Journal of Pediatric Urology最新文献

{"title":"Corrigendum to \"Trolox is more successful than allopurinol to reduce degenerative effects of testicular ischemia/reperfusion injury in rats\" [J Pediatr Urol 16 (2020) 465].","authors":"Ugur Seker, Yusuf Nergiz, Ayfer Aktas, Murat Akkus, Mehmet Ferit Ozmen, Emre Uyar, Sevda Soker","doi":"10.1016/j.jpurol.2025.02.008","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.008","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted uretero-ureterostomy.","authors":"M Monti, G Rotondi, M Carlucci, V Fiorenza, Girolamo Mattioli","doi":"10.1016/j.jpurol.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.007","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic uretero-ureterostomy (RUU) is a minimally invasive surgical technique that has gained popularity in recent years, especially for the treatment of duplex systems, as an alternative to ureteral reimplantation.</p><p><strong>Aims of the study: </strong>Focusing on technical considerations and supporting its use, we aim to describe our procedure and results in children.</p><p><strong>Materials and methods: </strong>From November 2018 to December 2023, we collected data on RUU performed by Da Vinci Surgical Robot Xi® in pediatric patients at our center. All patients underwent preoperative ultrasound, functional studies, and cystourethrography. Surgery was indicated for duplex systems with ectopic upper ureter. The orthotopic ureter was stented during preoperative cystoscopy. Three or four trocars were placed along the transverse umbilical line with the patient in 20° Trendelenburg position. The ectopic ureter was isolated below the iliac vessels, transected distally and anastomosed end-to-side to the stented ureter.</p><p><strong>Results: </strong>Eight robotic UU (7 females, 1 males) were performed. Median age and weight were 4.4 years (0,6-12,2) and 15,8 kg (8.5-62) respectively. Median operative time was 129,5 min (108-275) and median console time 66 min (36-175). Four robotic arms were used in 6 patients and 3 in the remaining two. Median distance between trocars was 4.8 cm (4-5). All patients maintained the stent for a median time of 45,5 days (37-67). No intraoperative complications nor conversion were reported. Median hospital stay was 3 days (2-9) and median follow-up 7 months (3.2-29). All patients reported a successful procedure as assessed clinically by resolution of urinary incontinence and ultrasonographically by reduced or resolved urinary dilatation.</p><p><strong>Conclusions: </strong>RUU can be safely performed in pediatric patients, including low-weight ones. It has acceptable operative times, short hospital stays and optimal success rates with no intraoperative complications. RUU is a feasible and safe alternative technique to duplex systems, resolving symptoms and obstruction and avoiding major bladder surgery.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensory processing in children with functional daytime urinary incontinence: A comparative study with autism spectrum disorder.","authors":"Anka J Nieuwhof-Leppink, Eline Helena Maria van de Wetering, André Bernard Rietman, Anita Reinders-van Zwam, Renske Schappin","doi":"10.1016/j.jpurol.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.002","url":null,"abstract":"<p><strong>Background: </strong>Functional daytime urinary incontinence (DUI) is a frequently occurring condition among children. The etiology of DUI is multifactorial, involving genetic, biological, and psychosocial factors. Autism Spectrum Disorder (ASD) seems related to DUI, as children with ASD have a higher risk of developing DUI. Sensory processing issues are prevalent in children with ASD and may contribute to DUI.</p><p><strong>Objective: </strong>This study aims to elucidate the role of sensory processing issues in children with functional daytime urinary incontinence in relation to ASD.</p><p><strong>Methods: </strong>A cross-sectional study was conducted, including parents of children aged 6-12 years old, categorized into four groups: healthy children, children with DUI-only, children with ASD-only, and children with both DUI and ASD. Parents completed the Dutch version of the Short Sensory Profile (SSP-NL) to compare sensory processing between groups.</p><p><strong>Results: </strong>A total of 225 eligible children participated in this study, with 75 otherwise healthy children, 58 children with DUI-only, 49 with ASD-only, and 43 children with DUI and ASD. Children with DUI-only scored significantly lower compared to their healthy peers in the SSP-NL domains of 'Low energy/weak' and the quadrant 'Low registration', indicating sensory under-responsivity and potential limitations in multisensory processing. Children diagnosed with ASD had the most sensory processing issues, independent of their DUI status.</p><p><strong>Conclusion: </strong>Our study suggests that children with DUI may experience more sensory processing issues than their healthy peers. A better understanding of these issues associated with incontinence may improve urotherapy by taking into account children's sensory challenges and by teaching them adaptive behavior.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary to \"Size matters: Total testicular volume predicts sperm count in Tanner V varicocele patients\" and subsequent commentary by Bogaert.","authors":"Dino Papes","doi":"10.1016/j.jpurol.2025.01.036","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.01.036","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaginoplasty in female bladder exstrophy-epispadias complex: Analysis of operative technique, outcomes, and complications.","authors":"Logan Galansky, Andrew T Gabrielson, Joseph Cheaib, Victoria Maxon, Ahmad Haffar, Alex Hirsch, Chad B Crigger, John P Gearhart, Heather N Di Carlo","doi":"10.1016/j.jpurol.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.005","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Bladder exstrophy-epispadias complex (BEEC) is a rare, but serious congenital malformation. After achieving urinary continence and upper tract preservation, genital reconstruction is performed for function and cosmesis. We evaluated our institutional experience with vaginoplasty, including technical considerations and post-operative outcomes.</p><p><strong>Patients and methods: </strong>An IRB-approved database was used to conduct an institutional retrospective review of BEEC patients undergoing vaginoplasty from 2000 to 2024. Patients with XY karyotype, primary vaginoplasty during BEEC closure or at another institution, or no urologic follow-up visits at least six months post-vaginoplasty were excluded. Data on age, reconstructive method, and suture type was collected. Post-operative complications were analyzed with the primary surgical outcome of vaginal stenosis requiring re-operation (VS) and secondary surgical outcomes including urinary tract infection (UTI), surgical site infection (SSI), dehiscence, rectal injury, fistula, and symptomatic pelvic organ prolapse (POP) after vaginoplasty.</p><p><strong>Results: </strong>A total of 240 female BEEC patients were identified with 54 (22.5 %) undergoing vaginoplasty. Median age at vaginoplasty was 15.6 years old. The majority of cases were perineal flap vaginoplasty (88.9 %). Nylon suture was most commonly used (46.3 %), with Vicryl and PDS used in 31.5 % and 22.2 % of cases, respectively. Median follow-up time was 55.2 months. Post-operative complication rates were VS 14.8 %, UTI 3.7 %, SSI 7.4 %, dehiscence 3.7 %, rectal injuries 0 %, fistula 0 %, and symptomatic POP 12.9 % (Table 1). The perioperative complication rate per-patient from post-operative day 1-90 was 20.4 % and the overall lifetime complication rate per-patient was 33.3 %. We found no significant association between reconstructive method and VS (p = 0.2). Among VS events, PDS was used in 50 % of cases (p = 0.041). On univariable analysis, PDS use was significantly associated with VS (OR 4.75, 95 % CI [1.02-23.1], p = 0.042). This finding remained significant when adjusting for reconstructive method on multivariable analysis (OR 5.83, 95 % CI [1.06-32.3], p = 0.043) (Table 2).</p><p><strong>Conclusions: </strong>As children with BEEC mature into adulthood, optimizing surgical outcomes for genital reconstruction is critical. In this large retrospective cohort of BEEC patients undergoing vaginoplasty, we observed that VS was the most common post-operative complication. Symptomatic POP was the second most common post-operative complication, but of these patients, the majority were managed conservatively. Use of PDS during vaginoplasty was significantly associated with VS, suggesting that other suture types may be more advantageous for successful surgical outcomes, but further investigation into the clinical significance of this finding is warranted.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contralateral orchiopexy during pediatric testicular torsion management: What are the national practice patterns?","authors":"Allison Grant, Justin A Lee, Joseph Marte, Belinda Li, Soo Jeong Kim, Christopher B Anderson, Christina P Carpenter","doi":"10.1016/j.jpurol.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.004","url":null,"abstract":"<p><strong>Purpose: </strong>Evidence-based guidelines for contralateral orchiopexy during testicular torsion surgery are lacking. We aim to evaluate the rates of contralateral orchiopexy at time of testicular torsion surgery.</p><p><strong>Material and methods: </strong>Utilizing Kids Inpatient Database, we performed a retrospective cohort study of children <18 years old who had surgery for testicular torsion from 2016 to 2019. Patients were identified using the ICD10 testicular torsion diagnosis code. Primary outcome was the rate of contralateral orchiopexy. Multivariable logistic regression evaluated patient and hospital factors associated with contralateral orchiopexy.</p><p><strong>Results: </strong>We identified 1544 children who had surgery for testicular torsion. Of the 531 patients who underwent ipsilateral orchiopexy, 170 (32 %) did not have concurrent contralateral orchiopexy. Of the 528 patients who underwent orchiectomy, 186 patients (35 %) did not have concurrent contralateral orchiopexy. Overall, 1188/1544 (76.9 %) children underwent bilateral orchiopexy, and 356/1544 (23.1 %) did not undergo contralateral fixation. Multivariable logistic regression analysis showed that increased patient age was associated with decreased likelihood of having a contralateral orchiopexy (OR = 0.96, 95 % CI [0.94-0.98], p < 0.01). Patients having surgery at Western region (OR = 0.50, 95 % CI [0.34-0.73], p < 0.01), private non-profit (OR = 0.60, 95 % CI [0.39-0.92], p < 0.02) and private investor owned (OR = 0.58, 95 % CI [0.35-0.95], p < 0.03) hospitals were less likely to have a contralateral orchiopexy.</p><p><strong>Conclusions: </strong>We observed that roughly a quarter of children having surgery for testicular torsion do not undergo a contralateral orchiopexy. Increasing patient age, surgery in Western region hospital, and private hospital, were associated with decreased likelihood of contralateral orchiopexy.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor regarding: \"Treatment algorithm for the comprehensive management of severe lichen sclerosus in boys based on the pathophysiology of the disease\".","authors":"William Fox, Patrick H McKenna","doi":"10.1016/j.jpurol.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.003","url":null,"abstract":"","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical repair techniques in hypospadias with unfavorable urethral plate: A systematic review and network meta-analysis.","authors":"Mukhlis Akmal Taher, Nicholas Jason Wijaya, Arnold Keane, Putu Angga Risky Raharja, Tariq O Abbas","doi":"10.1016/j.jpurol.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.009","url":null,"abstract":"<p><strong>Introduction: </strong>Hypospadias is one of the most common urogenital malformations in male newborns. Numerous techniques exist for repairing hypospadias, including urethral advancement, tubularized incised plate (TIP), flaps, and graft-tubularized incised plate (GTIP). However, it remains unclear which approach is optimal in cases with an unfavourable urethral plate.</p><p><strong>Objective: </strong>This systematic review and network meta-analysis compares efficacy, complication rates, and patient outcomes of the various surgical procedures used to repair hypospadias with an unfavorable urethral plate.</p><p><strong>Study design: </strong>Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) guidelines were used to conduct a search of PubMed, Cochrane Library, Embase, and Science Direct databases up to May 4, 2024. Studies were rigorously screened and evaluated using Cochrane Risk of Bias 2.0. A random-effects meta-analysis was conducted using R-Studio to combine effect estimates. Included were peer-reviewed publications of randomized controlled trials, prospective cohort studies, and retrospective studies involving male patients diagnosed with hypospadias and \"unfavorable urethral plate\".</p><p><strong>Results and discussion: </strong>A total of 20 studies representing n = 1483 patients were included, screened, and displayed low risk of bias. Four studies were included in the network meta-analysis. Narrow meatus were found to be more prevalent in TIP urethroplasty, while glans dehiscence was less common with flaps. Additionally, TIPs and GTIP displayed lower incidence of diverticulum compared to flaps. The network meta-analysis indicated no significant differences between the three procedures in terms of fistula complication (Flap [OR 0.41; 95 % CI 0.11-1.50] and GTIP [OR 0.52; 95 % CI 0.17-1.57]). GTIP procedures were associated with fewer overall complications (OR 0.37; 95 % CI [0.19-0.75]).</p><p><strong>Conclusion: </strong>Flap and GTIP techniques may display lower complication rates than TIP in cases of unfavorable urethral plate, with modest superiority of the GTIP approach. Flap and GTIP techniques may therefore be optimal for repairing hypospadias in cases of unfavorable urethral plate, although high-quality comparative studies are needed to confirm this finding.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the serum testosterone landscape in boys aged 1-14 years: A population-based study.","authors":"Prabudh Goel, Sonali Kashyap, Prativa Choudhury, Surabhi Gupta, P K Chaturvedi, Vishesh Jain, Devendra Kumar Yadav, Anjan Kumar Dhua, Minu Bajpai, Sandeep Agarwala","doi":"10.1016/j.jpurol.2025.01.034","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.01.034","url":null,"abstract":"<p><p>Testosterone plays a vital role in the development of boys. There is a lack of age-specific reference data for testosterone representing a gap in our abilities to differentiate physiological deviations from pathological conditions such as delayed or precocious puberty, anatomical aberrations such as hypospadias or epispadias, micro-penis or buried-penis and disorders of sex development.</p><p><strong>Objective: </strong>To establish age-specific reference values for serum testosterone in boys aged 1-14 years and generate centile curves to predict testosterone levels by age.</p><p><strong>Materials and methods: </strong>Serum testosterone levels were measured in 1398 boys aged 1-14 years using chemiluminescent microparticle immunoassay. The Generalized Additive Models for Location, Scale, and Shape framework was used to generate centile curves (3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 97th percentiles) for testosterone as a function of age.</p><p><strong>Results: </strong>The study revealed an age-dependent increase in serum testosterone (correlation coefficient:0.6; p ≤ 0.001). Serum testosterone remain low with minimal inter-individual variability until the onset of puberty, which is marked by a steep rise in levels. The inter-percentile range is widened significantly during puberty, indicating high variability in testosterone and co-existence of pre-pubertal boys with those already into puberty.</p><p><strong>Conclusions: </strong>The centile curves and reference values will bridge the literature-gap and serve as a critical tool in clinical practice. The findings also underscore the relevance of personalized assessment in view of individual variability in testosterone levels and the timings of the onset of puberty.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A single center, pilot study to compare the efficacy of an instructional male genital exam video to No prior education in the quality of telemedicine consultations in pediatric urology.","authors":"Abdul Qadar, Ritvik Ganguly, Meredith Rosenzweig, Michael Anderson, Adam Rensing, Bhalaajee Meenakshi-Sundaram, Dominic Frimberger","doi":"10.1016/j.jpurol.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.jpurol.2025.02.001","url":null,"abstract":"<p><strong>Background: </strong>Telemedicine (TM) has already been implemented into healthcare. TM visits are associated with shorter wait times, decreased missed work/school and less financial strain on families. Although high satisfaction has been reported with TM, studies suggest limitations with the physical exam (PE).</p><p><strong>Objective: </strong>If sending an instructional video to parents before their TM appointment teaching them how to perform a genital exam on a male child leads to greater parental comfortability during the visit and an increase in physician perception of PE adequacy in diagnosis.</p><p><strong>Secondary outcomes: </strong>parental PE knowledge, image quality, and physician perspective of caregiver comfortability/preparedness.</p><p><strong>Study design: </strong>This blinded randomized study had two groups each with 9 individual parents with a total of 3 pediatric urology physicians covering all 18 patients each for a 1:1 distribution: Video group: Received a pre-recorded video before appointment teaching parents how to perform PE on a male child. No-Video Group: Did not receive a video and physician instructed parents how to perform PE in real-time during visit. After each TM visit, a satisfaction questionnaire with five possible answers on the Likert scale with 1 being strongly disagree and 5 being strongly agree was administered to parents and the treating physician.</p><p><strong>Results: </strong>Parents who received the educational video prior to their TM visit felt more comfortable performing the PE (p < 0.005) and were able to capture on camera what the physician wanted to see better than the no video group (p < 0.05). Parents who received the educational video felt it was helpful in explaining the PE demonstrating clinical significance, but this was not statistically significant (p = 0.061). Physicians believed the parents who received the education video had a more adequate PE to aid in their diagnosis (p < 00.05), and were more prepared (p < 0.05), and more comfortable during the PE (p < 0.05).</p><p><strong>Discussion: </strong>This single institution study is limited by the small sample of exclusively male pediatric patients, unvalidated subjective survey use, and confounding factors such as internet speed. This study to our knowledge is the first to report upon a method to improve the PE portion of a pediatric urology TM visit.</p><p><strong>Conclusion: </strong>Primary study aims of increasing parental comfortability and physician diagnostic use of PE were met with statistical significance. Secondary aims of parental knowledge about the PE were clinically increased but not statistically. Physicians believed the parents who received the education video were more prepared and comfortable and had better image quality.</p>","PeriodicalId":16747,"journal":{"name":"Journal of Pediatric Urology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}