Archives of Dermatological Research最新文献

{"title":"Mohs micrographic surgery is non-inferior to wide local excision for disease specific survival in sebaceous carcinoma: analysis of the Surveillance, Epidemiology, and End Results (SEER) database (2000-2021).","authors":"Akshay Pulavarty, Lynn Liu, Michelle Juarez, Maressa C Criscito, Nayoung Lee, Mary Stevenson, John Carucci","doi":"10.1007/s00403-025-04290-z","DOIUrl":"https://doi.org/10.1007/s00403-025-04290-z","url":null,"abstract":"","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":"806"},"PeriodicalIF":1.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nicotinamide for secondary keratinocyte carcinoma prevention in solid organ transplant recipients.","authors":"Jonathan C Hwang, Kevin T Savage, Melissa Pugliano-Mauro","doi":"10.1007/s00403-025-04296-7","DOIUrl":"https://doi.org/10.1007/s00403-025-04296-7","url":null,"abstract":"<p><p>Nicotinamide has many well-established chemopreventive properties in protecting against ultraviolet-induced skin damage, mitigating inflammation, and reducing keratinocyte carcinoma (KC) development among immunocompetent individuals. Its effectiveness in immunosuppressed patients, however, is unclear. There is conflicting research on whether nicotinamide effectively decreases KCs in immunosuppressed solid organ transplant recipients (SOTRs). This study assesses the effectiveness of nicotinamide in the secondary prevention of KC in immunosuppressed patients. We conducted a retrospective cohort study in a single tertiary care institution. The primary outcome was KC incidence in the year before and after nicotinamide supplementation. Secondary outcomes included the incidence of invasive squamous cell carcinoma (SCC), SCC in situ (SCCis), and basal cell carcinoma (BCC) over one- and two-year intervals. All included patients had taken oral nicotinamide, 500 milligrams twice daily, for at least one year. A total of 47 SOTRs (74.5% male; mean age 65.2 years) were included in our retrospective cohort study. Of 81 patients initially screened, 34 were excluded due to inadequate follow-up, dermatologic care outside our institution, or early discontinuation of nicotinamide. At one year post-nicotinamide supplementation, total KC incidence decreased from 224 (78 SCC, 103 SCCis, 43 BCC) to 121 cases (40 SCC, 55 SCCis, 26 BCC), a mean reduction of 2.19 KCs (95% CI: -3.48 to -0.90; p = 0.0012). Significant reductions were observed in SCC (mean decrease of 1.15; 95% CI: -1.78 to -0.52; p = 0.00081) and SCCis (mean decrease of 1.37; 95% CI: -2.61 to -0.13; p = 0.032). BCC reduction was not statistically significant (p = 0.13). In the 31 patients with two-year follow-up data, KC incidence declined from 234 to 167, a mean reduction of 2.18 KCs (95% CI: -4.18 to -0.14; p = 0.037). Sensitivity analyses excluding patients on concomitant acitretin confirmed that reductions in total KC incidence maintained significance at both one-year and two-year intervals. Nicotinamide supplementation significantly decreased KC incidence in immunosuppressed SOTRs over the one-year and two-year intervals. We recommend nicotinamide as a low-risk, low-cost chemopreventive supplement for reducing KCs in SOTRs.</p>","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":"807"},"PeriodicalIF":1.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wells syndrome: emerging triggers and treatments- an updated systematic review.","authors":"Areeba Ahmed, Brian Cahn, Roger Haber","doi":"10.1007/s00403-025-04305-9","DOIUrl":"10.1007/s00403-025-04305-9","url":null,"abstract":"<p><strong>Importance: </strong>Wells syndrome (eosinophilic cellulitis) is a rare inflammatory dermatosis characterized by erythematous, edematous plaques and dermal eosinophilic infiltration. Understanding its evolving triggers and treatment options is critical for optimizing management, particularly in corticosteroid-refractory cases.</p><p><strong>Objective: </strong>To systematically review newly reported immunologic and iatrogenic triggers of Wells syndrome, as well as emerging therapies, with the goal of updating clinical guidance. This review focuses on diagnosis and therapy, emphasizing outcomes in patients with refractory or relapsing disease.</p><p><strong>Evidence review: </strong>A systematic literature search was conducted following PRISMA 2020 guidelines across six databases for English-language studies published between January 2016 and May 2025. Studies were eligible if they described new triggers or treatments for Wells syndrome. Article selection and data extraction were performed independently by two reviewers. Risk of bias was assessed using the Joanna Briggs Institute and Newcastle-Ottawa tools.</p><p><strong>Findings: </strong>Twenty-four studies met inclusion criteria: 21 case reports, 2 case series, and 1 retrospective cohort study. Newly identified triggers included COVID-19 infection, SARS-CoV-2 and influenza vaccines, aluminum- and gelatin-containing pediatric vaccines, and biologic therapies such as ustekinumab and tumor necrosis factor-alpha (TNF-α) inhibitors. In vaccine-related cases, causality was supported by positive patch testing. Novel therapies trialed in corticosteroid-refractory or relapsing patients included dupilumab, topical ruxolitinib, abrocitinib, and mepolizumab. Most patients experienced complete or near-complete resolution. However, recurrences were common, particularly in idiopathic cases or upon re-exposure to known triggers.</p><p><strong>Conclusions and relevance: </strong>Recent literature expands the clinical spectrum of Wells syndrome, highlighting new immunologic and iatrogenic triggers. Targeted treatments, especially biologics and Janus kinase inhibitors, demonstrate promising results and may offer steroid-sparing alternatives for patients with refractory disease. Clinicians should consider emerging triggers in differential diagnosis and evaluate newer therapies in recurrent or treatment-resistant cases. Further prospective and registry-based studies are warranted to validate efficacy and support development of evidence-based management guidelines.</p>","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":"805"},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study between intralesional acyclovir versus intralesional 5-flurouracil in treatment of recalcitrant warts.","authors":"Ghada Abdel Badea Abdel Aziz, Doaa Abd El-Maleek Hassan Pessar, Leila M R Semeda, Mona S A Ali","doi":"10.1007/s00403-025-04298-5","DOIUrl":"10.1007/s00403-025-04298-5","url":null,"abstract":"<p><strong>Background: </strong>Although different treatment modalities are available, the treatment of warts is still challenging with recalcitrant and recurrent lesions. Given that warts are viral in nature, acyclovir might be a viable treatment option. Intralesional acyclovir and 5-fluorouracil (5-FU) injections have been described for treating common warts and achieved a complete response in most of the patients.</p><p><strong>Aim: </strong>The aim of this work was to assess the efficacy and safety of intralesional acyclovir versus intralesional 5-flurouracil in treatment of recalcitrant cutaneous warts.</p><p><strong>Patients and methods: </strong>This comparative study was carried out on 60 patients diagnosed with recalcitrant cutaneous warts. The patients were categorized randomly into group I (30 patients treated with intralesional acyclovir) and group II (30 patients treated with intralesional 5-FU). Treatment was repeated every two weeks to a maximum of six sessions or until complete clearance occurred. Treatment response was assessed clinically and dermoscopically. This is the first randomized clinical trial comparing intralesional acyclovir with 5-FU for recalcitrant warts.</p><p><strong>Results: </strong>After the end of 6 months of follow-up, complete clearance was achieved in 20 patients (66.7%) and 19 patients (63.3%) in the acyclovir and 5-FU groups, respectively. Also, complete clearance of all dermoscopic findings was observed in 66.7% of patients in the acyclovir group compared to 63.3% of patients in the 5-FU group, with no statistically significant difference between both groups (p > 0.001). Both modalities were safe and well tolerated.</p><p><strong>Conclusion: </strong>Intralesional acyclovir and 5-FU are safe and effective methods in treatment of recalcitrant cutaneous warts.</p>","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":"800"},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Off-label use of biologics and janus kinase (JAK) inhibitors for scarring alopecias: a narrative review.","authors":"Priya Agarwal, Oghenevoke Ajuchi, Tess M Lukowiak, Babar K Rao","doi":"10.1007/s00403-025-04301-z","DOIUrl":"10.1007/s00403-025-04301-z","url":null,"abstract":"<p><p>Scarring alopecias, including lichen planopilaris, frontal fibrosing alopecia, folliculitis decalvans, central centrifugal cicatricial alopecia, discoid lupus erythematosus, and dissecting cellulitis cause permanent destruction of hair follicles, resulting in patches of hair loss that can be devastating for patients. Treatment options for scarring alopecias focus on disease stabilization and currently include corticosteroids and immunosuppressive agents, which often offer inconsistent disease improvements with waning patient satisfaction, especially in severe stages of the condition. Recent advances in therapeutics such as biologics and JAK inhibitors may offer some potential for disease stabilization and resolution through modulation of the inflammatory and immune-mediated pathways of scarring alopecias. This review examines literature reporting the off-label use of biologics and JAK inhibitors for the treatment of scarring alopecias. We find that TNF-α, IL-17, and JAK inhibitors demonstrate the most potential of currently available agents, with IL-23 and Interferon Alpha Receptor 1 inhibitors also showing some benefit.</p>","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":"803"},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of nutraceutical supplements on hair growth in non-scarring alopecia: a systematic review and meta-analysis.","authors":"Areeba Ahmed, Divija Sharma, Benjamin Ungar","doi":"10.1007/s00403-025-04306-8","DOIUrl":"https://doi.org/10.1007/s00403-025-04306-8","url":null,"abstract":"","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":"801"},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Localized corticosteroid delivery in alopecia areata using microneedle patch technology.","authors":"Pakveranun Ariya-Atthaya, Purit Pureesrisak, Jitlada Meephansan, Sasin Charoensuksira, Punyaphat Sirithanabadeekul, Wilai Thanasarnaksorn, Kittipong Tantisantisom, Sattra Thongma, Yossawat Rayanasukha, Paisan Khanchaitit, Poonkiat Suchonwanit","doi":"10.1007/s00403-025-04307-7","DOIUrl":"https://doi.org/10.1007/s00403-025-04307-7","url":null,"abstract":"<p><strong>Background: </strong>Alopecia areata (AA) is an autoimmune disorder characterized by non-scarring hair loss. Current treatment options, such as intralesional corticosteroid (ILCS) injections, are effective but often associated with adverse effects, including pain, skin atrophy, and reduced patient compliance. This study investigates the efficacy and safety of a corticosteroid-loaded microneedle patch as an alternative treatment modality for AA.</p><p><strong>Methods: </strong>A prospective experimental study was conducted on patients diagnosed with patch-type AA. Participants received treatment at intervals of 4-6 weeks for a total duration of 24-36 weeks using a corticosteroid-loaded microneedle patch. Treatment efficacy and safety were evaluated using hair regrowth scales, dermoscopic findings, and pain scores.</p><p><strong>Results: </strong>The study enrolled 14 participants, totaling 24 treated patches. Significant hair regrowth was observed, with a mean regrowth scale (RGS) increasing to 2.4 by the 16-24 week period and reaching 4 by 24-36 weeks. Dermoscopic analysis showed reductions in black dots and yellow dots, while vellus hairs increased. Mean pain scores remained low throughout treatment, ranging from 1.00 to 3.00, highlighting the treatment's good tolerability compared to traditional intralesional injections.</p><p><strong>Conclusions: </strong>Microneedle patch-based corticosteroid delivery demonstrated efficacy comparable to ILCS injections, with the added advantage of reduced treatment-related pain and potentially enhanced patient compliance.</p>","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":"804"},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disproportionality analyses of Tapinarof-related adverse events based on the FAERS database.","authors":"Xia Huang, Congzhong Zhang, Lingjin Zhang","doi":"10.1007/s00403-025-04297-6","DOIUrl":"https://doi.org/10.1007/s00403-025-04297-6","url":null,"abstract":"<p><strong>Background: </strong>Tapinarof, a novel topical aryl hydrocarbon receptor (AhR) modulator, has demonstrated promising therapeutic efficacy in the treatment of plaque psoriasis. However, its comprehensive safety profile in real-world settings remains underexplored.</p><p><strong>Objective: </strong>To assess the post-marketing safety of Tapinarof using data from the FDA Adverse Event Reporting System (FAERS), with a focus on identifying significant adverse event (AE) signals and subgroup-specific risks.</p><p><strong>Methods: </strong>A retrospective disproportionality analysis was conducted on FAERS data from Q2 2022 to Q4 2024. Reports listing Tapinarof as the primary suspect drug were extracted and analyzed using four established signal detection algorithms (ROR, PRR, EBGM, IC), complemented by Bonferroni correction for multiple comparisons.</p><p><strong>Results: </strong>A total of 1,227 AE reports were included. The majority of reports originated from adults aged 18-64 years and were submitted by healthcare professionals, with a balanced male-to-female ratio. The most frequently observed AE signals were related to skin and subcutaneous tissue disorders, including keratosis pilaris, contact dermatitis, and application site acne. Notable signals were also detected for infections (e.g., pustules) and hypersensitivity reactions. A novel tumor-related signal was identified for keratoacanthoma, with statistically significant associations also observed for squamous cell carcinoma of the skin. Gender subgroup analysis revealed a higher incidence of dermatological AEs in females and slightly stronger neoplasm-related signals in males. Age, weight, and indication data were largely missing, limiting subgroup-specific interpretation.</p><p><strong>Conclusion: </strong>Tapinarof is generally well tolerated in adults, particularly for psoriasis treatment, but is associated with strong cutaneous and immune-related AE signals. Novel findings-including pharyngeal swelling and tumor-related events-warrant heightened clinical vigilance, especially in patients requiring long-term or large-area application. Gender differences in AE reporting further underscore the need for personalized risk management strategies. Further longitudinal and mechanistic studies are essential to confirm these associations and guide safer clinical use.</p>","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":"802"},"PeriodicalIF":1.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor necrosis factor α inhibitor-induced alopecia in pediatric patients: a cohort of 20 patients and review of the literature.","authors":"Shiran Reiss-Huss, Daniel Hilewitz, Sharon Yacobovitz, Manar Matar, Yael Weintraub, Dror S Shouval, Chani Topf-Olivestone, Lev Pavlovsky, Rotem Tal, Gil Amarilyo, Yael Renert-Yuval, Rivka Friedland","doi":"10.1007/s00403-025-04300-0","DOIUrl":"10.1007/s00403-025-04300-0","url":null,"abstract":"<p><p>Anti TNFα agents can induce cutaneous adverse events in both adults and children. While drug-related alopecia was reported in adults treated with TNFα inhibitors for various indications, pediatric data are scarce. To describe clinical characteristics and outcomes in pediatric patients with TNFα inhibitor-induced alopecia we conducted a single center retrospective study (0748-21-RMC, retrospectively registered on January 2nd 2022) including all patients aged < 18 years who were treated with TNFα inhibitors for any indication and developed drug-induced alopecia between the years 2018-2023. A comprehensive literature review was also performed. Twenty patients were included (mean age 12.9 ± 3.1 years, male:female ratio 1:1.4). Fourteen were diagnosed with Crohn's disease, three with ulcerative colitis, and three with juvenile idiopathic arthritis. Half of the patients were treated with adalimumab and half with infliximab. Overall, alopecia was observed after 14.8 ± 10.8 months of treatment. Eighteen (90.0%) patients presented with psoriatic-like inflammatory alopecia, and two with alopecia areata-like lesions. Seventeen (85.0%) patients discontinued their anti-TNFα therapy due to the alopecia, all presented hair regrowth within six months. Hair regrowth was not recorded in three patients who continued TNFα inhibitors. Literature review of pediatric TNFα inhibitor-induced alopecia revealed comparable patients' demographics and response to treatment discontinuation. In conclusion, TNFα inhibitor-induced alopecia is a rare adverse event in children, occurring mainly in adolescents with inflammatory bowel diseases. Our relatively large cohort provides further evidence for the need for TNFα inhibitor cessation to improve drug-induced alopecia in pediatric patients.</p>","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":"799"},"PeriodicalIF":1.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of azithromycin on specific biochemical markers and sebum composition in acne vulgaris patients.","authors":"Alaa Sh Abdulbari, Noor M Ali, Ahmed Rahmah Abu-Raghif, Nadheer A Matloob, Hayder Ridha-Salman","doi":"10.1007/s00403-025-04299-4","DOIUrl":"https://doi.org/10.1007/s00403-025-04299-4","url":null,"abstract":"<p><p>Acne vulgaris (AV) is a persistent inflammatory skin disease that affects the pilosebaceous units. Oral azithromycin has shown significant effectiveness in treating AV, attributed to its robust anti-inflammatory and antimicrobial properties. This study aimed to evaluate the efficacy of azithromycin in patients with moderate-to-severe AV, with a focus on its influence on sebum composition and specific biomarkers, including pyridoxine (B6), biotin (B7), cobalamin (B12) (measured by HPLC), and homocysteine (measured by ELISA). A case-control study was conducted at the dermatology department of Al-Imamain-Alkadhimain Medical City, Baghdad. The study included thirty patients aged 15-35 years with moderate-to-severe AV, and thirty healthy individuals of the same age and sex served as a control group. Patients received 500 mg of azithromycin on alternate days for 12 weeks. Laboratory and clinical parameters were assessed at baseline and compared to the control group, then re-evaluated after treatment. The findings indicated a significant decrease in serum levels of folic acid, B7, and B6 at both 6 and 12 weeks post-treatment (p < 0.05). Serum homocysteine levels increased slightly over time, but this change was not statistically significant (p > 0.05). No significant difference in serum B12 levels was observed at 6 weeks (p > 0.05); however, a significant increase was noted at 12 weeks (p < 0.05). Clinical score, skin moisture, and sebum squalene (Sebum-SQ) content improved significantly post-treatment (p < 0.05), while sebum cholesterol (Sebum-Chol.) levels showed significant change only at 12 weeks (p < 0.05). The finding supports the efficacy of azithromycin in managing inflammatory acne and modulating sebum composition and specific biomarkers. However, the relatively small sample size and absence of power analysis limit the generalizability of the results. Future studies with larger cohorts are recommended to validate these findings.</p>","PeriodicalId":8203,"journal":{"name":"Archives of Dermatological Research","volume":"317 1","pages":"798"},"PeriodicalIF":1.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}