Samuel C. Okpechi, Dorota Wyczechowska, Bennett DeBoisblanc, Jessica L. Johnson, Mohamed A. Ghonim, Natalie Bauer, Hamid A. Boulares, Matthew R. Lammi
Introduction
There are no treatments directly targeting the pulmonary vasculature in chronic obstructive pulmonary disease (COPD), and further characterization of the underlying endothelial cell (EC) abnormalities could be helpful in drug development.
Methods
We investigated the influence of exercise and the prostacyclin analog iloprost on extracellular vesicles derived from ECs (eEVs) in 15 moderate–severe COPD patients who were enrolled in a randomized, placebo-controlled crossover trial of iloprost.
Results
Active smokers had a profile consistent with inflammatory-derived EVs, while exacerbation-prone COPD subjects had a profile consistent with apoptosis-derived eEVs. There were no significant effects of iloprost on eEV levels. However, there was a significant increase in CD144+ and CD31+/CD144+ EVs 1 h after exercise.
Conclusions
Endothelial-derived EV profiles differed based on smoking and exacerbation history. Iloprost did not affect eEV levels, although maximal exercise induced a delayed increase in a subset of eEVs, possibly through shear stress.
{"title":"Endothelial-Derived Extracellular Vesicles During Exercise in COPD Patients","authors":"Samuel C. Okpechi, Dorota Wyczechowska, Bennett DeBoisblanc, Jessica L. Johnson, Mohamed A. Ghonim, Natalie Bauer, Hamid A. Boulares, Matthew R. Lammi","doi":"10.1111/crj.70146","DOIUrl":"10.1111/crj.70146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>There are no treatments directly targeting the pulmonary vasculature in chronic obstructive pulmonary disease (COPD), and further characterization of the underlying endothelial cell (EC) abnormalities could be helpful in drug development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We investigated the influence of exercise and the prostacyclin analog iloprost on extracellular vesicles derived from ECs (eEVs) in 15 moderate–severe COPD patients who were enrolled in a randomized, placebo-controlled crossover trial of iloprost.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Active smokers had a profile consistent with inflammatory-derived EVs, while exacerbation-prone COPD subjects had a profile consistent with apoptosis-derived eEVs. There were no significant effects of iloprost on eEV levels. However, there was a significant increase in CD144+ and CD31+/CD144+ EVs 1 h after exercise.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Endothelial-derived EV profiles differed based on smoking and exacerbation history. Iloprost did not affect eEV levels, although maximal exercise induced a delayed increase in a subset of eEVs, possibly through shear stress.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12682462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To investigate the clinical features and risk factors for Mycoplasma pneumoniae pneumonia (MPP) complicated with plastic bronchitis (PB) and to provide a reference for the early diagnosis and treatment of this disease.
Methods
Clinical data from 75 pediatric patients diagnosed with MPP who underwent bronchoscopy at our hospital between June 16 and December 31, 2023, were retrospectively analyzed. Patients were stratified into PB and non-PB groups based on the presence or absence of bronchial cast removal during bronchoscopy. Comparative analysis of clinical characteristics was performed between the two groups. Binary logistic regression analysis was employed to identify risk factors associated with MPP complicated by PB. Additionally, bronchial cast components obtained from the PB group underwent compositional analysis using proteomic techniques via mass spectrometry.
Results
The composition ratio of children with fever frequency and a heat course ≥ 10 days in the PB group. The composition ratio, neutrophil ratio, erythrocyte sedimentation rate (ESR) and levels of C-reactive protein, lactate dehydrogenase, procalcitonin (PCT) and D-dimer in children with lung compaction were significantly greater than those in the non-PB group (t = 2.290–3.793, χ2 = 5.548, 5.659, Z = −2.085, p < 0.05). Multivariate logistic regression analysis revealed that the PCT level (OR = 1.071, 95% CI = 1.015–1.130, p < 0.05) and ESR (OR = 1.088, 95% CI = 1.033–1.146, p < 0.05) were risk factors for PB. Protein mass spectrometry showed that the bronchial plastic was rich in fibrinogen.
Conclusions
Compared with children with MPP alone, children with PB have a more intense inflammatory response, and the possibility of MPP with PB should be vigilant when the ESR > 25.20 mm/1 h and PCT > 0.19 μg/L. Bronchial plastics in children with PB contain a large amount of fibrin, which may be related to the abnormal activation of coagulation and fibrinolysis systems caused by inflammation.
{"title":"Risk Factor Analysis of Mycoplasma pneumoniae Pneumonia Complicated With Plastic Bronchitis in Children: A Single-Center Retrospective Study","authors":"Jian-Min Dong, Chun-Qing Zhou, Yuan-Yuan Zhen","doi":"10.1111/crj.70142","DOIUrl":"10.1111/crj.70142","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the clinical features and risk factors for <i>Mycoplasma pneumoniae</i> pneumonia (MPP) complicated with plastic bronchitis (PB) and to provide a reference for the early diagnosis and treatment of this disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical data from 75 pediatric patients diagnosed with MPP who underwent bronchoscopy at our hospital between June 16 and December 31, 2023, were retrospectively analyzed. Patients were stratified into PB and non-PB groups based on the presence or absence of bronchial cast removal during bronchoscopy. Comparative analysis of clinical characteristics was performed between the two groups. Binary logistic regression analysis was employed to identify risk factors associated with MPP complicated by PB. Additionally, bronchial cast components obtained from the PB group underwent compositional analysis using proteomic techniques via mass spectrometry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The composition ratio of children with fever frequency and a heat course ≥ 10 days in the PB group. The composition ratio, neutrophil ratio, erythrocyte sedimentation rate (ESR) and levels of C-reactive protein, lactate dehydrogenase, procalcitonin (PCT) and D-dimer in children with lung compaction were significantly greater than those in the non-PB group (<i>t</i> = 2.290–3.793, χ<sup>2</sup> = 5.548, 5.659, <i>Z</i> = −2.085, <i>p</i> < 0.05). Multivariate logistic regression analysis revealed that the PCT level (OR = 1.071, 95% CI = 1.015–1.130, <i>p</i> < 0.05) and ESR (OR = 1.088, 95% CI = 1.033–1.146, <i>p</i> < 0.05) were risk factors for PB. Protein mass spectrometry showed that the bronchial plastic was rich in fibrinogen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared with children with MPP alone, children with PB have a more intense inflammatory response, and the possibility of MPP with PB should be vigilant when the ESR > 25.20 mm/1 h and PCT > 0.19 μg/L. Bronchial plastics in children with PB contain a large amount of fibrin, which may be related to the abnormal activation of coagulation and fibrinolysis systems caused by inflammation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70142","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asthma is the most common chronic health condition affecting children in Aotearoa New Zealand, with Māori and Pacific children disproportionately burdened by high morbidity and inequitable care. Despite clinical guidelines and growing research, inconsistencies in diagnosis, treatment adherence, and education persist. This scoping review identifies and maps literature on care models, service delivery, education and support strategies, and experiences of children, young people, and their family/whānau in asthma care and management for those under 18 in Aotearoa New Zealand.
Methods
This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. We searched MEDLINE, CINAHL, Scopus, PsychINFO, and grey literature for articles published between 2014 and 2024 on asthma care for children under 18 in Aotearoa New Zealand. Eligible articles from health or community settings were thematically analysed using conventional content analysis.
Results
Twenty-one articles met inclusion criteria, including qualitative, quantitative, mixed-methods, and policy or guideline documents. Thematic analysis revealed four interconnected themes: (1) medications and adherence, (2) education and health literacy, (3) children and whānau experiences, and (4) culture and beliefs. Findings reflect persistent inequities in asthma outcomes and care access, especially for Māori and Pacific children and highlight opportunities to strengthen culturally safe and family/whānau-centred care to improve asthma care, treatment and its management.
Conclusion
This review identifies key gaps in asthma care for children in Aotearoa New Zealand and calls for more responsive, culturally grounded models to improve asthma outcomes across diverse settings.
{"title":"What Is Known About Asthma Care and Management for Children and Young People Under 18 Years of age in New Zealand. A Scoping Review","authors":"J. Blamires, M. Foster, B. Kanengoni-Nyatara","doi":"10.1111/crj.70139","DOIUrl":"10.1111/crj.70139","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Asthma is the most common chronic health condition affecting children in Aotearoa New Zealand, with Māori and Pacific children disproportionately burdened by high morbidity and inequitable care. Despite clinical guidelines and growing research, inconsistencies in diagnosis, treatment adherence, and education persist. This scoping review identifies and maps literature on care models, service delivery, education and support strategies, and experiences of children, young people, and their family/whānau in asthma care and management for those under 18 in Aotearoa New Zealand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. We searched MEDLINE, CINAHL, Scopus, PsychINFO, and grey literature for articles published between 2014 and 2024 on asthma care for children under 18 in Aotearoa New Zealand. Eligible articles from health or community settings were thematically analysed using conventional content analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-one articles met inclusion criteria, including qualitative, quantitative, mixed-methods, and policy or guideline documents. Thematic analysis revealed four interconnected themes: (1) medications and adherence, (2) education and health literacy, (3) children and whānau experiences, and (4) culture and beliefs. Findings reflect persistent inequities in asthma outcomes and care access, especially for Māori and Pacific children and highlight opportunities to strengthen culturally safe and family/whānau-centred care to improve asthma care, treatment and its management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This review identifies key gaps in asthma care for children in Aotearoa New Zealand and calls for more responsive, culturally grounded models to improve asthma outcomes across diverse settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12672922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ventilator-associated pneumonia (VAP) is associated with poor patient outcomes. Early identification of high-risk patients remains a major clinical challenge. We aimed to develop and validate a multimodal hybrid neural network (MM-HNN) for improved VAP prediction by integrating multisource data from a retrospective cohort.
Methods
This single-center, retrospective study analyzed data from 213 adult patients who received invasive mechanical ventilation for >48 h. The MM-HNN incorporated three data types: 1) computed tomography (CT) features quantifying consolidation volume through three-dimensional residual neural network-50; 2) dynamic ventilator parameters including fraction of inspired oxygen and positive end-expiratory pressure analyzed via long short-term memory networks; and 3) clinical predictors refined via least absolute shrinkage and selection operator regression to identify six key variables.
Results
The model achieved an area under the curve of 0.86 (95% confidence interval: 0.80–0.91), outperforming the clinical pulmonary infection score (p = 0.021). SHapley Additive exPlanation analysis revealed Acute Physiology and Chronic Health Evaluation II score and CT consolidation volume as primary contributors. The system provided early warnings with 87.5% accuracy (median lead time: 1.5 days), which was associated with a significant increase in appropriate antibiotic use from 68.3% to 92.1% (p = 0.016).
Conclusion
The MM-HNN demonstrates the feasibility of accurate, interpretable VAP risk prediction through multimodal data integration. This artificial intelligence framework provides a clinically actionable tool for dynamic risk assessment, enabling preemptive interventions and improved antibiotic stewardship.
{"title":"Risk Factor Assessment and Predictive Modeling for Ventilator-Associated Pneumonia: Design and Clinical Implementation of an Artificial Intelligence-Enhanced Early Detection Framework Using Multisource Data Analytics","authors":"Jia Zhang, Yitong Wang, Yuwei Cao, Jiaxin Li, Shuangmei Dai, Yulin Li, Zhe Zhang, Xin Zhang, Rui Yang, Xinjun Zhang, Jichao Chen, Wailong Zou","doi":"10.1111/crj.70144","DOIUrl":"10.1111/crj.70144","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Ventilator-associated pneumonia (VAP) is associated with poor patient outcomes. Early identification of high-risk patients remains a major clinical challenge. We aimed to develop and validate a multimodal hybrid neural network (MM-HNN) for improved VAP prediction by integrating multisource data from a retrospective cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center, retrospective study analyzed data from 213 adult patients who received invasive mechanical ventilation for >48 h. The MM-HNN incorporated three data types: 1) computed tomography (CT) features quantifying consolidation volume through three-dimensional residual neural network-50; 2) dynamic ventilator parameters including fraction of inspired oxygen and positive end-expiratory pressure analyzed via long short-term memory networks; and 3) clinical predictors refined via least absolute shrinkage and selection operator regression to identify six key variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The model achieved an area under the curve of 0.86 (95% confidence interval: 0.80–0.91), outperforming the clinical pulmonary infection score (<i>p</i> = 0.021). SHapley Additive exPlanation analysis revealed Acute Physiology and Chronic Health Evaluation II score and CT consolidation volume as primary contributors. The system provided early warnings with 87.5% accuracy (median lead time: 1.5 days), which was associated with a significant increase in appropriate antibiotic use from 68.3% to 92.1% (<i>p</i> = 0.016).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The MM-HNN demonstrates the feasibility of accurate, interpretable VAP risk prediction through multimodal data integration. This artificial intelligence framework provides a clinically actionable tool for dynamic risk assessment, enabling preemptive interventions and improved antibiotic stewardship.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12664907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lineage tracing is an emerging technology with the outstanding advantage of labeling stem cells and their descendants with temporal and spatial specificity in vivo. We aimed to systematically review the research advances of distal lung epithelial progenitors via lineage tracing strategies.
Results
The distal lung, including bronchioles and alveoli, carries the respiratory function and is the central region involved in acute respiratory distress syndrome and other diseases. Many endogenous epithelial stem cell/progenitor lineages such as Club cells, alveolar type II cells, bronchioalveolar stem cells, and basal-like progenitors that contribute to distal lung regeneration have been identified and are engaged in repairing lung injury for various reasons. Advances in lineage tracing technology have provided tremendous support in characterizing progenitor lineages, identifying new progenitor cell lineages, and discovering regulators of their behaviors.
Conclusions
The important role of distal lung epithelial progenitors and lineage tracing methods has been highlighted in recent years. Relevant studies provide a perspective for further deepening lineage tracing in lung progenitor research and laying the groundwork for endogenous stem cell therapies in the future.
{"title":"Lineage Tracing of Distal Lung Epithelial Progenitors in Injury-Induced Regeneration","authors":"Jian Xu, Yuhan Wang, Cuiping Zhang, Xiaoyan Chen, Tianchang Wei, Weiqi Mao, Yuanlin Song","doi":"10.1111/crj.70143","DOIUrl":"10.1111/crj.70143","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lineage tracing is an emerging technology with the outstanding advantage of labeling stem cells and their descendants with temporal and spatial specificity in vivo. We aimed to systematically review the research advances of distal lung epithelial progenitors via lineage tracing strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The distal lung, including bronchioles and alveoli, carries the respiratory function and is the central region involved in acute respiratory distress syndrome and other diseases. Many endogenous epithelial stem cell/progenitor lineages such as Club cells, alveolar type II cells, bronchioalveolar stem cells, and basal-like progenitors that contribute to distal lung regeneration have been identified and are engaged in repairing lung injury for various reasons. Advances in lineage tracing technology have provided tremendous support in characterizing progenitor lineages, identifying new progenitor cell lineages, and discovering regulators of their behaviors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The important role of distal lung epithelial progenitors and lineage tracing methods has been highlighted in recent years. Relevant studies provide a perspective for further deepening lineage tracing in lung progenitor research and laying the groundwork for endogenous stem cell therapies in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12664906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Raquel Annoni, Jôse Mára de Brito, Salvatore Battaglia, Natália de Souza Xavier Costa, Ligia Braga Lopes Couceiro, Renata Calciolari Rossi, Marisa Dolhnikoff, Pieter S. Hiemstra, Klaus F. Rabe, Peter J. Sterk, Thais Mauad
Background
Vascular alterations contribute significantly to the chronic obstructive pulmonary disease (COPD) pathophysiology. Thirty-nine percent of patients with COPD develop pulmonary hypertension, especially patients with the severe form of the disease. Cigarette-induced endothelial dysfunction is important in the pathogenesis of vascular alterations, even in the mild forms of the disease. This study investigates extracellular matrix (ECM) remodelling and endothelial activation in pulmonary (PMA) and bronchial muscular arteries (BMA) from non-smokers (NS), nonobstructed smokers (NOS) and patients with mild/moderate COPD.
Methods
Lung tissue samples from 44 patients undergoing lung resection were analysed. Morphometric parameters, ECM components (collagens, fibronectin, elastic fibres, tenascin-C and versican) and endothelial markers (VCAM-1, ICAM-1 and endothelin-1) were quantified in BMA and PMA using immunohistochemistry and morphometric analysis. Group differences and correlations with clinical parameters were assessed.
Results
COPD patients showed increased intimal thickness and fibronectin deposition in PMA, and larger adventitial areas in BMA compared to NS. NOS exhibited higher VCAM-1 expression in BMA and increased elastic fibre content in PMA. In COPD, elastic fibres and type-III collagen negatively correlated with smoking history (pack-years), while fibronectin positively correlated with age. VCAM-1 expression in BMA correlated negatively with lung function (FEV1 and FEV1/FVC).
Conclusions
This study demonstrates for the first time ECM remodelling and endothelial activation in bronchial arteries of smokers and patients with COPD. Fibronectin emerges as a key ECM component in arterial remodelling in mild–moderate COPD. Understanding vascular changes may provide new insights into the regulation of bronchial circulation and the development of pulmonary hypertension in COPD.
{"title":"Extracellular Matrix and Endothelial Activation Markers in the Bronchial and Pulmonary Arteries in COPD","authors":"Raquel Annoni, Jôse Mára de Brito, Salvatore Battaglia, Natália de Souza Xavier Costa, Ligia Braga Lopes Couceiro, Renata Calciolari Rossi, Marisa Dolhnikoff, Pieter S. Hiemstra, Klaus F. Rabe, Peter J. Sterk, Thais Mauad","doi":"10.1111/crj.70141","DOIUrl":"https://doi.org/10.1111/crj.70141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Vascular alterations contribute significantly to the chronic obstructive pulmonary disease (COPD) pathophysiology. Thirty-nine percent of patients with COPD develop pulmonary hypertension, especially patients with the severe form of the disease. Cigarette-induced endothelial dysfunction is important in the pathogenesis of vascular alterations, even in the mild forms of the disease. This study investigates extracellular matrix (ECM) remodelling and endothelial activation in pulmonary (PMA) and bronchial muscular arteries (BMA) from non-smokers (NS), nonobstructed smokers (NOS) and patients with mild/moderate COPD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Lung tissue samples from 44 patients undergoing lung resection were analysed. Morphometric parameters, ECM components (collagens, fibronectin, elastic fibres, tenascin-C and versican) and endothelial markers (VCAM-1, ICAM-1 and endothelin-1) were quantified in BMA and PMA using immunohistochemistry and morphometric analysis. Group differences and correlations with clinical parameters were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>COPD patients showed increased intimal thickness and fibronectin deposition in PMA, and larger adventitial areas in BMA compared to NS. NOS exhibited higher VCAM-1 expression in BMA and increased elastic fibre content in PMA. In COPD, elastic fibres and type-III collagen negatively correlated with smoking history (pack-years), while fibronectin positively correlated with age. VCAM-1 expression in BMA correlated negatively with lung function (FEV<sub>1</sub> and FEV<sub>1</sub>/FVC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrates for the first time ECM remodelling and endothelial activation in bronchial arteries of smokers and patients with COPD. Fibronectin emerges as a key ECM component in arterial remodelling in mild–moderate COPD. Understanding vascular changes may provide new insights into the regulation of bronchial circulation and the development of pulmonary hypertension in COPD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Idiopathic pulmonary arterial hypertension (IPAH) is a progressive and fatal disease characterized by pathological pulmonary vascular remodeling and right heart failure. Current biomarkers for IPAH demonstrate limited clinical utility, necessitating the discovery of noninvasive serum biomarkers to facilitate early diagnosis and prognosis.
Objective
To identify novel serum biomarkers for IPAH using tandem mass tag–based quantitative proteomics and validate their clinical relevance.
Methods
Serum samples from five IPAH patients and five age/sex-matched healthy controls (discovery cohort) were analyzed by tandem mass tag proteomics to screen differentially expressed proteins (DEPs). Functional enrichment and protein–protein interaction network analyses were performed. Serum galectin-3 binding protein (LGALS3BP) levels were validated by enzyme-linked immunosorbent assay (ELISA) in an expanded cohort (30 IPAH patients vs. 30 controls).
Results
Proteomic analysis identified 401 proteins and 1554 peptide fragments, with 114 DEPs between groups (47 up-regulated and 67 down-regulated). In biological processes, DEPs are primarily enriched in adaptive immune response, followed by signal transduction. Extracellular exosome and extracellular region are the most commonly enriched cell components. For molecular function, DEPs are mainly involved in antigen binding and calcium ion binding, with the top 30 Gene Ontology terms exhibiting similar distribution patterns between up- and down-regulated DEPs. Pathway analysis revealed significant enrichment in complement/coagulation cascades, immune response, and extracellular matrix remodeling. LGALS3BP was observed to be significantly up-regulated in IPAH serum compared with controls (fold change = 1.36, p < 0.001), a finding validated by independent ELISA (IPAH: 6.43 ± 1.73 μg/mL vs. controls: 2.33 ± 1.06 μg/mL; p < 0.001).
Conclusions
Integrated proteomic profiling and clinical validation provide the first evidence of elevated serum LGALS3BP in IPAH, indicating its putative role in pathogenesis and translational medicine.
特发性肺动脉高压（IPAH）是一种以病理性肺血管重构和右心衰为特征的进行性致命疾病。目前IPAH的生物标志物临床应用有限，需要发现无创血清生物标志物以促进早期诊断和预后。目的利用串联质量标记定量蛋白质组学技术鉴定IPAH的新型血清生物标志物，并验证其临床意义。方法采用串联质量标签蛋白质组学方法对5例IPAH患者和5例年龄/性别匹配的健康对照组（发现队列）的血清样本进行分析，筛选差异表达蛋白（DEPs）。功能富集和蛋白相互作用网络分析。在扩大的队列（30例IPAH患者和30例对照组）中，通过酶联免疫吸附试验（ELISA）验证血清半乳糖凝集素-3结合蛋白（LGALS3BP）水平。结果通过蛋白质组学分析，共鉴定出401个蛋白和1554个肽段，组间共鉴定出114个dep，其中上调47个，下调67个。在生物过程中，DEPs主要富集于适应性免疫反应，其次是信号转导。胞外外泌体和胞外区是最常见的富集细胞成分。在分子功能上，DEPs主要参与抗原结合和钙离子结合，前30个基因本体术语在上调和下调DEPs之间表现出相似的分布模式。通路分析显示补体/凝血级联、免疫反应和细胞外基质重塑显著富集。与对照组相比，IPAH血清中LGALS3BP明显上调（倍增变化= 1.36,p < 0.001），独立ELISA验证了这一发现（IPAH: 6.43±1.73 μg/mL，对照组：2.33±1.06 μg/mL, p < 0.001）。综合蛋白质组学分析和临床验证提供了IPAH患者血清LGALS3BP升高的第一个证据，表明其在发病机制和转化医学中的推测作用。
{"title":"Serum Proteomic Profiling Uncovers LGALS3BP as a Potential Biomarker for Idiopathic Pulmonary Arterial Hypertension","authors":"Mingfei Li, Qi Jin, Wenzhi Pan, Dan Tian, Peng Wang, Dandan Chen, Yuan Zhang, Shasha Chen, Daxin Zhou, Lihua Guan, Junbo Ge","doi":"10.1111/crj.70138","DOIUrl":"https://doi.org/10.1111/crj.70138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Idiopathic pulmonary arterial hypertension (IPAH) is a progressive and fatal disease characterized by pathological pulmonary vascular remodeling and right heart failure. Current biomarkers for IPAH demonstrate limited clinical utility, necessitating the discovery of noninvasive serum biomarkers to facilitate early diagnosis and prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify novel serum biomarkers for IPAH using tandem mass tag–based quantitative proteomics and validate their clinical relevance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Serum samples from five IPAH patients and five age/sex-matched healthy controls (discovery cohort) were analyzed by tandem mass tag proteomics to screen differentially expressed proteins (DEPs). Functional enrichment and protein–protein interaction network analyses were performed. Serum galectin-3 binding protein (LGALS3BP) levels were validated by enzyme-linked immunosorbent assay (ELISA) in an expanded cohort (30 IPAH patients vs. 30 controls).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Proteomic analysis identified 401 proteins and 1554 peptide fragments, with 114 DEPs between groups (47 up-regulated and 67 down-regulated). In biological processes, DEPs are primarily enriched in adaptive immune response, followed by signal transduction. Extracellular exosome and extracellular region are the most commonly enriched cell components. For molecular function, DEPs are mainly involved in antigen binding and calcium ion binding, with the top 30 Gene Ontology terms exhibiting similar distribution patterns between up- and down-regulated DEPs. Pathway analysis revealed significant enrichment in complement/coagulation cascades, immune response, and extracellular matrix remodeling. LGALS3BP was observed to be significantly up-regulated in IPAH serum compared with controls (fold change = 1.36, <i>p</i> < 0.001), a finding validated by independent ELISA (IPAH: 6.43 ± 1.73 μg/mL vs. controls: 2.33 ± 1.06 μg/mL; <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Integrated proteomic profiling and clinical validation provide the first evidence of elevated serum LGALS3BP in IPAH, indicating its putative role in pathogenesis and translational medicine.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The COVID-19 pandemic due to SARS-CoV-2 has initiated historically unparalleled global health, social, and economic impacts. Syntheses of the multivariable interdependent effects on the multiple clinical, immunologic, psychosocial, and health service realms are required to guide current and future public health preparedness and policy.
Methods
A systematic review of a meta-analysis was conducted using the PubMed, Scopus, and Web of Science databases from December 2019 to 2025 to identify observational studies and randomized controlled trials. Quantitative reporting studies of COVID-19 outcomes were included. Random-effects model aggregated effect sizes were estimated and tested for heterogeneity with Cochran's Q, τ2, and I2. Subgroup, moderator, publication bias, sensitivity, and leave-one-out analyses were conducted for exploration and validation.
Results
Twenty-four studies were classified into three categories: clinical outcomes (15 studies), immunogenicity (4 studies), and psychosocial/health service outcomes (5 studies). There was no statistically significant pooled effect (effect ratio 0.95, 95% CI: 0.55–1.62) with severe heterogeneity (I2 > 99%). Immunogenicity showed a statistically significant positive effect (pooled estimate 0.77, 95% CI: 0.38–1.16) with high heterogeneity (I2 ~96%). Psychosocial effects were highly heterogeneous with non-significant overall effects (estimate −1.03, 95% CI: −5.74 to 3.69). Sample size was an influential moderator that explained significant between-group heterogeneity.
Discussion
The outcomes reveal robust immunogenic vaccine impacts and indeterminate psychosocial and clinical impacts, consistent with the heterogeneity and complexity of COVID-19 effects. Great heterogeneity highlights methodological standardization and cautious interpretation. This present meta-analysis offers key lessons to guide subsequent study design and manufacture of fair health policy and pandemic readiness.
{"title":"COVID-19 Pandemic: A Comprehensive Meta-Review of Global Impacts, Responses, and Future Preparedness","authors":"Rulin Wang, Muhammad Ahsan Naeem","doi":"10.1111/crj.70134","DOIUrl":"10.1111/crj.70134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The COVID-19 pandemic due to SARS-CoV-2 has initiated historically unparalleled global health, social, and economic impacts. Syntheses of the multivariable interdependent effects on the multiple clinical, immunologic, psychosocial, and health service realms are required to guide current and future public health preparedness and policy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review of a meta-analysis was conducted using the PubMed, Scopus, and Web of Science databases from December 2019 to 2025 to identify observational studies and randomized controlled trials. Quantitative reporting studies of COVID-19 outcomes were included. Random-effects model aggregated effect sizes were estimated and tested for heterogeneity with Cochran's Q, <i>τ</i><sup>2</sup>, and <i>I</i><sup>2</sup>. Subgroup, moderator, publication bias, sensitivity, and leave-one-out analyses were conducted for exploration and validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-four studies were classified into three categories: clinical outcomes (15 studies), immunogenicity (4 studies), and psychosocial/health service outcomes (5 studies). There was no statistically significant pooled effect (effect ratio 0.95, 95% CI: 0.55–1.62) with severe heterogeneity (<i>I</i><sup>2</sup> > 99%). Immunogenicity showed a statistically significant positive effect (pooled estimate 0.77, 95% CI: 0.38–1.16) with high heterogeneity (I<sup>2</sup> ~96%). Psychosocial effects were highly heterogeneous with non-significant overall effects (estimate −1.03, 95% CI: −5.74 to 3.69). Sample size was an influential moderator that explained significant between-group heterogeneity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The outcomes reveal robust immunogenic vaccine impacts and indeterminate psychosocial and clinical impacts, consistent with the heterogeneity and complexity of COVID-19 effects. Great heterogeneity highlights methodological standardization and cautious interpretation. This present meta-analysis offers key lessons to guide subsequent study design and manufacture of fair health policy and pandemic readiness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 11","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Follicular dendritic cell sarcoma (FDCS) is an uncommon malignant neoplasm that arises from follicular dendritic cells (FDCs). The mediastinum is a more unusual site of FDCS. In this document, we detail a case involving the complete surgical removal of FDCS located in the mediastinum. A 28-year-old woman presented with symptoms of right chest pain. Accompanying symptoms include chest tightness, shortness of breath, and faintness. Chest computed tomography was performed and revealed abnormal enhancement in the mediastinal region. An excisional biopsy was carried out, and through the aid of immunohistochemistry (IHC), a diagnosis of FDCS was confirmed. Following surgery, the patient underwent radiotherapy for 27 sessions. The patient was followed up by the oncology service for 6 years and was still alive at the time of drafting this report. This exceedingly uncommon case underscores the challenges in making a differential diagnosis and emphasizes the significance of diagnostic indicators, including histopathology and IHC, in establishing a diagnosis. Clinicians should be alert to the possibility of encountering this disease and take into consideration various characteristics to avoid misdiagnosis.
{"title":"Follicular Dendritic Cell Sarcoma in Mediastinum: A Case Study and Literature Review","authors":"Qingxia Xu, Chong Zhang, Yang Ma, Longquan Xiang","doi":"10.1111/crj.70140","DOIUrl":"10.1111/crj.70140","url":null,"abstract":"<p>Follicular dendritic cell sarcoma (FDCS) is an uncommon malignant neoplasm that arises from follicular dendritic cells (FDCs). The mediastinum is a more unusual site of FDCS. In this document, we detail a case involving the complete surgical removal of FDCS located in the mediastinum. A 28-year-old woman presented with symptoms of right chest pain. Accompanying symptoms include chest tightness, shortness of breath, and faintness. Chest computed tomography was performed and revealed abnormal enhancement in the mediastinal region. An excisional biopsy was carried out, and through the aid of immunohistochemistry (IHC), a diagnosis of FDCS was confirmed. Following surgery, the patient underwent radiotherapy for 27 sessions. The patient was followed up by the oncology service for 6 years and was still alive at the time of drafting this report. This exceedingly uncommon case underscores the challenges in making a differential diagnosis and emphasizes the significance of diagnostic indicators, including histopathology and IHC, in establishing a diagnosis. Clinicians should be alert to the possibility of encountering this disease and take into consideration various characteristics to avoid misdiagnosis.</p>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 11","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Respiratory mechanics and gas exchange parameters are readily accessible indicators for evaluating ventilation in patients with acute respiratory distress syndrome (ARDS). Computed tomography (CT) is a widely used radiological imaging technique, while electrical impedance tomography (EIT) is a novel technique for pulmonary function monitoring developed in recent years. Studies suggest that EIT combined with quantitative CT holds unique value in assessing ventilation/perfusion (V/Q) function. Unlike classic ARDS, the pathophysiologic alterations in ARDS following lung transplantation are complex, and the specific mechanisms remain unclear. This study aims to explore the use of respiratory mechanics, gas exchange parameters, EIT, and quantitative CT for the multimodal assessment of V/Q function in post-lung transplantation ARDS. We further aim to integrate visualizing dynamic imaging and regional quantitative lung analysis into this multimodal assessment system.</p> </section> <section> <h3> Method</h3> <p>We retrospectively enrolled lung transplant recipients admitted to the intensive care unit who met the Berlin criteria for ARDS. Inclusion required an arterial partial pressure of oxygen to fraction of inspired oxygen ratio (P/F) ≤ 300 mmHg, with both EIT monitoring of V/Q and high-resolution CT performed within 24 h of documented P/F ≤ 300 mmHg. Patient baseline characteristics, respiratory mechanics parameters, gas exchange parameters, EIT data, and CT images were collected. Subjects were stratified into two groups according to P/F values: a low P/F group (P/F < 200 mmHg) and a high P/F group (200 mmHg ≤ P/F ≤ 300 mmHg). Ventilation parameters derived from EIT included global inhomogeneity index (GI), center of ventilation (COV), and regional ventilation delay index (RVDI). Using hypertonic saline contrast-enhanced EIT, we acquired V/Q parameters and calculated both global and regional EIT-based dead space fraction (EIT-Dead Space), intrapulmonary shunt fraction (EIT-Shunt), and V/Q matching (EIT-V/Q Match). Chest CT images were processed through a multitask learning U-net-based computer-aided diagnostic model. This enabled semiautomated lung segmentation, identification of high-density lesions, quantitative analysis, and three-dimensional visualization. Pulmonary volumes, lesion volumes, and percentage lesion volumes (calculated as lung lesion volume divided by lung volume) were, respectively, quantified for the left and right lungs.</p> </section> <section> <h3> Result</h3> <p>The study ultimately enrolled 21 lung transplant recipients with ARDS, comprising five patients in the low P/F group and 16 in
{"title":"EIT Outperforms Quantitative CT in Stratifying ARDS Severity After Lung Transplantation: A Retrospective Study","authors":"Hui Jiang, Hu Zhao, Wei Cui, Xinxin Zhu, Ruoruo Yang, Yuqiang Wang, Xia Zheng","doi":"10.1111/crj.70135","DOIUrl":"10.1111/crj.70135","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Respiratory mechanics and gas exchange parameters are readily accessible indicators for evaluating ventilation in patients with acute respiratory distress syndrome (ARDS). Computed tomography (CT) is a widely used radiological imaging technique, while electrical impedance tomography (EIT) is a novel technique for pulmonary function monitoring developed in recent years. Studies suggest that EIT combined with quantitative CT holds unique value in assessing ventilation/perfusion (V/Q) function. Unlike classic ARDS, the pathophysiologic alterations in ARDS following lung transplantation are complex, and the specific mechanisms remain unclear. This study aims to explore the use of respiratory mechanics, gas exchange parameters, EIT, and quantitative CT for the multimodal assessment of V/Q function in post-lung transplantation ARDS. We further aim to integrate visualizing dynamic imaging and regional quantitative lung analysis into this multimodal assessment system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We retrospectively enrolled lung transplant recipients admitted to the intensive care unit who met the Berlin criteria for ARDS. Inclusion required an arterial partial pressure of oxygen to fraction of inspired oxygen ratio (P/F) ≤ 300 mmHg, with both EIT monitoring of V/Q and high-resolution CT performed within 24 h of documented P/F ≤ 300 mmHg. Patient baseline characteristics, respiratory mechanics parameters, gas exchange parameters, EIT data, and CT images were collected. Subjects were stratified into two groups according to P/F values: a low P/F group (P/F < 200 mmHg) and a high P/F group (200 mmHg ≤ P/F ≤ 300 mmHg). Ventilation parameters derived from EIT included global inhomogeneity index (GI), center of ventilation (COV), and regional ventilation delay index (RVDI). Using hypertonic saline contrast-enhanced EIT, we acquired V/Q parameters and calculated both global and regional EIT-based dead space fraction (EIT-Dead Space), intrapulmonary shunt fraction (EIT-Shunt), and V/Q matching (EIT-V/Q Match). Chest CT images were processed through a multitask learning U-net-based computer-aided diagnostic model. This enabled semiautomated lung segmentation, identification of high-density lesions, quantitative analysis, and three-dimensional visualization. Pulmonary volumes, lesion volumes, and percentage lesion volumes (calculated as lung lesion volume divided by lung volume) were, respectively, quantified for the left and right lungs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>The study ultimately enrolled 21 lung transplant recipients with ARDS, comprising five patients in the low P/F group and 16 in ","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 11","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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