Maxime Tabey, Xavier Dubernard, Emilien Chebib, Nathaniel Assouly, Le-Uyen France Truong, Marc Labrousse, Esteban Brenet
{"title":"Use of 3D Exoscope for Free Flaps Microanastomosis in Head and Neck Reconstruction","authors":"Maxime Tabey, Xavier Dubernard, Emilien Chebib, Nathaniel Assouly, Le-Uyen France Truong, Marc Labrousse, Esteban Brenet","doi":"10.1111/coa.14255","DOIUrl":"10.1111/coa.14255","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"387-391"},"PeriodicalIF":1.7,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mahmoud F. Mandour, Mohamed Tomoum, Mohamed N. Elsheikh, Amani El-Gharib, Saad Elzayat, Maurizio Barbara, Valerio Margani, Haitham H. Elfarargy, Mohamed Amer
{"title":"Endoscopic Fat Graft Myringoplasty Augmented With Hyaluronic Acid for Managing Large-Sized Eardrum Perforations; A Prospective Comparative Randomised Study","authors":"Mahmoud F. Mandour, Mohamed Tomoum, Mohamed N. Elsheikh, Amani El-Gharib, Saad Elzayat, Maurizio Barbara, Valerio Margani, Haitham H. Elfarargy, Mohamed Amer","doi":"10.1111/coa.14252","DOIUrl":"10.1111/coa.14252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aimed to assess the outcomes of fat graft myringoplasty augmented with hyaluronic acid in closing large-sized eardrum perforations compared to the traditional underlay cartilage-perichondrium composite myringoplasty (CPCM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>It was a prospective randomised comparative study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Settings</h3>\u0000 \u0000 <p>It was held in tertiary referral institutions between May 2020 and April 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>We included 100 patients with a large-sized eardrum perforation (50%–75% of the eardrum surface area). Using the endoscopic transcanal approach, 50 patients were managed by fat graft myringoplasty augmented with hyaluronic acid, while CPCM managed the other 50 patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>We evaluated the closure rates 1, 6 months and 1 year after surgery. Also, we assessed the audiological performance of the patients with a successful closure before and 1 year after the operation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fat graft myringoplasty operation was statistically shorter than the CPCM. The closure rate 1 year after surgery was 92% in the first group and 86% in the second group, without a statistically significant difference between both groups. Successful air-bone gap closure to less than 10 dB occurred in 93.5% of group A and 81.4% of group B without a statistically significant difference. The mean postoperative air-bone gap was 5.3 ± 3.95 dB in the first group and 7.95 ± 5.17 dB in the second group, with a statistically significant difference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Fat graft myringoplasty augmented with hyaluronic acid was a reliable, safe, simple, and effective manoeuvre to close large-sized eardrum perforations compared to the conventional CPCM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"288-294"},"PeriodicalIF":1.7,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiang Xin, Yang Yang, Li Xuelei, Yao Hongbing, Tang Xinye, Liang Jia
{"title":"Causal Effects of Gastroesophageal Reflux on Chronic Rhinosinusitis: A Bidirectional Two-Sample Mendelian Randomization Study","authors":"Xiang Xin, Yang Yang, Li Xuelei, Yao Hongbing, Tang Xinye, Liang Jia","doi":"10.1111/coa.14251","DOIUrl":"10.1111/coa.14251","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Observational studies have shown a bidirectional association between gastroesophageal reflux (GER) and chronic rhinosinusitis (CRS) or chronic rhinitis (CR), but it is not clear whether this association is causal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study was to investigate the causality between GER and CRS or CR using bidirectional two-sample Mendelian randomization (MR) analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using pooled data from large genome-wide association studies (GWAS), genetic loci independently associated with GER, CRS and CR in populations of European and American ancestry were selected as instrumental variables (IVs). The inverse variance weighted (IVW) method was used to analyse the random effects model of MR, and the odds ratio (OR) was used as the evaluation index to explore the bidirectional causality between GER and CRS or CR. Single nucleotide polymorphism (SNP) outliers were detected using MR-pleiotropy Residual Sum and Outliers (MR-PRESSO). The MR–Egger intercept test examined the horizontal pleiotropy of SNPs. The “leave-one-out” sensitivity analysis examined whether MR results were affected by a single SNP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The main results of IVW showed that GER increased the risk of CRS (OR = 1.3795, 95% CI = 1.188–1.603, <i>p</i> < 0.0500) and CR (OR = 1.3941, 95% CI = 1.1671–1.6652, <i>p</i> < 0.0500). The obtained SNPs as IVs for GER, CRS and CR had no significant horizontal pleiotropy, heterogeneity or bias. Regarding the reverse directions, no notable associations could be found.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This MR analysis revealed that genetically predicted GER had a causal effect on an increased risk of CRS or CR, but not vice versa. These results have great implications for the management of CRS (especially for refractory CRS) or CR in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"280-287"},"PeriodicalIF":1.7,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hye-Bin Jang, Dong Hoon Lee, Shin Jung, Sang Chul Lim
{"title":"Safety of Simultaneous Surgery for Pituitary Neoplasms and Rhinosinusitis","authors":"Hye-Bin Jang, Dong Hoon Lee, Shin Jung, Sang Chul Lim","doi":"10.1111/coa.14248","DOIUrl":"10.1111/coa.14248","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"375-380"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Psychological Challenges in Children With Tracheostomies and Their Families—A Qualitative Study","authors":"Mairi Weir, Haytham Kubba","doi":"10.1111/coa.14249","DOIUrl":"10.1111/coa.14249","url":null,"abstract":"<p>Approximately 1,200 children require a new tracheostomy every year in the United Kingdom [<span>1</span>], and most are in place for more than 2 years, requiring prolonged periods of care at home [<span>2</span>]. The stress and worry associated with tracheostomy care can affect the whole family. Parents often feel an altered sense of their parental role and many suffer poor mental health [<span>3-5</span>].</p><p>As far as we are aware, no paediatric airway service in the UK has a dedicated clinical psychologist who sees all families in the service. In our catchment area, psychological support for children and families is available on referral to the Paediatric Clinical Psychology Service (PCPS) but this is done on a case-by-case basis and is not routinely integrated into the airway team. This qualitative study aims to explore parents' thoughts on the psychological support we currently offer at our tertiary paediatric centre by generating and exploring ideas through in-depth discussions with a small number of test subjects.</p><p>Parents of children with tracheostomy are well-trained in clinical aspects of care and most rapidly become experts in their child's condition [<span>6</span>]. Some parents consider their child's quality of life to be higher than their own [<span>7</span>] and lower perceived quality of life may have a negative impact on a parent's caregiving abilities. Some parents struggle to participate in their child's tracheostomy care due to feeling overwhelmed [<span>8</span>]. Psychological support can be invaluable in improving the long-term outcomes for both patient and their family. Previous studies have suggested that having a member of staff on hand who is familiar with the family can be invaluable [<span>9</span>]. Psychological support needs change over time, with parents wanting help in the early stages, while children may benefit most when they are older, especially during important times of transition such as starting school [<span>10</span>].</p><p>The main value of qualitative research is in identifying areas that are important to patients but which might be surprising to clinicians. Our biggest surprise was the lack of any perceived stigma in accessing psychological services. We expected this to be a major barrier to families accessing care but we were pleasantly surprised to see no sign of reticence on the part of parents in seeking psychological support. On the contrary, 70% actively requested referrals.</p><p>Our study is small, but that is often the way with qualitative studies, where in-depth analysis of response themes is more important than large study numbers. Our sample is representative of our tracheostomy cohort overall and the responses were consistent from family to family. The qualitative element of the study allowed us insights into parents' priorities, particularly the importance of long-term continuity in care. The main outcome is the strong demand from parents for integrated psychological suppor","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"370-374"},"PeriodicalIF":1.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14249","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adam J. Donne, Kim Keltie, Julie Burn, Emma Belilios, Steven Powell, Paola Cognigni, Iain J. Nixon, Neil Bateman, Haytham Kubba, Owen Judd, Andrew Sims
{"title":"Current Practice, Safety and Efficacy of Interventions for Recurrent Respiratory Papillomatosis: Evidence From a UK Registry","authors":"Adam J. Donne, Kim Keltie, Julie Burn, Emma Belilios, Steven Powell, Paola Cognigni, Iain J. Nixon, Neil Bateman, Haytham Kubba, Owen Judd, Andrew Sims","doi":"10.1111/coa.14245","DOIUrl":"10.1111/coa.14245","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To determine the current practice, safety and efficacy of interventions used in the management of recurrent respiratory papillomatosis (RRP) in the UK NHS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective registry (recruitment between 1st April 2018 and 31st August 2022, retrospective data from 1st January 2015 permitted with consent). Sub-group data-linked to Hospital Episode Statistics for additional follow-up (until 31st July 2022).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>UK NHS hospitals treating RRP patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Children and adults diagnosed with RRP and managed in an NHS hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Disease severity (Derkay, voice handicap and GRBAS scores), management (type and frequency of surgical and adjuvant intervention) and complications (cancer, death).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three hundred and thirty patients were entered into the registry; 304 (including 65 children) were eligible for analysis. Children had more severe disease than adults (median Derkay score 10 vs. 5). Microdebrider was the most common surgical intervention, particularly in children (86% of children, 49% of adults). Additionally, lasers (CO<sub>2</sub>, KTP and pulsed dye) were used in 34% of adults. Gardasil was the most common adjuvant therapy (21 children, 23 adults). Procedural complications were rare (10.8% children, 5.9% adults). Five patients developed laryngeal malignancy; there were six deaths during follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is the largest UK RRP study to date. RRP is more aggressive in children than adults, and treatment choice differs between age groups. Overall, management was safe with minimal complications reported, and generally effective in maintaining a safe airway. Standardised reporting is required to objectively monitor disease progression and safety over time.</p>\u0000 \u0000 <p>\u0000 <b>Trial Registration:</b> NCT03465280, ISRCTN36100560</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"271-279"},"PeriodicalIF":1.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antonino Maniaci, Gaia Vertillo Aluisio, Stefania Stefani, Salvatore Cocuzza, Jerome Rene Lechien, Thomas Radulesco, Justin Michel, Maria Santagati, Ignazio La Mantia
{"title":"Differential Nasal Recolonization and Microbial Profiles in Chronic Rhinosinusitis With Nasal Polyps Patients After Endoscopic Sinus Surgery or Dupilumab Treatment: A Prospective Observational Study","authors":"Antonino Maniaci, Gaia Vertillo Aluisio, Stefania Stefani, Salvatore Cocuzza, Jerome Rene Lechien, Thomas Radulesco, Justin Michel, Maria Santagati, Ignazio La Mantia","doi":"10.1111/coa.14246","DOIUrl":"10.1111/coa.14246","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The role of microbial profiles in Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) pathogenesis is increasingly recognised, with microbial imbalances perpetuating inflammation. We performed this study to associate the different nasal microbiological profile changes with the response to surgical or monoclonal treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective observational study evaluated changes in the nasal microbial profiles of 44 patients (22 dupilumab, 22 surgery) over 6 months. Clinical assessments were performed at baseline and follow-ups, including Sino-Nasal Outcome Test-22 (SNOT-22) scores and Sniffin Sticks-Identification (SS-I) olfactory testing. Microbial profiling of nasal swabs was carried out by microbial culture and subsequent molecular identification by Polymerase chain reaction (PCR) and sequencing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline characteristics of 44 patients (22 dupilumab, 22 surgery) enrolled in this study were similar between groups. In the dupilumab group, <i>Staphylococcus epidermidis</i> prevalence rose from 37.03% to 59.25%, while <i>Pseudomonas aeruginosa</i> was eradicated. Moreover, dupilumab stabilised <i>Staphylococcus aureus</i> at 63.64%, while its prevalence increased in the surgery group (from 22.72% to 50%). When bacterial groups were associated with clinical scores, <i>P. aeruginosa</i> carriers had worse SNOT-22 (21.00 ± 1.41) and SS-I (5.50 ± 0.71) scores. Instead, <i>S. epidermidis</i>-colonised patients exhibited significantly lower mean SNOT-22 (15.39 ± 8.54) and greater SS-I scores (8.39 ± 3.77). The best outcomes were found in the subgroup of <i>S. epidermidis</i> carriers undergoing the dupilumab treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The two treatments modulated the microbial profiles differently, and, most importantly, clinical responses might depend on the association between treatment and the dominant bacterial species colonising the nasal cavity. Further investigation into microbial-restorative strategies could enhance outcomes for better treatment of CRS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"262-270"},"PeriodicalIF":1.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yohanna M. Takwoingi, Shiraz Syed, Oghogho Braimah
{"title":"A Cold-Steel Dissection Tonsillectomy Protocol That Consistently Produces Few Complications in Paediatric Tonsillectomy: A Review of 953 Patients","authors":"Yohanna M. Takwoingi, Shiraz Syed, Oghogho Braimah","doi":"10.1111/coa.14250","DOIUrl":"10.1111/coa.14250","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"365-369"},"PeriodicalIF":1.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Expression of AQP8 in Serum of Patients With Meniere's Disease and Its Value in Evaluating the Degree of Hydrolabyrinth and Predicting Prognosis","authors":"Rui Zhao, Tianhua Yi, Qinqin Wu, Xuemei Liu, Jianqiao He, Yufang Tan","doi":"10.1111/coa.14241","DOIUrl":"10.1111/coa.14241","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to explore the role of serum aquaporin 8 (AQP8) expression in evaluating the degree of hydrolabyrinth and predicting prognosis in patients with Meniere's disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred and five patients diagnosed with Meniere's disease in our hospital were enrolled in the Meniere's disease group. Another 102 healthy subjects were enrolled as the control group. The expression of serum AQP8 mRNA was determined by the quantitative real-time PCR (qRT-PCR) method. Receiver operating characteristic (ROC) curve analysis was carried out to analyse the predictive value of serum AQP8 mRNA expression for poor prognosis in Meniere's disease patients. Multivariate logistic regression was used to analyse the influencing factors of poor prognosis in patients with Meniere's disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The expression level of serum AQP8 mRNA in the Meniere's disease group was significantly higher than that in the control group (<i>p</i> < 0.05). In the severe hydrops group, serum AQP8 mRNA expression levels were higher than in the mild hydrops group and the no endolymphatic hydrops group. Additionally, the mild hydrops group had higher serum AQP8 mRNA levels than the no endolymphatic hydrops group (<i>p</i> < 0.05). The disease course, proportion of severe hydrops and serum AQP8 mRNA expression were all higher in the poor prognosis group compared to the good prognosis group (<i>p</i> < 0.05). The area under the curve (AUC) for serum AQP8 mRNA in predicting poor prognosis in Meniere's disease patients was 0.812 (95%<i>CI</i>: 0.702–0.922).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AQP8 mRNA is associated with the degree of hydrolabyrinth in patients with Meniere's disease and plays an important role in predicting prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"255-261"},"PeriodicalIF":1.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}