Gland surgery最新文献

{"title":"Thyroid surgery outcomes in a 4-year series with intraoperative neuromonitoring: a retrospective cohort study.","authors":"Miguel Allen, Catarina Palma, Carlota Branco, Cesar Resende, Natacha Vieira, Ana Luísa Silva, Francisco Sobral do Rosário","doi":"10.21037/gs-2025-29","DOIUrl":"10.21037/gs-2025-29","url":null,"abstract":"<p><strong>Background: </strong>Meticulous surgical technique is essential for safe thyroid surgery, with high-volume surgeons experiencing the lowest complication rates. Intraoperative neuromonitoring (IONM) is increasingly adopted in high-volume centers to enhance outcomes and reduce complications. The aim of this study is to evaluate surgery outcomes during IONM introduction in daily practice.</p><p><strong>Methods: </strong>This retrospective cohort study evaluated morbidity associated with the introduction of IONM by analysing all consecutive thyroid surgeries performed between 2019 and 2022 at Hospital da Luz Lisboa. Patient demographics, clinical characteristics, and surgery-related data were collected. Primary outcomes were recurrent laryngeal nerve (RLN) palsy and annual progression of IONM use. Secondary outcomes included hypoparathyroidism and surgical complications.</p><p><strong>Results: </strong>A total of 502 patients (98 men and 404 women, with mean ages of 54.9 and 52.6 years, respectively) underwent either lobectomy or total thyroidectomy (TT), involving 719 RLNs at risk (RLNAR). A transient palsy rate of 0.56% and a definitive palsy rate of 0.28% were identified, with no associated risk factors. In the IONM group (n=237), transient RLN palsy occurred in 0.81% of patients, with no definitive palsy cases. IONM use increased from 35.9% in 2019 to 73.2% in 2022 (P<0.001). Permanent hypoparathyroidism occurred in 0.39% of patients. No cervical hematoma or surgical site infection was observed.</p><p><strong>Conclusions: </strong>The progressive implementation of IONM in thyroid surgery, alongside increasing case complexity and annual surgical volume, may support RLN preservation and reduce morbidity, while enabling gradual skill acquisition. Routine IONM use should be considered to improve patient outcomes, particularly in complex thyroid procedures.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 7","pages":"1230-1241"},"PeriodicalIF":1.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral granulomatous mastitis associated with ductoscopy.","authors":"Ranxi Shu, Ting Pan, Kehan Yao, Huijin Liu, Yongli Liu, Gang Lyu","doi":"10.21037/gs-2025-77","DOIUrl":"10.21037/gs-2025-77","url":null,"abstract":"<p><strong>Background: </strong>Some patients with granulomatous mastitis (GLM) exhibit nipple discharge from the healthy breast. Ductoscopy was conducted on healthy breasts with discharge in these patients, and it was observed that some patients developed contralateral GLM shortly after ductoscopy. This study investigated the association between ductoscopy and GLM formation.</p><p><strong>Methods: </strong>Forty patients diagnosed with GLM who underwent ductoscopy on the healthy breast were included and divided into bilateral (10 cases) and unilateral (30 cases) groups. General and clinical data of the patients were collected, and single- and multi-factor logistic regression analyses were used to screen potential risk factors for GLM formation after ductoscopy.</p><p><strong>Results: </strong>Univariate and multivariate analyses indicated that the detection of \"neutrophils and lymphocytes\" (P=0.02) in ductal cytology smears was an independent risk factor for the occurrence of masses after ductoscopy. The area under the curve (AUC) for predicting the occurrence of erythema in both lower limbs after the occurrence of a mass in the contralateral breast following ductoscopy was 0.843, with a specificity of 0.853 and a sensitivity of 0.833.</p><p><strong>Conclusions: </strong>We hypothesize that ductal injury with extravasation of static inflammatory substances within the lumen promotes a local granulomatous reaction in the breast lobules, which is closely associated with the pathogenesis of GLM. Ductoscopy may simulate the pathogenesis of GLM in the subtype with mammary duct injury after breast trauma.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 7","pages":"1336-1347"},"PeriodicalIF":1.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive biopsy technique predicting breast pathological complete response after neoadjuvant therapy for breast cancer.","authors":"Zhiqiang Shi, Pengfei Qiu, Yongsheng Wang, Hong Liu","doi":"10.21037/gs-2025-103","DOIUrl":"10.21037/gs-2025-103","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant therapy (NAT) is widely used in the treatment of breast cancer, and the pathological complete response (pCR) rate is increasing. However, currently, the prediction of pCR still lacks accuracy. This study aimed to investigate the accuracy of minimally invasive biopsy techniques in predicting breast pCR (bpCR) after NAT in breast cancer.</p><p><strong>Methods: </strong>From October 2022 to October 2024, a prospective single-arm study was conducted on 132 patients with primary breast cancer who achieved breast radiologic complete response (brCR) or breast radiologic partial response (brPR) after NAT at the Breast Center of Shandong Cancer Hospital. Before NAT, a marker clip was placed at the center of the tumor bed. After NAT, in patients with no residual lesions suggested by ultrasound, iodine-125 was placed under the guidance of mammography, followed by routine breast surgery (breast-conserving surgery or mastectomy). Postoperatively, multiple-site core needle biopsy (CNB) under ultrasound guidance was performed on the surgical specimen. The pathological results of CNB specimens were compared with those of surgical specimens to assess the accuracy of CNB in predicting bpCR (ypT0) after NAT.</p><p><strong>Results: </strong>A total of 52 patients (39.4%) achieved bpCR after NAT. Univariate analysis showed that tumor molecular subtypes, brCR after NAT, and axillary pathological complete response (apCR) were significantly associated with bpCR (P=0.02, 0.02, and P<0.001, respectively). Ultrasound-guided multiple-site CNB had an accuracy, negative predictive value (NPV), and false-negative rate (FNR) of 90.9%, 81.0%, and 14.8%, respectively, in predicting bpCR after NAT, which were superior to those of ultrasound, mammography, and magnetic resonance imaging. The combination of imaging examinations and ultrasound-guided multiple-site CNB significantly reduced the FNR compared with CNB alone (7.4% <i>vs.</i> 14.8%; P<0.001). No false-negative results were found in 45 cases using large-bore CNB needles (12G).</p><p><strong>Conclusions: </strong>The combination of imaging examinations and ultrasound-guided multiple-site CNB has the potential to accurately predict bpCR after NAT, making it possible to selectively avoid breast surgery in breast cancer patients after NAT.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 7","pages":"1263-1271"},"PeriodicalIF":1.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive nomogram for occult metastasis in central lymph nodes of papillary thyroid microcarcinoma based on clinical and ultrasound features.","authors":"Junping Zhang, Wanting Yi, Rongqian Wu, Ying Liu, Yuhang Chen, Xiaohui Deng, Zejin Hao, Shen Chen, Jixiong Xu","doi":"10.21037/gs-2025-159","DOIUrl":"10.21037/gs-2025-159","url":null,"abstract":"<p><strong>Background: </strong>Papillary thyroid microcarcinoma (PTMC) is prone to central lymph node metastasis (CLNM), and precise preoperative identification is crucial for the establishment of surgical protocol. We aimed to develop a nomogram based on clinical and ultrasound features to predict the presence of occult CLNM in clinically lymph node-negative (cN0) PTMC patients.</p><p><strong>Methods: </strong>We included 844 patients with cN0 PTMC admitted to The First Affiliated Hospital of Nanchang University between January 2022 and December 2023 who underwent thyroidectomy. Clinical and ultrasound characteristics were collected for univariate and multivariate analyses to determine the risk factors for CLNM metastasis, with consequent establishment of nomograms and internal validation.</p><p><strong>Results: </strong>A total of 303 patients with cN0 PTMC had CLNM (35.9%), and multifactorial analysis showed that male [odds ratio (OR) =2.96, 95% confidence interval (CI): 1.90-4.61, Ρ<0.001], age <55 years (OR =1.91, 95% CI: 1.20-3.04, Ρ=0.006), multifocal (OR =2.10, 95% CI: 1.43-3.09, Ρ<0.001), isthmus (OR =3.37, 95% CI: 1.42-8.03, Ρ=0.006), microcalcification (OR =2.02, 95% CI: 1.38-2.96, Ρ<0.001), and tumor size (OR =2.27, 95% CI: 1.47-3.49, Ρ<0.001) were independent risk predictors. The nomogram had good predictive ability. The area under the curve (AUC) of receiver operating characteristic (ROC) was 0.746 (95% CI: 0.704-0.789) in the training set and 0.726 (95% CI: 0.663-0.790) in the validation set. In addition, calibration curves were well fitted and decision curve analysis (DCA) indicated that patients could benefit clinically.</p><p><strong>Conclusions: </strong>The nomogram established in our study has a certain predictive ability for CLNM, which can be applied to the clinical management of cN0 PTMC patients, so as to provide more accurate preoperative evaluation and develop better treatment strategies.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 7","pages":"1295-1305"},"PeriodicalIF":1.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of high- and low-risk groups for ipsilateral recurrence within 10 years after breast-conserving surgery for ductal carcinoma in situ and personalized treatment: a retrospective study.","authors":"Jichun Zhou, Qingliang Wu, Xixi Lin, Ziyu Zhu, Yiqiu Hu, Zijie Guo, Shengkangle Wang, Linbo Wang, Shanming Ruan, Mingpeng Luo","doi":"10.21037/gs-2025-100","DOIUrl":"10.21037/gs-2025-100","url":null,"abstract":"<p><strong>Background: </strong>Breast-conserving surgery (BCS) is widely used for ductal carcinoma in situ (DCIS), but ipsilateral breast tumor recurrence (IBTR) remains a significant clinical challenge, highlighting the need for reliable predictive models to guide personalized treatment strategies. This study aims to fill the gap by developing a predictive model for IBTR in DCIS patients who have undergone BCS.</p><p><strong>Methods: </strong>A cohort of 40,770 DCIS patients who underwent BCS between 2000 and 2008 was identified from the Surveillance, Epidemiology, and End Results dataset. Chi-squared tests and logistic regression analyses were conducted to identify significant predictive factors for IBTR. These variables were incorporated into nomograms predicting the 5- and 10-year recurrence probabilities. The model was then used to categorize patients into risk groups.</p><p><strong>Results: </strong>The nomograms demonstrated good calibration and discriminative ability for predicting 5- and 10-year IBTR probabilities. Patients were stratified into extremely high- and low-risk groups. Among patients receiving adjuvant radiotherapy, those in the standard-risk group showed significantly lower recurrence rates compared to the extremely high-risk group (P<0.001). For the extremely low-risk group, no significant difference in recurrence risk was observed between patients who received adjuvant radiotherapy and those who did not (P=0.065).</p><p><strong>Conclusions: </strong>Patients with a recurrence rate above 10% were classified as extremely high-risk and may benefit from intensified treatment. Conversely, patients with a recurrence rate below 5% were considered extremely low-risk, suggesting that treatment could be safely de-escalated.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 7","pages":"1213-1229"},"PeriodicalIF":1.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant therapy and surgical resection successfully treating primary thyroid squamous cell carcinoma: a case report.","authors":"Yuhao Huang, Qihuan Shen, Jiong Lin, Hechao Zhou, Wenhua Hu, Zhi Zhang, Zumin Xu","doi":"10.21037/gs-2025-88","DOIUrl":"10.21037/gs-2025-88","url":null,"abstract":"<p><strong>Background: </strong>Primary squamous cell carcinoma of the thyroid is a rare, highly lethal malignancy, comprising less than 1% of all thyroid cancers. It is associated with poor prognosis due to its rapid progression, resistance to conventional therapies, and frequent presentation at an advanced stage. The preferred treatment approach combines surgical resection with adjuvant radiotherapy or chemotherapy, yet outcomes remain unsatisfactory.</p><p><strong>Case description: </strong>We report a case involving a 69-year-old female who presented with a progressively enlarging mass in the anterior neck. Computed tomography (CT) scans identified a right thyroid nodule measuring 4.0 cm × 4.7 cm × 5.3 cm. Subsequent fine needle aspiration biopsy confirmed thyroid squamous cell carcinoma, with molecular analysis revealing a positive BRAF (exon15:c.1801A>G:p.K601E) mutation. Given the substantial size of the neck mass and the unsuitability for surgical resection, neoadjuvant therapy was initiated. This included a combination of tislelizumab immunotherapy, chemotherapy, and anlotinib targeted therapy, which significantly reduced the size of tumor. The patient subsequently underwent a total thyroidectomy and remained disease-free for 2 years.</p><p><strong>Conclusions: </strong>The present case demonstrates the potential of a multimodal treatment regimen encompassing chemotherapy, immunotherapy and targeted therapy, followed by surgical excision, for primary thyroid squamous cell carcinoma. Further studies are needed to validate the efficacy and safety of this combined treatment modality in larger patient populations.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 7","pages":"1399-1405"},"PeriodicalIF":1.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological considerations in evaluating reconstructive strategies following postmastectomy radiotherapy.","authors":"Umar Wazir, Kefah Mokbel","doi":"10.21037/gs-2025-221","DOIUrl":"10.21037/gs-2025-221","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 7","pages":"1191-1194"},"PeriodicalIF":1.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synchronous occurrence of papillary thyroid carcinoma and medullary thyroid carcinoma in the setting of Hashimoto's thyroiditis: a case report with literature review.","authors":"Yue Shi, Yu Cheng, Shuang Zhang, Lili Liu, Jianhua Gu","doi":"10.21037/gs-2025-141","DOIUrl":"10.21037/gs-2025-141","url":null,"abstract":"<p><strong>Background: </strong>The incidence of medullary thyroid carcinoma (MTC) originating from parafollicular cells of the thyroid gland is relatively low among all thyroid cancers, and MTC combined with papillary thyroid carcinoma (PTC) is even rarer. In this article, we report a case of MTC combined with PTC on the background of Hashimoto's thyroiditis (HT) and discuss several points surrounding the diagnosis and management.</p><p><strong>Case description: </strong>A 59-year-old woman was admitted to the hospital with the main cause of \"right neck pain for 6 months and right thyroid nodules for 20 days\". Ultrasound showed multiple Thyroid Imaging-Reporting and Data System (TI-RADS) grade 3 hypoechoic nodules in the right lobe, and a hypoechoic nodule in the proximal isthmus of the right lobe, with a poorly defined border and TI-RADS grade 4a. No obvious enlarged lymph nodes were seen in the anterior neck. Preoperative calcitonin (Ctn) was found to be 614.9 pg/mL (normal range, 0.00-6.40 pg/mL). Postoperative histopathologic findings returned: papillary carcinoma of the right thyroid gland, invading the peritoneum of the thyroid gland, and another more diffuse growth nodule was seen, which was consistent with medullary carcinoma of the thyroid gland; with a background of HT. The patient was successfully discharged from the hospital after surgical treatment.</p><p><strong>Conclusions: </strong>HT with PTC and MTC is an extremely rare disease. By reporting the diagnosis and treatment of this case, this article can provide experience for subsequent clinical studies.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 7","pages":"1406-1414"},"PeriodicalIF":1.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implication of indocyanine green angiography for chest wall perforator flap reconstruction in breast-conserving surgery.","authors":"Sarun Thongvitokomarn, Sikrit Denariyakoon","doi":"10.21037/gs-2025-160","DOIUrl":"10.21037/gs-2025-160","url":null,"abstract":"<p><strong>Background: </strong>Volume replacement after breast-conserving surgery (BCS) can help achieve a good cosmetic outcome, especially in patients with small breast size, where volume displacement is limited. Latissimus dorsi myocutaneous flaps, which are widely used, require a longer hospital stay and have a risk of donor site morbidity. Chest wall perforator flap (CWPF) could be used as an alternative option. Although this has the advantage of a shorter hospital stay and muscle preservation, the dissection of perforator vessels is required. Using indocyanine green (ICG) intraoperatively can help the surgeon to visualize the perforators and assess the flap perfusion. Our study aimed to examine the roles of these techniques for CWPF reconstruction in BCS.</p><p><strong>Methods: </strong>We retrospectively reviewed 22 patients who underwent CWPF reconstruction at the Queen Sirikit Centre for Breast Cancer, King Chulalongkorn Memorial Hospital from January 2023 to October 2024. Patients' baseline characteristics, types of CWPF, number of perforators identified by ICG and by direct visualization, complications, and perfusion time of ICG were reviewed.</p><p><strong>Results: </strong>Eight patients had anterior intercostal artery perforator (AICAP) flap reconstruction. Thirteen patients had lateral intercostal arterial perforator (LICAP) flap reconstruction with or without lateral thoracic arterial perforator (LTAP) flap reconstruction. One patient had thoracodorsal arterial perforator (TDAP) reconstruction. The ICG was used in 21 flaps. ICG perfusion was completed within 2 minutes (range, 20-110 seconds). Most of the patients had two perforators identified by ICG. In 88% of cases, ICG perfusion of the perforator flap and adjacent normal tissue was visualized simultaneously. There was a difference in ICG perfusion onset time between flaps with one versus multiple perforators.</p><p><strong>Conclusions: </strong>ICG angiography can be used intraoperatively for flap assessment with helpful information. A perfusion time of less than 2 minutes was correlated with a good clinical outcome. Intraoperative ICG angiography can guide surgeons in evaluating flap perfusion, which can help address both immediate and long-term morbidity concerns.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 7","pages":"1242-1249"},"PeriodicalIF":1.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances in volume retention and evaluation methods of fat grafting for breast reconstruction.","authors":"Yuki Otsuki, Takashi Nuri, Koichi Ueda","doi":"10.21037/gs-2025-117","DOIUrl":"10.21037/gs-2025-117","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 7","pages":"1178-1182"},"PeriodicalIF":1.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}