BMC Gastroenterology最新文献

{"title":"Heterogeneity of treatment preferences in the absence of guideline recommendations - a case vignette study in colorectal cancer tumor boards in Germany, Austria and Switzerland.","authors":"Johannes Soff, Stefan Rolf Benz, Christoph Kowalski, Judith Hansinger, Michael Gerken, Daniel Maier, Soo-Zin Kim-Wanner, Jacqueline Witzmann, Anke Reinacher-Schick, Christian Peter Pox, Kees Kleihues-van Tol, Bianca Franke, Olaf Schoffer, Jochen Schmitt, Monika Klinkhammer-Schalke, Vinzenz Völkel","doi":"10.1186/s12876-025-04183-5","DOIUrl":"10.1186/s12876-025-04183-5","url":null,"abstract":"<p><strong>Background: </strong>For the treatment of colorectal cancer, the S3-Guideline of the German Guideline Program in Oncology supports clinical decision-making. Centers certified by the German Cancer Society are required to implement the guideline recommendations as comprehensively as possible. When guidelines provide insufficient or ambiguous evidence, heterogeneity of treatment preferences is likely to emerge across individual centers. The aim of this study is to describe the preferences of the centers' tumor boards for treatment decisions when clear, evidence-based guideline recommendations are lacking.</p><p><strong>Methods: </strong>To investigate the tumor boards' preferences for different treatment options, an anonymous online survey was conducted among 314 certified colorectal cancer centers. The survey included seven visceral oncological and nine visceral surgical case vignettes. Centers were asked to discuss the vignettes in the tumor board or, alternatively, delegate them to an appropriate physician representatively speaking for the tumor board. The responses were analyzed descriptively and normalized entropy estimates (NE) were calculated for each vignette.</p><p><strong>Results: </strong>A total of 123 centers (39%) responded to the survey. For oncological cases without clear guideline recommendations, substantial heterogeneity (NE: 0.39-0.71) in treatment preferences was observed. For instance, opinions varied widely for UICC II pT4a colon cancer. In this situation, 28% of centers would prefer fluoropyrimidine monotherapy, 39% oxaliplatin-based combination therapy and 33% no adjuvant chemotherapy at all. Surgical vignettes showed a preference for laparoscopic and robotic approaches, with variations based on tumor location (NE: 0.46-0.67). Importantly, in case of a clear evidence-based guideline recommendation, treatment preferences did not differ considerably between hospital sites.</p><p><strong>Conclusions: </strong>In prototypical case vignettes without evidence-based guideline recommendations, pronounced heterogeneity of treatment preferences between centers was found. Reconstructing these treatment preferences can contribute to enhancing the quality of evidence derived from observational studies. This seems especially important in the context of clinical questions that cannot be assessed in randomized trials; clinical routine data represent an adequate resource for evidence generation in these scenarios.</p><p><strong>Trial registration: </strong>After conducting this study, the main study was registered in the German Clinical Trials Register (DRKS) on October 4, 2024 under study No. DRKS00034650.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"700"},"PeriodicalIF":2.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243754","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":"Effect of AI-assisted diagnosis on adenomas of different sizes: a meta-analysis with evidence from RCTs and trial sequential analysis.","authors":"Dengchao Wang, Youyun Shi, Jinshan Liu, Anyin Wang, Yong Cheng","doi":"10.1186/s12876-025-04263-6","DOIUrl":"10.1186/s12876-025-04263-6","url":null,"abstract":"","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"698"},"PeriodicalIF":2.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243819","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":"Small bowel diverticular disease: are we clinically aware?","authors":"Yujen Tseng, Jiayinaer Bolatihan, Xiao Li, Jiajing Yu, Dou Wang, Yuqin Jin, Lili Ma, Zhongguang Luo","doi":"10.1186/s12876-025-04178-2","DOIUrl":"10.1186/s12876-025-04178-2","url":null,"abstract":"<p><strong>Background & objective: </strong>Small bowel diverticulum (SBD) is an outpouching of the small intestinal wall and is often neglected in clinical practice due to its undiscerning location. Majority of SBD can be asymptomatic but can also be associated with life-threatening complications. We hereby performed a clinical analysis to investigate the characteristics associated with SBD.</p><p><strong>Patients and methods: </strong>This retrospective case series analyzed clinical data from two tertiary referral centers. Clinical data including baseline characteristics, clinical presentation, diagnostic methods and treatment were systematically collected and reviewed. Subgroup analysis based on distinct location of the SBD, such as the duodenum, jejunum and ileum were also performed.</p><p><strong>Results: </strong>A total of 149 cases of SBD were ultimately included in the present study analysis. Among 114 duodenal SBD cases, 42 (36.8%) were asymptomatic, while 58 (50.9%) presented with pain/discomfort. In contrast, jejunoileal SBD (n = 35) were predominantly symptomatic: 21 (60.0%) required surgical intervention due to complications such as obstruction (n = 8), bleeding (n = 12), or perforation (n = 5). Endoscopic modalities (DBE/VCE) achieved a diagnostic accuracy of 92.3% for jejunoileal SBD, surpassing radiological methods (CT/BaFT) at 38.5% (p < 0.001). Distinctive case highlights also provided examples of SBD found at different locations.</p><p><strong>Conclusion: </strong>Small bowel diverticular (SBD) disease is often overlooked in clinical practice, due to its discrete location and limited access. With continuous diagnostic advancements, including endoscopic techniques, the detection of SBD is expected to rise, gaining clinical awareness amongst gastroenterologists.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"701"},"PeriodicalIF":2.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243810","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":"MMP11 predicts colorectal cancer outcomes and its inhibitor RXP03 exerts anti-tumor effects via apoptosis activation.","authors":"Cheng Wang, Peiyi Fu, Jianping Sheng","doi":"10.1186/s12876-025-04322-y","DOIUrl":"10.1186/s12876-025-04322-y","url":null,"abstract":"","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"699"},"PeriodicalIF":2.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243806","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":"Partial Splenic embolization combined with endoscopic variceal ligation in variceal rebleeding prevention among liver cirrhosis patients complicated with hypersplenism, thrombocytopenia, and esophagogastric variceal hemorrhage: a prospective observational study.","authors":"Bin Yue, Di Yang, Zhongqiao Lu, Shiyou Zhao, Zhenhong Tang","doi":"10.1186/s12876-025-04329-5","DOIUrl":"10.1186/s12876-025-04329-5","url":null,"abstract":"<p><strong>Background: </strong>Patients with liver cirrhosis often suffer from complications such as splenomegaly, thrombocytopenia, and esophagogastric variceal hemorrhage, necessitating effective preventive measures. This study aimed to investigate the outcome of partial splenic embolization (PSE) combined with endoscopic variceal ligation (EVL) in variceal rebleeding prevention among liver cirrhosis patients complicated with hypersplenism, thrombocytopenia, and esophagogastric variceal hemorrhage.</p><p><strong>Methods: </strong>This prospective observational study enrolled liver cirrhosis patients complicated with hypersplenism, thrombocytopenia, and esophagogastric variceal hemorrhage who received PSE combined with EVL (PSE & EVL) or EVL alone based on informed patient's choice at the Affiliated Wenshan Hospital between November 2019 and October 2021. The primary outcome was the variceal rebleeding rate at postoperative 2 years, secondary outcomes included changes in platelet, white blood cell (WBC) counts and complications.</p><p><strong>Results: </strong>The baseline characteristics between patients who received PSE & EVL (n = 26, aged 54.12 ± 9.39, 21 males) and EVL alone (n = 40, aged 52.08 ± 11.64, 33 males) were comparable (all P > 0.05). Two years after surgery, patients received PSE & EVL were more likely to have lower rate (23.3% vs. 53.5%, P = 0.020) and risk of variceal rebleeding [HR (hazard ratio) = 0.36, 95% confidence interval (CI): 0.17-0.77, P = 0.020] compared to those received EVL alone. The platelet (60.58 ± 13.55 vs. 48.84 ± 11.41, P = 0.007) and WBC (5.12 ± 0.91 vs. 4.18 ± 0.92, P = 0.002) levels in patients received PSE + EVL at postoperative 2 years were significantly higher than those received EVL alone, while the occurrence of postoperative complications, such as abdominal pain, abdominal distension, nausea, vomiting, postoperative fever, and palpitations between patients who received PSE & EVL and EVL alone were similar (all P > 0.05).</p><p><strong>Conclusion: </strong>Combining PSE with EVL may reduce variceal rebleeding risk and boosts postoperative platelet and WBC counts without increasing complications. This study highlights the significance of this combined therapy in managing liver cirrhosis complications, offering valuable guidance for clinical practice.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"696"},"PeriodicalIF":2.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237842","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":"The diagnostic value of serum cysteine protease inhibitor (CST4) in colorectal cancer: a preliminary study.","authors":"Yuan Lan, Li Zhang, Renjun Li","doi":"10.1186/s12876-025-04297-w","DOIUrl":"10.1186/s12876-025-04297-w","url":null,"abstract":"<p><strong>Background: </strong>CST4 is associated with various cancers but its diagnostic value in colorectal cancer (CRC) has not been clearly established. This study aims to further validate the diagnostic value of CST4 in colorectal cancer using random forest models in machine learning based on existing research.</p><p><strong>Methods: </strong>First, the expression of CST4 in CRC patients is analyzed using data from The Cancer Genome Atlas (TCGA) and the results show that CST4 is significantly high expression in CRC patients. To further investigate the diagnostic value of CST4, this retrospective study include 59 colorectal cancer patients, 51 patients with colorectal precancerous lesions and 40 patients with non-adenomatous polyps who visited Chaohu Hospital Affiliated to Anhui Medical University from August 2022 to September 2023. Their serum was collected and the CST4 level was detected by the double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) method. At the same time, CEA and CA199 were also tested.</p><p><strong>Results: </strong>Analysis of the TCGA database show that CST4 is significantly over expressed in colorectal cancer tissues, including colon adenocarcinoma (COAD) and rectum adenocarcinoma (READ). Serum tests confirm that CST4 levels in CRC patients are significantly higher than those in the precancerous lesion and the polyp group (P < 0.001). However, no significant difference is observed between the precancerous lesion and polyp group. In the ROC curve, the area under the curve (AUC) of CST4 is 0.768 in the CRC group versus the precancerous lesion group and 0.769 in the CRC group versus the polyp group, which is significantly higher than that of CEA (AUC = 0.651/0.659) and CA199 (AUC = 0.486/0.601). In the diagnostic model constructed based on CST4, CEA and CA199, CST4 has the highest weight in differentiating CRC, further confirming its diagnostic value.</p><p><strong>Conclusion: </strong>The study indicates that CST4 has a higher diagnostic value in colorectal cancer (CRC) and CST4 provides a new approach for early clinical diagnosis.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"692"},"PeriodicalIF":2.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237915","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":"The effect of a plant- and dairy-based protein diet on serum levels of inflammatory and oxidative stress biomarkers in patients with liver cirrhosis: a randomized controlled trial.","authors":"Banafshe Khalese Ranjbar, Mahdiyeh Taghizadeh, Soraiya Ebrahimpour-Koujan, Mir Saeed Yekaninejad, Amir Anushiravani, Mehdi Saberifiroozi, Somayyeh Asghari","doi":"10.1186/s12876-025-04276-1","DOIUrl":"10.1186/s12876-025-04276-1","url":null,"abstract":"","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"695"},"PeriodicalIF":2.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237867","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":"Association of serum osmolality with metabolic dysfunction-associated steatotic liver disease in adults.","authors":"Liping Peng, Minghua Ai","doi":"10.1186/s12876-025-04309-9","DOIUrl":"10.1186/s12876-025-04309-9","url":null,"abstract":"<p><strong>Purpose: </strong>Hydration status is linked to metabolic syndrome, hypertension, and obesity in adults, and dehydration is associated with metabolic dysfunction-associated steatotic liver disease (MASLD) in children. However, the relationship between serum osmolality (OSM) and MASLD odds in adults remains unclear.</p><p><strong>Methods: </strong>This cross-sectional study analyzed NHANES data (2017-March 2020). MASLD was defined as hepatic steatosis (controlled attenuation parameter >248 dB/m) plus at least one metabolic risk factor. Serum OSM was calculated using the ESPEN-recommended equation. Restricted cubic spline (RCS) and weighted logistic regression analyses were performed, adjusting for age, sex, poverty-income ratio (PIR), race, smoking, drinking, energy intake, and physical activity. Subgroup analyses were conducted to enhance the robustness of the results.</p><p><strong>Results: </strong>Among 3,799 participants, higher serum OSM (Q4 vs. Q1) was associated with increased odds of MASLD in unadjusted (OR=2.02, 95% CI 1.29-3.16), partially adjusted (OR=1.64, 95% CI 1.08-2.49), and fully adjusted models (OR=1.60, 95% CI 1.02-2.50). RCS analysis revealed a positive linear correlation (P_nonlinear=0.844). A significant interaction between PIR and OSM was observed (P_interaction=0.019).</p><p><strong>Conclusion: </strong>Serum OSM is positively and linearly associated with MASLD odds in US adults. Measuring OSM may help identify high-risk groups, enabling early intervention and informing public health strategies.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"693"},"PeriodicalIF":2.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238046","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":"Global prevalence of metabolic dysfunction-associated fatty liver disease in children and adolescents with overweight and obesity: a systematic review and meta-analysis.","authors":"Shuangzhen Jia, Xiaolin Ye, Tianwei Wu, Zhaoxia Wang, Jie Wu","doi":"10.1186/s12876-025-04314-y","DOIUrl":"10.1186/s12876-025-04314-y","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) among children and adolescents with overweight and/or obesity is rising globally, reflecting increasing obesity rates and metabolic syndrome. This study aims to provide a comprehensive global estimate of MAFLD prevalence in this population.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted using data from PubMed, Embase, Medline, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science, up to May 10, 2024. We included studies that diagnosed MAFLD in children and adolescents aged 1 to 19 years using histological, imaging, or blood biomarker evidence. The prevalence rates were analyzed, and subgroup analyses were performed based on continent, development status, time period, sample source, diagnostic technique, and body mass index (BMI).</p><p><strong>Results: </strong>The analysis included 176 studies with a total of 57,058 participants. The global prevalence of MAFLD among children and adolescents with overweight and/or obesity was 41.2% (95% CI 39.7-44.6). Significant geographical variations were observed, with the highest prevalence in North America (43.6%) and the lowest in Africa (31.1%). Studies conducted after 2010 reported higher prevalence rates (42.5%) compared to those before 2010 (38.2%). Hospital-based studies showed the highest prevalence (42.5%), while community-based studies reported lower rates. Liver biopsy yielded the highest prevalence (51.2%) among diagnostic methods.</p><p><strong>Conclusion: </strong>The global prevalence of MAFLD in children and adolescents with overweight and/or obesity is alarmingly high. The study highlights significant geographical and methodological variations, underscoring the need for standardized diagnostic criteria and targeted public health interventions to address this growing epidemic.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"691"},"PeriodicalIF":2.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238127","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":"Glutamine prevents diarrhea in colorectal cancer patients undergoing chemotherapy or chemoradiotherapy: a meta-analysis.","authors":"Lijuan Chen, Duo Wang, Chang Meng, Hongshuo Sun, Ruolin Li, Guobin Miao, Peng Liu","doi":"10.1186/s12876-025-04308-w","DOIUrl":"10.1186/s12876-025-04308-w","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy of glutamine in preventing diarrhea associated with chemotherapy or chemoradiotherapy in colorectal cancer.</p><p><strong>Methods: </strong>Randomized controlled trials of glutamine in the prevention of chemotherapy-associated diarrhea of colorectal cancer were retrieved from the Cochrane Library, Pubmed, EMBASE, CNKI, and Wanfang by computer up to August 1, 2024. Results were presented using relative risk (RR) or mean difference (MD) with a 95% confidence interval (CI). Publications were reviewed in accordance with the Cochrane Handbook and the guidelines of the Preferred Reporting Project for Systematic Review and Meta-Analysis (PRISMA2020). This study has been registered with INPLASY (registration number: INPLASY202490057).</p><p><strong>Results: </strong>A total of 5 studies were included, and the total number of patients was 311. Meta-analysis showed that compared with the control group, glutamine supplementation significantly reduced the incidence of chemoradiation-induced diarrhea in colorectal cancer patients (RR = 0.72, 95%CI: 0.60-0.87, P < 0.01, I²=37%). Subgroup analysis found that glutamine was more effective in reducing diarrhea in patients receiving chemotherapy alone than in those undergoing chemoradiotherapy (RR = 0.65, 95%CI: 0.43-0.98, P < 0.05, I²=35%). By tumor location, glutamine reduced diarrhea in the colorectal cancer subgroup (RR = 0.65, 95%CI: 0.44-0.97, P < 0.05, I²=30%) but not in the rectal cancer subgroup (P > 0.05). D-xylose levels were significantly higher in the glutamine group (MD = 0.32, 95%CI: 0.14-0.51, P < 0.01, I²=0%), while C-reactive protein levels were significantly lower (MD = 0.52, 95%CI: 0.32-0.72, P < 0.01, I²=0%). The certainty of evidence for diarrhea was rated as low.</p><p><strong>Conclusion: </strong>Glutamine supplementation is associated with a reduced incidence of diarrhea in patients with colorectal cancer, with a more pronounced efficacy observed in those receiving chemotherapy alone.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"697"},"PeriodicalIF":2.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238149","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}