Biochemia Medica最新文献

{"title":"Subfatin concentration decreases in acute coronary syndrome","authors":"Mustafa YILMAZ, Mehmet Cagri Goktekin, N. Ilhan","doi":"10.11613/BM.2022.020704","DOIUrl":"https://doi.org/10.11613/BM.2022.020704","url":null,"abstract":"Introduction We investigated the association of serum subfatin concentration and acute myocardial infarction (AMI) in patients with ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI). Materials and methods In this study, patients who presented with chest pain (STEMI, NSTEMI, or non-cardiac chest pain) were included, i.e. 49 patients with non-cardiac chest pain (control) and 66 patients hospitalised with AMI. In the AMI group, 35 patients had NSTEMI and 31 had STEMI. Serum subfatin concentrations were determined via enzyme-linked immunosorbent assay (ELISA). Descriptive data on the patients and their comorbidities were recorded, and subfatin concentrations were analysed. Results Subfatin concentrations were significantly different in the control, STEMI and NSTEMI groups (P = 0.002). In addition, subfatin concentrations were significantly lower in patients in the NSTEMI group than those in the control group (P < 0.001), but there was no significant difference between STEMI and the control group (P = 0.143). The receiver operating characteristic (ROC) analysis performed for differentiating the AMI and control groups found that subfatin had 64% sensitivity and 69% specificity, whereas troponin had 59% sensitivity and 95% specificity. In patients with AMI, the ROC analysis for differentiating NSTEMI from STEMI found that subfatin had 94% sensitivity and 41% specificity, while troponin had 65% sensitivity and 88% specificity. Conclusions Subfatin concentrations were lower in patients without STEMI than in patients with STEMI. Subfatin concentration is associated with NSTEMI.","PeriodicalId":9021,"journal":{"name":"Biochemia Medica","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49492384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An analysis of the vitamin D overtesting in a tertiary healthcare centre","authors":"M. Aralica, Vesna Supak Smolcic, T. Turk Wensveen, S. Hrabrić Vlah, Mihael Selar, Lidija Bilić Zulle","doi":"10.11613/BM.2022.020701","DOIUrl":"https://doi.org/10.11613/BM.2022.020701","url":null,"abstract":"Introduction Vitamin D testing is excessively used in clinical practice, despite of the clinical guidelines statements against population screening for vitamin D deficiency. This study aimed to assess an annual number of performed 25-hydroxy vitamin D (25(OH)D) tests that were unsupported by the national guidelines for prevention, detection and therapy of vitamin D deficiency in adults and to calculate associated financial burden for the publicly funded healthcare. Materials and methods A representative sample of requested 25(OH)D tests in 2018 (N = 474) was formed after selection and randomisation of data set (N = 5298) collected from the laboratory information system database of the Clinical Department for Laboratory Diagnostics, the Clinical Hospital Centre Rijeka. Records were classified in two groups depending on associated medical condition(s) according to the national guidelines. An annual cost of the total and group specific vitamin D testing was calculated on the base of a single test price reimbursed by the Croatian Healthcare Insurance Fund (CHIF). Results Medical conditions with high-risk for vitamin D deficiency were detected in 43% (206/474) of vitamin D requests (group 1). Conditions not associated with vitamin D deficiency were detected in 57% (268/474) requests (group 2). A total cost of 25(OH)D testing for the CHIF was 58,729.50 EUR (25,523.79 EUR in the group 1 and 33,205.71 EUR in the group 2). Conclusions More than half of all 25(OH)D tests performed in the clinical laboratory represent avoidable cost for the public healthcare. Prevention of population screening by vitamin D testing is needed.","PeriodicalId":9021,"journal":{"name":"Biochemia Medica","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42539464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cell-in-cell phenomenon in urinary sediment: a case report","authors":"Carlos Martínez-Figueroa, K. Cortés-Sarabia, J. Poloni, Enrique Alejandro Molina-Avilez, L. Palaoro, A. Vences-Velázquez","doi":"10.11613/BM.2022.020801","DOIUrl":"https://doi.org/10.11613/BM.2022.020801","url":null,"abstract":"The internalization of apoptotic cells by non-phagocytic cells has been observed in different tissues and could be an important mechanism for the elimination of dying cells. Here, we describe a probable event of phagocytosis of apoptotic cells mediated by urothelial cells in urinary sediment. A 90-years-old male patient was admitted unconscious to the hospital, visible signs included: pale skin and dry mucous membranes, presumptively diagnosed as dehydration. Blood test revealed anaemia (haemoglobin 130 g/L) and hyperglycaemia (glucose 7.8 mmol/L), urinalysis showed a picture of urinary tract infection (leukocyturia and bacteriuria). The microscopic analysis of urinary sediment revealed the presence of urothelial cells and leukocytes internalized in urothelial cells. Anti-CD68 (membrane marker of macrophages) was tested by immunocytochemistry and a negative result was observed. Based on the findings phagocytosis of apoptotic cells mediated by urothelial cells was identified. This phenomenon can be observed in urinary sediment and should not be confused with a neoplastic process since it is a physiological event of cell elimination.","PeriodicalId":9021,"journal":{"name":"Biochemia Medica","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46710388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long pentraxin 3 as a marker of COVID-19 severity: evidences and perspectives","authors":"R. Assandri, Silvia Accordino, Ciro Canetta, E. Buscarini, A. Scartabellati, Chiara Tolassi, F. Serana","doi":"10.11613/BM.2022.020901","DOIUrl":"https://doi.org/10.11613/BM.2022.020901","url":null,"abstract":"Introduction Several laboratory tests are characteristically altered in Coronavirus Disease 2019 (COVID-19), but are not totally accurate in predicting the disease outcome. The long pentraxin 3 (PTX3) is quickly released directly at inflammation sites by many immune cell types. Previous studies have shown that PTX3 correlated with disease severity in various inflammatory conditions. Our study investigated the use of PTX3 as a potential marker of COVID-19 severity and compared its performance in detecting a more severe form of the disease with that of routine laboratory parameters. Materials and methods Stored serum samples of RT-PCR confirmed COVID-19 cases that had been obtained at hospital admission were retrospectively analysed. Intensive care unit (ICU) stay was considered a surrogate endpoint of severe COVID-19. Pentraxin 3 was measured by a commercial enzyme-linked immunosorbent assay. Results A total of 96 patients were recruited from May 1st, 2020 to June 30th, 2020; 75/96 were transferred to ICU. Pentraxin 3 was higher in ICU vs non-ICU patients (35.86 vs 10.61 ng/mL, P < 0.001). Univariate and multivariate logistic regression models demonstrated that the only significant laboratory predictor of ICU stay was PTX3 (OR: 1.68 (1.19-2.29), P = 0.003), after controlling for comorbidities. The Receiver Operator Characteristic curve analysis showed that PTX3 had a higher accuracy compared to C-reactive protein (CRP), lactate dehydrogenase (LD), ferritin in identifying ICU patients (AUC of PTX3 = 0.98; CRP = 0.66; LD = 0.70; ferritin = 0.67, P < 0.001). A cut-off of PTX3 > 18 ng/mL yielded a sensitivity of 96% and a specificity of 100% in identifying patients requiring ICU. Conclusion High values of PTX3 predict a more severe COVID-19.","PeriodicalId":9021,"journal":{"name":"Biochemia Medica","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45692229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-collection acidification of spot urine sample is not needed before measurement of electrolytes","authors":"T. Šálek, P. Musil, M. Pšenčík, V. Palička","doi":"10.11613/BM.2022.020702","DOIUrl":"https://doi.org/10.11613/BM.2022.020702","url":null,"abstract":"Introduction Kidney stone formers can have higher oxalate and phosphate salt amounts in their urine than healthy people and we hypothesized that its acidification may be useful. The study aims to compare results of urine concentrations of calcium, magnesium, and inorganic phosphorus in the midstream portion of first voided morning urine samples without (FMU) and with post-collection acidification (FMUa) in kidney stone patients. Materials and methods This is a prospective single center study. A total of 138 kidney stone patients with spot urine samples were included in the study. Urine concentrations of calcium, magnesium and inorganic phosphorus were measured with and without post-collection acidification. Acidification was performed by adding 5 µL of 6 mol/L HCl to 1 mL of urine. Results The median age (range) of all participants was 56 (18-87) years. The median paired differences between FMU and FMUa concentrations of calcium, magnesium, and inorganic phosphorus were: - 0.040 mmol/L, 0.035 mmol/L, and 0.060 mmol/L, respectively. They were statistically different: P < 0.001, P < 0.001, P = 0.004, respectively. These differences are not clinically significant because biological variations of these markers are much higher. Conclusions No clinically significant differences in urinary calcium, magnesium, and inorganic phosphorus concentrations between FMU and FMUa in patients with kidney stones were found.","PeriodicalId":9021,"journal":{"name":"Biochemia Medica","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44398254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laboratory medicine in pandemic of COVID-19","authors":"L. Tandara, P. Filipi, Daniela Šupe Domić, Branka Krešić, Ivo Ivcic, Sanda Stojanovic Stipic, Žana Rubić, M. Tandara","doi":"10.11613/BM.2022.020501","DOIUrl":"https://doi.org/10.11613/BM.2022.020501","url":null,"abstract":"After the outbreak in China in the year 2019, severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) quickly spread around the world causing a protracted pandemic. Approximately one-third of infections appear to be asymptomatic. Symptomatic disease is characterized primarily by symptoms of respiratory tract infection of varying severity. But Coronavirus Disease 2019 (COVID-19) is much more than an acute respiratory disease because SARS-CoV-2 affects many organs inducing a vast number of symptoms such as cardiovascular, neurological, gastrointestinal, dermatological, with numerous complications. Short and long-term effects of infection, severe ones, and especially mild forms of the disease which affect a huge number of patients need to be further investigated. Laboratory medicine has a crucial role in early diagnosis of the disease, recognition of the patients who need hospital care, and close monitoring of hospitalized patients to timely identify associated clinical complications as well as follow-up of patients with long-term COVID-19.","PeriodicalId":9021,"journal":{"name":"Biochemia Medica","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48851583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of vitamin B12 deficiency neurological syndrome in a young adult due to late-onset cobalamin C (CblC) deficiency: a diagnostic challenge","authors":"Scott Ailliet, R. Vandenberghe, Toon Schiemsky, L. van Overbeke, P. Demaerel, W. Meersseman, D. Cassiman, P. Vermeersch","doi":"10.11613/BM.2022.020802","DOIUrl":"https://doi.org/10.11613/BM.2022.020802","url":null,"abstract":"Vitamin B12 deficiency can present with neurologic and psychiatric symptoms without macrocytic anaemia. We describe a case of late-onset cobalamin C deficiency which typically presents with normal serum vitamin B12 concentrations, posing an additional diagnostic challenge. A 23-year-old woman with decreased muscle strength and hallucinations was diagnosed with ‘catatonic depression’ and admitted to a residential mental health facility. She was referred to our hospital for further investigation 3 months later. Heteroanamnesis revealed that the symptoms had been evolving progressively over several months. Magnetic resonance imaging (MRI) of the brain showed diffuse symmetrical white matter lesions in both hemispheres. Routine laboratory tests including vitamin B12 and folic acid were normal except for a slight normocytic, normochromic anaemia. Over the next 6 weeks her symptoms deteriorated, and she became unresponsive to stimuli. A new MRI scan showed progression of the white matter lesions. The neurologist requested plasma homocysteine (Hcys) which was more than 8 times the upper limit of normal. Further testing revealed increased methylmalonic acid and the patient was diagnosed with adult-onset cobalamin C deficiency. This case illustrates that Hcys and/or methylmalonic acid should be determined in patients presenting with neuropsychiatric symptoms suggestive of vitamin B12 deficiency with a normal serum vitamin B12 to rule out a late-onset cobalamin C deficiency.","PeriodicalId":9021,"journal":{"name":"Biochemia Medica","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45458865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic profiles and predictive values of some biochemical and haematological quantities in COVID-19 inpatients.","authors":"María José Castro-Castro,&nbsp;Laura García-Tejada,&nbsp;Ariadna Arbiol-Roca,&nbsp;Lourdes Sánchez-Navarro,&nbsp;Loreto Rapún-Mas,&nbsp;Isabel Cachon-Suárez,&nbsp;Marta Álvarez-Álvarez,&nbsp;Dolors Dot-Bach,&nbsp;Roser Güell-Miró,&nbsp;Anna Cortés-Bosch de Bassea,&nbsp;Macarena Dastis-Arias,&nbsp;Ana Sancho-Cerro,&nbsp;Noelia Díaz-Troyano,&nbsp;Teresa Escartín-Diez,&nbsp;Diego Muñoz-Provencio,&nbsp;Rosa Navarro-Badal","doi":"10.11613/BM.2022.010706","DOIUrl":"https://doi.org/10.11613/BM.2022.010706","url":null,"abstract":"<p><strong>Introduction: </strong>Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in some hospitalized patients has shown some important alterations in laboratory tests. The aim of this study was to establish the most relevant quantities associated with the worst prognosis related to COVID-19.</p><p><strong>Materials and methods: </strong>This was a descriptive, longitudinal, observational and retrospective study, in a cohort of 845 adult inpatients from Bellvitge University Hospital (L'Hospitalet de Llobregat, Barcelona, Spain). A multivariate regression analysis was carried out in demographic, clinical and laboratory data, comparing survivors (SURV) and non-survivors (no-SURV). A receiver operating characteristic analysis was also carried out to establish the cut-off point for poor prognostic with better specificity and sensibility. Dynamic changes in clinical laboratory measurements were tracked from day 1 to day 28 after the onset of symptoms.</p><p><strong>Results: </strong>During their hospital stay, 18% of the patients died. Age, kidney disease, creatinine (CREA), lactate-dehydrogenase (LD), C-reactive-protein (CRP) and lymphocyte (LYM) concentration showed the strongest independent associations with the risk of death in the multivariate regression analysis. Established cut-off values for poor prognosis for CREA, LD, CRP and LYM concentrations were 75.0 μmol /L, 320 U/L, 80.9 mg/L and 0.69 x10⁹/L. Dynamic profile of laboratory findings, were in agreement with the consequences of organ damage and tissue destruction.</p><p><strong>Conclusions: </strong>Age, kidney disease, CREA, LD, CRP and LYM concentrations in COVID-19 patients from the southern region of Catalonia provide important information for their prognosis. Measurement of LD has demonstrated to be very good indicator of poor prognosis at initial evaluation because of its stability over time.</p>","PeriodicalId":9021,"journal":{"name":"Biochemia Medica","volume":"32 1","pages":"010706"},"PeriodicalIF":3.3,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8833247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834171","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":"Review of current incidents and risk calculations used in the Royal College of Australasian Pathologists Key Incident Management and Monitoring Systems - a system that could be used by all Australasian medical laboratories, and easily adapted to worldwide use.","authors":"Stephanie Gay,&nbsp;Belinda Pope,&nbsp;Tony Badrick,&nbsp;Michael Whiley","doi":"10.11613/BM.2022.010702","DOIUrl":"https://doi.org/10.11613/BM.2022.010702","url":null,"abstract":"<p><strong>Introduction: </strong>The Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP) Key Incident Monitoring and Management Systems (KIMMS) program has found that some existing Quality Indicators are too broad or not well defined. The risk matrix in use does not allow changes in incident Detection or Probability. In 2020, a review was performed: what issues should KIMMS include as Key Incidents and how could risk measurement be improved?</p><p><strong>Materials and methods: </strong>Twenty-seven networked and stand-alone laboratories enrolled in KIMMS during 2020 were surveyed on 45 current and new indicators of risk in the total testing process. They were asked which indicators they considered were significant in causing patient harm. Existing risk matrices in use by members of the KIMMS Advisory Committee laboratories were reviewed regarding their size or structure (3x3 or 5x5) and the descriptions of consequences and probability.</p><p><strong>Results: </strong>Thirteen participants indicated 21 indicators should be monitored, and the KIMMS Advisory committee added a further 13 (11 from the remaining 24 and 2 new). Of the five risk matrices reviewed, all consistently used a 5x5 matrix to estimate Consequences <i>vs</i> Probability of harm. The KIMMS advisory committee added a third parameter to the calculation of Risk, Detectability.</p><p><strong>Conclusion: </strong>All 34 pre- and post- indicators should be monitored, covering all aspects of the total testing cycle other than analytical. The risk measurement can be improved by introducing a 5x5 risk matrix to evaluate harm (consequences x probability) and then evaluating risk by adding detectability; risk equals harm x detectability.</p>","PeriodicalId":9021,"journal":{"name":"Biochemia Medica","volume":"32 1","pages":"010702"},"PeriodicalIF":3.3,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8672387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39763730","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":"National Guidelines for the Performance of the Sweat Test in Diagnosis of Cystic Fibrosis on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine and the Cystic Fibrosis Centre - Paediatrics and adults, University Hospital Centre Zagreb.","authors":"Jasna Leniček Krleža,&nbsp;Merica Aralica,&nbsp;Duška Tješić-Drinković,&nbsp;Karolina Crneković,&nbsp;Jelena Culej,&nbsp;Gordana Fressl Juroš,&nbsp;Verica Horvat,&nbsp;Dara Metzner,&nbsp;Dijana Pamuković Jaram,&nbsp;Alma Pipić Kitter,&nbsp;Fran Smaić,&nbsp;Sanela Šimić Vojak,&nbsp;Livija Šimičević,&nbsp;Valentina Verić","doi":"10.11613/BM.2022.010501","DOIUrl":"https://doi.org/10.11613/BM.2022.010501","url":null,"abstract":"<p><p>The sweat test (ST) is a cornerstone in the diagnosis of cystic fibrosis (CF), together with newborn screening and genetic testing. However, the performance of the ST can depend on the operator's skill, so several international guidelines have been published to standardise the ST, but inconsistencies remain. The joint Working Group for ST Standardisation (WG STS) of the Croatian Society of Medical Biochemistry and Laboratory Medicine, in association with cistic fybrosis health professional and the Cistic Fibrosis Centre for Paediatrics and Adults, have issued National Guidelines for the Performance of the Sweat Test in order to ensure consistency in ST performance and accuracy of reported results. Many of the standards were taken from the 2nd Edition of the UK Guidelines for Performance of the ST for the Diagnosis of CF, while others were taken from independent consensus statements from the WG STS based on local ST equipment and practices. The standards cover every step of the ST, from the indications for testing to reporting of results and their interpretation, including the analytical phase and quality control. In addition, National Guidelines include appendices with practical examples in order to aid implementation of the recommendations in routine practice.</p>","PeriodicalId":9021,"journal":{"name":"Biochemia Medica","volume":"32 1","pages":"010501"},"PeriodicalIF":3.3,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8833251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834170","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}