European urology focus最新文献

{"title":"Management of Primary Bladder Neck Obstruction and Dysfunctional Voiding in Young Men: A Systematic Review and Meta-analysis.","authors":"Massimiliano Creta, Michael Baboudjian, Vasileios Sakalis, Nikita Bhatt, Cosimo De Nunzio, Mauro Gacci, Thomas R W Herrmann, Markos Karavitakis, Sachin Malde, Lisa Moris, Christopher Netsch, Malte Rieken, Natasha Schouten, Manuela Tutolo, Yuhong Yuan, Hashim Hashim, Jean-Nicolas Cornu","doi":"10.1016/j.euf.2025.01.011","DOIUrl":"https://doi.org/10.1016/j.euf.2025.01.011","url":null,"abstract":"<p><strong>Background and objective: </strong>Management of young men with primary bladder neck obstruction (PBNO) and dysfunctional voiding (DV) is challenging. We systematically reviewed evidence on diagnostic strategies and treatment outcomes in men aged 18-50 yr with PBNO or DV.</p><p><strong>Methods: </strong>We conducted a comprehensive bibliographic search on the Embase, Medline, and Cochrane Library databases in July 2024.</p><p><strong>Key findings and limitations: </strong>Twenty-five publications were identified. Videourodynamics represents the standard diagnostic approach. Standard therapies for PBNO include alpha-blockers (ABs) as the first-line approach and bladder neck incision (BNI) in patients failing medical therapy. Pooled estimates of total International Prostate Symptom Score (IPSS) and maximum urinary flow rate (Q_max) improvements at 3 mo in patients receiving ABs are 7.0 points and 4.0 ml/s, respectively. The incidence of ejaculatory dysfunction (EjD) and failure rates range from 47% to 50% and from 23% to 52%, respectively. Corresponding figures in patients undergoing surgery are 11.2 points, 6.9 ml/s, 0-88.8%, and 11.1-13.3%, respectively. OnabotulinumtoxinA, as experimental second-line therapy in PBNO, provides 2-mo mean total IPSS and mean Q_max improvements of 14.1 points and 9.1 ml/s, respectively, with a 0% EjD rate. However, improvements deteriorate over time. Behavioral modifications plus biofeedback represent the only approach in patients with DV, providing symptom improvement of at least 50% in 83% of patients at 3 mo. Limits of evidence include few studies, mainly retrospective design, heterogeneous populations, small sample sizes, lack of direct comparisons, and short follow-up.</p><p><strong>Conclusions and clinical implications: </strong>Diagnosis of PBNO/DV in young men requires the integration of anatomical and functional data. ABs represent the first-line approach for PBNO followed by BNI in cases of failure. Behavioral modification plus biofeedback represents the only strategy tested for DV. Given the low quality of evidence, a shared decision-making approach for diagnosis and treatment is required.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448693","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":"Is the Microbiome Enough: Role of Diet and Metabolites in Our Interventions.","authors":"Michael A Liss","doi":"10.1016/j.euf.2025.01.017","DOIUrl":"https://doi.org/10.1016/j.euf.2025.01.017","url":null,"abstract":"<p><p>The gut microbiome may represent a new pillar in human health. As we move beyond the small data sets used for comparison, we will need to consider the bidirectional implications of interactions between diet/lifestyle (inputs) and metabolites (outputs) in interventional clinical trials to maximize the beneficial impact in health and disease.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406496","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":"Impact of Tumor Stage on Oncologic Outcomes of High-grade Bacillus Calmette-Guérin Unresponsive Non-muscle-invasive Bladder Cancer Undergoing Bladder-sparing Therapies.","authors":"Drupad Annapureddy, Jacob I Taylor, Ashish M Kamat, Michael A O'Donnell, Jeffrey Howard, Wei Shen Tan, Ian M McElree, Facundo Davaro, Kendrick Yim, Stephen Harrington, Elizabeth Dyer, Anna J Black, Pratik Kanabur, Mathieu Roumiguié, Seth Lerner, Peter C Black, Jay D Raman, Mark A Preston, Gary Steinberg, William Huang, Roger Li, Vignesh T Packiam, Solomon L Woldu, Yair Lotan","doi":"10.1016/j.euf.2025.01.001","DOIUrl":"https://doi.org/10.1016/j.euf.2025.01.001","url":null,"abstract":"<p><strong>Background and objective: </strong>Current data on bacillus Calmette-Guérin (BCG)-unresponsive non-muscle-invasive bladder cancer (NMIBC) do not differentiate outcomes by clinical stage. The purpose of this study is to investigate the role of tumor stage in oncologic outcomes in BCG-unresponsive NMIBC undergoing bladder-sparing therapies.</p><p><strong>Methods: </strong>Demographic and outcome data for patients with BCG-unresponsive NMIBC were reviewed at ten institutions. The Kaplan-Meier method was used to determine survival differences between the T1 ± carcinoma in situ (CIS), Ta alone, and CIS ± Ta groups. Exploratory analyses were conducted as follows: (1) T1 alone versus Ta alone versus CIS ± T1/Ta and (2) T1/Ta alone versus CIS ± T1/Ta.</p><p><strong>Key findings and limitations: </strong>Among 401 patients, 137 (34%) were T1 ± CIS, 104 (26%) Ta alone, and 160 (40%) CIS ± Ta. Disease progression (p < 0.001), metastasis (p < 0.001), and bladder cancer mortality (p = 0.009) were increased in the T1 ± CIS group versus the Ta alone and CIS ± Ta groups. Cystectomy occurred most often in the CIS ± Ta and T1 groups (p = 0.002). Similar increases were noted in progression (p < 0.001), metastasis (p < 0.001), and bladder cancer mortality (p = 0.004) in T1 alone patients versus the Ta alone and CIS ± T1/Ta groups. There were no differences in outcomes between the T1 alone and T1 + CIS groups. No significant differences in metastasis, bladder cancer mortality, or all-cause mortality were noted when comparing papillary disease only with any CIS. The primary limitation of this study is likely a selection bias due to the retrospective nature of the cohort.</p><p><strong>Conclusions and clinical implications: </strong>Presence of T1 disease is generally associated with worse oncologic outcomes compared with Ta or CIS. T1 and Ta should not be grouped together during comparison with CIS. Radical cystectomy appears largely driven by the presence of CIS.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373861","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: Francesco Montorsi, Francesco Montorsi, Giuseppe Rosiello, Marco Moschini, Andrea Salonia, and Alberto Briganti's letter to the Editor re: Akihiro Matsukawa, Takafumi Yanagisawa, Marcin Miszczyk, et al. Trimodality Therapy Versus Radical Cystectomy for Muscle-invasive Bladder Cancer: A Systematic Review and Meta-analysis of Matched Cohort Studies. Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2024.11.003.","authors":"Akihiro Matsukawa, Takafumi Yanagisawa, Marcin Miszczyk, Takahiro Kimura, Shahrokh F Shariat","doi":"10.1016/j.euf.2025.01.016","DOIUrl":"https://doi.org/10.1016/j.euf.2025.01.016","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373864","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":"Trends and Perioperative Outcomes of Surgical Treatments for Benign Prostatic Hyperplasia in Germany: Results from the GRAND Study.","authors":"Julian Marcon, Patrick Keller, Nikolaos Pyrgidis, Michael Atzler, Marc Kidess, Melanie Götz, Jan-Friedrich Jokisch, Michael Chaloupka, Christian G Stief, Gerald B Schulz, Philipp Weinhold","doi":"10.1016/j.euf.2025.01.002","DOIUrl":"https://doi.org/10.1016/j.euf.2025.01.002","url":null,"abstract":"<p><strong>Background and objective: </strong>Real-world data exploring the perioperative outcomes of different surgical treatments for benign prostatic hyperplasia (BPH) are lacking. We aimed to assess the trends of BPH surgeries and compare their perioperative outcomes.</p><p><strong>Methods: </strong>We used the GeRmAn Nationwide inpatient Data (GRAND), provided by the Research Data Center of the Federal Bureau of Statistics (2005-2022), and performed multiple patient-level analyses.</p><p><strong>Key findings and limitations: </strong>Our study included 1 355 845 surgical treatments for BPH. Of these, 1 084 650 (79.9%) were transurethral resection of the prostate (TURP), 90 735 (6.9%) simple prostatectomy, 64 325 (4.7%) holmium laser enucleation of the prostate (HoLEP), 58 406 (4.3%) laser vaporization, 25 747 (1.9%) electrovaporization, 15 241 (1.1%) thulium laser enucleation of the prostate (ThuLEP), 7873 (0.58%) prostate incision, 3298 (0.24%) water ablation, 2724 (0.2%) water vapor thermal therapy, 1235 (0.09%) prostate stent, 1100 (0.08%) transurethral needle ablation of the prostate, and 511 (0.03%) prostatic urethral lift. The use of HoLEP, ThuLEP, water ablation, and water vapor thermal therapy has increased exponentially in the last years. After adjusting for the major risk factors in the multivariate regression analysis, simple prostatectomy was associated with the worst outcomes compared with TURP, followed by electrovaporization. On the contrary, HoLEP and ThuLEP were associated with favorable outcomes, in terms of sepsis, ureteral stent placement, transfusion, admission to the intensive care unit, hospital stay, and mortality, compared with TURP. Similarly, minimally invasive surgical therapies were associated with high safety compared with TURP. Nevertheless, our findings are based on retrospective billing data and are prone to a selection bias.</p><p><strong>Conclusions and clinical implications: </strong>The trends and perioperative outcomes of BPH surgery should be taken into consideration to improve clinical decision-making and patient outcomes.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373877","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":"Re: Noel W. Clarke, Andrew J. Armstrong, Mototsugu Oya, et al. Efficacy and Safety of Olaparib Plus Abiraterone Versus Placebo Plus Abiraterone in the First-line Treatment of Patients with Asymptomatic/Mildly Symptomatic and Symptomatic Metastatic Castration-resistant Prostate Cancer: Analyses from the Phase 3 PROpel Trial. Eur Urol Oncol. In press. https://doi.org/10.1016/j.euo.2024.09.013.","authors":"Shiwang Yuan, Peng Chen, Fa Sun, Tao Li","doi":"10.1016/j.euf.2024.11.014","DOIUrl":"https://doi.org/10.1016/j.euf.2024.11.014","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373863","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":"Re: Akihiro Matsukawa, Takafumi Yanagisawa, Marcin Miszczyk, et al. Trimodality Therapy Versus Radical Cystectomy for Muscle-invasive Bladder Cancer: A Systematic Review and Meta-analysis of Matched Cohort Studies. Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2024.11.003.","authors":"Francesco Montorsi, Giuseppe Rosiello, Marco Moschini, Andrea Salonia, Alberto Briganti","doi":"10.1016/j.euf.2024.12.011","DOIUrl":"https://doi.org/10.1016/j.euf.2024.12.011","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254959","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":"Congenital Lower Urinary Tract Obstruction: Update and Summary of the European Association of Urology and European Society for Paediatric Urology Guidelines.","authors":"Michele Gnech, Lisette 't Hoen, Christian Radmayr, Berk Burgu, Guy Bogaert, Fardod O'Kelly, Marco Castagnetti, Josine Quaedackers, Mesrur Selcuk Silay, Uchenna Kennedy, Allon van Uitert, Martin Skott, Niklas Pakkasjärvi, Anna Bujons, Yuhong Yuan, Yazan F Rawashdeh","doi":"10.1016/j.euf.2025.01.012","DOIUrl":"https://doi.org/10.1016/j.euf.2025.01.012","url":null,"abstract":"<p><strong>Background and objective: </strong>The literature on congenital lower urinary tract obstruction (CLUTO) is still limited, resulting in a generally low level of evidence. These guidelines aim to provide a practical approach based on a consensus from the European Association of Urology (EAU)/European Society for Paediatric Urology (ESPU) Paediatric Urology Guidelines Panel. The primary aim of this update was to revise and expand the 2024 EAU/ESPU paediatric urology guidelines, focusing on the comprehensive management of CLUTO.</p><p><strong>Methods: </strong>A structured literature review was performed for all relevant publications published from the last update until March 21, 2023.</p><p><strong>Key findings and limitations: </strong>Antenatal management should be considered based on ultrasound findings, foetal urine biochemistry, amniotic fluid levels, and chromosomal status. In newborns with a suspected diagnosis of infravesical obstruction, bladder drainage should be performed and antibiotic prophylaxis initiated. Voiding cystography should be conducted as soon as possible in cases where posterior urethral valves (PUVs) are suspected. A serum creatinine nadir of above 0.85 mg/dl is associated with a poor prognosis. Despite optimal treatment, 20% of patients will progress to end-stage renal disease. Lifelong monitoring and management of both bladder and renal function are essential. Neonatal circumcision, as an adjunct to antibiotic prophylaxis in PUV patients, significantly reduces the risk of febrile urinary tract infections during the first 2 yr of life.</p><p><strong>Conclusions: </strong>This paper is a summary of the updated 2024 EAU/ESPU guidelines, and it provides practical considerations for patients with CLUTO.</p><p><strong>Patient summary: </strong>In this summary and update of the European Association of Urology/European Society for Paediatric Urology guidelines, we provide practical considerations for the management of children with congenital lower urinary tract obstruction.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254812","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":"Diagnostic Accuracy of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Primary Lymph Node Staging Before Radical Prostatectomy.","authors":"Reha-Baris Incesu, Felix Preisser, Raisa S Pompe, Florian Nohe, Philipp Mandel, Tobias Maurer, Markus Graefen, Derya Tilki","doi":"10.1016/j.euf.2025.01.015","DOIUrl":"https://doi.org/10.1016/j.euf.2025.01.015","url":null,"abstract":"<p><strong>Background and objective: </strong>Prostate-specific-membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) is more accurate than conventional imaging for lymph node (LN) staging in prostate cancer. However, it has limitations in detecting micrometastatic lymph node invasion (LNI). Our aim was to evaluate the accuracy of PSMA PET/CT for overall and size-dependent LNI detection in contemporary patients undergoing radical prostatectomy (RP) and pelvic lymph node dissection (PLND).</p><p><strong>Methods: </strong>Within a high-volume center database, we identified 873 patients who underwent PSMA PET/CT for primary staging before RP and PLND between 2016 and 2021. Data for lymph node status on imaging and histology results were analyzed.</p><p><strong>Key findings and limitations: </strong>Of 873 patients, 25% (n = 220) had LNI. Median prostate-specific antigen was 8.3 ng/ml (interquartile range 4.3-14.3). The majority of patients had high-risk (53%) or intermediate-risk disease (45%). In the overall cohort, the per-patient sensitivity, specificity, positive predictive value, negative predictive value (NPV), and accuracy calculated for LNI detection via PSMA PET/CT were 45.5%, 92.6%, 67.6%, 83.4%, and 80.8%, respectively. The median metastatic LN size in the group of 120 patients with false-negative PET/CT results was 2.5 mm. For metastatic LNs ≥5 mm, the sensitivity and NPV increased to 68.8% (+23.3%) and 95.4% (+12.0%), respectively. The main limitation is the lack of central review of PSMA PET/CT scans.</p><p><strong>Conclusions and clinical implications: </strong>PSMA PET/CT is accurate in the staging of pelvic LNs before RP, especially for detection of metastases in LNs with a diameter ≥5 mm.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188718","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":"Oncologic Outcomes of Endoscopic Management of Upper Tract Urothelial Carcinoma: A Systematic Review and Pooled Analysis from the EAU-YAU Urothelial Working Group.","authors":"Andrea Gallioli, Alessandro Uleri, Paolo Verri, Alessandro Tedde, Laura S Mertens, Marco Moschini, Francesco Del Giudice, Francesco Soria, Ekaterina Laukhtina, José Daniel Subiela, Wojciech Krajewski, David D'Andrea, Andrea Mari, Gautier Marcq, Keiichiro Mori, Jeremy Teoh, Luca Afferi, Simone Albisinni, Francesco Sanguedolce, Joan Palou, Alberto Breda, Benjamin Pradere","doi":"10.1016/j.euf.2025.01.009","DOIUrl":"https://doi.org/10.1016/j.euf.2025.01.009","url":null,"abstract":"<p><strong>Background and objective: </strong>Data about the mid- and long-term oncologic outcomes of endoscopic kidney-sparing surgery (eKSS) for upper tract urothelial carcinoma (UTUC) are scarce. Therefore, we aimed to summarize the current evidence on the oncologic outcomes of eKSS for UTUC.</p><p><strong>Methods: </strong>A literature search was conducted to identify reports published until May 2024. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed to identify eligible studies. The outcomes were the following: recurrence-free (RFS), intravesical recurrence-free (IV-RFS), progression-free (PFS), cancer-specific (CSS), and overall (OS) survival.</p><p><strong>Key findings and limitations: </strong>We found 56 studies (n = 52 retrospective) that met our inclusion criteria (n = 2862 patients). The 1-, 2-, 5-, and 10-yr OS rates were 96%, 87%, 80%, and 42%, respectively. The 1-, 2-, 5-, and 10-yr CSS rates were 97%, 89%, 82%, and 69%, respectively. RFS rates at 1, 2, and 5 yr were 69%, 55%, and 45%, respectively. IV-RFS rates at 1, 2, and 5 yr were 80%, 65%, and 64%, respectively. PFS rates at 2 and 5 yr were 75% and 69%, respectively. In low-grade UTUC, OS rates at 2 and 5 yr were 93% and 77%, respectively. The 2- and 5-yr CSS rates were 98% and 88%, respectively. At 2 yr, RFS, IV-RFS, and PFS were 52%, 54%, and 94%, respectively. For high-grade UTUC, only three studies reported data on 2-yr RFS, which was 34%. The main limitation is the heterogeneity found across the studies.</p><p><strong>Conclusions and clinical implications: </strong>Local recurrence, bladder recurrence, and progression of UTUC occur mainly within 2 yr after eKSS. After 5-yr follow-up, OS and CSS drop, while the risk of local recurrence is non-negligible.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079132","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}