Pub Date : 2025-01-14DOI: 10.3760/cma.j.cn112137-20241113-02544
A Q Xu, L Z Feng
The prevalence and evolution of respiratory pathogens are changing, and issues related to drug-resistance are becoming increasingly prominent in the post-COVID era. The urgency of controlling respiratory pathogens has intensified. This issue organizes expert discussions to address the resurgence of various respiratory pathogens, summarizing current status of pathogen surveillance, drug-resistance research and vaccine development, while suggesting countermeasures. It emphasizes the need to integrate of medical and preventive measures, conduct multi-pathogen surveillance and management, enhance the response capacity of respiratory infectious diseases, optimize vaccine policy and immunization services, improve the level of diagnosis and treatment, and strengthen protection for vulnerable populations, so as to reduce the burden of respiratory infectious diseases.
{"title":"[Optimize surveillance, prevention and control, vaccine strategies to respond to seasonal epidemics of respiratory infectious diseases].","authors":"A Q Xu, L Z Feng","doi":"10.3760/cma.j.cn112137-20241113-02544","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20241113-02544","url":null,"abstract":"<p><p>The prevalence and evolution of respiratory pathogens are changing, and issues related to drug-resistance are becoming increasingly prominent in the post-COVID era. The urgency of controlling respiratory pathogens has intensified. This issue organizes expert discussions to address the resurgence of various respiratory pathogens, summarizing current status of pathogen surveillance, drug-resistance research and vaccine development, while suggesting countermeasures. It emphasizes the need to integrate of medical and preventive measures, conduct multi-pathogen surveillance and management, enhance the response capacity of respiratory infectious diseases, optimize vaccine policy and immunization services, improve the level of diagnosis and treatment, and strengthen protection for vulnerable populations, so as to reduce the burden of respiratory infectious diseases.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 2","pages":"101-104"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-14DOI: 10.3760/cma.j.cn112137-20240908-02067
Y Q Xie, J C Hu, B Shen, W H Jiang, L Wang, J W Yu, X L Xu, Y Q Shi, W L Lyu, X Li, J R Xu, X Q Ding
<p><p><b>Objective:</b> To investigate anticoagulation effects of nafamostat mesylate(NM) in sustained low-efficiency dialysis (SLED) and its relevant factors. <b>Methods:</b> Critically ill patients with kidney disease who were admitted to Zhongshan Hospital Affiliated to Fudan University and underwent SLED treatment from May to August 2024 were retrospectively included. Baseline clinical data were collected, and the activated partial thromboplastin time (APTT) and activated clotting time (ACT) were measured at the arterial end, before the filter, and at the venous end two hours post-NM anticoagulation treatment. Patients were categorized into two groups: the anticoagulation achievement group and the anticoagulation non-achievement group, based on the observed clotting status of the filter and venous reservoir following treatment completion. Multivariate logistic regression analysis was employed to identify risk factors influencing the efficacy of NM anticoagulation. Additionally, the receiver operating characteristic (ROC) curve was utilized to ascertain optimal monitoring indicators for NM anticoagulation. <b>Results:</b> A total of 96 patients (64 males and 32 females) aged (60±18) years undergoing SLED were included in the study, with 75 patients in the anticoagulation achievement group and 21 patients in the anticoagulation non-achievement group. No statistically significant differences were observed in baseline characteristics such as age, gender, body weight, baseline liver and kidney function, and platelet count between the two groups (all <i>P</i>>0.05). The proportion of patients with a baseline hematocrit (HCT)>30% was higher in the anticoagulation non-achievement group than that in the achievement group [57.1% (12/21) vs 22.7% (17/75), <i>P</i>=0.009]. The proportion of patients with fibrinogen (Fib)>4 g/L was also higher in the anticoagulation non-achievement group [90.5% (19/21) vs 49.3% (37/75), <i>P</i><0.001]. The ultrafiltration rate in the anticoagulation achievement group was lower than that in the non-achievement group [232 (182, 353) ml/h vs 478 (289, 691) ml/h, <i>P</i><0.001], and the NM dose was higher in the achievement group [35 (30, 40) mg/h vs 30 (25, 35) mg/h, <i>P</i><0.001]. Multivariate logistic regression analysis revealed that high ultrafiltration rate (<i>OR</i>=1.489, 95%<i>CI</i>: 1.007-2.145, <i>P</i><0.001), HCT>30% (<i>OR</i>=6.907, 95%<i>CI</i>: 1.523-18.342, <i>P</i>=0.009), and low albumin level (<i>OR</i>=0.821, 95%<i>CI</i>: 0.709-0.951, <i>P</i>=0.002) were relevant factors for poor NM efficacy. After 2 hours of NM treatment, the ratio of ACT at the venous/baseline ACT and the ratio of APTT at the venous/baseline APTT in the anticoagulation achievement group were both higher than those in the non-achievement group (both <i>P</i><0.05). There was a positive correlation between APTT and ACT measured at the venous end 2 hours after NM treatment (<i>r</i>=0.763, <i>P</i><0.001). The ROC curve analysis r
{"title":"[Anticoagulation effects of nafamostat mesylate in sustained low-efficiency dialysis and its relevant factors].","authors":"Y Q Xie, J C Hu, B Shen, W H Jiang, L Wang, J W Yu, X L Xu, Y Q Shi, W L Lyu, X Li, J R Xu, X Q Ding","doi":"10.3760/cma.j.cn112137-20240908-02067","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240908-02067","url":null,"abstract":"<p><p><b>Objective:</b> To investigate anticoagulation effects of nafamostat mesylate(NM) in sustained low-efficiency dialysis (SLED) and its relevant factors. <b>Methods:</b> Critically ill patients with kidney disease who were admitted to Zhongshan Hospital Affiliated to Fudan University and underwent SLED treatment from May to August 2024 were retrospectively included. Baseline clinical data were collected, and the activated partial thromboplastin time (APTT) and activated clotting time (ACT) were measured at the arterial end, before the filter, and at the venous end two hours post-NM anticoagulation treatment. Patients were categorized into two groups: the anticoagulation achievement group and the anticoagulation non-achievement group, based on the observed clotting status of the filter and venous reservoir following treatment completion. Multivariate logistic regression analysis was employed to identify risk factors influencing the efficacy of NM anticoagulation. Additionally, the receiver operating characteristic (ROC) curve was utilized to ascertain optimal monitoring indicators for NM anticoagulation. <b>Results:</b> A total of 96 patients (64 males and 32 females) aged (60±18) years undergoing SLED were included in the study, with 75 patients in the anticoagulation achievement group and 21 patients in the anticoagulation non-achievement group. No statistically significant differences were observed in baseline characteristics such as age, gender, body weight, baseline liver and kidney function, and platelet count between the two groups (all <i>P</i>>0.05). The proportion of patients with a baseline hematocrit (HCT)>30% was higher in the anticoagulation non-achievement group than that in the achievement group [57.1% (12/21) vs 22.7% (17/75), <i>P</i>=0.009]. The proportion of patients with fibrinogen (Fib)>4 g/L was also higher in the anticoagulation non-achievement group [90.5% (19/21) vs 49.3% (37/75), <i>P</i><0.001]. The ultrafiltration rate in the anticoagulation achievement group was lower than that in the non-achievement group [232 (182, 353) ml/h vs 478 (289, 691) ml/h, <i>P</i><0.001], and the NM dose was higher in the achievement group [35 (30, 40) mg/h vs 30 (25, 35) mg/h, <i>P</i><0.001]. Multivariate logistic regression analysis revealed that high ultrafiltration rate (<i>OR</i>=1.489, 95%<i>CI</i>: 1.007-2.145, <i>P</i><0.001), HCT>30% (<i>OR</i>=6.907, 95%<i>CI</i>: 1.523-18.342, <i>P</i>=0.009), and low albumin level (<i>OR</i>=0.821, 95%<i>CI</i>: 0.709-0.951, <i>P</i>=0.002) were relevant factors for poor NM efficacy. After 2 hours of NM treatment, the ratio of ACT at the venous/baseline ACT and the ratio of APTT at the venous/baseline APTT in the anticoagulation achievement group were both higher than those in the non-achievement group (both <i>P</i><0.05). There was a positive correlation between APTT and ACT measured at the venous end 2 hours after NM treatment (<i>r</i>=0.763, <i>P</i><0.001). The ROC curve analysis r","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 2","pages":"163-170"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-14DOI: 10.3760/cma.j.cn112137-20240530-01229
Y Y Ma, M S Xu, G L Xu, Z Q Gong, J W Huang, Y Chen, D P Hu, Y Y Wang, J P Liang, W Q Zhao, L Y Liu, S X Cai, H J Zhao
<p><p><b>Objective:</b> To investigate the characteristics of type 2 inflammation in patients with nocturnal asthma, and analyze the improvement of asthma symptoms after the use of inhaled corticosteroids (ICS) combined with different long-acting bronchodilators. <b>Methods:</b> Data of 231 asthma patients who first visited the Respiratory and Critical Care Medical Clinic of Nanfang Hospital of Southern Medical University from January 2020 to June 2023 and had positive bronchodilator tests (BDT), were retrospectively analyzed. These patients were divided into nocturnal asthma group and non-nocturnal asthma group based on the presence or absence of nocturnal symptoms. According to fractional exhaled nitric oxide (FeNO) levels, patients were divided into type 2 inflammatory group [FeNO≥20 ppb (×10<sup>-12</sup>)] and non-type 2 inflammatory group (FeNO<20 ppb). Patients were further divided into ICS+long-actingβ2 agonist (LABA) group and ICS+LABA+long-acting anticholinergic agent (LAMA) group based on medication regimens. Patients were followed-up at the 3rd, 6th, and 12th months after enrollment to evaluate the patient's asthma control test (ACT) questionnaire, actual medication status and number of acute attacks. The clinical characteristics, treatment and prognosis of different groups were compared. <b>Results:</b> A total of 231 asthma patients were included, including 152 males and 79 females, with a age[<i>M</i> (<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>)] of 52 (42, 60) years. There were 144 cases (62.3%) in the nocturnal asthma group and 87 cases (37.7%) in the non-nocturnal asthma group. Among the 144 patients with nocturnal asthma, 133 patients completed FeNO testing, of which 95 were classified into the type 2 inflammation group and 38 to the non-type 2 inflammation group. The eosinophil (EOS) count and FeNO level in the nocturnal asthma group were both higher than those in the non-nocturnal asthma group [(0.45±0.40) ×10<sup>9</sup>/L vs (0.25±0.20)×10<sup>9</sup>/L, 38 (18, 82) vs 29 (15, 48) ppb, both <i>P</i><0.05]. Baseline ACT score was lower in nocturnal asthma group than in non-nocturnal asthma group [16 (14, 18) vs 21 (19, 23) scores, <i>P</i><0.001]. There was no significant difference in the forced expiratory volume in one second (FEV<sub>1</sub>), forced vital capacity (FVC), and peak expiratory flow (PEF) in the two groups (both <i>P</i>>0.05). During the follow-up at the 3rd, 6th, and 12th months, the improvement values of ACT scores (ΔACT) in the nocturnal asthma group were higher than the non-nocturnal asthma group [5 (3, 7) vs 2 (1, 3), 7 (4, 9) vs 3 (1, 4) and 7 (6, 9) vs 3 (1, 5) scores, all <i>P</i><0.05]. The EOS count [0.40 (0.29, 0.80)×10<sup>9</sup>/L vs 0.20 (0.12, 0.29)×10<sup>9</sup>/L] and percentage [5.10% (3.55%, 9.10%) vs 2.20% (1.65%, 3.85%)] of the type 2 inflammation group were both higher than the non-type 2 inflammation group (both <i>P</i><0.05). In the nocturnal asthma group, there was no significant
目的研究夜间哮喘患者的 2 型炎症特征，并分析吸入性皮质类固醇（ICS）与不同长效支气管扩张剂联合使用后哮喘症状的改善情况。研究方法回顾性分析2020年1月至2023年6月期间首次到南方医科大学南方医院呼吸与危重症医学门诊就诊、支气管扩张剂试验（BDT）阳性的231名哮喘患者的数据。这些患者根据有无夜间症状被分为夜间哮喘组和非夜间哮喘组。根据分数呼出一氧化氮（FeNO）水平，将患者分为 2 型炎症组[FeNO≥20 ppb (×10-12)]和非 2 型炎症组（FeNOResults：共纳入 231 例哮喘患者，其中男性 152 例，女性 79 例，年龄[M（Q1，Q3）]为 52（42，60）岁。夜间哮喘组有 144 例（62.3%），非夜间哮喘组有 87 例（37.7%）。在 144 名夜间哮喘患者中，133 人完成了 FeNO 测试，其中 95 人被归入 2 型炎症组，38 人被归入非 2 型炎症组。夜间哮喘组的嗜酸性粒细胞（EOS）计数和 FeNO 水平均高于非夜间哮喘组[(0.45±0.40) ×109/L vs (0.25±0.20)×109/L, 38 (18, 82) vs 29 (15, 48) ppb, 均为 PP1]，两组患者的用力肺活量（FVC）和呼气峰流速（PEF）均高于非夜间哮喘组（均为 P>0.05）。在第 3 个月、第 6 个月和第 12 个月的随访中，夜间哮喘组的 ACT 评分（ΔACT）改善值高于非夜间哮喘组 [5 (3, 7) vs 2 (1, 3), 7 (4, 9) vs 3 (1, 4) and 7 (6, 9) vs 3 (1, 5) scores, all P9/L vs 0.20（0.12，0.29）×109/L]和百分比[5.10%（3.55%，9.10%） vs 2.20%（1.65%，3.85%）]2型炎症组均高于非2型炎症组（PP均>0.05）。结论夜间哮喘患者的 2 型炎症更为明显，症状往往得不到很好的控制，甚至更加严重。使用 ICS 联合治疗一年后，可观察到哮喘症状明显改善。但在夜间哮喘组中，不同药物治疗方案对症状的改善没有明显差异。
{"title":"[Characteristics of type 2 inflammation in nocturnal asthma and evaluation of the effectiveness of inhaled corticosteroids combination therapy].","authors":"Y Y Ma, M S Xu, G L Xu, Z Q Gong, J W Huang, Y Chen, D P Hu, Y Y Wang, J P Liang, W Q Zhao, L Y Liu, S X Cai, H J Zhao","doi":"10.3760/cma.j.cn112137-20240530-01229","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240530-01229","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the characteristics of type 2 inflammation in patients with nocturnal asthma, and analyze the improvement of asthma symptoms after the use of inhaled corticosteroids (ICS) combined with different long-acting bronchodilators. <b>Methods:</b> Data of 231 asthma patients who first visited the Respiratory and Critical Care Medical Clinic of Nanfang Hospital of Southern Medical University from January 2020 to June 2023 and had positive bronchodilator tests (BDT), were retrospectively analyzed. These patients were divided into nocturnal asthma group and non-nocturnal asthma group based on the presence or absence of nocturnal symptoms. According to fractional exhaled nitric oxide (FeNO) levels, patients were divided into type 2 inflammatory group [FeNO≥20 ppb (×10<sup>-12</sup>)] and non-type 2 inflammatory group (FeNO<20 ppb). Patients were further divided into ICS+long-actingβ2 agonist (LABA) group and ICS+LABA+long-acting anticholinergic agent (LAMA) group based on medication regimens. Patients were followed-up at the 3rd, 6th, and 12th months after enrollment to evaluate the patient's asthma control test (ACT) questionnaire, actual medication status and number of acute attacks. The clinical characteristics, treatment and prognosis of different groups were compared. <b>Results:</b> A total of 231 asthma patients were included, including 152 males and 79 females, with a age[<i>M</i> (<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>)] of 52 (42, 60) years. There were 144 cases (62.3%) in the nocturnal asthma group and 87 cases (37.7%) in the non-nocturnal asthma group. Among the 144 patients with nocturnal asthma, 133 patients completed FeNO testing, of which 95 were classified into the type 2 inflammation group and 38 to the non-type 2 inflammation group. The eosinophil (EOS) count and FeNO level in the nocturnal asthma group were both higher than those in the non-nocturnal asthma group [(0.45±0.40) ×10<sup>9</sup>/L vs (0.25±0.20)×10<sup>9</sup>/L, 38 (18, 82) vs 29 (15, 48) ppb, both <i>P</i><0.05]. Baseline ACT score was lower in nocturnal asthma group than in non-nocturnal asthma group [16 (14, 18) vs 21 (19, 23) scores, <i>P</i><0.001]. There was no significant difference in the forced expiratory volume in one second (FEV<sub>1</sub>), forced vital capacity (FVC), and peak expiratory flow (PEF) in the two groups (both <i>P</i>>0.05). During the follow-up at the 3rd, 6th, and 12th months, the improvement values of ACT scores (ΔACT) in the nocturnal asthma group were higher than the non-nocturnal asthma group [5 (3, 7) vs 2 (1, 3), 7 (4, 9) vs 3 (1, 4) and 7 (6, 9) vs 3 (1, 5) scores, all <i>P</i><0.05]. The EOS count [0.40 (0.29, 0.80)×10<sup>9</sup>/L vs 0.20 (0.12, 0.29)×10<sup>9</sup>/L] and percentage [5.10% (3.55%, 9.10%) vs 2.20% (1.65%, 3.85%)] of the type 2 inflammation group were both higher than the non-type 2 inflammation group (both <i>P</i><0.05). In the nocturnal asthma group, there was no significant","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 2","pages":"155-162"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-07DOI: 10.3760/cma.j.cn112137-20240708-01538
M Li
With the population aging, the prevalence of osteoporosis is rapidly increasing, which has become serious public health problem. At present, there is a severe shortage of effective anti-osteoporotic drugs in China, making it difficult to control the growing trend of osteoporosis. The key pathological mechanism of osteoporosis is bone homeostasis imbalance. It is necessary to continuously study the bone cell biology, important pathway regulating bone homeostasis, and its regulatory network constituted by bone-muscle-vessel-immune system-nerve-gut microbiota, in order to identify key targets for new drug, and develop more novel effective drugs to increase bone mineral density, improve bone strength, reduce fracture risk and protect bone health.
{"title":"[Prospects for the development of new drugs for the treatment of osteoporosis].","authors":"M Li","doi":"10.3760/cma.j.cn112137-20240708-01538","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240708-01538","url":null,"abstract":"<p><p>With the population aging, the prevalence of osteoporosis is rapidly increasing, which has become serious public health problem. At present, there is a severe shortage of effective anti-osteoporotic drugs in China, making it difficult to control the growing trend of osteoporosis. The key pathological mechanism of osteoporosis is bone homeostasis imbalance. It is necessary to continuously study the bone cell biology, important pathway regulating bone homeostasis, and its regulatory network constituted by bone-muscle-vessel-immune system-nerve-gut microbiota, in order to identify key targets for new drug, and develop more novel effective drugs to increase bone mineral density, improve bone strength, reduce fracture risk and protect bone health.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 1","pages":"5-9"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-07DOI: 10.3760/cma.j.cn112137-20240730-01753
J S Lu, B P Qian, Y Qiu, B Wang, H D Bao, C Y Song, M Qiao, K Y Wang
<p><p><b>Objective:</b> To analyze the influence of cervical range of motion on the preferable sagittal vertical axis in ankylosis spondylitis (AS)-related thoracolumbar kyphosis following single-level pedicle subtraction osteotomy (PSO). <b>Methods:</b> The clinical data of sixty-five AS patients who underwent single-level PSO from February 2012 to November 2018 in the Drum Tower Hospital of Nanjing University Medical School were retrospectively reviewed. Of the patients, 59 were males and 6 were females with a mean age of (34.2±9.2) years. Radiographic parameters including cervical range of motion (CROM), global kyphosis (GK), C<sub>7</sub> sagittal vertical axis (C<sub>7</sub>SVA), thoracic kyphosis (TK), lumbar lordosis (LL), spinosacral angle (SSA), pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS) and chin-brow vertical angle (CBVA) were measured preoperatively, 10 days after surgery and at the last follow-up. Oswestry disability index (ODI) and visual analogue scale (VAS) of pain were recorded for all patients preoperatively and at the final follow-up. Based on preoperative CROM, patients were divided into cervical flexible group (CROM>20°, group Ⅰ) and cervical ankylosis group (CROM≤20°, group Ⅱ). The patients were further divided into four groups according to the C<sub>7</sub>SVA at the last follow-up: group ⅠA, CROM>20°, C<sub>7</sub>SVA<50 mm; group ⅠB, CROM>20°, C<sub>7</sub>SVA≥50 mm; group ⅡA, CROM≤20°, C<sub>7</sub>SVA<50 mm; and group ⅡB, CROM≤20°, C<sub>7</sub>SVA≥50 mm. Differences among baseline data, clinical efficacy and radiographic parameters between different groups were compared, and the optimal sagittal alignment balance after PSO in AS patients with thoracolumbar kyphosis under different CROM was explored. <b>Results:</b> All patients were followed-up for (31.0±10.2) months. A total of 65 patients were included, with 31 cases in group Ⅰ, comprising 16 cases in group ⅠA and 15 cases in group ⅠB, and 34 cases in group Ⅱ, with 18 cases in group ⅡA and 16 cases in group ⅡB. There was no significant difference in the age, gender and level of osteotomy between groups ⅠA and ⅠB and groups ⅡA and ⅡB (all <i>P</i>>0.05). Comparing between ⅠA and ⅠB groups, no significant difference was observed in radiographic parameters(all <i>P</i>>0.05), excepted for C<sub>7</sub>SVA [(14.3±27.6) mm vs (80.3±24.1) mm, <i>P</i><0.001]. At the last follow-up, ODI and VAS scores were significantly lower in group ⅠA than in group ⅠB [(7.1±6.2) points vs (13.3±7.0) points and (0.9±0.9) points vs (1.9±1.3) points] (both <i>P</i><0.05). Compared with group ⅡA, PT was significantly greater in group ⅡB before the operation, 10 days after surgery and at the final follow-up (all <i>P</i><0.05); the SSA and CBVA were also significantly greater in group ⅡB at the last follow-up (both <i>P</i><0.05). At the last follow-up, the quality-of-life scores were better in group ⅡB than those in group ⅡA [ODI: (12.6±10.7) points vs (22.9±12.5) points; VAS:
{"title":"[The best preferable sagittal vertical axis for the ankylosis spondylitis with thoracolumbar kyphosis following one-level pedicle subtraction osteotomy under different cervical range of motion].","authors":"J S Lu, B P Qian, Y Qiu, B Wang, H D Bao, C Y Song, M Qiao, K Y Wang","doi":"10.3760/cma.j.cn112137-20240730-01753","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240730-01753","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the influence of cervical range of motion on the preferable sagittal vertical axis in ankylosis spondylitis (AS)-related thoracolumbar kyphosis following single-level pedicle subtraction osteotomy (PSO). <b>Methods:</b> The clinical data of sixty-five AS patients who underwent single-level PSO from February 2012 to November 2018 in the Drum Tower Hospital of Nanjing University Medical School were retrospectively reviewed. Of the patients, 59 were males and 6 were females with a mean age of (34.2±9.2) years. Radiographic parameters including cervical range of motion (CROM), global kyphosis (GK), C<sub>7</sub> sagittal vertical axis (C<sub>7</sub>SVA), thoracic kyphosis (TK), lumbar lordosis (LL), spinosacral angle (SSA), pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS) and chin-brow vertical angle (CBVA) were measured preoperatively, 10 days after surgery and at the last follow-up. Oswestry disability index (ODI) and visual analogue scale (VAS) of pain were recorded for all patients preoperatively and at the final follow-up. Based on preoperative CROM, patients were divided into cervical flexible group (CROM>20°, group Ⅰ) and cervical ankylosis group (CROM≤20°, group Ⅱ). The patients were further divided into four groups according to the C<sub>7</sub>SVA at the last follow-up: group ⅠA, CROM>20°, C<sub>7</sub>SVA<50 mm; group ⅠB, CROM>20°, C<sub>7</sub>SVA≥50 mm; group ⅡA, CROM≤20°, C<sub>7</sub>SVA<50 mm; and group ⅡB, CROM≤20°, C<sub>7</sub>SVA≥50 mm. Differences among baseline data, clinical efficacy and radiographic parameters between different groups were compared, and the optimal sagittal alignment balance after PSO in AS patients with thoracolumbar kyphosis under different CROM was explored. <b>Results:</b> All patients were followed-up for (31.0±10.2) months. A total of 65 patients were included, with 31 cases in group Ⅰ, comprising 16 cases in group ⅠA and 15 cases in group ⅠB, and 34 cases in group Ⅱ, with 18 cases in group ⅡA and 16 cases in group ⅡB. There was no significant difference in the age, gender and level of osteotomy between groups ⅠA and ⅠB and groups ⅡA and ⅡB (all <i>P</i>>0.05). Comparing between ⅠA and ⅠB groups, no significant difference was observed in radiographic parameters(all <i>P</i>>0.05), excepted for C<sub>7</sub>SVA [(14.3±27.6) mm vs (80.3±24.1) mm, <i>P</i><0.001]. At the last follow-up, ODI and VAS scores were significantly lower in group ⅠA than in group ⅠB [(7.1±6.2) points vs (13.3±7.0) points and (0.9±0.9) points vs (1.9±1.3) points] (both <i>P</i><0.05). Compared with group ⅡA, PT was significantly greater in group ⅡB before the operation, 10 days after surgery and at the final follow-up (all <i>P</i><0.05); the SSA and CBVA were also significantly greater in group ⅡB at the last follow-up (both <i>P</i><0.05). At the last follow-up, the quality-of-life scores were better in group ⅡB than those in group ⅡA [ODI: (12.6±10.7) points vs (22.9±12.5) points; VAS:","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 1","pages":"48-55"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-07DOI: 10.3760/cma.j.cn112137-20240403-00779
B Tao, L H Sun, Y Y Yang, H Y Zhao, J M Liu
When diagnosing and treating primary osteoporosis and various calcium-phosphorus metabolism disorders, we must pay attention to some key points: diagnosing primary osteoporosis only after excluding secondary factors; understanding the features of various calcium supplements and anti-osteoporosis drugs; and selecting appropriate medications; foreseeing the changes in calcium-phosphorus metabolism after using anti-osteoporosis drugs. This article delves into the aforementioned key issues in the diagnosis and treatment of primary osteoporosis and various disorders of calcium and phosphorus metabolism. It emphasizes the pathophysiological mechanisms, diagnostic criteria, rational drug use, and precautions for primary osteoporosis and various disorders of calcium and phosphorus metabolism, aiming to enhance the level of disease diagnosis and treatment through a holistic thinking.
{"title":"[Certain key questions in the diagnosis and treatment of primary osteoporosis and other disorders related to abnormal calcium and phosphorus metabolism].","authors":"B Tao, L H Sun, Y Y Yang, H Y Zhao, J M Liu","doi":"10.3760/cma.j.cn112137-20240403-00779","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240403-00779","url":null,"abstract":"<p><p>When diagnosing and treating primary osteoporosis and various calcium-phosphorus metabolism disorders, we must pay attention to some key points: diagnosing primary osteoporosis only after excluding secondary factors; understanding the features of various calcium supplements and anti-osteoporosis drugs; and selecting appropriate medications; foreseeing the changes in calcium-phosphorus metabolism after using anti-osteoporosis drugs. This article delves into the aforementioned key issues in the diagnosis and treatment of primary osteoporosis and various disorders of calcium and phosphorus metabolism. It emphasizes the pathophysiological mechanisms, diagnostic criteria, rational drug use, and precautions for primary osteoporosis and various disorders of calcium and phosphorus metabolism, aiming to enhance the level of disease diagnosis and treatment through a holistic thinking.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 1","pages":"10-14"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-07DOI: 10.3760/cma.j.cn112137-20240805-01795
C Wang, Y Fang, F Shen, X K Yang
Objective: To explore the impact of gonadotropin-releasing hormone agonist (GnRH-a) on the pregnancy outcomes in frozen-thawed embryo transfer cycles for patients with recurrent implantation failure (RIF) complicated by chronic endometriti (CE). Methods: A total of 138 patients with RIF combined with CE who underwent in vitro fertilization/intracytoplamic sperm injection treatment-embryo transfer in the Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2020 to December 2023 were retrospectively included. According to the endometrial preparation protocol, they were divided into two groups: the pituitary downregulation group (n=59) and the artificial cycle group (n=79). The baseline data and pregnancy outcomes of the two groups were compared. Multivariate binary logistic regression analysis was conducted to assess the influencing factors of clinical pregnancy in patients with RIF complicated by CE. Results: The age of the artificial cycle group [M(Q1, Q3)] was 33(31, 37) years; the age of pituitary downregulation was 33(30, 36) years. No statistically significant differences were found in the baseline data of the patients, such as age, the type of infertility, duration of infertility, body mass index (BMI), anti-Müllerian hormone (AMH), and baseline endocrine parameters(all P>0.05). For patients with RIF combined with CE, compared to the artificial cycle group, the pituitary downregulation group had a higher number of previous failed attempts [M(Q1, Q3), 3(3, 4) vs 4(3, 4) ], and a higher clinical pregnancy rate[42.37% (25/59) vs 24.05% (19/79)](P<0.05). GnRH-a pretreatment in a pituitary downregulation cycle is a factor influencing clinical pregnancy in patients with RIF combined with CE (OR=2.229, 95%CI: 1.015-4.896, P<0.05). Conclusion: GnRH-a is effective in improving the clinical pregnancy rate of patients with RIF combined with CE.
{"title":"[Impact of gonadotropin-releasing hormone agonist on pregnancy outcomes in frozen-thawed embryo transfer cycles for patients with recurrent implantation failure combined with chronic endometritis].","authors":"C Wang, Y Fang, F Shen, X K Yang","doi":"10.3760/cma.j.cn112137-20240805-01795","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240805-01795","url":null,"abstract":"<p><p><b>Objective:</b> To explore the impact of gonadotropin-releasing hormone agonist (GnRH-a) on the pregnancy outcomes in frozen-thawed embryo transfer cycles for patients with recurrent implantation failure (RIF) complicated by chronic endometriti (CE). <b>Methods:</b> A total of 138 patients with RIF combined with CE who underwent in vitro fertilization/intracytoplamic sperm injection treatment-embryo transfer in the Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2020 to December 2023 were retrospectively included. According to the endometrial preparation protocol, they were divided into two groups: the pituitary downregulation group (<i>n</i>=59) and the artificial cycle group (<i>n</i>=79). The baseline data and pregnancy outcomes of the two groups were compared. Multivariate binary logistic regression analysis was conducted to assess the influencing factors of clinical pregnancy in patients with RIF complicated by CE. <b>Results:</b> The age of the artificial cycle group [<i>M</i>(<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>)] was 33(31, 37) years; the age of pituitary downregulation was 33(30, 36) years. No statistically significant differences were found in the baseline data of the patients, such as age, the type of infertility, duration of infertility, body mass index (BMI), anti-Müllerian hormone (AMH), and baseline endocrine parameters(all <i>P</i>>0.05). For patients with RIF combined with CE, compared to the artificial cycle group, the pituitary downregulation group had a higher number of previous failed attempts [<i>M</i>(<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>), 3(3, 4) vs 4(3, 4) ], and a higher clinical pregnancy rate[42.37% (25/59) vs 24.05% (19/79)](<i>P</i><0.05). GnRH-a pretreatment in a pituitary downregulation cycle is a factor influencing clinical pregnancy in patients with RIF combined with CE (<i>OR</i>=2.229, 95%<i>CI</i>: 1.015-4.896, <i>P</i><0.05). <b>Conclusion:</b> GnRH-a is effective in improving the clinical pregnancy rate of patients with RIF combined with CE.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 1","pages":"72-77"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-07DOI: 10.3760/cma.j.cn112137-20240601-01244
H Lin, H C Lyu, P F Tang
Osteoporotic fracture is a special type of pathological fracture characterized by high morbidity, high disability, high mortality and low diagnosis and treatment rate. Currently, the main problem with clinical intervention for osteoporotic fractures is the lack of proper understanding by doctors (especially orthopedic surgeons) of the pathologic changes in the disease itself. Aggressive surgical treatment is very important, but it cannot fundamentally solve the serious consequences of delayed healing of osteoporotic fractures and the occurrence of re-fractures. Early treatment by anabolic agents can effectively shorten the fracture healing time, prevent postoperative implants displacement, and reduce the occurrence of re-fractures. This article emphasizes the importance of actively facing the imminent risk of osteoporotic fracture; correctly recognizing the pathological changes of osteoporotic fracture; and comprehensively paying attention to the early intervention of osteoporotic fracture.
{"title":"[Pay attention to the early intervention of osteoporotic fractures].","authors":"H Lin, H C Lyu, P F Tang","doi":"10.3760/cma.j.cn112137-20240601-01244","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240601-01244","url":null,"abstract":"<p><p>Osteoporotic fracture is a special type of pathological fracture characterized by high morbidity, high disability, high mortality and low diagnosis and treatment rate. Currently, the main problem with clinical intervention for osteoporotic fractures is the lack of proper understanding by doctors (especially orthopedic surgeons) of the pathologic changes in the disease itself. Aggressive surgical treatment is very important, but it cannot fundamentally solve the serious consequences of delayed healing of osteoporotic fractures and the occurrence of re-fractures. Early treatment by anabolic agents can effectively shorten the fracture healing time, prevent postoperative implants displacement, and reduce the occurrence of re-fractures. This article emphasizes the importance of actively facing the imminent risk of osteoporotic fracture; correctly recognizing the pathological changes of osteoporotic fracture; and comprehensively paying attention to the early intervention of osteoporotic fracture.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-07DOI: 10.3760/cma.j.cn112137-20240814-01866
D Zhu, Y Chen, C Z Yang, J Y Zhao, Y C Sun, L C Wang, H M Chen, L Xiao, J Li
<p><p><b>Objective:</b> To analyze the influencing factors of toe-amputation in diabetic foot patients and construct a predictive model. <b>Methods:</b> The clinical data of 437 diabetic foot patients who were hospitalized in Air Force Medical Center from January 2017 to January 2024 were retrospectively analyzed, including 327 males and 110 females, with a median age[<i>M</i>(<i>Q</i><sub>1</sub>,<i>Q</i><sub>3</sub>)] of 63.0 (55.0, 69.0) years.The patients were divided into amputation group(<i>n</i>=344) and non-amputation group (<i>n</i>=93) according to whether toe-amputation surgery was performed within 3 months. The differences of clinical indicators between the two groups were analyzed.The patients were randomly divided into the training set and the validation set in a 7∶3 ratio using R 4.2. Multivariate logistic regression model was used to screen the influencing factors of toe-amputation in diabetic foot patients, and the nomogram of toe amputation prediction model was drawn. The predictive ability, accuracy and clinical applicability of the model were assessed using the area under the curve (AUC) of the receiver operating, calibration curve and decision curve analysis(DCA), respectively. <b>Results:</b> The patients in the toe amputation group had higher proportions of diabetes duration, lower extremity arterial disease (LEAD), white blood cell count, total bilirubin, fibrinogen, erythrocyte sedimentation rate, C-reactive protein level, and positive bacterial cultures in wound secretions compared to those in the non-toe amputation group. Conversely, the levels of high-density lipoprotein cholesterol, blood uric acid, the internal diameter and blood flow of dorsalis pedis artery were lower in the toe amputation group than those in the non-toe amputation group (all <i>P</i><0.05). Multivariate logistic regression model analysis indicated that LEAD (<i>OR</i>=4.19,95%<i>CI</i>:1.88-9.34), blood uric acid (<i>OR</i>=0.99,95%<i>CI</i>:0.99-0.99), fibrinogen (<i>OR</i>=1.86,95%<i>CI</i>:1.19-2.91), and wound secretion culture positive for staphylococcus aureus (<i>OR</i>=5.77,95%<i>CI</i>:2.72-12.25) or non-staphylococcus aureus infection (<i>OR</i>=4.74,95%<i>CI</i>:1.43-15.77), were influencing factors of diabetic foot toe-amputations (all <i>P</i><0.05). The prediction model of toe amputation in patients with diabetes foot was established using the above parameters. In the training set, the AUC, sensitivity and specificity of the prediction model for predicting toe amputation in diabetic foot patients were 0.86(95%<i>CI</i>:0.80-0.91)、90% and 72%, respectively. In the validation set, the AUC, sensitivity and specificity of the prediction model for predicting toe amputation in diabetic foot patients were 0.85(95%<i>CI</i>:0.78-0.92), 77% and 71%, respectively. The calibration curves of the training set and the validation set indicates that the model has good calibration ability. The DCA curve of the training set and the validation set sugg
{"title":"[Influencing factors analysis and prediction model establishment of toe-amputation in patients with diabetic foot].","authors":"D Zhu, Y Chen, C Z Yang, J Y Zhao, Y C Sun, L C Wang, H M Chen, L Xiao, J Li","doi":"10.3760/cma.j.cn112137-20240814-01866","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240814-01866","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the influencing factors of toe-amputation in diabetic foot patients and construct a predictive model. <b>Methods:</b> The clinical data of 437 diabetic foot patients who were hospitalized in Air Force Medical Center from January 2017 to January 2024 were retrospectively analyzed, including 327 males and 110 females, with a median age[<i>M</i>(<i>Q</i><sub>1</sub>,<i>Q</i><sub>3</sub>)] of 63.0 (55.0, 69.0) years.The patients were divided into amputation group(<i>n</i>=344) and non-amputation group (<i>n</i>=93) according to whether toe-amputation surgery was performed within 3 months. The differences of clinical indicators between the two groups were analyzed.The patients were randomly divided into the training set and the validation set in a 7∶3 ratio using R 4.2. Multivariate logistic regression model was used to screen the influencing factors of toe-amputation in diabetic foot patients, and the nomogram of toe amputation prediction model was drawn. The predictive ability, accuracy and clinical applicability of the model were assessed using the area under the curve (AUC) of the receiver operating, calibration curve and decision curve analysis(DCA), respectively. <b>Results:</b> The patients in the toe amputation group had higher proportions of diabetes duration, lower extremity arterial disease (LEAD), white blood cell count, total bilirubin, fibrinogen, erythrocyte sedimentation rate, C-reactive protein level, and positive bacterial cultures in wound secretions compared to those in the non-toe amputation group. Conversely, the levels of high-density lipoprotein cholesterol, blood uric acid, the internal diameter and blood flow of dorsalis pedis artery were lower in the toe amputation group than those in the non-toe amputation group (all <i>P</i><0.05). Multivariate logistic regression model analysis indicated that LEAD (<i>OR</i>=4.19,95%<i>CI</i>:1.88-9.34), blood uric acid (<i>OR</i>=0.99,95%<i>CI</i>:0.99-0.99), fibrinogen (<i>OR</i>=1.86,95%<i>CI</i>:1.19-2.91), and wound secretion culture positive for staphylococcus aureus (<i>OR</i>=5.77,95%<i>CI</i>:2.72-12.25) or non-staphylococcus aureus infection (<i>OR</i>=4.74,95%<i>CI</i>:1.43-15.77), were influencing factors of diabetic foot toe-amputations (all <i>P</i><0.05). The prediction model of toe amputation in patients with diabetes foot was established using the above parameters. In the training set, the AUC, sensitivity and specificity of the prediction model for predicting toe amputation in diabetic foot patients were 0.86(95%<i>CI</i>:0.80-0.91)、90% and 72%, respectively. In the validation set, the AUC, sensitivity and specificity of the prediction model for predicting toe amputation in diabetic foot patients were 0.85(95%<i>CI</i>:0.78-0.92), 77% and 71%, respectively. The calibration curves of the training set and the validation set indicates that the model has good calibration ability. The DCA curve of the training set and the validation set sugg","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 1","pages":"63-71"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-07DOI: 10.3760/cma.j.cn112137-20240727-01728
R Z Zhang, G W Liu, H Lin, Y J Xu
After the maturity period, human bones will experience aging changes such as decreased bone mass, abnormal trabecular structure and increased bone fragility. In recent years, with the development of aging research, research on bone aging markers has increased. Primary osteoporosis, which is related to aging, also belongs to the category of bone aging. This article will review the knowledge related to aging, bone aging markers and osteoporosis to explain the interrelationships between them, and combine some research progress to propose to learn from the bone aging markers research in the field of osteoporosis research. Combining bone aging markers and osteoporosis, the discussion around aging, bone aging, and osteoporosis will provide new ideas for further research on osteoporosis.
{"title":"[The reference value of bone aging markers for the study of primary osteoporosis].","authors":"R Z Zhang, G W Liu, H Lin, Y J Xu","doi":"10.3760/cma.j.cn112137-20240727-01728","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240727-01728","url":null,"abstract":"<p><p>After the maturity period, human bones will experience aging changes such as decreased bone mass, abnormal trabecular structure and increased bone fragility. In recent years, with the development of aging research, research on bone aging markers has increased. Primary osteoporosis, which is related to aging, also belongs to the category of bone aging. This article will review the knowledge related to aging, bone aging markers and osteoporosis to explain the interrelationships between them, and combine some research progress to propose to learn from the bone aging markers research in the field of osteoporosis research. Combining bone aging markers and osteoporosis, the discussion around aging, bone aging, and osteoporosis will provide new ideas for further research on osteoporosis.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 1","pages":"15-20"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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