Journal of endourology最新文献

{"title":"Precision in Access: The Laser Direct Alignment Radiation Reduction Technique <i>Versus</i> Conventional Fluoroscopic Renal Access.","authors":"Zhamshid Okhunov, Alphie Rotinsulu, Ala'a Farkouh, Rose Leu, Grant Sajdak, Matthew Buell, Akin S Amasyali, Kanha Shete, Vance Gentry, Udochukwu Oyoyo, David S Benjamin, D Duane Baldwin","doi":"10.1089/end.2024.0802","DOIUrl":"10.1089/end.2024.0802","url":null,"abstract":"<p><p><b><i>Introduction and Objective:</i></b> The laser direct alignment radiation reduction technique (DARRT) presents a novel approach integrating pulsed low-dose fluoroscopy, ultrasound, direct endoscopic visualization, and laser targeting to minimize fluoroscopy exposure during percutaneous nephrolithotomy (PCNL). This study aims to evaluate the safety and efficacy of laser DARRT in comparison with traditional fluoroscopic PCNL access. <b><i>Methods:</i></b> A retrospective analysis was conducted on patients who underwent PCNL. Patients with pre-existing nephrostomy tubes for access and those who underwent solely ultrasound-guided access were excluded from the study. The primary outcomes of the study were comparing fluoroscopy time used for renal access and total fluoroscopy time between the two groups. Secondary outcomes included relative stone-free rates (SFR) defined as ≤4 mm fragments on postoperative computed tomography scan and complication rates. Continuous variables were compared using an independent-sample <i>t</i> test, whereas categorical variables were compared using the chi-square test, with significance set at <i>p</i> < 0.05. <b><i>Results:</i></b> A total of 292 patients were eligible for the study. The laser DARRT reduced both access fluoroscopy time (10.8 <i>vs</i> 551.7 seconds; <i>p</i> < 0.001) and total fluoroscopy time (21.8 <i>vs</i> 597.7 seconds; <i>p</i> < 0.001). The relative SFR was significantly higher in the laser DARRT group compared with the conventional group (84.1% <i>vs</i> 64.1%; <i>p</i> < 0.001). There was no significant difference in complication rates between the two groups (<i>p</i> > 0.05). <b><i>Conclusions:</i></b> The laser DARRT led to a >95% reduction in access and total fluoroscopy times. By combining the advantages of fluoroscopy, ultrasound, endoscopic vision, and laser guidance, this technique represents a promising option for improving outcomes and minimizing radiation-related risk.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"443-450"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medium-Term Outcomes after Primary Whole-Gland High-Intensity Focused Ultrasound Ablation for the Treatment of Prostate Cancer: A Single-Center Experience.","authors":"Éder Silveira Brazão, Renato Almeida Rosa de Oliveira, Rafael Ribeiro Zanotti, Daniel Coser Gomes, Thiago Camelo Mourão, Victor Espinheira Santos, Cássia da Silva, Thiago Borges Marques Santana, Walter Henriques da Costa, Gustavo Cardoso Guimarães, Stênio de Cássio Zequi","doi":"10.1089/end.2024.0539","DOIUrl":"10.1089/end.2024.0539","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Our aim was to assess the oncologic and functional outcomes of primary whole-gland high-intensity focused ultrasound (WG-HIFU) treatment for non-metastatic prostate cancer (PCa). <b><i>Patients and Methods:</i></b> We retrospectively analyzed data from 227 men treated with WG-HIFU at a single center between 2011 and 2019. Patients with prostate-specific antigen (PSA) greater than 20 ng/mL, positive nodes, or missing data were excluded. Primary outcome was failure-free survival (FFS). Failure was defined as any recurrence requiring salvage radical or systemic treatment, metastasis, or PCa-specific death. <b><i>Results:</i></b> The median follow-up was of 47 months. FFS rates at 1, 3, and 5 years were 97%, 82%, and 75%, respectively. The 5-year FFS rates were 91%, 78%, and 59% for the low-, intermediate-, and high-risk patients, respectively. The 5-year metastasis-free survival and cancer-specific survival rates were 93% and 97%, respectively. The overall pad-free continence and social continence rates were 83% and 95%, respectively. Approximately 62% of previously potent patients undergoing WG-HIFU maintained erections sufficient for penetration. Bilateral nerve-sparing (NS) improved functional outcomes, with 68.6% achieving sufficient erections and 89.6% achieving pad-free continence. Clavien-Dindo grade 3 complications occurred in 22%. Higher PSA, clinical T stage, biopsy grade group, and nadir PSA levels were independently associated with treatment failure. <b><i>Conclusion:</i></b> WG-HIFU combined with transurethral resection of the prostate provides good medium-term oncologic control in appropriately selected patients and tolerable results in terms of genitourinary toxicity. Bilateral NS was associated with better urinary and erectile function.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"500-508"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daniel Wollin, MD.","authors":"","doi":"10.1089/end.2025.spot","DOIUrl":"https://doi.org/10.1089/end.2025.spot","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":"39 5","pages":"431"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced Artificial Intelligence in Bladder Cancer Management: A Comparative Analysis and Optimization Study of Multiple Large Language Models.","authors":"Kun-Peng Li, Li Wang, Shun Wan, Chen-Yang Wang, Si-Yu Chen, Shan-Hui Liu, Li Yang","doi":"10.1089/end.2024.0860","DOIUrl":"10.1089/end.2024.0860","url":null,"abstract":"<p><p><b><i>Background:</i></b> With the rapid advancement of artificial intelligence in health care, large language models (LLMs) demonstrate increasing potential in medical applications. However, their performance in specialized oncology remains limited. This study evaluates the performance of multiple leading LLMs in addressing clinical inquiries related to bladder cancer (BLCA) and demonstrates how strategic optimization can overcome these limitations. <b><i>Methods:</i></b> We developed a comprehensive set of 100 clinical questions based on established guidelines. These questions encompassed epidemiology, diagnosis, treatment, prognosis, and follow-up aspects of BLCA management. Six LLMs (Claude-3.5-Sonnet, ChatGPT-4.0, Grok-beta, Gemini-1.5-Pro, Mistral-Large-2, and GPT-3.5-Turbo) were tested through three independent trials. The responses were validated against current clinical guidelines and expert consensus. We implemented a two-phase training optimization process specifically for GPT-3.5-Turbo to enhance its performance. <b><i>Results:</i></b> In the initial evaluation, Claude-3.5-Sonnet demonstrated the highest accuracy (89.33% ± 1.53%), followed by ChatGPT-4 (85.67% ± 1.15%). Grok-beta achieved 84.33% ± 1.53% accuracy, whereas Gemini-1.5-Pro and Mistral-Large-2 showed similar performance (82.00% ± 1.00% and 81.00% ± 1.00%, respectively). GPT-3.5-Turbo demonstrated the lowest accuracy (74.33% ± 3.06%). After the first phase of training, GPT-3.5-Turbo's accuracy improved to 86.67% ± 1.89%. Following the second phase of optimization, the model achieved 100% accuracy. <b><i>Conclusion:</i></b> This study not only establishes the comparative performance of various LLMs in BLCA-related queries but also validates the potential for significant improvement through targeted training optimization. The successful enhancement of GPT-3.5-Turbo's performance suggests that strategic model refinement can overcome initial limitations and achieve optimal accuracy in specialized medical applications.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"494-499"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drivers of Cost Variability of Ureteroscopy with Laser Lithotripsy at an Academic Institution.","authors":"Tyler Bergeron, Ilir Agalliu, Alexander C Small, Dima Raskolnikov","doi":"10.1089/end.2024.0801","DOIUrl":"10.1089/end.2024.0801","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Ureteroscopy with laser lithotripsy (URS/LL) requires significant disposable equipment including wires, baskets, lasers, and stents. Surgeons choose this equipment based on preference, with higher- and lower-cost options available. We sought to explore factors that affect cost variability among urologists performing URS/LL within a single academic medical center. <b><i>Patients and Methods:</i></b> We retrospectively reviewed all patients who underwent URS/LL at our institution between September 2022 and June 2023. A weighted cost for each item's contribution to total cost was generated. Bivariate and then multivariate median regression models were generated to identify variables associated with higher total surgical cost. Statistical significance was considered <i>p</i> < 0.05. <b><i>Results:</i></b> A total of 311 patients underwent URS/LL during the study period with 14 different surgeons. The total median cost of disposable equipment for the entire cohort was $1488/operation. On multivariate regression, basket cost above the cohort median or specialized catheter cost above the cohort median was associated with increased total surgical cost (<i>p</i> < 0.001). Fellowship training in endourology was associated with a decreased cost of $90.40 per case (<i>p</i> < 0.05). <b><i>Conclusions:</i></b> There is significant variability in the cost of ureteroscopy, even at a single institution where all surgeons have access to identical supplies. Attention to specific categories of equipment, which appear to be associated with higher total cost, as well as the potential differences in technique between surgeons with varied training, may help to identify opportunities for institutional cost savings.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"438-442"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Measurement Methods for Stone Volume Estimation: An <i>In Vitro</i> Study.","authors":"Felipe Pauchard, Frederic Panthier, Catalina Espinoza, Nataly Vejar, Eugenio Ventimiglia, Olivier Traxer","doi":"10.1089/end.2024.0524","DOIUrl":"10.1089/end.2024.0524","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Urolithiasis guidelines still rely on the maximum stone diameter to propose treatment strategy, although this measure is known to have many pitfalls. Stone volume (SV) could represent a more accurate measurement, helping to plan the treatment or follow-up. Various methods to measure SV have been proposed. We aimed to compare different methods to estimate SV. <b><i>Methods:</i></b> Fifteen stones (human and artificial) were assessed. Real SV was measured using the water displacement method. Volume estimation included three diameter-based formulas (Ackerman, 4/3 Pi r³ and r³/2) and two 3D segmentation methods (Horos and Kidney Stone Calculator [KSC]). All measurements were done by a single operator. Spearman correlation test and comparative analyses were conducted between the real and the estimated SV. <b><i>Results:</i></b> Compared with real SVs, Ackerman and r³/2 formulas estimated volume accurately in 2/15 (13%) of stones each. No accurate measurement was reported using the sphere formula. KSC did estimate volume accurately in 4/15 (27%) stones compared with the reference SV; Horos did it in 7/15 (47%) stones. Both segmentation methods presented strong correlation coefficients (<i>r</i> = 0.9642 and 0.9659, <i>p</i> < 0.0001), while formula correlation was moderate (<i>r</i> = 0.7531, <i>p</i> < 0.0001). <b><i>Conclusion:</i></b> Formulas and segmentation methods for SV estimation resulted in divergent outcomes. Segmentation methods (Horos and KSC) presented higher accuracies in SV estimation, compared with real SV. Formulas were the least accurate.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"488-493"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Letter:</i> Miniaturized Percutaneous Nephrolithotomy: Time to Align with Expert Consensus.","authors":"Xin Zhu","doi":"10.1089/end.2025.0218","DOIUrl":"https://doi.org/10.1089/end.2025.0218","url":null,"abstract":"","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Outpatient Totally Tubeless Standard Percutaneous Nephrolithotomy Safe and Efficacious?","authors":"Kavita Gupta, Nir Tomer, Christopher Connors, Susan Gong, Raymond Khargi, Blair Gallante, William M Atallah, Mantu Gupta","doi":"10.1089/end.2024.0441","DOIUrl":"10.1089/end.2024.0441","url":null,"abstract":"<p><p><b><i>Introduction and Objectives:</i></b> Percutaneous nephrolithotomy (PCNL) is the gold standard treatment for large, complex intrarenal stones. Tubeless PCNL (t-PCNL) where no nephrostomy tube is placed and totally tubeless PCNL (tt-PCNL) in selected patients have been well described. There has been no study to our knowledge discharging patients the same day totally tubeless. In this study, we describe our experience with tt-PCNL on a totally outpatient basis-with the patient going home with absolutely no tube, catheter, or stent, evaluating its safety and efficacy vis-à-vis a comparison with outpatient t-PCNL patients discharged with an indwelling stent. <b><i>Methods:</i></b> We prospectively collected data from 130 consecutive patients scheduled for outpatient PCNL from August 2023 to January 2024. Demographics, stone characteristics, and intraoperative data were compared. Outcomes included postoperative (post-op) pain, stone-free rate (SFR), 30-day complications, and ED visits or readmissions. Categorical variables were compared using Chi-square or Fisher's exact tests and continuous variables via Mann-Whitney U tests. <b><i>Results:</i></b> After exclusions, 53 patients underwent tt-PCNL and 50 had t-PCNL. Demographics and stone burden did not differ between groups. No visceral or pleural injuries occurred in either group. Post-op transfusion rates, SFR, 30-day complications, ED visits, and readmissions were also comparable between the two groups. The mean operative (OR) time and incidence of Clavien-Dindo I complications were higher with t-PCNL with stent (80 minutes <i>vs</i> 58 minutes, <i>p</i> < 0.001,16% <i>vs</i> 3.8%, <i>p</i> = 0.048). Post-op pain scores and postanesthesia care unit stay times were similar. <b><i>Conclusions:</i></b> In this first ever comparison of outpatient t-PCNL to tt-PCNL, we found the same-day discharge of tt-PCNL patients to be safe and effective. Stent omission in our patients did not increase the risk of RF, ED visits, complications, or readmissions. A large, multicenter, randomized prospective controlled trial will help to confirm our findings.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"336-342"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and Short-Term Safety of Hydrogel Spacer before Treatment with Magnetic Resonance Imaging-Guided Transurethral Ultrasound Ablation for Prostate Cancer Treatment.","authors":"Emily Bochner, Victoria Schulte, Yair Lotan, Xiaosong Meng, Daniel N Costa","doi":"10.1089/end.2024.0700","DOIUrl":"10.1089/end.2024.0700","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Magnetic resonance imaging (MRI)-guided transurethral ultrasound ablation (TULSA) is a minimally invasive method of ablating prostate cancer (PCa) using ultrasound energy under real-time temperature mapping provided by MRI. Posterior prostate tumors can be challenging to treat with adequate margins because of the proximity of the anterior rectal wall. We report our initial experience with rectal hydrogel spacer (spacer) placement in men undergoing TULSA for PCa treatment. <b><i>Materials and Methods:</i></b> A small cohort of men with spacers placed before TULSA were analyzed. Spacers were recommended in patients with posterior lesions near the rectal wall. Spacers were placed before TULSA with no other significant modifications during treatment day. Anatomical separation from the spacer was evaluated with <i>ad hoc</i> review of pre-/postspacer placement images. <b><i>Results:</i></b> Nine patients underwent TULSA with spacers in place, of which two patients had pre-existing spacers in preparation for radiation before switching to TULSA, and seven had intentional spacer placement because of posterior lesions. Spacers resulted in a median separation between the rectal wall and posterior prostate at the index lesion of 6 mm (interquartile range 3-8). All treatments were completed as planned with no additional artifact introduced because of the spacer. No postoperative complications were attributed to the presence of spacer during TULSA. <b><i>Conclusions:</i></b> We demonstrated that TULSA can be safely performed in patients with both polyethylene glycol-based and hyaluronic acid-based hydrogel rectal spacers. The presence of rectal spacer does not appear to impact thermoablation of targeted lesions and enables wider margins during posterior ablations.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"418-425"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Augmentation Cystoplasty: Outcome of the Anterior and Posterior Approaches.","authors":"Chi-Hang Yee, Mandy H M Tam, Yeuk-Lam Hong, Pui-Tak Lai, Yuk-Him Tam, Eddie S Y Chan, Chi-Kwok Chan, Ka-Lun Lo, Wilson H C Chan, Jeremy Y C Teoh, Peter K F Chiu, Chi-Fai Ng","doi":"10.1089/end.2024.0485","DOIUrl":"10.1089/end.2024.0485","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> To describe the medium-term outcome of robotic augmentation ileocystoplasty by posterior and anterior approaches in the management of contracted low-capacity bladder from cystitis. <b><i>Materials and Methods:</i></b> Data on consecutive cases of robotic augmentation ileocystoplasty between 2011 and 2021 were prospectively collected and reviewed in our center. Retzius-sparing posterior approach was performed by anastomosis of an M-configuration small bowel plate to the posteriorly located U-shaped cystostomy. Conventional anterior augmentation ileocystoplasty was performed by anastomosis of an S-configuration small bowel plate to the anterior cystostomy. The procedure was as per conventional robotic pelvic surgery setting with the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA). Perioperative data and postoperative complications were assessed. Preoperative and postoperative functional outcomes were compared. <b><i>Results:</i></b> Six patients underwent posterior augmentation cystoplasty and 20 patients underwent anterior augmentation cystoplasty with a mean follow-up of 51 ± 26 months. Mean operative time was 274 ± 113 minutes and 267 ± 102 minutes, respectively (<i>p</i> = 0.889), and mean hospital stay was 9.0 ± 9.6 days and 8.3 ± 6.1 days, respectively (<i>p</i> = 0.831). Additional procedures include eight ureteral reimplantations and one ileal interposition. Mean functional bladder capacity (FBC) at 2 years of the two approaches were similar, which were 350.2 ± 126.3 mL (posterior approach) and 310.2 ± 151.4 mL (anterior approach) (<i>p</i> = 0.5936). Overall, FBC before the operation and at 24 months was 68.9 ± 48.2 mL and 318.5 ± 144.8 mL (<i>p</i> = <0.0001), respectively. Analgesic requirement was decreased after the operation (preoperative 19 patients, postoperative 4 patients; <i>p</i> < 0.0001). <b><i>Conclusions:</i></b> Posterior approach of robotic augmentation ileocystoplasty provided an alternate option to expand the bladder capacity for patients with a small contracted bladder. It could provide a similar symptom relief and functional improvement as the anterior approach. The clinical trial number is CRE-2011.454.</p>","PeriodicalId":15723,"journal":{"name":"Journal of endourology","volume":" ","pages":"356-363"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}