International Journal of Colorectal Disease最新文献

{"title":"Polidocanol foam sclerotherapy for patients with Goligher grade IV hemorrhoidal disease unwilling to undergo surgery: preliminary outcomes from a retrospective study with 6-month follow-up.","authors":"Gianpiero Gravante, Veronica De Simone, Arcangelo Picciariello, Roberto Sorge, Pierpaolo Sileri, Gaetano Gallo","doi":"10.1007/s00384-026-05208-5","DOIUrl":"https://doi.org/10.1007/s00384-026-05208-5","url":null,"abstract":"<p><strong>Background: </strong>Polidocanol foam (PF) sclerotherapy has shown promising results in low- and intermediate-grade hemorrhoidal disease (HD), but evidence in advanced stages remains limited. This study aimed to evaluate patient-reported outcomes following PF sclerotherapy in patients with Goligher grade IV HD who declined surgical treatment.</p><p><strong>Methods: </strong>This retrospective analysis included patients with Goligher grade IV HD that declined hemorrhoidectomy after appropriate counseling and underwent 3% PF sclerotherapy between June and October 2025. Outcomes were assessed using symptom-focused subsets derived from the PROM-HISS and HDSS instruments at baseline, 7 days, 30 days, and 6 months. Primary outcome was the change in scores over time. Secondary outcomes included need for additional treatment, complications, and subsequent surgery.</p><p><strong>Results: </strong>Fifteen patients were included (mean age 58 ± 11 years; 53.3% male). At 6 months, 66.7% of patients requested no further hemorrhoidal treatment. Significant improvements were observed in both scores across all follow-up timepoints (p < 0.05). Pain, bleeding, and prolapse showed the most consistent reductions. One patient (6.7%) required hemorrhoidectomy within 30 days, four patients (26.7%) a second sclerotherapy session. No major complications were observed.</p><p><strong>Conclusions: </strong>In selected patients with Goligher grade IV HD who are unwilling or unfit to undergo surgery, PF sclerotherapy may be associated with short-term symptom improvement and may represent a symptom-oriented minimally invasive option for selected patients unwilling or unfit to undergo surgery.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149244063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-expandable metal stents as a bridge to surgery for obstructive colorectal cancer: a propensity score-matched retrospective cohort study.","authors":"Jian-Jun Chen, Zhu-Lin Li, Yong Yang, Zhen-Jun Wang","doi":"10.1007/s00384-026-05207-6","DOIUrl":"10.1007/s00384-026-05207-6","url":null,"abstract":"<p><strong>Purpose: </strong>Acute colorectal obstruction constitutes a surgical emergency in patients with colorectal cancer (CRC) and is associated with high morbidity and mortality when managed with emergency surgery. Although self-expandable metal stents (SEMS) may optimize surgical conditions, concerns remain regarding their long-term oncologic safety.</p><p><strong>Methods: </strong>This retrospective cohort study included 355 patients with obstructive CRC treated between 2014 and 2023, including 65 patients in the SEMS group and 290 in the surgery-alone group. Perioperative outcomes, postoperative complications, disease-free survival (DFS), and overall survival (OS) were compared. Propensity score matching and multivariate Cox regression were applied to reduce selection bias and adjust for confounding factors.</p><p><strong>Results: </strong>Patients in the SEMS group had a markedly higher rate of laparoscopic surgery (89.2% vs. 62.8%, p < 0.001) as well as a significantly shorter postoperative hospital stay (11.05 ± 5.25 vs. 14.29 ± 11.86 days, p = 0.032). No significant differences were observed in overall postoperative complications, DFS, or OS between the two groups after adjustment. Although a higher crude recurrence rate, particularly intra-abdominal recurrence, was observed in the SEMS group, SEMS placement was not an independent predictor of adverse oncologic outcomes.</p><p><strong>Conclusion: </strong>SEMS as a bridge to surgery was associated with improved perioperative outcomes and showed no statistically significant adverse impact on long-term survival after adjustment for confounding factors. Further prospective studies are required to confirm oncologic safety in selected patients.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13687206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149238276","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":"Prehabilitation for colon cancer surgery: a systematic review of quality-of-life outcomes and a feasibility study.","authors":"Michelle V Stadelhofer, Helene R Dalby, Anne Thyø, Katrine J Emmertsen","doi":"10.1007/s00384-026-05203-w","DOIUrl":"10.1007/s00384-026-05203-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the feasibility of short-term prehabilitation and its impact on quality of life in patients with colorectal cancer through a systematic review and a feasibility study.</p><p><strong>Methods: </strong>The systematic review was conducted in accordance with the PRISMA guidelines. PubMed, PubPsych, CINAHL, EMBASE, Web of Science and EBSCOhost were searched for studies evaluating quality of life in colorectal cancer patients undergoing prehabilitation. We conducted a prospective non-randomised interventional feasibility study, with a 2-week post-surgery follow-up, enrolling patients diagnosed with colon cancer.</p><p><strong>Results: </strong>The systematic review included six studies from 517 unique records for final analysis. Among six studies, evidence for quality-of-life benefits of prehabilitation was conflicting but predominantly favourable, with generally low-to-moderate study quality and substantial heterogeneity. In the feasibility study, 110 patients were eligible for inclusion; 70 (64%) were included, and 63 completed the entire study. Of the 32 patients in the intervention group, compliance > 80% was observed in 66% (nutrition) and 88% (physical activity) of patients, with a median compliance of 100% for both. Quality-of-life outcomes were explored as secondary measures and showed potential favourable trends following prehabilitation.</p><p><strong>Conclusion: </strong>Evidence on the effect of prehabilitation on quality of life in colorectal cancer remains inconsistent; our feasibility study shows that short-term multimodal prehabilitation is feasible and supports the need for adequately powered trials.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13683530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227868","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":"Correspondence for the article \"Histological architecture of the intersphincteric region of the anal canal: implications for the anatomical basis of anal fistula pathways\".","authors":"Nicola Clemente, James C W Khaw","doi":"10.1007/s00384-026-05212-9","DOIUrl":"10.1007/s00384-026-05212-9","url":null,"abstract":"","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591126","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":"Technical overview and clinical outcomes of transabdominal strategies to eliminate or neutralize staple-line intersection during low anterior resection: a systematic review.","authors":"Alfredo Annicchiarico, Gianpiero Gravante, Rossella Melcarne, Leonardo Vincenti, Arcangelo Picciariello","doi":"10.1007/s00384-026-05205-8","DOIUrl":"10.1007/s00384-026-05205-8","url":null,"abstract":"<p><strong>Aim: </strong>To systematically classify and describe transabdominal surgical techniques designed to eliminate or neutralize staple-line intersection during low anterior resection (LAR), and to summarize their reported clinical outcomes.</p><p><strong>Methods: </strong>A systematic review was conducted according to PRISMA guidelines and registered in PROSPERO (CRD420261368367). Major databases were searched for studies describing transabdominal techniques aimed at eliminating or neutralizing staple-line intersection in colorectal anastomosis during LAR. Both modified double-stapling techniques (mDST) and abdominal single-stapled techniques (aSST) were included. Outcomes of interest included anastomotic leak (AL), use of protective stoma, and perioperative variables. Reported outcomes were descriptively summarized, and exploratory aggregated analyses were performed when appropriate.</p><p><strong>Results: </strong>Seventeen studies (998 patients) were included. Ten studies (529 patients) evaluated mDST (suture-based: n = 192; invagination-based: n = 337), while seven studies (469 patients) assessed aSST. Reported AL rates remained low across both mDST subgroups (3.1% suture-based vs 3.9% invagination-based), with an aggregated rate of 3.6%. The aSST group showed a leak rate of 6.0%. Protective stomas were used in 6.2% of mDST and 33.1% of aSST. Neoadjuvant therapy was used in 20.7% of aSST and 11.9% of mDST. Considerable heterogeneity in study design, technique, and outcome reporting was observed.</p><p><strong>Conclusions: </strong>Transabdominal techniques that eliminate or neutralize staple-line intersection appear feasible and associated with low anastomotic leak rates. Modified DST techniques appear technically feasible and have been associated with low reported leak rates. However, owing to the heterogeneity of the available evidence, comparative findings should be considered exploratory.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13687334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149238222","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":"Letter to the editor regarding \"Impact of gross tumor morphology on the clinical outcomes of colon cancer: multicenter retrospective cohort study\".","authors":"Rongwen Ni, Rijuan Jin","doi":"10.1007/s00384-026-05204-9","DOIUrl":"10.1007/s00384-026-05204-9","url":null,"abstract":"","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497572","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":"Nomogram for predicting lymph node metastasis in ypT0-2 rectal cancer after neoadjuvant chemoradiotherapy.","authors":"Hyeung-Min Park, Jaram Lee, Soo Young Lee, Chang Hyun Kim, Hyeong Rok Kim","doi":"10.1007/s00384-026-05201-y","DOIUrl":"10.1007/s00384-026-05201-y","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate prediction of lymph node (LN) metastasis is essential for determining completion radical surgery following local excision (LE) in rectal cancer treated with neoadjuvant chemoradiotherapy (CRT). This study aimed to identify predictors of LN metastasis and develop a nomogram to support post-excision decision-making in rectal cancer patients after CRT.</p><p><strong>Methods: </strong>We retrospectively reviewed 215 patients with pathological stage ypT0-2 rectal cancer who underwent radical surgery following CRT. Pre- and post-CRT magnetic resonance imaging findings and clinicopathological factors were analysed to identify predictors of LN metastasis. A predictive nomogram was subsequently constructed and evaluated using receiver operating characteristic (ROC) curve, calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC).</p><p><strong>Results: </strong>Factors associated with LN metastasis included pre-CRT mrN stage (mrN0 7.3% vs. mrN1 19.4% vs. mrN2 25.0%; p = 0.004), ypT stage (ypT0 2.7% vs. ypT1 13.3% vs. ypT2 19.8%; p = 0.003), and perineural invasion (PNI) (negative 11.1% vs. positive 35.3%; p = 0.013). Multivariable analysis identified pre-CRT mrN stage (p = 0.011), ypT stage (p = 0.033), and PNI (p = 0.036) as independent predictors. The nomogram exhibited acceptable calibration, with the area under the ROC curve of 0.777 (95% CI 0.681-0.874). DCA and CIC revealed the model's potential clinical utility.</p><p><strong>Conclusion: </strong>Pre-CRT mrN stage, ypT stage, and PNI were independent predictors of LN metastasis in ypT0-2 rectal cancer following CRT. The developed nomogram may help identify candidates for completion radical surgery after LE, potentially facilitating organ preservation and reducing unnecessary surgical morbidity.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497512","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":"Evaluating the usefulness of 18F-FDG PET/MR in rectal cancer staging: a prospective comparison with histopathological findings.","authors":"Rafał Maksim, Dominika Hempel, Małgorzata Mojsak, Justyna Śliwowska-Burzyńska, Konrad Zuzda, Patryk Gugnacki, Iwona Sidorkiewicz, Ewa Sierko","doi":"10.1007/s00384-026-05192-w","DOIUrl":"10.1007/s00384-026-05192-w","url":null,"abstract":"<p><strong>Background: </strong>Accurate preoperative staging of rectal cancer (RC) is essential for treatment planning. MRI is the standard for local assessment but has limitations in evaluating nodal involvement and tumor deposits. Hybrid PET/MR combines morphological and metabolic imaging and may improve staging accuracy. This study assessed PET/MR performance in RC and regional lymph nodes staging compared with histopathology.</p><p><strong>Methods: </strong>Sixteen patients with biopsy-proven rectal cancer underwent PET/MR with ^18F-FDG. Tumor size, T stage, nodal status, and tumor deposits were evaluated using multiparametric MR sequences (T1, T2, diffusion-weighted, contrast-enhanced) combined with PET. Imaging findings were compared to histopathological results. Diagnostic performance metrics, including accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were calculated with corresponding 95% confidence intervals.</p><p><strong>Results: </strong>PET/MR accurately staged the primary tumor in 81.25% of cases (95% CI: 57.0-93.4), with sensitivity of 100%, specificity of 50.0%, PPV of 76.9%, and NPV of 100% for advanced T-stage assessment. Three cT3 tumors were downstaged to pT2; no tumors were upstaged. For nodal staging based on ESGAR criteria, diagnostic accuracy was 75.0% (95% CI: 50.5-89.8), with sensitivity of 57.1%, specificity of 88.9%, PPV of 80.0%, and NPV of 72.7%. Tumor deposits were not detected on imaging but were present in four specimens. Incidental findings included a biopsy-confirmed breast adenocarcinoma and one benign thyroid lesion.</p><p><strong>Conclusion: </strong>18F-FDG PET/MR shows potential for accurate assessment of the primary tumor and reliable exclusion of advanced T-stage disease. However, its performance in nodal staging and tumor deposit detection remains limited. Given the small sample size and potential confounding from preoperative radiotherapy, these findings should be considered hypothesis-generating and require validation in larger prospective cohorts.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470270","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":"Patient-reported outcomes in low anterior resection syndrome: a comparison of open and robotic surgery.","authors":"Elisabeth Ammer, Sophie Winter, Christoph Ammer-Herrmenau, Johannes Moritz Riebeling, Philipp Horvath, Thomas Asendorf, Michael Ghadimi, Marian Grade","doi":"10.1007/s00384-026-05194-8","DOIUrl":"10.1007/s00384-026-05194-8","url":null,"abstract":"<p><strong>Purpose: </strong>Despite recent advances in multimodal treatment strategies, radical tumor resection remains a cornerstone in the management of patients with rectal cancer. However, a substantial proportion of patients develop postoperative functional impairment known as low anterior resection syndrome (LARS). Emerging evidence suggests that robotic-assisted surgery may offer superior functional outcomes compared to other approaches. Therefore, this study aimed to compare the incidence and severity of LARS after robotic and open surgery using a patient-reported outcome measure (PROM).</p><p><strong>Methods: </strong>This retrospective, single-center cohort study included patients with primary adenocarcinoma of the sigmoid colon or rectum who underwent open or robotic oncological resection between 2014 and 2024. Eligible participants completed a standardized, validated questionnaire to assess their individual LARS score. The LARS scores were subsequently correlated with selected clinicopathological characteristics.</p><p><strong>Results: </strong>LARS questionnaires were analyzed in 184 patients. The incidence of major LARS was comparable between open and robotic surgery (39.1% vs. 39.2%), as was the rate of minor LARS (20% vs. 15%), with no statistically significant difference observed in multivariable ordinal regression (p = 0.451). Independent risk factors for LARS included neoadjuvant treatment, hand-sewn coloanal anastomosis, formation of a protective stoma, tumor location in the middle and lower rectum, and total mesorectal excision.</p><p><strong>Conclusion: </strong>LARS remains a significant clinical challenge, irrespective of the surgical approach. This PROM-based finding is particularly relevant for preoperative counseling and shared decision-making, as it suggests that open surgery is not inherently associated with worse functional outcomes in terms of LARS. Future research should aim to identify the biological, anatomical, and clinical determinants underlying the variable susceptibility to LARS.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"41 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470288","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":"Mesenteric defect closure versus non-closure after complete mesocolic excision in minimally invasive right colectomy: a retrospective study.","authors":"Arcangelo Picciariello, Vito Leonardo Pinto, Salvatore Fedele, Fabrizio Aquilino, Vincenzo Papagni, Leonardo Vincenti","doi":"10.1007/s00384-026-05199-3","DOIUrl":"10.1007/s00384-026-05199-3","url":null,"abstract":"<p><strong>Background: </strong>The optimal management of the mesenteric defect after minimally invasive right hemicolectomy remains controversial, particularly in the setting of complete mesocolic excision (CME), where a large mesenteric defect is created. This study was aimed at evaluating whether mesenteric defect closure after CME reduces postoperative complications and whether the closure itself introduces additional risks.</p><p><strong>Methods: </strong>A single-center retrospective study was conducted using a prospectively maintained database of patients with stage II-III right colon cancer who underwent minimally invasive right hemicolectomy with CME between May 2022 and July 2025. Patients were divided into two groups according to whether the mesenteric defect was closed or left open. Demographic, operative, and postoperative outcomes were analyzed, including postoperative ileus (POI), internal herniation, small bowel obstruction, operative time, and length of hospital stay.</p><p><strong>Results: </strong>A total of 87 patients were included: 46 underwent mesenteric defect closure, and 41 did not. Baseline characteristics were comparable between groups. Postoperative gastrointestinal bleeding occurred in eight patients (9%), while two patients (2.3%) developed anastomotic leakage, one in each group. No symptomatic internal hernias or small bowel obstructions were observed. POI occurred in three patients (3.5%) with similar incidence between groups. Operative time, bowel recovery, harvested lymph nodes, and length of hospital stay did not differ significantly. No complications related to mesenteric defect closure were observed.</p><p><strong>Conclusions: </strong>Mesenteric defect closure after minimally invasive right hemicolectomy with CME appears safe but does not significantly reduce postoperative morbidity. Given the low incidence of internal herniation, routine closure may not be necessary.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455756","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}