European Journal of Anaesthesiology最新文献

{"title":"Preoperative assessment of adults undergoing elective non-cardiac surgery: A response.","authors":"Emma Murphy","doi":"10.1097/EJA.0000000000002131","DOIUrl":"10.1097/EJA.0000000000002131","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"42 4","pages":"381-382"},"PeriodicalIF":4.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing pulmonary complications after laparoscopic colorectal surgery: a lung-protective protocol vs. standard care: A randomised controlled trial.","authors":"Tao Yan, Hui-Xian Li, Yu-Lin Sun, Yi Liu, Rong Chen, Rong-Hui Peng, Zhao-Xu Zheng, Shi-Ning Qu, Fei Wang, Wei Tang, Lin Zhang, Shi-Jing Wei, Bao-Na Wang, Li Sun, Hui Zheng","doi":"10.1097/EJA.0000000000002161","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002161","url":null,"abstract":"<p><strong>Background: </strong>Placing patients in the steep Trendelenburg position with a pressurised pneumoperitoneum during laparoscopic colorectal surgery increases pulmonary airway pressure, increasing the risks of lung injury and postoperative pulmonary complications, even in patients with healthy lungs.</p><p><strong>Objectives: </strong>The aim was to determine whether an integrated anaesthesia protocol was superior to traditional protective ventilation in terms of preventing pulmonary complications.</p><p><strong>Design: </strong>This study used a randomised, controlled, parallel-group design.</p><p><strong>Setting: </strong>This single-centre trial was conducted at the National Cancer Centre/Cancer Hospital of the Chinese Academy of Medical Sciences from January to May 2023.</p><p><strong>Patients: </strong>A total of 120 patients who underwent laparoscopic surgery for colorectal cancer with intermediate to high risk of pulmonary complications, as determined by the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score.</p><p><strong>Interventions: </strong>Participants were randomly assigned to either lung protective ventilation with a tidal volume of 6 ml kg-1 of predicted body weight + deep neuromuscular block (a train-of-four count of 0 and post tetanic of 1 to 2) + low peritoneal pressure (10 mmHg) or conventional pulmonary ventilation with a tidal volume of 8 ml kg-1 of predicted body weight + moderate neuromuscular block (a train-of-four count of 1 to 2) + standard peritoneal pressure (15 mmHg).</p><p><strong>Main outcome measurements: </strong>The primary outcome was the incidence of pulmonary complications within 30 postoperative days. The secondary outcomes included serological biomarkers of lung injury.</p><p><strong>Results: </strong>The lung protective group had a significantly lower incidence of pulmonary complications (15.0%) than the conventional group (38.3%; hazard ratio, 0.332; 95% CI, 0.153 to 0.718; P = 0.003). There were no significant differences in the plasma biomarker levels of soluble receptor for advanced glycation end products and angiopoietin-2 for lung injury between the groups. The treatment-by-covariate interactive analysis revealed that the lung-protective strategy conferred considerable benefits for males and individuals aged 60 years or above. A nomogram that predicted pulmonary complications incorporating four variables exhibited a strong discriminative performance, and the results of the decision curve analysis revealed the potential clinical value of this nomogram.</p><p><strong>Conclusion: </strong>Compared with traditional strategies, the integrated lung-protective approach may mitigate pulmonary complications without causing lung injury in intermediate to high-respiratory-risk patients undergoing laparoscopic colorectal surgery.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Register Identifier: ChiCTR2100054215.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CO2-equivalent emissions of a Bispectral Index electrode.","authors":"Sarah Saxena, Mia Gisselbaek, Joana Berger-Estilita, Alain F Kalmar","doi":"10.1097/EJA.0000000000002175","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002175","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A dynamic elastance-based protocol to guide intraoperative fluid management in major abdominal surgery: A randomised clinical trial.","authors":"Andrea Russo, Paola Aceto, Laura Cascarano, Luca S Menga, Bruno Romanò, Simone Carelli, Edoardo Console, Francesca Pugliese, Chiara Cambise, Claudio Fiorillo, Sergio Alfieri, Massimo Antonelli, Liliana Sollazzi, Antonio M Dell'Anna","doi":"10.1097/EJA.0000000000002162","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002162","url":null,"abstract":"<p><strong>Background: </strong>Arterial hypotension during major surgery is related to postoperative complications and mortality. Both fluids and vasopressors increase blood pressure (BP) by inducing different physiological response. We devised a protocol which relies on dynamic arterial elastance (Eadyn) to guide BP optimisation during major abdominal surgery, and tested its effectiveness on tissue perfusion.</p><p><strong>Objective: </strong>to explore if an Eadyn-based optimisation protocol could affect lactate levels, fluid administration, and postoperative clinical complications.</p><p><strong>Design: </strong>randomised open-label clinical trial.</p><p><strong>Setting: </strong>High-volume tertiary care centre for pancreatic surgery.</p><p><strong>Patients: </strong>From 58 patients scheduled for cephalic duodenopancreatectomy 46 were eligible for the study.</p><p><strong>Main outcomes and measures: </strong>The primary endpoint was the lactate value one hour after extubation. Secondary endpoints were fluid balance, intraoperative hypotension and postoperative complications. In the control group, hypotension (mean arterial pressure < 65 mmHg) was treated based on stroke volume variation (SVV) while in the experimental group the treatment was based on assessment of dynamic arterial elastance (Eadyn group). Patient demographic and preoperative laboratory data were recorded. All haemodynamic data, including oxygen delivery and consumption, were recorded at four time points: after intubation (T0), after fascia opening (T1), after fascia closing (T2) and one hour after extubation (T3).</p><p><strong>Results: </strong>The patients were 70 [63 to 76] years and 15 (33%) were ASA 3. Lactate levels at T3 were similar between the control and Eadyn groups. Oxygen consumption was higher in the Eadyn group at T3, and lactate had a significant percentage decrease from T2 to T3: median [IQR], -24.5 [-30 to -14] vs. 0 [-24 to 7.6]%, P = 0.004). Those in Eadyn group received more vasopressors and had a lower fluid balance at T3: 2700 [2100 to 3800] vs. 2200 [1060 to 3000] ml, P = 0.020). There were no significant differences either in postoperative complications or hospital stay.</p><p><strong>Conclusions: </strong>A protocol including Eadyn to treat hypotension did not reduce lactate after major abdominal surgery, but it was associated with a significant reduction in fluid balance and increase in oxygen consumption.</p><p><strong>Registered at clinical trialsgov nct: </strong>05187273.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimum effective volume 90% for ultrasound-guided selective trunk block: A quantal bioassay.","authors":"Ranjith Kumar Sivakumar, Manoj Kumar Karmakar, Rosinni S L Wong, Winnie Samy","doi":"10.1097/EJA.0000000000002160","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002160","url":null,"abstract":"<p><strong>Background: </strong>Selective trunk block (SeTB) targets the three trunks of the brachial plexus and produces surgical anaesthesia of the entire upper extremity, including the shoulder. However, the optimal dose of local anaesthetic (LA) required for a SeTB is not known.</p><p><strong>Objective: </strong>This study aimed to evaluate the minimum effective volume 90% (MEV90) of LA required for a SeTB.</p><p><strong>Design: </strong>Quantal bioassay.</p><p><strong>Setting: </strong>Single-centre, University hospital in Hong Kong S.A.R, China.</p><p><strong>Patients: </strong>After ethical approval, 25 ASA I to III patients, aged 18 to 75 years, undergoing upper extremity surgery under an ultrasound-guided (USG) SeTB were included.</p><p><strong>Intervention: </strong>The volume of the LA (1 : 1 mixture of 2% lidocaine with 5 μg ml-1 epinephrine and 0.5% levobupivacaine) used, starting with 21 ml, was assigned by either increasing or decreasing 3 ml (1 ml each trunk), based on the modified Narayana sequential design.</p><p><strong>Main outcome measures: </strong>Readiness for surgery (sensory score ≤30 and motor score ≤1) at or within 30 min after the injection was the primary outcome measure. A successful block was defined as achieving readiness for surgery within 30 min and completing the intended surgery without rescue analgesia or conversion to general anaesthesia. The MEV90 was estimated using centred isotonic regression.</p><p><strong>Results: </strong>The MEV90 of the LA mixture for USG SeTB was 24.7 [95% confidence interval (CI), 23.8 to 28.9] ml. The median [IQR] time to 'readiness for surgery' and 'complete anaesthesia' was 6.6 [5 to 12.3] and 15 [7.3 to 18] minutes, respectively.</p><p><strong>Conclusion: </strong>The MEV90 of a 1 : 1 LA mixture for USG SeTB to produce surgical anaesthesia of the entire upper extremity (except for the T2 dermatome), using readiness for surgery as the success criterion, is 24.7 ml (95% CI, 23.8 to 28.9) ml.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, Trial Registration No: NCT04773405, Registered prospectively on 26 February 2021. Date of patient enrolment: 10 March 2021 (https://classic.clinicaltrials.gov/ct2/show/NCT04773405).</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peri-operative dexmedetomidine and emergence agitation in adults undergoing nasal surgery: A systematic review and meta-analysis.","authors":"Gustavo Roberto Minetto Wegner, Bruno Francisco Minetto Wegner, Larissa Santos Silva, Jaime Andres Arias","doi":"10.1097/EJA.0000000000002158","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002158","url":null,"abstract":"<p><strong>Background: </strong>There is a high risk of emergence agitation associated with nasal surgery.</p><p><strong>Objective: </strong>We aimed to assess the effect of dexmedetomidine on the incidence of emergence agitation during anaesthetic recovery in patients undergoing nasal surgeries under general anaesthesia.</p><p><strong>Design: </strong>A systematic review and meta-analysis of randomised controlled trials.</p><p><strong>Data sources: </strong>A systematic search was conducted in Embase, Web of Science (all databases), Cochrane Library and PubMed up to 20 June 2024, following the recommendations of the Cochrane Handbook and the PRISMA statement.</p><p><strong>Eligibility criteria: </strong>Adult patients undergoing nasal surgeries under general anaesthesia (P), peri-operative dexmedetomidine use (I), placebo (C) and emergence agitation assessment (O).</p><p><strong>Results: </strong>Nine randomised controlled trials with a total of 620 patients were included in the analysis. The incidence of emergence agitation with the use of dexmedetomidine was significantly lower than with placebo (relative risk (RR) = 0.31, 95% CI 0.19 to 0.49, P < 0.0001, I2 = 63%, GRADE: moderate). No significant difference was found in the incidence of severe emergence agitation (RR = 0.5, 95% CI 0.24 to 1.02, P = 0.0552, I2 = 0%, GRADE: Very low). A trial sequential analysis (TSA) was conducted to assess the reliability of the findings, with parameters set at a type 1 error (α) of 5% and a power (1-β) of 80%. TSA confirmed the result for emergence agitation, but did not reach required information size for severe emergence agitation. Both assessment results were consistent and not dependent on any single study, as shown by the leave-one-out sensitivity analysis.</p><p><strong>Conclusions: </strong>The use of dexmedetomidine significantly reduces the incidence of emergence agitation in patients undergoing nasal surgeries under general anaesthesia.</p><p><strong>Registration: </strong>PROSPERO ID: CRD42024561188.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between ultrasound-guided intertransverse process and erector spinae plane blocks for breast cancer surgery: A randomised controlled trial.","authors":"Lulu Qian, Hongye Zhang, Yongsheng Miao, Zongyang Qu, Yuelun Zhang, Bin Hua, Zhen Hua","doi":"10.1097/EJA.0000000000002091","DOIUrl":"10.1097/EJA.0000000000002091","url":null,"abstract":"<p><strong>Background: </strong>Clinical comparisons between intertransverse process block (ITPB) and erector spinae plane block (ESPB) are lacking.</p><p><strong>Objective: </strong>This study aimed to compare their blocking profile and clinical efficacy in breast cancer surgery.</p><p><strong>Design: </strong>Randomised, blinded, active-controlled superiority trial.</p><p><strong>Setting: </strong>A tertiary hospital in China from 20 February to 31 July 2023.</p><p><strong>Patients: </strong>Sixty-eight females undergoing unilateral breast cancer surgery.</p><p><strong>Intervention: </strong>Patients were randomised to receive either ITPB performed at T2-6 (5 ml of 0.5% ropivacaine per level) or ESPB at T4 (25 ml of 0.5% ropivacaine). General anaesthesia and postoperative analgesia were standardised.</p><p><strong>Main outcome measures: </strong>The primary outcome was the number of blocked dermatomes at anterior T2-7, assessed 45 min after block completion, with a predefined superiority margin of 1.5 dermatomes. The important secondary outcome was the worst resting pain scores (11-point numerical rating scale) within 30 min in the recovery room, which was tested following a gatekeeping procedure. Other secondary outcomes included resting pain scores at various time points, use of rescue analgesics, opioid consumption, patient satisfaction, recovery quality score, and adverse effects within 24 h postoperatively.</p><p><strong>Results: </strong>The ITPB group showed a median [q1, q3] of 5 [4, 6] blocked dermatomes at anterior T2-7, whereas the ESPB group had 1 [0, 4], with a median difference of 4 (95% confidence interval (CI), 3 to 4); the lower 95% CI limit exceeded the predefined superiority margin of 1.5 (superiority P  < 0.001). Worst resting pain scores within 30 min in the recovery room in the ITPB group were 1 [0, 2] vs. 3 [1, 4] in the ESPB group, with a median difference of -1 (95% CI, -2 to 0; P  = 0.004). Patients in the ITPB group required fewer rescue analgesics within 30 min in the recovery room than did those in the ESPB group. No other clinically relevant results were observed in the secondary outcomes.</p><p><strong>Conclusions: </strong>Although ITPB demonstrated more consistent anterior dermatomal spread and improved immediate postoperative analgesia compared to ESPB, no additional benefits were identified for breast cancer surgery. Future studies may investigate the potential of ITPB for surgical anaesthesia.</p><p><strong>Trial registration: </strong>www.chictr.org.cn (ChiCTR2300068454).</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"224-232"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of viral transmission must be assured before re-use of infusion sets.","authors":"Rune Andersson, Egil Lingaas, Ingemar Qvarfordt, Ann Tammelin","doi":"10.1097/EJA.0000000000002114","DOIUrl":"10.1097/EJA.0000000000002114","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"278-279"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: prevention of viral transmission must be assured before re-use of infusion sets.","authors":"Snorri Laxdal Karlsson, Jon Edman-Wallér, Magni Vidar Gudmundsson, Peter Bentzer, Per Werner Möller","doi":"10.1097/EJA.0000000000002115","DOIUrl":"10.1097/EJA.0000000000002115","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"279-281"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypotension after unilateral versus bilateral spinal anaesthesia: A Systematic review with meta-analysis.","authors":"Cansheng Gong, Xiuming Ye, Yanling Liao, Peng Ye, Ting Zheng, Xiaochun Zheng","doi":"10.1097/EJA.0000000000002098","DOIUrl":"10.1097/EJA.0000000000002098","url":null,"abstract":"<p><strong>Background: </strong>Spinal anaesthesia is frequently used in surgical procedures involving the lower abdomen and extremities, however, the occurrence of hypotension remains a common and clinically important adverse effect. Unilateral spinal anaesthesia seems to be a promising approach to minimise this complication but the effectiveness of this remains controversial.</p><p><strong>Objective: </strong>A meta-analysis was undertaken to evaluate the superiority of unilateral spinal anaesthesia over bilateral spinal anaesthesia with regard to the incidence of hypotension and other complications.</p><p><strong>Design: </strong>Systematic reviews and meta-analysis of randomised controlled trials (RCTs).</p><p><strong>Date sources: </strong>PUBMED, Embase, Web of Science and Cochrane Central Register of Controlled Trials databases were searched from their inception to 5 March 2024.</p><p><strong>Eligibility criteria: </strong>Randomised controlled trials (RCTs) comparing unilateral spinal anaesthesia with bilateral spinal anaesthesia were eligible for inclusion. Observational studies, case reports, case series, and studies not conducted in humans were excluded. The incidence of hypotension, vasopressor requirement, and other complications were compared. Heterogeneity was assessed by subgroup analyses and sensitivity analysis.</p><p><strong>Results: </strong>Twenty-one trials involving 1358 patients undergoing unilateral lower extremity surgery or lower abdominal surgery were included in the meta-analysis. Hyperbaric solutions were used in most trials. The Mantel-Haenszel random-effect model was used for the analysis of binary endpoints, reported as relative risk (RR) with a 95% confidence interval (CI). The incidence of hypotension was significantly lower in the unilateral spinal anaesthesia group compared with the bilateral spinal anaesthesia (RR 0.38, 95% CI 0.27 to 0.55; P  < 0.001; I2  = 38%). Subgroup analysis shows that the occurrence of hypotension was significantly lower in the unilateral subgroup, regardless of dosage, surgical site, adjuvants to the local anaesthetics, and different definitions of hypotension.</p><p><strong>Conclusions: </strong>Unilateral spinal anaesthesia is associated with a significant reduction in the occurrence of hypotension, despite variations in the definition of hypotension, adjuvants, and site of surgery. These results favour the use of lateral spinal anaesthesia in patients undergoing unilateral lower abdominal or lower limb surgery. However, the GRADE assessment of the quality of evidence was 'low' due to the high risk of bias and heterogeneity. All the results should be treated with caution.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"203-223"},"PeriodicalIF":4.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}