Journal of Orthopaedic Surgery最新文献

{"title":"Serum evaluation of synovial fluid biomarkers in osteoarthritis.","authors":"Lvlin Yang, BinYang Wang, Junjie Wang, Qing Ma, Yinghao Cheng","doi":"10.1177/10225536261498974","DOIUrl":"https://doi.org/10.1177/10225536261498974","url":null,"abstract":"<p><p>ObjectiveIn our previous study, we identified forty-seven differentially expressed proteins in the synovial fluid of osteoarthritis (OA) patients. Given that serum testing is less invasive and remains the first-line screening tool, this study aimed to explore whether these synovial fluid-derived protein candidates could be detected in serum and whether they might serve as translatable biomarkers for OA.MethodsUsing antibody array technology, we analyzed the expression levels of these forty-seven proteins in serum samples from forty OA patients and forty healthy controls.ResultsCompared to healthy individuals, seventeen proteins were significantly differentially expressed in the serum of OA patients, showing consistent trends with their levels in synovial fluid. Among these, LASSO regression analysis identified seven proteins including GITR L, Osteoactivin, BAFF, NT-4, PAI-1, EG-VEGF, and GROa, which had superior diagnostic and predictive properties for OA. These proteins demonstrated high sensitivity and specificity in ROC curve analysis and were significantly correlated with WOMAC and MOAKS scores. Notably, this study is the first to report abnormal levels of these seven proteins in the serum of OA patients.ConclusionOur findings suggest that these seven proteins may serve as novel serum biomarkers for OA, offering potential for improved diagnosis and disease monitoring.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261498974"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194598","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":"Longitudinal changes in postoperative physical activity are associated with psychosocial and functional recovery after hip fracture surgery.","authors":"Kyo Goto, Hideki Kataoka, Mihoko Shibuya, Koichi Nakagawa, Kaoru Morita, Yuki Nishi, Junya Sakamoto, Minoru Okita","doi":"10.1177/10225536261498095","DOIUrl":"10.1177/10225536261498095","url":null,"abstract":"<p><p>BackgroundPhysical activity is markedly reduced after hip fracture surgery, but the clinical relevance of changes in physical activity during postoperative recovery remains unclear. This study investigated whether the rate of change in physical activity during the 1-4 postoperative weeks was independently associated with clinical outcomes at discharge.MethodsThis prospective observational cohort study included 70 patients after hip fracture surgery. Physical activity was measured using an accelerometer, and the slope of weekly mean physical activity over postoperative weeks 1-4 was calculated using simple linear regression. Multivariable linear regression analyses examined associations between the physical activity slope and discharge outcomes, adjusting for age, sex, pre-admission Tokyo Metropolitan Institute of Gerontology Index of Competence, period from surgery to walking initiation, and physical activity at postoperative week 1. Multivariable logistic regression examined decline in walking ability from before admission to discharge.ResultsA greater physical activity slope was independently associated with higher physical activity at discharge (β = 0.27), lower Geriatric Depression Scale scores (β = -0.29), longer 6-minute walk distance (β = 0.33), and higher motor Functional Independence Measure scores (β = 0.29) (all p < 0.05). The physical activity slope was not independently associated with pain intensity, pain catastrophizing, fear of falling, handgrip strength, five-times sit-to-stand, or Timed Up and Go. A greater physical activity slope was also associated with lower odds of decline in walking ability (odds ratio = 0.13, 95% confidence interval = 0.02- 0.89, p = 0.01).ConclusionGreater increases in physical activity during the 1-4 postoperative weeks were independently associated with fewer depressive symptoms, greater exercise tolerance, better activities of daily living, and lower odds of decline in walking ability at discharge. Monitoring longitudinal changes in physical activity may help identify patients with limited recovery and support individualized postoperative rehabilitation.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261498095"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182295","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":"Re: Similar functional outcomes but different remodeling patterns: A minimum 5-years radiographic comparison of short fit-and-fill stem and quadrangular taper stem.","authors":"Haonan Pan, Junfeng Kang, Shi-Xin Xing","doi":"10.1177/10225536261496586","DOIUrl":"https://doi.org/10.1177/10225536261496586","url":null,"abstract":"","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 3","pages":"10225536261496586"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166953","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":"Cannabis use is associated with increased postoperative complications and healthcare utilization following knee arthroscopy: A propensity-matched cohort study.","authors":"Nicholas C Bank, William R Davis, Bradley J Lauck, Christopher Reynolds, Kyle Wallace, R Alexander Creighton, Ganesh V Kamath","doi":"10.1177/10225536261459767","DOIUrl":"10.1177/10225536261459767","url":null,"abstract":"<p><p>BackgroundCannabis use disorder (CUD) is increasingly encountered, but its association with outcomes after knee arthroscopy is unclear.Purpose/HypothesisTo compare postoperative complications, healthcare utilization, and subsequent procedures after primary knee arthroscopy in patients with versus without CUD. We hypothesized that CUD would be associated with higher complication, healthcare utilization, and reoperation rates.MethodsA retrospective multicenter cohort study was performed. Patients undergoing primary knee arthroscopy from 2015 to 2025 were identified. CUD was defined by preoperative diagnoses of cannabis use, abuse, and/or dependence. Exclusion criteria included prior knee surgery, corticosteroid injection within 3 months, or <1 year follow-up. Propensity score matching (1:1) was performed based on demographics, comorbidities, and index procedure(s). Outcomes were 90-day and 1-year rates of surgical and medical complications, including infection and reoperation. Statistical significance was determined using odds ratios (ORs) with 95% confidence intervals (CIs).ResultsAmong 3810 patients with CUD and 213,560 without CUD meeting eligibility criteria, 3805 per group were matched. At 90 days, CUD was associated with increased odds of surgical site infection (OR 2.189; 95% CI 1.071-4.476), wound complications (OR 2.143; 95% CI 1.159-3.964), oral antibiotic prescription (OR 1.468; 95% CI 1.260-1.710), emergency department visits (OR 2.036; 95% CI 1.748-2.372), and hospital admissions (OR 1.651; 95% CI 1.251-2.179). At 1 year, CUD was associated with increased odds of irrigation and debridement (OR 2.175; 95% CI 1.096-4.316), repeat knee arthroscopy (OR 1.285; 95% CI 1.061-1.557), anterior cruciate ligament reconstruction (1.448; 95% CI 1.007-2.084), and meniscectomy (OR 1.555; 95% CI 1.173-2.061).ConclusionPreoperative CUD was associated with increased infection-related complications, unplanned healthcare utilization, and subsequent knee procedures after primary knee arthroscopy.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261459767"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204805","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":"Fibular onlay grafting does not improve clinical or radiological outcomes but increases operative time in tibiotalocalcaneal arthrodesis after prior lateral malleolar fixation: A retrospective comparative study.","authors":"Adem Sahin, Ali Ozyalcin, Anil Agar, Fatih Şentürk, Soner Kocak, Cemil Erturk","doi":"10.1177/10225536261453550","DOIUrl":"10.1177/10225536261453550","url":null,"abstract":"<p><p>PurposeTibiotalocalcaneal (TTC) arthrodesis is a well-established treatment for end-stage ankle arthritis. In patients with prior lateral malleolar fixation, the role of the fibula during arthrodesis remains controversial. While some surgeons prefer fibular preservation as an onlay graft, concerns exist regarding its biological viability after previous surgical interventions. This study aimed to compare clinical and radiological outcomes of fibular excision versus fibular onlay grafting in this specific patient population.MethodsThis retrospective comparative study included patients who underwent TTC arthrodesis using retrograde intramedullary nailing following prior plate-and-screw fixation of the lateral malleolus. Patients were divided into two groups based on surgical technique: fibular excision and fibular preservation as an onlay graft. Clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score and Visual Analog Scale (VAS) for pain. Radiological evaluation included time to union. The primary outcome was postoperative pain assessed using the Visual Analog Scale (VAS), while secondary outcomes included AOFAS score, time to union, operative time, and complications.ResultsA total of 37 patients were included in the final analysis. Baseline characteristics were comparable between the groups. Both techniques resulted in significant improvement in AOFAS scores, with no significant difference between groups (<i>p</i> = 0.825). Postoperative VAS scores were significantly lower in the fibular excision group (<i>p</i> = 0.011), and this difference was supported by a moderate effect size (Cohen's d = 0.45), indicating clinical relevance. Time to union was similar between groups (<i>p</i> = 0.945). Operative time was significantly shorter in the fibular excision group (<i>p</i> < 0.001).ConclusionIn patients with prior lateral malleolar fixation, preserving the fibula as an onlay graft during TTC arthrodesis does not improve union or functional outcomes. Instead, fibular excision is associated with shorter operative time and lower postoperative pain.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261453550"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005535","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":"Intra-articular versus intravenous tranexamic acid in arthroscopic rotator cuff repair: Arthroscopic visual clarity and early postoperative pain in a propensity score-matched study.","authors":"Hyojune Kim, Taeho Oh, Jae Woo Kim, Kyoung Hwan Koh","doi":"10.1177/10225536261468081","DOIUrl":"https://doi.org/10.1177/10225536261468081","url":null,"abstract":"<p><p>PurposeWe aimed to find the distinctions between IV and IA TXA concerning intraoperative visual clarity, postoperative pain management during ARCR.MethodsIn our retrospective cohort, propensity score matching study, we included patients who had a history of rotator cuff tears and at least six months of unsuccessful conservative treatment. The primary outcome, visual clarity during surgery, was evaluated using a five-grade arthroscopic visual scale (AVS) by the operating surgeon. This scale ranged from grade 1, indicating optimal clarity, to grade 5, the least clarity necessitating a switch to open surgery. These assessments were made at 10-minute intervals during the review of the operation's video footage. We also measured postoperative pain levels as secondary outcomes.ResultsIA group included 30 patients and the IV group had 31 patients, with no significant differences in demographics or tear dimensions (p=0.686). The IA and IV groups showed similar irrigation fluid volumes, operation times, and AVS mean scores. IA group had a higher proportion of favorable AVS grades (grades 1-2) compared to IV group (90.0% vs 64.5%, p=0.011). Pain assessment using the Visual Analog Scales (VAS) were lower in the IA group at 24, 48, and 72 hours postoperatively; however, after Bonferroni correction, only the 48-hour difference remained statistically significant (2.7 vs. 4.2, p=0.008).ConclusionsBoth IA and IV TXA may be useful adjuncts in ARCR. In this propensity score-matched cohort, IA TXA was associated with a higher proportion of favorable AVS grades and a modest short-term pain benefit, with statistical significance only at 48 hours after correction for multiple comparisons. Within the limitations of this study, IA TXA may be considered a reasonable alternative, particularly when IV administration is not suitable.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261468081"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412042","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":"Hip revision arthroplasty for severe acetabular defects using custom 3D-printed porous titanium implants: Minimum 2-year follow-up.","authors":"Stanislav Bondarenko, Vasyl Makarov, Olena Pryz, Svitlana Burburska, Valentyna Maltseva","doi":"10.1177/10225536261475369","DOIUrl":"https://doi.org/10.1177/10225536261475369","url":null,"abstract":"<p><p>Purposewas to evaluate the outcomes of custom 3D-printed trabecular titanium implants for acetabular revision total hip arthroplasty (rTHA) in patients with severe acetabular defects (Paprosky type 2 or 3) at minimum 2-year follow up.MethodsA prospective analysis was conducted on 10 patients (8 female) undergoing rTHA with custom 3D-printed titanium implants (3D-TTi), manufactured via laser sintering from Ti6Al4V titanium powder. At 1-year follow-up were measured the angles of inclination and anteversion, the vertical (VCOR) and horizontal (HCOR) center of rotation, and leg length difference (LLD). The Harris hip score (HHS) and Oxford hip score (OHS) was used. The mean follow-up period was of 36.4 (range 24.5-48.2) months, ensuring a maximum follow-up at 4 years.ResultsAll custom 3D-TTi (100%) in patients were positioned within the Lewinnek safe zone:. The COR was restored in all patients after rTHA. HCOR did not differ from the contralateral limb before and after rTHA. The VCOR was different before surgery, and after rTHA it did not differ due to correction by -6.9 mm. In 9 of 10 patients, the correction of the length of the operated limb did not exceed 4 cm, and the mean LLD after rTHA was 6.3 mm. One patient had a dislocation at 3 weeks. At 1-year follow-up, HHS (24.0±11.4 vs. 93.3±1.6) and OHS (8.1±2.6 vs. 41.3±4.1) were significantly improved (p=0.005).ConclusionAt a minimum follow-up of 2 years, none of the 3D-printed trabecular titanium implants required revision, indicating promising early implant stability and function in patients with severe acetabular defects.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261475369"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630687","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":"Wide resection, freezing and implant retention (WFIR) for recurrent bone and soft tissue tumor of the limbs: A case series.","authors":"Chi-Wu Tsai, Wei-Lin Chang, Kuan-Lin Chen, Abigail R Tud, Chao-Ming Chen, Po-Kuei Wu, Wei-Ming Chen","doi":"10.1177/10225536261475963","DOIUrl":"10.1177/10225536261475963","url":null,"abstract":"<p><p>BackgroundRe-excision for recurrent bone and soft tissue tumor involves increased surgical morbidity, often with significant bone and soft tissue loss associated with removal of indwelling implants. The case series demonstrates Wide resection, freezing and implant retention (WFIR) after recurrent bone and soft tissue tumor with previous implant retention.MethodsA retrospective review was conducted on 11 consecutive patients who underwent WFIR for recurrent extremity musculoskeletal tumors between July 2011 and July 2023 at a tertiary referral center in Taipei, Taiwan. All procedures were performed by a single fellowship-trained musculoskeletal oncologic surgeon, with diagnoses confirmed by two independent pathologists. Outcomes included implant survival, local recurrence, infection, wound complications, reoperation, and amputation. Functional outcomes were assessed using the Musculoskeletal Tumor Society (MSTS) score. Additionally, 2-year limb preservation and local recurrence rates were recorded.ResultsEleven patients (mean age 46 years) were included, with the femur being the most common site (n=9). Osteosarcoma was the most frequent diagnosis (n=5). Four patients had prior unplanned excisions. Two patients underwent amputation due to recurrence or infection. Implant retention was achieved in 81.8% of cases, with a local recurrence rate of 9.1%. Implant retention was achieved in the remaining cases without major complications. The mean MSTS score was 95.2%.ConclusionWFIR provides satisfactory implant retention, acceptable oncological control, and favorable functional outcomes in recurrent musculoskeletal tumors, and may reduce morbidity associated with implant removal and extensive tissue loss.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261475963"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723812","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":"Locking plate fixation with coracoclavicular augmentation through cannulated locking screws for unstable distal clavicle fractures: A retrospective case series.","authors":"Ji Woong Kim, Da Jeong Pak, Sung Yoon Jung","doi":"10.1177/10225536261480762","DOIUrl":"https://doi.org/10.1177/10225536261480762","url":null,"abstract":"<p><p>PurposeTo describe a hybrid fixation technique combining a superior distal clavicle locking plate with coracoclavicular (CC) augmentation through cannulated locking screws and to report its radiological and clinical outcomes.MethodsWe retrospectively reviewed a consecutive surgical cohort treated between March 2022 and March 2025. Of 26 patients who underwent the procedure, 4 were excluded because of follow-up of less than 12 months or loss to follow-up, leaving 22 patients for analysis. Two 2.4-mm × 8.5-mm suture anchors were placed at the conoid and trapezoid footprints of the coracoid base, and the sutures were shuttled from the anteroinferior aspect of the clavicle through cannulated locking screw lumens. Outcomes included union, maintenance of reduction, complications, pain, function, and shoulder motion.ResultsAll 22 fractures united at a mean of 12.8 ± 2.5 weeks. The final CC distance ratio was 1.05 ± 0.10. The mean visual analogue scale and QuickDASH scores were 0.6 ± 0.8 and 5.4 ± 2.1, respectively. No coracoid cortical breach, neurovascular injury, implant failure, loss of reduction, or implant removal occurred. Three patients developed transient supraclavicular nerve irritation, which resolved spontaneously.ConclusionThis technique provided reliable union, maintained reduction, and favorable short-term clinical outcomes. It may provide an anatomically oriented option for supplementary CC stabilization, although comparative and biomechanical studies are required.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261480762"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794324","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":"Comparative outcomes of single condylar replacement and total knee arthroplasty in elderly patients with knee osteoarthritis: A controlled clinical study.","authors":"Xiangbing Zeng, Dongteng He","doi":"10.1177/10225536261440616","DOIUrl":"10.1177/10225536261440616","url":null,"abstract":"<p><p>IntroductionOsteoarthritis is a frequent degenerative joint disease, affecting older individuals in particular. When non-surgical treatment options are no longer effective or warranted, surgical options include single condylar replacement (SCR) or total knee arthroplasty (TKA). The optimal surgical approach for elderly patients remains a subject of debate, particularly with respect to short-term recovery and functional outcomes.Materials and Methods82 elderly patients with knee osteoarthritis treated between March 2022 and May 2023 were included in this controlled clinical study. Patients were allocated to the SCR group (n = 41) or TKA group (n = 41) based on clinical indication and patient preference in this non-randomized controlled study. Perioperative parameters, early postoperative inflammatory markers (C-reactive protein and interleukin-6), pain severity (visual analogue scale), knee function (Knee Society Score and Hospital for Special Surgery score), knee mobility, and short-term postoperative complications were evaluated.ResultsSCR was associated with shorter operative time and improved short-term functional outcomes compared with TKA. Early postoperative CRP, IL-6, and VAS scores were lower in the SCR group (p < 0.05). At 6 months, knee mobility and functional scores (KSS, HSS, and AIMS2-SF) were higher in the SCR group (p < 0.05). Differences in complication rates were observed, but should be interpreted cautiously given the short follow-up.ConclusionSCR was associated with improved short-term perioperative recovery and functional outcomes in selected elderly patients. Given the non-randomized design and short follow-up, these findings reflect association rather than superiority. Long-term outcomes and implant survival require confirmation in larger studies with extended follow-up.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"34 2","pages":"10225536261440616"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839181","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}