Journal of Hepato‐Biliary‐Pancreatic Sciences最新文献

{"title":"Artificial Intelligence-Enhanced Navigation for Early Detection of Inferior Vena Cava and Root of the Major Hepatic Veins During Robotic Hepatectomy.","authors":"Yutaka Nakano, Yosuke Uematsu, Yuta Abe, Masashi Takeuchi, Minoru Kitago, Yasushi Hasegawa, Shutaro Hori, Masayuki Tanaka, Hirofumi Kawakubo, Yuko Kitagawa","doi":"10.1002/jhbp.12195","DOIUrl":"https://doi.org/10.1002/jhbp.12195","url":null,"abstract":"","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymph Node Metastasis Around the Common Hepatic Artery Is Associated With Dismal Prognosis in Patients Undergoing Resection of Extrahepatic Cholangiocarcinoma.","authors":"Sho Kiritani, Yoshikuni Kawaguchi, Yusuke Kazami, Kyoji Ito, Yujiro Nishioka, Yuichiro Mihara, Akihiko Ichida, Takeshi Takamoto, Nobuhisa Akamatsu, Kiyoshi Hasegawa","doi":"10.1002/jhbp.12194","DOIUrl":"https://doi.org/10.1002/jhbp.12194","url":null,"abstract":"<p><strong>Background: </strong>Lymph node (LN) metastasis in extrahepatic cholangiocarcinoma (eCCA) is associated with poor prognosis, but the impact of specific metastatic sites is unclear. This study investigated the clinical significance of LN metastasis around the common hepatic artery (N [CHA]) in eCCA.</p><p><strong>Methods: </strong>A total of 291 patients who underwent curative resection for eCCA between 2002 and 2022 were retrospectively reviewed. Patients were classified as N1 (CHA), N1 (other, regional LN metastasis without CHA), or N0. Clinical characteristics and long-term outcomes were compared. The short-to-long axis ratio (SLR) of CHA nodes on preoperative CT was evaluated for diagnostic value.</p><p><strong>Results: </strong>Of 291 patients, 164 had perihilar and 127 had distal cholangiocarcinoma. The N1 (CHA), N1 (other), and N0 groups included 33, 103, and 155 patients, respectively. Five-year cancer-specific survival (CSS) rates were 6.9% (N1 [CHA]), 24.7% (N1 [other]), and 60.3% (N0). N1 (CHA) and N1 (other) had CSS hazard ratios of 3.34 and 1.86, respectively (p < 0.01). The area under the receiver operating characteristics curve for SLR in predicting N1 (CHA) was 0.779.</p><p><strong>Conclusions: </strong>N1 (CHA) is a strong negative prognostic factor in eCCA. CHA node status may serve as a useful imaging-based marker of biological resectability.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Usefulness of the Arantius Ligament Hanging Maneuver in Laparoscopic Caudate Lobectomy for the Tumor in the Paracaval Portion.","authors":"Yukihiro Okuda, Toyonari Kubota, Yuta Nishikawa, Masazumi Sakaguchi, Nobuyuki Tamaki, Tomohiko Mori, Kazuhiro Kami, Koichi Matsuo, Koichiro Hata","doi":"10.1002/jhbp.12190","DOIUrl":"https://doi.org/10.1002/jhbp.12190","url":null,"abstract":"","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison Between Cox Proportional Hazards and Machine Learning Models for the Prognostication of Recurrence and Survival Following Liver Resection for Hepatocellular Carcinoma.","authors":"Hwee-Leong Tan, Claudia Y T Liauw, Tse-Lert Chua, Amanda Y R Lam, Cliburn Chan, Ye-Xin Koh, Jin-Yao Teo, Peng-Chung Cheow, Alexander Y F Chung, Brian K P Goh","doi":"10.1002/jhbp.12186","DOIUrl":"https://doi.org/10.1002/jhbp.12186","url":null,"abstract":"<p><strong>Background: </strong>A robust prognostication model after liver resection for hepatocellular carcinoma (HCC) can guide clinical management. We aimed to develop a prognostication model for HCC recurrence and survival following liver resection, comparing between Cox proportional hazards (CPH) and supervised machine learning models.</p><p><strong>Methods: </strong>We studied all patients who underwent liver resection for HCC between January 1, 2000 and October 31, 2022 at our institution. We aimed to predict recurrence-free survival following resection and identify risk categories for HCC recurrence. The CPH model and two supervised machine learning models (random survival forest [RSF] and extreme gradient boosting [XGB]) were used. Model performance was assessed with C-index, time-dependent area under curve (tdAUC) and Brier score.</p><p><strong>Results: </strong>We studied 1290 patients, with 737 (57.1%) experiencing an event (HCC recurrence or death) over a median follow-up duration of 19.2 months. The CPH model had the overall best performance (C-index: 0.663, tdAUC at 6 months: 0.752; 1 year: 0.740; 2 years: 0.722; 5 years: 0.624). Using this model, patients stratified based on risk score could be discriminated between low, intermediate, and high-risk groups (p < 0.001).</p><p><strong>Conclusion: </strong>A CPH-derived prognostication model was effective for predicting and risk stratifying recurrence and survival following liver resection for HCC.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observership to Japan: What I Experienced in Japan and What I Will Practice in My Country.","authors":"Luisa Carmela G Bragais","doi":"10.1002/jhbp.12188","DOIUrl":"https://doi.org/10.1002/jhbp.12188","url":null,"abstract":"","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of IKOMAP Formulas for Determining Appropriate Liver Transection Line in Ultrasound-Guided Minimally Invasive Partial Hepatectomy Considering Liver Inclination.","authors":"Yusuke Yamamoto, Ryo Morimura, Taisuke Imamura, Hisashi Ikoma, Hiroki Shimizu, Tomohiro Arita, Hirotaka Konishi, Takeshi Kubota, Hitoshi Fujiwara, Atsushi Shiozaki","doi":"10.1002/jhbp.12189","DOIUrl":"https://doi.org/10.1002/jhbp.12189","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound-guided minimally invasive liver resection on inclined surfaces presents challenges in accurately setting transection lines.</p><p><strong>Methods: </strong>This study aimed to propose IKOMAP formulas to calculate the distance (Y) from the point directly above the tumor (Point C) to the optimal marking point (Point A) on inclined surfaces. The goal was to reliably reach Point D, which represents the shortest distance from the tumor while maintaining assigned surgical margins on the transection line. The formula was derived using five parameters: the probe incidence angle (a), hepatic resection angle (b), tumor radius (U), tumor depth (V), and resection margin distance (Z). The deepest point on the assumed straight transection line was defined as point B.</p><p><strong>Results: </strong>From triangle ABC, Y = BC × tan(90° - b + a), and from triangle BDE, BC = (U + Z)/sin(90° - b + a) + U + V. Substituting these values yields the final formula: Y = {(U + Z)/sin(b - a) + (U + V)/tan(b - a)}.</p><p><strong>Conclusions: </strong>IKOMAP formulas enable the precise calculation of the optimal marking point on inclined surfaces, ensuring surgical margin accuracy based on the preset and assigned parameters.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients With Pancreatic Cancer With Synchronous Liver Oligometastasis Show a Significant Long-Term Survival Benefit From Resection Under Specific Conditions: A Multicenter National Cohort Study","authors":"Kohei Nakata,&nbsp;Yoshihiro Miyasaka,&nbsp;Takeaki Ishizawa,&nbsp;Masayuki Ohtsuka,&nbsp;Masamichi Mizuma,&nbsp;Sohei Satoi,&nbsp;Masaaki Hidaka,&nbsp;Shuji Suzuki,&nbsp;Hiroshi Kurahara,&nbsp;Chie Kitami,&nbsp;Satoshi Hirano,&nbsp;Dongha Lee,&nbsp;Saiho Ko,&nbsp;Munenori Tahara,&nbsp;Isaku Yoshioka,&nbsp;Kenjiro Date,&nbsp;Kazuyuki Nagai,&nbsp;Goro Honda,&nbsp;Shugo Mizuno,&nbsp;Kenichi Hakamada,&nbsp;Yasuro Futagawa,&nbsp;Shigeru Marubashi,&nbsp;Hiroshi Yoshida,&nbsp;Akihiko Horiguchi,&nbsp;Yasuo Hosouchi,&nbsp;Masafumi Imamura,&nbsp;Naoto Gotohda,&nbsp;Hiroaki Nagano,&nbsp;Masaji Tani,&nbsp;Takeshi Sudo,&nbsp;Teijiro Hirashita,&nbsp;Junichi Arita,&nbsp;Katsutoshi Murase,&nbsp;Ken Fukumitsu,&nbsp;Toshiki Rikiyama,&nbsp;Teruyuki Usuba,&nbsp;Toshiya Abe,&nbsp;Masafumi Nakamura,&nbsp;Itaru Endo","doi":"10.1002/jhbp.12181","DOIUrl":"10.1002/jhbp.12181","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In this study, we investigated the criteria that predict the long-term survival benefits after surgical resection in patients with pancreatic cancer accompanied by liver oligometastasis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In total, 60 patients from 34 high-volume Japanese centers who underwent surgical resection for liver oligometastasis between 2005 and 2020 were included. Univariate and multivariate methods of survival analyses were performed. All patients were followed up for at least 36 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall survival (OS) was significantly longer in the preoperative chemotherapy group than in the up-front surgery group (37.4 vs. 20.4 months, <i>p</i> = 0.001). In the operation with preoperative chemotherapy group, a complete response was observed in eight patients (28.6%). The 1-, 3-, and 5-year OS rates were 92.9%, 50.0%, and 35.7%, respectively. The multivariate analysis showed that low CA19-9 (&lt; 100 U/mL; HR: 0.25; 95% CI: 0.06–0.96; <i>p</i> = 0.043), low CEA (&lt; 5 U/mL; HR: 0.14; 95% CI: 0.04–0.48; <i>p</i> = 0.002), and resectable (R) or borderline resectable pancreatic cancer invading the portal vein (BR-PV) status (HR: 0.19; 95% CI: 0.07–0.51; <i>p</i> &lt; 0.001) were positive prognostic factors. The median OS of the patients who met all three criteria was 106.6 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Preoperative chemotherapy is essential for the treatment of liver oligometastases. Despite the high recurrence rates, patients who met the specific criteria have a favorable prognosis with liver resection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 8","pages":"611-619"},"PeriodicalIF":2.8,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhbp.12181","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Impact of Pancreatic Body/Tail Cancer Involving the Portal Vein: A Project Study of the Japanese Society of Hepato-Biliary-Pancreatic Surgery","authors":"Yusuke Yamamoto,&nbsp;Teiichi Sugiura,&nbsp;Ryota Higuchi,&nbsp;Satoshi Hirano,&nbsp;Masayuki Sho,&nbsp;Yasuhiro Shimizu,&nbsp;Masayuki Ohtsuka,&nbsp;Manabu Kawai,&nbsp;Kenichiro Uemura,&nbsp;Takeshi Gocho,&nbsp;Hidehiro Tajima,&nbsp;Koji Amaya,&nbsp;Hiroyuki Ishizu,&nbsp;Minoru Tanabe,&nbsp;Katsutoshi Murase,&nbsp;Atsushi Nanashima,&nbsp;Takashi Aono,&nbsp;Toshiki Rikiyama,&nbsp;Shigeru Marubashi,&nbsp;Makoto Murakami,&nbsp;Chie Kitami,&nbsp;Isaku Yoshioka,&nbsp;Masaji Tani,&nbsp;Yoshihiro Sakamoto,&nbsp;Tomonari Ishimine,&nbsp;Hidetoshi Eguchi,&nbsp;Teruyuki Usuba,&nbsp;Mitsuhisa Takatsuki,&nbsp;Hideki Aoki,&nbsp;Makoto Yoshida,&nbsp;Kazuaki Nakanishi,&nbsp;Eigo Otsuji,&nbsp;Katsuhiko Uesaka,&nbsp;Masafumi Nakamura,&nbsp;Itaru Endo","doi":"10.1002/jhbp.12177","DOIUrl":"10.1002/jhbp.12177","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although portal vein (PV) contact ≤ 180° in pancreatic body/tail ductal adenocarcinoma (PbtCa) is a criterion for resectable, adequate evidence has not been established yet.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study analyzed 1693 patients with PbtCa who underwent distal pancreatectomy across 31 institutions in Japan. Clinicopathological factors, survival, and recurrence pattern were compared among non-PV contact, PV contact, and celiac axis (CeA) contact groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall survival (MST: 28.3 months) and the positive surgical margin rate (23%) in the PV contact (<i>n</i> = 168) were worse than those of non-PV contact (<i>n</i> = 1353, 47.9 months [<i>p</i> &lt; 0.001], 13% [<i>p</i> = 0.001]), and were comparable with CeA contact (<i>n</i> = 172, 26.4 months [<i>p</i> = 0.136], 26% [<i>p</i> = 0.447]). Incidence of local recurrence (26%) and peritoneal recurrence (20%) in the PV contact were comparable to those in the CeA contact (21%, <i>p</i> = 0.309, and 19%, <i>p</i> = 0.915). Cox proportional hazards analysis revealed PV contact (hazard ratio, 1.295; <i>p</i> = 0.003) as independent prognostic factors for overall survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PbtCa with PV contact should be considered borderline resectable because of a high positive surgical margin rate and poor survival, similar to those in PbtCa with CeA contact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>This study was registered in the UMIN Clinical Trial Registry (UMIN-CTR: UMIN000041642)</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 9","pages":"656-666"},"PeriodicalIF":2.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Pancreaticobiliary Maljunction and High Confluence of the Pancreaticobiliary Ducts: True Incidence of Gallbladder Cancer","authors":"Shintaro Shirai,&nbsp;Kenitiro Kaneko,&nbsp;Shoko Kato,&nbsp;Remi Kondo,&nbsp;Takaaki Osawa,&nbsp;Yasuyuki Fukami,&nbsp;Tsuyoshi Sano","doi":"10.1002/jhbp.12187","DOIUrl":"10.1002/jhbp.12187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although pancreaticobiliary maljunction (PBM) is associated with a high incidence of biliary cancer, it often goes undiagnosed. This means that the true prevalence of PBM and the incidence of biliary cancer are unknown. High confluence of the pancreaticobiliary ducts (HCPBD) may be an intermediate PBM variant, though reports are scarce. In this study, we aimed to determine the true prevalence of PBM and HCPBD and the actual incidence of biliary cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed data from adults who underwent cholecystectomy for benign gallbladder disease and compared them to those with gallbladder and bile duct cancers. The common channel (CC) and narrow distal segment (NDS) were measured using magnetic resonance cholangiopancreatography to diagnose PBM and HCPBD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PBM and HCPBD were identified in 0.44% and 0.88% of 2046 benign cholecystectomies, 16% and 4.2% of gallbladder cancers, and 1.3% and 3.8% of bile duct cancers, respectively (<i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The overall prevalence was 0.44%. Combined with national data, the gallbladder cancer incidence in PBM was estimated to be 2.4% over one decade, which is 38-fold higher than that in the general population. Approximately 1% of the population have HCPBD, which may be a risk factor for biliary cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":"32 9","pages":"649-655"},"PeriodicalIF":2.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhbp.12187","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of a Novel Highly-Rotatable Sphincterotome in Difficult Pancreatobiliary Cannulation During Balloon Endoscopy-Assisted ERCP in Surgically Altered Anatomy.","authors":"Haruka Toyonaga, Tatsuya Nakagawa, Arata Oka, Makoto Masaki, Takuya Takayama, Masahiro Orino, Hironao Matsumoto, Masaaki Shimatani","doi":"10.1002/jhbp.12183","DOIUrl":"https://doi.org/10.1002/jhbp.12183","url":null,"abstract":"","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}