Alimentary Pharmacology & Therapeutics最新文献

{"title":"Meta‐analysis: Risk of lymphoma in patients with inflammatory bowel disease in population‐based cohort studies","authors":"Mohammad Zamani, Shaghayegh Alizadeh‐Tabari, Mohammad Hassan Murad, Siddharth Singh, Ashwin N. Ananthakrishnan, Reza Malekzadeh, Nicholas J. Talley","doi":"10.1111/apt.18277","DOIUrl":"https://doi.org/10.1111/apt.18277","url":null,"abstract":"SummaryBackgroundThere are inconsistencies in the results of the studies investigating the association between inflammatory bowel disease (IBD) and lymphoma.AimsThe aim of this study is to systematically appraise the risk of lymphoma development in patients with IBD.MethodsWe searched Embase, PubMed and Scopus from inception to 30 April 2024 to identify population‐based cohort studies that evaluated the risk of lymphoma in patients with IBD in comparison with those without IBD. We carried out random‐effects meta‐analyses and estimated pooled relative risks (RRs) with 95% confidence intervals (CIs).ResultsWe identified 23 eligible studies reporting 2078 lymphoma events in 656,731 patients with IBD. Patients with IBD had 30% higher odds of lymphoma (RR = 1.30 [95% CI: 1.21–1.40]). The risk of developing both Hodgkin's lymphoma (nine studies, RR = 1.29 [95% CI: 1.06–1.53]) and non‐Hodgkin's lymphoma (16 studies, RR = 1.31 [95% CI: 1.20–1.42]) was increased in patients with IBD (p for interaction = 0.881). The increased risk of lymphoma was observed in both Crohn's disease (17 studies, RR = 1.54 [95% CI: 1.27–1.80]) and ulcerative colitis (20 studies, RR = 1.22 [95% CI: 1.09–1.35]) (p for interaction = 0.026). Meta‐regression demonstrated that mean age of patients, study year, mean study follow‐up duration, and percentages of immunomodulators and biologics use did not influence study outcome.ConclusionsThe risk of lymphoma is only modestly increased in patients with IBD, with Crohn's disease having a slightly higher risk than ulcerative colitis. In IBD, there appears to be no difference between the risks of Hodgkin's and non‐Hodgkin's lymphoma.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142276800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nationwide cohort study of inflammatory bowel disease, histological activity and fracture risk.","authors":"Karl Mårild, Jonas Söderling, Jordan Axelrad, Jonas Halfvarson, Anders Forss, Karl Michaëlsson, Ola Olén, Jonas F Ludvigsson","doi":"10.1111/apt.18275","DOIUrl":"https://doi.org/10.1111/apt.18275","url":null,"abstract":"<p><strong>Background: </strong>Individuals with inflammatory bowel disease (IBD) are at increased risk of fracture. It is unclear if this risk varies by recent histological activity.</p><p><strong>Aims: </strong>To determine the fracture risk in IBD during periods with and without histological inflammation.</p><p><strong>Methods: </strong>We studied a nationwide cohort of 54,591 individuals diagnosed with IBD in 1990-2016 with longitudinal data on ileo-colorectal biopsies. Fractures were identified by inpatient and hospital-based outpatient diagnoses. We derived Cox regression estimated hazard ratios (HRs) for fracture during 12 months following a histological inflammation (vs. histological remission) record after adjusting for socio-demographics, comorbidities, IBD duration, IBD-related surgery and hospitalization. We adjusted sensitivity analyses for medical IBD treatment including corticosteroids.</p><p><strong>Results: </strong>Mean age of patients was 44.0 (SD = 18.3) and 45.5 (SD = 17.1) years at biopsy with histological inflammation and remission, respectively. For histological inflammation, there were 1.37 (95% CI 1.29-1.46) fractures per 100 years' follow-up versus 1.31 (95% CI 1.19-1.44) for remission (adjusted [a]HR 1.12; 95% CI 1.00-1.26; p = 0.04). HRs were similar with histological inflammation of Crohn's disease (1.11; 95% CI 0.91-1.36) and ulcerative colitis (1.18; 95% CI 1.02-1.36). Estimates were consistent across age groups. An overall small excess risk of any fracture remained after accounting for corticosteroids. A more prominently raised fracture risk was observed in corticosteroid-naïve IBD patients with histological inflammation versus histological remission (aHR 1.41; 95% CI 1.07-1.85). The aHR of hip fracture following histological inflammation was 1.29 (95% CI 0.87-1.92).</p><p><strong>Conclusions: </strong>Histological inflammation in IBD predicted a small increase in short-term fracture risk. Measures to reduce disease activity may reduce fracture risk in IBD.</p>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142277480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Defining corticosteroid use in clinical trials","authors":"J. Siffledeen","doi":"10.1111/apt.18211","DOIUrl":"https://doi.org/10.1111/apt.18211","url":null,"abstract":"LINKED CONTENTThis article is linked to Schreiber et al paper. To view this article, visit <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"https://doi.org/10.1111/apt.18184\">https://doi.org/10.1111/apt.18184</jats:ext-link>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142276801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between alcohol consumption and cardiometabolic factors and liver fibrosis in metabolic dysfunction‐associated steatotic liver disease and metabolic dysfunction and alcohol‐associated liver disease","authors":"Masahiro Sogabe, Toshiya Okahisa, Miwako Kagawa, Takanori Kashihara, Ryo Shinomiya, Takanori Miyake, Tomoyuki Kawaguchi, Reiko Yokoyama, Kaizo Kagemoto, Yoshifumi Kida, Yasuyuki Okada, Tetsu Tomonari, Yutaka Kawano, Yasushi Sato, Masahiko Nakasono, Tetsuji Takayama","doi":"10.1111/apt.18280","DOIUrl":"https://doi.org/10.1111/apt.18280","url":null,"abstract":"SummaryBackgroundThe relationships between alcohol consumption, cardiometabolic factors, and liver fibrosis in patients with metabolic dysfunction‐associated steatotic liver disease and those with metabolic dysfunction and alcohol‐associated liver disease remain unclear.AimsTo investigate the longitudinal associations among alcohol consumption, cardiometabolic factors, and liver fibrosis in patients with these two liver diseases.MethodsThis observational cohort study included 1866 patients with metabolic dysfunction‐associated steatotic liver disease and 521 patients with metabolic dysfunction and alcohol‐associated liver disease who underwent &gt; two health checkups over &gt;2 years. The associations of both liver diseases with worsening non‐invasive liver fibrosis scores were assessed using the Cox regression analysis.ResultsBoth liver diseases independently worsened liver fibrosis in both sexes. However, the hazard ratio for worsening liver fibrosis in females was significantly higher with metabolic dysfunction and alcohol‐associated liver disease than with metabolic dysfunction‐associated steatotic liver disease. Worsening liver fibrosis was not associated with alcohol consumption. Among males with metabolic dysfunction‐associated steatotic liver disease, the hazard ratio for worsening liver fibrosis was significantly higher in those with multiple cardiometabolic factors compared to those with a single cardiometabolic factor.ConclusionsAlthough both metabolic steatotic liver disease and metabolic alcohol‐associated liver disease were correlated with liver fibrosis progression in both sexes, the impact of alcohol consumption and cardiometabolic factors on fibrosis progression differed by sex. Cardiometabolic factors may have a stronger impact on liver fibrosis than alcohol consumption in males with metabolic dysfunction‐associated steatotic liver disease.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142276845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of four novel acute‐on‐chronic liver failure clusters with distinct clinical trajectories and mortality using machine learning methods","authors":"Nipun Verma, Pratibha Garg, Arun Valsan, Akash Roy, Saurabh Mishra, Parminder Kaur, Sahaj Rathi, Arka De, Madhumita Premkumar, Sunil Taneja, Virendra Singh, Radha K. Dhiman, Ajay K. Duseja, Patrick Kamath","doi":"10.1111/apt.18274","DOIUrl":"https://doi.org/10.1111/apt.18274","url":null,"abstract":"SummaryBackground and AimsMachine learning (ML) can identify the hidden patterns without hypothesis in heterogeneous diseases like acute‐on‐chronic live failure (ACLF). We employed ML to describe and predict yet unknown clusters in ACLF.MethodsClinical data of 1568 patients with ACLF from a tertiary care centre (2015–2023) were subjected to distance‐, density‐ and model‐based clustering algorithms. Final model was selected on best cluster separation, viz. Silhouette width and Dunn's index (for distance‐ or density‐based algorithms) and minimum BIC (for model‐based algorithms). Cluster assignments, patient trajectories and survival were analysed through inferential statistics. Supervised ML models were trained in 70% data that predicted clusters in remaining 30% data followed by an temporal validation.ResultsThe cohort was male‐predominant (87%), aged 44.3 years, with alcohol‐associated hepatitis (62.9%) and survival of 50.5%. Due to poor performance of distance‐ and density‐based algorithms and better explainability, the latent class model (LCM) was selected for exploration. LCM revealed four clusters with distinct trajectories, reversibility and survival (independent of MELD, CLIF‐C ACLF and AARC scores). Cluster1 had patients with none/one organ failure and highest reversibility. Cluster2 had females with viral hepatitis and two organ failures. More‐than‐one acute precipitant, severity, infections, organ failures and irreversibility escalated from clusters 1 to 4. Circulatory and renal failures critically influenced cluster assignments. Incorporating clusters to CLIF‐C ACLF, infection and ACLF definition improved the discriminative accuracy of CLIF‐C‐ACLF by 11%. Extreme gradient boost and decision trees could predict clusters with AUCs of 0.989 (0.979–0.995) and 0.875 (0.865–0.890). MELD, CLIF‐C‐OF, haemoglobin, lactate, CLIF‐C‐ACLF and ALT were critical variables for cluster prediction. Clusters with distinct survival were documented in a temporal validation cohort.ConclusionsML for the first time could identify clusters with distinct phenotypes, trajectories and outcomes in ACLF. Stratification into clusters can address heterogeneity, guide prognosis, recruitment in trials, resource allocation and liver transplant discussions in ACLF.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142276799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Optimising public health policies to combat alcohol-associated liver disease in youth—Addressing key methodological and regional challenges","authors":"Rui Zhang,&nbsp;Hua Wei,&nbsp;Ming Liu","doi":"10.1111/apt.18239","DOIUrl":"10.1111/apt.18239","url":null,"abstract":"&lt;p&gt;We read with great interest the article by Danpanichkul et al. titled ‘Global Epidemiology of Alcohol-Associated Liver Disease in Adolescents and Young Adults’.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The study offers valuable insights into the global burden of alcohol-associated liver disease (ALD) among young populations. However, several limitations deserve further discussion.&lt;/p&gt;&lt;p&gt;First, the study relies heavily on the global burden of disease (GBD) data set. While comprehensive, the GBD data set may not fully capture regional differences in alcohol consumption patterns and liver disease prevalence, especially in low- and middle-income countries.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Cultural and religious factors often lead to underreporting of alcohol consumption in these areas, potentially resulting in an underestimation of ALD prevalence.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Future research could enhance data accuracy by integrating local epidemiological data or conducting targeted surveys that consider these contextual factors.&lt;/p&gt;&lt;p&gt;Second, although the Joinpoint regression analysis provides valuable insights into temporal trends, it does not account for potential confounders such as access to healthcare, socioeconomic changes and regional differences in alcohol policy enforcement.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; These factors could significantly influence ALD prevalence and mortality rates. Future studies should incorporate multivariate regression models to adjust for these confounders, enabling a more accurate identification of the key drivers behind ALD trends.&lt;/p&gt;&lt;p&gt;Moreover, with the global rise in obesity and metabolic syndrome, particularly among young people, it is crucial to investigate how metabolic dysfunction-associated steatotic liver disease might exacerbate ALD.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; The increasing prevalence of obesity-related metabolic disorders could further complicate ALD progression.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; Thus, future research should stratify data by metabolic risk factors to better understand their role in ALD development.&lt;/p&gt;&lt;p&gt;Lastly, while the authors emphasise the importance of public health policies aimed at reducing alcohol consumption, they do not thoroughly analyse the effectiveness of these policies across different regions. Given the variability in alcohol consumption patterns and healthcare infrastructure, policy outcomes can vary significantly.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; Region-specific interventions should be developed to address these differences.&lt;/p&gt;&lt;p&gt;In regions such as Europe and the Americas, where alcohol consumption is high, existing policies should be strengthened by increasing taxes on alcohol, restricting sales channels and promoting public education to reduce alcohol dependence.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; Additionally, policymakers should consider cultural attitudes towards alcohol and work to foster a healthier drinking culture. Innovative interventions are necessary in Africa and the Eastern Mediterranean, where traditional taxati","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.18239","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin-like growth factor-1 in cirrhosis is linked to hepatic dysfunction and fibrogenesis and predicts liver-related mortality","authors":"Lukas Hartl, Michael Schwarz, Benedikt Simbrunner, Mathias Jachs, Peter Wolf, David Josef Maria Bauer, Bernhard Scheiner, Lorenz Balcar, Georg Semmler, Benedikt Silvester Hofer, Nina Dominik, Rodrig Marculescu, Michael Trauner, Mattias Mandorfer, Thomas Reiberger","doi":"10.1111/apt.18289","DOIUrl":"https://doi.org/10.1111/apt.18289","url":null,"abstract":"We aimed to characterise insulin-like growth factor-1 (IGF-1) signalling in patients with advanced chronic liver disease (ACLD).","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic dysfunction-associated steatotic liver disease and MetALD increases the risk of liver cancer and gastrointestinal cancer: A nationwide cohort study","authors":"Yewan Park, Jooyi Jung, Seungbong Han, Gi-Ae Kim","doi":"10.1111/apt.18286","DOIUrl":"https://doi.org/10.1111/apt.18286","url":null,"abstract":"The new nomenclature of metabolic dysfunction-associated steatotic liver disease (MASLD) substituting nonalcoholic fatty liver disease was proposed along with a new category of MASLD with increased alcohol intake (MetALD).","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of non-selective beta blockers on further decompensation and death in decompensated cirrhosis: Benefit and risk stratification by MELD score.","authors":"Ting Wang,Xueying Wang,Siqi Jia,Haitao Zhao,Le Wang,Xianxian Zhang,Xiaohui Fang,Yong He,Hongyu Li,Frank Tacke,Xingshun Qi","doi":"10.1111/apt.18261","DOIUrl":"https://doi.org/10.1111/apt.18261","url":null,"abstract":"BACKGROUNDNon-selective beta blockers (NSBBs) can reduce the risk of decompensation, but their impact on further decompensation has been rarely investigated.AIMSThe aim is to evaluate the impact of NSBBs on further decompensation and death in decompensated cirrhosis stratified by the severity of liver disease.METHODSOverall, 332 decompensated cirrhotic patients were retrospectively included, of whom 149 used NSBBs. Kaplan-Meier and Nelson-Aalen cumulative risk curves as well as Cox regression and competing risk analyses were used to estimate the associations of NSBBs with further decompensation and death, if appropriate. Hazard ratio (HR) and sub-distribution HR (sHR) were calculated. Subgroup analyses were performed based on the model for end-stage liver disease (MELD) score at admission.RESULTSIn the overall analysis, the use of NSBBs was not significantly associated with further decompensation in multivariate competing risk analysis (sHR = 1.09, p = 0.580). In the subgroup analysis of patients with a MELD score of ≤9, the use of NSBBs was significantly associated with decreased risk of further decompensation in multivariate competing risk analysis (sHR = 0.57, p = 0.021). In the subgroup analysis of patients with a MELD score of >9, the use of NSBBs was associated with increased risk of further decompensation in multivariate competing risk analysis (sHR = 1.45, p = 0.044). Regardless of overall and subgroup analyses, the use of NSBBs was not significantly associated with death in multivariate Cox regression analyses.CONCLUSIONNSBBs may be beneficial for the prevention of further decompensation in cirrhotic patients with a MELD score of ≤9, but deleterious in those with a MELD score of >9.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review article: Recommendations for detection, assessment and management of suspected drug-induced liver injury during clinical trials in oncology patients","authors":"Anna Fettiplace, John Marcinak, Michael Merz, Hui-Talia Zhang, Luciana Kikuchi, Arie Regev, Melissa Palmer, Don Rockey, Robert Fontana, Paul H. Hayashi, Hans L. Tillmann, Adrian M. Di Bisceglie, James H. Lewis","doi":"10.1111/apt.18271","DOIUrl":"https://doi.org/10.1111/apt.18271","url":null,"abstract":"Drug-induced liver injury (DILI) is a major concern for oncology drugs in clinical practice and under development. Monitoring cancer patients for hepatotoxicity is challenging as these patients may have abnormal liver tests pre-treatment or on-study for many reasons including liver injury due to past oncology treatments, hepatic metastases, medical co-morbidities such as heart failure, and concomitant medications. At present, there are no regulatory guidelines or position papers that systematically address best practices pertaining to DILI detection, assessment and management in oncology patients.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}