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However, the clinical heterogeneity observed in PEM suggests that other pathophysiological systems, such as coagulation cascade abnormalities, autonomic dysfunction, and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, may coexist within the same patient population and potentially interact with the mechanisms outlined in this framework

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The epithelial thickness index (ETI) and the subepithelial thickness index (STI) were significantly lower in the AST-treated group, and the goblet cell count was higher in the AST group