Pub Date : 2026-02-01Epub Date: 2026-01-16DOI: 10.1016/j.medcli.2025.107283
Laura Pérez Abad , Miguel Ángel Aibar Arregui , Jimena Aramburu Llorente , Juan Ramón y Cajal Calvo , Alejandro Andrés Gracia , Pablo Revilla Martí , Saida Atienza Ayala , Carmen Lahuerta Pueyo , Amelia Campos Sáenz de Santamaría , Eduardo Ramos Ibañez , Borja del Carmelo Gracia Tello
Background
Wild-type transthyretin amyloidosis (ATTRwt) is a serious condition. At early stages, symptoms resemble those of heart failure with preserved ejection fraction (HFpEF). Our aim was to perform software-supported nailfold videocapillaroscopy (NVC) analysis to identify hallmarks useful for diagnosis and build machine learning (ML)-based models to assess severity.
Methods
Thirty-two ATTRwt patients underwent NVC. Nineteen initiated TTR-stabilizing therapy and had a new NVC 12 months afterwards. Forty-one capillary-related variables were analyzed. Thirty NVCs were randomly chosen to train models to discriminate between poorer or less poor prognosis according to N-terminal pro-B-type natriuretic peptide (NT-proBNP) or Cheng score (cut-offs: 2000 pg/mL and 4 points, respectively). The remaining 21 NVCs were used for validation purposes. A control population of 99 patients with heart failure with preserved ejection fraction (HFpEF) but without signs of amyloidosis was included.
Results
A profound disorganization in the nailfold capillary architecture was generally observed. The models achieved accuracies of 0.81 and 0.90, respectively, in predicting disease severity. An additional model designed to distinguish a profile suggestive of amyloidosis (vs. HFpEF controls) achieved an accuracy of 0.73.
Conclusions
NVC-based ML models may contribute to early diagnosis and staging of ATTRwt.
{"title":"Unlocking the potential of nailfold videocapillaroscopy in diagnosing and staging wild-type transthyretin amyloidosis: A preliminary approach","authors":"Laura Pérez Abad , Miguel Ángel Aibar Arregui , Jimena Aramburu Llorente , Juan Ramón y Cajal Calvo , Alejandro Andrés Gracia , Pablo Revilla Martí , Saida Atienza Ayala , Carmen Lahuerta Pueyo , Amelia Campos Sáenz de Santamaría , Eduardo Ramos Ibañez , Borja del Carmelo Gracia Tello","doi":"10.1016/j.medcli.2025.107283","DOIUrl":"10.1016/j.medcli.2025.107283","url":null,"abstract":"<div><h3>Background</h3><div>Wild-type transthyretin amyloidosis (ATTRwt) is a serious condition. At early stages, symptoms resemble those of heart failure with preserved ejection fraction (HFpEF). Our aim was to perform software-supported nailfold videocapillaroscopy (NVC) analysis to identify hallmarks useful for diagnosis and build machine learning (ML)-based models to assess severity.</div></div><div><h3>Methods</h3><div>Thirty-two ATTRwt patients underwent NVC. Nineteen initiated TTR-stabilizing therapy and had a new NVC 12 months afterwards. Forty-one capillary-related variables were analyzed. Thirty NVCs were randomly chosen to train models to discriminate between poorer or less poor prognosis according to N-terminal pro-B-type natriuretic peptide (NT-proBNP) or Cheng score (cut-offs: 2000<!--> <!-->pg/mL and 4 points, respectively). The remaining 21 NVCs were used for validation purposes. A control population of 99 patients with heart failure with preserved ejection fraction (HFpEF) but without signs of amyloidosis was included.</div></div><div><h3>Results</h3><div>A profound disorganization in the nailfold capillary architecture was generally observed. The models achieved accuracies of 0.81 and 0.90, respectively, in predicting disease severity. An additional model designed to distinguish a profile suggestive of amyloidosis (vs. HFpEF controls) achieved an accuracy of 0.73.</div></div><div><h3>Conclusions</h3><div>NVC-based ML models may contribute to early diagnosis and staging of ATTRwt.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"166 2","pages":"Article 107283"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate the utility of lung ultrasound (LUS) and serum KL-6 levels as screening tools for interstitial lung disease (ILD) in seropositive rheumatoid arthritis (RA) patients, as well as their correlation with ILD extent on high-resolution computed tomography (HRCT).
Methods
A single-center exploratory study including 20 seropositive RA patients with recent HRCT scans (<2 years) was conducted. Clinical data and pulmonary function tests were recorded. Patients were classified as RA-ILD (n = 10) or RA-noILD (n = 10). LUS assessed 14 intercostal spaces for B-lines and pleural abnormalities. Serum KL-6 was measured by chemiluminescence immunoassay. HRCT was evaluated by an expert radiologist to quantify ILD extent.
Results
KL-6 levels were higher in RA-ILD patients (p = 0.028). More than 10 B-lines per LUS field were exclusively found in RA-ILD (p = 0.003), and 5–10 B-lines per field were suggestive of ILD (p = 0.002). Pleural thickening was more frequent in RA-ILD (p = 0.035). Anterior lung fields were more specifically involved in RA-ILD. B-lines number correlated with ILD extent on HRCT (p = 0.001).
Conclusions
KL-6 and LUS are useful non-invasive screening tools for ILD in seropositive RA patients. A simplified LUS focusing on anterior fields may offer a rapid, reproducible method. Larger prospective studies are needed to establish cut-off values and validate clinical use.
{"title":"The utility of lung ultrasound and KL-6 values for the screening of rheumatoid arthritis-associated interstitial lung disease: An exploratory study","authors":"Ivette Casafont-Solé , Irene Peralta-Garcia , Carmen Centeno , María Martínez-Bujidos , Paloma Millán-Billi , Susana Holgado , Pau Alcubilla , Ignasi Guasch , Karina Portillo","doi":"10.1016/j.medcli.2025.107340","DOIUrl":"10.1016/j.medcli.2025.107340","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the utility of lung ultrasound (LUS) and serum KL-6 levels as screening tools for interstitial lung disease (ILD) in seropositive rheumatoid arthritis (RA) patients, as well as their correlation with ILD extent on high-resolution computed tomography (HRCT).</div></div><div><h3>Methods</h3><div>A single-center exploratory study including 20 seropositive RA patients with recent HRCT scans (<2 years) was conducted. Clinical data and pulmonary function tests were recorded. Patients were classified as RA-ILD (<em>n</em> <!-->=<!--> <!-->10) or RA-noILD (<em>n</em> <!-->=<!--> <!-->10). LUS assessed 14 intercostal spaces for B-lines and pleural abnormalities. Serum KL-6 was measured by chemiluminescence immunoassay. HRCT was evaluated by an expert radiologist to quantify ILD extent.</div></div><div><h3>Results</h3><div>KL-6 levels were higher in RA-ILD patients (<em>p</em> <!-->=<!--> <!-->0.028). More than 10 B-lines per LUS field were exclusively found in RA-ILD (<em>p</em> <!-->=<!--> <!-->0.003), and 5–10 B-lines per field were suggestive of ILD (<em>p</em> <!-->=<!--> <!-->0.002). Pleural thickening was more frequent in RA-ILD (<em>p</em> <!-->=<!--> <!-->0.035). Anterior lung fields were more specifically involved in RA-ILD. B-lines number correlated with ILD extent on HRCT (<em>p</em> <!-->=<!--> <!-->0.001).</div></div><div><h3>Conclusions</h3><div>KL-6 and LUS are useful non-invasive screening tools for ILD in seropositive RA patients. A simplified LUS focusing on anterior fields may offer a rapid, reproducible method. Larger prospective studies are needed to establish cut-off values and validate clinical use.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"166 2","pages":"Article 107340"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-14DOI: 10.1016/j.medcli.2025.107285
Marina Salido Olivares
{"title":"Agonistas de la trombopoyetina en monoterapia o asociados a fostamatinib en trombocitopenias graves o refractarias a inmunodepresores en pacientes con lupus eritematoso sistémico","authors":"Marina Salido Olivares","doi":"10.1016/j.medcli.2025.107285","DOIUrl":"10.1016/j.medcli.2025.107285","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"166 2","pages":"Article 107285"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-19DOI: 10.1016/j.medcli.2025.107254
Laura Moñino-Dominguez, Alicia Aguado-Paredes, Jaime Cordero-Ramos, Maria José Tirado-Pérez, Alejandro Martínez-Escudero, Federico Argüelles-Arias, Vicente Merino-Bohórquez
Introduction
The predictive value of therapeutic drug monitoring (TDM) of vedolizumab in Crohn's disease (CD) during the maintenance phase remains uncertain. This study assessed its association with clinical and biochemical remission in routine clinical practice and explored variables influencing trough concentration variability.
Methods
A retrospective observational study was conducted at a tertiary hospital between July 2022 and December 2024. Adult CD patients receiving vedolizumab during maintenance and undergoing routine TDM were included. Clinical variables (age, treatment duration, administration route, perianal disease), laboratory markers (albumin, C-reactive protein [CRP], fecal calprotectin [FCP]), and pharmacokinetic data were collected. Trough concentrations were measured using ELISA. Clinical remission was defined as a Harvey-Bradshaw Index < 5 and biochemical remission as FCP < 250 μg/g, both evaluated six months after the trough level. Non-parametric tests, multiple linear regression, ROC analysis, and multiple imputation were used for statistical analysis.
Results
Seventy patients were included. Clinical remission was observed in 76.8%. Median trough levels were higher in patients in clinical remission (17.5 μg/mL [IQR: 12.5–26.2]) than in those without remission (13.4 μg/mL [IQR: 8.8–23.5]; p = 0.07). A total of 65.2% reached ≥14 μg/mL; however, remission rates did not differ significantly between groups with high or low exposure, for either clinical (84.4% vs. 62.5%; p = 0.07) or biochemical remission (73.1% vs. 69.2%; p = 1). ROC analysis identified an optimal threshold of 11.3 μg/mL (AUC = 0.647). Subcutaneous administration was associated with higher concentrations (p = 0.0057), as were higher albumin levels (p = 0.012). Significant correlations were found between vedolizumab levels and CRP (positive, p = 0.0025) and FCP (inverse, p = 0.0186). No anti-drug antibodies were detected.
Conclusions
Vedolizumab trough levels were not significantly associated with clinical or biochemical remission during maintenance. These findings suggest that the isolated use of TDM may have limited predictive value. However, factors such as administration route, albumin, and inflammation levels influence exposure and should be integrated into the interpretation of drug concentrations in clinical practice.
vedolizumab治疗性药物监测（TDM）在克罗恩病（CD）维持期的预测价值仍不确定。本研究在常规临床实践中评估其与临床和生化缓解的关系，并探讨影响谷浓度变异性的变量。方法：于2022年7月至2024年12月在某三级医院进行回顾性观察研究。在维持期间接受维多单抗治疗并接受常规TDM的成年CD患者被纳入研究。收集临床变量（年龄、治疗时间、给药途径、肛周疾病）、实验室标志物（白蛋白、c反应蛋白（CRP）、粪钙保护蛋白（FCP））和药代动力学数据。采用ELISA法测定谷浓度。临床缓解定义为哈维-布拉德肖指数。结果：纳入70例患者。76.8%的患者临床缓解。临床缓解组中位谷水平（17.5μg/mL [IQR: 12.5-26.2]）高于无缓解组（13.4μg/mL [IQR: 8.8-23.5]; p=0.07）。65.2%≥14μg/mL；然而，无论是临床缓解（84.4% vs. 62.5%, p=0.07）还是生化缓解（73.1% vs. 69.2%, p=1），高暴露组和低暴露组之间的缓解率均无显著差异。ROC分析确定最佳阈值为11.3μg/mL （AUC=0.647）。皮下给药与较高的白蛋白浓度相关（p=0.0057），白蛋白水平也较高（p=0.012）。vedolizumab水平与CRP（阳性，p=0.0025）和FCP（阴性，p=0.0186）之间存在显著相关性。未检出抗药物抗体。结论：Vedolizumab谷水平与维持期间的临床或生化缓解无显著相关性。这些发现表明单独使用TDM可能具有有限的预测价值。然而，诸如给药途径、白蛋白和炎症水平等因素影响暴露，应纳入临床实践中对药物浓度的解释。
{"title":"Utilidad de la monitorización terapéutica de vedolizumab en el control de la respuesta en enfermedad de Crohn","authors":"Laura Moñino-Dominguez, Alicia Aguado-Paredes, Jaime Cordero-Ramos, Maria José Tirado-Pérez, Alejandro Martínez-Escudero, Federico Argüelles-Arias, Vicente Merino-Bohórquez","doi":"10.1016/j.medcli.2025.107254","DOIUrl":"10.1016/j.medcli.2025.107254","url":null,"abstract":"<div><h3>Introduction</h3><div>The predictive value of therapeutic drug monitoring (TDM) of vedolizumab in Crohn's disease (CD) during the maintenance phase remains uncertain. This study assessed its association with clinical and biochemical remission in routine clinical practice and explored variables influencing trough concentration variability.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted at a tertiary hospital between July 2022 and December 2024. Adult CD patients receiving vedolizumab during maintenance and undergoing routine TDM were included. Clinical variables (age, treatment duration, administration route, perianal disease), laboratory markers (albumin, C-reactive protein [CRP], fecal calprotectin [FCP]), and pharmacokinetic data were collected. Trough concentrations were measured using ELISA. Clinical remission was defined as a Harvey-Bradshaw Index <<!--> <!-->5 and biochemical remission as FCP <<!--> <!-->250<!--> <!-->μg/g, both evaluated six months after the trough level. Non-parametric tests, multiple linear regression, ROC analysis, and multiple imputation were used for statistical analysis.</div></div><div><h3>Results</h3><div>Seventy patients were included. Clinical remission was observed in 76.8%. Median trough levels were higher in patients in clinical remission (17.5<!--> <!-->μg/mL [IQR: 12.5–26.2]) than in those without remission (13.4<!--> <!-->μg/mL [IQR: 8.8–23.5]; p<!--> <!-->=<!--> <!-->0.07). A total of 65.2% reached ≥14<!--> <!-->μg/mL; however, remission rates did not differ significantly between groups with high or low exposure, for either clinical (84.4% vs. 62.5%; p<!--> <!-->=<!--> <!-->0.07) or biochemical remission (73.1% vs. 69.2%; p<!--> <!-->=<!--> <!-->1). ROC analysis identified an optimal threshold of 11.3<!--> <!-->μg/mL (AUC<!--> <!-->=<!--> <!-->0.647). Subcutaneous administration was associated with higher concentrations (p<!--> <!-->=<!--> <!-->0.0057), as were higher albumin levels (p<!--> <!-->=<!--> <!-->0.012). Significant correlations were found between vedolizumab levels and CRP (positive, p<!--> <!-->=<!--> <!-->0.0025) and FCP (inverse, p<!--> <!-->=<!--> <!-->0.0186). No anti-drug antibodies were detected.</div></div><div><h3>Conclusions</h3><div>Vedolizumab trough levels were not significantly associated with clinical or biochemical remission during maintenance. These findings suggest that the isolated use of TDM may have limited predictive value. However, factors such as administration route, albumin, and inflammation levels influence exposure and should be integrated into the interpretation of drug concentrations in clinical practice.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"166 2","pages":"Article 107254"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146011263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Asociación entre la obstrucción al flujo aéreo y la mortalidad en una cohorte de pacientes con insuficiencia cardíaca","authors":"Nerea Alonso Suárez , Aida Muñoz Ferrer , Evelyn Santiago-Vacas , Ignasi Garcia-Olivé","doi":"10.1016/j.medcli.2025.107337","DOIUrl":"10.1016/j.medcli.2025.107337","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"166 2","pages":"Article 107337"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-13DOI: 10.1016/j.medcli.2025.107301
Emilia Fernández Fernández , Marta Costas Vila , Francisco Javier De la Hera Fernández
{"title":"Eficacia de anifrolumab en una hemorragia alveolar difusa recidivante asociada a un lupus eritematoso sistémico","authors":"Emilia Fernández Fernández , Marta Costas Vila , Francisco Javier De la Hera Fernández","doi":"10.1016/j.medcli.2025.107301","DOIUrl":"10.1016/j.medcli.2025.107301","url":null,"abstract":"","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"166 2","pages":"Article 107301"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-13DOI: 10.1016/j.medcli.2025.107316
Esteban Pérez Pisón , Pau Llàcer , François Croset , Jorge Campos , Marina García Melero , Carlos Pérez , Alberto Pérez Nieva , Marina Vergara , Paul Cevallos , Cristina Fernández , Martín Fabregate , Luis Manzano
Introduction
Pleural effusion (PE) is a frequent complication in acute heart failure (AHF), driven by hydrostatic pressure, impaired lymphatic drainage, and systemic inflammation. This study aimed to evaluate the association between carbohydrate antigen 125 (CA125) and the presence of PE, stratified by atrial fibrillation (AF).
Material and methods
This retrospective observational study analyzed 506 patients hospitalized with AHF at Ramón y Cajal University Hospital. The presence of PE was assessed through bedside thoracic ultrasound or chest radiography. A multivariable logistic regression model was employed to identify independent predictors of PE. Interaction analyses were conducted to examine the combined effect of CA125 levels and AF on the likelihood of PE.
Results
The mean (SD) age was 85.1 years (7.8) and 66.0% were women. PE was identified in 43.7% of patients at admission, AF were present in 299 (59.1%) and median values CA125 were 58.8 U/mL (43.0–89.0). After multivariable adjustment, an interaction between CA125 and AF emerged as a significant predictor of PE (p for the interaction = 0.022). Each 10U/ml increase in CA125 was associated with an OR of 1.03, 95% CI: 1.01–1.06 for every 10 U/ml increase in CA125 levels.
Conclusions
In patients with acute heart failure, the predictive value of CA125 for pleural effusion is influenced by atrial fibrillation. Elevated CA125 levels were associated with PE only in the presence of AF. Conversely, in the absence of AF, high CA125 levels did not predict PE.
{"title":"Valor del antígeno carbohidrato 125 en el derrame pleural en insuficiencia cardiaca aguda y su relación con la fibrilación auricular","authors":"Esteban Pérez Pisón , Pau Llàcer , François Croset , Jorge Campos , Marina García Melero , Carlos Pérez , Alberto Pérez Nieva , Marina Vergara , Paul Cevallos , Cristina Fernández , Martín Fabregate , Luis Manzano","doi":"10.1016/j.medcli.2025.107316","DOIUrl":"10.1016/j.medcli.2025.107316","url":null,"abstract":"<div><h3>Introduction</h3><div>Pleural effusion (PE) is a frequent complication in acute heart failure (AHF), driven by hydrostatic pressure, impaired lymphatic drainage, and systemic inflammation. This study aimed to evaluate the association between carbohydrate antigen 125 (CA125) and the presence of PE, stratified by atrial fibrillation (AF).</div></div><div><h3>Material and methods</h3><div>This retrospective observational study analyzed 506 patients hospitalized with AHF at Ramón y Cajal University Hospital. The presence of PE was assessed through bedside thoracic ultrasound or chest radiography. A multivariable logistic regression model was employed to identify independent predictors of PE. Interaction analyses were conducted to examine the combined effect of CA125 levels and AF on the likelihood of PE.</div></div><div><h3>Results</h3><div>The mean (SD) age was 85.1 years (7.8) and 66.0% were women. PE was identified in 43.7% of patients at admission, AF were present in 299 (59.1%) and median values CA125 were 58.8 U/mL (43.0–89.0). After multivariable adjustment, an interaction between CA125 and AF emerged as a significant predictor of PE (p for the interaction<!--> <!-->=<!--> <!-->0.022). Each 10U/ml increase in CA125 was associated with an OR of 1.03, 95% CI: 1.01–1.06 for every 10 U/ml increase in CA125 levels.</div></div><div><h3>Conclusions</h3><div>In patients with acute heart failure, the predictive value of CA125 for pleural effusion is influenced by atrial fibrillation. Elevated CA125 levels were associated with PE only in the presence of AF. Conversely, in the absence of AF, high CA125 levels did not predict PE.</div></div>","PeriodicalId":18578,"journal":{"name":"Medicina Clinica","volume":"166 2","pages":"Article 107316"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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