Indian Journal of Orthopaedics最新文献

{"title":"Comparative Analysis of Outcomes of Lateral Versus Medial Approach in the Total Knee Arthroplasty for Valgus Deformity: A Systematic Review and Meta-analysis","authors":"Rajesh Kumar Rajnish, Amit Srivastava, Sandeep Kumar Yadav, Abhay Elhence, Nitesh Gahlot, Prasoon Kumar, Saurabh Gupta, Sameer Aggarwal","doi":"10.1007/s43465-024-01211-6","DOIUrl":"https://doi.org/10.1007/s43465-024-01211-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Valgus knee deformity poses great challenges in total knee arthroplasty (TKA) and requires precision in balancing of soft tissue and implant component positioning. The surgical approach used for TKA has a determinantal impact on intraoperative soft tissue balancing, postoperative knee function, and complications. We executed a systematic review and meta-analysis of current literature, which included a maximum number of studies with quantitative analysis of all possible outcomes to substantiate the current evidence of the advantage of lateral versus medial approach in TKA for valgus knee deformity.</p><h3 data-test=\"abstract-sub-heading\">Methodology</h3><p>We performed a meticulous primary electronic search across PubMed, Emabse, Scopus, and Cochrane Library databases, and looked for the comparative studies that evaluated the medial versus lateral approach in TKA for valgus knees. Statistical analyses were executed with RevMan-5.4.1.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>On the evaluation of four randomized controlled trials (RCTs), two prospective and five retrospective comparative studies, our analysis revealed a better functional outcome in terms of Knee Society Score [MD 2.24, 95% CI 0.42, 4.05; p = 0.02] with the medial approach. However, comparable results were observed for two approaches with regard to Knee Society Function [MD 0.69, 95% CI − 1.77, 3.15; p = 0.58], knee flexion range of motion (ROM) [MD 3.30, 95% CI − 1.34, 7.95; p = 0.16], overall complications [OR 0.60, 95% CI 0.27,1.34; p = 0.22], wound-related complications, infection, nerve injury, periprosthetic fracture, post-operative valgus, blood loss, duration of surgery, postoperative pain, and patellar tilt for TKA in valgus knee.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Evidence from the currently available published data suggests that the lateral approach, compared to the medial approach in TKA for the valgus knee, does not show clear superiority.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141509602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound as a Diagnostic Modality in Hand and Wrist Musculoskeletal Pathologies: A Narrative Review","authors":"J. Terrence Jose Jerome","doi":"10.1007/s43465-024-01206-3","DOIUrl":"https://doi.org/10.1007/s43465-024-01206-3","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Musculoskeletal ultrasonography of the hand and wrist is becoming the trend in assessing and diagnosing most hand and wrist injuries, soft-tissue mass, and occult fractures. Its advantages include ultra-high frequency probes, noninvasiveness, cost-effectiveness, lack of ionising radiation, and portability. The patients are comfortable doing this procedure in the outpatient department, and visualising the ultrasound images increases their confidence.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Ultrasound has a practical and dynamic real-time diagnostic capability compared to other modalities, playing an important role in hand and wrist pathologies. Apart from the diagnostic utility, it has also been beneficial in musculoskeletal intervention procedures, such as trigger finger, carpal tunnel syndrome, and various tenosynovitis. The learning curve and limited deeper penetrations are relative limitations to ultrasound usage. More dedicated training centres and modules for future generations and CT/MRI for deeper structures are always an alternative. This article reviews the role of ultrasound in hand and wrist pathologies.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141531080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity and Reliability of the Timed 360° Turn Test in Individuals with Ankle Sprain","authors":"Nazım Tolgahan Yıldız, Mehmet Canlı, Hikmet Kocaman, Şafak Kuzu, İrem Valamur, Hasan Yıldırım, Halil Alkan","doi":"10.1007/s43465-024-01213-4","DOIUrl":"https://doi.org/10.1007/s43465-024-01213-4","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>The Timed 360° turn test (T-360° TT) was developed to assess balance and turning ability. Although validity and reliability have been performed in different diseases, validity and reliability have not been performed in individuals with ankle sprain (AS).</p><h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>The purpose of this study was to investigate the validity and reliability of the T-360° TT in individuals with AS.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>The study included 54 individuals with AS. Participants were initially evaluated with T-360° TT, Timed Up and Go (TUG) test and Biodex Balance System (BBS). To assess test–retest reliability, the T-360° TT was performed again 5 days after the first measurement by the same assessor.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>At the end of the study, strong positive correlations were found between T-360° TT with TUG test and BBS (<i>p</i> &lt; 0.05). In addition, T-360° TT had excellent test–retest reliability (Intraclass correlation coefficient = 0.87).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The T-360° TT is a valid and reliable tool for the evaluation of balance and turning ability in individuals with AS. We also think that it can be used practically in clinical settings because it is a test that can be easily and quickly performed.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141516980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmentation of Autologous Platelet-Rich Plasma in Hip Salvage in Stages I and II of Avascular Necrosis: Randomized Blinded Trial Comparing 3 Surgical Techniques in 82 Patients","authors":"Nishit Palo, Binayak Ray, Mahima Lakhanpal, Naveen Jeyaraman, Abhishek Shukla, Abhishek Malik","doi":"10.1007/s43465-024-01204-5","DOIUrl":"https://doi.org/10.1007/s43465-024-01204-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Avascular necrosis of the femoral head is common in routine orthopedic clinics. The challenge arises in managing early stages (I and II) without obvious radiological evidence. Authors explore this naïve research area by comparing surgical procedures in early AVN patients.</p><h3 data-test=\"abstract-sub-heading\">Materials and Methods</h3><p>A prospective multicentric study was performed from November 2020 to February 2023 on 82 patients treated with surgical decompression and adjuvants, concerning the defined inclusion and exclusion criteria. Radiopacity and intraosseous edema resolution and THA conversion rates were assessed. Hip pain VAS, groin/thigh pain, difficulty in sitting cross-legged incidence, pain-free walking distance, Harris hip scores, 30-s chair test, and complications were noted.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Among 82 patients, the mean age was 28.46 years. Male:female ratio of 3.9:1. 8.5% had bilateral affection and 48.78% had a positive family history. 93.90% presented with groin pain and difficulty in sitting cross-legged, restricted hip movements in 85.3%, and thigh pain in 54.87%. Harris hip scored worst in Group 3 followed by Group 2 and Group 1. 63.41% and 36.58% of patients had Grades 1 and 2 AVN, respectively. At 1 week post-operatively, 96.3% and 93.9% of patients were relieved from groin and thigh pain, respectively (<i>p</i> &lt; 0.001); the trend being Group 3 &gt; Group 2 &gt; Group 1. Hip pain VAS followed a similar trend. At 4 weeks, Harris hip scores improved in Group 3 &gt; Group 2 &gt; Group 1. At 6 months, the trend was Group 2 &gt; Group 3 &gt; Group 1. Group 3 had better 30-s chair test results, pain-free walking distance, and longer cross-legged sitting time. Complication rate of 3.6%. 6.09% of patients underwent THA later. Sclerotic patch and marrow edema resolution early in Group 3, i.e., 46 and 31 days respectively, followed by Group 2 and Group 1.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>In Stages I and II AVN, biplanar core decompression (double) and intraosseous PRP injection is a promising salvage option; patients have better early hip scores (4 weeks), and early groin and thigh pain recovery. Patients treated early have better clinical and radiological recovery.</p><h3 data-test=\"abstract-sub-heading\">Graphical abstract</h3>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141509616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum IL-6 as a Surrogate Biomarker of Post-operative Complications in Invasive Orthopaedic Surgeries: A Prospective Observational Study","authors":"Kanchana Laishram, Bhaskar Borgohain, Aparna Laishram, Tashi G. Khonglah, Alice A. Ruram, Sachlang Debbarma","doi":"10.1007/s43465-024-01195-3","DOIUrl":"https://doi.org/10.1007/s43465-024-01195-3","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Interleukin-6 (IL-6) is a cytokine released in response to tissue injury. Elevated serum IL-6 levels in trauma patients have been linked with increased risk of complications such as inapparent hypoxia (SpO₂ &lt; 94%), acute respiratory distress syndrome, fat embolism syndrome (FES), systemic inflammatory response syndrome, multiple organ dysfunction syndrome and sepsis. This study aims to determine the role of serum IL-6 as surrogate biomarker of post-operative complications after invasive orthopaedic surgeries.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Thirty-seven adults between 18 and 65 years of age undergoing invasive orthopaedic surgeries were included in this hospital-based study. Serum IL-6 levels were estimated serially in the pre-operative period, after 24 h and 7 days post-operatively. Cases were monitored for post-operative complications.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Serum IL-6 levels showed maximum rise in the first 24 h post-operatively especially among older patients (&gt; 60 years). Older patients undergoing bipolar hemiarthroplasty for neck of femur fracture showed highest median post-operative IL-6 level of 258 pg/ml. Serum IL-6 level &gt; 130 pg/ml measured 24 h after surgery was predictive of post-operative complications (sensitivity of 75%). Among the cases with post-operative complications, inapparent hypoxia was the most common complication/event observed. Cases with sub-clinical FES had highest level of serum IL-6 in first 24 h following surgery with median IL-6 level of 300 pg/ml (range 155–444 pg/ml).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Monitoring serum IL-6 level may help in both anticipation and early detection of post-operative complications in patients undergoing invasive orthopaedic surgeries; potentially enhancing patient safety.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141509617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shape-Change Phenomenon of the Knee in LET Surgery: Reduced Diameter Leaflets Maybe the Solution.","authors":"Manit Arora","doi":"10.1007/s43465-024-01216-1","DOIUrl":"10.1007/s43465-024-01216-1","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11286599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859584","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":"Efficacy of Autologous Adult Live-Cultured Osteoblast (AALCO) Implantation in Avascular Necrosis of the Femoral Head: A Mid-Term Outcome Analysis","authors":"Bishnu Prasad Patro, Naveen Jeyaraman, Tarun Jayakumar, Gurudip Das, Arulkumar Nallakumarasamy, Madhan Jeyaraman","doi":"10.1007/s43465-024-01203-6","DOIUrl":"https://doi.org/10.1007/s43465-024-01203-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Avascular Necrosis (AVN) of the femoral head, a condition characterized by the interruption of blood supply leading to bone tissue death, presents significant therapeutic challenges. Recent advancements in orthobiologics, including the use of Autologous Adult Live-Cultured Osteoblasts (AALCO), combined with core decompression, offer a novel approach for managing AVN. This study assesses the efficacy of this treatment modality in improving functional outcomes and hindering disease progression.</p><h3 data-test=\"abstract-sub-heading\">Materials and methods</h3><p>This retrospective observational study encompassed 30 patients treated between 2020 and 2023 for idiopathic AVN of the femoral head, grades I to III, who had not responded to conservative treatment. Patients were excluded based on specific criteria including age, secondary AVN causes, and certain health conditions. The treatment involved a two-stage surgical procedure under spinal anesthesia with OSSGROW^® for AALCO generation. Post-operative care emphasized early mobilization, DVT prevention, and avoidance of NSAIDs. Outcome measures were evaluated using the Visual Analog Scale (VAS) for pain, modified Harris Hip Score, and annual MRI imaging for up to 36 months.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Among 26 patients (41 hips) completing the study, statistically significant improvements in pain and hip functionality were documented, alongside positive radiological signs of osteogenesis in the majority of cases. However, four instances required advancement to total hip replacement due to disease progression.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The combination of core decompression and AALCO implantation shows promise as an effective treatment for AVN of the femoral head, with notable improvements in functional and radiological outcomes. This study supports the potential of orthobiologic approaches in AVN treatment, warranting further investigation through comprehensive randomized controlled trials.</p><h3 data-test=\"abstract-sub-heading\">Graphical Abstract</h3>\u0000","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141516983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiologic Evaluation of the Distal End Radius Indices in Indian Paediatric Population","authors":"Binoti Sheth, Neeraj Kalra, Rajan Gupta, Aibin Michael","doi":"10.1007/s43465-024-01209-0","DOIUrl":"https://doi.org/10.1007/s43465-024-01209-0","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>The distal end radius's bony anatomy in relation to three variables—Radial Inclination, Volar tilt, and radial height—has been discussed commonly in the adult population and is not very well defined in the growing skeleton. In children aged 8–16 years old, we measured the osseous distal end radius according to radiography standards. The research comprised 130 patients, 65 males and 65 females aged 8–16. In each child, the norms for radial inclination, volar tilt, and radial epiphyseal height were established. This research defines these radiographic parameters for the paediatric population in India for the first time.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This research is an Unicentric Cross-sectional observational analytical study. We studied 130 normal wrist posteroanterior and lateral radiographs of the Indian paediatric population aged 8–16 years who reported to our OPD and calculated the three parameters—(1) Radial height, (2) Volar Tilt, and (3) Radial Inclination. Mean measurement values were analysed statistically.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The Mean distal end radius volar tilt is 10.92° ± 1.76° SD with a range from 4° to 15°. The Mean distal end radial inclination is 21.04° ± 2.10° SD with a range from 15° to 25°. The Mean distal end radial height is 11.93 ± 1.44 mm SD with a range from 9.0 to 14.50 mm.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>In true Postero-anterior and lateral wrist radiographs of the Indian paediatric population, we have established normal values that may be utilized as a guide for the evaluation and treatment of a variety of traumatic and non-traumatic problems in Indian children.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141516981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on 'Role of Biplane Double-Supported Screw Fixation (BDSF) in Management of Fracture Neck Femur and Its Comparison with Conventional CC Screw Fixation'.","authors":"Vikash Raj, Sitanshu Barik, Vishal Kumar","doi":"10.1007/s43465-024-01207-2","DOIUrl":"10.1007/s43465-024-01207-2","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11286600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859583","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":"Decoding the Decade: Exploring the Efficacy of Platelet-Rich Plasma (PRP) in Complex Wound Management — A Comprehensive Study","authors":"Sandeep Shrivastava, Siddharth Patel, Aditya Pundkar, Ankit Jaiswal, Priyal Shrivastava","doi":"10.1007/s43465-024-01212-5","DOIUrl":"https://doi.org/10.1007/s43465-024-01212-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Autologous platelet-rich plasma (PRP) therapy has emerged as a promising regenerative treatment modality, offering potential improvements in healing outcomes through its rich content of growth factors and cytokines. We evaluated the effectiveness of PRP therapy in the management of complex wounds, using a decade-long retrospective analysis of treatments conducted at a tertiary care center from 2010 to 2020. The study introduces and assesses the efficacy of the Sandeep’s Technique for Assisted Regeneration of Skin (STARS) in enhancing wound healing and quality of life for patients with complex wounds.</p><h3 data-test=\"abstract-sub-heading\">Materials and methods</h3><p>A prospective interventional study was conducted, involving two phases: the development and initial testing of PRP therapy (2010–2015) and the application and evaluation of the STARS protocol (2015–2020). The study included patients with complex wounds, utilizing autologous PRP prepared through a double spin centrifuge technique. Outcome measures included wound-healing rates, infection management, and complication rates, compared to conventional treatment methods.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The study treated 500 wounds in 432 patients with autologous PRP, noting significant improvements in wound-healing rates, 97.7% had infection control without antibiotics (even in MRSA cases), and all had a good pain control. Histopathological examinations confirmed collagen-rich healing with minimal scarring. The STARS protocol demonstrated the potential of PRP therapy in accelerating wound healing, reducing the need for additional surgical interventions, and enhancing patient outcomes.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>PRP therapy, particularly when administered following the STARS protocol, represents a safe, effective, and patient-friendly approach for the management of complex wounds. This study supports the integration of PRP therapy into regenerative care strategies, suggesting a shift toward more innovative and efficacious treatments in wound management.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141509619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}