Journal of Orthopaedic Surgery最新文献

{"title":"Multivariate logistic regression analysis to explore the high-risk factors of deep vein embolism/pulmonary embolism after knee replacement in the elderly.","authors":"Ming Liu, Zhanwen Zhou, Xiaohu Ma, Jinguo Ma, Xiaojin Wu, Binghan Chen, Yanbin Tian","doi":"10.1177/10225536251345202","DOIUrl":"https://doi.org/10.1177/10225536251345202","url":null,"abstract":"<p><p>ObjectiveThis study aims to identify and quantify the high-risk factors for deep vein thrombosis (DVT) and pulmonary embolism (PE) in elderly patients undergoing total knee replacement (TKA).Methods621 patients who underwent TKA were divided into DVT/PE positive group (<i>N</i> = 52) and a negative group (<i>N</i> = 569).ResultStatistically significant differences were observed in the following factors: Caprini score (χ² = 11.385, <i>p</i> < .001), prevalence of chronic obstructive pulmonary disease (COPD) (χ² = 4.502, <i>p</i> = .034), history of heart failure (χ² = 4.326, <i>p</i> = .012), duration of surgery (t = 3.723, <i>p</i> = .002), and early postoperative activity (χ² = 4.014, <i>p</i> = .045). The incidence of DVT/PE was significantly higher in the very high-risk group compared to the high-risk group (9.89% vs 4.84%, χ² = 2.080, <i>p</i> = .032). Multivariate logistic regression analysis identified the Caprini score as an extremely high-risk factor (adjusted OR = 2.87, 95% CI: 1.53-5.39, <i>p</i> = .001), alongside COPD (OR = 1.94, 95% CI: 1.08-3.48, <i>p</i> = .026), history of heart failure (OR = 1.68, 95% CI: 1.01-2.78, <i>p</i> = .048), and surgical duration exceeding 2 hours (OR = 1.35, 95% CI: 1.08-1.68, <i>p</i> = .008) as independent risk factors. The model, developed using multi-factor regression variables, demonstrates strong predictive performance for the occurrence of DVT/PE, with an area under the receiver operating characteristic curve of 0.842 (95%CI: 0.791-0.894).ConclusionIn elderly patients undergoing TKA, even with standard anticoagulation prophylaxis, a high Caprini risk score, COPD, a history of heart failure, and prolonged operative time remain independent risk factors for DVT. Early postoperative mobilization has been shown to have a protective effect.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251345202"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159564","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":"Global research trends in AI-related foot and ankle surgery research: A bibliometric and visualized study.","authors":"Liyi Zhang, Hui Du","doi":"10.1177/10225536251366814","DOIUrl":"https://doi.org/10.1177/10225536251366814","url":null,"abstract":"<p><p>BackgroundArtificial intelligence (AI) has experienced rapid advancements leading to numerous applications in foot and ankle surgery. This study aimed to assess the current status, research trends, and future directions of AI in foot and ankle surgery and to identify emerging hotspots in this field.MethodsRelevant publications on AI in foot and ankle surgery were retrieved from the Web of Science Core Collection database up to December 31, 2024. A bibliometric analysis was conducted, and data visualization was performed using VOSviewer and CiteSpace.ResultsA total of 2047 publications from 1999 to 2024 were included. The number of AI-related studies in foot and ankle surgery has shown a steady annual increase. China (581 publications, H-index = 47) and the United States (489 publications, H-index = 53) are the leading contributors in terms of publication volume and research impact. Keyword co-occurrence analysis indicates that AI research in this field has progressed from foundational algorithms to the study of lower limb kinematics and clinical disease applications. Keyword burst analysis highlights diabetic foot ulcers and computer-aided diagnosis as key research focuses and emerging hotspots for future investigation.ConclusionAI research in foot and ankle surgery has expanded rapidly, with China and the United States at the forefront. The field has evolved from algorithm development to applications in lower limb kinematics and clinical disease management, with diabetic foot ulcers and computer-aided diagnosis identified as major areas of future research.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251366814"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821635","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":"Intraosseous endoscopic-assisted lesion debridement combined with free fibular vascularized transplantation for non-traumatic femoral head necrosis: A comparative study with core decompression.","authors":"Yalong Yang, Zhao Zhang, Yuanyuan Wei, Yang Li, Junliang Liu, Bo Wang, Shouhu Mi, Jintong Liu, Yongqiang Zhang, Yongming Guo, Meng Wu","doi":"10.1177/10225536251348726","DOIUrl":"https://doi.org/10.1177/10225536251348726","url":null,"abstract":"<p><p>BackgroundNon-traumatic femoral head necrosis results from insufficient blood supply to the femoral head, causing hip pain, restricted movement, and eventual collapse. This study compares the efficacy of endoscopy-assisted lesion debridement with free vascularized fibular grafting versus core decompression (CD) to identify a more effective surgical approach for treating osteonecrosis of the femoral head (ONFH).MethodsThis retrospective study included 83 patients with femoral head necrosis who were treated between January 2010 and December 2020. The patients were divided into Group A (intraosseous endoscopic-assisted lesion debridement combined with free fibular grafting, <i>n</i> = 45) and Group B (CD, <i>n</i> = 38) based on their treatment approach. Preoperative general data, intraoperative variables such as operation time and blood loss, and postoperative assessments of Harris Hip Score, Visual Analog Scale (VAS), as well as imaging evaluations through X-ray and MRI for femoral head shape restoration and healing, were conducted at 1 week, 4 weeks, 3 months, 6 months, and 12 months post-surgery.ResultsA follow-up of more than 2 years was conducted for both groups of patients. Preoperative general data, such as age, showed no significant difference between the two groups (<i>p</i> > 0.05). Group A patients had significantly better Harris Hip Scores at 3, 6, and 12 months postoperatively, as well as significantly lower VAS scores at 4 weeks, 3 months, 6 months, and 12 months post-surgery compared to Group B (<i>p</i> < 0.05). In Group A, 3 patients experienced elevated body temperature (maximum 38.6°C), which was considered to be postoperative absorption heat; their temperatures returned to normal within 2-3 days following symptomatic treatment. All surgical incisions in both groups healed well, with no vascular or nerve injuries or other related complications. Additionally, imaging results showed that 4 hips in Group A developed femoral head collapse, compared to 10 hips in Group B. In Group A, 4 patients (4/45, 8.9%) with collapse were in ARCO stage II, while in Group B, 6 patients (6/38, 15.7%) were in ARCO stage I and 4 patients (4/38, 10.5%) were in ARCO stage II. Overall, Group A had a non-collapse rate of 91.1% (41/45) in early-stage femoral head necrosis, which was significantly higher than Group B's 73.7% (28/38) (<i>p</i> < 0.05).ConclusionIntraosseous Endoscopic-assisted lesion debridement combined with free fibular grafting shows superior clinical efficacy compared to CD in the treatment of femoral head necrosis. It effectively improves femoral head morphology, alleviates pain, restores joint function, and has a lower complication rate, making it a promising approach for further clinical application and promotion.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251348726"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208784","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":"Letter to the editor on \"anxiety and depression as risk factors for postoperative complications and pain in lumbar spine surgery\".","authors":"Aqsa Elle, Arooj Ihsan Ullah, Muhammad Hamza Shafiq","doi":"10.1177/10225536251368679","DOIUrl":"10.1177/10225536251368679","url":null,"abstract":"","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251368679"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835357","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":"Critique and considerations on 3D printing in complex pelvic and acetabular fractures.","authors":"Hieu Dinh Nguyen, Tuyen Trung Nguyen, Long Hoang Vo","doi":"10.1177/10225536251369144","DOIUrl":"10.1177/10225536251369144","url":null,"abstract":"","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251369144"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855539","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":"Invited review article: Patient-specific 3D-Printed metal plates for osteotomy and fracture fixation: An illustrative series with workflow and regulatory considerations.","authors":"Rahat Jarayabhand, Chittawee Jiamton, Chedtha Puncreobutr, Boonrat Lohwongwatana, Apivatthakakul Theerachai, Christian Fang","doi":"10.1177/10225536251356724","DOIUrl":"10.1177/10225536251356724","url":null,"abstract":"<p><p>ObjectivesTo report on the process and results of clinical application of 3D printed patient-specific metal plates in orthopaedic trauma.Materials and MethodsA retrospective review was conducted on 11 pilot patients managed with 3D printed Patient-Specific Plates (PSPs) together with 3D printed guides, 3D printed bone models and 3D virtual planning for malunions or acute fractures. There were six clavicles, three forearm shafts, one ankle, and one tibial plateau. The surgeon and the engineering team collaborated on the designing of customized treatment solutions for each case.ResultsFrom obtaining the CT data to manufacture of all 3D printed parts, the required ranged from 3 to 43 days (mean 16 days) and the cost ranged from 1590 to 4100 USD (mean 1360 USD). All 11 patients were followed up from 6 to 24 months. All patients had bony union, good to excellent clinical outcomes documented from clinical scores and with no complications. Challenges with the workflow were collected qualitatively and listed out.ConclusionImplementation of 3D printing technology with customized patient specific implants appears to be beneficial with good outcomes in patients with complex anatomy and malunions. We have described the logistical and regulatory considerations. Further studies should be conducted to demonstrate its cost-effectiveness compared to conventional solutions.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251356724"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731859","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":"Comparison between virtual reality with bench-top simulation in the acquisition of arthroscopic skill: A meta-analysis of randomized controlled trials.","authors":"Chaojie Ju, Hongwen Yu, Songnan Hao, Yong Qin, Kerui Yao, Zhenyong Hao, Yuli Fang","doi":"10.1177/10225536251374369","DOIUrl":"10.1177/10225536251374369","url":null,"abstract":"<p><p>BackgroundTo compare the effectiveness of VR simulation versus bench-top simulation in the acquisition and transfer of arthroscopic skills among surgical trainees.MethodsA systematic search was conducted across databases including PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials (RCTs) comparing VR and bench-top simulation training for arthroscopy. Studies involving surgical novices, such as medical students and residents with minimal prior arthroscopic experience, were included. Data extracted encompassed study design, participant demographics, intervention details, and outcome measures related to skill acquisition and transfer. The primary outcomes assessed were improvements in arthroscopic skills, procedural efficiency, and task accuracy. Secondary outcomes included skill transferability to cadaveric or live surgical settings, skill retention over time, and participant confidence levels. A random-effects model was utilized for meta-analysis, with standardized mean differences (SMD) and 95% confidence intervals (CI) calculated for continuous variables. Heterogeneity was assessed using the I² statistic.ResultsBoth VR and bench-top simulation training resulted in significant improvements in arthroscopic skills compared to baseline measurements. However, the VR simulation group consistently outperformed the bench-top model group in diagnostic arthroscopy crossover tests and in simulated cadaveric setups. Furthermore, the VR group demonstrated superior skill transfer in surprise skill transfer tasks. These findings suggest that while both simulation modalities are effective for arthroscopic skill acquisition, VR simulation may offer advantages in terms of skill transferability and overall performance enhancement.ConclusionsBoth VR and bench-top simulation trainings are effective in enhancing arthroscopic skills among surgical trainees. However, VR simulation demonstrates superior outcomes in skill acquisition and transferability to real-world surgical settings.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251374369"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957540","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":"Arthroscopic additional biceps augmentation and biceps superior capsular reconstruction yield similar clinical and radiological outcomes for patients with medium to large rotator cuff tears.","authors":"Meng Huan Tsai, Poyu Chen, Alexandre Lädermann, Cheng-Pang Yang, You-Hung Cheng, Chen-Heng Hsu, Joe Chih-Hao Chiu","doi":"10.1177/10225536251345183","DOIUrl":"https://doi.org/10.1177/10225536251345183","url":null,"abstract":"<p><p><b>Purpose:</b> To compare the outcomes of additional biceps augmentation (ABA) and biceps superior capsule reconstruction (BSCR) in arthroscopic medium to large rotator cuff tear (RCT) repair. <b>Hypothesis:</b> Both ABA and BSCR yielded comparable clinical and radiological outcomes and retear rates at the 2-year follow-up in patients with medium to large RCTs. <b>Methods:</b> Patients undergoing ABA or BSCR for RCT repairs were included retrospectively between January 2019 and May 2020. The preoperative and postoperative Constant-Murley score (CMS), American Shoulder and Elbow Surgeons (ASES) score, subjective shoulder value (SSV), visual analog scale (VAS), and range of motion (ROM) were recorded, as well as the radiographic evaluation. <b>Results:</b> 67 patients (41 with ABA, 26 with BSCR) were included. There were no significant differences regarding preoperative patient demographics between groups unless forward flexion. In the ABA group, CMS, ASES, SSV, and VAS improved significantly from 33.9 ± 6.0, 37.3 ± 8.7, 24.9 ± 12.3, and 5.1 ± 1.1 to 79.3 ± 8.4, 82.7 ± 8.4, 77.5 ± 10.9, and 2.4 ± 0.6, at 2-year follow-up (all <i>p</i> < .001). In the BSCR group, the CMS, ASES, SSV, and VAS significantly improved from 33.9 ± 5.5, 33.5 ± 11.6, 20.8 ± 9.8, and 5.3 ± 1.5 to 72.8 ± 12.9, 79.6 ± 12.1, 73.1 ± 10.2, and 2.7 ± 0.8, at follow-up (all <i>p</i> < .001). All ROM improved at follow-up in both groups (all <i>p</i> < .001). No significant differences were found between the two groups regarding the postoperative clinical and radiological results. All patients reached minimal clinically important differences for CMS, ASES, SSV, and VAS at the final follow-up. The retear rates in the ABA and BSCR groups were 0% and 7.7%, respectively (<i>p</i> = .001). <b>Conclusions:</b> Both ABA and BSCR provided similar clinical and radiological outcomes in patients with medium to large RCTs. The BSCR group had a higher retear rate than the ABA group. <b>Level of Evidence:</b> Level III, Retrospective comparative therapeutic trial. <b>Clinical Relevance:</b> Both ABA and BSCR provided comparable clinical and radiological outcomes in patients with medium to large RCTs.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251345183"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119910","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":"Ensemble learning guided survival prediction and chemotherapy benefit analysis in high-grade chondrosarcoma: A study based on the surveillance, epidemiology, and end results (SEER) database.","authors":"Xu Zheng, Longqiang Shu, Shanyi Lin, Hanqiang Jin, Xiaoyu Wang, Ting Yuan","doi":"10.1177/10225536251340113","DOIUrl":"https://doi.org/10.1177/10225536251340113","url":null,"abstract":"<p><p><b>Purpose:</b> The chemotherapy benefit for high-grade chondrosarcoma remains controversial. Ensemble learning has better overall performance than single computational approaches for clinical decision. The primary objective was to select prognostic variables and develop optimal ensemble learning algorithms for survival prediction and analyzing chemotherapy benefit in high-grade chondrosarcoma. The secondary objective included identifying specific patient groups with estimated survival benefit for guidance in chemotherapy strategies. <b>Methods:</b> The data of 1931 patients with chondrosarcoma from 2000 to 2019 were obtained from the Surveillance, Epidemiology, and End Results database to conduct the retrospective analysis. Among 468 patients with high-grade chondrosarcoma, cox proportional hazards models and random survival forests were used for feature selection. Ensemble learning and survival support vector machine with different kernel methods were developed and compared for their prognostic performance. <b>Results:</b> Ensemble learning outperformed the single models, with the concordance index reaching 0.764 (based on inverse probability of censoring weights) and the mean area under time-dependent receiver operating characteristic curve of 0.851. According to the ensemble model, overall survival generally improved in younger patients after chemotherapy. Age-stratified analysis revealed differential chemotherapy benefits across various clinical subgroups. Survival benefits were observed in: Age ≤ 10 with dedifferentiated chondrosarcoma, amputation, local surgical treatment, absence of distant metastasis, or grade III tumor; Age ≤ 20 who were male with clear cell chondrosarcoma, non-axial primary sites, or no radiotherapy; Age ≤ 30 who were female with primary site at pelvis/limb, received radiotherapy, extension beyond periosteum, further extension, or distant metastasis; Age≤40 with chondrosarcoma NOS (including mesenchymal, juxtacortical and classical chondrosarcoma); Age ≤ 50 with grade IV tumor or no surgery received. <b>Conclusion:</b> Ensemble learning algorithms demonstrate outstanding overall performance in prognostic assessment of high-grade chondrosarcoma and identification of age-specific factors associated with chemotherapy benefit for tailored chemotherapy strategy.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251340113"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002955","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":"Decreasing cast saw injuries: Developing a novel real-time temperature sensor system for cast saw blades.","authors":"Jenny L Zheng, Leta J Ashebo, J Todd R Lawrence, Sulagna Sarkar, Giangabriel Velez, B David Horn","doi":"10.1177/10225536251345190","DOIUrl":"https://doi.org/10.1177/10225536251345190","url":null,"abstract":"<p><p><b>Introduction:</b> Cast saws may cause burns secondary to generated heat. This study aimed to develop a real-time temperature feedback system to alert users of increasingly unsafe saw blade temperatures. <b>Methods:</b> A sensor device was designed for the Stryker 940 cast saw, measuring temperature at the two blade ends and providing real-time feedback through an LED-light system (green, yellow, red, blinking red) with adjustable temperature ranges. LED ranges were determined using temperature data from four cast technicians. \"Skin\" touches were assessed with conductivity from the blade to copper strips within cast padding. Users were asked to remove standardized casts, completing three test runs with LED indicators off and three with the light on. Time spent within each temperature range and number of \"skin\" touches per run were analyzed. <b>Results:</b> With the LED on, the percentage of time spent in the green zone increased (<i>p</i> < .0001) while percentage of time in the red zone decreased (<i>p</i> < .0001) across all test groups. Average time per run increased with the LED on. Although not statistically significant, the number of \"skin\" touches decreased across all groups with LED on (<i>p</i> = .0630). <b>Conclusions:</b> A temperature-sensitive LED light connection to cast saw blades can potentially decrease user time spent in unsafe temperatures and risk of cast saw burns.</p>","PeriodicalId":16608,"journal":{"name":"Journal of Orthopaedic Surgery","volume":"33 2","pages":"10225536251345190"},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258301","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}