Blood Coagulation & Fibrinolysis最新文献

{"title":"Comparing fondaparinux and low molecular weight heparin for thromboprophylaxis after hip and knee arthroplasty: a systematic review and meta-analysis.","authors":"Muhammad Hassan Waseem, Zain Ul Abideen, Nohela Rehman, Sarosh Ali, Esha Dilawar, Haseeb Javed Khan, Burhan Khalid, Muhammad Ansab, Sania Aimen, Areehah Zafar Masood","doi":"10.1097/MBC.0000000000001352","DOIUrl":"https://doi.org/10.1097/MBC.0000000000001352","url":null,"abstract":"<p><p>Venous thromboembolism (VTE) remains a significant cause of perioperative morbidity and mortality despite the availability of prophylactic medications. There has been a debate about which thromboprophylaxis medication, Fondaparinux or low-molecular weight heparin (LMWH), is better after hip and knee arthroplasty. We have compared these two treatment regimens in our study. Electronic databases like PubMed, Cochrane, and ScienceDirect were searched from inception to August 2024. The weighted mean difference (WMD) for continuous outcomes and risk ratio (RR) for dichotomous outcomes were pooled using the Review Manager software version 5.4.1, and a random effects model was employed. The Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool (ROB 2.0) were used to assess the quality of the included studies. Publication bias was evaluated visually through funnel plots and statistically through Egger's regression. GRADE assessment was used to analyze the certainty of evidence. A total of 17 studies, 9 Cohorts, and 8 Randomized controlled trials (RCTs) pooling a total of 74 499 patients were included in this meta-analysis. Fondaparinux showed a statistically significant reduction in the risk of VTE [0.59; 95% confidence interval (CI): [0.48, 0.71]; P < 0.00001; I2 = 36%] and deep venous thrombosis (DVT) (RR = 0.75, 95% CI: [0.56, 1.00]; P = 0.05; I2 = 68%) compared to LMWH. Major bleeding (RR = 2.06, 95% CI: [1.19, 3.57]; P = 0.01; I2 = 43%), surgical site bleeding (RR = 1.67, 95% CI: [1.04, 2.66]; P = 0.03; I2 = 9%), and postoperative transfusions (RR = 1.07, 95% CI: [1.02, 1.12]; P = 0.004; I2 = 0%) were significantly higher in the Fondaparinux group. Symptomatic VTE, pulmonary embolism, mortality, and operating time showed no significant difference between the two groups. In conclusion, Fondaparinux is superior to LMWH in VTE and DVT prophylaxis. However, it is associated with an increased risk of major bleeding, surgical site bleeding, and postoperative transfusions.</p>","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699477","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":"Massive transfusion protocol prediction decision aids in an Australian trauma setting.","authors":"Kush Wangoo, Vinh Dat David Nguyen, Karen Byth, Rajesh Malik, Andrew Coggins","doi":"10.1097/MBC.0000000000001338","DOIUrl":"https://doi.org/10.1097/MBC.0000000000001338","url":null,"abstract":"<p><strong>Background: </strong>Trauma patients may require activation of an emergent massive transfusion protocol (MTP). Several decision aids are designed to predict massive transfusion requirements but have not been widely studied in the Australasian setting.</p><p><strong>Methods: </strong>Commonly used MTP decision aids were assessed for accuracy in injured patients at an urban Level 1 trauma centre. Consecutive cases were prospectively enrolled to a complete registry of thromboelastogram assays in trauma patients. Analysis was undertaken using receiver operating characteristic (ROC) curves, sensitivity and specificity.</p><p><strong>Results: </strong>A total of 114 patients met inclusion criteria (56 received MTP). More detailed and military derived scores including McLaughlin and Larson demonstrated >90% specificity. Area under ROC curve results were similar to prior reports, but the ABC score performed less accurately than expected.</p><p><strong>Conclusion: </strong>In the setting of traumatic haemorrhage, the available MTP prediction decision aids should be applied cautiously and used only in combination with on-going clinical judgement.</p>","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":"36 2","pages":"58-61"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370163","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":"The role of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as venous thromboembolism predictors in breast cancer patients pre- and post-therapy.","authors":"Alyssa Qian, Armita Zandi, Regan Bucciol, Maha Othman","doi":"10.1097/MBC.0000000000001341","DOIUrl":"https://doi.org/10.1097/MBC.0000000000001341","url":null,"abstract":"<p><strong>Objectives: </strong>Breast cancer (BC) accounts for 12.3% of all cancer-associated venous thromboembolism (VTE). Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are recognized inflammatory biomarkers but have not been incorporated into thrombosis risk stratification models. We evaluated NLR and PLR as predictive biomarkers for VTE in BC patients to determine their optimal predictive cutoffs and net predictive value before and after treatment.</p><p><strong>Methods: </strong>We conducted a prospective pilot study that involved 56 women with BC, recruited prior to treatment (chemotherapy and immunotherapy) initiation with at least 6-month monitoring for VTE. NLR and PLR were assessed pre and posttreatment.</p><p><strong>Results: </strong>Five patients (8.9%) developed VTE. NLR and PLR increased significantly posttreatment (P = 0.001). Post, not pretreatment, NLR (P = 0.029) and PLR (P = 0.033) were significantly associated with VTE occurrence. Receiver Operating curve analysis indicated enhanced predictive capacity for VTE postimmunotherapy. Optimal posttreatment cutoffs were 3.6 for NLR and 280 for PLR, aligning with existing literature, with slightly elevated NLR.</p><p><strong>Conclusions: </strong>Posttreatment NLR and PLR have higher predictability for VTE in patients receiving immunotherapy compared to chemotherapy. NLR outperforms PLR, particularly postimmunotherapy. This data holds promise for thrombosis risk stratification in the context of immunotherapy but requires evaluation in larger studies.</p>","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":"36 2","pages":"62-67"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370178","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":"Two patients with protein S deficiency and cerebral venous sinus thrombosis: nonsense mutations of the PROS1 gene may account for these deficiencies.","authors":"Lingling Hou, Xiaoli Chen, Haixiao Xie, Ke Zhang, Yanhui Jin, Minshan Wang, Lihong Yang, Fei Xu","doi":"10.1097/MBC.0000000000001343","DOIUrl":"https://doi.org/10.1097/MBC.0000000000001343","url":null,"abstract":"<p><p>Cerebral venous sinus thrombosis (CVST) is a rare and atypical thrombotic condition, particularly prevalent among young adults, with a complex cause. In July and October 2023, two patients were diagnosed with hereditary protein S deficiency (PSD) presenting with CVST at the Department of Neurology, the first affiliated hospital of Wenzhou Medical University. This study analysed the phenotypes and gene mutations in two hereditary PSD pedigrees to investigate the link between hereditary PSD and CVST. A total of 11 individuals from these two pedigrees were involved. We measured protein S activity (PS:A) and total protein S antigen (TPS:Ag), and free protein S antigen (FPS:Ag) for all participants, screened them for mutations in the protein S1 (PROS1) gene. Both probands with CVST were diagnosed at a young to middle age. The concurrent reductions in PS:A, TPS:Ag, and FPS:Ag levels observed in the probands and their family members (A-I2, A-II1, A-II2, A-II3, A-III1, A-III2, B-I2) indicate type I PSD. Gene analysis unveiled two heterozygous nonsense mutations, c.1687C>T (p. Gln563∗) and c.1680T>A (p. Tyr560∗), in exon 14 of the PROS1 gene for pedigrees A and B, respectively. The reduced protein S levels in the probands and their relatives, along with CVST in both probands, are all linked to nonsense mutations p. Gln563∗ and p. Tyr560∗ in the PROS1 gene.</p>","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":"36 2","pages":"51-57"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370180","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":"Rare coagulation factor deficiencies: a five-year experience from a single tertiary care center in South India.","authors":"Nivedita Suresh, Bitty Kurian, Reshma Jeladharan, Amrita Sao, Neeraj Sidharthan, Reema Miria Abraham","doi":"10.1097/MBC.0000000000001339","DOIUrl":"https://doi.org/10.1097/MBC.0000000000001339","url":null,"abstract":"<p><strong>Objective: </strong>Rare coagulation factor deficiencies (RCFD) comprise a heterogeneous class of coagulation disorders due to deficiencies/abnormalities in coagulation factors other than factors VIII, IX and von Willebrand factor (VWF). Due to its rarity and varying geographic prevalence, bleeding characteristics and behaviour pattern are not known. Our aim was to study the frequency and clinical profile of RCFD, assess the severity of deficiency, evaluate blood component requirements and surgical outcomes.</p><p><strong>Methods: </strong>This is a retrospective cohort study done at Advanced Coagulation Laboratory, Amrita Hospital, Kerala from September 2018 to October 2023. Clinical characteristics including bleeding phenotype were noted. The patients were diagnosed based on their complete coagulation workup.</p><p><strong>Results: </strong>Total of 1019 patients were evaluated, 93 (9.1%) patients had RCFD. Males and females were 60 (64.5%) and 33 (35.5%), respectively (M : F ratio 2 : 1). Median age at diagnosis was 26 years (range: 2 months-74 years). Half the patients (47) had bleeding episodes, 23 (25%) patients were detected incidentally and 23 (25%) patients as a part of preoperative evaluation. Mucocutaneous bleeding was the commonest symptom. The most common RCFD was factor VII deficiency (40%). Transfusion/hemostatic support was required for 29 (31.2%) patients during their life time. No adverse outcome was noted in 27 (29%) patients who underwent surgeries.</p><p><strong>Conclusion: </strong>Factor VII deficiency was the commonest RCFD. Only half of the patients with RCFD were symptomatic. RCFDs generally have a favorable surgical/ pregnancy outcome. Data from resource limited settings are lacking; more studies are required to formulate management guidelines.</p>","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":"36 2","pages":"37-43"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370168","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":"Compound heterozygous mutations (p.L68R∗37 and p.T241N) lead to abnormal protein levels and structures in hereditary FVII deficiency.","authors":"Bingqing Luo, Xia Wu, Jing Zhu, Shu Chen, Shifeng Lou, Xiaoyan Tan","doi":"10.1097/MBC.0000000000001340","DOIUrl":"10.1097/MBC.0000000000001340","url":null,"abstract":"<p><strong>Background: </strong>Congenital factor VII (FVII) deficiency is a genetic disorder characterized by decreased FVII activity, which sometimes leads to fatal bleeding. Numerous variants have been found in FVII deficiency, but mutations vary among patients. Each mutation deserves further exploration for each patient at risk of bleeding. We previously reported a Chinese patient with p.L68R∗37 and p.T241N compound heterozygous mutations. In this study, we further investigated the impact of these two mutations on the FVII expression through in vitro expression experiments.</p><p><strong>Methods: </strong>Mutations were introduced into the FVII coding region using site-directed mutagenesis, and recombinant FVII was combined with two different plasmids, and then quantitative PCR and western blot analyses were performed subsequently.</p><p><strong>Results: </strong>The p.L68R∗37 mutation had no effect on mRNA levels but caused a significant decrease in protein levels. In the p.T241N mutant vector, mRNA levels did not show a noticeable decrease, but protein levels exhibited a slight decrease. Structural analysis revealed that the p.T241N mutation resulted in an altered secondary structure and protein instability, indicating impaired functional properties.</p><p><strong>Conclusion: </strong>Our study demonstrated that the p.L68R∗37 and p.T241N mutations impacted the protein levels and function of FVII, ultimately leading to a severe reduction in FVII activity. This study may contribute to further understanding of the molecular pathogenesis of FVII deficiency and offer insights for genetic counseling.</p>","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":" ","pages":"44-50"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999595","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":"Who is currently dying from pulmonary embolism? Analysis of the US National Vital Statistics System.","authors":"Camilla Mattiuzzi, Giuseppe Lippi","doi":"10.1097/MBC.0000000000001344","DOIUrl":"https://doi.org/10.1097/MBC.0000000000001344","url":null,"abstract":"","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":"36 2","pages":"68-69"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370181","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":"Generation and characterization of zebrafish f9l mutant confirmed that f9l is f10 like gene.","authors":"Sanchi Dhinoja, Jabila Mary, Ayah Al Qaryoute, Anthony De Maria, Pudur Jagadeeswaran","doi":"10.1097/MBC.0000000000001337","DOIUrl":"10.1097/MBC.0000000000001337","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to create an f9l mutant zebrafish using clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) and characterize its coagulation properties to investigate its functional similarity to human FX and explore the potential synergy between f9l and f10 .</p><p><strong>Methods: </strong>Three gRNAs targeting exon 8 encoded by the catalytic domain of the f9l gene were injected into 300 single-cell zebrafish embryos using CRISPR/Cas9 technology. DNA from the resulting adults was extracted from tail tips, and PCR was used to detect indels. The identified founder mutant was bred to homozygosity, and functional assays, kinetic Russel viper venom time, bleeding assay in adults, and venous laser injury on larvae were conducted to assess its hemostatic function. Additionally, f10 was knocked down in f9l homozygous embryos using f10 antisense morpholinos to study their interaction by monitoring its survival.</p><p><strong>Results: </strong>DNA from 60 adults was screened for indels, resulting in a fish with a heritable complex mutation involving one insertion and two deletions in exon 8. The f9l homozygous mutants exhibited impaired F10 activity, mild bleeding after mechanical injury, and developmental deformities in early larval stages. The caudal vein thrombosis assay showed variable occlusion times, indicating a bleeding phenotype with incomplete penetrance. Knocking down f10 in f9l homozygous embryos resulted in 50% mortality within five dpf, compared to f9l homozygous embryos injected with control morpholinos.</p><p><strong>Conclusion: </strong>In summary, we generated f9l knockout and showed it is a paralog to f10. We also found a synergy between f9l and f10 genes, highlighting its importance in hemostasis.</p>","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":" ","pages":"26-33"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812062","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":"The determination of euglobulin clot lysis time reference intervals in Beckton Dickinson and Kima 3.2% sodium citrate coagulation tubes.","authors":"Ivona Kuktić, Ante Pašalić, Ognjen Čančarević, Edvard Galić, Andrea Saračević, Vanja Radišić Biljak","doi":"10.1097/MBC.0000000000001334","DOIUrl":"10.1097/MBC.0000000000001334","url":null,"abstract":"<p><p>Enhanced fibrinolysis or hyperfibrinolysis may lead to life-threatening blood loss, while reduced activity may contribute to thrombosis. Euglobulin clot lysis time (ECLT) is a manual method that measures plasma fibrinolytic activity and is considered the gold standard. However, the data on reference interval is scarce and outdated. We have employed one-sided reference interval (>3 h) since the implementation of ECLT in our laboratory; therefore, we aimed to establish reliable ECLT reference interval and to explore the possible preanalytical influence of different blood collection tubes on the established ECLT reference interval. Establishing a reference interval for fibrinolysis was performed according to CLSI EP28-A3c guidelines by employing a posteriori direct sampling technique. The predefined exclusion criteria included a history of malignant or hepatobiliary disease, a history of deep vein thrombosis/pulmonary embolism (DVT/PE), an acute inflammatory state at the time of the venipuncture. We collected vein blood samples in Vacutest plastic coagulation tubes (Kima, Italy) and Vacutainer glass coagulation tubes (Beckton Dickinson, USA) containing 0.109 mol/l buffered trisodium citrate as an anticoagulant at a blood-to-anticoagulant ratio 9 : 1. We calculated two-sided reference interval and presented as 2.5th and 97.5th percentiles. ECLT values did not differ between sexes or the types of tubes enrolled in the study ( P  = 0.8979). The established reference interval ranged from 130 to 297 min for the KIMA Vacutest tube and from 120 to 292 min for the BD Vacutainer tube. The established ECLT reference interval differed significantly from the currently used cut-off value in our laboratory, thus enabling the assessment of hyperfibrinolysis by employing double-sided reference interval.</p>","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":" ","pages":"14-17"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812070","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":"The role of eosinophil counts and megakaryocyte nuclei for distinction of acute and chronic immune thrombocytopenic purpura.","authors":"Kubra Cilesiz, Ulker Kocak, Zuhre Kaya, Idil Yenicesu","doi":"10.1097/MBC.0000000000001328","DOIUrl":"10.1097/MBC.0000000000001328","url":null,"abstract":"<p><strong>Objective: </strong>Immune thrombocytopenic purpura (ITP), the most common cause of thrombocytopenia, is clinically classified as acute and chronic. This study aimed to distinguish between acute/chronic ITP parameters examined at diagnosis via complete blood count (CBC), peripheral blood (PB) and bone marrow aspirate (BMA) smears. It would also contribute to early treatment options, cost-effective policies, and the life quality of patients.</p><p><strong>Methods: </strong>This study consisted of 304 ITP patients aged under 18 years diagnosed and followed up between 1982-2018. Differences between acute and chronic groups were compared by eosinophilia, megakaryocytes (MKs), and megakaryocyte nuclei. Diagnostic scales were created using simple parameters both to guide the distinction between acute and chronic ITP as well as for the prediction of the chronic progression of the patients at diagnosis.</p><p><strong>Results: </strong>Of the patients in this study, 71% had acute and 29% had chronic ITP. In CBC and PB smears, eosinophil and lymphocyte counts were higher in acute whereas neutrophil counts were higher in chronic ITP patients. Eosinophil counts in the BMA were also significantly higher in acute ITP patients. There was no significant difference in MK counts. However, the mean number of MK nuclei was higher in acute ITP patients.</p><p><strong>Conclusion: </strong>Comparison analyses between acute/chronic ITP with the methods developed for the first time are low-cost and promising. Using only eosinophil percentages in the CBC and PB smear, we could identify acute cases by 100%. Further studies including the integration of our study and clinical risk scoring models would contribute to the diagnosis and treatment process of ITP.</p>","PeriodicalId":8992,"journal":{"name":"Blood Coagulation & Fibrinolysis","volume":" ","pages":"1-7"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812079","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}