{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T13:36:45Z","timestamp":1781876205716,"version":"3.54.5"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"he Natural Science Research General Project of Colleges and Universities in Jiangsu Province","award":["24KJB320013"],"award-info":[{"award-number":["24KJB320013"]}]},{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82272411"],"award-info":[{"award-number":["82272411"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the Jiangsu Provincial Key Medical Discipline","award":["ZDXK202240"],"award-info":[{"award-number":["ZDXK202240"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Exp Med"],"DOI":"10.1007\/s10238-025-01938-y","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T02:40:20Z","timestamp":1763433620000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Serum tRF-18-HR05X6D2 may serve as a promising potential diagnostic biomarker for gastric cancer"],"prefix":"10.1007","volume":"26","author":[{"given":"Xian","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiwei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yalan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyuan","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongrong","family":"Jing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoqing","family":"Ju","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"issue":"3","key":"1938_CR1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209\u201349. https:\/\/doi.org\/10.3322\/caac.21660.","journal-title":"CA Cancer J Clin"},{"issue":"10","key":"1938_CR2","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1002\/cac2.12197","volume":"41","author":"H Qiu","year":"2021","unstructured":"Qiu H, Cao S, Xu R. Cancer incidence, mortality, and burden in China: a time-trend analysis and comparison with the United States and United Kingdom based on the global epidemiological data released in 2020. Cancer Commun. 2021;41(10):1037\u201348. https:\/\/doi.org\/10.1002\/cac2.12197.","journal-title":"Cancer Commun"},{"issue":"3","key":"1938_CR3","doi-asserted-by":"publisher","first-page":"166","DOI":"10.32074\/1591-951x-166","volume":"112","author":"I Gullo","year":"2020","unstructured":"Gullo I, Grillo F, Mastracci L, et al. Precancerous lesions of the stomach, gastric cancer and hereditary gastric cancer syndromes. Pathologica. 2020;112(3):166\u201385. https:\/\/doi.org\/10.32074\/1591-951x-166.","journal-title":"Pathologica"},{"issue":"4","key":"1938_CR4","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1007\/s00423-004-0482-y","volume":"390","author":"N Yuasa","year":"2005","unstructured":"Yuasa N, Nimura Y. Survival after surgical treatment of early gastric cancer, surgical techniques, and long-term survival. Langenbecks Arch Surg. 2005;390(4):286\u201393. https:\/\/doi.org\/10.1007\/s00423-004-0482-y.","journal-title":"Langenbecks Arch Surg"},{"issue":"2","key":"1938_CR5","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1053\/j.gastro.2023.02.044","volume":"165","author":"X Guo","year":"2023","unstructured":"Guo X, Peng Y, Song Q, et al. A liquid biopsy signature for the early detection of gastric cancer in patients. Gastroenterology. 2023;165(2):402\u201313. https:\/\/doi.org\/10.1053\/j.gastro.2023.02.044.","journal-title":"Gastroenterology"},{"issue":"12","key":"1938_CR6","first-page":"1651","volume":"84","author":"H Allgayer","year":"1997","unstructured":"Allgayer H, Heiss MM, Schildberg FW. Prognostic factors in gastric cancer. Br J Surg. 1997;84(12):1651\u201364.","journal-title":"Br J Surg"},{"issue":"17","key":"1938_CR7","doi-asserted-by":"publisher","first-page":"2515","DOI":"10.3748\/wjg.v29.i17.2515","volume":"29","author":"T Matsuoka","year":"2023","unstructured":"Matsuoka T, Yashiro M. Novel biomarkers for early detection of gastric cancer. World J Gastroenterol. 2023;29(17):2515\u201333. https:\/\/doi.org\/10.3748\/wjg.v29.i17.2515.","journal-title":"World J Gastroenterol"},{"issue":"9","key":"1938_CR8","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1038\/s43018-020-00114-3","volume":"1","author":"X Zhang","year":"2020","unstructured":"Zhang X, Meyerson M. Illuminating the noncoding genome in cancer. Nat Cancer. 2020;1(9):864\u201372. https:\/\/doi.org\/10.1038\/s43018-020-00114-3.","journal-title":"Nat Cancer"},{"issue":"1","key":"1938_CR9","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1038\/nrc.2017.99","volume":"18","author":"E Anastasiadou","year":"2018","unstructured":"Anastasiadou E, Jacob LS, Slack FJ. Non-coding RNA networks in cancer. Nat Rev Cancer. 2018;18(1):5\u201318. https:\/\/doi.org\/10.1038\/nrc.2017.99.","journal-title":"Nat Rev Cancer"},{"issue":"2","key":"1938_CR10","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1038\/nrg3861","volume":"16","author":"S Kirchner","year":"2015","unstructured":"Kirchner S, Ignatova Z. Emerging roles of tRNA in adaptive translation, signalling dynamics and disease. Nat Rev Genet. 2015;16(2):98\u2013112. https:\/\/doi.org\/10.1038\/nrg3861.","journal-title":"Nat Rev Genet"},{"issue":"22","key":"1938_CR11","doi-asserted-by":"publisher","first-page":"2639","DOI":"10.1101\/gad.1837609","volume":"23","author":"YS Lee","year":"2009","unstructured":"Lee YS, Shibata Y, Malhotra A, et al. A novel class of small RNAs: tRNA-derived RNA fragments (tRFs). Genes Dev. 2009;23(22):2639\u201349. https:\/\/doi.org\/10.1101\/gad.1837609.","journal-title":"Genes Dev"},{"issue":"11","key":"1938_CR12","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1038\/s41576-022-00501-9","volume":"23","author":"EA Orellana","year":"2022","unstructured":"Orellana EA, Siegal E, Gregory RI. tRNA dysregulation and disease. Nat Rev Genet. 2022;23(11):651\u201364. https:\/\/doi.org\/10.1038\/s41576-022-00501-9.","journal-title":"Nat Rev Genet"},{"key":"1938_CR13","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.canlet.2019.03.012","volume":"452","author":"L Zhu","year":"2019","unstructured":"Zhu L, Ge J, Li T, et al. tRNA-derived fragments and tRNA halves: the new players in cancers. Cancer Lett. 2019;452:31\u20137. https:\/\/doi.org\/10.1016\/j.canlet.2019.03.012.","journal-title":"Cancer Lett"},{"issue":"1","key":"1938_CR14","doi-asserted-by":"publisher","DOI":"10.1186\/s12943-023-01739-5","volume":"22","author":"M Fu","year":"2023","unstructured":"Fu M, Gu J, Wang M, et al. Emerging roles of tRNA-derived fragments in cancer. Mol Cancer. 2023;22(1):30. https:\/\/doi.org\/10.1186\/s12943-023-01739-5.","journal-title":"Mol Cancer"},{"issue":"1","key":"1938_CR15","doi-asserted-by":"publisher","DOI":"10.1038\/s41523-020-00211-7","volume":"7","author":"J Wang","year":"2021","unstructured":"Wang J, Ma G, Ge H, et al. Circulating tRNA-derived small RNAs (tsRNAs) signature for the diagnosis and prognosis of breast cancer. NPJ Breast Cancer. 2021;7(1):4. https:\/\/doi.org\/10.1038\/s41523-020-00211-7.","journal-title":"NPJ Breast Cancer"},{"issue":"1","key":"1938_CR16","doi-asserted-by":"publisher","DOI":"10.1186\/s12943-021-01389-5","volume":"20","author":"F Jin","year":"2021","unstructured":"Jin F, Yang L, Wang W, et al. A novel class of tsRNA signatures as biomarkers for diagnosis and prognosis of pancreatic cancer. Mol Cancer. 2021;20(1):95. https:\/\/doi.org\/10.1186\/s12943-021-01389-5.","journal-title":"Mol Cancer"},{"issue":"5","key":"1938_CR17","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.1111\/cas.70003","volume":"116","author":"X Xu","year":"2025","unstructured":"Xu X, Chen J, Bai M, et al. Plasma tsRNA signatures serve as a novel biomarker for bladder cancer. Cancer Sci. 2025;116(5):1255\u201367. https:\/\/doi.org\/10.1111\/cas.70003.","journal-title":"Cancer Sci"},{"issue":"5","key":"1938_CR18","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1631\/jzus.B2300215","volume":"25","author":"Y Zhang","year":"2024","unstructured":"Zhang Y, Gu X, Li Y, et al. Transfer RNA-derived fragment tRF-23-Q99P9P9NDD promotes progression of gastric cancer by targeting ACADSB. J Zhejiang Univ Sci B. 2024;25(5):438\u201350. https:\/\/doi.org\/10.1631\/jzus.B2300215.","journal-title":"J Zhejiang Univ Sci B"},{"issue":"1","key":"1938_CR19","doi-asserted-by":"publisher","DOI":"10.1186\/s13046-024-03132-6","volume":"43","author":"R Xu","year":"2024","unstructured":"Xu R, Du A, Deng X, et al. TsRNA-GlyGCC promotes colorectal cancer progression and 5-FU resistance by regulating SPIB. J Exp Clin Cancer Res. 2024;43(1):230. https:\/\/doi.org\/10.1186\/s13046-024-03132-6.","journal-title":"J Exp Clin Cancer Res"},{"issue":"31","key":"1938_CR20","doi-asserted-by":"publisher","DOI":"10.1002\/advs.202400115","volume":"11","author":"X Ying","year":"2024","unstructured":"Ying X, Hu W, Huang Y, et al. A novel tsRNA, m(7)G-3\u2019 tiRNA Lys(TTT), promotes bladder cancer malignancy via regulating ANXA2 phosphorylation. Adv Sci. 2024;11(31):e2400115. https:\/\/doi.org\/10.1002\/advs.202400115.","journal-title":"Adv Sci"},{"issue":"1","key":"1938_CR21","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-022-01190-w","volume":"7","author":"ZN Lei","year":"2022","unstructured":"Lei ZN, Teng QX, Tian Q, et al. Signaling pathways and therapeutic interventions in gastric cancer. Signal Transduct Target Ther. 2022;7(1):358. https:\/\/doi.org\/10.1038\/s41392-022-01190-w.","journal-title":"Signal Transduct Target Ther"},{"issue":"1","key":"1938_CR22","doi-asserted-by":"publisher","DOI":"10.1186\/s12943-022-01527-7","volume":"21","author":"S Roy","year":"2022","unstructured":"Roy S, Kanda M, Nomura S, et al. Diagnostic efficacy of circular RNAs as noninvasive, liquid biopsy biomarkers for early detection of gastric cancer. Mol Cancer. 2022;21(1):42. https:\/\/doi.org\/10.1186\/s12943-022-01527-7.","journal-title":"Mol Cancer"},{"key":"1938_CR23","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.addr.2014.09.001","volume":"81","author":"G Cheng","year":"2015","unstructured":"Cheng G. Circulating miRNAs: roles in cancer diagnosis, prognosis and therapy. Adv Drug Deliv Rev. 2015;81:75\u201393. https:\/\/doi.org\/10.1016\/j.addr.2014.09.001.","journal-title":"Adv Drug Deliv Rev"},{"key":"1938_CR24","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.749250","volume":"8","author":"M Chivu-Economescu","year":"2021","unstructured":"Chivu-Economescu M, Necula L, Matei L, et al. Clinical applications of liquid biopsy in gastric cancer. Front Med Lausanne. 2021;8:749250. https:\/\/doi.org\/10.3389\/fmed.2021.749250.","journal-title":"Front Med Lausanne"},{"issue":"1","key":"1938_CR25","doi-asserted-by":"publisher","DOI":"10.1186\/s12943-023-01715-z","volume":"22","author":"S Ma","year":"2023","unstructured":"Ma S, Zhou M, Xu Y, et al. Clinical application and detection techniques of liquid biopsy in gastric cancer. Mol Cancer. 2023;22(1):7. https:\/\/doi.org\/10.1186\/s12943-023-01715-z.","journal-title":"Mol Cancer"},{"issue":"4","key":"1938_CR26","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1007\/s10120-021-01161-0","volume":"24","author":"S Abe","year":"2021","unstructured":"Abe S, Matsuzaki J, Sudo K, et al. A novel combination of serum microRNAs for the detection of early gastric cancer. Gastric Cancer: Off J Int Gastric Cancer Assoc Japan Gastric Cancer Assoc. 2021;24(4):835\u201343. https:\/\/doi.org\/10.1007\/s10120-021-01161-0.","journal-title":"Gastric Cancer: Off J Int Gastric Cancer Assoc Japan Gastric Cancer Assoc"},{"key":"1938_CR27","doi-asserted-by":"publisher","DOI":"10.3389\/fgene.2020.00237","volume":"11","author":"S Tang","year":"2020","unstructured":"Tang S, Cheng J, Yao Y, et al. Combination of four serum exosomal miRNAs as novel diagnostic biomarkers for early-stage gastric cancer. Front Genet. 2020;11:237. https:\/\/doi.org\/10.3389\/fgene.2020.00237.","journal-title":"Front Genet"},{"issue":"7","key":"1938_CR28","doi-asserted-by":"publisher","first-page":"1063","DOI":"10.1515\/cclm-2018-0929","volume":"57","author":"W Zong","year":"2019","unstructured":"Zong W, Feng W, Jiang Y, et al. Evaluating the diagnostic and prognostic value of serum long non-coding RNA CTC-497E21.4 in gastric cancer. Clin Chem Lab Med (CCLM). 2019;57(7):1063\u201372. https:\/\/doi.org\/10.1515\/cclm-2018-0929.","journal-title":"Clin Chem Lab Med (CCLM)"},{"issue":"8","key":"1938_CR29","doi-asserted-by":"publisher","first-page":"720","DOI":"10.3349\/ymj.2019.60.8.720","volume":"60","author":"Y Li","year":"2019","unstructured":"Li Y, Sun H, Guan J, et al. Serum microRNA-381: a potential marker for early diagnosis of gastric cancer. Yonsei Med J. 2019;60(8):720\u20136. https:\/\/doi.org\/10.3349\/ymj.2019.60.8.720.","journal-title":"Yonsei Med J"},{"issue":"24","key":"1938_CR30","doi-asserted-by":"publisher","first-page":"14502","DOI":"10.1111\/jcmm.16077","volume":"24","author":"L Ge","year":"2020","unstructured":"Ge L, Zhang N, Li D, et al. Circulating exosomal small RNAs are promising non-invasive diagnostic biomarkers for gastric cancer. J Cell Mol Med. 2020;24(24):14502\u201313. https:\/\/doi.org\/10.1111\/jcmm.16077.","journal-title":"J Cell Mol Med"},{"key":"1938_CR31","doi-asserted-by":"publisher","DOI":"10.1007\/s00210-025-03914-5","author":"Y Tang","year":"2025","unstructured":"Tang Y, Ni K, Jin K, et al. Identification and potential mechanism of a novel gastric cancer suppressor tRF-24-6VR8K09LE9. Naunyn-Schmiedebergs Arch Pharmacol. 2025. https:\/\/doi.org\/10.1007\/s00210-025-03914-5.","journal-title":"Naunyn-Schmiedebergs Arch Pharmacol"},{"key":"1938_CR32","doi-asserted-by":"publisher","DOI":"10.3892\/ijo.2024.5624","author":"HH Hu","year":"2024","unstructured":"Hu HH, Wang SQ, Zhao H, et al. HER2(+) advanced gastric cancer: current state and opportunities (Review). Int J Oncol. 2024. https:\/\/doi.org\/10.3892\/ijo.2024.5624.","journal-title":"Int J Oncol"},{"issue":"4","key":"1938_CR33","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1007\/s11864-025-01300-0","volume":"26","author":"L He","year":"2025","unstructured":"He L, Liu B, Wang Z, et al. Evolving landscape of HER2-targeted therapies for gastric cancer patients. Curr Treat Options Oncol. 2025;26(4):260\u201377. https:\/\/doi.org\/10.1007\/s11864-025-01300-0.","journal-title":"Curr Treat Options Oncol"},{"key":"1938_CR34","doi-asserted-by":"publisher","DOI":"10.1186\/s12915-014-0078-0","volume":"12","author":"P Kumar","year":"2014","unstructured":"Kumar P, Anaya J, Mudunuri SB, et al. Meta-analysis of tRNA derived RNA fragments reveals that they are evolutionarily conserved and associate with AGO proteins to recognize specific RNA targets. BMC Biol. 2014;12:78. https:\/\/doi.org\/10.1186\/s12915-014-0078-0.","journal-title":"BMC Biol"},{"issue":"5","key":"1938_CR35","doi-asserted-by":"publisher","DOI":"10.1038\/tp.2017.82","volume":"7","author":"AK Short","year":"2017","unstructured":"Short AK, Yeshurun S, Powell R, et al. Exercise alters mouse sperm small noncoding RNAs and induces a transgenerational modification of male offspring conditioned fear and anxiety. Transl Psychiatry. 2017;7(5):e1114. https:\/\/doi.org\/10.1038\/tp.2017.82.","journal-title":"Transl Psychiatry"},{"issue":"7683","key":"1938_CR36","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1038\/nature25005","volume":"552","author":"HK Kim","year":"2017","unstructured":"Kim HK, Fuchs G, Wang S, et al. A transfer-RNA-derived small RNA regulates ribosome biogenesis. Nature. 2017;552(7683):57\u201362. https:\/\/doi.org\/10.1038\/nature25005.","journal-title":"Nature"},{"key":"1938_CR37","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.canlet.2019.05.007","volume":"457","author":"D Mo","year":"2019","unstructured":"Mo D, Jiang P, Yang Y, et al. A tRNA fragment, 5\u2019-tiRNA(Val), suppresses the Wnt\/\u03b2-catenin signaling pathway by targeting FZD3 in breast cancer. Cancer Lett. 2019;457:60\u201373. https:\/\/doi.org\/10.1016\/j.canlet.2019.05.007.","journal-title":"Cancer Lett"},{"issue":"7","key":"1938_CR38","doi-asserted-by":"publisher","first-page":"1570","DOI":"10.7150\/ijms.53220","volume":"18","author":"Y Shen","year":"2021","unstructured":"Shen Y, Yu X, Ruan Y, et al. Global profile of tRNA-derived small RNAs in gastric cancer patient plasma and identification of tRF-33-P4R8YP9LON4VDP as a new tumor suppressor. Int J Med Sci. 2021;18(7):1570\u20139. https:\/\/doi.org\/10.7150\/ijms.53220.","journal-title":"Int J Med Sci"},{"issue":"11","key":"1938_CR39","doi-asserted-by":"publisher","first-page":"3230","DOI":"10.7150\/jca.51567","volume":"12","author":"Y Shen","year":"2021","unstructured":"Shen Y, Xie Y, Yu X, et al. Clinical diagnostic values of transfer RNA-derived fragment tRF-19-3L7L73JD and its effects on the growth of gastric cancer cells. J Cancer. 2021;12(11):3230\u20138. https:\/\/doi.org\/10.7150\/jca.51567.","journal-title":"J Cancer"},{"issue":"4","key":"1938_CR40","doi-asserted-by":"publisher","first-page":"1454","DOI":"10.1159\/000438514","volume":"37","author":"D Wang","year":"2015","unstructured":"Wang D, Fan Z, Liu F, et al. Hsa-miR-21 and Hsa-miR-29 in tissue as potential diagnostic and prognostic biomarkers for gastric cancer. Cell Physiol Biochem. 2015;37(4):1454\u201362. https:\/\/doi.org\/10.1159\/000438514.","journal-title":"Cell Physiol Biochem"}],"container-title":["Clinical and Experimental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10238-025-01938-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10238-025-01938-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10238-025-01938-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T02:40:22Z","timestamp":1763433622000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10238-025-01938-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,18]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1938"],"URL":"https:\/\/doi.org\/10.1007\/s10238-025-01938-y","relation":{},"ISSN":["1591-9528"],"issn-type":[{"value":"1591-9528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,18]]},"assertion":[{"value":"10 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 November 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 no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This research was conducted in strict accordance with the Helsinki Declaration, and the study protocol was approved by the Ethics Committee of the Affiliated Hospital of Nantong University (approval No.: 2023-L166).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}}],"article-number":"15"}}