{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:04:00Z","timestamp":1789725840207,"version":"4.0.1"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":51,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Quanzhou City Science and Technology Program, China"},{"name":"The Key Science and Technology Project of Quanzhou Medical College, China"},{"name":"Natural Science Foundation project of Fujian Province, China"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"DOI":"10.1186\/s12872-026-06368-6","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:25:17Z","timestamp":1785324317000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of ACE2 gene polymorphisms with risk of pulmonary arterial hypertension in neonates with congenital heart disease"],"prefix":"10.1186","volume":"26","author":[{"given":"Youfang","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuiling","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingfan","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimu","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinshuang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lifeng","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"issue":"2","key":"6368_CR1","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.ijgo.2016.05.010","volume":"135","author":"KMJ Verdurmen","year":"2016","unstructured":"Verdurmen KMJ, Eijsvoogel NB, Lempersz C, Vullings R, Schroer C, van Laar JOEH, et al. A systematic review of prenatal screening for congenital heart disease by fetal electrocardiography. Int J Gynaecol Obstet. 2016;135(2):129\u201334.","journal-title":"Int J Gynaecol Obstet"},{"issue":"7","key":"6368_CR2","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1016\/S2352-4642(23)00051-2","volume":"7","author":"Y Zhang","year":"2023","unstructured":"Zhang Y, Wang J, Zhao J, Huang G, Liu K, Pan W, et al. Current status and challenges in prenatal and neonatal screening, diagnosis, and management of congenital heart disease in China. Lancet Child Adolesc Health. 2023;7(7):479\u201389.","journal-title":"Lancet Child Adolesc Health"},{"issue":"5","key":"6368_CR3","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1007\/s00431-025-06099-4","volume":"184","author":"J Wacker","year":"2025","unstructured":"Wacker J, Beghetti M. Pulmonary hypertension in pediatrics: from clinical suspicion to management. Eur J Pediatr. 2025;184(5):288.","journal-title":"Eur J Pediatr"},{"issue":"7","key":"6368_CR4","first-page":"172","volume":"4","author":"IJ Jumoboyev","year":"2025","unstructured":"Jumoboyev IJ. Congenital heart disease and pulmonary hypertension in pediatrics. Sci Innov. 2025;4(7):172\u201384.","journal-title":"Sci Innov"},{"issue":"18","key":"6368_CR5","doi-asserted-by":"publisher","first-page":"e009729","DOI":"10.1161\/JAHA.118.009729","volume":"7","author":"D Kolte","year":"2018","unstructured":"Kolte D, Lakshmanan S, Jankowich MD, Brittain EL, Maron BA, Choudhary G. Mild Pulmonary Hypertension Is Associated With Increased Mortality: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2018;7(18):e009729.","journal-title":"J Am Heart Assoc"},{"key":"6368_CR6","first-page":"445","volume":"38","author":"A Constantine","year":"2020","unstructured":"Constantine A, Dimopoulos K, Opotowsky AR. Congenital Heart Disease and Pulmonary Hypertension. Cardiol Clin. 2020;38:445\u201356.","journal-title":"Cardiol Clin"},{"issue":"9","key":"6368_CR7","doi-asserted-by":"publisher","first-page":"715","DOI":"10.2174\/1381612033455431","volume":"9","author":"RP Marshall","year":"2003","unstructured":"Marshall RP. The pulmonary renin-angiotensin system. Curr Pharm Des. 2003;9(9):715\u201322.","journal-title":"Curr Pharm Des"},{"key":"6368_CR8","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.coph.2017.12.002","volume":"40","author":"WSD Tan","year":"2018","unstructured":"Tan WSD, Liao W, Zhou S, Mei D, Wong W-SF. Targeting the renin-angiotensin system as novel therapeutic strategy for pulmonary diseases. Curr Opin Pharmacol. 2018;40:9\u201317.","journal-title":"Curr Opin Pharmacol"},{"key":"6368_CR9","doi-asserted-by":"publisher","first-page":"13","DOI":"10.21873\/invivo.12672","volume":"36","author":"I Gintoni","year":"2022","unstructured":"Gintoni I, Adamopoulou M, Yapijakis C. The Impact of ACE and ACE2 Gene Polymorphisms in Pulmonary Diseases Including COVID-19. Vivo. 2022;36:13\u201329.","journal-title":"Vivo"},{"key":"6368_CR10","doi-asserted-by":"publisher","first-page":"E1","DOI":"10.1161\/01.RES.87.5.e1","volume":"87","author":"M Donoghue","year":"2000","unstructured":"Donoghue M, Hsieh F, Baronas E, Godbout K, Gosselin M, Stagliano N, et al. A novel angiotensin-converting enzyme-related carboxypeptidase (ACE2) converts angiotensin I to angiotensin 1\u20139. Circ Res. 2000;87:E1\u20139.","journal-title":"Circ Res"},{"key":"6368_CR11","doi-asserted-by":"publisher","first-page":"33238","DOI":"10.1074\/jbc.M002615200","volume":"275","author":"SR Tipnis","year":"2000","unstructured":"Tipnis SR, Hooper NM, Hyde R, Karran E, Christie G, Turner AJ. A human homolog of angiotensin-converting enzyme. Cloning and functional expression as a captopril-insensitive carboxypeptidase. J Biol Chem. 2000;275:33238\u201343.","journal-title":"J Biol Chem"},{"key":"6368_CR12","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1007\/s11906-014-0420-5","volume":"16","author":"J Varagic","year":"2014","unstructured":"Varagic J, Ahmad S, Nagata S, Ferrario CM. ACE2: angiotensin II\/angiotensin-(1\u20137) balance in cardiac and renal injury. Curr Hypertens Rep. 2014;16:420.","journal-title":"Curr Hypertens Rep"},{"key":"6368_CR13","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1042\/CS20120269","volume":"124","author":"LM Burrell","year":"2013","unstructured":"Burrell LM, Harrap SB, Velkoska E, Patel SK. The ACE2 gene: its potential as a functional candidate for cardiovascular disease. Clin Sci (Lond). 2013;124:65\u201376.","journal-title":"Clin Sci (Lond)"},{"key":"6368_CR14","doi-asserted-by":"publisher","first-page":"17441","DOI":"10.3390\/ijms242417441","volume":"24","author":"KA Papavassiliou","year":"2023","unstructured":"Papavassiliou KA, Gogou VA, Papavassiliou AG. Angiotensin-Converting Enzyme 2 (ACE2) Signaling in Pulmonary Arterial Hypertension: Underpinning Mechanisms and Potential Targeting Strategies. IJMS. 2023;24:17441.","journal-title":"IJMS"},{"key":"6368_CR15","first-page":"650","volume":"10","author":"B Saravi","year":"2021","unstructured":"Saravi B, Li Z, Lang CN, Schmid B, Lang FK, Grad S, et al. The Tissue Renin-Angiotensin System and Its Role in the Pathogenesis of Major Human Diseases. Quo Vadis? Cells. 2021;10:650.","journal-title":"Quo Vadis? Cells"},{"key":"6368_CR16","doi-asserted-by":"publisher","first-page":"914","DOI":"10.1161\/01.HYP.0000244543.91937.79","volume":"48","author":"GI Rice","year":"2006","unstructured":"Rice GI, Jones AL, Grant PJ, Carter AM, Turner AJ, Hooper NM. Circulating Activities of Angiotensin-Converting Enzyme, Its Homolog, Angiotensin-Converting Enzyme 2, and Neprilysin in a Family Study. Hypertension. 2006;48:914\u201320.","journal-title":"Hypertension"},{"key":"6368_CR17","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1159\/000346884","volume":"124","author":"H Dai","year":"2013","unstructured":"Dai H, Guo Y, Guang X, Xiao Z, Zhang M, Yin X. The Changes of Serum Angiotensin-Converting Enzyme 2 in Patients with Pulmonary Arterial Hypertension due to Congenital Heart Disease. Cardiology. 2013;124:208\u201312.","journal-title":"Cardiology"},{"key":"6368_CR18","doi-asserted-by":"publisher","first-page":"1902416","DOI":"10.1183\/13993003.02416-2019","volume":"56","author":"J Sandoval","year":"2020","unstructured":"Sandoval J, Del Valle-Mondrag\u00f3n L, Masso F, Zayas N, Pulido T, Teijeiro R, et al. Angiotensin converting enzyme 2 and angiotensin (1\u20137) axis in pulmonary arterial hypertension. Eur Respir J. 2020;56:1902416.","journal-title":"Eur Respir J"},{"key":"6368_CR19","doi-asserted-by":"publisher","first-page":"e22033","DOI":"10.1002\/jcla.22033","volume":"31","author":"Y-H Wu","year":"2017","unstructured":"Wu Y-H, Li J-Y, Wang C, Zhang L-M, Qiao H. The ACE2 G8790A Polymorphism: Involvement in Type 2 Diabetes Mellitus Combined with Cerebral Stroke. J Clin Lab Anal. 2017;31:e22033.","journal-title":"J Clin Lab Anal"},{"key":"6368_CR20","doi-asserted-by":"publisher","first-page":"e12917","DOI":"10.1097\/MD.0000000000012917","volume":"97","author":"Q Zhang","year":"2018","unstructured":"Zhang Q, Cong M, Wang N, Li X, Zhang H, Zhang K, et al. Association of angiotensin-converting enzyme 2 gene polymorphism and enzymatic activity with essential hypertension in different gender: A case\u2013control study. Medicine. 2018;97:e12917.","journal-title":"Medicine"},{"key":"6368_CR21","doi-asserted-by":"crossref","unstructured":"Asselta R, Paraboschi EM, Mantovani A, Duga S. ACE2 and TMPRSS2 variants and expression as candidates to sex and country differences in COVID-19 severity in Italy. Aging (Albany NY). 2020 Jun 5;12(11):10087\u201398.","DOI":"10.18632\/aging.103415"},{"key":"6368_CR22","doi-asserted-by":"crossref","unstructured":"Khayat AS, De Assump\u00e7\u00e3o PP, Meireles Khayat BC, Thomaz Ara\u00fajo TM, Batista-Gomes JA, Imbiriba LC et al. ACE2 polymorphisms as potential players in COVID-19 outcome. Pershouse MA, editor. PLoS ONE. 2020;15:e0243887.","DOI":"10.1371\/journal.pone.0243887"},{"key":"6368_CR23","doi-asserted-by":"publisher","first-page":"6581","DOI":"10.1007\/s11033-012-1487-1","volume":"39","author":"N Lu","year":"2012","unstructured":"Lu N, Yang Y, Wang Y, Liu Y, Fu G, Chen D, et al. ACE2 gene polymorphism and essential hypertension: an updated meta-analysis involving 11,051 subjects. Mol Biol Rep. 2012;39:6581\u20139.","journal-title":"Mol Biol Rep"},{"key":"6368_CR24","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1038\/s41440-018-0166-6","volume":"42","author":"Y Luo","year":"2019","unstructured":"Luo Y, Liu C, Guan T, Li Y, Lai Y, Li F, et al. Association of ACE2 genetic polymorphisms with hypertension-related target organ damages in south Xinjiang. Hypertens Res. 2019;42:681\u20139.","journal-title":"Hypertens Res"},{"key":"6368_CR25","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1186\/s12944-018-0890-6","volume":"17","author":"Y Pan","year":"2018","unstructured":"Pan Y, Wang T, Li Y, Guan T, Lai Y, Shen Y, et al. Association of ACE2 polymorphisms with susceptibility to essential hypertension and dyslipidemia in Xinjiang, China. Lipids Health Dis. 2018;17:241.","journal-title":"Lipids Health Dis"},{"key":"6368_CR26","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1016\/j.trsl.2007.06.002","volume":"150","author":"W Niu","year":"2007","unstructured":"Niu W, Qi Y, Hou S, Zhou W, Qiu C. Correlation of angiotensin-converting enzyme 2 gene polymorphisms with stage 2 hypertension in Han Chinese. Transl Res. 2007;150:374\u201380.","journal-title":"Transl Res"},{"key":"6368_CR27","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1038\/jhh.2016.24","volume":"30","author":"YY Chen","year":"2016","unstructured":"Chen YY, Liu D, Zhang P, Zhong JC, Zhang CJ, Wu SL, et al. Impact of ACE2 gene polymorphism on antihypertensive efficacy of ACE inhibitors. J Hum Hypertens. 2016;30:766\u201371.","journal-title":"J Hum Hypertens"},{"key":"6368_CR28","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1177\/147323000603400306","volume":"34","author":"L Yi","year":"2006","unstructured":"Yi L, Gu Y, Wang X, An L, Xie X, Shao W, et al. Association of ACE, ACE2 and UTS2 Polymorphisms with Essential Hypertension in Han and Dongxiang Populations from North-western China. J Int Med Res. 2006;34:272\u201383.","journal-title":"J Int Med Res"},{"key":"6368_CR29","doi-asserted-by":"publisher","first-page":"1237","DOI":"10.1038\/aps.2009.110","volume":"30","author":"X Fan","year":"2009","unstructured":"Fan X, Wang Y, Wang H, Sun K, Zhang W, Song X, et al. Polymorphisms of angiotensin-converting enzyme (ACE) and ACE2 are not associated with orthostatic blood pressure dysregulation in hypertensive patients. Acta Pharmacol Sin. 2009;30:1237\u201344.","journal-title":"Acta Pharmacol Sin"},{"key":"6368_CR30","doi-asserted-by":"publisher","first-page":"147642","DOI":"10.1016\/j.gene.2023.147642","volume":"882","author":"Y Zi-yang","year":"2023","unstructured":"Zi-yang Y, Nanshan X, Dongling L, Tao H, Yigao H, Danqing Y, et al. ACE2 gene polymorphisms are associated with elevated pulmonary artery pressure in congenital heart diseases. Gene. 2023;882:147642.","journal-title":"Gene"},{"key":"6368_CR31","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1080\/10641963.2022.2085736","volume":"44","author":"Q-F Lin","year":"2022","unstructured":"Lin Q-F, Rao J-H, Luo S-M, Wang Q-M, Deng L-F, Chen X, et al. Relation between endothelial nitric oxide synthase genetic polymorphisms and pulmonary arterial hypertension in newborns with congenital heart disease. Clin Exp Hypertens. 2022;44:567\u201372.","journal-title":"Clin Exp Hypertens"},{"key":"6368_CR32","unstructured":"Pulmonary Embolism and Pulmonary Vascular Disease Group of the Respiratory Disease Branch of the Chinese Medical Association, Chinese Guidelines for Diagnosis and Treatment of Pulmonary Hypertension. (2021 Edition). Zhonghua Yi Xue Za Zhi. 2021;101.1:11\u201351."},{"key":"6368_CR33","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1038\/sj.cr.7290272","volume":"15","author":"YY Shi","year":"2005","unstructured":"Shi YY, He L. SHEsis, a powerful software platform for analyses of linkage disequilibrium, haplotype construction, and genetic association at polymorphism loci. Cell Res. 2005;15:97\u20138.","journal-title":"Cell Res"},{"key":"6368_CR34","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1038\/cr.2009.33","volume":"19","author":"Z Li","year":"2009","unstructured":"Li Z, Zhang Z, He Z, Tang W, Li T, Zeng Z, et al. A partition-ligation-combination-subdivision EM algorithm for haplotype inference with multiallelic markers: update of the SHEsis. Cell Res. 2009;19:519\u201323. http:\/\/analysis.bio-x.cn.","journal-title":"Cell Res"},{"key":"6368_CR35","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.1177\/1470320314549221","volume":"16","author":"M Yang","year":"2015","unstructured":"Yang M, Zhao J, Xing L, Shi L. The association between angiotensin-converting enzyme 2 polymorphisms and essential hypertension risk: A meta-analysis involving 14,122 patients. J Renin Angiotensin Aldosterone Syst. 2015;16:1240\u20134.","journal-title":"J Renin Angiotensin Aldosterone Syst"},{"key":"6368_CR36","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s12920-022-01177-0","volume":"15","author":"X Zhang","year":"2022","unstructured":"Zhang X, Wang Y, Zheng Y, Yuan J, Tong J, Xu J, et al. Effect of ACE, ACE2 and CYP11B2 gene polymorphisms and noise on essential hypertension among steelworkers in China: a case\u2013control study. BMC Med Genomics. 2022;15:22.","journal-title":"BMC Med Genomics"},{"key":"6368_CR37","doi-asserted-by":"crossref","unstructured":"Pinheiro DS, Santos RS, Jardim PCBV, Silva EG, Reis AAS, Pedrino GR et al. The combination of ACE I\/D and ACE2 G8790A polymorphisms revels susceptibility to hypertension: A genetic association study in Brazilian patients. Ciccacci C, editor. PLoS ONE. 2019;14:e0221248.","DOI":"10.1371\/journal.pone.0221248"},{"key":"6368_CR38","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.lfs.2019.03.059","volume":"225","author":"Z Fan","year":"2019","unstructured":"Fan Z, Wu G, Yue M, Ye J, Chen Y, Xu B, et al. Hypertension and hypertensive left ventricular hypertrophy are associated with ACE2 genetic polymorphism. Life Sci. 2019;225:39\u201345.","journal-title":"Life Sci"},{"key":"6368_CR39","doi-asserted-by":"publisher","first-page":"1321","DOI":"10.1177\/1470320314534510","volume":"16","author":"J Li","year":"2015","unstructured":"Li J, Feng M, Wang Y, Li Y, Zhang Y, Li L, et al. The relationship between three X-linked genes and the risk for hypertension among northeastern Han Chinese. J Renin Angiotensin Aldosterone Syst. 2015;16:1321\u20138.","journal-title":"J Renin Angiotensin Aldosterone Syst"},{"key":"6368_CR40","first-page":"11159","volume":"10","author":"Y He","year":"2017","unstructured":"He Y, Yang W, Liu S, Gan L, Zhang F, Mu C, et al. Interactions between angiotensin-converting enzyme-2 polymorphisms and high salt intake increase the risk of hypertension in the Chinese Wa population. Int J Clin Exp Pathol. 2017;10:11159\u201368.","journal-title":"Int J Clin Exp Pathol"},{"key":"6368_CR41","doi-asserted-by":"publisher","first-page":"e0304271","DOI":"10.1371\/journal.pone.0304271","volume":"19","author":"L Al-Eitan","year":"2024","unstructured":"Al-Eitan L, Al-Khaldi S, Ibdah RK. ACE gene polymorphism and susceptibility to hypertension in a Jordanian adult population. PLoS ONE. 2024;19:e0304271.","journal-title":"PLoS ONE"},{"key":"6368_CR42","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1093\/ajh\/hpaa223","volume":"34","author":"P Hamet","year":"2021","unstructured":"Hamet P, Pausova Z, Attaoua R, Hishmih C, Haloui M, Shin J, et al. SARS-CoV-2 Receptor ACE2 Gene Is Associated with Hypertension and Severity of COVID 19: Interaction with Sex, Obesity, and Smoking. Am J Hypertens. 2021;34:367\u201376.","journal-title":"Am J Hypertens"},{"key":"6368_CR43","doi-asserted-by":"publisher","first-page":"e3876","DOI":"10.1097\/MD.0000000000003876","volume":"95","author":"D Liu","year":"2016","unstructured":"Liu D, Chen Y, Zhang P, Zhong J, Jin L, Zhang C, et al. Association between circulating levels of ACE2-Ang-(1\u20137)-MAS axis and ACE2 gene polymorphisms in hypertensive patients. Medicine. 2016;95:e3876.","journal-title":"Medicine"},{"key":"6368_CR44","doi-asserted-by":"publisher","first-page":"547154","DOI":"10.1155\/2014\/547154","volume":"2014","author":"P Bhaumik","year":"2014","unstructured":"Bhaumik P, Gopalakrishnan C, Kamaraj B, Purohit R. Single nucleotide polymorphisms in microRNA binding sites: implications in colorectal cancer. ScientificWorldJournal. 2014;2014:547154.","journal-title":"ScientificWorldJournal"}],"container-title":["BMC Cardiovascular Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-026-06368-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-026-06368-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-026-06368-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T09:17:03Z","timestamp":1789723023000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12872-026-06368-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,29]]},"references-count":44,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6368"],"URL":"https:\/\/doi.org\/10.1186\/s12872-026-06368-6","relation":{},"ISSN":["1471-2261"],"issn-type":[{"value":"1471-2261","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,29]]},"assertion":[{"value":"13 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study adhered to the Helsinki Declaration and was reviewed and approved by the Medical Ethics Committee of Quanzhou Medical College [Quanzhou Medical College Ethics Censorship: 2019002]. Written informed consent was obtained from all participants and from the parents or legal guardians of participants under 16 years old.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"814"}}