-fold increase in mortality rate.</p></div><div><h3>Conclusions</h3><p>AIH has a severe clinical phenotype in Brazilians, with high rates of cirrhosis and low remission rates. Early diagnosis and treatment are essential for achieving remission and reducing complications. The presence of ascites is significantly associated with mortality, emphasizing the importance of monitoring and prompt intervention. This study also stresses the need for further research on AIH in Latin America.</p></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 4","pages":"Article 101497"},"PeriodicalIF":3.8,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124002916/pdfft?md5=757dabd68d5373708d7d62f617a7ba14&pid=1-s2.0-S1665268124002916-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140068082","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":"Efficacy and safety of terlipressin and albumin vs. noradrenaline and albumin in adult patients with hepatorenal syndrome: A systematic review and meta-analysis","authors":"Adnan Malik ,&nbsp;Muhammad Imran Malik ,&nbsp;Shahbaz Qureshi ,&nbsp;Abdul Nadir","doi":"10.1016/j.aohep.2024.101495","DOIUrl":"10.1016/j.aohep.2024.101495","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>Hepatorenal syndrome (HRS) is a serious complication of cirrhosis treated with various medications. We aim to evaluate terlipressin and albumin's effectiveness and safety compared to albumin and noradrenaline in adult hepatorenal disease patients.</p></div><div><h3>Materials and Methods</h3><p>Clinical trials from four databases were included. Cochrane's approach for calculating bias risk was utilized. We rated the quality evaluation by Grading of Recommendations Assessment, Development, and Evaluation (GRADE). We included the following outcomes: serum creatinine (mg/dl), urine output (ml/24 h), mean arterial pressure (mmHg), reversal rate of HRS, mortality rate, blood plasma renin activity (ng/ml/h), plasma aldosterone concentration (pg/ml), urine sodium (mEq/l), and creatinine clearance (ml/min).</p></div><div><h3>Results</h3><p>Our analysis of nine clinical studies revealed that the noradrenaline group was associated with higher creatinine clearance (MD = 4.22 [0.40, 8.05]), (<em>P</em> = 0.03). There were no significant differences in serum creatinine levels (MD = 0.03 [-0.07, 0.13]), urinary sodium (MD = -1.02 [-5.15, 3.11]), urine output (MD = 32.75 [-93.94, 159.44]), mean arterial pressure (MD = 1.40 [-1.17, 3.96]), plasma renin activity (MD = 1.35 [-0.17, 2.87]), plasma aldosterone concentration (MD = 55.35 [-24.59, 135.29]), reversal rate of HRS (RR = 1.15 [0.96, 1.37]), or mortality rate (RR = 0.87 [0.74, 1.01]) between the two groups (p-values &gt; 0.05).</p></div><div><h3>Conclusions</h3><p>Noradrenaline is a safe alternative medical therapy for HRS.</p></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 4","pages":"Article 101495"},"PeriodicalIF":3.8,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124002898/pdfft?md5=3f6be3d05cf94aba9dd7a458332f07ad&pid=1-s2.0-S1665268124002898-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140068083","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":"Outcomes of liver transplantation for hepatocellular carcinoma in donation after circulatory death compared with donation after brain death: A systematic review and meta-analysis","authors":"Abdulahad Abdulrab Mohammed Al-Ameri ,&nbsp;Shusen Zheng","doi":"10.1016/j.aohep.2024.101484","DOIUrl":"10.1016/j.aohep.2024.101484","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>Due to organ shortages, liver transplantation (LT) using donation-after-circulatory-death (DCD) grafts has become more common. There is limited and conflicting evidence on LT outcomes using DCD grafts compared to those using donation-after-brain death (DBD) grafts for patients with hepatocellular carcinoma (HCC). We aimed to summarize the current evidence on the outcomes of DCD-LT and DBD-LT in patients with HCC.</p></div><div><h3>Materials and Methods</h3><p>Online databases were searched for studies comparing DCD-LT and DBD-LT outcomes in patients with HCC and a meta-analysis was conducted using fixed- or random-effects models.</p></div><div><h3>Results</h3><p>Five studies involving 487 (33.4%) HCC DCD-LT patients and 973 (66.6%) DBD-LT patients were included. The meta-analysis showed comparable 1-year [relative risk (RR)=0.99, 95%CI:0.95 to 1.03, p=0.53] and 3-year [RR=0.99, 95%CI:0.89 to 1.09, p=0.79] recurrence-free survival. The corresponding 1-year [RR=0.98, 95%CI:0.93 to 1.03, p=0.35] and 3-year [RR=0.94, 95%CI:0.87 to 1.01, p=0.08] patient survival and 1-year [RR=0.91, 95%CI:0.71 to 1.16, p=0.43] and 3-year [RR=0.92, 95%CI:0.67 to 1.26, p=0.59] graft survival were also comparable. There were no significant differences between the two cohorts regarding the tumor characteristics, donor/recipient risk factors and the incidence of post-operative complications, including acute rejection, primary non-function, biliary complications and retransplantation.</p></div><div><h3>Conclusions</h3><p>Based on the current evidence, it has been found that comparable outcomes can be achieved in HCC patients using DCD-LT compared to DBD-LT, particularly when employing good quality graft, strict donor and recipient selection, and effective surgical management. The decision to utilize DCD-LT for HCC patients should be personalized, taking into consideration the risk of post-LT HCC recurrence. (PROSPERO ID: CRD42023445812).</p></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 3","pages":"Article 101484"},"PeriodicalIF":3.8,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124002783/pdfft?md5=677db4e13ee0ff002d37514dba73575b&pid=1-s2.0-S1665268124002783-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989133","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":"Dietary macro and micronutrients associated with MASLD: Analysis of a national US cohort database","authors":"Mary Nemer ,&nbsp;Fauzia Osman ,&nbsp;Adnan Said","doi":"10.1016/j.aohep.2024.101491","DOIUrl":"10.1016/j.aohep.2024.101491","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>Our objective was to measure and compare the intake of macro and micronutrients in a cohort of individuals with Metabolic Syndrome Associated Steatotic Liver Disease (MASLD) compared with matched controls to identify areas of further research in this area; we identified nutrition-associated associations with MASLD in the United States general population.</p></div><div><h3>Materials and Methods</h3><p>We used the 2017 – 2018 NHANES dataset. Elastography Controlled Attenuation Parameter (CAP score&gt;280) in the absence of other liver disease was defined as MASLD in adults (&gt;18). Advanced fibrosis was defined by transient elastography &gt;10 kPa. Controls were adults without liver disease.</p></div><div><h3>Results</h3><p>1648 MASLD cases (11.4 % advanced fibrosis) and 2527 controls were identified. MASLD cases were older (<em>P</em>&lt;0.001), more likely males (<em>P</em> = 0.01), less likely to have a college education (<em>P</em> = 0.04) and more likely married (<em>P</em> = 0.002). MASLD cases were more likely to be of Mexican American or Hispanic ethnicity (<em>P</em> = 0.002), have higher BMI, higher prevalence of diabetes, hyperlipidemia and hypertension (<em>P</em>&lt;0.001 for all). MASLD cases had higher hs-CRP (<em>P</em> = 0.02) and ferritin (<em>P</em> = 0.02). MASLD cases had lower total (<em>P</em> = 0.004) and added vitamin E in their diet (<em>P</em> = 0.002), lower vitamin K intake (<em>P</em> = 0.005), and higher Selenium intake (<em>P</em> = 0.03). Caloric intake (<em>P</em> = 0.04), carbohydrate intake (<em>P</em> = 0.02), cholesterol intake (<em>P</em> = 0.03) and saturated fatty acid intake (<em>P</em> = 0.05) were higher in MASLD. Individuals with MASLD were more likely to be on a diet (<em>P</em>&lt;0.001), sedentary (<em>P</em> = 0.008) and less likely to participate in moderate or vigorous recreational activities (<em>P</em>&lt;0.001).</p></div><div><h3>Conclusions</h3><p>The deficiencies of micronutrients and excess of macronutrients point to oxidative stress, pro-inflammatory state, and lipotoxicity as pathways linking the US diet to MASLD. MASLD patients are more often on special diets, which may reflect prior provider counseling on diet changes to improve health.</p></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 3","pages":"Article 101491"},"PeriodicalIF":3.8,"publicationDate":"2024-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124002850/pdfft?md5=3c2256e847d706670c2da0928463629f&pid=1-s2.0-S1665268124002850-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982204","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":"MASLD identifies patients with significant hepatic fibrosis and steatosis in fatty liver population","authors":"You Deng ,&nbsp;Wenya Chen ,&nbsp;Wen Xie","doi":"10.1016/j.aohep.2024.101488","DOIUrl":"10.1016/j.aohep.2024.101488","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 3","pages":"Article 101488"},"PeriodicalIF":3.8,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124002825/pdfft?md5=b0d7565178c8ffc843461b6c038f0100&pid=1-s2.0-S1665268124002825-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139954700","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":"Impact of new fatty liver disease nomenclature on primary care— cerebration of gastroenterologists in a regional tertiary care hospital","authors":"Xingcen Chen ,&nbsp;Deliang Liu ,&nbsp;Rong Li","doi":"10.1016/j.aohep.2024.101486","DOIUrl":"10.1016/j.aohep.2024.101486","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 3","pages":"Article 101486"},"PeriodicalIF":3.8,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124002801/pdfft?md5=fa6facb72761001a581cd193fe223727&pid=1-s2.0-S1665268124002801-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139954697","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":"Gradual dosing of ursodeoxycholic acid in mothers with intrahepatic cholestasis of pregnancy may improve composite neonatal outcome","authors":"Amir Hamud ,&nbsp;Matan J. Cohen ,&nbsp;Drorith Hochner-Celnikier ,&nbsp;Benjamin Bar-Oz ,&nbsp;Zvi Ackerman","doi":"10.1016/j.aohep.2024.101490","DOIUrl":"10.1016/j.aohep.2024.101490","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><p>Intrahepatic cholestasis of pregnancy (ICP) is often accompanied by fetal and maternal complications.</p></div><div><h3>Materials and Methods</h3><p>Retrospective review of the clinical course of women with ICP and their neonates treated at our medical center over a 10-year period. Special attention was paid to the maternal and neonatal response to 2 different modes of ursodeoxycholic acid (UDCA) administration.</p></div><div><h3>Results</h3><p>Neonates of mothers with high total bile acid levels had a poorer composite neonatal outcome. Twenty-seven women who presented at an advanced stage of their pregnancies did not receive UDCA. UDCA was administered in 2 modes: either a full dose at admission (76 women) or a gradually increasing dose until the desired dosage was reached (25 women). The mean gestational age at delivery for the 94 neonates that were exposed to full UDCA dose was the lowest (36±2.3 weeks for the full dose, 37±1.4 weeks for the 30 neonates from the gradually increasing dose, 38±1.6 weeks for the 29 neonates from the no treatment group, <em>p&lt;</em>0.001). The group of neonates that were exposed to full UDCA dose had the highest rate of unfavorable composite neonatal outcome (53% for full dose, 30% for gradually increasing dose, 24% for the no treatment group, <em>p</em>=0.006).</p></div><div><h3>Conclusions</h3><p>Compared to the administration of a full UDCA dose, the administration of a gradually increasing dose of UDCA may be associated with a greater gestational age at delivery and fewer events of unfavorable composite neonatal outcomes. These novel findings should be retested prospectively in a large cohort of patients.</p></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 3","pages":"Article 101490"},"PeriodicalIF":3.8,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124002849/pdfft?md5=6a87588f5edccfe8b23700b537d94065&pid=1-s2.0-S1665268124002849-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139954701","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":"Correspondence: “A multisociety Delphi consensus statement on new fatty liver disease nomenclature”","authors":"Kim Sui Wan,&nbsp;Wah-Kheong Chan,&nbsp;Muhammad Fadhli Mohd Yusoff,&nbsp;Feisul Mustapha,&nbsp;Halizah Mat Rifin,&nbsp;Kishwen Kanna Yoga Ratnam,&nbsp;Noor Ani Ahmad","doi":"10.1016/j.aohep.2024.101485","DOIUrl":"10.1016/j.aohep.2024.101485","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 4","pages":"Article 101485"},"PeriodicalIF":3.8,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1665268124002795/pdfft?md5=d97e92a266af3f1effd37e861196b658&pid=1-s2.0-S1665268124002795-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139954989","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}