Journal of diabetes and its complications最新文献

{"title":"Assessing the influence of rural residence and economic distress on lower extremity risk stratification among diabetic foot ulcer patients utilizing the Wound, Ischemia, and Foot Infection (WIfI) classification system","authors":"","doi":"10.1016/j.jdiacomp.2024.108814","DOIUrl":"10.1016/j.jdiacomp.2024.108814","url":null,"abstract":"<div><h3>Objective</h3><p>Diabetic foot ulcers (DFU) are a major sequela of uncontrolled diabetes with a high risk of adverse outcomes. Poor DFU outcomes disproportionately impact patients living in rural and economically distressed communities with lack of access to consistent, quality care. This study aimed to analyze the risk of geographic and economic disparities, including rural status and county economic distress, on the disease burden of DFU at presentation utilizing the SVS WIfI classification system.</p></div><div><h3>Methods</h3><p>We conducted a retrospective review of 454 patients diagnosed with a DFU from 2011 to 2020 at a single institution's inpatient and outpatient wound care service. Patients &gt;18 years old, with type II diabetes mellitus, and diabetic foot ulcer were included.</p></div><div><h3>Results</h3><p>ANCOVA analyses showed rural patients had significantly higher WIfI composite scores (F(1,451) = 9.61, <em>p</em> = .002), grades of wound (F(1,439) = 11.03, <em>p</em> = .001), and ischemia (F(1,380) = 12.574, p = .001) compared to the urban patients. Patients that resided in at-risk economic counties had significantly higher overall WIfI composite scores (F(2,448) = 3.31, <em>p</em> = .037) than patients who lived in transitional economic counties, and higher foot infection grading (F(2,440) = 3.02, <em>p</em> = .05) compared to patients who lived in distressed economic counties. DFU patients who resided in distressed economic counties presented with higher individual grades of ischemia (F(2, 377) = 3.14, <em>p</em> = .04) than patients in transitional economic counties. Chi-Square analyses demonstrated patients who resided in urban counties were significantly more likely to present with grade 1 wounds (χ2(3) = 9.86, <em>p</em> = .02) and grade 0 ischemia (χ2(3) = 16.18, <em>p</em> = .001) compared to patients in rural areas. Economically distressed patients presented with significantly less grade 0 ischemia compared to patients in transitional economic counties (χ2(6) = 17.48, <em>p</em> = .008).</p></div><div><h3>Conclusions</h3><p>Our findings are the first to demonstrate the impact of geographic and economic disparities on the disease burden of DFU at presentation utilizing the SVS WIfI classification system. This may indicate need for improved multidisciplinary primary care prevention strategies with vascular specialists in these communities to mitigate worsening DFU and promote early intervention.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141630158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can tirzepatide untie the Gordian knot of eating disorders among individuals with type 2 diabetes and obesity?","authors":"","doi":"10.1016/j.jdiacomp.2024.108812","DOIUrl":"10.1016/j.jdiacomp.2024.108812","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141630159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of prior gestational diabetes on the risk of cardiovascular disease and death in women with type 2 diabetes: The Fremantle Diabetes Study Phase II","authors":"","doi":"10.1016/j.jdiacomp.2024.108811","DOIUrl":"10.1016/j.jdiacomp.2024.108811","url":null,"abstract":"<div><h3>Background</h3><p>To examine whether prior gestational diabetes mellitus (GDM) is associated with prevalent coronary heart disease (CHD), cerebrovascular disease (CeVD) and peripheral arterial disease (PAD), and all-cause mortality, in community-based women with type 2 diabetes.</p></div><div><h3>Methods</h3><p>Baseline prevalences of CHD/CeVD/PAD/prior GDM were determined in 718 females (mean ± SD age 65.5 ± 11.9 years) from the Fremantle Diabetes Study Phase II. Deaths between baseline (2008–2011) and end-2016 were ascertained. Cox regression identified predictors of mortality with GDM as a candidate variable.</p></div><div><h3>Results</h3><p>Compared to the 673 women without GDM, the 39 (5.4 %) with prior GDM were younger, more likely Aboriginal, smokers and obese, had longer diabetes duration and higher HbA_1c levels, and were more dyslipidemic (<em>P</em> ≤ 0.046). Prevalences of CHD (24.6 versus 23.1 %), CeVD (7.5 % versus 2.6 %) and PAD (27.5 % versus 23.7 %) were not significantly different in those without versus with prior GDM (<em>P</em> ≥ 0.35). There were 116 deaths (16.2 %) during 6.8 ± 1.6 years of follow-up. Age, Aboriginal ethnicity, marital status, current smoking, heart rate, estimated glomerular filtration rate, CHD and PAD were independently associated with all-cause mortality (<em>P</em> ≤ 0.023); GDM status did not add to the most parsimonious model (<em>P</em> = 0.62).</p></div><div><h3>Conclusions</h3><p>Prior GDM does not increase CVD risk or all-cause mortality in women with type 2 diabetes.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1056872724001375/pdfft?md5=c9dd159b8a51cfeb88b6dc4fbab8449c&pid=1-s2.0-S1056872724001375-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141639239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A phase 4 randomized active-controlled clinical study to compare the efficacy and safety of sustained-release pregabalin with immediate-release pregabalin in type 2 diabetic patients with peripheral neuropathic pain","authors":"","doi":"10.1016/j.jdiacomp.2024.108809","DOIUrl":"10.1016/j.jdiacomp.2024.108809","url":null,"abstract":"<div><h3>Aims</h3><p>The objective of this study was to demonstrate that sustained-release (SR) pregabalin is non-inferior to immediate-release (IR) pregabalin in attenuating diabetic peripheral neuropathic (DPN) pain along with patient satisfaction and compliance.</p></div><div><h3>Methods</h3><p>This was an 8-week, randomized, active-controlled, open-label, phase 4 study. Eligible subjects who had been on IR pregabalin for 4 weeks were randomized to 1:1 ratio to either continue with twice-daily IR pregabalin (75 mg), or to switch to once-daily SR pregabalin (150 mg). Primary efficacy endpoint was the change in visual analogue scale (VAS) scores after 8 weeks of treatment compared to baseline in both SR and IR pregabalin groups.</p></div><div><h3>Results</h3><p>Among 130 randomized subjects, 125 patients were included in full analysis set. For the change in VAS pain score, the least squares (LS) mean were −17.95 (SR pregabalin) and −18.74 (IR pregabalin) and the LS mean difference between both groups was 0.79, with the upper limit of the 95 % confidence interval [−5.99, 7.58] below the pre-specified non-inferiority margin of 9.2 mm.</p></div><div><h3>Conclusions</h3><p>This study demonstrates that the new once-daily SR pregabalin formulation is not different to the twice-daily IR pregabalin in alleviating DPN pain, indicating its potential as a promising treatment for DPN pain with a comparable safety profile.</p></div><div><h3>Trial registration</h3><p><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, <span><span>NCT05624853</span><svg><path></path></svg></span>.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141630156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in association of joint glycemic, blood pressure and lipid control and two-year risk of falls among older adults with diabetes","authors":"","doi":"10.1016/j.jdiacomp.2024.108815","DOIUrl":"10.1016/j.jdiacomp.2024.108815","url":null,"abstract":"<div><h3>Aims</h3><p>To characterize the risk of falls among males and females by joint glycemic, blood pressure (BP) and cholesterol control among older adults (≥65 years) with diagnosed diabetes in USA.</p></div><div><h3>Methods</h3><p>Using longitudinal data from the Health and Retirement Study (2006–2019), we studied the association of joint glycemic (HbA1c &lt; 7.5 %), BP (systolic &lt;140 and diastolic &lt;90 mmHg) and cholesterol (total &lt; 200 mg/dL) control with two-year risk of falls. We estimated risk ratios (RR) to describe the associations for joint ABC control and independent biomarker control by sex, using modified Poisson regressions after adjusting for known individual and household risk factors.</p></div><div><h3>Results</h3><p>The analytic sample consisted of 4509 observations from 2829 older adults (54.7 % female) with a mean age of 72.2 (SD: 6.6) years and duration of diabetes of 9.9 years. Joint ABC control was not associated with risk of falls among females but was associated with lower risk among males (0.91 [95%CI: 0.81–1.02]). Furthermore, achievement of glycemic control (0.85 [95%CI: 0.73–0.98]) and BP control (0.89 [95%CI: 0.79–1.01]) were associated with lower risk but cholesterol control (1.15 [95%CI: 0.99, 1.34]) was associated with higher risk of falls among males.</p></div><div><h3>Conclusions</h3><p>Joint achievement of glycemic, BP and cholesterol targets may prevent falls among older males. Future studies among people with diabetes should consider biomarker control as a preventive factor for falls.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141639238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dipeptidyl peptidase 4 inhibitors, sodium glucose cotransporter 2 inhibitors, and glucagon-like peptide 1 receptor agonists do not worsen diabetic macular edema","authors":"","doi":"10.1016/j.jdiacomp.2024.108808","DOIUrl":"10.1016/j.jdiacomp.2024.108808","url":null,"abstract":"<div><h3>Aims</h3><p>There are limited studies on dipeptidyl-peptidase 4 inhibitor (DPP-4i), sodium glucose cotransporter 2 inhibitor (SGLT2-i), and glucagon-like peptide 1 (GLP-1) receptor agonist use and occurrence of diabetic macular edema (DME). The objective of this study was to determine the association between DPP-4i, SGLT2-i, and GLP-1 receptor agonist use and occurrence of DME.</p></div><div><h3>Methods</h3><p>Proportional hazard models were used to evaluate the change in hazard of developing DME associated with DPP-4i, SGLT2-i, or GLP-1 receptor agonist use. Models accounted for age at DR diagnosis, DR severity (proliferative vs non-proliferative stage), time-weighted average of HbA1c level, sex, and self-reported race/ethnicity. A <em>p</em>-value ≤ 0.05 was considered statistically significant.</p></div><div><h3>Results</h3><p>The hazard ratio of developing DME after diagnosis of DR was 1.2 (CI = 0.75 to 1.99; <em>p</em> = 0.43) for DPP-4i use, 0.93 (CI = 0.54 to 1.61; <em>p</em> = 0.81) for GLP-1 receptor agonist use, 0.82 (CI = 0.20 to 3.34; <em>p</em> = 0.78) for SGLT2-i use, 1.1 (CI = 0.75 to 1.59; <em>p</em> = 0.66) for any one medication use, 1.1 (CI = 0.62 to 2.09; <em>p</em> = 0.68) and for any two or more medications use.</p></div><div><h3>Conclusions</h3><p>We did not find an association between DPP-4i, SGLT2-i, or GLP-1 receptor agonist use and increased hazard of development of DME among patients with DR.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141630157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of bariatric surgery on diabetes related foot complications among patients with type 2 diabetes: A systematic review","authors":"","doi":"10.1016/j.jdiacomp.2024.108813","DOIUrl":"10.1016/j.jdiacomp.2024.108813","url":null,"abstract":"<div><h3>Background</h3><p>Bariatric surgery leads to considerable weight loss and improved glycaemic control and seems to have a favourable impact on diabetes related foot complications (DFC).</p></div><div><h3>Objectives</h3><p>To assess the effect of bariatric surgery on diabetes related foot complications in patients with type 2 diabetes and determine whether DFC symptoms are improved after bariatric surgery.</p></div><div><h3>Methods</h3><p>We searched MEDLINE, Embase and Cochrane Central Register of Controlled Trials. The primary outcome was the presence of DFC after bariatric surgery. The secondary outcome was the improvement of DFC after bariatric surgery among patients who already had DFC before surgery.</p></div><div><h3>Results</h3><p>There were nine studies showing the presence of DFC post bariatric surgery and six detailing the changes in DFC post bariatric surgery. Bariatric surgery was not associated with a lower risk of developing or worsening DFC compared to conventional medical treatment based on 4 randomised control trials (IR 0.87, 95 % CI, 0.26, 2.98), while from observational studies was associated with 51 % lower risk of DFC (IR 0.49, 95 % CI, 0.31, 0.77). Bariatric surgery was associated with improvement in diabetic neuropathy assessment parameters including toe tuning fork score, self-reported neuropathy symptoms, neuropathy symptom score, and neuropathy symptom profile.</p></div><div><h3>Conclusion</h3><p>Bariatric surgery led to a greater reduction in developing or worsening DFC among patients with type 2 diabetes compared to medical treatment in observational studies, but not among RCTs. Bariatric surgery was associated with improvements in diabetic neuropathy related assessment parameters and symptoms. Bariatric surgery could be a promising treatment for patients with type 2 diabetes who are at high risk of DFC.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ameliorating effect of Chinese jujube polyphenol on blood glucose oxidative stress in type 2 diabetic rats","authors":"","doi":"10.1016/j.jdiacomp.2024.108804","DOIUrl":"10.1016/j.jdiacomp.2024.108804","url":null,"abstract":"<div><h3>Background</h3><p>Type 2 diabetes mellitus (T2DM) is a common metabolic disease characterized by insulin resistance and insufficient relative insulin secretion, leading to elevated blood sugar and the development of diabetic complications. T2DM not only seriously affects people's health and quality of life, but also brings a heavy burden to society and economy. At present, the treatment of T2DM mainly relies on drug therapy, but these drugs often have problems such as side effects, resistance and high cost, and can not fully meet the needs and expectations of patients. Therefore, it is of great significance and value to find safe and effective natural medicines or functional foods to assist the treatment and prevention of T2DM.</p></div><div><h3>Objective</h3><p>Chinese jujube are a common fruit that contain abundant polyphenolic compounds, which exhibit multiple physiological activities, such as antioxidation, anti-inflammation, and blood glucose lowering. The objective of this study was to explore the impact of red date polyphenols on glycemic control and oxidative stress status in patients with type 2 diabetes mellitus (T2DM).</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin A influences the incretin hormone profiles by activating the retinoic acid receptor β","authors":"Baowen Yu ,&nbsp;Jie Chen ,&nbsp;Yuming Wang ,&nbsp;Junming Zhou ,&nbsp;Huiying Wang ,&nbsp;Huiqin Li ,&nbsp;Tingting Cai ,&nbsp;Rong Huang ,&nbsp;Yunting Zhou ,&nbsp;Jianhua Ma","doi":"10.1016/j.jdiacomp.2024.108806","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108806","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to investigate the impact of Vitamin A (VA) on intestinal glucose metabolic phenotypes.</p></div><div><h3>Methods</h3><p>Male C57BL/6 mice were randomized assigned to a VA-normal diet (VAN) or a VA-deficient diet (VAD) for 12 weeks. After12 weeks, the VAD mice were given 30 IU/g/d retinol for 10 days and VAN diet (VADN) for 10 weeks. By using glucose tolerance tests, immunofluorescence staining, quantitative polymerase chain reaction, siRNA transduction, and enzyme-linked immunosorbent assay, the glucose metabolic phenotypes as well as secretory function and intracellular hormone changes of STC-1 were assessed.</p></div><div><h3>Results</h3><p>VAD mice showed a decrease of glucose-stimulated insulin secretion and a loss of intestinal glucagon-like peptide-1 (GLP-1) expression. Through reintroducing dietary VA to VAD mice, the intestinal VA levels, GLP-1 expression and normal glucose can be restored. The incubation with retinol increased VA signaling factors expression within STC-1 cells, especially retinoic acid receptor β (RARβ). The activation of RARβ restored intracellular incretin hormone synthesis and secretory function.</p></div><div><h3>Conclusions</h3><p>VA deficiency leads to an imbalance of intestinal glucose metabolic phenotypes through a mechanism involving RARβ signaling pathway, suggesting a new method to achieve the treatment for VAD induced glucose metabolism impairment.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin combined with N-acetylcysteine attenuates type 1 diabetes-induced splenic inflammatory injury in canines by inhibiting the MAPKs-NF-κB signaling pathway and pyroptosis","authors":"","doi":"10.1016/j.jdiacomp.2024.108805","DOIUrl":"10.1016/j.jdiacomp.2024.108805","url":null,"abstract":"<div><h3>Purpose</h3><p>Type 1 diabetes (T1DM) is a chronic metabolic disorder that can cause damage to multiple organs including the spleen. Sole insulin therapy is not satisfactory. This study aims to investigate the effects and mechanisms of combined treatment with insulin and <em>N</em>-acetylcysteine (NAC) on spleen damage in T1DM canines, in order to identify drugs that may better assist patients in the management of diabetes and its complications.</p></div><div><h3>Methods</h3><p>The canine model of T1DM was established by intravenous injection of alloxan (ALX) and streptozotocin (STZ). The therapeutic effects of insulin and NAC were evaluated by clinical manifestations, spleen protein and mRNA expression.</p></div><div><h3>Results</h3><p>The results indicate that the combined treatment of insulin and NAC can alleviate hyperglycemia and hematologic abnormalities, improve splenic histopathological changes, prevent fibrous tissue proliferation, and glycogen deposition. In addition, we observed that this combination treatment significantly suppressed the protein expression of p-P65/P65 (17.6 %, <em>P</em> &lt; 0.05), NLRP3 (46.8 %, <em>P</em> &lt; 0.05), and p-P38/P38 (37.1 %, <em>P</em> &lt; 0.05) induced by T1DM when compared to insulin treatment alone. Moreover, it also significantly decreased the mRNA expression of TLR4 (45.0 %, <em>P</em> &lt; 0.01), TNF-α (30.3 %, <em>P</em> &lt; 0.05), and NLRP3 (43.3 %, <em>P</em> &lt; 0.05).</p></div><div><h3>Conclusions</h3><p>This combination has the potential to mitigate splenic inflammatory injury in T1DM canines by suppressing the activation of MAPKs-NF-κB pathway and pyroptosis. These findings provide a reference for the treatment strategies of diabetes and its complications.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141694222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}