Journal of neurosurgery最新文献

{"title":"Stereo-electroencephalography pattern and long-term seizure outcome in hypothalamic hamartoma treated by radiofrequency thermocoagulation.","authors":"Chang Liu, Xiu Wang, Zhong Zheng, Wenhan Hu, Xiaoli Yang, Xiaoqiu Shao, Kai Zhang, Shuli Liang","doi":"10.3171/2024.9.JNS241261","DOIUrl":"https://doi.org/10.3171/2024.9.JNS241261","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the long-term outcomes and clinical predictors for seizure freedom in patients with hypothalamic hamartomas (HHs) undergoing radiofrequency thermocoagulation (RFTC) guided by stereo-electroencephalography (SEEG).</p><p><strong>Methods: </strong>The authors enrolled 30 patients with HH-related epilepsy who underwent SEEG-guided RFTC and were followed up for at least 3 years. Seizure outcomes were assessed using the International League Against Epilepsy (ILAE) classification, with classes 1 and 2 defined as seizure freedom. Considering the observed time to relapse, the authors defined postoperative follow-up within 1 year as short-term follow-up. They analyzed lesion features, epileptic characteristics, and SEEG patterns for their relationship with short-term and long-term seizure freedom separately. Long-term complications were also reported.</p><p><strong>Results: </strong>The mean follow-up was 69.2 months (range 36-107 months) since the first RFTC. At the last follow-up, 20 patients (66.7%) achieved seizure freedom (ILAE classes 1 and 2). Regarding different seizure types, freedom was achieved in 81.8% of patients (18/22, after 2 cases relapsed) with gelastic seizures (GS) and in 52.9% patients (9/17, after 4 cases relapsed) with other types of seizures (i.e., nongelastic seizures [NGS]). Seizures characterized by focal low-voltage fast activity recorded by SEEG were more likely to achieve freedom both in the short term (p = 0.021) and the long term (p = 0.022). A history of HH resection might negatively impact a patient's outcome at long-term follow-up, whereas lesion location, volume, seizure types, or the seizure duration showed no significant influence on both short-term and long-term outcomes. Weight gain was the most common long-term complication (26.7%).</p><p><strong>Conclusions: </strong>The SEEG signal can guide HH ablation and serve as an important predictor for favorable seizure outcomes in both the short term and long term, a capability not exhibited by other factors thus far. Patients with a history of HH resection but who still experience NGSs should be considered carefully, as there may be a speculated mechanism of an NGS network re-forming, which can partly explain the outcome difference between patients with GSs and those with NGSs, as well as the progression of secondary epileptogenesis.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-8"},"PeriodicalIF":3.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370764","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":"Editorial. The future of publications for the Journal of Neurosurgery Publishing Group: embracing change.","authors":"James T Rutka","doi":"10.3171/2025.1.JNS243152","DOIUrl":"https://doi.org/10.3171/2025.1.JNS243152","url":null,"abstract":"","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-9"},"PeriodicalIF":3.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370680","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":"Letter to the Editor. Refinement of electrophysiological monitoring during MVD for hemifacial spasm.","authors":"Chongjing Sun, Jin Xu, Wei Zhu","doi":"10.3171/2024.11.JNS242701","DOIUrl":"https://doi.org/10.3171/2024.11.JNS242701","url":null,"abstract":"","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-2"},"PeriodicalIF":3.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370786","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":"Outcomes following stereotactic radiosurgery for high-grade brain arteriovenous malformations: a systematic review and meta-analysis.","authors":"Imran Farhad, Adam Ridzuan-Allen, Saniya Ansari, Marwan Al-Munaer, Benjamin Hall, Basel Taweel, Christina Skourou, David Fitzpatrick, Ahmad M S Ali, Cathal John Hannan, Julian Cahill, Jawad Yousaf, Jason P Sheehan, Mohsen Javadpour","doi":"10.3171/2024.9.JNS241110","DOIUrl":"https://doi.org/10.3171/2024.9.JNS241110","url":null,"abstract":"<p><strong>Objective: </strong>Arteriovenous malformations (AVMs) of the brain are a leading cause of stroke in the young and carry a lifetime risk of intracerebral hemorrhage. The management options for high-grade AVMs are limited. Resection is often associated with high rates of postoperative morbidity, and the results of stereotactic radiosurgery (SRS) for these lesions thus far have been mixed. The aim of this study was to summate the published data on the outcomes of SRS for high-grade AVMs in order to better inform the management of these otherwise untreatable lesions.</p><p><strong>Methods: </strong>A search of four online databases for literature pertaining to the use of SRS to treat high-grade (Spetzler-Martin grades IV-VI) AVMs was performed. Data pertaining to AVM obliteration, incidence of adverse radiation effects (AREs), and posttreatment hemorrhage were extracted, and a meta-analysis of proportions was performed. The study protocol was prospectively registered with PROSPERO.</p><p><strong>Results: </strong>Fifteen studies describing the results of SRS treatment of 562 high-grade AVMs were analyzed. The overall rate of AVM obliteration during a median follow-up period of 50 months was 34.2% (95% CI 27.0%-42.1%, I2 = 65.1%). The pooled rate of hemorrhage following SRS treatment was 12.2% (95% CI 7.8%-18.7%, I2 = 25%). For previously ruptured AVMs, the rate of hemorrhage was 12.7% (95% CI 8.5%-18.7%, I2 = 0%) compared with 5.2% (95% CI 1.0%-23.1%, I2 = 0%) for unruptured AVMs. The overall incidence of AREs was 9.3% (95% CI 5.2%-15.9%, I2 = 0%).</p><p><strong>Conclusions: </strong>SRS for high-grade AVMs is associated with a modest rate of obliteration and is complicated by AREs in 9% of cases. Patients harboring previously ruptured AVMs or lesions with high-risk angioarchitectural features may be more likely to benefit from this treatment.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-13"},"PeriodicalIF":3.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370793","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":"Prognostic factors for long-term outcomes of bilateral pallidal deep brain stimulation in the treatment of Meige syndrome.","authors":"Wentao Zheng, Qingpei Hao, Xi Chen, Yezu Liu, Zihao Zhang, Zhangyu Li, Jianyao Mao, Liwei Zhou, Sifang Chen, Guowei Tan, Ruen Liu","doi":"10.3171/2024.9.JNS241430","DOIUrl":"https://doi.org/10.3171/2024.9.JNS241430","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the effects of bilateral globus pallidus internus (GPi) deep brain stimulation (DBS) on both motor and nonmotor symptoms in patients with Meige syndrome and to further explore prognostic factors for postoperative outcomes based on the long-term follow-up results.</p><p><strong>Methods: </strong>The authors retrospectively reviewed the medical records of a consecutive cohort of patients with refractory Meige syndrome who underwent GPi-DBS at their center from January 2016 to October 2023. Motor function, quality of life, neuropsychological status, and emotional state were assessed using standardized scales at baseline and every 3-6 months thereafter. Univariate and multivariate linear regression analyses were performed to identify independent risk factors affecting long-term motor function after GPi-DBS in patients with steady-state (stable) Meige syndrome.</p><p><strong>Results: </strong>Fifty steady-state patients were ultimately included and assessed, with a mean follow-up duration of 62.9 ± 24.8 months. At the final postoperative evaluation, Burke-Fahn-Marsden Dystonia Rating Scale movement and disability scores showed improvements of 69% (p < 0.001) and 61% (p < 0.001), respectively. A significant improvement from baseline was observed in postoperative scores on the 36-item Short-Form General Health Survey. Throughout continuous neurostimulation, global cognitive function, neuropsychological status, and mood remained stable. Multivariate linear regression analysis revealed that longer disease duration (standardized β-coefficient -0.375, 95% CI -0.033 to -0.011; p < 0.001) and reduced volume of activated tissue within the sensorimotor subregion of the GPi (standardized β-coefficient 0.597, 95% CI 0.002-0.003; p < 0.001) were independently associated with worse long-term motor performance.</p><p><strong>Conclusions: </strong>Bilateral GPi-DBS is an effective, safe, and promising treatment option for intractable Meige syndrome and provides sustained benefits in motor function and quality of life without inducing cognitive or mood-related side effects. Early intervention and accurate electrode placement in the sensorimotor subregion of the GPi are essential for optimizing long-term therapeutic outcomes.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-11"},"PeriodicalIF":3.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070944","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":"Letter to the Editor. Feasibility of causal relationship between obesity and meningioma.","authors":"Xueying Li, Baoyin Shan, Jianguo Xu","doi":"10.3171/2024.10.JNS242582","DOIUrl":"https://doi.org/10.3171/2024.10.JNS242582","url":null,"abstract":"","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-2"},"PeriodicalIF":3.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070939","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":"Seven Cavernomas, Project \"Connectomunculus,\" and the mind.","authors":"Michael T Lawton, Ali Tayebi Meybodi, Michael E Sughrue, Kristen Larson Keil, Peter M Lawrence, Michael D Hickman, Danielle VanBrabant","doi":"10.3171/2024.9.JNS241578","DOIUrl":"https://doi.org/10.3171/2024.9.JNS241578","url":null,"abstract":"","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-19"},"PeriodicalIF":3.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070946","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":"Clinical and radiological presentation of cavernomas according to the Zabramski classification.","authors":"Emilia Saari, Timo Koivisto, Tuomas Rauramaa, Juhana Frösen","doi":"10.3171/2024.8.JNS24246","DOIUrl":"https://doi.org/10.3171/2024.8.JNS24246","url":null,"abstract":"<p><strong>Objective: </strong>Cerebral cavernous malformations (CCMs) are a cluster of abnormal vessels of the brain. CCMs have a low risk for intracerebral hemorrhage and appear increasingly often as incidental findings on MRI. Zabramski classification has been used to describe the radiological features of CCMs. How the Zabramski classification associates with the clinical symptoms at presentation and clinical course of the disease is not well established.</p><p><strong>Methods: </strong>The authors reviewed the medical records of conservatively managed and surgically treated CCM patients over a 20-year period treated in Kuopio and Tampere University Hospitals. Both clinical and radiological data were analyzed. The modified Rankin Scale (mRS) was used to score the symptoms.</p><p><strong>Results: </strong>Altogether, 775 CCM patients were identified. In both cohorts, most patients were asymptomatic (53% in the Kuopio University Hospital [KUH] cohort and 64% in the Tampere University Hospital [TAUH] cohort). Most CCMs were located supratentorially (77%, 661/858), and most patients presented with epileptic seizures. Of the infratentorial CCMs, most were located in the cerebellum (61%, 121/198). The most common symptoms caused by these CCMs were double vision, sensory deficits, and impaired balance. The median mRS score for symptoms in all CCMs was 0, and if only symptomatic CCMs were accounted for, it was 2. Most CCMs were Zabramski type II, and these CCMs were relatively asymptomatic, similar to Zabramski type III CCMs. Zabramski type I CCMs were mostly symptomatic, whereas Zabramski type IV CCMs were completely asymptomatic. Of patients with type I CCMs, approximately 15% developed new symptoms within 1 year, and in the long-term follow-up 26% had new symptoms. In radiological follow-up, 81% of the type I CCMs regressed to type II or III. Of type II or III CCMs, 2.3% changed over time to type I. Age was associated with the Zabramski classification (p < 0.001 in the TAUH cohort and p = 0.034 in the KUH cohort).</p><p><strong>Conclusions: </strong>Most CCMs are asymptomatic, incidental findings, in particular, nearly all Zabramski type IV CCMs. If symptoms are present, they are mainly associated with Zabramski type I CCMs and occasionally with Zabramski type II or III CCMs. Although most Zabramski type I CCMs will regress to type II or III and remain asymptomatic, over long-term follow-up, up to one-quarter develop new symptoms.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-12"},"PeriodicalIF":3.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070930","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":"Impact of smoking on recurrence rates among wide-neck intracranial aneurysms treated with Woven EndoBridge: a multicenter retrospective study.","authors":"Dhrumil Vaishnav, Muhammed Amir Essibayi, Basel Musmar, Nimer Adeeb, Hamza Adel Salim, Assala Aslan, Nicole M Cancelliere, Rachel M McLellan, Oktay Algin, Sherief Ghozy, Sovann V Lay, Adrien Guenego, Leonardo Renieri, Joseph Carnevale, Guillaume Saliou, Panagiotis Mastorakos, Kareem El Naamani, Eimad Shotar, Kevin Premat, Markus Möhlenbruch, Michael Kral, Omer Doron, Charlotte Chung, Mohamed M Salem, Ivan Lylyk, Paul M Foreman, Jay A Vachhani, Hamza Shaikh, Vedran Župančić, Muhammad U Hafeez, Joshua Catapano, Muhammad Waqas, Giyas Ayberk, Yasin Celal Gunes, James D Rabinov, Yifan Ren, Clemens M Schirmer, Mariangela Piano, Anna L Kühn, Caterina Michelozzi, Stéphanie Elens, Robert M Starke, Ameer E Hassan, Mark Ogilvie, Anh Nguyen, Jesse Jones, Waleed Brinjikji, Marie T Nawka, Marios Psychogios, Christian Ulfert, Jose Danilo Bengzon Diestro, Bryan Pukenas, Jan-Karl Burkhardt, Thien Huynh, Juan Carlos Martinez-Gutierrez, Sunil A Sheth, Gary Spiegel, Rabih G Tawk, Boris Lubicz, Pietro Panni, Ajit S Puri, Guglielmo Pero, Erez Nossek, Eytan Raz, Monika Killer-Oberpfalzer, Christoph J Griessenauer, Hamed Asadi, Adnan Siddiqui, Allan L Brook, Neil Haranhalli, Andrew F Ducruet, Felipe C Albuquerque, Robert W Regenhardt, Christopher J Stapleton, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Boddu, Jared Knopman, Mohammad A Aziz-Sultan, Stavropoula I Tjoumakaris, Frédéric Clarençon, Nicola Limbucci, Hugo H Cuellar-Saenz, Pascal M Jabbour, Vitor Mendes Pereira, Aman B Patel, David J Altschul, Adam A Dmytriw","doi":"10.3171/2024.10.JNS241058","DOIUrl":"https://doi.org/10.3171/2024.10.JNS241058","url":null,"abstract":"<p><strong>Objective: </strong>Tobacco smoking is among the factors known to significantly augment the risk of untreated intracranial aneurysm (IA) growth and rupture. Smoking appears to have a variable effect on different endovascular treatment modalities. The impact of smoking on the safety, efficacy, and outcomes of Woven EndoBridge (WEB) device use for wide-neck IAs has not been evaluated. This study aimed to investigate the outcomes of WEB devices by smoking status.</p><p><strong>Methods: </strong>A retrospective multicenter analysis was conducted on the data of patients from 36 sites worldwide treated with the WEB device for intracranial saccular aneurysms. Patients were stratified based on smoking status (current, former, and never smokers). The Student t-test and chi-square test were performed for continuous and categorical variables, respectively. Multivariable logistic regression was used to adjust for confounders.</p><p><strong>Results: </strong>Of 1376 patients with available smoking status, 504 were current smokers, 358 were former smokers, and 514 were never smokers. Upon adjusting for significant confounders, no association was found between smoking and recurrence outcomes (OR 1.39, 95% CI 0.69-2.80; p = 0.36), thromboembolic and hemorrhagic complications, and mortality among IAs treated with the WEB device. There was no statistically significant difference in outcomes between former and never smokers (OR 1.23, 95% CI 0.70-2.18; p = 0.46). The location of aneurysms differed between smoking groups, with former smokers having more anterior circulation aneurysms compared with current and never smokers (99.0% vs 96.9% vs 95.3%; p = 0.01). In terms of clinical symptoms, headache and dizziness were more common in the never smokers compared with current and former smokers (13.9% vs 8.9% vs 7.7%, p = 0.01).</p><p><strong>Conclusions: </strong>This large-scale study suggests no significant correlation between smoking and the recurrence of IAs treated with the WEB device. Biological studies are warranted to better understand the biological impact of smoking on the growth and rupture of treated IAs.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-9"},"PeriodicalIF":3.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070937","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":"The effect of delayed-release antibiotics on the rate of postoperative wound infection for implanted neuromodulatory devices.","authors":"Daniel R Cleary, Mihir J Palan, Nemanja Useinovic, Kim J Burchiel","doi":"10.3171/2024.9.JNS241705","DOIUrl":"https://doi.org/10.3171/2024.9.JNS241705","url":null,"abstract":"<p><strong>Objective: </strong>Implanted neuromodulatory devices are important for the surgical management of pain, epilepsy, movement disorders, and spasticity. These devices are surgically implanted, but many must be periodically explanted and replaced as batteries deplete or devices fail. Replacement surgery risks further infections that require device explantation, incur large financial costs, and reduce patient quality of life. To reduce infection rates, a single surgeon began using vancomycin-impregnated absorbable calcium sulfate delayed-response beads with neuromodulatory device and intrathecal pump primary implantations and replacements. The infection rates when using vancomycin-impregnated beads were compared with previously published rates from the same surgeon.</p><p><strong>Methods: </strong>Patients were identified who underwent primary placement or replacement of an implanted neuromodulatory control device (pumps, generators, and stimulators) with vancomycin-impregnated absorbable calcium sulfate beads between 2019 and 2022. Control data were obtained from patients who underwent surgery prior to the start of using antibiotic beads (2016-2019). Postoperative infection status as well as de-identified demographic and clinical data were extracted from electronic health records. Patients were stratified by use of antibiotic beads, device type, and whether they had an infection within 1 year requiring explantation. Statistical comparisons were made using independent t-tests, Fisher's exact test, and the chi-square test, with α set at 0.05. Effect size was calculated using Cohen's h statistic.</p><p><strong>Results: </strong>A total of 665 surgeries were included for 611 patients who received antibiotic beads with device implantation, compared to 393 surgeries for 379 patients without antibiotic beads. The postoperative wound infection rate was 1.5% (n = 10 patients) versus 3.6% (n = 14 patients) for antibiotic beads versus controls (p = 0.03). When stratified by device type, a significant reduction in infection rate was found only with deep brain stimulation (DBS) generators (3.4% for controls vs 0.2% for beads, p = 0.002), which corresponds to a small to medium effect size (h = 0.27).</p><p><strong>Conclusions: </strong>The use of vancomycin-impregnated absorbable calcium sulfate beads was associated with a reduced rate of postoperative infection rates with implantable devices, and specifically for DBS primary implantation and replacement surgeries.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-10"},"PeriodicalIF":3.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070948","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}