CARTILAGE最新文献

{"title":"Acellular Particulated Costal Allocartilage Improves Cartilage Regeneration in High Tibial Osteotomy: Data From a Randomized Controlled Trial.","authors":"Kwangho Chung, Min Jung, Ki-Mo Jang, Sanghoon Park, Jaehong Kim, Sung-Hwan Kim","doi":"10.1177/19476035241292321","DOIUrl":"10.1177/19476035241292321","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare short-term arthroscopic and clinical outcomes between microfractures with (treatment group) and without (control group) acellular particulated costal allocartilage in patients undergoing concurrent high tibial osteotomy (HTO).</p><p><strong>Design: </strong>This retrospective cohort study enrolled 19 and 21 patients in the treatment and control groups, respectively, and reviewed them at a minimum 2-year follow-up after HTO. Cartilage regeneration status was evaluated according to the International Cartilage Repair Society-Cartilage Repair Assessment (ICRS-CRA) grading and Koshino's macroscopic staging systems during medial locked plate removal. Patient-reported measures, including the visual analog scale pain score, Knee Injury and Osteoarthritis Outcome Score, and International Knee Documentation Committee score, assessed clinical outcomes.</p><p><strong>Results: </strong>The total points of the ICRS-CRA grading system were significantly higher in the treatment group than in the control group (7.7 ± 3.8 vs 4.2 ± 3.0, respectively; <i>P</i> = 0.007). Likewise, the cartilage status according to Koshino's macroscopic staging system was better in the treatment group (<i>P</i> = 0.022). Patient-reported functional outcomes significantly improved postoperatively but were equivalent between the study groups at the final follow-up.</p><p><strong>Conclusions: </strong>Microfractures augmented with acellular particulated costal allocartilage resulted in better repair quality than microfractures alone at a minimum 2-year follow-up after HTO, but functional outcomes improved similarly for both treatment approaches.</p>","PeriodicalId":9626,"journal":{"name":"CARTILAGE","volume":" ","pages":"19476035241292321"},"PeriodicalIF":2.7,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495755","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":"Fluctuation of Bone Marrow Lesions and Inflammatory MRI Markers over 2 Years and Concurrent Associations with Quantitative Cartilage Loss.","authors":"Frank W Roemer, Mylène P Jansen, Susanne Maschek, Simon C Mastbergen, Anne-Karien Marijnissen, Anna Wisser, Rafael Heiss, Harrie H Weinans, Francisco J Blanco, Francis Berenbaum, Margreet Kloppenburg, Ida K Haugen, Felix Eckstein, David J Hunter, Ali Guermazi, Wolfgang Wirth","doi":"10.1177/19476035241287694","DOIUrl":"10.1177/19476035241287694","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether change of semiquantitatively magnetic resonance imaging (MRI)-defined bone marrow lesions (BMLs) and inflammatory markers is associated with change in quantitatively-assessed cartilage loss in the femorotibial joint (FTJ) in knees with radiographic osteoarthritis (OA) over 24 months.</p><p><strong>Design: </strong>Participants were included from the IMI-APPROACH and the Osteoarthritis Initiative FNIH studies. Semiquantitative MRI assessment was performed for BMLs, Hoffa- and effusion-synovitis. Quantitative cartilage thickness measurements were performed manually. Definitions of change included number of subregions with BMLs, change in sum and change in maximum increase in size. Change in Hoffa-synovitis and effusion-synovitis was categorized in addition. Between-group comparisons regarding cartilage loss in the FTJ, medial and lateral compartments were performed using analysis of variance (ANOVA).</p><p><strong>Results: </strong>A total of 629 participants were included. Knees without any BMLs at baseline (BL) and follow-up (FU) had significantly less cartilage loss compared to the other subgroups. Change in both directions in the sum score of BMLs was associated with increased rates of cartilage loss. Maximum increase in size of BMLs was associated with increased rates of cartilage loss (FTJ increase by 2 grades -0.183 mm, 95% CI [-0.335, -0.031], by 3 grades -0.306 mm, [-0.511, -0.101]). Worsening of Hoffa-synovitis was associated with increased rates of cartilage loss.</p><p><strong>Conclusion: </strong>Knees without BMLs at BL and FU showed lowest rates of cartilage loss. Knees with an increase in BML size showed increased rates of concurrent cartilage loss. Approaches with the aim to inhibit BML development, avoidance of increase in size and avoidance of Hoffa-synovitis worsening may have beneficial effects on cartilage loss.</p>","PeriodicalId":9626,"journal":{"name":"CARTILAGE","volume":" ","pages":"19476035241287694"},"PeriodicalIF":2.7,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495756","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":"Exploring Trends and Gaps in Osteoarthritis Biomarker Research (1999-2024): A Citation Analysis of Top 50 Cited Articles.","authors":"Wenjin Hu, Jiyong Yang, Li Liu, Dongchao Li, Yun Zhao, Aiguo Wang","doi":"10.1177/19476035241288660","DOIUrl":"10.1177/19476035241288660","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to comprehensively analyze the landscape of osteoarthritis (OA) biomarker research through the citation analysis of top-cited articles, identifying trends and gaps in this field.</p><p><strong>Methods: </strong>The Web of Science Core Collection was utilized to retrieve the top 50 cited articles on OA biomarkers. Data extraction included publication characteristics, citation metrics, and biomarker categorization. Statistical analyses were conducted to discern correlations and assess significance.</p><p><strong>Results: </strong>The top 50 cited articles spanned the years 1999 to 2020, and collectively cited 4849 articles, accumulating a total of 6177 citations, resulting in an average of 123.5 citations per document. Citations per article varied between 78 and 359, with a citation density ranging from 3.9 to 23.93. Analysis of the top 50 cited articles revealed comparable impact between recent and older publications. Predominant trends included cartilage-related and blood-based biomarkers, while inflammation-related, radiomics, and multi-omics emerged as potential future research directions. In BIPEDS classification, gaps were identified in biomarkers evaluating intervention efficacy and safety.</p><p><strong>Conclusion: </strong>Despite significant advancements, there is no universally acknowledged biomarker for OA. Addressing gaps in biomarker exploration is crucial for enhancing OA management strategies. This study provides insights into prevailing trends and future research directions in OA biomarkers, guiding future investigations and therapeutic development.</p>","PeriodicalId":9626,"journal":{"name":"CARTILAGE","volume":" ","pages":"19476035241288660"},"PeriodicalIF":2.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458766","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":"Commercial Insurance Coverage Criteria for Autologous Chondrocyte Implantation Poorly Reflect Current Research.","authors":"Jacob L Kotlier, Eric H Lin, Amir Fathi, Avinash S Iyer, Sahil S Telang, Ioanna K Bolia, Aamir Ahmad, Frank A Petrigliano, Joseph N Liu","doi":"10.1177/19476035241276930","DOIUrl":"10.1177/19476035241276930","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to both quantify and qualify the way insurance companies justify their coverage policies for autologous chondrocyte implantation (ACI) and determine whether these policies align with recent research on the subject.</p><p><strong>Design: </strong>The top 11 national commercial health insurance payers for ACI were identified. Coverage policy documents were recovered for 8 payers. These documents were examined, and the type of reference and the level of evidence (LOE) were recorded for each applicable reference. Specific coverage criteria for each individual payer were then extracted and assessed for similarities among commercial payers. Finally, all references cited by each payer were examined to determine whether they mentioned the specific payer criteria.</p><p><strong>Results: </strong>This study found that the majority of cited references were primary journal articles (86, 58.1%) and that only 30 (20.2%) references were level I or level II evidence. This study also found significant homogeneity among payer coverage criteria. Cited sources inconsistently mentioned specific payer coverage criteria. In addition, payer criteria tended to be poorly supported by current evidence on ACI.</p><p><strong>Conclusions: </strong>This study demonstrates that commercial insurance payers' coverage policies for ACI poorly cite references, cite a majority of references with low LOE, and cite references which infrequently mention their specific coverage criteria. In addition, payer coverage policies have a high degree of homogeneity and many of their specific criteria are poorly supported by current research on ACI.</p>","PeriodicalId":9626,"journal":{"name":"CARTILAGE","volume":" ","pages":"19476035241276930"},"PeriodicalIF":2.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342261","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":"Suture Tying Force for Cut-Out during Radial Meniscus Tear Repair: A Biomechanical Evaluation of Failure Loads during the Knot-Tying Process.","authors":"Patrick A Massey, Edwin Dudoussat, Carver Montgomery, Wayne Scalisi, Hayden McBride, Robert Rutz, Giovanni F Solitro","doi":"10.1177/19476035241284827","DOIUrl":"10.1177/19476035241284827","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of the study was to determine average tensile forces resulting in suture failure while tying a knot during repair of complete radial meniscus tears and to compare the failure tensile force based on meniscus tissue location: the peripheral (red-red) versus inner (white-white).</p><p><strong>Design: </strong>This study was designed as a cadaveric biomechanical study using 24 menisci harvested from fresh frozen cadaveric knees with midbody radial tears. Tears were repaired using 2-0 nonabsorbable suture in both the inner meniscus and the peripheral meniscus. A force gauge was used to measure the tension of a surgeon's knot until failure of either the suture or the meniscus tissue. Statistical analysis was performed comparing suture failure tensile forces between inner and peripheral sutures using 2-sample <i>t</i> test.</p><p><strong>Results: </strong>Suture repairs primarily failed due to meniscal tissue cut-out after suture tensioning (96%). There was no statistical difference in failure mode between medial and lateral meniscus for both the inner (100% cut-out) and the peripheral (92% cut-out; <i>P</i> = 0.703) sutures. The peripheral sutures failed as significantly higher loads (54 ± 26 N) than the inner sutures (36 ± 11 N, <i>P</i> = 0.006). The peripheral meniscus tissue tolerated significantly higher tension at failure (36 ± 7 N) than the inner meniscus (26 ± 7 N, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>When tying parallel sutures to repair a radial meniscus tear, suture tensile forces above 30 N may tear through meniscus tissue. Surgeons should not use suture tying forces above 30 N when repairing radial meniscus tears with parallel sutures. The peripheral meniscus can withstand higher knot-tying forces than the inner meniscus, so surgeons should consider tying the peripheral suture before the inner suture.</p>","PeriodicalId":9626,"journal":{"name":"CARTILAGE","volume":" ","pages":"19476035241284827"},"PeriodicalIF":2.7,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342263","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":"Regenerative Variability of Human Juvenile Chondrocyte Sheets From Different Cell Donors in an Athymic Rat Knee Chondral Defect Model.","authors":"Keisuke Matsukura, Makoto Kondo, Nicolas F Metzler, Adam J Ford, Travis G Maak, Douglas T Hutchinson, Angela A Wang, Masato Sato, David W Grainger, Teruo Okano","doi":"10.1177/19476035241277946","DOIUrl":"10.1177/19476035241277946","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to establish a combined histological assessment system of neo-cartilage outcomes and to evaluate variations in an established rat defect model treated with human juvenile cartilage-derived chondrocyte (JCC) sheets fabricated from various donors.</p><p><strong>Methods: </strong>JCCs were isolated from the polydactylous digits of eight patients. Passage 2 (P2) JCC sheets from all donors were transplanted into nude rat chondral defects for 4 weeks (27 nude rats in total). Defect-only group served as control. Histological samples were stained for safranin O, collagen 1 (COL1), and collagen 2 (COL2). (1) All samples were scored, and correlation coefficients for each score were calculated. (2) Donors were divided into \"more effective\" and \"less effective\" groups based on these scores. Then, differences between each group in each category of modified O'Driscoll scoring were evaluated.</p><p><strong>Results: </strong>(1) Modified O'Driscoll scores were negatively correlated with %COL1 area, and positively correlated with %COL2 area and COL2/1 ratio. (2) Four of 8 donors exhibited significantly higher modified O'Driscoll scores and %COL2 areas. JCC donors were divided into two groups by average score values. Significant differences between the two groups were observed in modified O'Driscoll categories of \"Nature of predominant tissue,\" \"Reconstruction of subchondral bone,\" and \"Safranin O staining.\"</p><p><strong>Conclusion: </strong>The combined histological evaluation method is useful for detailed <i>in vivo</i> efficacy assessments of cartilage defect regeneration models. Variations in histological scores among juvenile cartilage-derived chondrocyte donors were correlated to the quality of regenerated cartilage hyaline structure and subchondral bone remodeling observed in the nude rat defect model.</p>","PeriodicalId":9626,"journal":{"name":"CARTILAGE","volume":" ","pages":"19476035241277946"},"PeriodicalIF":2.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342262","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":"An Evidence-Based Update on Fixation Procedures for Acute and Chronic Osteochondral Lesions of the Talus.","authors":"Tomoyuki Nakasa, Yasunari Ikuta, Naoki Haraguchi, Chul Hyun Park, Christian David Weber, Quinten G H Rikken, Jari Dahmen, Sjoerd A S Stufkens, Gino M M J Kerkhoffs, Masato Takao","doi":"10.1177/19476035241280072","DOIUrl":"10.1177/19476035241280072","url":null,"abstract":"<p><p>Osteochondral lesions of the talus (OLT) involve the subchondral bone and the overlying articular cartilage. Various surgical treatments for these lesions are available, such as bone marrow stimulation (BMS), autologous osteochondral grafting, and fixation of an osteochondral fragment. Treatment choice depends on the condition of the lesion, which includes lesion size, morphology, location, and the presence of cysts. Among the surgical procedures available to date, <i>in situ</i> fixation of the osteochondral fragment has the advantage of restoring the articular surface while preserving the native hyaline cartilage and its subchondral bone. Fixation for OLT has been shown to be clinically successful for the treatment of both acute and chronic lesions. Moreover, the indication for osteochondral fragment fixation is expanding as recent studies have found good clinical outcomes in relatively small-sized lesions. The present article describes the current evidence on fixation for acute and chronic OLT.</p>","PeriodicalId":9626,"journal":{"name":"CARTILAGE","volume":" ","pages":"19476035241280072"},"PeriodicalIF":2.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280605","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":"Peptides for Targeting Chondrogenic Induction and Cartilage Regeneration in Osteoarthritis","authors":"Hsiu-Jung Liao, Hui-Ting Chen, Chih-Hung Chang","doi":"10.1177/19476035241276406","DOIUrl":"https://doi.org/10.1177/19476035241276406","url":null,"abstract":"ObjectsOsteoarthritis (OA) is a widespread degenerative joint condition commonly occurring in older adults. Currently, no disease-modifying drugs are available, and safety concerns associated with commonly used traditional medications have been identified. In this review, a significant portion of research in this field is concentrated on cartilage, aiming to discover methods to halt cartilage breakdown or facilitate cartilage repair.MethodsResearchers have mainly investigated the cartilage, seeking methods to promote its repair. This review focuses on peptide-based molecules known for their ability to selectively bind to growth factor cytokines and components of the cartilage extracellular matrix.ResultsChondroinductive peptides, synthetically producible, boast superior reproducibility, stability, modifiability, and yield efficiency over natural biomaterials. This review outlines a chondroinductive peptide design, molecular mechanisms, and their application in cartilage tissue engineering and also compares their efficacy in chondrogenesis in vitro and in vivo.ConclusionsIn this paper, we will summarize the application of peptides engineered to regenerate cartilage by acting as scaffolds, functional molecules, or both and discuss additional possibilities for peptides. This review article provides an overview of our current understanding of chondroinductive peptides for treating OA-affected cartilage and explores the delivery systems used for regeneration. These advancements may hold promise for enhancing or even replacing current treatment methodologies.","PeriodicalId":9626,"journal":{"name":"CARTILAGE","volume":"99 1","pages":"19476035241276406"},"PeriodicalIF":2.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266201","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":"Corrigendum to \"Observation of Solute Transport Between Articular Cartilage and Subchondral Bone in Live Mice\".","authors":"","doi":"10.1177/19476035241270725","DOIUrl":"10.1177/19476035241270725","url":null,"abstract":"","PeriodicalId":9626,"journal":{"name":"CARTILAGE","volume":" ","pages":"19476035241270725"},"PeriodicalIF":2.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153192","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":"Microbiome and Femoral Cartilage Thickness in Knee Osteoarthritis: Is There a Link?","authors":"Noha Abdelhalim Elsawy, Aya Hanafy Ibrahiem, Gihan Abdellatif Younis, Marwa Ahmed Meheissen, Yousra Hisham Abdel-Fattah","doi":"10.1177/19476035241276852","DOIUrl":"10.1177/19476035241276852","url":null,"abstract":"<p><strong>Objective: </strong>To assess the relation between microbiome and lipopolysaccharide (LPS), in the blood and synovial fluid (SF) with femoral cartilage thickness (FCT) measured by ultrasound (US) in knee osteoarthritis (KOA) patients.</p><p><strong>Methods: </strong>This cross-sectional study included 40 primary KOA patients recruited between September 2022 and June 2023. Age, gender, and body mass index (BMI) were recorded. Patients underwent full clinical examination, standing plain x-ray of the knee joint and knee US examination to measure medial, intercondylar, and lateral FCT. Microbiomes (specific bacterial phyla) were detected by real-time polymerase chain reaction and LPS levels were measured by enzyme-linked immunosorbent assay kit in the patients' serum and SF.</p><p><strong>Results: </strong>The patient's age ranged from 43 to 72 years. Most patients were females (72.5%), with a mean BMI of 35.8 ± 6.21 kg/m². The mean medial, intercondylar, and lateral FCT were less than cut-off values. All 40 (100%) patients showed positive bacterial deoxyribonucleic acid (16S ribosomal RNA) in both blood and SF samples. <i>Firmicutes</i> was the most abundant in patients' blood (48.49%) and SF (63.59%). The mean serum LPS level was significantly higher compared to mean SF LPS (<i>t</i> =4.702, <i>P</i> < 0.001). There was a statistically significant negative correlation between lateral FCT and <i>Firmicutes</i> relative abundance in both patients' blood and SF.</p><p><strong>Conclusion: </strong>Microbiome and LPS are present in the blood and SF of primary KOA patients. Microbiome (<i>Firmicutes</i>) was associated with decreased lateral FCT. This might provide a potential link between both systemic and local microbiomes and cartilage affection in KOA patients.</p>","PeriodicalId":9626,"journal":{"name":"CARTILAGE","volume":" ","pages":"19476035241276852"},"PeriodicalIF":2.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131903","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}