Journal of Cardiothoracic Surgery最新文献

{"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}

{"title":"A two-sample Mendelian randomization study of atrial fibrillation screening, risk factor analysis, and serum uric acid levels.","authors":"Zhenhua Shi, Wuming Hu, Kexing Ye, Ranran Xia","doi":"10.1186/s13019-025-03448-0","DOIUrl":"10.1186/s13019-025-03448-0","url":null,"abstract":"<p><strong>Background: </strong>It aimed to explore the relationship between atrial fibrillation (AF) screening, risk factor analysis, and serum uric acid (UA) levels. By analyzing the results of AF screening and risk factors, the potential impact of serum UA levels on AF risk was further investigated.</p><p><strong>Methods: </strong>The study population consisted of 979 patients who underwent physical examinations between January 2023 to October 2023, and were divided into two groups based on AF screening results: the AF screening group (n = 490) and the routine examination group (n = 489). The AF screening group underwent AF screening, risk factor analysis, and measurement of serum UA levels, while the routine examination group only received AF screening and routine health check-ups. Utilizing the Global Urate Genetics Consortium (GUGC) dataset, 28 single nucleotide polymorphisms (SNPs) associated with serum UA levels were identified and applied in a Mendelian randomization (MR) study to assess the causal relationship between serum UA levels and AF.</p><p><strong>Results: </strong>Apart from gender, the general data of the experimental and control groups were similar. In patients aged 50-59 and over 70 years, the detection rate of AF in males was significantly higher than that in females (P < 0.05). After adjusting for age and gender, hyperlipidemia, stroke, hyperuricemia, and hyperthyroidism were identified as risk factors for AF. Multivariate logistic regression analysis showed a significant association between elevated serum UA levels and increased AF risk. Further analysis indicated a clear dose-response relationship between serum UA levels and AF risk (P < 0.05), suggesting a potential causal effect of serum UA levels on AF risk.</p><p><strong>Conclusion: </strong>This article demonstrated a significant dose-response relationship between elevated serum UA levels and AF risk, further supporting serum UA as an independent risk factor for AF. Moreover, through MR analysis, the potential causal relationship between serum UA levels and AF was validated, providing a new perspective and basis for AF screening and early diagnosis.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"285"},"PeriodicalIF":1.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567475","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":"Role of Col1a2 and Postn in left ventricular noncompaction cardiomyopathy.","authors":"Huibing Liu, Ling-Bing Meng, Qian Liu","doi":"10.1186/s13019-025-03509-4","DOIUrl":"10.1186/s13019-025-03509-4","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular noncompaction cardiomyopathy (LVNC) is a rare myocardial developmental anomaly characterized by incomplete myocardial compact layer development in the left ventricular wall, resulting in a multilayered trabeculated myocardium.</p><p><strong>Methods: </strong>The datasets GSE71912 and GSE113251 of left ventricular noncompaction cardiomyopathy were downloaded from the gene expression omnibus (GEO) database generated from GPL13912 and GPL11002 platforms. Batch normalization was performed, followed by differentially expressed genes (DEGs), principal component analysis (PCA), functional enrichment analysis, weighted gene co-expression network analysis (WGCNA), construction and analysis of protein-protein interaction (PPI) networks. Heatmaps of gene expression levels were generated. Correlation with core genes was explored through comparative toxicogenomics database (CTD) analysis.</p><p><strong>Results: </strong>A total of 500 DEGs were identified. WGCNA with a soft threshold power of 16 generated three modules. Hierarchical clustering dendrograms were constructed for all genes, identifying 4 core genes (Col1a2, Postn, Timp1, Dcn). These core genes were validated through enrichment analysis using Metascape. Heatmaps revealed high expression of core genes (Col1a2, Postn, Timp1, Dcn) in left ventricular noncompaction cardiomyopathy tissue samples. CTD analysis linked core genes (Col1a2, Postn, Timp1, Dcn) with conditions such as left ventricular hypertrophy, arrhythmias, heart diseases, heart failure, myocardial ischemia, vascular diseases, and inflammation.</p><p><strong>Conclusion: </strong>Col1a2 and Postn are significantly upregulated in left ventricular noncompaction cardiomyopathy, suggesting their potential role as molecular targets.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"287"},"PeriodicalIF":1.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567476","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 combination of chemotherapy and immune checkpoint inhibitors in recurrent extensive-stage small cell lung cancer: a case report.","authors":"Chunxiu Hu, Mingtu Zhang, Min Fang, Yi Liu, Zhengqi Yang","doi":"10.1186/s13019-025-03513-8","DOIUrl":"10.1186/s13019-025-03513-8","url":null,"abstract":"<p><p>Small cell lung cancer (SCLC) accounts for approximately 15% of all lung cancer cases and is characterized by high malignancy, rapid progression, and poor prognosis. Here, we report a case of a 58-year-old female patient who was initially diagnosed with extensive-stage SCLC (ES-SCLC) with liver metastasis. The patient underwent etoposide and cisplatin (EP) chemotherapy combined with local radiotherapy and achieved a complete response. The progression-free survival reached 48 months, and upon relapse, the patient received EP chemotherapy combined with the programmed cell death protein 1 (PD-1) inhibitor, tislelizumab, as immunotherapy. During the treatment period, the patient experienced immune-related pancreatitis, but the symptoms were relieved with timely intervention and treatment. As of January 2, 2024, the patient's overall survival exceeded 95 months. This case highlights the potential efficacy of the combination of chemotherapy and immunotherapy in recurrent ES-SCLC patients and underscores the importance of close monitoring and management of immune-related adverse reactions. The study provides valuable insights into the application of personalized treatment in lung cancer management and offers new possibilities for extending patient survival.</p>","PeriodicalId":15201,"journal":{"name":"Journal of Cardiothoracic Surgery","volume":"20 1","pages":"286"},"PeriodicalIF":1.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567477","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}