CorneaPub Date : 2025-05-06DOI: 10.1097/ICO.0000000000003876
Sandrine Ninotta, David Toubeau, Tomy Sagnial, Zhiguo He, Sylvain Poinard, Gauthier Travers, Philippe Gain, Gilles Thuret, Marc Muraine
{"title":"Comparison of Two Commercial Medias for Corneal Organ Culture and Deswelling: CorneaMax/CorneaJet Versus Tissue-C/Carry-C.","authors":"Sandrine Ninotta, David Toubeau, Tomy Sagnial, Zhiguo He, Sylvain Poinard, Gauthier Travers, Philippe Gain, Gilles Thuret, Marc Muraine","doi":"10.1097/ICO.0000000000003876","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003876","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the endothelial cell density (ECD) of corneas stored in organ culture (OC) using CorneaMax/CorneaJet and Tissue-C/Carry-C media.</p><p><strong>Methods: </strong>Three complementary experiments included paired corneas stored in CorneaMax or Tissue-C and subsequently deswelled in CorneaJet or Carry-C. In experiment 1, storage media renewal was performed only for CorneaMax as per the manufacturer's guidelines, with storage/deswelling times of 30/4 days (D). In experiment 2, both storage media were renewed on D4, with storage/deswelling time of 28/2 days. In experiment 3, both storage media were renewed, with storage/deswelling times of 22/4 days. In addition to ECD (in the three experiments), the viable ECD (Hoechst 33342/Calcein-AM staining) and central corneal thickness (CCT) were measured in exp. 2.</p><p><strong>Results: </strong>In experiment 1 (16 pairs), ECD was significantly higher in CorneaMax than in Tissue-C on D30 (2265 ± 379 vs. 2097 ± 344 cells/mm2, P = 0.0248) and postdeswelling (2106 ± 405 vs. 1910 ± 355 cells/mm2, P = 0.0290). In experiment 2 (10 pairs), ECD did not differ after 28 days of OC; however, CCT was lower on D4, higher on D28 in Tissue-C, and showed no difference after deswelling. Postdeswelling, viable ECD was significantly higher in CorneaJet versus Carry-C (1647 ± 324 vs. 1436 ± 235 cells/mm2, P = 0.0189). In experiment 3 (eight pairs), ECD showed no significant difference.</p><p><strong>Conclusions: </strong>Endothelial survival is reduced in Tissue-C/Carry-C unless storage is limited to 3 weeks and the medium is renewed. The major corneal edema in Tissue-C may contribute to the reduced ECD.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CorneaPub Date : 2025-05-02DOI: 10.1097/ICO.0000000000003891
David Mikhail, Daniel Milad, Mona Harissi-Dagher
{"title":"Letter Regarding: Intermediate-Term Outcomes and Complications of Ahmed Glaucoma Valve in Type 1 Keratoprostheses.","authors":"David Mikhail, Daniel Milad, Mona Harissi-Dagher","doi":"10.1097/ICO.0000000000003891","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003891","url":null,"abstract":"","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CorneaPub Date : 2025-05-02DOI: 10.1097/ICO.0000000000003887
Larissa Gouvea, Jyh Haur Woo, Manokamna Agarwal, Emily Witsberger, Gregory H Borschel, Kamiar Mireskandari, Asim Ali
{"title":"Outcomes of Corneal Transplantation After Minimally Invasive Corneal Neurotization in Children.","authors":"Larissa Gouvea, Jyh Haur Woo, Manokamna Agarwal, Emily Witsberger, Gregory H Borschel, Kamiar Mireskandari, Asim Ali","doi":"10.1097/ICO.0000000000003887","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003887","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the outcomes of corneal transplantation after minimally invasive corneal neurotization (MICN) in pediatric patients.</p><p><strong>Methods: </strong>Medical records of all children who underwent corneal transplantation post-MICN with sural nerve graft for neurotrophic keratopathy between 2015 and 2021 were reviewed retrospectively. Data collected included demographic information, ocular comorbidities, maximum corneal sensitivity by Cochet-Bonnet aesthesiometer (CBA) preoperatively and postoperatively measured in the central graft area, graft survival (primary outcome), and rejection.</p><p><strong>Results: </strong>Of 28 eyes which underwent MICN, six underwent corneal transplant surgery (mean age 11.9 ± 4.4 years) 2.4 ± 0.4 years after initial surgery. Mean maximum recorded CBA across all quadrants before corneal transplantation was 53.3 ± 9.4 mm. Reepithelialization was observed in all eyes by postoperative month 2. Mean follow-up was 4.5 ± 2.1 years. Penetrating keratoplasty was performed in 2 cases, and deep anterior keratoplasty in four cases. Graft survival at final follow-up was 83.3%. Mean recorded central CBA after corneal transplantation was 53.8 ± 8.2 mm. No improvement was observed in visual acuity from baseline (1.2 ± 0.4 logMAR) to final postoperative follow-up (1.1 ± 0.4 logMAR; P = 0.68).</p><p><strong>Conclusions: </strong>Corneal transplantation after corneal neurotization has survival rates >80%. Manual deep anterior keratoplasty can be performed in patients who have not undergone previous penetrating keratoplasty. Despite graft clarity, improvement in best-corrected visual acuity may be limited by amblyopia in this age group.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CorneaPub Date : 2025-05-02DOI: 10.1097/ICO.0000000000003877
Silke Oellerich, Daniel F Larkin, Sorcha Ní Dhubhghaill
{"title":"Drug Repurposing for Corneal Diseases-Should We Look Back More Often to Move Forward?","authors":"Silke Oellerich, Daniel F Larkin, Sorcha Ní Dhubhghaill","doi":"10.1097/ICO.0000000000003877","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003877","url":null,"abstract":"","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CorneaPub Date : 2025-05-02DOI: 10.1097/ICO.0000000000003892
Radwa Elsharawi, Daniel Lee, Abhiniti Mittal, Winston D Chamberlain, Joseph Tauber, Travis K Redd
{"title":"Use of Decellularized Descemet Membrane Anterior Keratoplasty to Facilitate Epithelialization of Pediatric Penetrating Keratoplasty for Total Sclerocornea.","authors":"Radwa Elsharawi, Daniel Lee, Abhiniti Mittal, Winston D Chamberlain, Joseph Tauber, Travis K Redd","doi":"10.1097/ICO.0000000000003892","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003892","url":null,"abstract":"<p><strong>Purpose: </strong>To report the first known use of combined decellularized Descemet membrane anterior keratoplasty with penetrating keratoplasty (PKP) in a pediatric patient.</p><p><strong>Methods: </strong>A 2-month-old boy with bilateral sclerocornea underwent bilateral sequential PKP. In the left eye, PKP performed at 2 months of age was complicated by a persistent epithelial defect postoperatively with a 1 month delay in epithelialization. As a result, the patient underwent PKP with a combined decellularized Descemet membrane corneal allograft implantation in the right eye at 3 months of age to enhance early postoperative healing. This was performed by creating a central 3-mm superficial keratectomy before placing Descemet membrane allograft onto the full-thickness graft.</p><p><strong>Results: </strong>Compared to the 1-month delay in epithelialization after PKP in the left eye, the right eye, which underwent combined PKP and decellularized Descemet membrane corneal allograft, was fully epithelialized by the first postoperative week. The grafts remain clear and intact at 12 months of age. The patient exhibited significant improvement in visual behavior.</p><p><strong>Conclusions: </strong>This case highlights the successful use of decellularized Descemet membrane anterior keratoplasty in preventing a persistent epithelial defect in the early postoperative period for a pediatric patient with sclerocornea. This may be a viable option for similar pediatric cases with delayed epithelial healing while promoting graft survival and minimizing the need for additional surgical interventions.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intrastromal Keratoplasty Using Biosynthetic Corneas Versus Human Donor Corneas in Advanced Keratoconus.","authors":"Vidit Bansal, Aafreen Bari, Mehrdad Rafat, Rajesh Sinha, Tushar Agarwal, Prafulla Kumar Maharana, Dewang Angmo, Tanuj Dada, Jeewan Singh Titiyal, Shideh Tabe, Alina Miron, Namrata Sharma","doi":"10.1097/ICO.0000000000003882","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003882","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study was to compare the clinical outcomes of intrastromal keratoplasty using biosynthetic corneas with human donor corneas in cases of advanced keratoconus.</p><p><strong>Methods: </strong>A prospective nonblinded randomized controlled study was conducted at a tertiary eye center in India. Treatment-naïve patients with advanced keratoconus aged 18 years or older were included. Twenty eyes were randomized into 2 groups-group 1 (human donor corneal lenticule, n = 10) and group 2 (biosynthetic corneal lenticule, n = 10). Efficacy analyses included an increase in the thinnest pachymetry and a decrease in the maximum keratometry (Kmax). Safety analyses included any adverse events in the postoperative period.</p><p><strong>Results: </strong>At 6 months postoperatively, the rise in the thinnest pachymetry in group 1 was 346.8 ± 40.82 to 486.7 ± 15.7 μm (P < 0.001) and in group 2 was 366.2 ± 31.3 to 548.3 ± 59.1 μm (P < 0.001). The biosynthetic group exhibited a significant increase in the thinnest pachymetry (P = 0.005). However, both groups showed a similar decrease in Kmax (71.06 ± 7.95 to 63.3 ± 3.74 D in group 1 and 69.13 ± 8.54 to 61.5 ± 6.2 D in group 2; P = 0.44). No adverse events were seen at 6 months of follow-up.</p><p><strong>Conclusion: </strong>Femtosecond-assisted intrastromal implantation of biosynthetic corneas is a safe and effective alternative to human donor corneas in cases of advanced keratoconus.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CorneaPub Date : 2025-04-29DOI: 10.1097/ICO.0000000000003883
Reziwan Maimaitiming, Ru Zhao, Lin Ding, Maierdang Ailimu, Yanli Qin, Gulmira Yasin, Xinping Hou, Tao Shen
{"title":"A Novel Homozygous Nonsense Mutation in TACSTD2 Gene Causes Gelatinous Drop-like Corneal Dystrophy in a Chinese Consanguineous Family: A Case Report and Literature Review.","authors":"Reziwan Maimaitiming, Ru Zhao, Lin Ding, Maierdang Ailimu, Yanli Qin, Gulmira Yasin, Xinping Hou, Tao Shen","doi":"10.1097/ICO.0000000000003883","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003883","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case of gelatinous drop-like corneal dystrophy (GDLD) caused by a novel homozygous tumor-associated calcium signal transducer 2 (TACSTD2) gene mutation and summarize the correlations of clinical phenotypes and genotypes in patients with GDLD.</p><p><strong>Methods: </strong>We analyzed the clinical characteristics and treatment outcomes of a 42-year-old man with GDLD. The patient with GDLD received multiple keratoplasties, and histopathological staining of the corneal sections was performed. We performed genetic testing and clinical evaluations on all family members. In addition, we conducted a literature review of previously reported patients with GDLD with pathogenic TACSTD2 gene mutations.</p><p><strong>Results: </strong>Genetic sequencing of the proband identified a novel nonsense homozygous mutation c.588C > A in the TACSTD2 gene. The histopathological analysis revealed intense amyloid deposition in the subepithelial region of the cornea. We summarized the clinical features of patients with GDLD with 33 previously reported TACSTD2 gene mutations.</p><p><strong>Conclusions: </strong>This study reported a novel homozygous nonsense mutation in a Chinese patient with GDLD, thereby expanding the mutation spectrum of the TACSTD2 gene.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CorneaPub Date : 2025-04-29DOI: 10.1097/ICO.0000000000003884
Mohit Parekh, Ula V Jurkunas
{"title":"Cultivated Autologous Limbal Epithelial Cell Transplantation: A Comprehensive Review of Clinical Trials and Applications.","authors":"Mohit Parekh, Ula V Jurkunas","doi":"10.1097/ICO.0000000000003884","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003884","url":null,"abstract":"<p><strong>Purpose: </strong>Limbal stem cells (LSCs) are essential for corneal epithelial regeneration and ocular surface homeostasis. Dysfunction of LSCs results in LSC deficiency (LSCD), a leading cause of global blindness. Although ex vivo expansion and autologous transplantation of LSCs have demonstrated promising clinical outcomes, no Food and Drug Administration-approved therapies for LSCD are available in the United States. To address this gap, we developed a novel 2-step process for isolating and expanding LSCs on human amniotic membrane under good manufacturing practice conditions, using a xenobiotic-free, serum-free, and antibiotic-free environment.</p><p><strong>Methods: </strong>Autologous limbal biopsies were used to generate cultivated autologous limbal epithelial cell (CALEC) constructs, ensuring rigorous safety and efficacy measures. Furthermore, we compared the success rates of good manufacturing practice-manufactured cultivated limbal epithelial transplantation (CLET) products with those of CALEC.</p><p><strong>Results: </strong>Among 16 limbal biopsies harvested from 15 participants, 14 resulted in successful manufacturing of CALEC grafts. Phase I clinical trial demonstrated preliminary feasibility and no safety concerns. In the phase II trial, 92% of grafts showed partial or complete success at 18 months, with no safety issues. The success rate of CALEC grafts was comparable to currently available CLET products.</p><p><strong>Conclusions: </strong>The findings underscore the safety and efficacy of CALEC transplantation as a promising therapeutic strategy for LSCD. The current review focuses on the manufacturing, quality control, and clinical performance of CALEC constructs in phase I/II trials for unilateral LSCD, paving the way for future trials in advancing LSC-based regenerative therapies in the United States.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CorneaPub Date : 2025-04-22DOI: 10.1097/ICO.0000000000003885
Margaret C Pollard, Alex Mammen, Gaurav Prakash, Vishal Jhanji
{"title":"Corneal Collagen Crosslinking for Progressive Post-Laser In Situ Keratomileusis Ectasia in Patients Older Than 50 years: A Case Series.","authors":"Margaret C Pollard, Alex Mammen, Gaurav Prakash, Vishal Jhanji","doi":"10.1097/ICO.0000000000003885","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003885","url":null,"abstract":"<p><strong>Purpose: </strong>Post-laser in situ keratomileusis (LASIK) ectasia has been rarely reported in older patients. We present the ectasia progression and treatment outcomes after corneal collagen crosslinking (CXL) in 5 patients with post-LASIK ectasia aged older than 50 years.</p><p><strong>Methods: </strong>This retrospective case series included patients with post-LASIK ectasia. Primary outcome parameters included preoperative and postoperative best corrected distance visual acuity (logMAR best corrected visual acuity). Corneal topography values included maximum keratometry (Kmax), flat keratometry (K1), and steep keratometry (K2). All patients underwent epithelium-off CXL using the Dresden protocol.</p><p><strong>Results: </strong>Five eyes of 5 patients were included. The mean patient age at CXL was 62.8 years (range 51-73 years). The average time since laser in situ keratomileusis surgery was 19 years (range 16-24 years). Patients were followed preoperatively for 343 days ± 150 and postoperatively for 3 to 5 years. Postoperatively, flattening of K2 and improvement in logMAR best corrected visual acuity were noted in all patients. There were no intraoperative or postoperative complications.</p><p><strong>Conclusions: </strong>Unlike primary corneal ectasia, post-LASIK corneal ectasia progresses in older patients. Our results support that CXL is effective in patients with post-LASIK ectasia aged older than 50 years.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CorneaPub Date : 2025-04-16DOI: 10.1097/ICO.0000000000003880
Sofía Del-Pozo-Lérida, Antonio Sabala Llopart, Júlia Widmer-Pintos, Consuelo Arnaldos-López, Maria Julia Martínez, Maria Teresa Salcedo Allende, Ariadna Quer Pi-Sunyer
{"title":"Bilateral Corneal Copper Deposition in Monoclonal Gammopathy of Undetermined Significance: Diagnostic Insights and Treatment With Descemet Membrane Endothelial Keratoplasty and Descemet Stripping Only.","authors":"Sofía Del-Pozo-Lérida, Antonio Sabala Llopart, Júlia Widmer-Pintos, Consuelo Arnaldos-López, Maria Julia Martínez, Maria Teresa Salcedo Allende, Ariadna Quer Pi-Sunyer","doi":"10.1097/ICO.0000000000003880","DOIUrl":"https://doi.org/10.1097/ICO.0000000000003880","url":null,"abstract":"<p><strong>Purpose: </strong>To present a case of bilateral corneal copper deposition as the initial sign of monoclonal gammopathy of undetermined significance (MGUS), detailing diagnostic insights and outcomes of treatment with Descemet Membrane Endothelial Keratoplasty (DMEK) and Descemet Stripping Only (DSO).</p><p><strong>Methods: </strong>Comprehensive ophthalmological evaluation and laboratory testing (including serum copper, protein electrophoresis, immunofixation) were performed. Surgical interventions were DMEK (right eye) and subsequently DSO (left eye), with postoperative monitoring. Anatomic pathology of the surgical specimen was also analyzed.</p><p><strong>Results: </strong>Ophthalmological evaluation revealed bilateral central corneal deposits at Descemetx{2019}s membrane. Elevated serum copper and high levels of gamma globulin with absence of malignancy in bone marrow biopsy confirmed MGUS by the hematologist. As to ocular treatment,DMEK initially improved visual acuity but deposits recurred within a year, decreasing vision by 18 months. DSO achieved corneal clearing and improved vision at 3 months, showing promising early results.</p><p><strong>Conclusions: </strong>Bilateral corneal copper deposition can be a presenting sign of MGUS, mandating systemic investigation. While DMEK offered temporary improvement although recurrence occurred. DSO shows potential as a therapeutic alternative. Recognizing these ocular findings is critical for timely MGUS diagnosis and monitoring, though optimal corneal treatment requires further research.</p>","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}