Journal of Artificial Organs最新文献

{"title":"Combined veno-venous ECMO and direct aortic impella 5.5 support enabling emergency mitral valve replacement in acute severe mitral regurgitation with fulminant pulmonary edema.","authors":"Ryoji Kinoshita, Taiju Watanabe, Kazuya Okaguchi, Kazunobu Hirooka","doi":"10.1007/s10047-026-01592-5","DOIUrl":"10.1007/s10047-026-01592-5","url":null,"abstract":"<p><p>Acute severe mitral regurgitation (MR) can cause cardiogenic shock and fulminant pulmonary edema. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may worsen pulmonary congestion by increasing left ventricular afterload. We report a 61-year-old man with acute severe MR and extreme respiratory failure (FiO₂ 1.0: pH 7.144, PaO₂ 48 mmHg, PaCO₂ 101 mmHg) who underwent emergency mitral valve replacement. Because severe pulmonary edema and post-cardiotomy shock compromised separation from cardiopulmonary bypass, an Impella 5.5 was inserted via a direct aortic graft, followed by veno-venous (VV) ECMO. This combined support enabled decoupled circulatory and respiratory stabilization. Although substantial vasoactive and inotropic support was initially required, systemic perfusion was maintained and subsequently stabilized with Impella-mediated antegrade flow without conversion to VA- or V-AV ECMO. Serum lactate transiently peaked at 10.9 mmol/L on postoperative day (POD) 1 and subsequently normalized as circulatory function recovered. Respiratory function and bilateral pulmonary opacities progressively improved under VV-ECMO-supported lung rest and intensive diuretic therapy. VV-ECMO was removed on POD 3, Impella on POD 6, and the patient was discharged on POD 46 without neurological sequelae. This case suggests that combined VV-ECMO and Impella support may provide an effective decoupled strategy for selected patients with concomitant severe respiratory and circulatory failure.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 4","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024917","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":"Preoperative predictors of low flow limit controller configuration following HeartMate 3 implantation.","authors":"Hiroshi Nishioka, Takuma Sato, Megumi Komiyama, Koki Iwanaga, Kohei Tonai, Nana Kitahata, Yuzo Takahashi, Sachie Miyagawa, Kazuya Sawada, Hideki Yotsuida, Naoki Tadokoro, Satsuki Fukushima, Tomoyuki Fujita, Toshia Fujisato, Yasumasa Tsukamoto","doi":"10.1007/s10047-026-01590-7","DOIUrl":"10.1007/s10047-026-01590-7","url":null,"abstract":"<p><p>This study aimed to identify preoperative factors associated with postoperative replacement to a controller configured with a Low Flow Limit (LFL) of 2.0 L/min following HeartMate 3 (HM3) left ventricular assist device (LVAD) implantation, with the goal of establishing proactive selection criteria to improve patient safety and quality of life (QOL). This single-center, retrospective, observational study included 127 patients who underwent primary HM3 implantation between June 2019 and March 2025. Patients were divided into those who maintained the standard LFL of 2.5 L/min controller throughout follow-up (Standard group, n = 78) and those who required postoperative replacement with a controller configured with an LFL of 2.0 L/min (2.0-LFL group, n = 49). Preoperative clinical, laboratory, echocardiographic, and hemodynamic parameters were compared using univariate and multivariate logistic regression analyses, together with receiver operating characteristic (ROC) curve analysis. 2.0-LFL group had significantly lower anthropometric indices, including height, weight, body mass index, and body surface area (BSA), as well as a shorter duration of heart failure, compared with Standard group. Although multiple clinical, echocardiographic, and hemodynamic variables were evaluated, multivariate analysis identified BSA as the sole independent predictor of postoperative controller replacement (odds ratio: 0.03; 95% confidence interval: 0.00-0.60; p = 0.022). ROC curve analysis demonstrated that a preoperative BSA cutoff value of 1.43 m² yielded an area under the curve of 0.74, with a specificity of 89.7% and a sensitivity of 38.8%. Patient body size, particularly BSA, appears to be the primary determinant of the need for postoperative replacement to an LFL 2.0 L/min controller after HM3 implantation. Pre-emptive selection of a 2.0 L/min controller based on a BSA threshold of 1.43 m² may provide a practical strategy to reduce unnecessary postoperative controller replacements while maintaining patient safety and QOL in LVAD patients.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 4","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930062","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":"Abrupt flow decline as the initial indicator of early HeartMate 3 pump thrombosis.","authors":"Yoshikazu Ishii, Tomoko S Kato, Kazuyoshi Takagi, Shigeru Sano, Sho Yoshimatsu, Masanori Shinoda, Toshiyuki Yanai, Tatsuhiro Shibata, Mami Uehara, Hirokazu Uchimura, Gaku Sugihara, Yoshihiro Fukumoto, Eiki Tayama","doi":"10.1007/s10047-026-01588-1","DOIUrl":"10.1007/s10047-026-01588-1","url":null,"abstract":"<p><p>Pump thrombosis shortly after HeartMate 3 (HM3) implantation is rare. We report a man in his 50s who developed pump thrombosis 14 days after HM3 implantation. The patient initially presented with an abrupt decline in pump flow accompanied by only mild laboratory abnormalities, while remaining clinically stable. Contrast-enhanced computed tomography raised suspicion of thrombus formation within the outflow graft, prompting emergent pump exchange. Subsequent manufacturer analysis demonstrated thrombus attached to the metallic edge at the inflow aspect of the pump, with no thrombus identified in the rotor or on the blade surfaces. This case highlights the challenges in the early detection and prediction of early HM3 pump thrombosis and the limitations of relying solely on laboratory findings. An abrupt decline in pump flow-even in the absence of marked hemolysis or increased pump power-may represent an early and clinically important warning indicator. Prompt recognition and intervention are essential to prevent clinical deterioration.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 4","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919879","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":"Successful bridge to heart transplantation in a pediatric patient with biventricular heart failure associated with Barth syndrome: a case report.","authors":"Kazuto Arita, Takashi Kido, Masaki Taira, Takuji Watanabe, Jun Narita, Hidekazu Ishida, Ryo Ishii, Takayoshi Ueno, Shigeru Miyagawa","doi":"10.1007/s10047-026-01587-2","DOIUrl":"10.1007/s10047-026-01587-2","url":null,"abstract":"<p><p>Long waiting times for donor organs in pediatric patients have increased the need for mechanical circulatory support as a bridge to heart transplantation. We report the case of a one-year-old boy with Barth syndrome who presented with cardiogenic shock due to severe biventricular heart failure. Emergency biventricular assist device support using centrifugal pumps was initiated. Under severe pulmonary hypertension and pulmonary regurgitation, the right ventricular assist device outflow was temporarily directed to the left atrium to optimize left ventricular preload. As pulmonary hemodynamics improved, the right ventricular assist device outflow was redirected to the pulmonary artery, allowing evaluation of native pulmonary circulation and subsequent right ventricular assist device weaning. After recovery of end-organ function, the left ventricular assist device was converted to a Berlin Heart EXCOR 76 days after biventricular assist device implantation. The patient remained stable on Berlin Heart EXCOR support for 374 days and subsequently underwent successful heart transplantation. This case highlights the importance of early right ventricular assist device support and strategic management of right ventricular assist device outflow to optimize left ventricular assist device performance in pediatric patients with severe pulmonary hypertension. Such an approach may facilitate successful bridge-to-candidacy and eventual heart transplantation in high-risk pediatric patients.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 4","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912121","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":"PFA-200 closure times in ECMO: Are ceiling effects and hematocrit confounding the bleeding association?","authors":"Barina Khan","doi":"10.1007/s10047-026-01589-0","DOIUrl":"10.1007/s10047-026-01589-0","url":null,"abstract":"","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 4","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887535","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":"Clinical differences between destination therapy and bridge-to-transplant left ventricular assist device implantation: a 17-year single-center experience in Japan.","authors":"Koichi Inoue, Daisuke Yoshioka, Yusuke Misumi, Ai Kawamura, Shin Yajima, Takuji Kawamura, Shunsuke Saito, Takashi Yamauchi, Shigeru Miyagawa","doi":"10.1007/s10047-026-01581-8","DOIUrl":"10.1007/s10047-026-01581-8","url":null,"abstract":"<p><p>The use of left ventricular assist device (LVAD) implantation for destination therapy (DT) has been recently increased worldwide. In 2021, DT was also approved in Japan. Here, we report a single-institution experience of LVAD implantation for DT. This retrospective observational study was conducted at Osaka University Medical Hospital in Japan. Forty patients who underwent LVAD implantation for DT were included. The primary endpoint was on-device survival, and the secondary endpoint was the incidence of LVAD-related complications at five years. The on-device survival rates were 82.3%, 73.3%, and 49.8% at 1, 3, and 5 years, respectively. Most patients (90.6%) experienced rehospitalization during the follow-up period and the most common cause was LVAD-related infection. One-quarter of the patients (10 cases) required LVAD pump exchange, also most commonly due to LVAD-related infection. Comparative analysis with 213 patients who underwent LVAD implantation for bridge to transplant (BTT) revealed no significant change in the primary and secondary outcomes. Our results demonstrate favorable clinical outcomes for LVAD implantation for DT in this Japanese cohort.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 3","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793682","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":"Post-transplant predictors of mortality and primary graft dysfunction in lung transplant recipients bridged with veno-venous extracorporeal membrane oxygenation.","authors":"Nathan T Kim, Yudai Miyashita, Joshua T Kim, Taisuke Kaiho, Yuriko Yagi, Chitaru Kurihara","doi":"10.1007/s10047-026-01584-5","DOIUrl":"10.1007/s10047-026-01584-5","url":null,"abstract":"<p><strong>Purpose: </strong>Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is increasingly used to bridge critically ill candidates to lung transplantation, with reported outcomes approaching those of non-ECMO recipients. However, factors associated with early mortality in this high-risk subpopulation remain incompletely defined, particularly when postoperative complications occur after transplantation and may introduce time-dependent bias. We aimed to explore factors associated with 1-year survival among VV-ECMO-bridged lung transplant recipients.</p><p><strong>Methods: </strong>We performed a single-center retrospective cohort study of adult lung transplant recipients bridged with preoperative VV-ECMO between January 2018 and May 2024. The primary endpoint was 1-year overall survival. Associations with primary graft dysfunction grade 3 were assessed using logistic regression. Because postoperative complications occurred after transplantation, landmark Kaplan-Meier analyses were performed to explore their associations with subsequent survival while reducing immortal time bias.</p><p><strong>Results: </strong>Forty recipients were included, and 1-year mortality was 20% (8/40). Primary graft dysfunction grade 3 occurred in 16 recipients (40%). Higher pretransplant creatinine and lower albumin showed suggestive associations with primary graft dysfunction grade 3, although these associations did not reach statistical significance in multivariable analysis. In conventional Cox analyses, postoperative pulmonary embolism, dialysis/renal replacement therapy, and antibody-mediated rejection were associated with mortality; however, these findings should be interpreted cautiously because these postoperative complications were time-dependent and the number of deaths was limited. Landmark analyses showed that dialysis/renal replacement therapy by POD30 was associated with worse subsequent survival, whereas the associations for pulmonary embolism by POD90 and antibody-mediated rejection by POD90 were limited by sparse events.</p><p><strong>Conclusions: </strong>In this single-center cohort of VV-ECMO-bridged lung transplant recipients, postoperative complications including pulmonary embolism, dialysis/renal replacement therapy, and antibody-mediated rejection were associated with mortality in exploratory analyses, with dialysis showing the most consistent association in landmark analysis. Given the small sample size and limited number of events, these findings should be interpreted as hypothesis-generating and require validation in larger multicenter cohorts.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 3","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793649","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":"Impact of preoperative venovenous extracorporeal membrane oxygenation bridging on postoperative acute kidney injury after lung transplantation.","authors":"Rachel Reichenbach, Yudai Miyashita, Taichi Nagano, Taisuke Kaiho, Yuriko Yagi, Ankit Bharat, G R Scott Budinger, Ambalavanan Arunachalam, Chitaru Kurihara","doi":"10.1007/s10047-026-01585-4","DOIUrl":"10.1007/s10047-026-01585-4","url":null,"abstract":"<p><p>Venovenous extracorporeal membrane oxygenation (VV-ECMO) bridging to lung transplant has the potential to reduce mortality among patients awaiting transplant. However, there continue to be notable morbidity risks, including acute kidney injury (AKI). This paper seeks to evaluate both short and long-term morbidity and mortality trends related to AKI development post-transplant, among VV-ECMO bridged and non-ECMO bridged patients respectively. We performed a retrospective cohort study of adult patients (≥ 18 years) who underwent lung transplantation at a single tertiary care center between January 2018 and May 2024. 443 lung transplant recipients were included: 46 were bridged with preoperative VV-ECMO, and 397 underwent transplantation without ECMO bridge. Univariate logistic regression was used to evaluate predictors of postoperative AKI. A multivariable logistic regression model was then constructed using clinically relevant covariates and variables associated with AKI in univariate analyses. The initial incidence of post-operative AKI was significantly higher among patients bridged with VV-ECMO (67% vs. 44% P = 0.005), as were overall complications, including primary graft dysfunction grade 3 (41% vs. 9.8%, P < 0.001) and longer duration of mechanical ventilation (6.0 [2.0-17.0] vs. 2.0 [1.0-3.0] days, P < 0.001). However, there was no significant difference in renal function trajectories between VV-ECMO bridged and non-bridged groups from 1 month to 1 year, operationalized via GFR and creatinine trends. There was no statistically significant difference in survival between VV-ECMO bridged and non-bridged groups (P = 0.93). Independent of bridging status, patients who developed AKI post-operatively had significantly worse short and long-term survival after transplantation than those without AKI (log-rank P < 0.0001). Preoperative VV-ECMO bridging was not associated with a statistically significant difference in overall survival during the available follow-up. In contrast, postoperative AKI was independently associated with increased mortality after lung transplantation.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 3","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793684","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":"Berlin heart EXCOR® implantation for Fontan failure in right-sided heterotaxy with ventricular septal protuberance: autopsy case report.","authors":"Hiroshi Sakamoto, Shunji Uchita, Kazuki Tanimoto, Masaki Taira, Mayumi Kamada, Hironori Izutani","doi":"10.1007/s10047-026-01586-3","DOIUrl":"10.1007/s10047-026-01586-3","url":null,"abstract":"<p><p>A 4-year-old boy with a diagnosis of right-sided heterotaxy syndrome was transferred to our hospital under the extracorporeal membrane oxygenation (ECMO). He had undergone an extracardiac total cavopulmonary connection (TCPC) with a fenestration. Approximately 6 months after the TCPC procedure, common atrioventricular valve regurgitation worsened and persisted despite multiple valve repair procedures. ECMO support was initiated 318 days after the TCPC procedure for progressive heart failure and multiple organ dysfunction. Although ECMO was initially discontinued after transient improvement, recurrent circulatory failure necessitated reinitiation, and the patient remained ECMO-dependent thereafter. We implanted a Berlin Heart EXCOR® Pediatric ventricular assist device. In the operation, the fenestration of the TCPC conduit was closed. An expanded polytetrafluoroethylene conduit for the arterial cannula was anastomosed to the ascending aorta in an end-to-side fashion. The apex of the left-sided ventricle was incised, followed by the meticulous resection of residual ventricular septal tissue to obtain effective venting from both ventricles. An inflow cannula was anastomosed to the coring site. Ventricular assist support was initiated without complications. On the postoperative day 433, intracerebral hemorrhage was abruptly developed, necessitating management in the intensive care unit. Two hematoma evacuation procedures of decompressing surgery for intracerebral hemorrhage were required. Despite these interventions, the patient ultimately died on postoperative day 488. The autopsy confirmed that the residual ventricular septum-like tissue had been almost completely resected and that the inflow cannula tip was positioned away from any muscular structures, suggesting that the resection enabled effective ventricular drainage without obstruction or suction.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 3","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706534","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":"Sustained postoperative elevation of ionized magnesium levels following cardiac surgery with magnesium-enriched cardioplegia: a prospective observational study.","authors":"Satoshi Kometani, Shiro Matsuo, Tomohide Takei, Toshiki Nakamura, Mimiko Tabata, Hiroyuki Ikezaki","doi":"10.1007/s10047-026-01583-6","DOIUrl":"10.1007/s10047-026-01583-6","url":null,"abstract":"<p><p>This study aimed to clarify perioperative changes in ionized magnesium levels (iMg), a physiologically active fraction, and particularly the persistence of hypermagnesemia at the time of extubation in cardiac surgery using magnesium-enriched cardioplegia. We conducted a prospective observational study of 48 patients undergoing elective cardiac surgery. iMg was measured at three time points: induction of anesthesia, intensive care unit (ICU) admission, and extubation. The median duration of postoperative mechanical ventilation was 17 h. iMg increased markedly to 1.49 [1.23-1.85] mmol/L at ICU admission and remained significantly elevated at extubation (0.97 [0.80-1.14] mmol/L), exceeding the physiological reference value in 46 patients (96%). Correlation analysis demonstrated a moderate positive correlation between total cardioplegia volume and iMg at ICU admission (r = 0.549), whereas this association was no longer significant at extubation. To the best of our knowledge, this study is the first to demonstrate, using direct measurement of physiologically active iMg, that hypermagnesemia due to exogenous magnesium loading from magnesium-enriched cardioplegia can persist until the phase of ventilator weaning. Perioperative magnesium kinetics in cardiac surgery are difficult to predict accurately owing to the complex interactions among multiple perioperative factors. Monitoring iMg provides clinicians with essential information regarding the actual physiological magnesium status, which may serve as a supportive guide for avoiding unnecessary magnesium supplementation.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 3","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701216","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}