{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T19:10:09Z","timestamp":1779909009307,"version":"3.53.1"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82474604"],"award-info":[{"award-number":["82474604"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Bone Miner Metab"],"published-print":{"date-parts":[[2025,7]]},"DOI":"10.1007\/s00774-025-01609-8","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T11:52:44Z","timestamp":1748346764000},"page":"430-438","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Higher systemic immune-inflammation index associates with vertebral marrow proton density fat fraction in postmenopausal women"],"prefix":"10.1007","volume":"43","author":[{"given":"Li","family":"Lu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeyang","family":"Miao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyong","family":"Zuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shixin","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0840-9022","authenticated-orcid":false,"given":"Guanwu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"1609_CR1","doi-asserted-by":"publisher","first-page":"103169","DOI":"10.1016\/j.jaut.2024.103169","volume":"143","author":"J Bi","year":"2024","unstructured":"Bi J, Zhang C, Lu C, Mo C, Zeng J, Yao M, Jia B, Liu Z, Yuan P, Xu S (2024) Age-related bone diseases: role of inflammaging. J Autoimmun 143:103169","journal-title":"J Autoimmun"},{"key":"1609_CR2","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s41232-023-00279-1","volume":"43","author":"J Kushioka","year":"2023","unstructured":"Kushioka J, Chow SKH, Toya M, Tsubosaka M, Shen H, Gao Q, Li X, Zhang N, Goodman SB (2023) Bone regeneration in inflammation with aging and cell-based immunomodulatory therapy. Inflamm Regen 43:29","journal-title":"Inflamm Regen"},{"key":"1609_CR3","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1016\/j.cca.2020.03.040","volume":"506","author":"S Mazzaferro","year":"2020","unstructured":"Mazzaferro S, De Martini N, Rotondi S, Tartaglione L, Ure\u00f1a-Torres P, Bover J, Pasquali M (2020) Bone, inflammation and chronic kidney disease. Clin Chim Acta 506:236\u2013240","journal-title":"Clin Chim Acta"},{"key":"1609_CR4","doi-asserted-by":"publisher","first-page":"10662","DOI":"10.1038\/s41598-023-37377-6","volume":"13","author":"Z Huang","year":"2023","unstructured":"Huang Z, Xu Z, Wan R, Hu D, Huang Y (2023) Associations between blood inflammatory markers and bone mineral density and strength in the femoral neck: findings from the MIDUS II study. Sci Rep 13:10662","journal-title":"Sci Rep"},{"key":"1609_CR5","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1186\/s13018-023-03795-5","volume":"18","author":"S Chen","year":"2023","unstructured":"Chen S, Sun X, Jin J, Zhou G, Li Z (2023) Association between inflammatory markers and bone mineral density: a cross-sectional study from NHANES 2007\u20132010. J Orthop Surg Res 18:305","journal-title":"J Orthop Surg Res"},{"key":"1609_CR6","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.1007\/s00198-005-1840-5","volume":"16","author":"JM Koh","year":"2005","unstructured":"Koh JM, Khang YH, Jung CH, Bae S, Kim DJ, Chung YE, Kim GS (2005) Higher circulating hsCRP levels are associated with lower bone mineral density in healthy pre-and postmenopausal women: evidence for a link between systemic inflammation and osteoporosis. Osteoporos Int 16:1263\u20131271","journal-title":"Osteoporos Int"},{"key":"1609_CR7","doi-asserted-by":"publisher","first-page":"508","DOI":"10.18295\/squmj.11.2021.145","volume":"22","author":"A Al Salmani","year":"2022","unstructured":"Al Salmani A, Al Shidhani A, Al-Alawi NM, Al Sulaimi AA, Al-Hashemi MA (2022) Inflammatory markers as a predictor of postmenopausal osteoporosis: cross-sectional study from sultan qaboos university hospital. Sultan Qaboos Univ Med J 22:508\u2013514","journal-title":"Sultan Qaboos Univ Med J"},{"key":"1609_CR8","doi-asserted-by":"publisher","first-page":"e220461","DOI":"10.1530\/EC-22-0461","volume":"12","author":"J Zhang","year":"2023","unstructured":"Zhang J, Jiang J, Qin Y, Zhang Y, Wu Y, Xu H (2023) Systemic immune-inflammation index is associated with decreased bone mass density and osteoporosis in postmenopausal women but not in premenopausal women. Endocr Connect 12:e220461","journal-title":"Endocr Connect"},{"key":"1609_CR9","doi-asserted-by":"publisher","first-page":"1412298","DOI":"10.3389\/fimmu.2024.1412298","volume":"15","author":"Q Dong","year":"2024","unstructured":"Dong Q, Wu J, Zhang H, Luo L, Wu W (2024) The causal role of circulating inflammatory markers in osteoporosis: a bidirectional Mendelian randomized study. Front Immunol 15:1412298","journal-title":"Front Immunol"},{"key":"1609_CR10","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1080\/09513590.2021.1885642","volume":"37","author":"YN Du","year":"2021","unstructured":"Du YN, Chen YJ, Zhang HY, Wang X, Zhang ZF (2021) Inverse association between systemic immune-inflammation index and bone mineral density in postmenopausal women. Gynecol Endocrinol 37:650\u2013654","journal-title":"Gynecol Endocrinol"},{"key":"1609_CR11","doi-asserted-by":"publisher","first-page":"12637","DOI":"10.1038\/s41598-024-63193-7","volume":"14","author":"H Zhuo","year":"2024","unstructured":"Zhuo H, Zhou Z, Chen X, Song Z, Shang Q, Huang H, Xiao Y, Wang X, Chen H, Yan X, Zhang P (2024) Constructing and validating a predictive nomogram for osteoporosis risk among Chinese single-center male population using the systemic immune-inflammation index. Sci Rep 14:12637","journal-title":"Sci Rep"},{"key":"1609_CR12","doi-asserted-by":"publisher","first-page":"e1365","DOI":"10.1002\/iid3.1365","volume":"12","author":"X Jin","year":"2024","unstructured":"Jin X, Wang Y, Wang H, Wang L, Huan B, Liu C (2024) Correlation study: bone density and circulating inflammatory markers in postmenopausal patients. Immun Inflamm Dis 12:e1365","journal-title":"Immun Inflamm Dis"},{"key":"1609_CR13","doi-asserted-by":"publisher","first-page":"e992","DOI":"10.1002\/iid3.992","volume":"11","author":"S Zhang","year":"2023","unstructured":"Zhang S, Ni W (2023) High systemic immune-inflammation index is relevant to osteoporosis among middle-aged and older people: a cross-sectional study. Immun Inflamm Dis 11:e992","journal-title":"Immun Inflamm Dis"},{"key":"1609_CR14","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.ejrad.2019.02.020","volume":"113","author":"L Zhu","year":"2019","unstructured":"Zhu L, Xu Z, Li G, Wang Y, Li X, Shi X, Lin H, Chang S (2019) Marrow adiposity as an indicator for insulin resistance in postmenopausal women with newly diagnosed type 2 diabetes\u2013an investigation by chemical shift-encoded water-fat MRI. Eur J Radiol 113:158\u2013164","journal-title":"Eur J Radiol"},{"key":"1609_CR15","doi-asserted-by":"publisher","first-page":"724","DOI":"10.3390\/cells13090724","volume":"13","author":"E Marinelli Busilacchi","year":"2024","unstructured":"Marinelli Busilacchi E, Morsia E, Poloni A (2024) Bone marrow adipose tissue. Cells 13:724","journal-title":"Cells"},{"key":"1609_CR16","doi-asserted-by":"publisher","first-page":"853765","DOI":"10.3389\/fendo.2022.853765","volume":"13","author":"N Aaron","year":"2022","unstructured":"Aaron N, Costa S, Rosen CJ, Qiang L (2022) The implications of bone marrow adipose tissue on inflammaging. Front Endocrinol (Lausanne) 13:853765","journal-title":"Front Endocrinol (Lausanne)"},{"key":"1609_CR17","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1002\/jbmr.3986","volume":"35","author":"S Polineni","year":"2020","unstructured":"Polineni S, Resulaj M, Faje AT, Meenaghan E, Bredella MA, Bouxsein M, Lee H, MacDougald OA, Klibanski A, Fazeli PK (2020) Red and white blood cell counts are associated with bone marrow adipose tissue, bone mineral density, and bone microarchitecture in premenopausal women. J Bone Miner Res 35:1031\u20131039","journal-title":"J Bone Miner Res"},{"key":"1609_CR18","doi-asserted-by":"publisher","first-page":"1442046","DOI":"10.3389\/fendo.2024.1442046","volume":"15","author":"X Li","year":"2024","unstructured":"Li X, Zuo X, Lu L, Xu R, Wang Y, Chang S, Wang Y, Luo P, Li G (2024) Vertebral marrow fat fraction is associated with circulating RANKL in postmenopausal females. Front Endocrinol (Lausanne) 15:1442046","journal-title":"Front Endocrinol (Lausanne)"},{"key":"1609_CR19","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1002\/jmri.25351","volume":"45","author":"G Li","year":"2017","unstructured":"Li G, Xu Z, Gu H, Li X, Yuan W, Chang S, Fan J, Calimente H, Hu J (2017) Comparison of chemical shift-encoded water\u2013fat MRI and MR spectroscopy in quantification of marrow fat in postmenopausal females. J Magn Reson Imaging 45:66\u201373","journal-title":"J Magn Reson Imaging"},{"key":"1609_CR20","doi-asserted-by":"publisher","first-page":"1046547","DOI":"10.3389\/fendo.2022.1046547","volume":"13","author":"Y Leonhardt","year":"2022","unstructured":"Leonhardt Y, Ketschau J, Ruschke S, Gassert FT, Glanz L, Feuerriegel GC, Gassert FG, Baum T, Kirschke JS, Braren RF, Schwaiger BJ (2022) Associations of incidental vertebral fractures and longitudinal changes of MR\u2013based proton density fat fraction and T2* measurements of vertebral bone marrow. Front Endocrinol (Lausanne) 13:1046547","journal-title":"Front Endocrinol (Lausanne)"},{"key":"1609_CR21","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.arr.2017.03.008","volume":"36","author":"C Jackaman","year":"2017","unstructured":"Jackaman C, Tomay F, Duong L, Razak NBA, Pixley FJ, Metharom P, Nelson DJ (2017) Aging and cancer: the role of macrophages and neutrophils. Ageing Res Rev 36:105\u2013116","journal-title":"Ageing Res Rev"},{"key":"1609_CR22","doi-asserted-by":"publisher","first-page":"20012","DOI":"10.1073\/pnas.1116110108","volume":"108","author":"WW Pang","year":"2011","unstructured":"Pang WW, Price EA, Sahoo D, Beerman I, Maloney WJ, Rossi DJ, Schrier SL, Weissman IL (2011) Human bone marrow hematopoietic stem cells are increased in frequency and myeloid-biased with age. Proc Natl Acad Sci USA 108:20012\u201320017","journal-title":"Proc Natl Acad Sci USA"},{"key":"1609_CR23","doi-asserted-by":"publisher","first-page":"2941","DOI":"10.1182\/blood-2011-01-330050","volume":"118","author":"T Yahata","year":"2011","unstructured":"Yahata T, Takanashi T, Muguruma Y, Ibrahim AA, Matsuzawa H, Uno T, Sheng Y, Onizuka M, Ito M, Kato S, Ando K (2011) Accumulation of oxidative DNA damage restricts the self-renewal capacity of human hematopoietic stem cells. Blood 118:2941\u20132950","journal-title":"Blood"},{"key":"1609_CR24","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1038\/s41590-019-0407-0","volume":"20","author":"G Caputa","year":"2019","unstructured":"Caputa G, Castoldi A, Pearce EJ (2019) Metabolic adaptations of tissue-resident immune cells. Nat Immunol 20:793\u2013801","journal-title":"Nat Immunol"},{"key":"1609_CR25","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1111\/j.1469-7580.2011.01423.x","volume":"219","author":"SR Tuljapurkar","year":"2011","unstructured":"Tuljapurkar SR, McGuire TR, Brusnahan SK, Jackson JD, Garvin KL, Kessinger MA, Lane JT, O\u2019Kane BJ, Sharp JG (2011) Changes in human bone marrow fat content associated with changes in hematopoietic stem cell numbers and cytokine levels with aging. J Anat 219:574\u2013581","journal-title":"J Anat"},{"key":"1609_CR26","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1016\/j.mad.2010.10.002","volume":"131","author":"SK Brusnahan","year":"2010","unstructured":"Brusnahan SK, McGuire TR, Jackson JD, Lane JT, Garvin KL, O\u2019kane BJ, Berger AM, Tuljapurkar SR, Kessinger MA, Sharp JG (2010) Human blood and marrow side population stem cell and stro-1 positive bone marrow stromal cell numbers decline with age, with an increase in quality of surviving stem cells: correlation with cytokines. Mech Ageing Dev 131:718\u2013722","journal-title":"Mech Ageing Dev"},{"key":"1609_CR27","doi-asserted-by":"publisher","first-page":"e23016","DOI":"10.1002\/jcla.23016","volume":"34","author":"H Fang","year":"2020","unstructured":"Fang H, Zhang H, Wang Z, Zhou Z, Li Y, Lu L (2020) Systemic immune-inflammation index acts as a novel diagnostic biomarker for postmenopausal osteoporosis and could predict the risk of osteoporotic fracture. J Clin Lab Anal 34:e23016","journal-title":"J Clin Lab Anal"},{"key":"1609_CR28","doi-asserted-by":"publisher","first-page":"297","DOI":"10.2147\/JIR.S385220","volume":"16","author":"Y Chen","year":"2023","unstructured":"Chen Y, Yu J, Shi L, Han S, Chen J, Sheng Z, Deng M, Jin X, Zhang Z (2023) Systemic inflammation markers associated with bone mineral density in perimenopausal and postmenopausal women. J Inflamm Res 16:297\u2013309","journal-title":"J Inflamm Res"},{"key":"1609_CR29","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.semcdb.2021.05.014","volume":"123","author":"V Fischer","year":"2022","unstructured":"Fischer V, Haffner-Luntzer M (2022) Interaction between bone and immune cells: Implications for postmenopausal osteoporosis. Semin Cell Dev Biol 123:14\u201321","journal-title":"Semin Cell Dev Biol"},{"key":"1609_CR30","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1002\/j.2040-4603.2018.tb00043.x","volume":"8","author":"A Tchernof","year":"2018","unstructured":"Tchernof A, Brochu D, Maltais-Payette I, Mansour MF, Marchand GB, Carreau AM, Kapeluto J (2018) Androgens and the regulation of adiposity and body fat distribution in humans. Compr Physiol 8:1253\u20131290","journal-title":"Compr Physiol"},{"key":"1609_CR31","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1080\/13685538.2018.1482487","volume":"22","author":"NV Mohamad","year":"2019","unstructured":"Mohamad NV, Wong SK, Wan Hasan WN, Jolly JJ, Nur-Farhana MF, Ima-Nirwana S, Chin KY (2019) The relationship between circulating testosterone and inflammatory cytokines in men. Aging Male 22:129\u2013140","journal-title":"Aging Male"},{"key":"1609_CR32","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/j.tem.2022.03.003","volume":"33","author":"G Pachon-Pena","year":"2022","unstructured":"Pachon-Pena G, Bredella MA (2022) Bone marrow adipose tissue in metabolic health. Trends Endocrinol Metab 33:401\u2013408","journal-title":"Trends Endocrinol Metab"},{"key":"1609_CR33","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1016\/j.stem.2017.02.009","volume":"20","author":"TH Ambrosi","year":"2017","unstructured":"Ambrosi TH, Scialdone A, Graja A, Gohlke S, Jank AM, Bocian C, Woelk L, Fan H, Logan DW, Sch\u00fcrmann A, Saraiva LR (2017) Adipocyte accumulation in the bone marrow during obesity and aging impairs stem cell-based hematopoietic and bone regeneration. Cell Stem Cell 20:771-784.e776","journal-title":"Cell Stem Cell"},{"key":"1609_CR34","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1016\/j.bone.2019.06.016","volume":"127","author":"A Al Saedi","year":"2019","unstructured":"Al Saedi A, Bermeo S, Plotkin L, Myers DE, Duque G (2019) Mechanisms of palmitate-induced lipotoxicity in osteocytes. Bone 127:353\u2013359","journal-title":"Bone"},{"key":"1609_CR35","doi-asserted-by":"publisher","first-page":"110669","DOI":"10.1016\/j.ejrad.2022.110669","volume":"159","author":"A Yu","year":"2023","unstructured":"Yu A, Huang M, Wang L, Zhang Y, Li K, Lou L, Liang W, Blake GM, Deng W, Cheng X (2023) Age and gender differences in vertebral bone marrow adipose tissue and bone mineral density, based on MRI and quantitative CT. Eur J Radiol 159:110669","journal-title":"Eur J Radiol"},{"key":"1609_CR36","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.mri.2018.07.001","volume":"53","author":"D Martel","year":"2018","unstructured":"Martel D, Leporq B, Bruno M, Regatte RR, Honig S, Chang G (2018) Chemical shift-encoded MRI for assessment of bone marrow adipose tissue fat composition: pilot study in premenopausal versus postmenopausal women. Magn Reson Imaging 53:148\u2013155","journal-title":"Magn Reson Imaging"},{"key":"1609_CR37","doi-asserted-by":"publisher","first-page":"7707","DOI":"10.1038\/s41598-018-26053-9","volume":"8","author":"LT Ho-Pham","year":"2018","unstructured":"Ho-Pham LT, Ho-Le TP, Mai LD, Do TM, Doan MC, Nguyen TV (2018) Sex-difference in bone architecture and bone fragility in Vietnamese. Sci Rep 8:7707","journal-title":"Sci Rep"},{"key":"1609_CR38","doi-asserted-by":"publisher","first-page":"568","DOI":"10.3389\/fimmu.2015.00568","volume":"6","author":"A Keselman","year":"2015","unstructured":"Keselman A, Heller N (2015) Estrogen signaling modulates allergic inflammation and contributes to sex differences in asthma. Front Immunol 6:568","journal-title":"Front Immunol"},{"key":"1609_CR39","doi-asserted-by":"publisher","first-page":"1478","DOI":"10.2174\/1871530320666200604160614","volume":"20","author":"NV Mohamad","year":"2020","unstructured":"Mohamad NV, Ima-Nirwana S, Chin KY (2020) Are oxidative stress and inflammation mediators of bone loss due to estrogen deficiency? a review of current evidence. Endocr Metab Immune Disord Drug Targets 20:1478\u20131487","journal-title":"Endocr Metab Immune Disord Drug Targets"},{"key":"1609_CR40","first-page":"207","volume":"22","author":"S Ehnert","year":"2023","unstructured":"Ehnert S, Schreiner AJ, Seeliger C, Ecker J, Springer F et al (2023) Amount and composition of total fatty acids in red and yellow bone marrow are altered with changes in bone mineral density. Excli J 22:207\u2013220","journal-title":"Excli J"}],"container-title":["Journal of Bone and Mineral Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00774-025-01609-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00774-025-01609-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00774-025-01609-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T15:50:44Z","timestamp":1757173844000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00774-025-01609-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,27]]},"references-count":40,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["1609"],"URL":"https:\/\/doi.org\/10.1007\/s00774-025-01609-8","relation":{},"ISSN":["0914-8779","1435-5604"],"issn-type":[{"value":"0914-8779","type":"print"},{"value":"1435-5604","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,27]]},"assertion":[{"value":"14 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the Institutional Review Board of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, according to the ethical and moral principles stated in the Declaration of Helsinki and its late amendments. Written informed consent was obtained from all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}