Bone最新文献

{"title":"Duplications within exon 1 of TNFRSF11A encoding receptor activator of nuclear factor-kappa B (RANK) are associated with tendon avulsion","authors":"Jill H. Simmons ,&nbsp;Edna E. Mancilla ,&nbsp;Steven Mumm ,&nbsp;Kathryn M. Dahir ,&nbsp;Shenghui Duan ,&nbsp;Kristie I. Aamodt ,&nbsp;John T. Lawrence ,&nbsp;Robert B. Carrigan ,&nbsp;Michael P. Whyte","doi":"10.1016/j.bone.2025.117486","DOIUrl":"10.1016/j.bone.2025.117486","url":null,"abstract":"<div><h3>Introduction</h3><div>Different length in-frame duplications within exon 1 of <em>TNFRSF11A</em> encoding receptor activator of nuclear factor-kappa B (RANK) increase osteoclast action and cause rapid turnover bone disease. Complications include deafness, fractures, immobilization hypercalcemia, tooth resorption, and painful skeletal deformities. We investigated two siblings and their father and an unrelated girl with this autosomal dominant dento-osseous phenotype who suffered tendon avulsions.</div></div><div><h3>Patients</h3><div>A 13-year-old boy, his 16-year-old sister, and their 43-year-old father, all with hearing loss and progressive tooth root resorption, have a heterozygous 27-bp duplication within exon 1 of <em>TNFRSF11A</em>. Within 3 years, the siblings suffered seven tendon avulsions with minimal trauma, including the distal Achilles, triceps, and quadriceps tendons. Alendronate was given weekly, which decreased bone turnover markers (BTMs) and treated mild immobilization hypercalcemia following tendon repairs. Their father suffered an Achilles tendon avulsion without a clear mechanism at 20 years of age.</div><div>An unrelated 10-year-old girl with hearing loss and progressive tooth root resorption was heterozygous de novo for a 12-bp duplication within exon 1 of <em>TNFRSF11A</em>. Alendronate was given weekly. At age 15 years, she bilaterally avulsed her triceps while playing volleyball and then avulsed her Achilles tendon two months later.</div></div><div><h3>Conclusions</h3><div>Tendon avulsion seems to be a complication of constitutive RANK activation from select duplications of <em>TNFRSF11A</em>, but its precise pathogenesis and the impact of bisphosphonate therapy remain uncertain. Bisphosphonate therapy can treat or prevent associated immobilization hypercalcemia and decrease BTMs in people with constitutive RANK activation from such mutations.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"197 ","pages":"Article 117486"},"PeriodicalIF":3.5,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reference values for cross-linked C-telopeptide of type 1 collagen and pro-collagen type1 N-terminal propeptide in children and adolescents: Results from the Canadian Health Measures Survey","authors":"Hyunwoo Kim ,&nbsp;Leanne M. Ward ,&nbsp;Lehana Thabane ,&nbsp;Alexandra Papaioannou ,&nbsp;Andy Kin On Wong ,&nbsp;Jonathan Derrick Adachi ,&nbsp;Jinhui Ma ,&nbsp;Frank Rauch","doi":"10.1016/j.bone.2025.117487","DOIUrl":"10.1016/j.bone.2025.117487","url":null,"abstract":"<div><h3>Introduction</h3><div>Procollagen type 1 N-propeptide (P1NP) and carboxy-terminal telopeptide of type 1 collagen (CTX) are bone turnover markers for diagnosing and monitoring metabolic bone diseases and growth disorders. This study aimed to establish representative reference ranges for CTX and P1NP, as measured with an IDS-iSYS system, in Canadian children and adolescents.</div></div><div><h3>Methods</h3><div>Serum levels of CTX and P1NP were measured in participants of the Canadian Health Measures Survey, a nationally representative study. The LMSP method, using Box–Cox power exponential distribution to accommodate kurtosis in the distribution, was employed to estimate age- and sex-specific reference curves and parameters for Z-score calculation. In addition, non-parametric analysis was utilized to establish 95 % reference intervals for two-year age brackets. Reference curves were generated based on the cohort aged 6 to 27 years, and reference intervals were calculated based on the age range 6 to 20 years.</div></div><div><h3>Results</h3><div>The cohort included 1840 participants for CTX (51.6 % males) and 4069 for P1NP (50.5 % males). Reference ranges for age and sex showed the expected patterns with peaks at the age of puberty (earlier in females than males). As the aim of the study was to present representative reference data, results were provided based on the entire study population regardless of ethnicity and health status. Results obtained in the most common ethnicity (‘white’) and in the subgroup of ‘healthy white’ study participants were similar.</div></div><div><h3>Conclusion</h3><div>This study establishes age- and sex-specific reference values for serum concentrations of CTX and P1NP in Canadian individuals from 6 to 20 years of age. These results have the potential to enhance diagnostic accuracy and inform bone health clinical decision-making for this population.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"196 ","pages":"Article 117487"},"PeriodicalIF":3.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Craniosynostosis among children with X-linked hypophosphatemia: A systematic review and meta-analysis","authors":"Samuel A. Fisch ,&nbsp;Alina Tudor ,&nbsp;El Mahdi Benchekroun ,&nbsp;Wally Landsberg ,&nbsp;Neil Feldstein ,&nbsp;Michael Lamb ,&nbsp;Thomas O. Carpenter ,&nbsp;Andrew G. Rundle ,&nbsp;Judith S. Jacobson ,&nbsp;Alfred I. Neugut ,&nbsp;Daniel E. Freedberg","doi":"10.1016/j.bone.2025.117488","DOIUrl":"10.1016/j.bone.2025.117488","url":null,"abstract":"<div><h3>Background</h3><div>X-linked hypophosphatemia (XLH) is a rare genetic disorder caused by <em>PHEX</em> gene variants, leading to elevated FGF23 levels and impaired phosphate reabsorption, resulting in abnormal bone growth. Skull abnormalities, including craniosynostosis, are often reported in children with XLH, but the true prevalence of craniosynostosis among children with XLH is unknown.</div></div><div><h3>Methods</h3><div>We performed a systematic review and meta-analysis to estimate craniosynostosis prevalence in children with XLH. We searched PubMed, Embase, and Web of Science for cohort studies or large case series published before June 2024. Eligible studies included at least ten children with XLH and reported craniosynostosis prevalence without selection based on skull abnormalities. Pooled prevalence was calculated using a random-effects model, with heterogeneity assessed.</div></div><div><h3>Results</h3><div>Of 517 studies initially identified, ten studies with 461 patients met the criteria for inclusion. The pooled prevalence of craniosynostosis among children with XLH was 22 % (95 % confidence interval (CI) 9.0 % to 44 %) with significant heterogeneity across studies (I² = 88.5 %, <em>p</em> &lt; 0.01). This prevalence is far greater than the prevalence of craniosynostosis in the general pediatric population, which is estimated to be one in 2100–2500 births. We confirmed an expected female predominance among children with XLH (median 65.9 % female, interquartile range [IQR] 53.7 % to 68.4 %) but not among children with XLH and craniosynostosis (median 42 % female, range 21 % to 48 %).</div></div><div><h3>Conclusion</h3><div>Craniosynostosis is more common among children with XLH compared to the general pediatric population and may be disproportionately common among males. Increased vigilance for craniosynostosis is warranted for children with XLH.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"196 ","pages":"Article 117488"},"PeriodicalIF":3.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise alleviates osteoporosis by regulating the secretion of the Senescent Associated Secretory Phenotype","authors":"Kaihong Weng ,&nbsp;Yuting He ,&nbsp;Xiquan Weng ,&nbsp;Yu Yuan","doi":"10.1016/j.bone.2025.117485","DOIUrl":"10.1016/j.bone.2025.117485","url":null,"abstract":"<div><div>As the elderly population grows, the number of patients with metabolic bone diseases such as osteoporosis has increased sharply, posing a significant threat to public health and social economics. Although pharmacological therapies for osteoporosis demonstrate therapeutic benefits, their prolonged use is associated with varying degrees of adverse effects. As a non-pharmacological intervention, exercise is widely recognized for its cost-effectiveness, safety, and lack of toxic side effects, making it a recommended treatment for osteoporosis prevention and management. Previous studies have demonstrated that exercise can improve metabolic bone diseases by modulating the Senescent Associated Secretory Phenotype (SASP). However, the mechanisms through which exercise influences SASP remain unclear. Therefore, this review aims to summarize the effects of exercise on SASP and elucidate the specific mechanisms by which exercise regulates SASP to alleviate osteoporosis, providing a theoretical basis for osteoporosis through exercise and developing targeted therapies.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"196 ","pages":"Article 117485"},"PeriodicalIF":3.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scanning acoustic microscopy for biomechanical characterization of reindeer antler using singular spectral analysis","authors":"Adarsh Sharma ,&nbsp;Shivam Ojha ,&nbsp;Amit Shelke ,&nbsp;Anowarul Habib","doi":"10.1016/j.bone.2025.117475","DOIUrl":"10.1016/j.bone.2025.117475","url":null,"abstract":"<div><div>Scanning Acoustic Microscopy (SAM) has become a vital tool in materials science and biology, allowing for non-destructive and non-invasive analysis of biological specimens and bio-inspired materials. Its deep-penetrating imaging capabilities enable a broad range of applications. This study combines SAM with Singular Spectral Analysis (SSA) to enhance signal processing and extract key data, particularly acoustic impedance. Reindeer antlers, known for their rapid growth and unique mechanical properties, were chosen as a focus for this method. SAM was used to quantify the specific acoustic impedance, longitudinal stiffness, bulk modulus, and Young's modulus of the material at three orientations (0°, 45°, and 90°). This analysis provides a comprehensive understanding of the directional dependence of its structural behavior, highlighting its orthotropic nature. By analyzing cross-sections along three axes, this study reveals the orthotropic biomechanical properties of reindeer antlers, offering a systematic approach to characterizing biological materials. Their unique strength, resilience, and rapid growth highlight their potential as a sustainable and innovative biomaterial for bioengineering and advanced composites.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"196 ","pages":"Article 117475"},"PeriodicalIF":3.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming growth factor, beta-2 gene mutation causes autosomal dominant Camurati-Engelmann disease, type 2 (OMIM % 606631)","authors":"Steven Mumm ,&nbsp;José L. Paz-Ibarra ,&nbsp;Philippe M. Campeau ,&nbsp;Elizabeth Garrido-Carrasco ,&nbsp;Jonathan C. Baker ,&nbsp;Ethel Pino-Nina ,&nbsp;Shenghui Duan ,&nbsp;William H. McAlister ,&nbsp;Michael P. Whyte","doi":"10.1016/j.bone.2025.117477","DOIUrl":"10.1016/j.bone.2025.117477","url":null,"abstract":"<div><div><em>Camurati-Engelmann disease</em>, <em>type 1</em> (CED1, OMIM # <span><span>131300</span><svg><path></path></svg></span>) is the rare autosomal dominant skeletal dysplasia caused by select heterozygous loss-of-function defects within the gene <em>TGFB1</em>, which encodes transforming growth factor beta 1 (TGFB1). CED1 mutations are found in <em>TGFB1</em> exons 1–4 that form the latency-associated peptide (LAP) of pro-TGFB1. Consequently, skeletal action of TGFB1 increases and thereby enhances bone formation manifest clinically as “progressive diaphyseal dysplasia”. Beginning 24 years ago negative <em>TGFB1</em> analysis suggested rare genetic heterogeneity for CED, and Online Mendelian Inheritance In Man designated, of unknown etiology, “<em>CED2</em>” (OMIM % 606631). In 2024, three sporadic occurrences considered CED2 were reported to harbor either of two mutations of <em>TGFB2</em>, which encodes the LAP of transforming growth factor beta 2 (TGFB2).</div><div>Herein, three adults (father, son, daughter) having the CED2 phenotype in a Peruvian family revealed a novel missense variant (c.108G &gt; T, p.R36S) within the TGFB2 LAP domain. Debilitating painful skeletal disease featuring hyperostosis of entire long bones, worse in the men, presented early in childhood. Aminobisphosphonate therapy seemed helpful. Their <em>TGFB2</em> variant was within a highly conserved domain across species, absent in the gnomAD database, “possibly damaging” by Polyphen-2, not tolerated by SIFT, homologous with TGFB1 at the same amino acid position (R36) as one reported TGFB2 mutation, co-segregated as autosomal dominant, and “likely pathogenic” per ACMG guidelines.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"197 ","pages":"Article 117477"},"PeriodicalIF":3.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influences and strategies for bone regeneration based on microenvironment pH adjustment","authors":"Jing Zhang ,&nbsp;Xinyi Shen ,&nbsp;Zhikang Wang,&nbsp;Jiawen Yong,&nbsp;Zhiwei Jiang,&nbsp;Guoli Yang","doi":"10.1016/j.bone.2025.117484","DOIUrl":"10.1016/j.bone.2025.117484","url":null,"abstract":"<div><div>Bone possesses remarkable endogenous regenerative capacity. Bone regeneration is typically divided into three stages: inflammation, bone formation, and bone remodeling, during which pH is a critical variable. The influence of pH on the bone regeneration process depends on three main factors: (1) the activity and differentiation of cells involved in bone regeneration are affected by pH; (2) protein activity is regulated by pH; and (3) extracellular calcium phosphate precipitates in a pH-dependent manner. The aim of this study is to review the mechanisms by which microenvironment pH affects bone regeneration and to explore specific sites and signaling pathways involved in pH regulation during the bone regeneration process. Therapeutic approaches aimed at enhancing bone regeneration <em>via</em> modulation of microenvironment pH are discussed, including pH adjustment <em>via</em> biological implant materials, pH-responsive material setting, and pH stabilization through anti-inflammatory therapy. Investigating the impact of microenvironment pH on bone regeneration is of considerable clinical importance, as it provides valuable insights for improving the success rates of bone implants and promoting bone healing. This review offers insights into regulatory mechanisms, establishes theoretical foundations, and presents new perspectives for current research on bone defect repair.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"196 ","pages":"Article 117484"},"PeriodicalIF":3.5,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond BMD: Clinical implications of vertebral biomechanical decline under ADT","authors":"Shengyi Chen ,&nbsp;Yuekun Fang ,&nbsp;Bin Cheng","doi":"10.1016/j.bone.2025.117476","DOIUrl":"10.1016/j.bone.2025.117476","url":null,"abstract":"","PeriodicalId":9301,"journal":{"name":"Bone","volume":"196 ","pages":"Article 117476"},"PeriodicalIF":3.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PTH pre-treatment prior to tibial mechanical loading improves their synergistic anabolic effects in mice","authors":"Tyler J. McNeill ,&nbsp;Amanda M. Rooney ,&nbsp;F. Patrick Ross ,&nbsp;Mathias P.G. Bostrom ,&nbsp;Marjolein C.H. van der Meulen","doi":"10.1016/j.bone.2025.117474","DOIUrl":"10.1016/j.bone.2025.117474","url":null,"abstract":"<div><div>Parathyroid hormone (PTH) increases bone mass and decreases fracture risk. However, the anabolic effects of PTH are limited to a period of approximately 24 months, motivating the need to maximize bone growth during this timeframe. Concurrent mechanical loading with weight-bearing exercise is synergistic with PTH treatment. We sought to determine if priming with PTH prior to initiating mechanical loading would enhance their synergistic effects. We pre-treated 10-week-old, female C57Bl/6J mice with either PTH or saline vehicle (VEH) for six weeks. We subsequently initiated cyclic tibial compression for either two or six weeks while continuing PTH or VEH treatment. We analyzed bone morphology in cortical and cancellous compartments of the proximal tibia. To further explore the effects of PTH and loading in cancellous bone, we measured bone cell presence and changes in bone morphology via histology, immunohistochemistry, and dynamic histomorphometry. Concurrent treatment with PTH enhanced load-induced increases in bone mass in cortical bone but blunted the effects of loading in cancellous bone. PTH pre-treatment further increased load-induced changes in cortical bone mass and rescued the load effects in cancellous bone, returning values to those of VEH-treated animals. Osteoclast populations decreased with loading, independent of PTH treatment. Active osteoblast populations increased with PTH pre-treatment but did not change with loading. Bone formation rate increased with PTH pre-treatment in the 2-week group but did not differ between treatment groups after 6-weeks. Collectively, pre-treating with PTH prior to mechanical loading primed the skeletal tissue and enhanced the anabolic response of concurrent treatment and loading.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"196 ","pages":"Article 117474"},"PeriodicalIF":3.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum bicarbonate concentration is associated with bone density in adults with type 2 diabetes mellitus: African American-Diabetes Heart Study","authors":"Minesh Khatri ,&nbsp;Kishan Rao ,&nbsp;Meredith Akerman ,&nbsp;Jean Ancion ,&nbsp;Barry I. Freedman ,&nbsp;Jasmin Divers","doi":"10.1016/j.bone.2025.117470","DOIUrl":"10.1016/j.bone.2025.117470","url":null,"abstract":"<div><h3>Background</h3><div>Osteoporosis is a significant cause of morbidity and mortality in the aging population. Individuals with type 2 diabetes mellitus (T2D) typically have higher bone density yet also a higher rate of fractures. Blacks, meanwhile, have a lower incidence of osteoporosis compared to European Americans. Serum bicarbonate may be a risk factor for bone loss, but studies are conflicting, and little is known about this relationship in T2D or Blacks.</div></div><div><h3>Methods</h3><div>We examined the longitudinal relationship between serum bicarbonate and change in bone density in 300 participants with T2D in the African American-Diabetes Heart Study (AA-DHS). Serum bicarbonate was measured at baseline, and bone density was assessed using CT volumetric bone mineral density (vBMD) scans of the thoracic and lumbar vertebrae at baseline and after five years of follow-up. Multivariate linear regression models assessed associations between baseline serum bicarbonate and longitudinal change in vBMD, adjusted for multiple confounders.</div></div><div><h3>Results</h3><div>The cohort was 50 % female, with mean age and T2D duration 55.1 years and 10.2 years, respectively. The mean baseline serum bicarbonate was 26.6 (SD 3.3) mEq/L; median baseline lumbar spine vBMD 179.3 (IQR 148.2, 208.9) mg/cm³, and median baseline thoracic spine vBMD 204.9 (IQR 171.6, 231.9) mg/cm³. In fully-adjusted analyses, each 1 mEq/L increase in baseline serum bicarbonate was significantly associated with 5-year relative increase in lumbar vBMD (0.94 mg/cm³, p &lt; 0.001) and thoracic vBMD (1.35 mg/cm³, p &lt; 0.001), without a clear threshold effect or differences by sex.</div></div><div><h3>Conclusions</h3><div>In this cohort of Blacks with T2D, higher baseline serum bicarbonate levels were associated with improved changes in bone density over time. Further studies are needed to determine if alkali supplementation would ameliorate loss of bone density in this population.</div></div>","PeriodicalId":9301,"journal":{"name":"Bone","volume":"196 ","pages":"Article 117470"},"PeriodicalIF":3.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143740064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}