Cardiorenal Medicine最新文献

{"title":"Association of Uric Acid to High-Density Lipoprotein Cholesterol Ratio with Left Ventricular Hypertrophy in Chronic Kidney Disease.","authors":"Li Wang, Fangfang Xiang, Jun Ji, Lin Zhang, Xiaotian Jiang, Yi Fang, Xiaoqiang Ding, Wuhua Jiang","doi":"10.1159/000545822","DOIUrl":"10.1159/000545822","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) is associated with a high prevalence of cardiovascular complications, including left ventricular hypertrophy (LVH), which significantly increases morbidity and mortality. LVH in CKD results from a complex interplay of hemodynamic, neurohormonal, and metabolic factors. The uric acid-to-high density lipoprotein cholesterol ratio (UHR) has recently been proposed as a potential marker for cardiovascular outcomes, combining the effects of uric acid and HDL-C on inflammation and cardiovascular risk. However, the relationship between UHR and LVH in CKD patients remains unexplored. This study aimed to investigate the association between UHR and LVH in patients with CKD.</p><p><strong>Methods: </strong>This cross-sectional study included CKD patients admitted to the Division of Nephrology between April 2019 and October 2019. CKD was staged according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. LVH was assessed using transthoracic echocardiography, and left ventricular mass index (LVMI) was calculated. LVH was defined as an LVMI >115 g/m2 for men and >95 g/m2 for women. UHR was calculated by dividing serum uric acid levels (µmol/L) by HDL-C levels (mmol/L). Multivariable logistic regression models were used to assess the association between UHR and LVH, adjusting for covariates including age, gender, BMI, and other relevant clinical factors.</p><p><strong>Results: </strong>A total of 466 patients were included, of whom 56 had LVH. Patients with LVH had significantly higher UHR levels compared to those without LVH. In multivariable regression analysis, the natural logarithm of UHR (LnUHR) was significantly associated with an increased risk of LVH (OR: 2.04, 95% CI: 1.05-4.12, p = 0.035) after full adjustment for confounders. Further analysis using restricted cubic splines revealed a non-linear relationship between UHR and LVH, with an inflection point at UHR = 0.60. Below this threshold, each increase of one standard deviation in UHR was associated with a 2.11-fold increase in LVH risk (OR: 2.11, 95% CI: 1.51-3.03, p < 0.001), while above this threshold, the association was not significant (OR: 0.82, 95% CI: 0.39-1.47, p = 0.54).</p><p><strong>Conclusion: </strong>This study provides the first evidence of an association between UHR and LVH in CKD patients, particularly at lower UHR levels. The findings suggest that UHR could serve as a novel marker for cardiovascular risk stratification in CKD, reflecting the balance between pro-inflammatory and protective cardiovascular factors. These results highlight the potential of UHR as a cost-effective tool for identifying CKD patients at increased risk of LVH, warranting further investigation in longitudinal studies to establish causality and explore targeted interventions.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"323-332"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974938","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 Wnt3a/β-Catenin/TCF7L2 Pathway in Diabetes and Cardiorenal Complications.","authors":"Yilinuer Adeerjiang, Abudulimu Sidike, Xiao-Xue Gan, Qin-Tian Li, Sheng Jiang","doi":"10.1159/000543145","DOIUrl":"10.1159/000543145","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus is a prevalent chronic disease that is becoming increasingly common worldwide and can lead to a number of dangerous complications. The Wnt signaling pathway is important for the onset and progression of diabetes. Wnt3a is a typical Wnt ligand that can increase the stability of β-catenin, control TCF7L2 expression, promote β-cell proliferation, and reduce apoptosis.</p><p><strong>Summary: </strong>The involvement of the Wnt3a/β-catenin/TCF7L2 signaling pathway in the development of diabetes and associated problems related to the kidneys is reviewed in this article.</p><p><strong>Key message: </strong>We believe that a thorough comprehension of the molecular connections between diabetes and signaling pathways will eventually lead to improved diabetes management.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"72-82"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876240","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":"Uncovering Candidate Genes Associated with Cardiovascular Disease in Patients with Arteriovenous Fistula and End-Stage Renal Disease.","authors":"Guoxin Zhang, Jieqiong Fu, Limin Nie","doi":"10.1159/000546299","DOIUrl":"10.1159/000546299","url":null,"abstract":"<p><strong>Background: </strong>The molecular association between end-stage renal disease (ESRD), arteriovenous fistula (AVF) failure, and cardiovascular disease (CVD) remains unclear. This study aimed to investigate their potential relationship.</p><p><strong>Methods: </strong>Three datasets were downloaded from the public database. AVF-failure-related differentially expressed genes (DEGs), CVD-related DEGs, and ESRD-related DEGs were identified by differential expression analysis and weighted gene co-expression network analysis. Then, AVF-failure-related, CVD-related, and ESRD-related DEGs were overlapped to obtain the hub genes. The diagnostic values of hub genes were evaluated. Finally, the immune infiltration analysis and drug prediction were performed.</p><p><strong>Results: </strong>A total of four hub genes (ABCC8, ALPI, FGF11, and OBP2A) were identified, and those genes have excellent diagnostic accuracy. Among them, ABCC8, ALPI, and FGF11 showed good sensitivity and specificity. However, compared to the nondiabetic subgroup, the diagnostic ability of these genes was weaker in the diabetic subgroup for distinguishing AVF failure in ESRD patients. Type 17 T helper cells and gamma delta T cells may be associated with CVD caused by ESRD and AVF. A total of 15 drugs associated with hub genes were predicted.</p><p><strong>Conclusion: </strong>ABCC8, ALPI, and FGF11 could serve as potential diagnostic biomarkers for AVF failure and CVD in HD-treated ESRD patients. Their robustness needs to be validated in larger cohorts and additional subgroups with comorbidities.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"386-398"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977477","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":"Secondary Cardiorenal Syndromes in Children: Focus on Type 3 to 5 Cardiorenal Syndrome.","authors":"Emre Leventoğlu, Akif Kavgacı, Utku Arman Örün, Bahar Büyükkaragöz","doi":"10.1159/000545791","DOIUrl":"10.1159/000545791","url":null,"abstract":"<p><strong>Background: </strong>The interaction between the heart and kidneys involves complex mechanisms, leading to a clinical condition known as cardiorenal syndrome (CRS), where dysfunction in one organ leads to impairment of the other. This syndrome can be acute or chronic, affecting both organs simultaneously.</p><p><strong>Summary: </strong>In 2008, the Acute Dialysis Quality Group classified CRS into two main categories: cardiorenal CRS and renocardiac CRS, based on the primary organ affected. Cardiorenal CRS includes two subtypes where heart failure causes kidney injury (types 1 and 2), while renocardiac CRS (types 3 and 4) refers to kidney injury leading to cardiac dysfunction, either from acute kidney injury or chronic kidney disease. Type 5 CRS is termed as secondary CRS which involves both organ dysfunction due to an acute systemic disease, such as sepsis, infections, or chronic conditions like diabetes mellitus. This review examines the cardiovascular involvement in various nephrological diseases commonly seen in clinical practice, with a focus on types 3-5 CRS in children from a nephrology perspective.</p><p><strong>Key messages: </strong>CRS is common in pediatric patients with cardiac, renal, or systemic conditions and poses a significant risk of mortality. The lack of longitudinal studies or specific biomarkers for the diagnosis, treatment, and follow-up of CRS in children is evident. Aspects such as the development of new biomarkers, ongoing research into neurohormonal mechanisms, meta-analyses, and introduction of algorithms for the follow-up period may reshape patient management. Specific diagnostic tools or therapeutic interventions for CRS management in children should be implemented. Collaborative efforts among pediatricians, cardiologists, and nephrologists are essential for developing effective treatments. Large-scale studies are needed to better understand CRS and develop targeted therapies to improve outcomes for pediatric patients, reducing morbidity and mortality.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"358-373"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953625","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":"Cardiorenal Benefits of SGLT2 Inhibitors in Patients with Chronic Kidney Disease and Concomitant Hypertension.","authors":"Mi Wang, Li Zuo","doi":"10.1159/000545622","DOIUrl":"10.1159/000545622","url":null,"abstract":"<p><strong>Background: </strong>Uncontrolled hypertension is both a driver of chronic kidney disease (CKD) and a complication of the disease, as well as a risk factor for cardiovascular disease (CVD). Therefore, renal protective agents with antihypertensive properties are desirable for management of cardiorenal syndrome in CKD. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are emerging as a new class of renal protective agents, with robust efficacy in delaying progression of CKD and reducing cardiovascular events. Here, we present an overview of SGLT2 inhibitors and discuss the alternative mechanisms contributing to the antihypertensive and cardiorenal benefits of SGLT2 inhibitors, with a focus on people with CKD and concomitant hypertension. We also explore the role of SGLT2 as a central node in the pathways underlying these mechanisms.</p><p><strong>Summary: </strong>Beyond its well-known renal benefit, SGLT2 inhibitors have shown blood pressure (BP)-lowering effects in people with CKD, with an average reduction of 3-5 mm Hg in systolic BP. Clinical evidence has shown that SGLT2 inhibitors confer cardiorenal protective effects in patients with CKD regardless of diabetes status, and these benefits appear to extend to individuals with hypertensive CKD. The antihypertensive effects of SGLT2 inhibitors were also demonstrated in patients with CKD and hypertension. While osmotic diuresis is thought to be a predominant mechanism underlying the antihypertensive effects of SGLT2 inhibitors in the CKD population, we believe that the underlying mechanisms are likely to be multifactorial, with alternative pathways also involved, particularly in hypertension-associated CKD.</p><p><strong>Key messages: </strong>Given the rising incidence of hypertension and CKD, the BP-lowering and cardioprotective effects of SGLT2 inhibitors could provide additional value in using this drug class for management of patients with CKD who have hypertension. Further subgroup analyses or larger studies on this specific population will provide more insights into the role of SGLT2 inhibitors in improving cardiorenal outcomes in this setting.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"496-509"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983452","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":"Biomarkers for Predicting of Sepsis-Induced Cardiorenal Syndrome in Emergency Settings.","authors":"Yuanyuan Pei, Liping Guo, Guangping Zhou, Lingjie Cao, Wenfeng Huang, Fengtao Yang, Dilu Li, Cheng Chi, Jihong Zhu","doi":"10.1159/000543462","DOIUrl":"10.1159/000543462","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiorenal syndrome (CRS) is a common and critical complication of sepsis, with high morbidity and mortality rates. Studies on biomarkers for the early prediction of septic CRS are sporadic. Classic and novel potential biomarkers were identified to explore their diagnostic performance of in patients with septic CRS.</p><p><strong>Methods: </strong>A total of 138 patients with sepsis from Peking University People's Hospital were enrolled in this prospective observational study, which was conducted between May 2019 and June 2022. The patients were divided into non-CRS (n = 106) and CRS (n = 32) groups. Serum levels of cystatin C, KIM-1, neutrophil gelatinase-associated lipocalin (NGAL), and α-Klotho were detected at admission using enzyme-linked immunosorbent assay. The relationship between the biomarker levels and risk factors of CRS were analyzed, as well as discrimination accuracy comparisons were performed.</p><p><strong>Results: </strong>The incidence of CRS in patients with sepsis was 23.2% (32/138) during hospitalization, with an obvious mortality. Compared with the non-CRS group, serum cystatin C, brain natriuretic peptide (BNP), troponin-I (TNI), KIM-1, and NGAL levels were both significantly elevated at admission in patients with sepsis complicated with CRS. Logistic regression analysis revealed that BNP, TNI, cystatin C, albumin, Lac, D-dimer were risk factors for CRS in sepsis patients. Compared with other biomarkers, serum cystatin C had moderate discriminative power for predicting septic CRS (area under a receiver operating characteristic curve, 0.746; sensitivity, 0.719; specificity, 0.783). BNP combined with cystatin C and D-dimer demonstrated an excellent discrimination performance, for its AUROC was up to 0.878 (sensitivity, 0.844; specificity, 0.759).</p><p><strong>Conclusion: </strong>Serum cystatin C, BNP, TNI, KIM-1, and NGAL levels are elevated in patients with septic CRS. Our study provides reliable evidence that cystatin C in combination with BNP and D-dimer might better predict septic CRS upon admission. Further research on sensitive biomarkers is needed.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"198-208"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439630","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":"From Renal Markers to Muscle Mass: A Sarcopenia Index Predicts Outcomes in Coronary Artery Disease Patients with Aortic Valve Sclerosis.","authors":"Yifeng Zhang, Hui Chen, Xihao Du, Yanping Wang, Jiawei Chen, Mirenuer Aikebaier, Shuyao Shan, Ling Yang, Anqi Zhao, Wei Chu, Yehong Liu, Zhongli Chen, Ke Yang","doi":"10.1159/000545619","DOIUrl":"10.1159/000545619","url":null,"abstract":"<p><strong>Background: </strong>Renal function plays a pivotal role in influencing various diseases, particularly cardiovascular conditions. Renal markers show strong associations with coronary artery disease (CAD), aortic valve sclerosis (AVSc), and sarcopenia. The sarcopenia index (SI), a biomarker derived from renal markers, serves a dual purpose: it precisely quantifies muscle mass while also acting as a prognostic indicator for adverse cardiovascular outcomes, especially in patients with concurrent CAD and AVSc.</p><p><strong>Methods: </strong>A retrospective analysis was performed on consecutive CAD patients treated from 2013 to 2014. The SI was calculated using the formula (serum creatinine [mg/dL]/cystatin C [mg/dL]) × 100. The primary composite endpoint was cardiovascular death or rehospitalization for heart failure or acute coronary syndrome events. The secondary endpoint included the primary endpoint plus all-cause mortality. Kaplan-Meier analysis and Cox proportional hazards modeling was applied to analyze the association between SI and outcomes.</p><p><strong>Results: </strong>Among the 1,123 CAD patients, 277 had AVSc. Patients with AVSc had significantly lower SI, which was independently associated with AVSc presence (OR = 1.750, p < 0.001). Associations between SI and both endpoints were identified in CAD patients with AVSc rather than in those without AVSc. SI below the median (89.40) was predictive of worse outcomes. Lower SI significantly increased the risk for the primary (HR = 1.883, p = 0.035) and secondary (HR = 1.910, p = 0.021) endpoints in AVSc subgroup.</p><p><strong>Conclusion: </strong>Lower SI is independently associated with AVSc in CAD patients and was also associated with adverse cardiovascular events and mortality in CAD patients with AVSc.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"374-385"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977345","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 Paradox of Hypertonic Saline Infusion for Patients with Heart Failure.","authors":"Negiin Pourafshar, Siddharth S Madapoosi, Ashkan Karimi, Jeffrey Testani, Christopher S Wilcox","doi":"10.1159/000544046","DOIUrl":"10.1159/000544046","url":null,"abstract":"<p><strong>Background: </strong>Fluid/sodium overload is the primary reason for hospital admission for patients with acute decompensated heart failure. Unfortunately, congestion often remains undertreated and is associated with significant adverse outcomes in patients with congestive heart failure (CHF). Potent loop diuretics have long been accepted as the first-line treatment for these patients. However, recurrent hospital admission, due in part to a lack of response to diuretics, becomes common as heart failure progresses.</p><p><strong>Summary: </strong>While the goal of acute decompensated heart failure (ADHF) therapy has historically been to correct the excess of sodium chloride and water in the body, recent studies in patients with diuretic-resistant CHF have reported a paradoxical role for repletion with hypertonic saline (HS) infusion during continued use of loop diuretics to enhance diuresis. With the increasing use of combined therapy in the intensive care unit and recent trials of combined therapy in ambulatory patients, nephrologists are increasingly involved in its use.</p><p><strong>Key messages: </strong>Several clinical trials in ADHF have demonstrated a role for HS in the improvement of outcomes such as decongestion, diuresis, kidney function, weight loss, mortality, length of stay, and readmission rates. This is a review for nephrologists of the potential effects of infusion of HS in combination with loop diuretics in patients with ADHF.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"552-559"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574894","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":"Hepatocardiorenal Syndrome: Integrating Pathophysiology with Clinical Decision-Making via Point-Of-Care Ultrasound.","authors":"Abhilash Koratala, Claudio Ronco, Amir Kazory","doi":"10.1159/000543681","DOIUrl":"10.1159/000543681","url":null,"abstract":"<p><strong>Background: </strong>Accumulating evidence has challenged the traditional model of the liver-kidney connection in hepatorenal syndrome. Cirrhosis can significantly impact cardiac function, leading to cirrhotic cardiomyopathy. Recent understanding reveals how cardiac dysfunction plays a pivotal role in the development of renal dysfunction in this setting, suggesting that disturbances traditionally categorized under hepatorenal syndrome may actually represent a hepatic form of cardiorenal syndrome - hepatocardiorenal syndrome - where the liver affects the kidney through cardiorenal pathways.</p><p><strong>Summary: </strong>Effective management of hepatocardiorenal syndrome and acute kidney injury in cirrhosis relies on accurately assessing a patient's hemodynamic and volume status. Point-of-care ultrasound, including lung and focused cardiac ultrasound, is a valuable diagnostic tool that provides crucial data on fluid tolerance, subclinical pulmonary congestion, and left ventricular filling pressures. This objective, bedside approach offers a comprehensive assessment that directly influences patient management and therapeutic decisions.</p><p><strong>Key messages: </strong>Point-of-care ultrasound plays an essential role in evaluating and managing hepatocardiorenal syndrome, providing insights into the underlying pathophysiology. By assessing hemodynamic parameters, it helps guide therapy and monitor patient responses, ensuring more accurate and effective treatment of patients with cirrhosis and acute kidney injury.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"184-197"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398241","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":"Fluid Overload in Cardiorenal Medicine: From Bench to Bedside.","authors":"Marta Cobo Marcos, Gregorio Romero-González, Julio Núñez","doi":"10.1159/000546349","DOIUrl":"10.1159/000546349","url":null,"abstract":"","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"427-429"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141447","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}