{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T00:17:20Z","timestamp":1793924240329,"version":"4.8.0"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T00:00:00Z","timestamp":1699315200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T00:00:00Z","timestamp":1699315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Practice and Innovation Plan of Jiangsu Province","award":["SJCX21_1147"],"award-info":[{"award-number":["SJCX21_1147"]}]},{"DOI":"10.13039\/501100001809","name":"National\u00a0Natural\u00a0Science\u00a0Foundation\u00a0of\u00a0China","doi-asserted-by":"crossref","award":["82270731"],"award-info":[{"award-number":["82270731"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004608","name":"Jiangsu\u00a0Provincial\u00a0Natural\u00a0Science\u00a0Foundation","doi-asserted-by":"crossref","award":["BK20211054"],"award-info":[{"award-number":["BK20211054"]}],"id":[{"id":"10.13039\/501100004608","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Qing\u00a0Lan\u00a0of\u00a0Jiangsu\u00a0Province"},{"name":"Jiangsu\u00a0Provincial\u00a0Post\u00a0Graduate\u00a0Innovation\u00a0Plan","award":["KYCX21_2701"],"award-info":[{"award-number":["KYCX21_2701"]}]},{"name":"Xuzhou\u00a0key\u00a0R\u00a0&\u00a0D\u00a0Program","award":["KC20160"],"award-info":[{"award-number":["KC20160"]}]},{"name":"Xuzhou\u00a0Medical\u00a0leading\u00a0Talent\u00a0training\u00a0Project","award":["XWRCHT20210038"],"award-info":[{"award-number":["XWRCHT20210038"]}]},{"name":"Beanstalk\u00a0talent\u00a0of\u00a0Affiliated\u00a0Hospital\u00a0of\u00a0Xuzhou\u00a0Medical\u00a0University"},{"name":"Science\u00a0and\u00a0technology\u00a0development\u00a0fund\u00a0of\u00a0Affiliated\u00a0Hospital\u00a0of\u00a0Xuzhou\u00a0Medical\u00a0University","award":["XYFC2020001"],"award-info":[{"award-number":["XYFC2020001"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Med Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Roxadustat is an oral hypoxia inducing factor-prolyl hydroxylase inhibitor (HIF-PHI) that regulates iron metabolism in patients with chronic kidney disease (CKD) primarily by reducing hepcidin levels and mobilizing internal iron stores. More data are needed to demonstrate the efficacy of roxadustat in regulating iron metabolism in patients with peritoneal dialysis (PD) compared with erythropoiesis stimulating agents (ESAs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study enrolled PD patients with a mean hemoglobin level of 60\u2013100\u00a0g\/L. All subjects were randomized into two groups at a ratio of 2:1 the roxadustat group (106 cases), and the ESA group (53 cases). The primary endpoint was the change in the iron biomarker levels and the proportion of patients with absolute iron deficiency and functional iron deficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with ESAs, roxadustat significantly decreased hepcidin level (difference, \u2212\u00a020.09\u00a0ng\/mL; 95% CI, \u2212\u00a030.26 to \u2212\u00a09.92), attenuated the increase in serum soluble transferrin receptor (sTFR) level (difference, \u2212\u00a07.87\u00a0nmol\/L; 95% CI, \u2212\u00a012.11 to \u2212\u00a03.64), and reduced the proportion of patients with functional iron deficiency (roxadustat, 11.43%; ESA, 33.33%). There was no significant difference in safety of the two groups over the duration of the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with ESA group, roxadustat group showed significant differences in all iron biomarker levels except\u00a0serum ferritin (sFt) and transferrin saturation (TSAT). These results suggest that roxadustat was superior to ESAs as a therapy for iron metabolism in PD patients.<\/jats:p>\n                    <jats:p>\n                      <jats:italic>Trial registration<\/jats:italic>\n                      : This study completed Chinese Clinical Trial Registration on March 4, 2022 (registration number: ChiCTR2200057231).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s40001-023-01465-0","type":"journal-article","created":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T03:02:29Z","timestamp":1699326149000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effect of roxadustat on iron metabolism in patients with peritoneal dialysis: a real-world 24-week study"],"prefix":"10.1186","volume":"28","clinical-trial-number":[{"clinical-trial-number":"chictr2200057231","registry":"10.18810\/chictr"}],"author":[{"given":"Xuejie","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruoyu","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhifang","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luhua","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yizhou","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok","family":"Raj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,11,7]]},"reference":[{"key":"1465_CR1","unstructured":"Shaikh H, Hashmi MF, Aeddula NR. Anemia of chronic renal disease. In: StatPearls. StatPearls Publishing, Treasure Island (FL): 2022."},{"key":"1465_CR2","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1053\/j.ajkd.2017.09.026","volume":"71","author":"S Fishbane","year":"2018","unstructured":"Fishbane S, Spinowitz B. Update on anemia in ESRD and earlier stages of CKD: core curriculum 2018. Am J Kidney Dis. 2018;71:423\u201335.","journal-title":"Am J Kidney Dis"},{"key":"1465_CR3","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/S0140-6736(20)32594-0","volume":"397","author":"SR Pasricha","year":"2021","unstructured":"Pasricha SR, Tye-Din J, Muckenthaler MU, Swinkels DW. Iron deficiency. Lancet. 2021;397:233\u201348.","journal-title":"Lancet"},{"key":"1465_CR4","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-043021-032816","author":"E Nemeth","year":"2022","unstructured":"Nemeth E, Ganz T. Hepcidin and iron in health and disease. Annu Rev Med. 2022. https:\/\/doi.org\/10.1146\/annurev-med-043021-032816.","journal-title":"Annu Rev Med"},{"key":"1465_CR5","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.1007\/s10557-021-07257-0","volume":"36","author":"JA Requena-Ib\u00e1\u00f1ez","year":"2022","unstructured":"Requena-Ib\u00e1\u00f1ez JA, Santos-Gallego CG, Rodriguez-Cordero A, Zafar MU, Badimon JJ. Prolyl hydroxylase inhibitors: a new opportunity in renal and myocardial protection. Cardiovasc Drugs Ther. 2022;36:1187\u201396.","journal-title":"Cardiovasc Drugs Ther"},{"key":"1465_CR6","doi-asserted-by":"publisher","first-page":"539","DOI":"10.3747\/pdi.2018.00249","volume":"39","author":"RL Perlman","year":"2019","unstructured":"Perlman RL, Zhao J, Fuller DS, et al. International anemia prevalence and management in peritoneal dialysis patients. Perit Dial Int. 2019;39:539\u201346.","journal-title":"Perit Dial Int"},{"key":"1465_CR7","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1111\/joim.13004","volume":"287","author":"MD Cappellini","year":"2020","unstructured":"Cappellini MD, Musallam KM, Taher AT. Iron deficiency anaemia revisited. J Intern Med. 2020;287:153\u201370.","journal-title":"J Intern Med"},{"key":"1465_CR8","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.23342","volume":"34","author":"L Hou","year":"2020","unstructured":"Hou L, Lu J, Jiang X, Guo X, Ma C, Cheng X. Analytical evaluation of three soluble transferrin receptor measurement systems for diagnosis of iron deficiency anemia: a retrospective study. J Clin Lab Anal. 2020;34: e23342.","journal-title":"J Clin Lab Anal"},{"key":"1465_CR9","doi-asserted-by":"publisher","first-page":"1606S","DOI":"10.3945\/ajcn.117.155887","volume":"106","author":"CM Pfeiffer","year":"2017","unstructured":"Pfeiffer CM, Looker AC. Laboratory methodologies for indicators of iron status: strengths, limitations, and analytical challenges. Am J Clin Nutr. 2017;106:1606S-1614S.","journal-title":"Am J Clin Nutr"},{"key":"1465_CR10","doi-asserted-by":"publisher","DOI":"10.1007\/s10557-022-07321-3","author":"T Miura","year":"2022","unstructured":"Miura T, Sato T, Yano T, et al. Role of erythropoiesis-stimulating agents in cardiovascular protection in CKD patients: reappraisal of their impact and mechanisms. Cardiovasc Drugs Ther. 2022. https:\/\/doi.org\/10.1007\/s10557-022-07321-3.","journal-title":"Cardiovasc Drugs Ther"},{"key":"1465_CR11","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1159\/000516901","volume":"52","author":"MR Weir","year":"2021","unstructured":"Weir MR. Managing anemia across the stages of kidney disease in those hyporesponsive to erythropoiesis-stimulating agents. Am J Nephrol. 2021;52:450\u201366.","journal-title":"Am J Nephrol"},{"key":"1465_CR12","doi-asserted-by":"publisher","first-page":"725","DOI":"10.3390\/ijms21030725","volume":"21","author":"A Gluba-Brz\u00f3zka","year":"2020","unstructured":"Gluba-Brz\u00f3zka A, Franczyk B, Olszewski R, Rysz J. The influence of inflammation on anemia in CKD patients. Int J Mol Sci. 2020;21:725.","journal-title":"Int J Mol Sci"},{"key":"1465_CR13","doi-asserted-by":"publisher","first-page":"1369","DOI":"10.1093\/ndt\/gfaa034","volume":"36","author":"F Locatelli","year":"2021","unstructured":"Locatelli F, Del Vecchio L, De Nicola L, Minutolo R. Are all erythropoiesis-stimulating agents created equal? Nephrol Dial Transplant. 2021;36:1369\u201377.","journal-title":"Nephrol Dial Transplant"},{"key":"1465_CR14","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1080\/13543784.2020.1777276","volume":"29","author":"E Souza","year":"2020","unstructured":"Souza E, Cho KH, Harris ST, Flindt NR, Watt RK, Pai AB. Hypoxia-inducible factor prolyl hydroxylase inhibitors: a paradigm shift for treatment of anemia in chronic kidney disease? Expert Opin Investig Drugs. 2020;29:831\u201344.","journal-title":"Expert Opin Investig Drugs"},{"key":"1465_CR15","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1007\/s40265-019-01077-1","volume":"79","author":"S Dhillon","year":"2019","unstructured":"Dhillon S. Roxadustat: first global approval. Drugs. 2019;79:563\u201372.","journal-title":"Drugs"},{"key":"1465_CR16","doi-asserted-by":"publisher","first-page":"1966","DOI":"10.1681\/ASN.2022040413","volume":"33","author":"F Locatelli","year":"2022","unstructured":"Locatelli F, Del Vecchio L. Hypoxia-inducible factor-prolyl hydroxyl domain inhibitors: from theoretical superiority to clinical noninferiority compared with current ESAs? J Am Soc Nephrol. 2022;33:1966\u201379.","journal-title":"J Am Soc Nephrol"},{"key":"1465_CR17","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.cell.2019.12.010","volume":"180","author":"RA Voit","year":"2020","unstructured":"Voit RA, Sankaran VG. Stabilizing HIF to ameliorate anemia. Cell. 2020;180:6.","journal-title":"Cell"},{"key":"1465_CR18","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.2215\/CJN.02440222","volume":"17","author":"W McCallum","year":"2022","unstructured":"McCallum W, Weiner DE. HIF-PHIs for anemia management in CKD: potential and uncertainty ASCEND. Clin J Am Soc Nephrol. 2022;17:1255\u20138.","journal-title":"Clin J Am Soc Nephrol"},{"key":"1465_CR19","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2022.108272","volume":"239","author":"M Sugahara","year":"2022","unstructured":"Sugahara M, Tanaka T, Nangaku M. Future perspectives of anemia management in chronic kidney disease using hypoxia-inducible factor-prolyl hydroxylase inhibitors. Pharmacol Ther. 2022;239: 108272.","journal-title":"Pharmacol Ther"},{"key":"1465_CR20","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1056\/NEJMoa1813599","volume":"381","author":"N Chen","year":"2019","unstructured":"Chen N, Hao C, Peng X, et al. Roxadustat for anemia in patients with kidney disease not receiving dialysis. N Engl J Med. 2019;381:1001\u201310.","journal-title":"N Engl J Med"},{"key":"1465_CR21","doi-asserted-by":"publisher","first-page":"1070","DOI":"10.1056\/NEJMe1908978","volume":"381","author":"J Kaplan","year":"2019","unstructured":"Kaplan J. Roxadustat and anemia of chronic kidney disease. N Engl J Med. 2019;381:1070\u20132.","journal-title":"N Engl J Med"},{"key":"1465_CR22","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1182\/blood-2018-06-856500","volume":"133","author":"G Weiss","year":"2019","unstructured":"Weiss G, Ganz T, Goodnough LT. Anemia of inflammation. Blood. 2019;133:40\u201350.","journal-title":"Blood"},{"key":"1465_CR23","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1182\/blood-2017-05-786590","volume":"131","author":"S Aschemeyer","year":"2018","unstructured":"Aschemeyer S, Qiao B, Stefanova D, et al. Structure-function analysis of ferroportin defines the binding site and an alternative mechanism of action of hepcidin. Blood. 2018;131:899\u2013910.","journal-title":"Blood"},{"key":"1465_CR24","doi-asserted-by":"publisher","first-page":"1294","DOI":"10.3389\/fphys.2019.01294","volume":"10","author":"A Pagani","year":"2019","unstructured":"Pagani A, Nai A, Silvestri L, Camaschella C. Hepcidin and anemia: a tight relationship. Front Physiol. 2019;10:1294.","journal-title":"Front Physiol"},{"key":"1465_CR25","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1681\/ASN.2019020213","volume":"31","author":"EK Batchelor","year":"2020","unstructured":"Batchelor EK, Kapitsinou P, Pergola PE, Kovesdy CP, Jalal DI. Iron deficiency in chronic kidney disease: updates on pathophysiology, diagnosis, and treatment. J Am Soc Nephrol. 2020;31:456\u201368.","journal-title":"J Am Soc Nephrol"},{"key":"1465_CR26","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/j.cmet.2017.10.005","volume":"27","author":"H Choudhry","year":"2018","unstructured":"Choudhry H, Harris AL. Advances in hypoxia-inducible factor biology. Cell Metab. 2018;27:281\u201398.","journal-title":"Cell Metab"},{"key":"1465_CR27","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1159\/000496492","volume":"142","author":"A Gafter-Gvili","year":"2019","unstructured":"Gafter-Gvili A, Schechter A, Rozen-Zvi B. Iron deficiency anemia in chronic kidney disease. Acta Haematol. 2019;142:44\u201350.","journal-title":"Acta Haematol"},{"key":"1465_CR28","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1172\/JCI122359","volume":"129","author":"AJ Schwartz","year":"2019","unstructured":"Schwartz AJ, Das NK, Ramakrishnan SK, et al. Hepatic hepcidin\/intestinal HIF-2\u03b1 axis maintains iron absorption during iron deficiency and overload. J Clin Invest. 2019;129:336\u201348.","journal-title":"J Clin Invest"},{"key":"1465_CR29","doi-asserted-by":"publisher","first-page":"1280","DOI":"10.1016\/j.kint.2021.03.020","volume":"99","author":"JL Babitt","year":"2021","unstructured":"Babitt JL, Eisenga MF, Haase VH, et al. Controversies in optimal anemia management: conclusions from a kidney disease: improving global outcomes (KDIGO) conference. Kidney Int. 2021;99:1280\u201395.","journal-title":"Kidney Int"},{"key":"1465_CR30","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1002\/ejhf.2036","volume":"23","author":"R Sierpinski","year":"2021","unstructured":"Sierpinski R, Josiak K, Suchocki T, et al. High soluble transferrin receptor in patients with heart failure: a measure of iron deficiency and a strong predictor of mortality. Eur J Heart Fail. 2021;23:919\u201332.","journal-title":"Eur J Heart Fail"},{"key":"1465_CR31","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1111\/apt.15739","volume":"51","author":"S Daude","year":"2020","unstructured":"Daude S, Remen T, Chateau T, et al. Comparative accuracy of ferritin, transferrin saturation and soluble transferrin receptor for the diagnosis of iron deficiency in inflammatory bowel disease. Aliment Pharmacol Ther. 2020;51:1087\u201395.","journal-title":"Aliment Pharmacol Ther"},{"key":"1465_CR32","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.015480","volume":"9","author":"H Weidmann","year":"2020","unstructured":"Weidmann H, Bannasch JH, Waldeyer C, et al. Iron metabolism contributes to prognosis in coronary artery disease: prognostic value of the soluble transferrin receptor within the atherogene study. J Am Heart Assoc. 2020;9: e015480.","journal-title":"J Am Heart Assoc"},{"key":"1465_CR33","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2022.874846","volume":"10","author":"S Zhu","year":"2022","unstructured":"Zhu S, Liu C, Zhao C, et al. Increased serum soluble transferrin receptor levels were associated with high prevalence of cardiovascular diseases: insights from the national health and nutrition examination survey 2017\u20132018. Front Cell Dev Biol. 2022;10: 874846.","journal-title":"Front Cell Dev Biol"},{"key":"1465_CR34","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1913712","volume":"383","author":"K Zielniok","year":"2020","unstructured":"Zielniok K, Burdzinska A, Paczek L. Roxadustat for anemia in patients with chronic kidney disease. N Engl J Med. 2020;383: e3.","journal-title":"N Engl J Med"},{"key":"1465_CR35","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1056\/NEJMoa1901713","volume":"381","author":"N Chen","year":"2019","unstructured":"Chen N, Hao C, Liu BC, et al. Roxadustat treatment for anemia in patients undergoing long-term dialysis. N Engl J Med. 2019;381:1011\u201322.","journal-title":"N Engl J Med"},{"key":"1465_CR36","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1007\/s40620-019-00656-5","volume":"32","author":"BR Di Iorio","year":"2019","unstructured":"Di Iorio BR, Bellasi A, Raphael KL, et al. Treatment of metabolic acidosis with sodium bicarbonate delays progression of chronic kidney disease: the UBI study. J Nephrol. 2019;32:989\u20131001.","journal-title":"J Nephrol"},{"key":"1465_CR37","doi-asserted-by":"publisher","first-page":"1520","DOI":"10.1126\/science.aal2022","volume":"359","author":"DL Zhang","year":"2018","unstructured":"Zhang DL, Wu J, Shah BN, et al. Erythrocytic ferroportin reduces intracellular iron accumulation, hemolysis, and malaria risk. Science. 2018;359:1520\u20133.","journal-title":"Science"},{"key":"1465_CR38","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2020.104664","volume":"153","author":"F Wunderer","year":"2020","unstructured":"Wunderer F, Traeger L, Sigurslid HH, Meybohm P, Bloch DB, Malhotra R. The role of hepcidin and iron homeostasis in atherosclerosis. Pharmacol Res. 2020;153: 104664.","journal-title":"Pharmacol Res"}],"container-title":["European Journal of Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40001-023-01465-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40001-023-01465-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40001-023-01465-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T03:04:09Z","timestamp":1699326249000},"score":1,"resource":{"primary":{"URL":"https:\/\/eurjmedres.biomedcentral.com\/articles\/10.1186\/s40001-023-01465-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,7]]},"references-count":38,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["1465"],"URL":"https:\/\/doi.org\/10.1186\/s40001-023-01465-0","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3265565\/v1","asserted-by":"object"}]},"ISSN":["2047-783X"],"issn-type":[{"value":"2047-783X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,7]]},"assertion":[{"value":"15 August 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 October 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 November 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethics Committee of the Affiliated Hospital of Xuzhou Medical University (XYFY-KL39-01). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee. All the enrolled patients signed an informed consent form.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None declared.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"489"}}