Journal of Cardiothoracic Surgery最新文献

{"title":"Identification and analysis of pyroptosis-related key genes in heart failure.","authors":"Jing Zhang, Zhijie Yue, Na Zhu, Na Zhao","doi":"10.1186/s13019-025-03530-7","DOIUrl":"10.1186/s13019-025-03530-7","url":null,"abstract":"<p><strong>Background: </strong>Pyroptosis plays a pivotal role in the pathogenesis of Heart Failure (HF). However, the current understanding of how pyroptosis-related genes (PRGs) influence HF is scarce. This study aimed to explore the link between PRGs and HF based on bioinformatics.</p><p><strong>Methods: </strong>Three datasets of HF were involved in this study.Candidate genes were identified by overlapping two sets of genes. The first set consisted of differentially expressed genes from differential expression analysis. The second set included critical module genes from weighted gene co-expression network analysis. Further, the key genes were screened based on machine learning algorithms. Furthermore, immune infiltration analysis and mRNA-Transcription factor (TF)/drug regulatory networks construction were implemented. Ultimately, we also verified the expression of key genes.</p><p><strong>Results: </strong>In this study, we pinpointed seven key genes (SNORD76, RPS3A, SNORD1A, CCDC159, AMT, RANBP6, and CRAT) exhibiting superior diagnostic potential in HF. We found five distinct immune cell types to be significantly associated with these key genes. Moreover, CRAT and AMT were subject to regulation by PHF8. Additionally, AMT, RPS3A, and CRAT corresponded to eight potential therapeutic drugs. Importantly, the expression of CCDC159, CRAT, and AMT was consistent with the dataset.</p><p><strong>Conclusion: </strong>We identified the seven key genes that were intimately associated with HF, offering novel insights into the therapeutic targets for HF.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"300"},"PeriodicalIF":1.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637121","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":"The role of thoracic surgeons in spinal surgery: our clinical experiences.","authors":"Kadir Baturhan Ciflik, Busra Ozdemir Ciflik, Yucel Akkas, Suleyman Anil Akboga, Anil Gokce, Ercan Bal, Mehmet Atif Erol Aksekili, Bulent Kocer","doi":"10.1186/s13019-025-03537-0","DOIUrl":"10.1186/s13019-025-03537-0","url":null,"abstract":"<p><strong>Objective: </strong>In the thoracic area, the outside edge of the vertebrae exhibits intricate anatomical features. A multidisciplinary approach is necessary, particularly in scoliosis surgery, while performing manipulations on the vertebra from the front. Our objective in this study was to enhance the existing body of knowledge by sharing our firsthand experience in the field of spinal surgery.</p><p><strong>Methods: </strong>We have seen a total of 35 cases in our investigation. When doing vertebral body tethering (VBT) in chosen scoliosis patients, thoracoscopy and thoracotomy have been the favored methods. On the other hand, alternative circumstances have favored the usual thoracotomy method.</p><p><strong>Results: </strong>We operated on three (8.6%) patients for trauma, six (17.1%) for mass, and 26 (74.2%) for scoliosis. Twenty (57.1%) of the patients operated for scoliosis underwent VBT. In patients undergoing VBT, a greater number of vertebrae were accessed thoracoscopy compared to thoracotomy (p = 0.003). There was no significant difference between the two groups in terms of chest tube follow-up time, length of stay in the intensive care unit, and hospital stay (p = 0.451, p = 0.403, p = 0.125).</p><p><strong>Conclusion: </strong>Our investigation demonstrated that the thoracoscopy is capable of intervening with a greater number of vertebrae compared to thoracotomy. Thoracic surgeons primarily focus their research on masses and trauma related to spinal surgery. Our study's large patient population with scoliosis surgery adds to the existing body of knowledge in the field of thoracic surgery. This study is significant as it is the second in the existing literature to document the experiences of thoracic surgeons from Turkey use of VBT.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"297"},"PeriodicalIF":1.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626408","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":"Elevated tumour markers in the pleural effusion of a patient with spontaneous esophageal rupture: a rare case report.","authors":"Huaimin Liang, Xiaoning Li, Zhengliang Wei","doi":"10.1186/s13019-025-03539-y","DOIUrl":"10.1186/s13019-025-03539-y","url":null,"abstract":"<p><strong>Background: </strong>Esophageal rupture is a rare but life-threatening condition. Esophageal tumours do not usually cause esophageal ruptures, and elevated tumour markers have rarely been detected in pleural effusion after esophageal rupture with no detectable tumour. The presence of elevated tumor markers in pleural effusion can lead to a misdiagnosis of esophageal cancer in patients with esophageal rupture, resulting in inappropriate treatment.</p><p><strong>Case presentation: </strong>The 65-year-old male patient who was admitted to the emergency department with left chest pain and dyspnoea after severe vomiting. Chest computed tomography (CT) indicated left hydropneumothorax and mediastinal emphysema. The patient underwent bedside closed thoracic drainage. The drainage fluid was coffee-coloured and turbid, with significantly elevated CA199, CA125 and CEA levels. After transferring the patient to the emergency operating room, the esophageal defect was repaired, and a jejunostomy was performed. No tumours were detected in the thoracic cavity during surgery. The patient recovered and was discharged from the hospital.</p><p><strong>Conclusion: </strong>Esophageal tumours should be suspected in patients with elevated pleural effusion CA199, CA125 and CEA levels. The findings from chest CT and oesophagography did not support the diagnosis of a thoracic tumor.These tumor markers may be concomitant changes during esophageal rupture.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"301"},"PeriodicalIF":1.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637120","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":"Concomitant tricuspid surgery for moderate tricuspid regurgitation improves survival in left-sided valve surgery - a meta-analysis.","authors":"Anupama Barua, Nicholas Wong, Shubham Jain, Mohsin Uzzaman, Prakash Nanjaiah, Ravish Jeeji, Lognathen Balacumaraswami","doi":"10.1186/s13019-025-03464-0","DOIUrl":"10.1186/s13019-025-03464-0","url":null,"abstract":"<p><strong>Objectives: </strong>There is controversy over the optimal management of moderate tricuspid valve regurgitation during left-sided valve surgery due to the paucity of robust evidence for enhanced outcomes from concomitant tricuspid valve repair. Hence, we assessed the literature to compare clinical outcomes in patients undergoing left-sided valve procedures either with or without tricuspid valve repair surgery.</p><p><strong>Methods: </strong>We performed a literature search using MEDLINE, EMBASE, Scopus and Web of Science. We identified articles to evaluate primary outcomes of both, cardiac and overall mortality. Secondary outcomes included stroke, wound infection, reoperation, new-onset atrial fibrillation, renal failure, duration of intensive care stay and permanent pacemaker implantation. All analysis was done using the random effects model.</p><p><strong>Results: </strong>A total of 36 studies were included with 76,249 patients. There was significant reduction in cardiac mortality (p < 0.0001) with concomitant tricuspid valve repair despite higher CPB (p < 0.00001) and X-Clamp times (p < 0.00001). There was no significant difference in overall mortality. There was significantly lower postoperative tricuspid regurgitation (p < 0.00001) with concomitant tricuspid repair. There were no differences in postoperative stroke, wound infection, atrial fibrillation, renal failure, and intensive care unit duration of stay between the two groups.</p><p><strong>Conclusions: </strong>Concomitant tricuspid valve surgery for moderate tricuspid regurgitation during left-sided valve surgery offers improved survival benefit due to significant decrease in cardiac mortality. Additionally, this strategy results in significant decrease in late tricuspid regurgitation with no increase in morbidity.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"294"},"PeriodicalIF":1.5,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618117","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":"Thoracic outlet syndrome induced by extrathoracic giant lipoma: first case in the literature due to the atypical location.","authors":"Kadir Baturhan Çiflik, Büşra Özdemir Çiflik","doi":"10.1186/s13019-025-03536-1","DOIUrl":"10.1186/s13019-025-03536-1","url":null,"abstract":"<p><strong>Introduction: </strong>Lipoma is one of the most common mesenchymal tumours. It is mostly benign in character. Those whose size is > 10 centimetres are called giant lipomas. Although its incidence is low in the extrathoracic axillary region, brachial plexus, and pectoral region, it also causes thoracic outlet syndrome (TOS), especially if it compresses the neurovascular bundle at the thoracic outlet.</p><p><strong>Case presentation: </strong>A 51-year-old male patient was admitted to the hospital with pain, numbness, and tingling in his left arm that started three months ago. A mass measuring approximately 10 × 10 cm was found in the left lateral thoracic wall, in the region just inferior to the axilla and along the lateral border of the scapula. When the patient was in the supine position, the mass was observed to migrate to the axillary region. When the patient leaned forward, it was observed that the mass shifted towards the upper part of the pectoral muscle. There was paraesthesia and tingling in the fingertips of the left hand, however, muscle strength was normal. Adson's and Wright's tests were positive. Considering the symptoms in the left upper extremity, we decided to excise the lesion. On postoperative day one, the patient stated that the pain and tingling in the left extremity had significantly decreased. We observed that neurological complaints significantly decreased, and oedema regressed in the first postoperative month. In the third postoperative month, the patient stated that he had no complications.</p><p><strong>Conclusion: </strong>There is no study in the literature reporting that lipoma seen outside the extrathoracic regions mentioned causes TOS. Particularly mobile and large-sized lipomas might cause compression of the neurovascular bundle in the thoracic outlet areas by pushing the tissues. We aimed to report the first case of TOS caused by a giant lipoma located on the lateral thoracic wall, just inferior to the axilla and outside the thoracic cavity.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"292"},"PeriodicalIF":1.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608488","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":"The impact of systemic inflammation index on prolonged mechanical ventilation after cardiac surgery: a retrospective study.","authors":"Quan Liu, Yifei Zhou, Xu Cao, Wuwei Wang, Chenguang Pan, YichenXu, Rui Fan, Wen Chen, Rui Wang, Xin Chen","doi":"10.1186/s13019-025-03514-7","DOIUrl":"10.1186/s13019-025-03514-7","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in surgical techniques and intensive care management, the incidence of prolonged mechanical ventilation (PMV) following cardiac surgery remains a significant concern.</p><p><strong>Objectives: </strong>Investigate the relationship between the Systemic Inflammation Index (SII) and the occurrence of PMV, as well as the medium-term prognostic outcomes in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).</p><p><strong>Methods: </strong>This retrospective observational study was conducted at Nanjing First Hospital, including data from adult patients who underwent CPB for cardiac surgery between January 2020 and December 2020. PMV was defined as mechanical ventilation lasting more than 24 h post-surgery. Clinical characteristics, including demographic data and preoperative biomarkers, were collected. Statistical analyses included univariate and multivariate logistic regression to identify predictors of PMV.</p><p><strong>Results: </strong>A total of 1128 patients were included in the final analysis. Higher SII levels were associated with an increased likelihood of PMV and longer hospital stays. Multivariate logistic regression identified several independent predictors of PMV, including age, female gender, chronic lung disease, preoperative SII, and intraoperative plasma infusion. The risk of PMV increased by 7% for every 100-unit increase in SII. Kaplan-Meier survival analysis indicated that patients with PMV had higher mid-term mortality rates, and those with elevated preoperative SII levels exhibited lower survival rates.</p><p><strong>Conclusion: </strong>This study demonstrates that elevated preoperative SII is a significant predictor of PMV following cardiac surgery. Identifying patients at risk for PMV can aid in developing individualized treatment strategies and improving postoperative outcomes.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"293"},"PeriodicalIF":1.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608466","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 coronary artery bypass grafting in pediatric cardiac surgery: emphasizing the importance of internal thoracic artery usage.","authors":"Burak Bozkurt, Murat Çiçek, Fatih Ozdemir, Okan Yurdakök, Numan Ali Aydemir","doi":"10.1186/s13019-024-03197-6","DOIUrl":"10.1186/s13019-024-03197-6","url":null,"abstract":"<p><p>Coronary artery bypass grafting (CABG) is an exceedingly rare procedure in pediatric cardiac surgery, primarily due to the low incidence of coronary artery disease in this population. However, when indicated, the use of the internal thoracic artery (ITA) as a graft is crucial for ensuring long-term success. This case report describes a patient with a coronary artery anomaly where the right coronary artery is taking its origin from the left main coronary artery and transversing along the right ventricle outflow tract. The patient experienced late coronary compression after Rastelli operation, highlighting the critical role of ITA grafts in the surgical treatment.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"290"},"PeriodicalIF":1.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600571","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":"Cardiac calcified amorphous tumor in the right atrium: a rare cardiac neoplasm.","authors":"Wentao Fu, Kun Liu, Yan Zhang, Jing Wang, Wan Cai, Yaoyao Wu, Hao Chi, Wen Ge","doi":"10.1186/s13019-025-03501-y","DOIUrl":"10.1186/s13019-025-03501-y","url":null,"abstract":"<p><strong>Background: </strong>Cardiac calcified amorphous tumors (CATs) represent rare, nonneoplastic intraluminal heart masses, with limited case reports in existing literature. Asymptomatic cases localized in the right atrium are particularly unusual.</p><p><strong>Case presentation: </strong>An asymptomatic 46-year-old male was discovered to have a cardiac mass upon echocardiograph. Echocardiography revealed a 13.2 × 11.8 mm pedunculated mass in the right atrium, attached to the interatrial septum. Then we performed surgical treatment. Histopathology revealed some myocardial tissue, a powdery stained, calcified amorphous area, and a few localized lymphocytes and red blood cells. The final diagnosis confirmed a cardiac CAT.</p><p><strong>Conclusions: </strong>CATs, rarely occurring endocardium-based pseudotumors, comprise calcium nodules and amorphous fibrin material. Typically presenting as a calcified pedunculated mass, they may arise in any heart chamber, with a significant propensity for distal embolism. Differentiating CATs from calcified atrial myxomas, calcified thrombi, or other cardiac tumors is challenging. Histopathology remains a critical diagnostic cornerstone. Although complete surgical resection is the recommended treatment, anticoagulation and ongoing surveillance may serve as viable alternatives when primary treatment, surgical resection, is deemed excessively hazardous.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"288"},"PeriodicalIF":1.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600572","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":"Factors contributing to transient and persistent worsening renal function in elderly patients with acute decompensated heart failure.","authors":"Yu-Qing Sun, Lei-Ming Luo, Zhi-Yan Wang, Qiang Lv, Xin Du, Jian-Zeng Dong","doi":"10.1186/s13019-025-03527-2","DOIUrl":"10.1186/s13019-025-03527-2","url":null,"abstract":"","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"291"},"PeriodicalIF":1.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600573","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":"Identification of lipid metabolism-related genes in myocardial infarction: implications for diagnosis and therapy.","authors":"Qiang Wang, Xian Wu, Bo Yu","doi":"10.1186/s13019-025-03525-4","DOIUrl":"10.1186/s13019-025-03525-4","url":null,"abstract":"<p><strong>Background: </strong>Myocardial infarction(MI), a severe and often fatal cardiovascular condition, strongly contributes to global mortality and morbidity. Lipids are critical underlying factors in cardiovascular disease. They influence inflammatory responses and modulate leukocyte, vascular cell and cardiac cell functions, affecting the vasculature and heart. We aimed to identify novel biomarkers and therapeutic targets for MI that are linked to lipid metabolism.</p><p><strong>Materials and methods: </strong>Endothelial cell transcriptomes from MI patients and controls were downloaded from the Gene Expression Omnibus (GEO) database. Lipid metabolism genes were obtained from the Molecular Signatures Database (MSigDB). First, we employed the \"limma\" package to identify differentially expressed genes (DEGs). Moreover, we utilized weighted gene coexpression network analysis (WGCNA) to explore the module genes involved in MI. By intersecting the DEGs, module genes, and lipid metabolism genes, we pinpointed the differentially expressed lipid metabolism genes. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment and protein‒protein interaction (PPI) analyses were subsequently conducted. Cytoscape with MCODE was adopted to identify biomarkers, and receiver operating characteristic (ROC) curve analysis was applied to gauge the discriminatory power of these genes in distinguishing MI patients from controls. Regulatory network analysis involving microRNAs and transcription factors was performed for biomarkers.</p><p><strong>Results: </strong>Overall, 1760 DEGs, comprising 862 upregulated and 898 downregulated DEGs, were identified. By overlapping the module genes and lipid metabolism-related genes, 73 lipid metabolism-related genes were identified. GO analysis highlighted the most significantly enriched terms, including fatty acid metabolic process, regulation of lipid metabolism, and glycerolipid metabolic process. KEGG analysis revealed that these genes were enriched in pathways such as adipocytokine signalling, arachidonic acid metabolism, and cholesterol metabolism. We constructed a PPI network from the 73 identified lipid metabolism-related genes, highlighting 5 biomarkers (MBOAT2, ABHD5, DGAT2, LCLAT1 and PLPPR2). The expression of the 5 biomarkers significantly differed between the MI patients and the controls (P < 0.05). The area under the ROC curve (AUC) of all the biomarkers was greater than 0.7.</p><p><strong>Conclusion: </strong>MBOAT2, ABHD5, DGAT2, LCLAT1 and PLPPR2 were identified as biomarkers of MI, providing new ideas for diagnostic and therapeutic approaches.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"289"},"PeriodicalIF":1.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600574","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}