Journal of Investigative Surgery最新文献

{"title":"Development and Preliminary Clinical Evaluation of a Multifunctional Operative Support Arm in Reproductive Laparoscopic Surgery: A Randomized Controlled Study.","authors":"Wenying Mao, Nan Lu","doi":"10.1080/08941939.2026.2668806","DOIUrl":"10.1080/08941939.2026.2668806","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate short-term clinical outcomes, surgeon-reported fatigue, and staff user experience associated with a multifunctional operative support arm in reproductive laparoscopic surgery.</p><p><strong>Design: </strong>Single-center, parallel-group randomized controlled trial.</p><p><strong>Setting: </strong>Tertiary university-affiliated reproductive medicine center.</p><p><strong>Patients: </strong>One hundred women aged 25-40 years undergoing laparoscopic surgery for stage I pelvic endometriosis, hydrosalpinx, or benign ovarian cysts.</p><p><strong>Interventions: </strong>Participants were randomized to surgery using the multifunctional operative support arm or a conventional passive support condition.</p><p><strong>Main outcome measures: </strong>The primary outcome was surgeon-reported fatigue assessed using a 0-10 visual analog scale. Secondary outcomes included staff satisfaction and device-related comfort. Clinical outcomes included operative duration, postoperative infection, length of stay, anti-Müllerian hormone, and antral follicle count.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups. Operative duration, length of stay, postoperative infection, and ovarian reserve indicators did not differ significantly. Mixed-effects analysis of 550 surgeon and 450 nurse evaluations showed lower surgeon fatigue with the device than with conventional support (-0.66, 95% CI -0.78 to -0.54; <i>p</i> < 0.001). Ventilation, temperature control, and comfort scores were also higher, although satisfaction differences were small.</p><p><strong>Conclusion: </strong>The device improved staff-reported ergonomic comfort without adverse short-term clinical effects, but confirmation with objective measures is needed.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2668806"},"PeriodicalIF":3.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150104","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":"Impact of COPD-OSA Overlap Syndrome on Outcomes of Total Hip Arthroplasty: A Propensity Score Analysis of the US National Inpatient Sample.","authors":"Chih-Hui Chen, Chiu-Liang Chen, Yi-An Li, Yu-Cheng Lo","doi":"10.1080/08941939.2026.2652800","DOIUrl":"10.1080/08941939.2026.2652800","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) together is known as overlap syndrome. This study evaluated whether overlap syndrome is associated with worse inpatient outcomes after total hip arthroplasty (THA) compared with COPD alone.</p><p><strong>Methods: </strong>Adult patients (≥18 years) with COPD undergoing elective THA were identified from the National Inpatient Sample database. Propensity-score matching (PSM) balanced baseline differences between patients with COPD-OSA overlap syndrome and those with COPD alone. Regression analyses evaluated in-hospital mortality, length of hospital stay, unfavorable discharge, and postoperative complications.</p><p><strong>Results: </strong>After PSM, 25,926 patients were included. Compared with COPD alone, patients with COPD-OSA overlap had higher rates of unfavorable discharge (36.0% vs 29.7%), respiratory failure (3.6% vs 1.7%), and acute kidney injury (AKI) (6.3% vs 3.8%). In adjusted analyses, COPD-OSA overlap was significantly associated with higher risks of unfavorable discharge (aOR = 1.10, 95% CI: 1.03, 1.18), respiratory failure (aOR = 1.65, 95% CI: 1.37, 1.99), and AKI (aOR = 1.18, 95% CI: 1.03, 1.35). Age-stratified analyses demonstrated increased respiratory risk in patients ≥70 years, whereas younger patients had higher risks of both respiratory failure and AKI.</p><p><strong>Conclusion: </strong>Among patients undergoing elective THA, COPD-OSA overlap syndrome is associated with increased adverse inpatient outcomes.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2652800"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723002","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":"Preoperative Albumin to Alkaline Phosphatase Ratio Correlates to Postoperative Complications After Radical Gastrectomy in Elderly Gastric Cancer Patients.","authors":"Shuangzhen Bao, Xinying Wang, Jiangang Zhao","doi":"10.1080/08941939.2026.2656833","DOIUrl":"10.1080/08941939.2026.2656833","url":null,"abstract":"<p><strong>Background: </strong>The role of albumin-to-alkaline phosphatase ratio (AAPR) in predicting complications in elderly gastric cancer (GC) patients is unclear.</p><p><strong>Methods: </strong>This retrospective study included 358 elderly GC patients (≥60 years of age) who underwent laparoscopic radical gastrectomy between 2020 and 2023. Based on AAPR values, patients were categorized into high (≥0.545) and low (<0.545) AAPR groups based on receiver operating characteristic (ROC) analysis. Clinical characteristics, surgical parameters, and postoperative outcomes were collected. The incidence and severity of complications were compared between groups. Independent risk factors for postoperative complications were identified using multivariate logistic regression.</p><p><strong>Results: </strong>Among the 358 patients, 105 (29.3%) experienced postoperative complications. The low AAPR group had a significantly higher overall complication rate (50.4% vs. 15.7%, <i>p</i> < 0.001) and a greater proportion of severe complications. Multivariate analysis identified low AAPR as an independent predictor of postoperative complications (OR = 0.284, 95% CI: 0.158-0.502, <i>p</i> < 0.001), alongside TNM stage III-IV, ASA grade III, and prolonged operative time. Patients with low AAPR also had significantly longer hospital stays, higher ICU re-admission rates, and increased unplanned 30-day re-admissions (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Preoperative AAPR is a key predictor of postoperative complications in elderly GC patients undergoing laparoscopic gastrectomy.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2656833"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729181","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":"Sentinel Lymph Node Mapping with Indocyanine Green in Endometrial Cancer: Does the Minimally Invasive Platform Matter?","authors":"Giuseppe D'Angelo, Mario Ascione, Mario Palumbo, Ilenia Nobile, Maria Rotonda Conte, Attilio Di Spiezio Sardo, Pierluigi Giampaolino, Luigi Della Corte, Giuseppe Bifulco","doi":"10.1080/08941939.2026.2675729","DOIUrl":"10.1080/08941939.2026.2675729","url":null,"abstract":"<p><strong>Introduction: </strong>To compare indocyanine green (ICG) sentinel lymph node (SLN) mapping between conventional laparoscopy and robot-assisted surgery in apparent early-stage endometrial cancer.</p><p><strong>Methods: </strong>Consecutive patients undergoing minimally invasive surgery with SLN mapping at the University of Naples Federico II between January 2023 and December 2024 were retrospectively analyzed. Intracervical ICG was injected according to a standardized protocol; reinjection and side-specific pelvic lymphadenectomy were performed in case of persistent mapping failure. All SLN specimens underwent ultrastaging. The primary endpoint was SLN detection (bilateral/unilateral/absent; any mapping). Multivariable logistic regression assessed any SLN mapping success, controlling for age, BMI, and diabetes. Adjusted median regression assessed the length of hospital stay using the same covariates.</p><p><strong>Results: </strong>Overall, 169 patients were included (62 laparoscopic, 107 robotic). Any mapping was 90.3% vs 91.6% (<i>p</i> = 1.000) and the mapping pattern did not differ (global <i>p</i> = 0.718). After adjustment for age, BMI, and diabetes, robotic surgery was not independently associated with any SLN mapping success (adjusted OR 1.33, 95% CI 0.43-4.09; <i>p</i> = 0.618). Operative time and blood loss were comparable. LOS was shorter after robotics (30.0 [27.0-34.5] vs 49.0 [44.2-52.0] hours, <i>p</i> < 0.001) and remained significant after adjustment. Postoperative complications were rare (3.2% vs 0.9%, <i>p</i> = 0.555).</p><p><strong>Discussion: </strong>In this retrospective cohort using a standardized ICG protocol with ultrastaging and predefined failure management, no statistically significant difference in SLN mapping performance was observed between laparoscopic and robot-assisted surgery. Robot-assisted surgery was associated with a shorter hospital stay.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2675729"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973055","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":"Meta-Analysis of PENG+LFCN versus FICB on ERAS-Related Outcomes: Postoperative Pain, Motor Function and Recovery in Hip Surgery.","authors":"Jin Li, Xuebo Zhang, Chao Zu, Qing Chen, Lulu Lian, Zhehui Zhu, Shuanghu Hou, He Sun, Yuming Zhang, Jingyuan Li","doi":"10.1080/08941939.2026.2663595","DOIUrl":"10.1080/08941939.2026.2663595","url":null,"abstract":"<p><strong>Objective: </strong>To compare pericapsular nerve group block combined with lateral femoral cutaneous nerve block (PENG+LFCN) with fascia iliaca compartment block (FICB) for postoperative analgesia and functional recovery after hip surgery within Enhanced Recovery After Surgery (ERAS) pathways.</p><p><strong>Methods: </strong>PubMed, Embase, the Cochrane Library, CNKI, Wanfang Data, and CQVIP were searched through January 2026. Comparative studies of PENG+LFCN versus FICB in hip surgery were included. Data were pooled using a random-effects model, with assessment of bias, heterogeneity, and publication bias.</p><p><strong>Results: </strong>Sixteen studies were included. The PENG+LFCN group had significantly lower resting VAS (MD = -0.54; <i>p</i> < 0.00001) and dynamic VAS (MD = -0.98; <i>p</i> < 0.00001) scores. It also showed a lower incidence of postoperative muscle weakness (OR = 0.10; <i>p</i> = 0.0001), better preservation of quadriceps muscle strength, shorter time to first ambulation (MD = -9.22 h; <i>p</i> < 0.0001), and reduced length of stay (MD = -0.75 days; <i>p</i> < 0.00001). Additionally, morphine consumption (MD = -24.22 mg; <i>p</i> = 0.001) and PCA pump activations (MD = -2.46; <i>p</i> < 0.00001) were lower in the PENG+LFCN group.</p><p><strong>Conclusion: </strong>PENG+LFCN may be a more favorable regional analgesic strategy than FICB for hip surgery within ERAS pathways.</p><p><strong>Protocol registration: </strong>This systematic review and meta-analysis was registered at PROSPERO https://www.crd.york.ac.uk/PROSPERO/view/CRD420261295309.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2663595"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868602","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":"Prevention and Management of Postoperative Seroma in Patients with Breast Cancer: A Narrative Review.","authors":"Anastasiia Samusieva, Vitalii Zaichuk, Prokip Gordiichuk","doi":"10.1080/08941939.2026.2719252","DOIUrl":"https://doi.org/10.1080/08941939.2026.2719252","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative seroma remains a frequent complication following breast cancer surgery in both sexes. Despite continuous surgical advancements, its incidence widely ranges from 3% to 85%, significantly affecting the postoperative course, extending hospitalization duration, and diminishing patients' quality of life.</p><p><strong>Aims and objectives: </strong>The primary objective of this narrative review is to evaluate current preventive and therapeutic approaches for postoperative seromas, analyzing the efficacy of surgical techniques, dead space closure, and drainage optimization protocols.</p><p><strong>Methods: </strong>This article provides a comprehensive review of current concepts regarding the complex pathogenesis, multifactorial risk structure, and management approaches for postoperative seromas. The study systematically examines preventive possibilities, evaluating the efficacy of modern surgical instruments, dead space closure techniques, and drainage optimization protocols.</p><p><strong>Results: </strong>Seroma formation results from a combination of localized inflammatory responses and mechanical lymphatic trauma. Preventive measures such as fibrin sealants, early drain removal, and flap fixation demonstrate varying efficacy. Standard management primarily involves repeated aspiration punctures and the active prevention of secondary infections.</p><p><strong>Discussion: </strong>No single method is universally effective; therefore, seroma prevention must be comprehensive and individualized, factoring in the specific surgical strategy, tissue healing characteristics, and the patient's somatic status.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2719252"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794174","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":"A Thought on Interpreting Single-Center Findings in the Oliceridine PONV Trial.","authors":"Jing Zhang, Rongjun Liu","doi":"10.1080/08941939.2026.2720975","DOIUrl":"https://doi.org/10.1080/08941939.2026.2720975","url":null,"abstract":"","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2720975"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808639","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":"Combined Epidural-General Anesthesia is Associated with Increased Postoperative Complications in Patients Receiving Neoadjuvant Chemotherapy Followed by Gastrointestinal Radical Surgery: A Propensity Score Weighting Study.","authors":"Yuqin Long, Xue Li, Chaoyang Tong, Hao Zhang, Ke Peng, Jie Zhang, Changhong Miao","doi":"10.1080/08941939.2025.2611441","DOIUrl":"10.1080/08941939.2025.2611441","url":null,"abstract":"<p><strong>Background: </strong>Combined epidural-general anesthesia (TEA+GA) can enhance postoperative recovery after gastrointestinal surgery. However, in patients receiving preoperative neoadjuvant chemotherapy (NACT), a known risk factor for postoperative complications, it remains unclear whether TEA+GA improves postoperative outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study included 365 patients with NACT followed by radical resection of gastrointestinal cancer at Zhongshan Hospital between January 2020 and December 2022. TEA was initiated before the induction of GA. The primary outcome was the incidence of any postoperative in-hospital complications. Secondary outcomes included intraoperative sufentanil consumption, hypotension, vasopressor use, extubation time, post-anesthesia care unit stay, postoperative hospital length of stay, and intensive care unit admission. Inverse probability of treatment weighting (IPTW) and overlap weighting (OW) were applied to adjust for baseline differences.</p><p><strong>Results: </strong>Of the 365 patients, 152 received TEA+GA, while 213 received GA alone. TEA+GA was associated with a significantly higher rate of postoperative complications (23.7% vs. 15.0%, OR [95% CI]: 1.76 (1.05-2.96), <i>p</i> = 0.036) without subgroup difference. This association remained significant after IPTW (24.1% vs 11.7%, OR [95% CI]: 2.39 [1.24-4.59], <i>p</i> = 0.009) and OW (23.3% vs 10.4%; OR [95% CI]: 2.62 [1.36-5.08], <i>p</i> = 0.004) adjustment. The TEA+GA group had a lower dose of intraoperative sufentanil use and shorter extubation times but showed a higher rate of intraoperative hypotension and increased vasopressor requirements.</p><p><strong>Conclusions: </strong>In patients who underwent NACT followed by gastrointestinal radical surgery, Combined epidural-general anesthesia was associated with an increased incidence of postoperative in-hospital complications.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2611441"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952346","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":"Development and Validation of Nomograms to Predict Overall Survival and Cancer-Specific Survival for Non-Small Cell Lung Cancer with Chest Wall Invasion: A Retrospective Study Based on SEER Database.","authors":"Quzhe Lu, Jie Yang, Hui Yin, Zhengrong You, Chao Liu, Zhi Hu, Zhijian Xu","doi":"10.1080/08941939.2025.2611440","DOIUrl":"10.1080/08941939.2025.2611440","url":null,"abstract":"<p><strong>Background: </strong>Chest wall invasion is a relatively kind of infrequent direct tumor extension in non-small cell lung cancer (NSCLC) with a poor survival outcome. Risk factors that impact overall survival (OS) and cancer-specific survival (CSS) remain unclear. We aimed to explore prognostic factors and construct predictive nomograms to predict both OS and CSS in NSCLC patients with chest wall invasion.</p><p><strong>Methods: </strong>We extracted a total of 2091 patients between 2010 and 2015 from the SEER database. The total patients were divided into the training cohort (1463 patients) and the validation cohort (628 patients). Univariate and multivariate Cox regression analyses were applied to distinguish the independent prognostic factors. Two prognostic nomograms for OS and CSS were established. The concordance index (C-index), receiver operating characteristic curves (ROC), calibration curves, and decision curve analysis (DCA) curves were applied to assess the performance of these two nomograms.</p><p><strong>Results: </strong>After analysis, age, sex, histology, grade, N stage, M stage, surgery, and chemotherapy were identified as independent prognostic factors for OS, meanwhile, age, histology, grade, N stage, M stage, surgery, and chemotherapy for CSS. The C-index for OS in the training and validation cohorts was 0.711 and 0.716, respectively. The C-index for CSS was 0.721 and 0.726, respectively. The ROC curves, calibration curves, DCA curves, and K-M survival curves also exhibited good predictive performance.</p><p><strong>Conclusion: </strong>Two nomograms provide a useful tool to predict both OS and CSS in NSCLC patients with chest wall invasion.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2611440"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145970956","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":"Effect of Ileal Feces Transplantation in Preventing Diversion Colitis and Its Complications Due to Protective Loop Ileostomy in Rectal Cancer Cases.","authors":"Remzi Can Cakir, Nurhan Haluk Belen, Senay Yildirim, Sema Avci, Aydin Dincer, Murat Kazim Kazan, Omer Celik, Arif Aslaner, Kemal Eyvaz, Tugrul Cakir","doi":"10.1080/08941939.2025.2609429","DOIUrl":"10.1080/08941939.2025.2609429","url":null,"abstract":"<p><p>To evaluate the effectiveness of fecal transplantation (FT) in preventing the development of diversion colitis (DC) and reducing its complications in patients who underwent protective loop ileostomy (PLI) following low anterior resection for rectal cancer. The study was prospectively conducted at Tertiary Hospital. Seventeen patients who underwent PLI were assigned to the FT group (FT+), and 19 patients served as the control group (FT-). In the FT+ group, ileal content was delivered to the efferent loop <i>via</i> a catheter placed during surgery. Both groups were evaluated postoperatively through biopsies taken for histopathological examination. In the FT+ group, significant reductions were observed in parameters specific to DC, such as the severity of inflammation, ulceration, goblet cell loss, and crypt abscesses, compared to the FT- group (<i>p</i> < 0.05). The epithelial structure and crypt organization in the FT+ group were closer to normal. FT is an effective and easily applicable method for preventing DC development and reducing the severity of inflammatory changes in patients undergoing PLI. The technique is low-cost, has high patient compliance, and aligns with methods reported in the literature for DC prevention.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"39 1","pages":"2609429"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029907","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}