Indian Journal of Orthopaedics最新文献

{"title":"The Uses of Banked Bone Allograft for Non-oncological Orthopaedic Surgeries: A Preliminary Report of the First 28 Cases in Nigeria.","authors":"Kehinde Adesola Alatishe, Oluwaseyi Kayode Idowu, Mustapha Alimi","doi":"10.1007/s43465-025-01460-z","DOIUrl":"10.1007/s43465-025-01460-z","url":null,"abstract":"<p><strong>Background: </strong>The use of bone allograft in Orthopaedics is a novel practice but the detailed information about the indications and outcomes is yet to be reported in Nigeria.</p><p><strong>Objective: </strong>To highlight the non-oncological indications and early outcomes of the uses of irradiated frozen bone allografts for orthopaedic procedures in Nigeria.</p><p><strong>Materials and methods: </strong>This was a prospective study of patients who had bone allograft implanted between 1st September 2020 and 31st August 2022 for various non-oncological orthopaedic conditions at our tertiary center. The donors were selected based on American Association of Tissue Bank (AATB) guidelines. The bone allografts were prepared, irradiated, and stored in a freezer at - 80 °C. Ethical clearance was obtained from the institutional ethics committee and written informed consent was signed by patients. They all had implantation of banked femoral head allograft. The details on demographics, indications, and early outcomes were documented in a questionnaire and analyzed with SPSS software version 20.</p><p><strong>Results: </strong>A total of 28 patients with follow-up results were included in the study. The follow-up duration was a minimum of 1 year. The male-to-female ratio was 2.5: 1 with mean age of 51.0 ± 9.8 years. The indications were acetabular reconstruction in complex primary and revision total hip replacement (67.9%), non-union fractures (14.3%), tibial plateau fractures (10.7%), and spinal fusion surgery (7.1%). Most of the grafts were implanted as structural grafts (57.9%) while others were used as either morselized (26.3%) or composite grafts (15.8%). The mean incorporation time of 6.2 ± 0.7 months was recorded. Most of the patients (92.9%) had satisfactory osteo-integration of the graft (Oswestry's ≥ 2). There was no incidence of infection in this early report.</p><p><strong>Conclusion: </strong>The use of deep frozen and irradiated bone allografts in the management of non-oncological orthopaedic conditions is a new development in Nigeria. This preliminary report is encouraging and we hope to arrive at a definite conclusion after a long-term follow-up.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1249-1254"},"PeriodicalIF":1.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the Efficacy and Safety Landscape of Duloxetine in Osteoarthritis Management: A Meta-Analysis of Randomized Controlled Trials.","authors":"Baibhav Bhandari, Kanchan Bisht, Gaurav Purohit, Shiwam Gupta, Girish Kumar Singh, Sonal Goyal, Pradeep Atter, Ajit Kumar, Praveen Talawar","doi":"10.1007/s43465-025-01372-y","DOIUrl":"10.1007/s43465-025-01372-y","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of duloxetine in treatment of osteoarthritis compared with placebo.</p><p><strong>Method: </strong>We conducted a comprehensive search for pertinent randomized controlled trials (RCTs) across multiple databases, including PubMed, Embase, Scopus, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and Google scholar. These selected RCTs aimed to assess the effectiveness and safety of duloxetine versus a placebo in the management of osteoarthritis (OA). We computed the mean difference (MD) for continuous outcome measures and calculated the risk ratio (RR) for dichotomous outcome measures.</p><p><strong>Results: </strong>Data from 10 RCT including 2294 participants comparing duloxetine and placebo were pooled. Duloxetine showed improvement in BPI-S (Brief Pain Inventory-Severity)MD =  - 0.66; 95% CI, [- 0.75, - 0.57], BPI-I (Brief Pain Inventory-Interference)MD =  - 0.59; 95% CI [- 0.66, - 0.52], WOMAC (Western Ontario and McMaster Universities Arthritis Index) pain sub scale scores SMD =  - 2.56; 95% CI, [- 4.24, - 0.89] <i>P</i> = 0.003; physical function MD =  - 4.59; 95% CI, [- 5.83, - 3.34] <i>P</i> < 0.00001; SF 36 (Short Form) Physical function MD = 1.56; 95% CI, [0.14, 2.97] <i>P</i> = 0.03 and patients global impressions scores SMD =  - 0.47; 95% CI, [- 0.62, - 0.32]. Duloxetine resulted in higher number of treatment emergent adverse events RR = 1.34; 95% CI, [1.12,1.61] <i>P</i> = 0.002; and discontinuations RR = 2.54; 95%, CI, [1.89, 3.42] <i>P</i> < 0.00001. However duloxetine was no different from placebo in improving stiffness and in terms of incidence of serious adverse effects.</p><p><strong>Conclusion: </strong>Duloxetine demonstrates effectiveness in addressing chronic pain and mitigating the decline in physical function associated with knee osteoarthritis (OA), while maintaining a reasonable level of tolerable adverse events. However, it does not offer a distinct advantage in alleviating joint stiffness.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s43465-025-01372-y.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1123-1136"},"PeriodicalIF":1.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fragility Fracture of the Neck of Femur in the Young Elderly.","authors":"Vishal Kumar, Tharun Teja Aduri, Sachin Yashwant Kale, Akhilesh Kumar, S S Amarnath","doi":"10.1007/s43465-025-01370-0","DOIUrl":"10.1007/s43465-025-01370-0","url":null,"abstract":"<p><strong>Background: </strong>Fragility fractures of the femoral neck (NOF) are a growing concern in the \"young elderly\" (aged 65-84), a group experiencing the intersection of aging and active lifestyles. These fractures occur with minimal trauma due to weakened bones, primarily from osteoporosis. The management of such fractures in this population presents distinct challenges, requiring a balance between rapid recovery and the limitations imposed by aging physiology.</p><p><strong>Management: </strong>The rising incidence of femoral neck fractures is linked to age-related bone loss and comorbidities like osteoporosis, sarcopenia, and chronic diseases. Women, due to post-menopausal bone loss, are disproportionately affected. Early surgical intervention (internal fixation, hemiarthroplasty, or total hip arthroplasty) is crucial for restoring mobility. Surgical complications such as avascular necrosis, fixation failure, and dislocation remain significant concerns. Rehabilitation involving early mobilization and osteoporosis management is essential for optimal recovery, though the risk of mortality and permanent disability remains elevated.</p><p><strong>Conclusion: </strong>Fragility fractures in the young elderly require a multidisciplinary approach that combines prompt surgical intervention, targeted rehabilitation, and long-term osteoporosis management. Preventive strategies focused on bone health and fall prevention will be critical in reducing the incidence and improving outcomes for this population.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1014-1025"},"PeriodicalIF":1.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intertrochanteric Fractures: Ten Commandments for Getting Good Results with Proximal Femoral Nailing.","authors":"B Shivashankar, Sachin Sitarampant Kulkarni","doi":"10.1007/s43465-025-01485-4","DOIUrl":"10.1007/s43465-025-01485-4","url":null,"abstract":"<p><strong>Background: </strong>Intertrochanteric (IT) fractures in the elderly are a major orthopaedic challenge due to osteoporotic bone quality, implant anchorage difficulties, and associated comorbidities. These factors contribute to nearly one-third mortality within a year of injury, representing a significant global health and economic burden.</p><p><strong>Methods: </strong>Historically, stable IT fractures were treated with surface implants such as dynamic hip screws (DHS), whilst intramedullary (IM) implants like proximal femoral nails (PFN) were reserved for unstable patterns. Evidence from 1999 to 2010, including Cochrane reviews, supported this practice. However, recent studies and updated Cochrane data advocate intramedullary fixation for both stable and unstable fractures. The authors draw from their extensive experience on intertrochanteric fracture management, ten important principles on fixing intertrochanteric fractures using PFN.</p><p><strong>Results: </strong>Current evidence supports the use of intramedullary implants as the preferred method for intertrochanteric fracture fixation. The authors concur with this trend and share practical tips to improve outcomes using PFN. Emphasis is placed on achieving optimal fracture reduction, which directly correlates with surgical success. Once adequate reduction is attained, a variety of intramedullary devices can effectively maintain alignment. These principles are presented as ten commandments in this article.</p><p><strong>Conclusion: </strong>Intramedullary fixation, particularly with proximal femoral or trochanteric fixation nail (TFN) utilising a dual screw system, is recommended for both stable and unstable intertrochanteric fractures in the elderly. Despite the availability of single screw systems favoured for their ease of use, the authors maintain preference for the two-screw design due to enhanced stability. Surgical expertise in achieving and maintaining reduction remains paramount to successful outcomes.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1147-1163"},"PeriodicalIF":1.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Osteoporosis Care through Surgical Innovations.","authors":"S S Jha","doi":"10.1007/s43465-025-01505-3","DOIUrl":"10.1007/s43465-025-01505-3","url":null,"abstract":"<p><p>This editorial entitled \"Advancing Osteoporosis Care through Surgical Innovations\" for \"Osteoporosis-Surgical Care\" Special Issue 2, is slated to be published in the August Abstract following the publication of comprehensive medical management of osteoporosis, the \"Osteoporosis-Surgical Care\" Issue 1. The remaining articles are scheduled to be published in \"Osteoporosis-Surgical Care: Issue 2. The article focuses on various novel surgical techniques in different locations of fragility fractures. These articles are expected to inspire orthopaedic surgeons to adopt these innovative approaches.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1013"},"PeriodicalIF":1.1,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bio-Active Composite Therapy (BACT) in Regenerative Orthopaedics.","authors":"Naveen Jeyaraman, Madhan Jeyaraman, Swaminathan Ramasubramanian, Sathish Muthu, Harish V K Ratna, Sangeetha Balaji","doi":"10.1007/s43465-025-01475-6","DOIUrl":"10.1007/s43465-025-01475-6","url":null,"abstract":"<p><strong>Background: </strong>Bio-Active Composite Therapy (BACT) represents a significant advancement in regenerative orthopaedics, integrating bioactive materials with biological systems to enhance bone and tissue regeneration. This comprehensive approach leverages materials such as hydroxyapatite, bioactive glasses, polymers, and metals to create scaffolds that mimic the extracellular matrix, facilitating cellular activities essential for tissue repair.</p><p><strong>Methods: </strong>A systematic literature review was conducted using databases including PubMed, Scopus, Web of Science, and Google Scholar. Keywords such as \"Bio-Active Composite Therapy,\" \"regenerative orthopaedics,\" and \"bioactive materials\" were employed to identify relevant studies published between 2000 and 2024. Inclusion criteria focused on peer-reviewed articles, reviews, and clinical trials related to the development, application, and evaluation of BACT in bone and soft tissue regeneration. Data extraction emphasized bioactive material types, fabrication techniques, clinical applications, outcomes, and associated challenges. The findings were categorized thematically to synthesize current advancements and identify knowledge gaps.</p><p><strong>Results: </strong>BACT utilizes a diverse range of bioactive materials, with hydroxyapatite and bioactive glasses being predominant due to their osteoconductive and osteoinductive properties. Advanced fabrication techniques, particularly additive manufacturing (e.g., 3D printing), enable the creation of scaffolds with precise geometries and tailored porosity, enhancing cellular adhesion and proliferation. Clinically, BACT has demonstrated efficacy in bone regeneration, cartilage repair, and ligament healing, although biocompatibility and immunotoxicity remain challenges, especially with certain metal oxides like TiO₂. Economic barriers and technical precision in scaffold application also pose significant limitations.</p><p><strong>Conclusion: </strong>BACT holds transformative potential in regenerative orthopaedics by offering tailored, effective treatments for musculoskeletal disorders. Overcoming biocompatibility, safety, and accessibility challenges through interdisciplinary collaboration and technological innovation is essential for its widespread clinical adoption. Future research should focus on optimizing bioactive materials and fabrication methods, alongside rigorous clinical trials to validate long-term efficacy and safety.</p><p><strong>Graphical abstract: </strong></p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1112-1122"},"PeriodicalIF":1.1,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Half-Yearly Reflections from the IJO Editorial Office.","authors":"Srinivas B S Kambhampati, Murali Poduval","doi":"10.1007/s43465-025-01450-1","DOIUrl":"https://doi.org/10.1007/s43465-025-01450-1","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 7","pages":"861-862"},"PeriodicalIF":1.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Vertebral Intraosseous Arteriovenous Fistula with Large Epidural Venous Varices and Vertebral Collapse: Multimodal Imaging and Treatment Options.","authors":"Nitish Gupta, B T Pushpa, Ajoy Prasad Shetty, Shanmuganathan Rajasekaran, Bhupendar Singh","doi":"10.1007/s43465-025-01403-8","DOIUrl":"https://doi.org/10.1007/s43465-025-01403-8","url":null,"abstract":"<p><p>Spinal arteriovenous fistulas (AVF) are uncommon spinal pathologies and the presence of exclusive intraosseous vertebral AVF is a rarity. Only a handful of cases are documented in the literature. We present a case of large vertebral intraosseous spinal AVF causing vertebral collapse with associated large epidural venous pouches causing compression and congestion of cauda equina nerve roots. We highlight the clinico-radiological features of this entity and the importance of endovascular embolization before surgery in the management of vertebral intraosseous AVF. A 22-year lady presented with complaints of low back ache that had radiation to the right lower limb. MRI and contrast enhanced CT of lumbosacral spine showed areas of L5 vertebral destruction with large vascular channels. These channels were in contiguity with multiple venous pouches present in the anterior epidural spaces. Catheter angiography showed these venous pouches draining into the paravertebral venous plexus. The intraosseous AVF was completely occluded by the techniques of transarterial embolization with glue. The symptoms showed significant reduction after embolization. Although extremely rare, spinal intraosseous AVFs can develop and cause symptoms like back ache, congestive myelopathy and compressive myelopathy. Endovascular embolization is useful for the cases of spinal intraosseous AVFs as the primary treatment method and can be used presurgery in patients requiring vertebral instrumentation for stabilisation of the spine.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 7","pages":"1007-1011"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Surgical Technique for Achilles Tendon Rupture: A Retrospective Study of 18 Cases.","authors":"Dawei Xin, Zhuosong Mu, Linru Zeng, Gan Luo, Yafeng Mo","doi":"10.1007/s43465-025-01459-6","DOIUrl":"10.1007/s43465-025-01459-6","url":null,"abstract":"<p><strong>Background: </strong>The optimal treatment for acute closed Achilles tendon rupture (ATR) is still controversial. Many grassroots hospitals lack advanced equipment to perform effective minimally invasive surgeries, and open surgeries increase the incidence of complications. Therefore, we have developed a new technique specifically for grassroots hospitals. It involves using oval forceps-assisted minimally invasive suture bridge technology to treat acute closed Achilles tendon ruptures. This technique is easy to perform and has shown good clinical outcomes.</p><p><strong>Methods: </strong>We reviewed the therapeutic effectiveness of using oval forceps-assisted minimally invasive suture bridge technique in the treatment of 18 patients with ATR. All patients were followed up for a minimum of 12 months. Preoperative and postoperative follow-up data were reviewed to analyze the results and evaluate the surgical outcomes.</p><p><strong>Results: </strong>The patients were followed up for 12-16 months [( <math><mrow><mn>13.9</mn> <mo>±</mo> <mn>1.6</mn></mrow> </math> ) months]. There was no statistically significant difference in the ankle joint visual analog scale (VAS) scores at 3, 6, and 12 months postoperatively ( <math><mrow><mi>P</mi> <mo>></mo></mrow> </math> 0.05). However, there was a statistically significant increase in ankle joint active range of motion(AROM) at 3, 6, and 12 months postoperatively ( <math><mrow><mi>P</mi> <mo><</mo></mrow> </math> 0.05). At the same time, there was no statistically significant difference in AROM between the healthy side and the affected side at 12 months postoperatively. The American Orthopaedic Foot & Ankle Society(AOFAS) scores and Achilles Tendon Total Rupture Score (ATRS) showed a gradual improvement at 3, 6, and 12 months postoperatively, with statistical significance ( <math><mrow><mi>P</mi> <mo><</mo></mrow> </math> 0.05). All surgical incisions healed well without complications such as injury to the sural nerve or incision infection. Three patients experienced pain at the site of ATR at 3 months postoperatively, which resolved after a 2-week course of oral nonsteroidal anti-inflammatory drugs (NSAIDs). One patient experienced transient pain at the Achilles tendon insertion point after 6 months of activity, which disappeared after a 2-week course of oral NSAIDs.</p><p><strong>Conclusion: </strong>The use of oval forceps-assisted suture bridge technique for the treatment of acute closed ATR is characterized by its small incision, simple operation, and minimal complications, meeting the requirements for early functional rehabilitation of patients. For grassroots hospitals that receive a large number of patients, the oval forceps-assisted suture bridge technique is a surgical method worth popularizing.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1211-1218"},"PeriodicalIF":1.1,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not All That Glitters Is Gold: Questioning High-Dose Vitamin D Supplementation in Young Children.","authors":"Berkay Yalçınkaya, Ahmet Furkan Çolak, Murat Kara","doi":"10.1007/s43465-025-01466-7","DOIUrl":"10.1007/s43465-025-01466-7","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1274-1275"},"PeriodicalIF":1.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}