Annals of clinical and laboratory science最新文献

{"title":"Evaluation of the Prevalence of Myelodysplastic Syndromes and Associated Hematologic and Coagulation Findings in Southern Saudi Arabia.","authors":"Sultan Ziyad, Omayma Bakheet, Sultan Alasmari, Mohammed Makkawi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the prevalence of Myelodysplastic syndromes (MDS) among patients evaluated for suspected disease at a tertiary hospital in Southern Saudi Arabia and to evaluate associated hematologic and coagulation findings.</p><p><strong>Methods: </strong>A retrospective study was conducted on 70 patients evaluated between 2021 and 2025 at Asir Central Hospital (ACH). Clinical and laboratory data were obtained from medical records. Diagnosis and classification of MDS were based on peripheral blood smear, bone marrow examination, and available cytogenetic findings according to the current WHO guidelines. Statistical analysis was performed to assess hematologic and coagulation profiles and their association with disease characteristics.</p><p><strong>Results: </strong>Among the 70 patients evaluated for suspected MDS, 22 (31.4%) were diagnosed with MDS. The disease predominantly affected older individuals. Hematological findings demonstrated that cytopenias were the most consistent feature. In particular, anemia was the most prominent finding, followed by leukopenia and thrombocytopenia; notably, there were statistically significant differences observed in key parameters (<i>p</i><0.05). Coagulation abnormalities were evidenced by significant prolongation of prothrombin time (PT) in patients with MDS. Cytogenetic analysis was available for 20 patients. The analysis identified abnormalities in 35.0% of cases; this was most commonly del(5q) and del(20q), contributing to diagnosis and risk stratification.</p><p><strong>Conclusion: </strong>MDS represented a substantial proportion of patients evaluated for suspected disease and was characterized by significant multilineage cytopenias and coagulation abnormalities, particularly prolonged PT. Integrated evaluation of hematological, morphological, and cytogenetic findings is essential for accurate diagnosis and effective clinical management. Further large-scale studies are recommended to better define the regional burden of MDS.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"310-318"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576800","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":"Breast Mucoepidermoid Carcinoma: A Report of Two Cases.","authors":"Xiaoyang Ding, Hongxia Sun","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Mucoepidermoid carcinoma (MEC) of the breast is a very rare salivary gland-type tumor that is often missed by pathologists and may pose significant diagnostic challenges. We report two cases of breast MEC which both presented as breast masses. Core needle biopsies revealed moderately differentiated carcinomas (based on intermediate nuclear atypia) with squamous features and focal intra- and extracellular mucin production. Immunohistochemical analysis demonstrated that the tumor cells were positive for CK7, CK5/6, p63, GATA3, and TRPS1. They were negative for SOX10, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. Both patients underwent breast-conserving surgery. One patient also received an axillary lymph node excision. Histologic examination of the resected masses showed cystic components lined by squamous cells and occasional mucous cells, whereas the solid areas were predominantly composed of intermediate cells. Molecular testing demonstrated MAML2 gene rearrangement in both tumors, confirming the diagnosis of breast MEC. No adjuvant therapy was administered in either of the patients. Post-operative surveillance over 24 months showed no evidence of locoregional recurrence or distant metastasis. Recognition of this rare entity is important to avoid misdiagnosis and potential overtreatment of breast MEC as conventional triple negative breast carcinoma.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"344-349"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576770","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":"A Rare Cause of Pneumonia-Exogenous Lipoid Pneumonia.","authors":"Xiangqiong Lu, Fang Huang, You Zhang, Daguo Zhao, Jun Wang, Jing Li","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Exogenous lipoid pneumonia (ELP) is a rare respiratory disorder. We are describing its clinical manifestations, diagnosis, and treatment.</p><p><strong>Methods: </strong>Patients with ELP were identified by reviewing the hospital medical records between January 2020 and December 2024. Clinical characteristics, disease progression, examination results, treatments, and outcomes were presented.</p><p><strong>Results: </strong>Three male patients and one female patient were identified (59-78 years old), all with a history of oil exposure. They presented with fever, cough, and expectoration. Laboratory tests revealed elevated neutrophil counts, C-reactive protein, and interleukin-6, as well as decreased lymphocyte counts and normal procalcitonin levels. All patients underwent bronchoscopy. Pathological examination revealed neutrophil infiltration, fat droplets, and lipid-laden macrophages. One patient had a positive chylous test in bronchoalveolar lavage fluid. In the chest images, four patients had large areas of consolidation; two patients had exudation and heterogeneous density within the consolidation areas, which were identified as fat attenuation zones on the mediastinal window. Bronchoscopic alveolar lavage and glucocorticoids were the key treatments. Three patients developed respiratory distress. Two of these patients required mechanical ventilation and circulatory support. One patient with esophageal cancer died, while the other patients successfully recovered after veno-venous extracorporeal membrane oxygenation treatment.</p><p><strong>Conclusions: </strong>ELP is rare. Affected patients can rapidly progress into respiratory failure. Pulmonary imaging with heterogeneous fat attenuation areas in the mediastinal window can suggest its diagnosis. Identification of lipid droplets and lipid-laden macrophages or having a positive chylous test in bronchoalveolar lavage fluid can facilitate its early and rapid diagnosis. ELP treatment requires a comprehensive approach, including bronchoscopic lavage, glucocorticoids, and respiratory and circulatory support.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"370-377"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576816","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":"Resolution of a False-Positive Fourth-Generation HIV Screening Test by Polyethylene Glycol Precipitation: A Case Report.","authors":"Mel-Marie Datka, Whitney Fuller, Hennessy Williams, Liyun Cao","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fourth generation human immunodeficiency virus (HIV) antigen/antibody (Ag/Ab) combination assays are highly sensitive and enable early detection of HIV infection; however, rare false positive results due to immunoassay interference may occur. We report a case of discordant HIV testing characterized by a reactive ARCHITECT HIV Ag/Ab Combo screening assay with negative HIV 1/HIV 2 antibody differentiation and negative HIV 1/HIV 2 qualitative nucleic acid testing. To investigate the mechanism of reactivity, polyethylene glycol (PEG6000) precipitation was performed. Following PEG treatment, the patient's specimen converted to non reactive on repeat screening; comparatively, a confirmed HIV positive control specimen remained strongly reactive, despite partial signal reduction. These findings support the presence of PEG-precipitable immune interference as a likely contributor to false reactivity and highlight PEG precipitation as a useful problem solving tool in selected cases of discordant HIV serologic results.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"341-343"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576910","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":"Hepatoid Adenocarcinoma of the Stomach with Liver Metastasis Misdiagnosed as Hepatocellular Carcinoma: A Case Report and Literature Review.","authors":"Yan-Yan Zhu, Jia-Rong Zhao, Chun-Li Xu, Li-Pei Wu, Zhao-Ying Wu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hepatoid adenocarcinoma of the stomach (HAS) is a rare, highly aggressive gastric cancer subtype with a poor prognosis. Herein, we report a 61-year-old male initially misdiagnosed with multifocal hepatocellular carcinoma (HCC) at another hospital in December 2025, based on multiple hepatic nodules on MRI and elevated serum AFP. Admitted to our hospital in January 2026 for worsening fatigue and anorexia, he had severe anemia, a family history of gastric cancer and progressively rising AFP. Gastroscopy and histopathology confirmed HAS with multiple liver and lymph node metastases. After one cycle of XE-LOX plus cadonilimab palliative chemotherapy, the disease progressed rapidly with sharply elevated AFP and new metastases, and the patient refused further treatment. This case shows HAS is easily misdiagnosed as HCC, especially with occult gastric lesions and liver metastasis. Imaging and tumor markers have limited diagnostic value, while gastroscopy and histopathology are the gold standard. Comprehensive clinical evaluation is essential to reduce misdiagnosis. HAS is characterized by rapid disease progression and poor therapeutic response. Nevertheless, as a novel biomarker, the diagnostic and therapeutic value of CLDN18.2 in this disease remains to be further validated by large scale clinical data.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"359-364"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576827","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":"Analysis of the Effect of <i>in vitro</i> Hemolysis Test in the Treatment of Patients with Autoimmune Hemolytic Anemia.","authors":"Weiwei Gan, Weiwei Lin, Hongyu Cai, Conghai Tang, Dongqing Zhan, Yanxue Huang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy of the in vitro hemolysis test in the treatment of patients with autoimmune hemolytic anemia (AIHA).</p><p><strong>Methods: </strong>This retrospective study analyzed data from AIHA patients treated at our hospital. Patients were categorized into two groups based on the blood-matching method recorded in their records: a control group and a research group. In the control group, the microcolumn gel method was applied for blood allocation and transfusion. In the research group, blood allocation and transfusion were guided by the in vitro hemolysis test.</p><p><strong>Results: </strong>After transfusion, hematological indices (RBC, TBil, Hb, Ret) improved in both groups compared to pre-transfusion values. The research group showed higher RBC and Hb levels, and lower TBil and Ret levels than the control group (<i>P</i><0.05). Coagulation parameters (PT, APTT, FIB) also improved after transfusion. The research group had lower PT and APTT, and higher FIB than the control group (<i>P</i><0.05). The total effective rate was higher in the research group (86.0% vs 66.7%, <i>P</i><0.05).</p><p><strong>Conclusions: </strong>The <i>in vitro</i> hemolysis assay for blood matching can improve hematological and coagulation parameters in AIHA patients and enhance transfusion efficacy, demonstrating significant clinical value.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"331-338"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576765","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":"Serum Progranulin as a Potential Marker for Disease Activity and Thrombotic Events in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis.","authors":"Yue Zhong, Wen-Lu Yu, Tie-Gang Lv, Li-Ping Xu, Jian Hao","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Progranulin (PGRN) is a secreted glycoprotein that can have pro-inflammatory or anti-inflammatory effects, depending on the disease. The serum and urinary levels and mechanism of action of PGRN in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are unclear.</p><p><strong>Methods: </strong>Thirty patients with active AAV were enrolled from May 2022 to May 2024; 28 were myeloperoxidase-positive, and two were proteinase 3-positive. A healthy control cohort consisted of five male and five female volunteers. Age, gender, AAV subtype, and laboratory data were collected. Using an enzyme-linked immunosorbent assay, Whole blood and urine samples were collected for measurements of PGRN.</p><p><strong>Results: </strong>The median patient age was 69.0 years (range: 58.8-75.5); 56.7% of them were female, and 94.3% of them were MPO-ANCA-positive. Compared with healthy controls, the AAV patients had higher serum PGRN levels (52.0±30.9 vs. 3.3±1.7 ng/mL, <i>P</i><0.05) and lower urinary PGRN levels. The serum PGRN level also had a positive correlation with the Birmingham vasculitis activity score (r=0.776, <i>P</i><0.001), and moderate positive correlations with coagulation-related parameters (activated partial thromboplastin time, fibrin degradation products, and D-dimer). Patients who subsequently developed thrombotic events had higher serum PGRN levels than those without thrombotic events.</p><p><strong>Conclusion: </strong>The serum PGRN level was associated with disease activity and coagulation abnormalities in patients with active AAV, particularly in those with MPO-ANCA positivity. Although serum PGRN had a positive association with thrombotic events, its elevation may be influenced by renal dysfunction and systemic inflammation. Therefore, serum PGRN may serve as an activity-related biomarker rather than a disease-specific marker in AAV.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"295-302"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576902","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":"<i>Technical Note:</i> Implementation of Point of Care High Sensitivity Troponin I on the i-STAT Device and Comparative Analysis with a Beckman DxI 800 Laboratory-Based Assay.","authors":"Melody Nelson, John Kummer, Kristine Zinn, Amitava Dasgupta","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>High sensitivity troponin I (hs-TnI) is a sensitive biomarker for the diagnosis of myocardial infarction. Recently, the FDA has approved a point of care (POC) hs-TnI assay on the i-STAT device (Abbott Laboratories, Abbott Park, IL). We evaluated concordance of this assay with a laboratory based hs-TnI assay using the DXI 800 analyzer (Beckman, Brea, CA).</p><p><strong>Methods: </strong>i-STAT device precision for hs-TnI was studied using two controls provided by the manufacturer across all i-STAT analyzers (n=68) to be used at our health system. For initial concordance study, 40 plasma specimens were analyzed using the DXI 800 hs-TnI assay and i-STAT hs-TnI assay. Then, for further evaluation, in 20 plasma specimens (10 males and 10 females), hs-TnI concentrations were determined by using two DXI analyzers (each measurement in duplicate) and 17 i-STAT devices (each run in duplicate). For overall reproducibility of results using i-STAT devices, all 68 analyzers were assessed side-by-side using a large plasma pool. Moreover, in four patients, i-STAT hs-TnI whole blood values were compared with plasma hs-TnI values using the DXI 800.</p><p><strong>Results: </strong>Both short- and long-term precision of hs-TnI controls demonstrated acceptability. When the mean hs-TnI concentrations obtained by the DXI 800 were plotted in the x-axis (reference method) and corresponding mean values obtained by i-STAT were plotted in the y-axis, we observed the following regression equation: y=1.06x+2.72, r=0.97, (r=0.98). When all 68 i-STAT analyzers were compared with each other using pooled plasma specimens, we observed acceptable results. Additionally, in 20 plasma specimens, where hs-TnI obtained by two DXI 800 analyzers (mean value) were plotted in the x-axis and the corresponding overall mean of hs-TnI results obtained using 17 i-Stat analyzers were plotted in the y-axis, we observed the following regression equation: y=0.97x+2.36 (r=0.98). We also observed concordance between whole blood hs-TnI and plasma-based TnI in four patients.</p><p><strong>Conclusions: </strong>We observed good concordance in hs-TnI values obtained by i-STAT and DXI 800; however, due to different analytical cut-offs, assay design, and lack of a TnI standard, this concordance should not be interpreted as equivalent performance.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"378-381"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576584","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":"A Heterozygous IFIH1-Δ14 Polymorphism that Causes Severe Systemic Inflammatory Reactions Resembling Hemophagocytic Lymphohistiocytosis.","authors":"Ina Jeong, Seong-Eun Ryu, Hyun Ji Lee, Sun Min Lee, In Suk Kim, Chulhun L Chang, Seung Hwan Oh","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Type I interferon signaling is central to antiviral innate immunity, and disruption of this pathway may contribute to unusually severe illness during otherwise common viral infections in children. We report a previously healthy 12-month-old girl who presented with a fever for two weeks, followed by a generalized skin rash. She then subsequently developed a persistent fever, pancytopenia, splenomegaly, elevated soluble IL-2 receptor, and hypofibrinogenemia, fulfilling diagnostic criteria for hemophagocytic lymphohistiocytosis (HLH). Because an underlying immune disorder was suspected, targeted panel sequencing was performed, followed by Sanger confirmation and RNA transcript analysis; this identified a heterozygous <i>IFIH1</i> splice-site variant (NM_022168.4:c.2807+1G>A (rs35732034)). Reverse transcription-polymerase chain reaction and transcript sequencing demonstrated exon 14 skipping (Δ14) in patient RNA, providing direct confirmation of the predicted splicing abnormality and aligning with the prior report by Asgari et al. regarding this same variant in children with severe viral illness. Although these findings support the biological relevance of the variant in this clinical setting, they do not establish a causal relationship or indicate that the variant was the sole cause of the inflammatory syndrome. As a single case report, this observation should therefore be interpreted cautiously; however, it suggests that <i>IFIH1</i> abnormalities may be associated with infection-related hyperinflammation or an HLH-like presentation in some patients and highlights the value of RNA-based validation when interpreting candidate splice-site variants in innate immune genes.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"354-358"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576571","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":"Morphological and Severity Patterns of Anemia among Children in Taif City, Saudi Arabia.","authors":"Rana Ghazi Zaini","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Anaemia remains a common public health concern among children and may adversely affect growth, cognitive development, immune function, and overall health. This study aimed to assess the morphological and severity patterns of anaemia among children in Taif City, Saudi Arabia.</p><p><strong>Methods: </strong>A cross-sectional observational study was conducted among pediatric patients attending two government hospitals in Taif City between March and June 2026. Children aged 2-12 years without a previous diagnosis of anaemia or chronic disease affecting red blood cell production were included. Demographic and clinical data were collected, and complete blood counts were performed using an Abbott hematology analyzer. Anaemia was diagnosed using age-specific haemoglobin thresholds and classified according to morphology and severity based on World Health Organization criteria.</p><p><strong>Results: </strong>A total of 242 children were included, with a mean age of 6.2±2.9 years. Anaemia was identified in 30 children, yielding a prevalence of 12.4%. Mean haemoglobin levels were significantly lower among anaemic children than non-anaemic children (10.17±0.90 vs. 13.11±0.93 g/dL; <i>p</i><0.001). Most anaemic cases occurred among children aged 2-6 years (83.3%). Microcytic anaemia was the predominant morphological pattern (66.7%), and mild anaemia was the most common severity category (73.3%).</p><p><strong>Conclusion: </strong>Anaemia among children in Taif City was predominantly mild and microcytic, highlighting the importance of routine screening and early detection.</p>","PeriodicalId":8228,"journal":{"name":"Annals of clinical and laboratory science","volume":"56 3","pages":"324-330"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576841","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}