Journal of Craniofacial Surgery最新文献

{"title":"Effects of Rapid Palate Expander on Facial Soft Tissues and Dental Arch: Study Conducted With Stereophotogrammetry and Intraoral Scans in Cleft Patients.","authors":"Francesca Zalunardo, Alessandro Frezza, Antonio Luigi Tiberio Gracco, Stefano Sivolella, Giovanni Bruno, Alberto De Stefani, Katherine Ann Piacentile, Federico Apolloni","doi":"10.1097/SCS.0000000000011359","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011359","url":null,"abstract":"<p><strong>Introduction: </strong>This pilot study explores the impact of rapid palatal expansion on facial soft tissues and dental arches, utilizing stereophotogrammetry and intraoral scanner in a cleft population.</p><p><strong>Materials and methods: </strong>Forty-five patients with unilateral cleft lip-palate (27), bilateral cleft lip-palate (9), and cleft palate (9) were included and underwent rapid palatal expansion. Stereophotogrammetric scans were conducted using (VECTRA M3) and intraoral scans (CEREC Primescan) at T0 (expander application) and at T1 (end of activations). Superimpositions and variations in surface and volume within the right cheek, left cheek, upper lip, and lower third were executed using the VECTRA Analysis Module (VAM) to compare soft tissues at T0 and T1. Expansion of the dental arches was verified on Meshmixer.</p><p><strong>Results: </strong>In unilateral cleft lip and palate patients the increase in the cheek area was 0.88 mm2 and 2.06 cm3 on the cleft side, whereas on the cleft side was 0.92 mm2 and 2.18 cm3. In bilateral cleft lip and palate the increase was of 0.75 mm2 and 1.7 cm3 on the left side and 0.58 mm2 and 1.4 cm3 on the right and in cleft patients there is an increase of 0.79 mm2 and 2.05 cm3 on the left and 0.95 mm2 and 2.01 cm3 on the right. On upper lip area the increase was 1.19 mm2 and 1.7 cm3 in unilateral cleft lip and palate, 0.88 mm2 and 1.1 cm3 in bilateral cleft lip and palate and 0.85 mm2 and 1.2 cm3 in cleft patients. On lower third area the increase was 1.58 mm2 and 6.15 cm3 in unilateral cleft lip and palate, 1.62 mm2 and 5.34 cm3 in bilateral cleft lip and palate, 1.37 mm2 and 5.37 cm3 in cleft palate. On dental arches symmetric expansion was present in no patient with unilateral cleft lip and palate, 55.6% of bilateral cleft lip and palate patient and 88.9% of cleft palate.</p><p><strong>Discussion and conclusions: </strong>Palatal expansion influences soft tissues as well as dental arches in terms of surface and volumetric changes. It was not possible to identify a relationship between the expansion of the dental arches and effects on the soft tissues. In unilateral cleft lip and palate, there was a non-symmetrical expansion of the arch; however, the position of the cleft does not influence the expansion. A symmetric expansion was frequent in the isolated cleft palate. Volumetric changes are mostly evident in the lower facial third.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772517","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":"Approaches to Establish an Animal Model With Composite Bone-soft Tissue Defects for Complex Regenerative Strategies.","authors":"Bingxu Lu, Ziming Wei, Yaping Yin, Yunyi Wang, Jiajia Linghu, Lei Chen, Junyan Fang, Zhaoqiang Zhang","doi":"10.1097/SCS.0000000000011311","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011311","url":null,"abstract":"<p><p>Regenerative strategies of composite tissue defects represent a formidable clinical challenge due to the distinct regeneration pathways of each tissue type and their complex interactions. To address the limitations of single-tissue defect models, the authors firstly established an animal model with simultaneously composite bone-soft tissue defects and then observed the wound healing, body weight, and overall health after the operation. The soft tissue defects exhibited complete macroscopic closure within 21 days. Furthermore, micro-computed tomography and histological assessments at 8 weeks demonstrated that the calvarial defect was unhealed, confirming its characteristics as a critical-size defect. In the authors' model, a 5 mm defect remained unhealed at 8 weeks, suggesting that it also exhibits critical-size defect properties, though a direct comparison with the classical 8 mm model requires further validation. Quantitative evaluations revealed limited new bone formation confined primarily to the defect margins, while the central portion of the defect remained filled with fibrous tissue. This composite model not only advances authors' understanding of multitissue repair processes but also offers a valuable preclinical platform for the development and optimization of next-generation regenerative strategies for complex tissue injuries.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772497","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":"Application of Narrative Medicine in Undergraduate Orthodontics Education.","authors":"Min Huang, Lei Zhao, Xiao-Yong He, Zhi-Juan Luo, Rong-Yu Yang, Li-Ming He","doi":"10.1097/SCS.0000000000011301","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011301","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to incorporate narrative medicine (NM) into undergraduate orthodontics educational courses, evaluate its impact on the empathy levels and professional skills of students, and examine student feedback on the curriculum.</p><p><strong>Methods: </strong>A cohort of 120 fifth-year undergraduate orthodontics students enrolled between June 2023 and June 2024 were selected as participants in the study and randomly assigned to the experimental and control groups. Students in the control group received training through traditional teaching methods that combined textbook content with clinical cases. Those in the experimental group received training through an NM-integrated orthodontics curriculum structured around the 5E instructional model: engagement, exploration, explanation, elaboration, and evaluation. The Chinese version of the Jefferson Scale of Physician Empathy-Student Version (JSPE-S) and the mini clinical evaluation exercise (Mini-CEX) were used to evaluate the effectiveness of the course. In addition, a self-administered questionnaire was used to collect students' feedback on the curriculum.</p><p><strong>Results: </strong>Upon course completion, students in the experimental group had significantly higher scores in both the JSPE-S and Mini-CEX compared with those in the control group (P<0.05). The evaluation of the NM-integrated orthodontics course by students in the experimental group was extremely positive, with the majority advocating for its continued implementation.</p><p><strong>Conclusion: </strong>In this study, the integration of NM into the undergraduate orthodontics curriculum yielded positive educational outcomes, enhancing students' empathy and professional competencies by fostering a more engaging learning environment.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772493","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":"Characterizing Comprehensive Cleft Care in the United States: A National Inpatient Sample Study.","authors":"Nicholas Paliwoda, Ethan D Paliwoda, Avi A Gajjar, Adam Goldsmith, Lauren Angnardo, Stephanie M C Bray","doi":"10.1097/SCS.0000000000011280","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011280","url":null,"abstract":"<p><p>Cleft lip and palate (CLP) are among the most common congenital craniofacial anomalies impacting feeding, speech, and facial appearance. Comprehensive management involves multidisciplinary care, including surgical interventions, orthodontics, speech therapy, and psychosocial support. This study examines demographic, clinical, and economic factors influencing hospital charges and outcomes associated with CLP management in the United States. Using ICD-10-CM/PCS codes and data from the National Inpatient Sample (NIS) for 2016 and 2017, this study included patients primarily or secondarily treated for combined CLP. Baseline demographics and outcomes were analyzed using descriptive statistics, and multivariable logistic regression was used to identify factors influencing non-home discharges and extended length of stay (LOS). The study population comprised 4205 patients (60.2% male and 39.8% female). The majority were White (44.3%) and Hispanic (29.3%). Most patients were privately insured (47.0%) or on Medicaid (42.7%). The mean cost of care was $13,291, and total hospital charges averaged $49,229, inflation adjusted. The average LOS was 1.981 days (SD=6.850), and 1.3% of patients experienced non-home discharges. Native American patients and those with higher risks of mortality showed higher odds of non-home discharge, whereas patients in the West had lower odds of non-home discharge. Those of unspecified racial background, treated at urban non-teaching hospitals, or with higher risks of mortality experienced higher odds of extended LOS. This study highlights sociodemographic and geographic disparities in CLP care. Addressing systemic barriers and standardizing care protocols are essential to improving outcomes and reducing financial burdens.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772500","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":"Dehydroepiandrosterone Suppresses Keloid Fibroblasts Fibrosis by Inhibiting the TGF-β1/Smad Signaling Pathway.","authors":"Xuemei Quan, Lei Zhao, Jingyu Jin, Changzhe Jing, Kun Yang, Shan Jin, Zhehu Jin","doi":"10.1097/SCS.0000000000011369","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011369","url":null,"abstract":"<p><p>The pathogenesis of keloid is complex and unclear, and current therapies of this condition remain unsatisfactory. Dehydroepiandrosterone (DHEA), a steroid prohormone, exhibits a wide range of pharmacologic activities, including anti-inflammatory and pro-immune effects, as well as anti-tumor and anti-fibrotic properties. Herein, the authors explored the potential effects and underlying mechanisms of DHEA on keloid fibroblasts in vitro. The authors' findings indicated that DHEA significantly inhibited the proliferation, migration, and invasion of keloid fibroblasts, while promoting cell apoptosis. In addition, DHEA significantly reduced the expression of fibrosis-related proteins in keloid fibroblasts by suppressing the TGF-β1/Smad signaling pathway. In conclusion, the authors' in vitro results highlight the therapeutic potential of DHEA as a promising candidate for keloid treatment.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772513","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":"Secondary Alveolar Bone Grafting in the Mixed Dentition Phase: Patients of Younger Age Associated With Enhanced Osteogenesis and Midfacial Skeletal Symmetry.","authors":"Siqi Wei, Zhilu Zhang, Guang Zhang, Qian Wu, Yongqian Wang","doi":"10.1097/SCS.0000000000011351","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011351","url":null,"abstract":"<p><strong>Introduction: </strong>Alveolar bone grafting during the mixed dentition period is a common treatment, but the optimal surgical timing remains unclear. This study aims to evaluate how age influences the outcomes of secondary alveolar cleft repair, focusing on bone formation and midfacial symmetry.</p><p><strong>Materials and methods: </strong>This study retrospectively analyzed patients who underwent autologous iliac cancellous bone grafting for alveolar cleft repair from January 2019 to August 2023. Preoperative and 1-year postoperative skull CT data were used to measure osteogenesis rate and midface bony structures, with statistical analysis conducted using R.</p><p><strong>Results: </strong>A total of 68 patients aged 8 to 12 years were included in the study, with no significant differences in baseline data. Autologous iliac bone grafting for alveolar cleft repair resulted in significant improvements in the symmetry of the midfacial skeletal structure, with younger patients showing more pronounced improvements. Univariate linear regression analysis revealed a linear relationship between age and osteogenesis rate, which was further confirmed by multiple linear regression analysis. Age was identified as the most significant factor influencing the osteogenesis rate (β=-0.037, P=0.003), while the deviation of the nasal septum was also found to significantly affect the osteogenesis rate (β=0.004, P=0.009).</p><p><strong>Conclusions: </strong>Age significantly impacts the outcomes of alveolar cleft repair using autologous iliac cancellous bone grafting. Younger patients have better bone formation and facial symmetry improvements, suggesting that earlier surgery may be more beneficial. Preoperative nasal septal deviation assessment is also essential for optimizing surgical planning.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764065","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":"Study of Incidence and Location of Latero-Orbital Foramen Along With Associated Clinical Implications in Adult Indian Dry Skulls.","authors":"Rajani Singh","doi":"10.1097/SCS.0000000000011350","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011350","url":null,"abstract":"<p><p>The frontal bone is an integral part of viscero-cranium. It forms the roof of the orbit and its lateral projection namely the zygomatic process of frontal bone forms part of the lateral wall of the orbit. There is a paucity of literature describing foramen in the zygomatic process of frontal bone. Hence the study was conducted. The aim of the study is to expound the incidence and location along with the clinical implications of the foramen on the zygomatic process of frontal bone designated as latero-orbital foramen. The study was conducted using 80 skulls (160 sides) of unknown age and sex. The presence of foramen was noted by visual inspection and its location was determined by measuring distances of this foramen from temporal crest and fronto-zygomatic suture by vernier caliper. The incidence and mean and SD were calculated using Microsoft Excel 2021. The number of latero-orbital foramina ranged between 0 and 3. The latero-orbital foramen was absent in 84.3% of sides. Single foramen was observed in 11.3 sides, double in 3.8% and triple in 0.6% sides. The mean distance of latero-orbital foramen from the temporal crest of the frontal bone on the right and left sides are 0.5±0.3 and 0.4±0.2 cm, respectively. The mean distance of the foramen under study from fronto-zygomatic suture on the right and left sides are 1.1±0.5 and 1.4±0.5 cm, respectively. The data related to latero-orbital foramen provided will be of paramount importance in carrying out uneventful surgeries along the lateral orbital wall and forehead.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764068","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":"Immediate Implant Survival in Graftless Maxillary Sinus Lift Without Biological (Membrane) Barrier.","authors":"Sergio Olate, Víctor Ravelo, Marcelo Parra, José Valdivia","doi":"10.1097/SCS.0000000000011321","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011321","url":null,"abstract":"<p><p>The surgery for dental implants in atrophic sites is a constant challenge. The sinus lift has some recognized techniques; however, the use of low morbidity and low-cost techniques is a trend in surgery. This study aims to identify implant stability observed in dental implants installed in an atrophic maxillary sinus using the lateral window technique without bone graft or biological barrier. A clinical series included 20 patients with 25 conical design dental implants installed, with 1 year of follow-up performed. Bone height was analyzed in the preoperative stage and at 1 year of follow-up using panoramic radiography. All the implants were installed using a lateral window sinus lift, respecting a minimum insertion torque of 35N. Four months later, the second surgery installed the healing abutment and then the prosthetic abutment; the fixed prosthesis on the implant was performed conventionally. After 1 year of follow-up, only one implant was lost at the healing abutment installation stage, the remaining 24 implants were rehabilitated conventionally with no issues. All the implants were stable 1 year after surgery; an average bone gain of 4.9 mm was observed between the preoperative stage and the 1-year follow-up, a statistically significant increase (P > 0.05). The immediate implant with primary stability in maxillary sinus lift using the lateral window approach, without bone grafts or biological barriers, has a high survival rate and facilitates new bone formation around the implant.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764143","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":"Epidemiology and Incidence of Pierre Robin Sequence in the Maltese Islands: A Population-Based Study.","authors":"David Borg, Kurt Lee Chircop, Zane Attard, Juanita Parnis","doi":"10.1097/SCS.0000000000011277","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011277","url":null,"abstract":"<p><strong>Background: </strong>Pierre Robin Sequence (PRS) is a congenital condition characterized by a triad of micrognathia, glossoptosis, and cleft palate. This study aims to investigate the incidence and epidemiology of PRS in the Maltese population, providing valuable insights into its prevalence, clinical characteristics, and surgical management.</p><p><strong>Method: </strong>A population-based retrospective analysis was conducted utilizing data from the years 2000 to 2019. Aggregate data were collected from the Maltese Public Health Department, capturing registered PRS cases in the Maltese population. Incidence rates were calculated, and demographic factors, gestational distribution, and associations with cleft palate were evaluated.</p><p><strong>Results: </strong>The incidence of PRS in the Maltese population was found to be 12.5 per 100,000 births, higher than global estimates. Among the registered cases, 63.6% were male. Gestational distribution analysis revealed a concentration of PRS cases born at 39 weeks. Furthermore, 90.9% of PRS cases were associated with cleft palate.</p><p><strong>Conclusion: </strong>This study highlights a higher prevalence of PRS in the Maltese population compared with global estimates, indicating a unique epidemiological profile specific to the Maltese Islands. The findings provide valuable insights for plastic surgeons and health care professionals involved in the management of PRS patients. Further research is needed to explore the underlying factors contributing to this increased prevalence and to optimize treatment strategies for PRS patients in the Maltese Islands.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764135","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":"Is Airway-Related Pathology the Main Risk Factor for Difficult Intubation in Children Under 6 Years Old?","authors":"Sandra Galve-Navarro, Francisca Munar-Bauzá, Cristina Muro-Castro, Irene García-Martínez, Susana Manrique-Muñoz, Miriam de Nadal","doi":"10.1097/SCS.0000000000011304","DOIUrl":"https://doi.org/10.1097/SCS.0000000000011304","url":null,"abstract":"<p><strong>Introduction: </strong>Evaluating pediatric airways is challenging, particularly in identifying those at risk for difficult intubation, which is often linked to craniofacial malformations. Limited cooperation from preschoolers further complicates this evaluation.</p><p><strong>Objective: </strong>To evaluate the predictive accuracy of the Arné Score in identifying risk factors for difficult intubation in preschool-aged children (under 6 y) and develop a model to prevent difficult laryngoscopy and intubation. Secondary objectives include determining the incidence of difficult intubation and the appropriate age for preanesthetic airway assessments.</p><p><strong>Methods: </strong>This retrospective observational study analyzed 1385 patients aged 0 to 16 years, all undergoing general anesthesia and tracheal intubation in 2018 at a tertiary hospital in Barcelona. Among them, 708 were under 6 years. Predictive tests included the Arné Score, with difficult intubation defined by Cormack-Lehane scores, intubation attempts, and alternative device use. Logistic regression analyzed predictors with significant odds ratios.</p><p><strong>Results: </strong>Unrecorded Mallampati test values were common in children under 6 years (99.04%). Of those without a history, 8.07% faced intubation difficulties, compared with 50% with a history. Relative risk was 6.23, and the odds ratio was 11.46. Among 202 classified with airway difficulties, 82.67% had no intubation issues. Statistically significant associations highlighted greater risks for those with a difficult intubation history.</p><p><strong>Conclusions: </strong>Arné Score tests are impractical for children under 6. If no history or airway pathology exists, there's a 95.14% chance of successful intubation. The history of difficult intubation increases risks more than airway pathology alone.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764146","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}