Hernia最新文献

{"title":"Clinical and perioperative outcomes of abdominal wall reconstruction and panniculectomy in a single surgical procedure: experience from a high-complexity center in bogotá, Colombia.","authors":"Carolina Riscanevo Bobadilla, Alejandro Lora Aguirre, Juan Pablo Ruiz, Neil Valentín Vega, Arnold José Barrios, Ana María Sastre, German Paez, David Duque, Camilo Mejia, Camilo Herrera, Luis Arturo Molina, María Del Pilar Montilla","doi":"10.1007/s10029-025-03415-7","DOIUrl":"10.1007/s10029-025-03415-7","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"236"},"PeriodicalIF":2.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674573","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}

{"title":"Frailty predicts recurrence after laparoscopic Nissen fundoplication with mesh cruroplasty for giant sliding hiatal hernia with severe reflux esophagitis in elderly patients: a multicenter retrospective study.","authors":"Tamer A A M Habeeb, Abdulzahra Hussain, Alberto Aiolfi, Jose Bueno- Lledó, Massimo Chiaretti, Igor A Kryvoruchko, Mohammad Kermansaravi, Abdelrahman Nimeri, Abd Al-Kareem Elias, Saad Mohamed Ali Ahmed, Esmail Tharwat Kamel Awad, Mohamed A Gadallah, Ahmed Khyrallh, Mohammed H Alsayed, Mohamed Fathy Labib, Sobhy Rezk Ahmed Teama, Abdelhafez Seleem, Mohammed Hassan Elshafey, Mostafa Mahmoud Salama Mostafa, Hamdi Elbelkasi, Mahmoud Ali Abou Zaid, Ahmed Hamdy, Mohamed Ibrahim Abo Alsaad, Maged Z Youssef, Rasha Mohamed Motawea Ali, Ibtsam AbdelMaksoud Mohamed El Shamy, Ahmed Salah Arafa, Ibrahim A Heggy, Sameh Mohamed Naguib, Tamer Wasefy, Mohamed Abozaid, Tamer Mohamed Elshahidy, Abdelshafy Mostafa, Mohamed Elnemr, Abdelrahman Mohamed Hasanin Nawar, Mostafa M Khairy, Ahmed Mesbah Abdelaziz, Abdelfatah H Abdelwanis, Ahmed M El Teliti","doi":"10.1007/s10029-025-03416-6","DOIUrl":"10.1007/s10029-025-03416-6","url":null,"abstract":"<p><strong>Purpose: </strong>Giant sliding hiatal hernias (HH) are prevalent in the elderly population (EP) and often present with multiple comorbidities and a high surgical risk. Frailty has been increasingly recognized as a predictor of surgical outcomes in the EP. This study assessed the rate of recurrent sliding HH following mesh cruroplasty and laparoscopic Nissen fundoplication (LNF), and evaluated frailty as a potential risk factor of recurrence.</p><p><strong>Methods: </strong>This retrospective multicenter study included 266 patients aged ≥ 60 years who underwent mesh cruroplasty and LNF for giant sliding HH (> 5 cm) with severe reflux esophagitis (Demeester score > 100) between March 2016 and March 2022, stratified into non-recurrence (n = 241) and recurrence (n = 25) HH.</p><p><strong>Results: </strong>The mean age was 66.92 ± 4.3 years vs. 67.79 ± 3.7 years in the non-recurrence and recurrence group, respectively. Twenty-five (9.4%) patients developed recurrent HH, with a median size of 5.2 cm (4.1-6.0 cm), and the median time from surgery to recurrence was 16 months (13-20 months). Frailty was significantly correlated with recurrence, with moderately and severely frail patients demonstrating higher recurrence rates (44% vs. 17%, p = 0.02). Multivariate analysis confirmed that frailty was an independent predictor of recurrence (odds ratio [OR], 1.4; 95% CI, 1.003-1.982; p = 0.04). Time to recurrence included mild frailty (75% recurrence rate within 16 months), moderate frailty (90.9% recurrence within 12 months), and severe frailty (80% recurrence within 9 months).</p><p><strong>Conclusions: </strong>Frailty was an independent predictor of HH recurrence. Integrating frailty assessment into preoperative workflows could optimize patient selection and outcomes.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"235"},"PeriodicalIF":2.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659054","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}

{"title":"The impact of Abdominal Wall Hernia (AWH) on patients' social and sexual relationships: a Qualitative Analysis.","authors":"Olivia Smith, Asim Abbas, Mark Mierzwinski, Veronica Oliver-Jenkins, Praminthra Chitsabesan, Srinivas Chintapatla","doi":"10.1007/s10029-025-03414-8","DOIUrl":"10.1007/s10029-025-03414-8","url":null,"abstract":"<p><strong>Background: </strong>Abdominal Wall Hernia (AWH) impacts interpersonal relationships, which are vital to human wellbeing [1, 2], however social and sexual dimensions of AWH remain underexplored. This study investigates the impact of AWH on social disconnection and sexual intimacy challenges, and how this could be viably assessed in health related quality of life (HRQoL) assessment tools.</p><p><strong>Methods: </strong>A qualitative approach using Interpretative Phenomenological Analysis (IPA) was employed [3]. Fifteen participants (8 men and 7 women, aged 36-85 years) were purposively sampled. Data collected via semi-structured interviews was analysed iteratively until no new themes emerged [4].</p><p><strong>Results: </strong>AWH significantly impacted participants' interpersonal relationships, mainly through 'difficulties in connecting socially' and 'changes in sexual relationships'. Participants' social withdrawal was driven by physical limitations, altered self-perception, and stigma, leading to loneliness and reduced engagement. Changes in sexual relationships were shaped by pain, body image concerns, and perceived sexual pressure, often diminishing physical intimacy. Despite these challenges, emotional intimacy frequently persisted, largely due to empathetic and supportive partners. Postoperative improvements were highlighted as pivotal in restoring body confidence and intimacy.</p><p><strong>Conclusions: </strong>This study illustrates the profound social and sexual disruptions AWH causes. These effects should be included in holistic and patient centred care, and incorporated into HRQoL assessment tools. Preoperative counselling should include issues of social connection and intimacy, whilst postoperative care should integrate structured support networks, psychoeducational interventions, and psychosexual counselling. Future research should pilot, revise and test the effectiveness of such measures.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"234"},"PeriodicalIF":2.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642479","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}

{"title":"Rectus diastasis is a risk factor for incisional hernia after robot assisted laparoscopic radical prostatectomy for prostate cancer.","authors":"Shusaku Honma, Kana Ishikawa, Takashi Kumode, Takahisa Suzuki, Teppei Murakami, Shinichi Hosokawa, Takatsugu Kan, Sanae Nakajima","doi":"10.1007/s10029-025-03419-3","DOIUrl":"https://doi.org/10.1007/s10029-025-03419-3","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the association between rectus diastasis (RD) and incisional hernia (IH) following robot-assisted laparoscopic radical prostatectomy (RARP).</p><p><strong>Methods: </strong>We retrospectively reviewed all patients who underwent RARP for prostate cancer at our hospital between January 2017 and December 2023. All participants were required to undergo computed tomography imaging prior to RARP and at least once no less than five months after RARP to assess RD and IH, respectively. RD was defined as a widening of the linea alba exceeding 2 cm. A backward stepwise regression modeling was used to construct a multivariate logistic model. The cumulative incidence of IH was calculated and compared between patients with and without RD using the Kaplan-Meier method.</p><p><strong>Results: </strong>Among 145 eligible patients, 45 (31.0%) developed IH. Multivariable logistic regression analysis identified RD (Odds ratio 4.03, 95% confidence interval 1.92-8.48) as an independent risk factor associated with IH after adjusting for pre-existing primary umbilical hernia, body mass index, specimen weight, and surgical site complication. The cumulative incidence of IH was significantly higher in patients with RD than those without.</p><p><strong>Conclusion: </strong>RD is a significant risk factor for IH after RARP. Vertical midline incisions at the specimen extraction site should be avoided in patients with RD whenever possible.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"233"},"PeriodicalIF":2.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642448","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":"Mesh suture repair of rectus diastasis with and without a concurrent ventral hernia.","authors":"Megan M Perez, Taaha Hassan, Paige N Hackenberger, Gregory A Dumanian, Michael Shapiro","doi":"10.1007/s10029-025-03409-5","DOIUrl":"10.1007/s10029-025-03409-5","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"232"},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626072","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}

{"title":"Lateral-dock single-port robotic-assisted extended totally extraperitoneal plasty (eTEP)-Sublay-Herniotomy-Procedure- presentation of a novel technique for robotic-assisted ventral hernia surgery (with video).","authors":"Julian Hipp, Robin Klewitz, Hannes Neeff, Stefan Fichtner-Feigl, Philipp Anton Holzner","doi":"10.1007/s10029-025-03420-w","DOIUrl":"10.1007/s10029-025-03420-w","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic-assisted minimally-invasive extended totally extraperitoneal plasty (eTEP)-sublay-herniotomy is one of the most promising novel techniques for the management of ventral hernia. While several techniques for multiport-robotic-assisted eTEP have been described, only very few reports on suprapubic single-port robotic-assisted eTEP-techniques have been published. The technical limitations of this access leave room for further technical development using single-port-robotic systems.</p><p><strong>Methods: </strong>We give a detailed description of our novel lateral-dock single-port robotic-assisted eTEP-procedure (Freiburg approach, FReTEP). Feasibility of the access was demonstrated within a human cadaveric procedure, and two consecutive patients were treated using the FReTEP-procedure.</p><p><strong>Results: </strong>Two consecutive patients were successfully treated without postoperative complications and without early hernia recurrence using the FReTEP-procedure.</p><p><strong>Conclusion: </strong>The FReTEP-procedure is a promising novel technique for single-port-robotic-assisted ventral hernia repair. Further studies are needed to evaluate the novel procedure.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"231"},"PeriodicalIF":2.6,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617395","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}

{"title":"Transabdominal pre-peritoneal hernia repair: risk of operation for recurrence depends on choice of both mesh and fixation device. A study from the Danish Hernia Database.","authors":"Alexander Mortensen, Anne Bodilsen, Hans Friis-Andersen","doi":"10.1007/s10029-025-03344-5","DOIUrl":"10.1007/s10029-025-03344-5","url":null,"abstract":"<p><strong>Purpose: </strong>Multiple methods of mesh fixation are available in laparoscopic inguinal hernia repair, as well as multiple types of mesh. No previous studies compare all methods of fixation in TAPP against each other in regards to risk of reoperation for recurrence. In addition, there is little data comparing types of mesh or the relationship between mesh and fixation method.</p><p><strong>Methods: </strong>We compare the tissue-penetrating methods with non-penetrative as well as no fixation, and examines the interaction of fixation method and choice of mesh. Cohort was established by way of the Danish Hernia Database, identifying patients operated with TAPP from Jan. 2010 to Dec. 2022. Cox' regression analyses were performed, with multivariate analysis correcting for significant confounding variables, yielding adjusted hazard ratios (aHR) for reoperation for each fixation method. Follow-up analyses investigated whether differences in mesh types significantly impacted the results.</p><p><strong>Results: </strong>Among 49,029 TAPP repairs, 3.6% experienced reoperation for recurrence over a mean follow-up of 5.76 years. Tack fixation, the most common method, showed the highest reoperation rates (5.3% at 5 years). Glue, self-fixating meshes, and no fixation, had significantly lower risk in comparison (aHRs of 0.25, 0.21, and 0.51, respectively). Even after correcting for weight and pore size, some mesh types significantly impacted risk, with aHRs spanning 0.28 - 1.</p><p><strong>Conclusion: </strong>Non-penetrative fixation methods and no fixation are associated with lower reoperation rates compared to tissue-penetrative methods, with self-fixating meshes carrying the lowest risk. In addition, we found significant differences in aHR between types of mesh.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"229"},"PeriodicalIF":2.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608240","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}

{"title":"Prophylactic mesh reinforcement in elective abdominal surgeries: a systematic review, meta-analysis, and GRADE evidence assessment.","authors":"Ahmed W Abbas, Mohamed F Abo-Elsoad, Mahmoud Diaa Hindawi, Mohamed Abo Zeid, Abd-Elfattah Kalmoush, Menna M Aboelkier, Mohamed A Aldemerdash, Rashad G Mohamed, Hosam Elghadban","doi":"10.1007/s10029-025-03421-9","DOIUrl":"10.1007/s10029-025-03421-9","url":null,"abstract":"<p><strong>Background: </strong>Elective laparotomies account for a larger fraction of laparotomy procedures performed worldwide. Although surgical techniques continue to advance, the incidence of incisional hernia (IH) and other post-operative complications remain challenging to surgeons. This study aimed to evaluate the significance of using prophylactic mesh reinforcement during elective laparotomy.</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed, Scopus, and Web of Science to identify studies that included adults undergoing elective abdominal surgery and compared prophylactic mesh reinforcement of the abdominal wall using any type of mesh in any anatomical position to standard fascial closure with sutures alone, without mesh. The analysis aimed to assess the impact of mesh reinforcement on the incidence of IH at all possible timepoints, in addition to secondary outcomes based on mesh technique, such as wound infections, dehiscence, seroma, re-operation for IH, and prolonged hospital stay. Data analysis was performed using the R programming language.</p><p><strong>Results: </strong>Fifteen RCTs, including 2,233 patients with follow-up durations ranging from 1.5 to 5 years, were analyzed. Prophylactic mesh reinforcement significantly reduced the incidence of IH following elective gastrointestinal surgeries at 12 months (risk ratio [RR] = 0.35, 95% confidence interval [CI] [0.14; 0.86], p = 0.02), 24 months (RR = 0.28, 95% CI [0.11; 0.68], p < 0.01), 36 months (RR = 0.62, 95% CI [0.36; 1.06], p = 0.08), and 48 months (RR = 0.35, 95% CI [0.11; 1.17], p = 0.09). Similarly, mesh significantly reduced IH rates following open abdominal aortic aneurysm repair at 12 months (RR = 0.13, 95% CI [0.04; 0.41], p < 0.01), 24 months (RR = 0.31, 95% CI [0.21; 0.45], p < 0.01), and 36 months (RR = 0.23, 95% CI [0.10; 0.54], p < 0.01).</p><p><strong>Conclusions: </strong>Prophylactic mesh reinforcement during elective abdominal laparotomy significantly reduced the incidence of IH and the need for reoperation. However, it is associated with an increased risk of seroma formation and, to a lesser extent, wound infection, particularly with the Sublay technique.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"230"},"PeriodicalIF":2.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617396","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}

{"title":"Does prior mesh infection matter? Clinical outcomes of patients undergoing complex abdominal wall reconstruction after infected mesh explantation.","authors":"Daphne Remulla, Brianna L Slatnick, Kimberly P Woo, William C Bennett, Alvaro Carvalho, Cammy Tang, Kimberly S Miles, Li-Ching Huang, Benjamin T Miller, Lucas R Beffa, David M Krpata, Clayton C Petro, Ajita S Prabhu, Michael J Rosen","doi":"10.1007/s10029-025-03405-9","DOIUrl":"https://doi.org/10.1007/s10029-025-03405-9","url":null,"abstract":"<p><strong>Background: </strong>While mesh infection after ventral hernia repair often requires explantation and subsequent repair, the association between prior mesh infection with outcomes following complex abdominal wall reconstruction remains poorly understood.</p><p><strong>Methods: </strong>A two-stage propensity score-matched analysis was performed using the Abdominal Core Health Quality Collaborative database. Patients undergoing clean, elective, open ventral hernia repair with prior mesh infections were compared with those with no prior wound morbidity and non-mesh-related surgical site infections (SSIs). All patients underwent elective open ventral hernia repair with transversus abdominis release (TAR) and retromuscular synthetic mesh placement.</p><p><strong>Results: </strong>After propensity score matching, 205 patients with prior mesh infection were matched to 205 patients with prior non-mesh-related SSI and to 548 patients with no prior wound morbidity. Patients with a prior mesh infection experienced significantly higher rates of 30-day surgical site occurrences (SSO) (24.9% vs. 14.1%; p < 0.001) and surgical site occurrences requiring procedural intervention (14.1% vs. 7.7%; p = 0.007), compared with those with no prior wound morbidity. Compared with those with prior non-mesh-related SSIs, patients with a prior mesh infection also had a higher rate of SSO (25% vs. 14%; p = 0.004) and a higher proportion of deep SSIs (65% vs. 20%; p = 0.004). Despite these differences, mesh excision rates were low across all groups (0.1-0.2%). Patients with prior mesh infection reported significantly worse quality of life at baseline (median HerQLes: 22 vs. 32; p = 0.008) and worse pain scores at 30 days (median PROMIS 3 A: 52 vs. 46; p = 0.007). Reoperation and hernia recurrence rates were similar between groups throughout the five-year follow-up period.</p><p><strong>Conclusions: </strong>Prior mesh infection is associated with increased short-term wound morbidity following complex abdominal wall reconstruction, despite similar long-term hernia recurrence rates and low rates of mesh excision. While transversus abdominis release (TAR) with retromuscular mesh placement may mitigate the risk of repeated mesh infection and explantation, prior mesh infections impact patient outcomes well beyond the immediate postoperative period. These findings can help guide informed discussion and set appropriate patient expectations.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"226"},"PeriodicalIF":2.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591148","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":"Comment to: Planned iliohypogastric neurectomy for prevention of chronic pain after inguinal hernia repair.","authors":"Christoph Paasch, R Fortelny","doi":"10.1007/s10029-025-03412-w","DOIUrl":"10.1007/s10029-025-03412-w","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"224"},"PeriodicalIF":2.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591147","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}