Journal of Cardiothoracic Surgery最新文献

{"title":"The impact of thyroid function on surgical prognosis in patients undergoing cardiac and major vascular surgeries.","authors":"Qi Sun, Wei Wang, Xiaoming Mao, Hao Liu","doi":"10.1186/s13019-025-03365-2","DOIUrl":"10.1186/s13019-025-03365-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to elucidate the relationship between thyroid function and surgical prognosis in patients undergoing cardiac and major vascular surgeries.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on patients undergoing cardiac or major vascular surgeries. Preoperative thyroid function tests, including TSH, free T3, and free T4 levels, as well as postoperative thyroid function tests, were assessed. Key postoperative outcomes, such as total hospital stay, postoperative hospital stay, ICU stay, and duration of mechanical ventilation, were recorded and analyzed. The analytical approach included Pearson correlation, multivariable logistic regression models, and restricted cubic splines.</p><p><strong>Results: </strong>This study analyzed a cohort of 472 patients who underwent various cardiovascular surgeries, including coronary artery bypass grafting (173 patients), aortic surgery (131 patients), valve surgery (125 patients), and primary cardiac neoplasms resection (43 patients). Significant changes in thyroid hormone levels were observed preoperatively and postoperatively, with TSH, FT3, and FT4 levels showing a significant decrease from preoperative values (p < 0.001). Multivariate logistic regression analysis further revealed that ΔTSH is significantly associated with total hospital stay, postoperative hospital stay, and duration of mechanical ventilation; postoperative FT3 levels were significantly inversely related to total hospital stay, ICU stay, and ventilator requirements. Additionally, although no significant nonlinear relationships were found (all p > 0.05).</p><p><strong>Conclusions: </strong>Thyroid dysfunction may impact postoperative outcomes in cardiac and major vascular surgery patients.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"152"},"PeriodicalIF":1.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624839","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 myxoma: a comprehensive review.","authors":"Chigozie C Okongwu, Olaejirinde O Olaofe","doi":"10.1186/s13019-024-03333-2","DOIUrl":"10.1186/s13019-024-03333-2","url":null,"abstract":"<p><p>Heart tumours are a diverse group of tumours that may present with symptoms or be discovered incidentally when a patient is being evaluated for a physical or seemingly unrelated ailment. Cardiac myxoma, although rare, is the second most common benign primary cardiac tumours after papillary fibroelastoma. It occurs in sporadic form and familial form, as seen in Carney complex disorder. Cardiac myxoma can affect all age groups, but the majority manifests in their third to sixth decade of life, with a mean age of 50 years at diagnosis. There is a slight preponderance in females in a ratio of 2:1. Conversely, they are incredibly uncommon in fetuses and newborns but commonly diagnosed in children around a mean age of 9-10 years. About 90% originate in the atrium as a solitary or pedunculated mass. Within the atrial chamber, 75% occur on the left atrium close to the fossa ovalis, while others occur in the right atrium, ventricles, and valves. Serious complications often arise even in the absence of symptoms, and such complications include intracardiac obstruction, systemic and pulmonary emboli, as well as constitutional symptoms that mimic connective tissue and inflammatory diseases. There is no pathognomonic clinical presentation. Complete surgical excision of the tumour, including the use of robotic surgery, is the key component of a successful course of treatment. To monitor for tumour recurrence, long-term follow-up is frequently carried out with interval echocardiography. This review will focus on providing information on the various forms of cardiac myxoma, aetiology, molecular genetics, clinical presentation, histopathologic findings, differential diagnosis, treatment, and complications.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"151"},"PeriodicalIF":1.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624834","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":"An environmental scan of current mentorship: fostering the next generations in cardiothoracic surgery in the UK.","authors":"Michelle Lee, Georgia R Layton, Elizabeth Belcher, Deborah Harrington, Gillian Hardman, Betsy Evans, Narain Moorjani, Karen Booth","doi":"10.1186/s13019-024-03240-6","DOIUrl":"10.1186/s13019-024-03240-6","url":null,"abstract":"<p><strong>Objectives: </strong>Mentorship is critical to the professional development of junior colleagues in cardiothoracic surgery. Despite its presumed importance and frequent discussion, its impact within cardiothoracic surgery training remains uncharacterised within the UK. We aimed to evaluate mentorship experience and identify gaps in the system of mentorship education. The differences between men and women's views on mentorship are also considered.</p><p><strong>Methods: </strong>We prospectively collected of 92 responses [50 M:42 F] over 18 weeks. 'Society for Cardiothoracic Surgery in Great Britain and Ireland (SCTS) Critically Appraising mentorship' survey was formulated using electronic questionnaire system and distributed via emails to health professionals and medical students by using SCTS membership directory. The survey domains explore respondents' demographics, current or previous academic appointments, leadership roles, experience of mentorship, and opinions regarding ideal implementation of mentorship model, including the views on necessity for racial and gender concordance between mentor and mentee.</p><p><strong>Results: </strong>43% of respondents (40/92) had less than 5 years of experience in practice, but in general men were more experienced than women with over 15 years of practice (40% versus 9.52%) (p = 0.01). Women are more likely to change their practice due to favourable work-life balance (40%, 4/10) or due to financial incentives (40%, 4/10). On the other hand, men were mostly likely to transit due to career specialisation (38.1%, 8/21) (p = 0.014). 48% of respondents (45/92) have a system of mentorship in the current practice, but 66.67% (30/92) did not have formal evaluations. All male participants did not think gender of mentor/mentee was important, but 21.43% (9/42) of women did (p = 0.002).</p><p><strong>Conclusion: </strong>The need for mentorship programme is widely recognised and is imperative to achieve maximum career potential, both professionally and personally. The key will be to establish more structured mentoring programme, finding apposite mentor-mentee dyad, predefining mentorship need, and recognising the unique needs associated with the mentee's identity. Women face unique challenges as a minority, and this must be considered when forming mentorship relationship.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"150"},"PeriodicalIF":1.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615548","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":"Acquired ventricular septal defect secondary to aortic valve endocarditis.","authors":"Courtney M Hanson, Maria T Tibesar, Timothy L Pansegrau","doi":"10.1186/s13019-024-03244-2","DOIUrl":"10.1186/s13019-024-03244-2","url":null,"abstract":"<p><p>Infective endocarditis remains a deadly disease with a significant mortality rate. While ventricular septal defects (VSDs) have been linked to an increased risk of infective endocarditis, cases of acquired VSDs resulting from infective endocarditis are not well-documented in the literature. Our report highlights a rare case of acquired VSD that resulted directly from aortic valve endocarditis, treated with successful repair and placement of permanent pacemaker.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"149"},"PeriodicalIF":1.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605012","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":"Multimodal imaging in the assessment of quadricuspid aortic valve.","authors":"Michele D'Alonzo, Antonino Massimiliano Grande, Ivan Casale, Antonio Fiore","doi":"10.1186/s13019-024-03195-8","DOIUrl":"10.1186/s13019-024-03195-8","url":null,"abstract":"<p><p>Quadricuspid aortic valve (QAV) is a rare congenital anomaly of the aortic valve, with an incidence of 0.05-0.1%, often associated with aortic regurgitation. The condition typically presents between the ages of 46 and 50, with a slight male predominance. While diagnosis is generally made via transthoracic echocardiography (TTE), this method can occasionally fail to identify QAV, necessitating the use of transoesophageal echocardiography and cardiac computed tomography for more accurate assessment of valve morphology. We present the case of a 57-year-old male who experienced chest pain for three months. Although TTE revealed severe aortic regurgitation, it did not detect the QAV. The anomaly was ultimately identified through advanced imaging techniques prior to surgery, which confirmed the presence of this rare aortic valve morphology.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"148"},"PeriodicalIF":1.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11889870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585709","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 efficacy of the 4-hook needle localization for pulmonary ground glass nodules: a single-center retrospective analysis.","authors":"Yonghui Wu, Jiannan Xu, Kai Zhang, Yuanheng Huang, Jian Zhang, Huiguo Chen","doi":"10.1186/s13019-025-03371-4","DOIUrl":"10.1186/s13019-025-03371-4","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the efficacy of the 4-hook needle localization for pulmonary ground glass nodules (GGNs).</p><p><strong>Methods: </strong>From November 1, 2021, to May 31, 2024, 194 patients were diagnosed with one or more GGNs by computed tomography (CT) scan and underwent preoperative CT-guided 4-hook needle localization followed by video-assisted thoracoscope surgery (VATS) wedge resection, segmentectomy or lobectomy. There were 226 nodules in all patients. We analyzed the 4-hook needle localization safety, complications, safe margin and localization depth.</p><p><strong>Results: </strong>The 4-hook needle localizations success rate was 100% and didn't take place in displacement and dislodgment. The tumor margin distance is about 5-20 mm and all tumor margin was negative thorough final pathology result. 9 patients occurred small parenchymal hemorrhage, 13 patients occurred small pneumothorax and 8 patients occurred small hemoptysis, those complications needn't intervene or tackle and didn't affect surgery. Compared upper and middle lobe to lower lobe, localization time was 13.92 ± 4.6 min vs 13.66 ± 4.28 min respectively, p = 0.69, there was no significant statistical difference. Localization depth was 18.63 ± 7.8 mm vs 15.87 ± 8.52 mm respectively, p = 0.02, there were statistical differences, but the margin tumor distance was 5.16 ± 4.94 mm vs 4.93 ± 3.64 mm, p = 0.73 respectively, there was no statistical difference.</p><p><strong>Conclusions: </strong>Preoperative 4-hook needle localization is safe and feasible for GGNs. Guided by 4-hook needle localization, wedge resection can ensure enough safe margins and patient was well tolerated.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"146"},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573058","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":"Abnormal arterial ligation alone for patients with anomalous systemic arterial supply to the left basal segment of the lung: three case series.","authors":"Huiming Han, Sida Cheng, Hui Zhao, Jianfeng Li, Fan Yang, Hao Li","doi":"10.1186/s13019-024-03280-y","DOIUrl":"10.1186/s13019-024-03280-y","url":null,"abstract":"<p><strong>Background: </strong>Anomalous systemic arterial supply to the left basal segment of the lung is a rare congenital pulmonary vascular malformation, historically classified as a variant of intra-lobar pulmonary sequestration. The standard surgical approach has typically involved ligation of the anomalous artery in combination with lobectomy or segmentectomy.</p><p><strong>Case description: </strong>We present three cases of anomalous systemic arterial supply to the left basal segment of the lung, all successfully treated with thoracoscopic anomalous arterial ligation alone. In one case, indocyanine green was used to assess the blood supply, enhancing procedural safety.</p><p><strong>Conclusion: </strong>Thoracoscopic ligation of the anomalous artery alone may be a safe and lung-preserving surgical option for patients with this rare anomaly. The use of indocyanine green can further improve the safety of the procedure.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"147"},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573055","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 ELISA IgG antibodies in diagnosis of cystic echinococosis of lung. A retrospective study of a single centre activity in Albania.","authors":"Fatmir Caushi, Eritjan Tashi, Arben Tanka, Arian Mezini, Valbona Gjoni, Ilir Skenduli, Silva Tafaj, Silvana Bala, Ornela Nuredini, Agron Meshi, Emira Hysa, Francesco Rulli","doi":"10.1186/s13019-024-03308-3","DOIUrl":"10.1186/s13019-024-03308-3","url":null,"abstract":"<p><strong>Background: </strong>Cystic Echinococcosis presents significant biological, medical, economic, and social challenges. The diagnosis of cystic echinococcosis relies on immunodiagnostic methods alongside radiological in combinations with clinical findings. In human Cystic Echinococcosis, false negative immunologic results can occur in 3-5% of patients and reach up to 35-40% in hyper endemic regions. This study aimed to assess the role of Elisa IgG CE serum antibody titres in diagnosing pulmonary Cystic Echinococcosis.</p><p><strong>Material and methods: </strong>A retrospective review of medical records for 362 CE patients diagnosed in a cohort of 20 years was conducted. Diagnosis was based on radiological and clinical data, personal and family history with confirmation by serodiagnosis or histology in surgery cases. Age, sex, cysts location, size, complications and treatment were reviewed. ELISA IgG CE was studied preoperatively in all cases with its specificity and sensitivity in all cases RESULTS: The cohort included 362 patients of whom 51.4% males and 48.6% females, with a mean age of 40 years (range 12-80). 42 % were from rural regions. Among the cases, 112 (31%) presented with intact cysts, while 250 (69%) were complicated. ELISA IgG CE serum antibody titre tests were conducted for all cases. 350 (96.7%) underwent surgical treatment, while the remainder received conservative care. ELISA IgG CE was positive in 181 patients (50%). The sensitivity was 70% (175 patients) for complicated cases, but only 18.8% (21 patients) for uncomplicated cases.</p><p><strong>Conclusions: </strong>ELISA IgG CE has limited value in diagnosing CE. However, it may aid in identifying complicated CE. Interpretation of ELISA IgE CE results should consider clinical imaging findings. Establishing pre and postoperative surveillance protocols involving family doctors and diagnostic imaging services can enhance patient care quality.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"145"},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557039","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":"Application feasibility of virtual models and computational fluid dynamics for the planning and evaluation of aortic repair surgery for Williams syndrome.","authors":"Jixiang Liang, Xuewei Fang, Dianyuan Li, Guangyu Pan, Gen Zhang, Bingheng Lu","doi":"10.1186/s13019-024-03286-6","DOIUrl":"10.1186/s13019-024-03286-6","url":null,"abstract":"<p><strong>Background: </strong>Accurate diagnosis and evaluation of Williams Syndrome (WS) are essential yet challenging for effective surgical management. This study aimed to quantify the hemodynamic changes of surgical repair for WS through virtual surgery and computational fluid dynamics (CFD) for surgical guidance and postoperative evaluation.</p><p><strong>Methods: </strong>A patient preliminarily diagnosed with WS was included in this study. 3D model alongside hemodynamic analysis was used to guide and evaluate the surgical procedure. Preoperative, predictive and postoperative models were created and analyzed using CFD. Key parameters, including blood flow velocity, pressure differences, wall shear stress, and other critical factors, were assessed to evaluate the surgery's effectiveness.</p><p><strong>Results: </strong>In the hemodynamics analysis, the CFD results of predictive model and postoperative model demonstrated a high level of consistency, and showed significant differences compared to the preoperative model. The velocity at the stenosis on the aorta decreased from 5.6 m/s before the operation to 1.6 m/s in the virtual model and 1.5 m/s in the postoperative model. Surgical repair increased the proportion of outlet flow of the descending aorta (dAo) from 28.7% to 35.5%.</p><p><strong>Conclusions: </strong>Virtual surgery and CFD can predict surgical outcomes, enabling doctors to optimize and rehearse the procedure before the actual surgery. The method of predicting surgery through virtual surgery and CFD is accurate and feasible.</p><p><strong>Trial registration: </strong>Registered by the Ethics Committee of Peking University International Hospital (No. IRB2019-062).</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"144"},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556980","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":"Evaluation of hemolysis in patients supported with Impella 5.5: a single center experience.","authors":"Jessica S Clothier, Serge Kobsa, Lynette Lester, Nithya Rajeev, Markian Bojko, Jonathan Praeger, Mark Barr, Raymond Lee","doi":"10.1186/s13019-025-03352-7","DOIUrl":"10.1186/s13019-025-03352-7","url":null,"abstract":"<p><strong>Background: </strong>Hemolysis, variably defined in mechanical circulatory support (MCS), is understudied in percutaneous left ventricular assist devices. We characterize hemolytic sequelae of Impella 5.5-supported patients in the largest series to date.</p><p><strong>Methods: </strong>All Impella 5.5 patients at our center from 2020 to 2023 were identified (n = 169) and retrospectively reviewed. Patients with a plasma free hemoglobin (PfHb) recorded (and not previously elevated) were included (n = 123). The top (high hemolysis [HH], n = 26) and bottom (low hemolysis [LH], n = 25) quintiles were categorized based on PfHb levels. Analysis between groups identified factors associated with hemolysis.</p><p><strong>Results: </strong>HH patients had higher admission SCAI stages (p = 0.008), more Impella 5.5 days (23.5 v 10.0, p = 0.001), more additional MCS (16/26 [61.5%] v 6/25 [24.0%], p = 0.015), and more transfusions of packed red blood cells (12.5 v 4.0, p = 0.001), fresh frozen plasma (2.5 v 0.0, p = 0.033), and platelets (3.0 v 0.0, p = 0.002). Logistic regression identified additional MCS (OR 10.82, p = 0.004) and more Impella days (OR 1.13 p = 0.006) as hemolysis risk factors. Eleven (44%) LH and 19/26 (73%) HH patients died, with no significant differences between postoperative complications. Compared with those who died, HH survivors had fewer platelet transfusions (2.0 vs. 5.0, p = 0.01) and less PfHb elevation days (3.0 v 6.0, p = 0.007).</p><p><strong>Conclusions: </strong>Hemolysis in this high-risk cohort has a poor prognosis. HH patients spent more days on Impella 5.5, needed more MCS, and required more blood product transfusions.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"143"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531495","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}