Bingshen Guo, Yanzhi Bai, Yicheng Yang, Yi Zhu, Xiaoguang Zhang, Feng Wei, Xu Zhang, Sumei Gu, Xixing Ma
Objective
Observational studies indicate that psoriasis (PSO) patients have an increased risk of depression; however, potential confounding factors and reverse causality limit these findings, leaving the exact causal relationship between these two conditions remain to be determined. The objective of this study is to investigate the causal relationship between PSO and depression using a two-sample Mendelian randomization (MR) approach.
Methods
Summary statistics from multiple genomewide association studies (GWAS) in European populations were analyzed using Z-scores to assess correlations between PSO and depression. MR design, which uses genetic variants as instrumental variables, was employed to examine causality, with primary analyses conducted using the inverse variance weighted (IVW) method. Additional MR Steiger (testing causal direction) and colocalization (identifying shared genetic variants) analyses were performed to verify the robustness of genetic variants associated with both conditions.
Results
The results revealed a positive relationship, with genetic susceptibility to PSO correlating to a higher depression risk (OR: 1.348, 95% CI: 1.141–1.592, p = 0.004). This finding was consistently supported by multiple MR methods, including MR-Egger and MR-PRESSO. The MR Steiger method supported a causal link, while colocalization identified a shared causal variant (rs12189871) between the two conditions.
Conclusion
These findings suggest a potential causal relationship between PSO and depression, highlighting the need for depression screening in PSO patients.
{"title":"Genetic Susceptibility to Psoriasis Increases Risk of Depression: Evidence From a Mendelian Randomization Study","authors":"Bingshen Guo, Yanzhi Bai, Yicheng Yang, Yi Zhu, Xiaoguang Zhang, Feng Wei, Xu Zhang, Sumei Gu, Xixing Ma","doi":"10.1155/ijcp/9238266","DOIUrl":"https://doi.org/10.1155/ijcp/9238266","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Observational studies indicate that psoriasis (PSO) patients have an increased risk of depression; however, potential confounding factors and reverse causality limit these findings, leaving the exact causal relationship between these two conditions remain to be determined. The objective of this study is to investigate the causal relationship between PSO and depression using a two-sample Mendelian randomization (MR) approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Summary statistics from multiple genomewide association studies (GWAS) in European populations were analyzed using Z-scores to assess correlations between PSO and depression. MR design, which uses genetic variants as instrumental variables, was employed to examine causality, with primary analyses conducted using the inverse variance weighted (IVW) method. Additional MR Steiger (testing causal direction) and colocalization (identifying shared genetic variants) analyses were performed to verify the robustness of genetic variants associated with both conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results revealed a positive relationship, with genetic susceptibility to PSO correlating to a higher depression risk (OR: 1.348, 95% CI: 1.141–1.592, <i>p</i> = 0.004). This finding was consistently supported by multiple MR methods, including MR-Egger and MR-PRESSO. The MR Steiger method supported a causal link, while colocalization identified a shared causal variant (rs12189871) between the two conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings suggest a potential causal relationship between PSO and depression, highlighting the need for depression screening in PSO patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/9238266","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145750677","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}
Teresa Gómez-Garcia, Javier de Miguel-Diez, Valentín Hernández-Barrera, Ana López-de-Andrés, David Carabantes-Alarcon, Ana Jiménez-Sierra, Elena Labajo-González, Andrés Bodas-Pinedo, Rodrigo Jiménez-Garcia
Purpose
Depression is a frequent comorbidity in individuals with chronic obstructive pulmonary disease (COPD) and is associated with adverse clinical outcomes, including an increased risk of exacerbations and death. This study aimed to describe national trends in the prevalence of depression among COPD hospitalizations in Spain, from 2016 to 2023, to assess sex-related differences, to evaluate its impact on hospital outcomes, and to determine how the COVID-19 pandemic modified these associations.
Patients and Methods
We carried out a population-based cohort study using data from the Spanish National Hospital Discharge Database (RAE-CMBD). All admissions of patients aged 40 years or older with a diagnosis of COPD were included. Depression was identified through International Classification of Diseases, Tenth Revision (ICD-10) codes. We analyzed temporal changes and sex-stratified patterns and factors independently associated with in-hospital mortality (IHM).
Results
During the study period, 2,545,151 hospitalizations with COPD were recorded nationwide, of which 106,337 (4.17%) included a diagnosis of depression. The prevalence rose progressively, remaining consistently higher in women. Female patients exhibited greater frequencies of anxiety, obesity, and personality disorders, whereas men showed higher rates of alcohol (17.9% vs. 6.1%; p < 0.001) and tobacco use (58.5% vs. 43.4%; p < 0.001) and a greater proportion of suicide attempts (0.11% vs. 0.06%; p < 0.001). Men were also older (74.1 vs. 73.3 years; p < 0.001) and had higher Charlson Comorbidity Index (CCI) values (1.31 vs. 1.01; p < 0.001). ICU admissions (5.0% vs. 4.6%; p < 0.001) and IHM (7.8% vs. 5.6%; p < 0.001) were more common in men. In multivariable models, older age and greater comorbidity burden were the strongest predictors of IHM in both sexes. COVID-19 infection and dementia increased the odds of death, whereas anxiety and obesity were inversely associated with mortality.
Conclusion
Between 2016 and 2023, depression among COPD hospitalizations in Spain increased steadily, with clear sex-based differences in prevalence, clinical profile, and hospital outcomes. The results emphasize the need to integrate mental health screening and management into routine COPD care.
{"title":"Prevalence and Impact of Depression Among Patients Hospitalized With COPD From 2016 to 2023: A Population-Based Study in Spain","authors":"Teresa Gómez-Garcia, Javier de Miguel-Diez, Valentín Hernández-Barrera, Ana López-de-Andrés, David Carabantes-Alarcon, Ana Jiménez-Sierra, Elena Labajo-González, Andrés Bodas-Pinedo, Rodrigo Jiménez-Garcia","doi":"10.1155/ijcp/5057728","DOIUrl":"https://doi.org/10.1155/ijcp/5057728","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Depression is a frequent comorbidity in individuals with chronic obstructive pulmonary disease (COPD) and is associated with adverse clinical outcomes, including an increased risk of exacerbations and death. This study aimed to describe national trends in the prevalence of depression among COPD hospitalizations in Spain, from 2016 to 2023, to assess sex-related differences, to evaluate its impact on hospital outcomes, and to determine how the COVID-19 pandemic modified these associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>We carried out a population-based cohort study using data from the Spanish National Hospital Discharge Database (RAE-CMBD). All admissions of patients aged 40 years or older with a diagnosis of COPD were included. Depression was identified through International Classification of Diseases, Tenth Revision (ICD-10) codes. We analyzed temporal changes and sex-stratified patterns and factors independently associated with in-hospital mortality (IHM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the study period, 2,545,151 hospitalizations with COPD were recorded nationwide, of which 106,337 (4.17%) included a diagnosis of depression. The prevalence rose progressively, remaining consistently higher in women. Female patients exhibited greater frequencies of anxiety, obesity, and personality disorders, whereas men showed higher rates of alcohol (17.9% vs. 6.1%; <i>p</i> < 0.001) and tobacco use (58.5% vs. 43.4%; <i>p</i> < 0.001) and a greater proportion of suicide attempts (0.11% vs. 0.06%; <i>p</i> < 0.001). Men were also older (74.1 vs. 73.3 years; <i>p</i> < 0.001) and had higher Charlson Comorbidity Index (CCI) values (1.31 vs. 1.01; <i>p</i> < 0.001). ICU admissions (5.0% vs. 4.6%; <i>p</i> < 0.001) and IHM (7.8% vs. 5.6%; <i>p</i> < 0.001) were more common in men. In multivariable models, older age and greater comorbidity burden were the strongest predictors of IHM in both sexes. COVID-19 infection and dementia increased the odds of death, whereas anxiety and obesity were inversely associated with mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Between 2016 and 2023, depression among COPD hospitalizations in Spain increased steadily, with clear sex-based differences in prevalence, clinical profile, and hospital outcomes. The results emphasize the need to integrate mental health screening and management into routine COPD care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5057728","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145750728","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}
Patients with critical illnesses frequently experience tachyarrhythmias as a result of excessive sympathetic hyperactivity and high levels of inflammatory cytokines. Ultrashort-acting β-blockers like landiolol are commonly utilized in intensive care units (ICUs) because of their unique features.
Methods
Electronic databases (Cochrane Library, PubMed, Web of Science, and Embase) were searched for randomized controlled trials (RCTs) from inception to September 1, 2025 assessing the efficacy of landiolol in critically ill patients. The primary outcome was new-onset arrhythmias. All-cause mortality, heart rate (HR), length of ICU and hospital stay, and need for norepinephrine following landiolol therapy were the secondary outcomes. Trial sequential analysis (TSA) was performed to further evaluate the robustness of findings. The quality of evidence was evaluated through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method.
Results
Nine studies totaling 836 patients were included. Overall, our meta-analysis exhibited that landiolol might considerably lower the incidence of new-onset arrhythmias when compared to the control treatment (9 studies [836 patients]; odds ratio [OR], 0.44; 95% confidence interval [CI] 0.23 to 0.82; p = 0.01), and TSA agreed with this finding. We also observed that landiolol could reduce HR (mean difference [MD], −6.41, 95% CI, −8.63 to −4.18, p < 0.001). However, there was no considerable decrease in requirement of norepinephrine dose (MD, 0.04, 95% CI, −0.01 to 0.09, p = 0.11), length of hospital stay (MD, −0.87, 95% CI, −7.40 to 5.65, p = 0.79), or all-cause mortality (OR, 1.10, 95% CI, 0.62 to 1.96, p = 0.75). Additionally, the length of ICU stay in the landiolol group was longer than that in the control group (MD, 0.19; 95% CI 0.01 to 0.37; p = 0.03).
Conclusion
New-onset arrhythmias and HR were significantly reduced in critical illness patients receiving landiolol.
{"title":"The Effect of Landiolol in Patients With Critical Illness: A Systematic Review and Meta-Analysis","authors":"Huanming Kuang, Jian Qiu Zhu, Ying Qiu Xie, Youfeng Zhu, Xing Luo","doi":"10.1155/ijcp/8739008","DOIUrl":"https://doi.org/10.1155/ijcp/8739008","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with critical illnesses frequently experience tachyarrhythmias as a result of excessive sympathetic hyperactivity and high levels of inflammatory cytokines. Ultrashort-acting <i>β</i>-blockers like landiolol are commonly utilized in intensive care units (ICUs) because of their unique features.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Electronic databases (Cochrane Library, PubMed, Web of Science, and Embase) were searched for randomized controlled trials (RCTs) from inception to September 1, 2025 assessing the efficacy of landiolol in critically ill patients. The primary outcome was new-onset arrhythmias. All-cause mortality, heart rate (HR), length of ICU and hospital stay, and need for norepinephrine following landiolol therapy were the secondary outcomes. Trial sequential analysis (TSA) was performed to further evaluate the robustness of findings. The quality of evidence was evaluated through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine studies totaling 836 patients were included. Overall, our meta-analysis exhibited that landiolol might considerably lower the incidence of new-onset arrhythmias when compared to the control treatment (9 studies [836 patients]; odds ratio [OR], 0.44; 95% confidence interval [CI] 0.23 to 0.82; <i>p</i> = 0.01), and TSA agreed with this finding. We also observed that landiolol could reduce HR (mean difference [MD], −6.41, 95% CI, −8.63 to −4.18, <i>p</i> < 0.001). However, there was no considerable decrease in requirement of norepinephrine dose (MD, 0.04, 95% CI, −0.01 to 0.09, <i>p</i> = 0.11), length of hospital stay (MD, −0.87, 95% CI, −7.40 to 5.65, <i>p</i> = 0.79), or all-cause mortality (OR, 1.10, 95% CI, 0.62 to 1.96, <i>p</i> = 0.75). Additionally, the length of ICU stay in the landiolol group was longer than that in the control group (MD, 0.19; 95% CI 0.01 to 0.37; <i>p</i> = 0.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>New-onset arrhythmias and HR were significantly reduced in critical illness patients receiving landiolol.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8739008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145750729","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}
<div> <section> <h3> Background</h3> <p>Endoscopic treatment has gradually become the main method for internal hemorrhoids because of its advantages of less trauma, shorter treatment time, less adverse reactions, and obvious improvement of symptoms.</p> </section> <section> <h3> Objective</h3> <p>To evaluate the efficacy and safety of endoscopic ligation and endoscopic injection sclerotherapy for internal hemorrhoids.</p> </section> <section> <h3> Patients</h3> <p>This is a retrospective cohort study that included 123 patients diagnosed with internal hemorrhoids and treated with endoscopic ligation or endoscopic injection sclerotherapy at the First Affiliated Hospital of Nanchang University between January 2019 and December 2021.</p> </section> <section> <h3> Method</h3> <p>In this retrospective cohort study, 123 patients with internal hemorrhoids were divided into endoscopic ligation (<i>n</i> = 55) or endoscopic injection sclerotherapy (<i>n</i> = 68) groups according to the treatment received. The treatment effect was evaluated at baseline and at least one year after operation. The evaluation criteria were based on the “Diagnostic Efficacy Criteria of Anorectal Department of Traditional Chinese Medicine” issued by the State Administration of Traditional Chinese Medicine. The efficacy was divided into cure, improvement, ineffective, and recurrence. The safety of treatment was evaluated using postoperative adverse reactions and VAS scores.</p> </section> <section> <h3> Results</h3> <p>In this study, the effective rates of endoscopic ligation and endoscopic injection sclerotherapy were 87.3% and 86.8% respectively, and there was no significant difference between the two groups. However, the incidence of postoperative hematochezia, perianal pain, and the degree of perianal pain in endoscopic ligation group were significantly higher than those in endoscopic injection sclerotherapy group (<i>p</i> < 0.05). In addition, the hospitalization cost and duration of endoscopic ligation group were significantly higher than those of endoscopic injection sclerotherapy group (<i>p</i> < 0.05). The median follow-up time was 596 days. During the follow-up period, the recurrence rates of endoscopic ligation group and endoscopic injection sclerotherapy group were 25.0% and 16.9%, respectively. The median recurrence time after operation was 6 months and 5.5 months, respectively. There was no significant difference in recurrence rates between the two groups (<i>p</i> > 0.
{"title":"Comparative Evaluation of the Efficacy and Safety of Endoscopic Ligation and Endoscopic Injection Sclerotherapy for Internal Hemorrhoids","authors":"Shanshan Cai, Bowen Cheng, Hangcheng Zhang, Yongjie Lin, Miaomiao Zhou, Bushan Xie","doi":"10.1155/ijcp/8868241","DOIUrl":"https://doi.org/10.1155/ijcp/8868241","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Endoscopic treatment has gradually become the main method for internal hemorrhoids because of its advantages of less trauma, shorter treatment time, less adverse reactions, and obvious improvement of symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the efficacy and safety of endoscopic ligation and endoscopic injection sclerotherapy for internal hemorrhoids.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients</h3>\u0000 \u0000 <p>This is a retrospective cohort study that included 123 patients diagnosed with internal hemorrhoids and treated with endoscopic ligation or endoscopic injection sclerotherapy at the First Affiliated Hospital of Nanchang University between January 2019 and December 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>In this retrospective cohort study, 123 patients with internal hemorrhoids were divided into endoscopic ligation (<i>n</i> = 55) or endoscopic injection sclerotherapy (<i>n</i> = 68) groups according to the treatment received. The treatment effect was evaluated at baseline and at least one year after operation. The evaluation criteria were based on the “Diagnostic Efficacy Criteria of Anorectal Department of Traditional Chinese Medicine” issued by the State Administration of Traditional Chinese Medicine. The efficacy was divided into cure, improvement, ineffective, and recurrence. The safety of treatment was evaluated using postoperative adverse reactions and VAS scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this study, the effective rates of endoscopic ligation and endoscopic injection sclerotherapy were 87.3% and 86.8% respectively, and there was no significant difference between the two groups. However, the incidence of postoperative hematochezia, perianal pain, and the degree of perianal pain in endoscopic ligation group were significantly higher than those in endoscopic injection sclerotherapy group (<i>p</i> < 0.05). In addition, the hospitalization cost and duration of endoscopic ligation group were significantly higher than those of endoscopic injection sclerotherapy group (<i>p</i> < 0.05). The median follow-up time was 596 days. During the follow-up period, the recurrence rates of endoscopic ligation group and endoscopic injection sclerotherapy group were 25.0% and 16.9%, respectively. The median recurrence time after operation was 6 months and 5.5 months, respectively. There was no significant difference in recurrence rates between the two groups (<i>p</i> > 0.","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8868241","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145750730","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}
Cardiovascular–renal–metabolic syndrome (CRMS), often referred to as the “two birds with one stone” condition, is a complex disorder characterized by the intricate interplay between cardiovascular, renal, and metabolic dysfunctions. This mini-review aims to provide an in-depth examination of the pathophysiological mechanisms, clinical implications, and potential therapeutic interventions for CRMS, focusing on the critical role of addressing social determinants of health (SDOH). Drawing upon the recent Presidential Advisory from the American Heart Association (AHA) on Cardiovascular-Renal-Metabolic Health, this mini-review seeks to elucidate the multifaceted relationships between these three major systems and their far-reaching impact on overall health. The synergistic interactions between cardiovascular, renal, and metabolic health underline the importance of adopting a comprehensive approach for healthcare providers and policymakers in managing patients with CRMS.
{"title":"Cardiovascular–Renal–Metabolic Syndrome: Hit Two Birds With One Stone?—Mini-Review and Complementary on “Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association”","authors":"May Thu Kyaw","doi":"10.1155/ijcp/9112371","DOIUrl":"https://doi.org/10.1155/ijcp/9112371","url":null,"abstract":"<p>Cardiovascular–renal–metabolic syndrome (CRMS), often referred to as the “two birds with one stone” condition, is a complex disorder characterized by the intricate interplay between cardiovascular, renal, and metabolic dysfunctions. This mini-review aims to provide an in-depth examination of the pathophysiological mechanisms, clinical implications, and potential therapeutic interventions for CRMS, focusing on the critical role of addressing social determinants of health (SDOH). Drawing upon the recent Presidential Advisory from the American Heart Association (AHA) on Cardiovascular-Renal-Metabolic Health, this mini-review seeks to elucidate the multifaceted relationships between these three major systems and their far-reaching impact on overall health. The synergistic interactions between cardiovascular, renal, and metabolic health underline the importance of adopting a comprehensive approach for healthcare providers and policymakers in managing patients with CRMS.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/9112371","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145695060","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}
The incidence of chronic kidney disease (CKD) is on the rise globally. The aim of this study was to characterize the profile of inpatients in the nephrology department of a hospital in Southern Anhui Province, China, during 2007–2022.
Methods
We constructed a retrospective cohort of inpatients from the nephrology department of a hospital and retrieved basic information through the Medical Record Management System (MRMS), including sex, age, length of hospital stay, diagnosis, and outcome of treatment.
Results
This cross-sectional study involved 35,963 inpatients. Both the total number of hospitalized patients and the average age of inpatients from 2007 to 2022 presented a significant increasing trend (p < 0.001). The number of cases aged 40–60 years old is the largest, followed by the cases aged 60–80 years old. CKD is the main cause of hospitalization. Among the causes of CKD, the number of cases with diabetic kidney disease (DKD) had exceeded chronic glomerulonephritis (CGN) and become the main cause for the hospitalization of CKD patients starting from 2016. The average hospitalized day presented a downward trend (11.4 ± 0.5 vs. 9.6 ± 1.2 days, p = 0.002), and the improvement rate presented an upward trend (90.7 ± 4.7% vs. 96.6 ± 1.7%, p = 0.008) from 2007 to 2022.
Conclusion
The renal disease spectrum of hospitalization is changing with variations over time in the nephrology department of our hospital. Understanding the change of the CKD spectrum is crucial to develop effective public health strategies to control the burden of CKD and improve the average hospitalized day.
{"title":"Changes in the Epidemiological Characteristics of Inpatients in the Nephrology Department in a Hospital in Anhui During 2007–2022","authors":"Jing Zhang, Lijuan Tang, Jun Hu","doi":"10.1155/ijcp/1885064","DOIUrl":"https://doi.org/10.1155/ijcp/1885064","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The incidence of chronic kidney disease (CKD) is on the rise globally. The aim of this study was to characterize the profile of inpatients in the nephrology department of a hospital in Southern Anhui Province, China, during 2007–2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We constructed a retrospective cohort of inpatients from the nephrology department of a hospital and retrieved basic information through the Medical Record Management System (MRMS), including sex, age, length of hospital stay, diagnosis, and outcome of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This cross-sectional study involved 35,963 inpatients. Both the total number of hospitalized patients and the average age of inpatients from 2007 to 2022 presented a significant increasing trend (<i>p</i> < 0.001). The number of cases aged 40–60 years old is the largest, followed by the cases aged 60–80 years old. CKD is the main cause of hospitalization. Among the causes of CKD, the number of cases with diabetic kidney disease (DKD) had exceeded chronic glomerulonephritis (CGN) and become the main cause for the hospitalization of CKD patients starting from 2016. The average hospitalized day presented a downward trend (11.4 ± 0.5 vs. 9.6 ± 1.2 days, <i>p</i> = 0.002), and the improvement rate presented an upward trend (90.7 ± 4.7% vs. 96.6 ± 1.7%, <i>p</i> = 0.008) from 2007 to 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The renal disease spectrum of hospitalization is changing with variations over time in the nephrology department of our hospital. Understanding the change of the CKD spectrum is crucial to develop effective public health strategies to control the burden of CKD and improve the average hospitalized day.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/1885064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145695061","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}
Acute upper gastrointestinal bleeding (AUGIB) is a life-threatening complication of liver cirrhosis. Clinical characteristics and predictors for short-term mortality in older patients with liver cirrhosis–associated AUGIB remain little known. Consecutive cirrhotic patients with AUGIB admitted in the Department of Emergency from April 1st, 2021, to Dec 31st, 2022, were analyzed. Clinical characteristics of older cirrhotic patients with AUGIB and predictors for short-term mortality were analyzed. A total of 628 patients aged ≥ 60 years constituted the older group. Compared with the control group (age < 60 years), all-cause in-hospital mortality and 6-week mortality were higher (16.7% vs. 9.25%, p < 0.001; 24.0% vs. 15.6%, p < 0.001), respectively, in older patients. Female gender and melena were independent predictors for both in-hospital mortality and 6-week mortality. Esophageal sclerotherapy, moderate–severe encephalopathy, hyperlipoidemia, and coexisting portal vein thrombosis (PVT)/diabetes mellitus (DM) were independent predictors for in-hospital mortality, whereas an unknown source of AUGIB and hepatocellular carcinoma (HCC) were independent predictors for 6-week mortality. In older cirrhotic patients with AUGIB, female gender and melena contribute to lower in-hospital mortality and 6-week mortality. Esophageal sclerotherapy, control of DM, treatment of encephalopathy, and PVT are beneficial in reducing in-hospital mortality. An unknown source of AUGIB and HCC enhance 6-week mortality.
{"title":"Short-Term Mortality Rate and Predictors for Older Patients With Liver Cirrhosis–Associated Acute Upper Gastrointestinal Bleeding","authors":"Qi Li, Qikun Zhang, Zhao Liu, Lingna Lyu, Chunlei Fan, Huiguo Ding","doi":"10.1155/ijcp/6615949","DOIUrl":"https://doi.org/10.1155/ijcp/6615949","url":null,"abstract":"<p>Acute upper gastrointestinal bleeding (AUGIB) is a life-threatening complication of liver cirrhosis. Clinical characteristics and predictors for short-term mortality in older patients with liver cirrhosis–associated AUGIB remain little known. Consecutive cirrhotic patients with AUGIB admitted in the Department of Emergency from April 1st, 2021, to Dec 31st, 2022, were analyzed. Clinical characteristics of older cirrhotic patients with AUGIB and predictors for short-term mortality were analyzed. A total of 628 patients aged ≥ 60 years constituted the older group. Compared with the control group (age < 60 years), all-cause in-hospital mortality and 6-week mortality were higher (16.7% vs. 9.25%, <i>p</i> < 0.001; 24.0% vs. 15.6%, <i>p</i> < 0.001), respectively, in older patients. Female gender and melena were independent predictors for both in-hospital mortality and 6-week mortality. Esophageal sclerotherapy, moderate–severe encephalopathy, hyperlipoidemia, and coexisting portal vein thrombosis (PVT)/diabetes mellitus (DM) were independent predictors for in-hospital mortality, whereas an unknown source of AUGIB and hepatocellular carcinoma (HCC) were independent predictors for 6-week mortality. In older cirrhotic patients with AUGIB, female gender and melena contribute to lower in-hospital mortality and 6-week mortality. Esophageal sclerotherapy, control of DM, treatment of encephalopathy, and PVT are beneficial in reducing in-hospital mortality. An unknown source of AUGIB and HCC enhance 6-week mortality.</p>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/6615949","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686116","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}
Xueying Wu, Qingsheng Zheng, Shuai Peng, Sicong Jiang, Ning Hu
Background
Gastric cancer (GC) displays profound molecular heterogeneity, leading to divergent therapeutic responses and prognoses. Programmed cell death (PCD) pathways and the tumor microenvironment (TME) are critical determinants of GC progression, yet their interplay and clinical significance remain insufficiently understood.
Methods
We conducted integrative multiomics analyses using bulk RNA-seq data from TCGA-STAD (426 tumors, 35 normals) and single-cell RNA-seq (GSE167297; 4 tumor/normal pairs). PCD-based molecular subtypes were identified through consensus clustering. Drug sensitivity (pRRophetic), immune infiltration (ESTIMATE/CIBERSORT), and functional enrichment (GSVA/clusterProfiler) were systematically evaluated. A prognostic risk model was established via LASSO-Cox regression and externally validated in GSE26901.
Results
Two distinct PCD-associated subtypes were identified. Cluster 1, characterized by elevated PCD activity, enriched KRAS signaling and interferon response, showed a poorer prognosis; whereas Cluster 2 exhibited favorable survival with activation of E2F and mTORC1 pathways. Cluster 1 demonstrated higher immune and stromal scores but lower tumor purity, along with upregulation of immune checkpoints (PDCD1, CD40LG). Drug sensitivity profiling revealed subtype-specific vulnerabilities, including heightened sensitivity of Cluster 1 to cJQ1_2172. A nine-gene prognostic model (5 year AUC = 0.73) robustly predicted survival, with NRP1 identified as an independent risk factor (HR = 1.91, p < 0.05).
Conclusions
This study delineates the PCD–TME crosstalk underlying GC heterogeneity and proposes a clinically relevant molecular classification and prognostic tool. Our findings highlight subtype-specific therapeutic vulnerabilities and underscore the potential of targeting PCD pathways to advance precision oncology in GC.
{"title":"A Novel PCD-Driven Risk Model Predicts Prognosis and Chemoresistance in Gastric Cancer Through Tumor Microenvironment Deregulation","authors":"Xueying Wu, Qingsheng Zheng, Shuai Peng, Sicong Jiang, Ning Hu","doi":"10.1155/ijcp/6204187","DOIUrl":"https://doi.org/10.1155/ijcp/6204187","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gastric cancer (GC) displays profound molecular heterogeneity, leading to divergent therapeutic responses and prognoses. Programmed cell death (PCD) pathways and the tumor microenvironment (TME) are critical determinants of GC progression, yet their interplay and clinical significance remain insufficiently understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted integrative multiomics analyses using bulk RNA-seq data from TCGA-STAD (426 tumors, 35 normals) and single-cell RNA-seq (GSE167297; 4 tumor/normal pairs). PCD-based molecular subtypes were identified through consensus clustering. Drug sensitivity (pRRophetic), immune infiltration (ESTIMATE/CIBERSORT), and functional enrichment (GSVA/clusterProfiler) were systematically evaluated. A prognostic risk model was established via LASSO-Cox regression and externally validated in GSE26901.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two distinct PCD-associated subtypes were identified. Cluster 1, characterized by elevated PCD activity, enriched KRAS signaling and interferon response, showed a poorer prognosis; whereas Cluster 2 exhibited favorable survival with activation of E2F and mTORC1 pathways. Cluster 1 demonstrated higher immune and stromal scores but lower tumor purity, along with upregulation of immune checkpoints (PDCD1, CD40LG). Drug sensitivity profiling revealed subtype-specific vulnerabilities, including heightened sensitivity of Cluster 1 to cJQ1_2172. A nine-gene prognostic model (5 year AUC = 0.73) robustly predicted survival, with NRP1 identified as an independent risk factor (HR = 1.91, <i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study delineates the PCD–TME crosstalk underlying GC heterogeneity and proposes a clinically relevant molecular classification and prognostic tool. Our findings highlight subtype-specific therapeutic vulnerabilities and underscore the potential of targeting PCD pathways to advance precision oncology in GC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/6204187","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686341","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}
Based on previous reports that elevated NSE levels may predict diabetic neuropathy, we aimed to validate this association in a well-characterized cohort. Using strict exclusion criteria, standardized clinical scales, and nerve conduction studies, we aimed to evaluate the clinical utility of NSE levels in diabetic patients with and without neuropathic pain.
Methods
A total of 144 Type 2 diabetic patients were included in this prospective cross-sectional study. Neuropathic pain symptoms were assessed using the Douleur Neuropathique 4 questionnaire (DN4) and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS). The diagnosis of diabetic peripheral neuropathy (DPNP) was established based on electrophysiological findings. Patients were divided into three groups as follows: those having neuropathic pain with DPNP (Group 1, n = 60) and without DPNP (Group 2, n = 56). The patients without neuropathic pain (n = 28) were defined as Group 3. Serum NSE levels were derived via electrochemiluminescence immunoassay.
Results
There was no significant between-group difference in age or gender (both p > 0.05). The disease duration was significantly longer in patients having neuropathic pain, compared to those without neuropathic pain (p = 0.004). The serum levels of NSE (p < 0.001) and the scores on the DN4 (p = 0.001) and LANSS (p = 0.016) instruments were higher in Group 1 than in Group 2. The NSE level was positively correlated with the LANSS score (r = 0.260, p = 0.005) and independently associated with the presence of DPNP in a multivariate model (OR 1.33, 95% confidence interval 1.12–1.58, p = 0.001). On the ROC analysis, an NSE cutoff of 9.51 ng/mL predicted the presence of DPNP.
Conclusion
Elevated serum NSE levels were significantly associated with DPNP in diabetic patients, indicating that NSE may serve as a potential biomarker for large-fiber involvement. However, this finding warrants confirmation in larger, multicenter studies.
{"title":"Serum Neuron-Specific Enolase Levels in Patients With Diabetic Peripheral Neuropathy","authors":"Selcen Duran, Asuman Celikbilek, Aysu Yetis, Bilal Ilanbey, Burc Esra Sahin, Aydan Koysuren, Himmet Durmaz","doi":"10.1155/ijcp/5569034","DOIUrl":"https://doi.org/10.1155/ijcp/5569034","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Based on previous reports that elevated NSE levels may predict diabetic neuropathy, we aimed to validate this association in a well-characterized cohort. Using strict exclusion criteria, standardized clinical scales, and nerve conduction studies, we aimed to evaluate the clinical utility of NSE levels in diabetic patients with and without neuropathic pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 144 Type 2 diabetic patients were included in this prospective cross-sectional study. Neuropathic pain symptoms were assessed using the Douleur Neuropathique 4 questionnaire (DN4) and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS). The diagnosis of diabetic peripheral neuropathy (DPNP) was established based on electrophysiological findings. Patients were divided into three groups as follows: those having neuropathic pain with DPNP (Group 1, <i>n</i> = 60) and without DPNP (Group 2, <i>n</i> = 56). The patients without neuropathic pain (<i>n</i> = 28) were defined as Group 3. Serum NSE levels were derived via electrochemiluminescence immunoassay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was no significant between-group difference in age or gender (both <i>p</i> > 0.05). The disease duration was significantly longer in patients having neuropathic pain, compared to those without neuropathic pain (<i>p</i> = 0.004). The serum levels of NSE (<i>p</i> < 0.001) and the scores on the DN4 (<i>p</i> = 0.001) and LANSS (<i>p</i> = 0.016) instruments were higher in Group 1 than in Group 2. The NSE level was positively correlated with the LANSS score (<i>r</i> = 0.260, <i>p</i> = 0.005) and independently associated with the presence of DPNP in a multivariate model (OR 1.33, 95% confidence interval 1.12–1.58, <i>p</i> = 0.001). On the ROC analysis, an NSE cutoff of 9.51 ng/mL predicted the presence of DPNP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Elevated serum NSE levels were significantly associated with DPNP in diabetic patients, indicating that NSE may serve as a potential biomarker for large-fiber involvement. However, this finding warrants confirmation in larger, multicenter studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5569034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145695029","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}
Yirixiatijiang Amier, Jiabo Li, Dongfeng Yuan, Xianmiao Li, Wenlong Wan, Junyi Yang, Yisheng Huang, Wenke Ji, Yang Xun, Xiao Yu
Objective
To evaluate the risk factors associated with ureteral stent–related symptoms in patients undergoing short-term ureteral stent placement using a validated questionnaire.
Methods
A total of 263 patients who underwent short-term stent placement following upper urinary tract stone surgery or ureteroscopy were included in this prospective study. The linguistically validated Chinese version of the Ureteral Stent Symptom Questionnaire was administered to all patients on Days 7 and 28 after stent placement to assess stent-related symptoms. Univariate and multivariate linear regression analyses were performed to identify risk factors, and a two-tailed p < 0.05 was considered statistically significant.
Results
Compared to Day 7, scores for urinary symptoms, body pain, general health, work performance, sexual matters, and additional problems significantly decreased by Day 28 (p < 0.05). Multivariate linear regression revealed that stent placement due to urinary tract stone surgery, stent positioning beyond the midline, and a lower distal length ratio (positioned closer to the bladder neck) were common risk factors for both early and late stent-related symptoms. Stent positioning beyond the midline was associated with at least three symptom domains. In addition, a higher body mass index and no history of previous stent placement were risk factors for worse body pain and more additional problems in the early phase, respectively. The presence of recurrent urinary tract infections was a risk factor for more severe urinary symptoms and poorer general health in the late phase.
Conclusions
The stent-related symptoms are most pronounced in the early period, with a noticeable reduction in these effects over time. The distal position characteristics of the stent have the greatest impact on patient discomfort. Stent placement due to urinary tract stone surgery, presence of recurrent urinary tract infections, and higher BMI are also risks for experiencing severe stent-related symptoms.
{"title":"Analysis of Risk Factors for Ureteral Stent–Related Symptoms in Patients Undergoing Short-Term Ureteral Stent Placement due to Ureteroscopy and Urinary Stones","authors":"Yirixiatijiang Amier, Jiabo Li, Dongfeng Yuan, Xianmiao Li, Wenlong Wan, Junyi Yang, Yisheng Huang, Wenke Ji, Yang Xun, Xiao Yu","doi":"10.1155/ijcp/8677297","DOIUrl":"https://doi.org/10.1155/ijcp/8677297","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the risk factors associated with ureteral stent–related symptoms in patients undergoing short-term ureteral stent placement using a validated questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 263 patients who underwent short-term stent placement following upper urinary tract stone surgery or ureteroscopy were included in this prospective study. The linguistically validated Chinese version of the Ureteral Stent Symptom Questionnaire was administered to all patients on Days 7 and 28 after stent placement to assess stent-related symptoms. Univariate and multivariate linear regression analyses were performed to identify risk factors, and a two-tailed <i>p</i> < 0.05 was considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to Day 7, scores for urinary symptoms, body pain, general health, work performance, sexual matters, and additional problems significantly decreased by Day 28 (<i>p</i> < 0.05). Multivariate linear regression revealed that stent placement due to urinary tract stone surgery, stent positioning beyond the midline, and a lower distal length ratio (positioned closer to the bladder neck) were common risk factors for both early and late stent-related symptoms. Stent positioning beyond the midline was associated with at least three symptom domains. In addition, a higher body mass index and no history of previous stent placement were risk factors for worse body pain and more additional problems in the early phase, respectively. The presence of recurrent urinary tract infections was a risk factor for more severe urinary symptoms and poorer general health in the late phase.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The stent-related symptoms are most pronounced in the early period, with a noticeable reduction in these effects over time. The distal position characteristics of the stent have the greatest impact on patient discomfort. Stent placement due to urinary tract stone surgery, presence of recurrent urinary tract infections, and higher BMI are also risks for experiencing severe stent-related symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/8677297","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686496","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}
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