Seminars in arthritis and rheumatism最新文献

{"title":"VEXAS syndrome and cancer: Insights about a possible “Tip of the Iceberg”. Ambidirectional data from the international AIDA network registries","authors":"Francesco Gavioli ,&nbsp;Valeria Caggiano ,&nbsp;Jessica Sbalchiero ,&nbsp;Micol Frassi ,&nbsp;Francesca Crisafulli ,&nbsp;Ilaria Cavazzana ,&nbsp;Andrea Hinojosa-Azaola ,&nbsp;Eduardo Martín-Nares ,&nbsp;Guillermo Arturo Guaracha-Basañez ,&nbsp;Jiram Torres-Ruiz ,&nbsp;Ewa Wiesik-Szewczyk ,&nbsp;Paolo Sfriso ,&nbsp;Samuele Rizzo ,&nbsp;Marta Schermi ,&nbsp;Sara Bindoli ,&nbsp;José Hernández-Rodríguez ,&nbsp;Verónica Gómez-Caverzaschi ,&nbsp;Olga Araújo ,&nbsp;Annachiara Alemanno ,&nbsp;Henrique A Mayrink Giardini ,&nbsp;Antonio Vitale","doi":"10.1016/j.semarthrit.2026.152932","DOIUrl":"10.1016/j.semarthrit.2026.152932","url":null,"abstract":"<div><h3>Background</h3><div>VEXAS (Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic) syndrome is an acquired autoinflammatory disorder characterized by severe chronic inflammation and an increased occurrence of hematologic neoplasms. Although chronic inflammation is a well-established risk factor for cancer, the specific contribution of <em>UBA1</em> gene mutations to tumorigenesis remains unclear. Therefore, this study aimed to evaluate the overall cancer risk in patients with VEXAS syndrome, including both hematologic and non-hematologic neoplasms.</div></div><div><h3>Methods</h3><div>The relative risk (RR) of cancer was compared between VEXAS patients and a control cohort comprising individuals with Still’s disease, Behçet’s disease, and Schnitzler’s syndrome. Logistic regression analysis was performed to identify variables potentially associated with cancer development. Patient’s data were drawn from the International AutoInflammatory Disease Alliance (AIDA) Network registries for VEXAS syndrome, Still’s disease, Behçet’s disease, and Schnitzler’s syndrome.</div></div><div><h3>Results</h3><div>Ninety-six VEXAS patients and 2181 controls were enrolled. To minimize selection bias, only subjects aged &gt;60 years were included, yielding 90 and 174 individuals in the exposed and control groups, respectively. The overall RR for cancer in VEXAS patients was 1.93 (95 % Confidence Interval [C.I.] 1.03-3.60, <em>p</em> = 0.036). Logistic regression analysis identified associations between cancer development and relapsing polychondritis (RR = 2.67, 95 %C.I. 1.22-10.64, <em>p</em> = 0.01), the p.Met41Thr mutation (RR = 3.33, 95 %C.I. 1.29-17.33, <em>p</em> = 0.02), elevated serum erythrocyte sedimentation rate (RR = 1.02, 95 %C.I. 1.01-1.05 <em>p</em> = 0.01), and lactate dehydrogenase (RR = 1.02, 95 %C.I. 1.01-1.07 <em>p</em> = 0.04) levels outside of flares.</div></div><div><h3>Conclusions</h3><div>VEXAS patients exhibit a significantly increased risk of both hematologic and non-hematologic malignancies compared with controls, particularly among those with RP, p.Met41Thr mutation, and persistent systemic inflammation.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152932"},"PeriodicalIF":4.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hormone therapy in menopause increases rheumatoid arthritis risk: A systematic review and meta-analysis","authors":"Camila Guimarães ,&nbsp;Eduarda Balbinot ,&nbsp;Fernanda Marçal ,&nbsp;Sarah Dagostin Ferraz ,&nbsp;Maria Laura Rodrigues Uggioni ,&nbsp;Ana Cristina Lacerda Macedo ,&nbsp;Antonio Jose Grande ,&nbsp;Tamy Colonetti ,&nbsp;Maria Inês da Rosa","doi":"10.1016/j.semarthrit.2026.152935","DOIUrl":"10.1016/j.semarthrit.2026.152935","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the association between menopausal hormone therapy use and Rheumatoid Arthritis (RA) incidence among postmenopausal women.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted following PRISMA guidelines. MEDLINE, Embase, and the Cochrane Library were searched up to October 2025 for observational studies evaluating menopausal hormone therapy use and RA risk. Pooled risk ratios (RR) with 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup analyses explored current versus former use and therapy duration.</div></div><div><h3>Results</h3><div>Five studies comprising 22,291,843 person-years of follow-up were included. Overall, menopausal hormone therapy use was associated with a modestly increased RA risk (Rate Ratio 1.15, 95% CI 1.10–1.21, <em>p</em> &lt; 0.001; I² = 0%). Current users had higher risk (Rate Ratio 1.18, 95% CI 1.00–1.37, <em>p</em> = 0.04) compared with former users (Rate Ratio 1.11, 95% CI 0.94–1.32, <em>p = 0.20).</em> Long-term use (≥4 years) conferred greater risk (Rate Ratio 1.19, 95% CI 1.07–1.33, <em>p</em> = 0.002).</div></div><div><h3>Conclusions</h3><div>Current menopausal hormone therapy use is associated with a modestly higher incidence of rheumatoid arthritis. Although the absolute increase is small, the widespread use highlights the need for individualized risk–benefit assessment, especially in women with autoimmune susceptibility.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152935"},"PeriodicalIF":4.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients’ perspectives of living with Sjögren disease: A systematic review of qualitative studies from the OMERACT Sjögren disease working group","authors":"Adrian Y.S. Lee ,&nbsp;Hanna Zembrzuska ,&nbsp;Kyle B. Franke ,&nbsp;Rachael Gordon ,&nbsp;Elisabeth F. Franke ,&nbsp;Lindsay Kumble ,&nbsp;Brianna Boderman ,&nbsp;Cristina Pelkas ,&nbsp;Mary E. Hitchcock ,&nbsp;Divi Cornec ,&nbsp;Maureen Rischmueller ,&nbsp;Simon J. Bowman ,&nbsp;Raphaèle Seror ,&nbsp;Sara S. McCoy ,&nbsp;Dana DiRenzo","doi":"10.1016/j.semarthrit.2026.152929","DOIUrl":"10.1016/j.semarthrit.2026.152929","url":null,"abstract":"<div><h3>Objectives</h3><div>Sjögren disease (SjD) is a common systemic autoimmune disease and patients experience a wide range of symptoms with unique emotional, social and physical impacts. Understanding the individual experience of SjD is crucial to providing comprehensive and sensitive care in the clinics. Therefore, the aim of this systematic review was to analyze primary literature that examined the lived experiences of patients with SjD.</div></div><div><h3>Methods</h3><div>Primary literature qualitatively exploring the lived experiences of SjD patients through interviews and/or focus groups were identified. Papers were included if they were written in English, participants were ≥ 18 years old and they fulfilled a diagnosis of SjD as per the 2002 American-European Consensus or 2016 American College of Rheumatology/European Alliance of Associations for Rheumatology criteria. Thematic analyses were performed using the Thomas and Harden approach.</div></div><div><h3>Results</h3><div>Nine of 1990 screened manuscripts (0.5 %) fulfilled our selection criteria. These comprised a total of 162 participants (154, 95 % female) across 10 countries. Thematic analysis revealed several key themes: the burden of the physical symptoms (such as sicca), social isolation, negative impact on function, unpredictability of the disease, diverse coping strategies, and the challenges of navigating the healthcare system. Few studies addressed any bias in the recruitment of patients or analyses of data.</div></div><div><h3>Conclusion</h3><div>SjD patients encounter a large variety of individual experiences in their illness that have important repercussions on quality of life. Understanding these experiences will help create a harmonized set of patient-centered outcomes to inform the generation of Outcome Measurement in Rheumatology (OMERACT) target domains in SjD.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152929"},"PeriodicalIF":4.4,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of achieving clinical remission in ACPA-positive RA-patients treated with abatacept and methotrexate and methotrexate monotherapy: a post-hoc analysis of the AVERT and AVERT-II trials","authors":"S.A. Bergstra,&nbsp;M. Verstappen,&nbsp;E. Niemantsverdriet,&nbsp;T.W.J. Huizinga,&nbsp;A.H.M. van der Helm-van Mil","doi":"10.1016/j.semarthrit.2026.152917","DOIUrl":"10.1016/j.semarthrit.2026.152917","url":null,"abstract":"<div><h3>Objective</h3><div>To predict which early RA-patients achieve clinical remission on initial treatment with methotrexate monotherapy or with abatacept+methotrexate.</div></div><div><h3>Methods</h3><div>This study is a subanalysis of the AVERT and AVERT-2 randomized controlled trials, which were performed in ACPA-positive early RA-patients who received methotrexate monotherapy or abatacept + methotrexate. External model validation of patients on methotrexate monotherapy was performed in the observational Leiden Early Arthritis Clinic (EAC) cohort. Primary outcome was DAS28-CRP remission at 6 and 12 months follow-up. Prediction models were developed using logistic regression analysis. First, a model including clinical baseline variables only was estimated. Subsequently, it was assessed whether adding serological or imaging data, shared epitope or early DAS28 response improved model performance.</div></div><div><h3>Results</h3><div>In the methotrexate-monotherapy group (n=388), 27% and 39% of patients achieved DAS28-remission after 6 and 12-months. In the abatacept + methotrexate group (n=743) this was 43% and 53%. Baseline DAS28-CRP was predictive for clinical remission in all models. Optimism-adjusted model performance (AUROC) for DAS28-remission at 6 and 12-months was 0.66/0.65 in the methotrexate-group and 0.68/0.59 in the abatacept + methotrexate group. Adding baseline MRI-detected joint-inflammation, baseline serology or HLA-shared epitope alleles did not significantly improve model performance. Early DAS28-response did improve model performance. In the external validation cohort model performance was very similar.</div></div><div><h3>Conclusion</h3><div>Determining which patients achieve clinical remission upon methotrexate or abatacept+methotrexate treatment remains challenging. Disease activity at disease presentation and early DAS response were the only consistent predictors for achieving clinical remission. Genetic, imaging and serology parameters did not improve model performance.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152917"},"PeriodicalIF":4.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to: Self-administered screening questionnaires for spondyloarthritis in inflammatory bowel disease: Methodological and conceptual gaps","authors":"Xavier Romand ,&nbsp;Romain Schotkosky ,&nbsp;Tiphaine Dujardin ,&nbsp;Marianne Hupé ,&nbsp;Athan Baillet","doi":"10.1016/j.semarthrit.2026.152922","DOIUrl":"10.1016/j.semarthrit.2026.152922","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152922"},"PeriodicalIF":4.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-administered screening questionnaires for spondyloarthritis in inflammatory bowel disease: Methodological and conceptual gaps","authors":"Suling Li,&nbsp;Yun Zhang","doi":"10.1016/j.semarthrit.2026.152924","DOIUrl":"10.1016/j.semarthrit.2026.152924","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152924"},"PeriodicalIF":4.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: comment on: Miedany et al. response letter: Beyond the symptoms: personalizing giant cell arteritis care through multidimensional patient reported outcome measure. Volume 75, December 2025, 152844","authors":"JC Robson ,&nbsp;J Dawson ,&nbsp;SL Mackie ,&nbsp;M Ndosi","doi":"10.1016/j.semarthrit.2026.152919","DOIUrl":"10.1016/j.semarthrit.2026.152919","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152919"},"PeriodicalIF":4.4,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease activity and hyperuricemia predict the development of cardiovascular events in patients with Psoriatic Arthritis: results of the 10-year prospective evaluation in the CARMA cohort","authors":"Javier Llorca ,&nbsp;Iván Ferraz-Amaro ,&nbsp;María José Moreno-Martínez ,&nbsp;Zulema Plaza ,&nbsp;Fernando Sánchez-Alonso ,&nbsp;Manuel José Moreno-Ramos ,&nbsp;Carmen García-Gómez ,&nbsp;Santos Castañeda ,&nbsp;Carlos González-Juanatey ,&nbsp;Miguel Ángel González-Gay","doi":"10.1016/j.semarthrit.2026.152923","DOIUrl":"10.1016/j.semarthrit.2026.152923","url":null,"abstract":"<div><h3>Objective</h3><div>To identify predictors of cardiovascular (CV) events in psoriatic arthritis (PsA) patients from the CARdiovascular in RheuMAtology (CARMA) project during 10 years of prospective follow-up.</div></div><div><h3>Methods</h3><div>Between July 2010 and January 2012, 725 PsA patients were enrolled from 67 Spanish hospitals. Analyses focused on 682 patients without prior CV events at baseline. At 10-year follow-up, CV event occurrence, patient-years, and linearized event rates were evaluated. Cox regression analyses were performed, both crude and adjusted for the PREVENT-CVD score.</div></div><div><h3>Results</h3><div>Over 6397 patient-years, 85 patients (12.46%) experienced CV events, yielding a rate of 1.33 per 100 patient-years. Patients with CV events were older (67.1 ± 11.1 vs. 56.7 ± 11.8 years, <em>p</em> &lt; 0.001), more often male (68.2% vs. 51.9%, <em>p</em> = 0.005), and had higher frequencies of hypertension (60.0% vs. 21.8%, <em>p</em> &lt; 0.001), diabetes (18.8% vs. 6.0%, <em>p</em> = 0.001), and dyslipidemia (56.5% vs. 29.8%, <em>p</em> &lt; 0.001). They also showed greater abdominal perimeter and body mass index (<em>p</em> &lt; 0.05 for both). After adjusting for PREVENT-CVD, the highest tertile of DAS28-ESR remained a significant predictor of CV events (HR 1.79; 95%CI: 1.03–3.14; <em>p</em> = 0.04). Urate in the highest tertile was also independently associated in the crude model (HR 1.88; 95%CI: 1.11–3.20; <em>p</em> = 0.02). When stratified (&lt;6.5, 6.5–8.9, and ≥9.0 mg/dl), urate≥9.0 mg/dl was also associated with increased risk of CV events in the adjusted model (HR 3.50; 95%CI: 1.10–11.2; <em>p</em> = 0.02). While HAQ score in the third tertile was associated with increased CV risk in the crude analysis (HR 1.70; <em>p</em> = 0.04), this association did not persist after adjustment.</div></div><div><h3>Conclusions</h3><div>Disease activity and elevated urate levels independently predict CV events in PsA, highlighting their value as markers of CV risk beyond traditional factors captured by the PREVENT-CVD score.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152923"},"PeriodicalIF":4.4,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fronto-cerebellar features associate with cognitive dysfunction in childhood-onset systemic lupus erythematosus","authors":"Hanne Van der Heijden ,&nbsp;Gabrielle Alonzi ,&nbsp;Amanda Cao ,&nbsp;Raquel van Gool ,&nbsp;Merve Koç Yekedüz ,&nbsp;Lise Vrolix ,&nbsp;Itamar Ronen ,&nbsp;Vanessa Rameh ,&nbsp;Kyle McBrearty ,&nbsp;Aditi Deokar ,&nbsp;Robert P. Sundel ,&nbsp;Eyal Muscal ,&nbsp;Joseph Gonzalez-Heydrich ,&nbsp;Andrea Knight ,&nbsp;Joyce C. Chang ,&nbsp;Jaymin Upadhyay","doi":"10.1016/j.semarthrit.2026.152916","DOIUrl":"10.1016/j.semarthrit.2026.152916","url":null,"abstract":"<div><h3>Objective</h3><div>Cognitive dysfunction (CD) is a prevalent symptom in childhood-onset systemic lupus erythematosus (cSLE). This study aimed to investigate the neurobehavioral basis of CD in cSLE.</div></div><div><h3>Methods</h3><div>Patients with cSLE (N=20) and age- and sex-matched healthy controls (HCs, N=20) completed questionnaires and multiple neurocognitive tests. The Systemic Lupus Erythematosus Disease Activity Index 2000 and laboratory markers were used to monitor patients’ clinical status. Neuroimaging assessments included functional near-infrared spectroscopy (fNIRS), functional magnetic resonance imaging (fMRI), and structural MRI.</div></div><div><h3>Results</h3><div>cSLE patients demonstrated moderate disease activity with high inflammation and immune dysregulation, alongside low medication adherence. Relative to HCs, cSLE patients showed worse cognitive functioning, higher emotional distress and more physical symptoms. fNIRS revealed higher prefrontal cortex activity in cSLE vs. HCs during the color-word Stroop task, suggesting impaired cognitive flexibility. fMRI performed during the N-back working memory task revealed altered frontal cortex and cerebellum activity, while modulations in resting-state fronto-cerebellar connectivity in the cSLE cohort were observed. Patients with cSLE were characterized by reduced gray matter morphological properties in frontal cortex and cerebellar subdivisions (e.g., crus II) alongside altered white matter structural connectivity among these cognitive processing hubs. K-means clustering analysis delineated three subgroups within the cSLE cohort based on neuroimaging profiles, where subgroups varied based on cognitive and emotional health.</div></div><div><h3>Conclusion</h3><div>This study provides evidence of fronto-cerebellar abnormalities and their associations with CD in cSLE. This investigation underscores the need for multidisciplinary research efforts to further elucidate the neurobiological underpinnings of CD in cSLE.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152916"},"PeriodicalIF":4.4,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to letter to the editor","authors":"Yasser El Miedany","doi":"10.1016/j.semarthrit.2026.152918","DOIUrl":"10.1016/j.semarthrit.2026.152918","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"77 ","pages":"Article 152918"},"PeriodicalIF":4.4,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}