TB is one of the most deathly infections worldwide, affecting disproportionally people living with HIV (PLHIV). Furthermore, HIV co-infection is related to worse outcomes for TB patients, including lower treatment success.
Methods
Using surveillance records of all TB cases notified in Barcelona city from 2001 to 2021, we analyzed TB treatment success according to HIV status. Additionally, we explored potential social and health related and factors associated to unsuccessful treatment in PLHIV, using multiple regression analyses.
Results
Out of the 8406 new TB cases diagnosed during the study period, 9% were co-infected with HIV. According to our regression models, PLHIV were more frequently men, users of injected drugs (aOR = 45.81; 95% CI (33.10–64.26)), had previously been treated for TB (aOR = 1.77; 95% CI (1.30–2.40)) and had a lower rate of contact tracing (aOR = 0.51; 95% CI (0.40–0.64)). Among PLHIV, unsuccessful treatment was related to the use of injected drugs and homelessness, but it was lower for those who had undergone contact tracing.
Conclusion
PLHIV have higher odds of unsuccessful TB treatment, especially those who are homeless and use injected drugs. Contact tracing improved treatment success, calling for further efforts and resources to correctly follow-up on these patients, with the goal of increasing treatment success.
{"title":"Unsuccessful tuberculosis-treatment in HIV-positive patients and associated factors","authors":"Guillermo Bosch , Joan-Pau Millet , Àngels Orcau , Isabel Moreira , Carles Pericas , Lluïsa Forns , Isabel Marcos , Raquel Prieto , Anna Hernandez , Lídia Arranz , Cristina Rius","doi":"10.1016/j.eimc.2025.06.008","DOIUrl":"10.1016/j.eimc.2025.06.008","url":null,"abstract":"<div><h3>Background</h3><div>TB is one of the most deathly infections worldwide, affecting disproportionally people living with HIV (PLHIV). Furthermore, HIV co-infection is related to worse outcomes for TB patients, including lower treatment success.</div></div><div><h3>Methods</h3><div>Using surveillance records of all TB cases notified in Barcelona city from 2001 to 2021, we analyzed TB treatment success according to HIV status. Additionally, we explored potential social and health related and factors associated to unsuccessful treatment in PLHIV, using multiple regression analyses.</div></div><div><h3>Results</h3><div>Out of the 8406 new TB cases diagnosed during the study period, 9% were co-infected with HIV. According to our regression models, PLHIV were more frequently men, users of injected drugs (aOR<!--> <!-->=<!--> <!-->45.81; 95% CI (33.10–64.26)), had previously been treated for TB (aOR<!--> <!-->=<!--> <!-->1.77; 95% CI (1.30–2.40)) and had a lower rate of contact tracing (aOR<!--> <!-->=<!--> <!-->0.51; 95% CI (0.40–0.64)). Among PLHIV, unsuccessful treatment was related to the use of injected drugs and homelessness, but it was lower for those who had undergone contact tracing.</div></div><div><h3>Conclusion</h3><div>PLHIV have higher odds of unsuccessful TB treatment, especially those who are homeless and use injected drugs. Contact tracing improved treatment success, calling for further efforts and resources to correctly follow-up on these patients, with the goal of increasing treatment success.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"43 10","pages":"Pages 666-673"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645492","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}
Pub Date : 2025-12-01DOI: 10.1016/j.eimc.2025.06.020
Paula Corihuela Menéndez, Sacramento M. Segovia López, Alejandra Méndez Sánchez, Lara González García
{"title":"Sobre «Análisis comparativo de las infecciones respiratorias agudas de etiología viral en menores de 6 meses con y sin nirsevimab en Baleares (2022-2023 y 2023-2024)»","authors":"Paula Corihuela Menéndez, Sacramento M. Segovia López, Alejandra Méndez Sánchez, Lara González García","doi":"10.1016/j.eimc.2025.06.020","DOIUrl":"10.1016/j.eimc.2025.06.020","url":null,"abstract":"","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"43 10","pages":"Pages 723-724"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645697","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}
Pub Date : 2025-12-01DOI: 10.1016/j.eimc.2025.07.008
Min Guo , Chaoyang Chen , Wenling Wang , Cairong Zhang , Jie Ma , Maidinamu Sadike , Mayinuer Niyazi , Xiaoli Feng , Kaichun Zhu
Objective
To investigate the changes in vaginal microbiota under different HPV infection statuses and explore the correlation between vaginal microbiota alterations and HPV infection.
Methods
151 cervical samples from gynecological outpatients were grouped into HPV-negative (HN, N = 51), transient infection (HTI, N = 42), and persistent infection (HPI, N = 58). Vaginal secretions were collected to assess microecology (pH, vaginal cleanliness, hydrogen peroxide, leukocyte esterase) via genital secretion analyzer. 16S ribosomal RNA (rRNA) sequencing analyzed vaginal microbiota characteristics, community state types (CST), richness, diversity, and biomarkers.
Results
16S rRNA sequencing identified 5 CST II, 52 CST III, and 94 mixed CST IV samples, showing diverse microbiota. Compared with HN, HTI and HPI had lower vaginal cleanliness, higher sialidase activity, elevated pH, and fewer Lactobacilli (P < 0.05). Lactobacillus iners dominated all groups, while Sneathia amnii was significantly higher in HPI (P < 0.05). HPV infection increased vaginal microbiota richness (HPI > HTI/HN, P < 0.05), with distinct group compositions (P < 0.05). Linear Discriminant Analysis Effect Size identified Lactobacillus gasseri, Atopobium vaginae, and Lactobacillus jensenii as biomarkers.
Conclusion
This study found significant differences in microbial community characteristics under different HPV infection statuses. The identification of biomarkers in vaginal microbiota under different infection statuses could provide new targets for clinical screening and prevention of cervical cancer.
目的观察不同HPV感染状态下阴道菌群的变化，探讨阴道菌群变化与HPV感染的相关性。方法将151例妇科门诊患者宫颈标本分为hpv阴性（HN, N = 51）、短暂性感染（HTI, N = 42）和持续性感染（HPI, N = 58）。收集阴道分泌物，通过阴道分泌物分析仪评估微生态（pH、阴道清洁度、过氧化氢、白细胞酯酶）。16S核糖体RNA （rRNA）测序分析阴道微生物群特征、群落状态类型（CST）、丰富度、多样性和生物标志物。结果16s rRNA测序鉴定出5份CST II、52份CST III和94份混合CST IV样品，显示出不同的微生物群。与HN相比，HTI和HPI阴道清洁度较低，唾液酸酶活性较高，pH升高，乳酸菌较少（P < 0.05）。各组均以嗜乳杆菌为主，羊水Sneathia HPI显著高于对照组（P < 0.05）。HPV感染增加了阴道菌群丰富度（HPI > HTI/HN, P < 0.05），但组间组成差异显著（P < 0.05）。线性判别分析效应大小鉴定出气体乳杆菌、阴道托泊菌和延seni乳杆菌作为生物标志物。结论不同HPV感染状态下微生物群落特征存在显著差异。不同感染状态下阴道菌群生物标志物的鉴定可为宫颈癌的临床筛查和预防提供新的靶点。
{"title":"Research on the relationship between HPV infection and alterations in vaginal microbial ecology","authors":"Min Guo , Chaoyang Chen , Wenling Wang , Cairong Zhang , Jie Ma , Maidinamu Sadike , Mayinuer Niyazi , Xiaoli Feng , Kaichun Zhu","doi":"10.1016/j.eimc.2025.07.008","DOIUrl":"10.1016/j.eimc.2025.07.008","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the changes in vaginal microbiota under different HPV infection statuses and explore the correlation between vaginal microbiota alterations and HPV infection.</div></div><div><h3>Methods</h3><div>151 cervical samples from gynecological outpatients were grouped into HPV-negative (HN, <em>N</em> <!-->=<!--> <!-->51), transient infection (HTI, <em>N</em> <!-->=<!--> <!-->42), and persistent infection (HPI, <em>N</em> <!-->=<!--> <!-->58). Vaginal secretions were collected to assess microecology (pH, vaginal cleanliness, hydrogen peroxide, leukocyte esterase) via genital secretion analyzer. 16S ribosomal RNA (rRNA) sequencing analyzed vaginal microbiota characteristics, community state types (CST), richness, diversity, and biomarkers.</div></div><div><h3>Results</h3><div>16S rRNA sequencing identified 5 CST II, 52 CST III, and 94 mixed CST IV samples, showing diverse microbiota. Compared with HN, HTI and HPI had lower vaginal cleanliness, higher sialidase activity, elevated pH, and fewer <em>Lactobacilli</em> (<em>P</em> <!--><<!--> <!-->0.05). <em>Lactobacillus iners</em> dominated all groups, while <em>Sneathia amnii</em> was significantly higher in HPI (<em>P</em> <!--><<!--> <!-->0.05). HPV infection increased vaginal microbiota richness (HPI<!--> <!-->><!--> <!-->HTI/HN, <em>P</em> <!--><<!--> <!-->0.05), with distinct group compositions (<em>P</em> <!--><<!--> <!-->0.05). Linear Discriminant Analysis Effect Size identified <em>Lactobacillus gasseri</em>, <em>Atopobium vaginae</em>, and <em>Lactobacillus jensenii</em> as biomarkers.</div></div><div><h3>Conclusion</h3><div>This study found significant differences in microbial community characteristics under different HPV infection statuses. The identification of biomarkers in vaginal microbiota under different infection statuses could provide new targets for clinical screening and prevention of cervical cancer.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"43 10","pages":"Pages 688-697"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645915","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}
Pub Date : 2025-12-01DOI: 10.1016/j.eimc.2025.06.016
Alejandro G. García-Ruiz de Morales , María Jesús Vivancos , Beatriz Romero-Hernández , David Rial-Crestelo , Francisco Arnaiz de las Revillas , Jorge Sanchez-Villegas , Marta Montero Alonso , María de la Villa López Sánchez , María Remedios Alemán Valls , Santiago Moreno , Javier Martínez-Sanz , María Jesús Pérez-Elías , on behalf of CoRIS
Background
Recent improvements in the HIV care cascade have reduced HIV incidence in high- and middle-income countries, yet late HIV diagnosis remains a critical issue. This study examines the impact of a two-hour training session on HIV testing and diagnosis rates in primary care centers in Madrid, Spain.
Methods
In 2017, we conducted a non-mandatory, two-hour training session on updated HIV and HCV guidelines for primary care providers in 20 centers within the Ramón y Cajal Hospital area. We compared yearly HIV testing rates and late diagnosis rates in the five years before and after the intervention. We used data from Ramón y Cajal Hospital Microbiology Department's electronic records and the CoRIS cohort, including demographic and clinical information.
Results
Of the 630 target primary care providers, 454 (72%) attended the sessions. HIV testing rates increased from 1780 to 2155 tests per 100,000 inhabitants (p < 0.0001) post-intervention, with a stable rate of positive tests. Late diagnosis rates in our area decreased from 58.9% to 48.7%, while rates in the rest of Madrid and Spain increased (AOR 1.22, p < 0.001). The intervention area showed a significant reduction in advanced HIV disease (AOR 0.66, p = 0.095), contrasting with the upward trend in other regions.
Conclusion
A simple two-hour training session for primary care providers effectively increased HIV testing rates and reduced late diagnoses in our health area compared to national trends. Implementing similar strategies on a broader scale could help mitigate the rising rates of late HIV diagnosis and improve overall community health outcomes.
最近艾滋病毒护理级联的改进降低了高收入和中等收入国家的艾滋病毒发病率，但艾滋病毒的晚期诊断仍然是一个关键问题。本研究考察了西班牙马德里初级保健中心的两个小时培训课程对艾滋病毒检测和诊断率的影响。方法2017年，我们在Ramón y Cajal医院地区的20个中心对初级保健提供者进行了为期两小时的非强制性培训，内容是最新的HIV和HCV指南。我们比较了干预前后五年的年度HIV检测率和晚期诊断率。我们使用的数据来自Ramón y Cajal医院微生物科的电子记录和CoRIS队列，包括人口统计和临床信息。结果630名目标初级保健提供者中，454名（72%）参加了会议。干预后，艾滋病毒检测率从每10万居民1780例增加到2155例（p < 0.0001），阳性检测率保持稳定。我们地区的晚期诊断率从58.9%下降到48.7%，而马德里和西班牙其他地区的晚期诊断率上升（AOR为1.22,p < 0.001）。干预区HIV晚期发病率显著降低（AOR为0.66,p = 0.095），而其他地区呈上升趋势。结论与全国趋势相比，对初级保健提供者进行简单的两小时培训可有效提高本卫生区域的艾滋病毒检测率，减少晚期诊断。在更广泛的范围内实施类似的战略可以帮助减缓艾滋病毒晚期诊断率的上升，并改善总体社区卫生结果。
{"title":"Low-effort HIV training in Spanish primary care: Long-term impact on testing and diagnosis","authors":"Alejandro G. García-Ruiz de Morales , María Jesús Vivancos , Beatriz Romero-Hernández , David Rial-Crestelo , Francisco Arnaiz de las Revillas , Jorge Sanchez-Villegas , Marta Montero Alonso , María de la Villa López Sánchez , María Remedios Alemán Valls , Santiago Moreno , Javier Martínez-Sanz , María Jesús Pérez-Elías , on behalf of CoRIS","doi":"10.1016/j.eimc.2025.06.016","DOIUrl":"10.1016/j.eimc.2025.06.016","url":null,"abstract":"<div><h3>Background</h3><div>Recent improvements in the HIV care cascade have reduced HIV incidence in high- and middle-income countries, yet late HIV diagnosis remains a critical issue. This study examines the impact of a two-hour training session on HIV testing and diagnosis rates in primary care centers in Madrid, Spain.</div></div><div><h3>Methods</h3><div>In 2017, we conducted a non-mandatory, two-hour training session on updated HIV and HCV guidelines for primary care providers in 20 centers within the Ramón y Cajal Hospital area. We compared yearly HIV testing rates and late diagnosis rates in the five years before and after the intervention. We used data from Ramón y Cajal Hospital Microbiology Department's electronic records and the CoRIS cohort, including demographic and clinical information.</div></div><div><h3>Results</h3><div>Of the 630 target primary care providers, 454 (72%) attended the sessions. HIV testing rates increased from 1780 to 2155 tests per 100,000 inhabitants (<em>p</em> <!--><<!--> <!-->0.0001) post-intervention, with a stable rate of positive tests. Late diagnosis rates in our area decreased from 58.9% to 48.7%, while rates in the rest of Madrid and Spain increased (AOR 1.22, <em>p</em> <!--><<!--> <!-->0.001). The intervention area showed a significant reduction in advanced HIV disease (AOR 0.66, <em>p</em> <!-->=<!--> <!-->0.095), contrasting with the upward trend in other regions.</div></div><div><h3>Conclusion</h3><div>A simple two-hour training session for primary care providers effectively increased HIV testing rates and reduced late diagnoses in our health area compared to national trends. Implementing similar strategies on a broader scale could help mitigate the rising rates of late HIV diagnosis and improve overall community health outcomes.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"43 10","pages":"Pages 645-651"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645479","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}
Pub Date : 2025-12-01DOI: 10.1016/j.eimc.2025.06.014
Diego González Polo, David Vázquez Gómez, Nieves Gutiérrez Zufiaurre
{"title":"Mycolicibacterium iranicum en un paciente con bronquiectasias: importancia clínica y dificultades diagnósticas","authors":"Diego González Polo, David Vázquez Gómez, Nieves Gutiérrez Zufiaurre","doi":"10.1016/j.eimc.2025.06.014","DOIUrl":"10.1016/j.eimc.2025.06.014","url":null,"abstract":"","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"43 10","pages":"Pages 717-718"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645475","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}
Pub Date : 2025-12-01DOI: 10.1016/j.eimc.2025.06.005
Sara Vela-Bernal , Carlos Bea-Serrano , Ana Isabel de Gracia-Leon , Andreu Belmonte-Domingo , Carolina Pinto-Pla , Ana Ferrer-Ribera , Andrea de Castro-Oliver , Ignacio Torres , Javier Colomina , María Rosa Oltra-Sempere
Introduction
Rapid pathogen identification is key in the management of bloodstream infections. Antimicrobial stewardship programs (ASPs) have been shown to reduce resistance, adverse effects, and healthcare costs. MALDI-TOF MS enables fast and accurate microbial identification. This study evaluates the impact of its implementation on antibiotic therapy adequacy and mortality in Staphylococcus aureus bacteremia.
Methods
A quasi-experimental pre-post study was conducted at a university hospital, covering two periods: June 2015/April 2017 (pre) and June 2021/April 2023 (post). The impact of MALDI-TOF on antibiotic adequacy and mortality was analyzed.
Results
A total of 176 episodes were included (85 pre, 91 post). No significant epidemiological differences were observed between groups, although higher rates of sepsis and septic shock were noted in the post phase. MALDI-TOF was associated with improved antibiotic adjustment (3.51 vs. 1.75 days; P<.001). A non-significant trend toward lower early mortality was observed in the post-intervention group (P=.06). Mortality was associated with higher comorbidity (Charlson index), sepsis/septic shock, and MRSA bacteremia.
Conclusion
The implementation of MALDI-TOF, in conjunction with a multidisciplinary ASP, enhances early adjustment of empirical antibiotic therapy and may be associated with reduced early mortality in Staphylococcus aureus bacteremia. Incorporating rapid diagnostics, especially for MRSA detection, is a key strategy to improve clinical outcomes.
{"title":"Impacto de la implementación de MALDI-TOF y programas PROA en la optimización de la antibioterapia en bacteriemias por Staphylococcus aureus","authors":"Sara Vela-Bernal , Carlos Bea-Serrano , Ana Isabel de Gracia-Leon , Andreu Belmonte-Domingo , Carolina Pinto-Pla , Ana Ferrer-Ribera , Andrea de Castro-Oliver , Ignacio Torres , Javier Colomina , María Rosa Oltra-Sempere","doi":"10.1016/j.eimc.2025.06.005","DOIUrl":"10.1016/j.eimc.2025.06.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Rapid pathogen identification is key in the management of bloodstream infections. Antimicrobial stewardship programs (ASPs) have been shown to reduce resistance, adverse effects, and healthcare costs. MALDI-TOF MS enables fast and accurate microbial identification. This study evaluates the impact of its implementation on antibiotic therapy adequacy and mortality in <em>Staphylococcus aureus</em> bacteremia.</div></div><div><h3>Methods</h3><div>A quasi-experimental pre-post study was conducted at a university hospital, covering two periods: June 2015/April 2017 (pre) and June 2021/April 2023 (post). The impact of MALDI-TOF on antibiotic adequacy and mortality was analyzed<strong>.</strong></div></div><div><h3>Results</h3><div>A total of 176 episodes were included (85 pre, 91 post). No significant epidemiological differences were observed between groups, although higher rates of sepsis and septic shock were noted in the post phase. MALDI-TOF was associated with improved antibiotic adjustment (3.51 vs. 1.75 days; <em>P</em><.001). A non-significant trend toward lower early mortality was observed in the post-intervention group (<em>P</em>=.06). Mortality was associated with higher comorbidity (Charlson index), sepsis/septic shock, and MRSA bacteremia.</div></div><div><h3>Conclusion</h3><div>The implementation of MALDI-TOF, in conjunction with a multidisciplinary ASP, enhances early adjustment of empirical antibiotic therapy and may be associated with reduced early mortality in <em>Staphylococcus aureus</em> bacteremia. Incorporating rapid diagnostics, especially for MRSA detection, is a key strategy to improve clinical outcomes.</div></div>","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"43 10","pages":"Pages 674-681"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645493","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}
Pub Date : 2025-12-01DOI: 10.1016/j.eimc.2025.06.019
María Ángeles Asencio Egea , José María López-Pintor Huertas , Martín Cabero Becerra , Javier Sánchez López
{"title":"Manejo de esofagitis por citomegalovirus refractaria en un paciente con linfoma e inmunosupresión severa: foscarnet versus maribavir","authors":"María Ángeles Asencio Egea , José María López-Pintor Huertas , Martín Cabero Becerra , Javier Sánchez López","doi":"10.1016/j.eimc.2025.06.019","DOIUrl":"10.1016/j.eimc.2025.06.019","url":null,"abstract":"","PeriodicalId":11608,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica","volume":"43 10","pages":"Pages 718-719"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645476","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}
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