Journal of thoracic disease最新文献

{"title":"Diaphragm excursion difference as an adjunct predictor marker of postoperative pulmonary complications in video-assisted thoracoscopic surgery: a prospective, observational study.","authors":"Ruixue Yuan, Wanling Xiong, Wei Ran, Ning Liang, Jie Tang, Lin Cheng, Xia Yin, Jin Gao","doi":"10.21037/jtd-24-1454","DOIUrl":"10.21037/jtd-24-1454","url":null,"abstract":"<p><strong>Background: </strong>Video-assisted thoracoscopic surgery (VATS) often leads to a significant number of postoperative pulmonary complications (PPCs). The diaphragm is the primary muscle involved in respiration. Diaphragm ultrasound is increasingly used as a noninvasive and portable tool for evaluating diaphragmatic contractile function. The diaphragm excursion difference (DED) provides a valuable predictive measure for clinical outcomes. This prospective, observational study aimed to evaluate the predictive feasibility of DED in relation to PPCs in patients undergoing VATS.</p><p><strong>Methods: </strong>Between March and August 2023, a total of 151 patients undergoing VATS were enrolled in the study. Each patient underwent diaphragm ultrasound examinations both before anesthesia and within one hour after extubation. During these examinations, diaphragm excursion (DE) was recorded during quiet breathing (QB) and deep breathing (DB). The DED and diaphragm excursion fraction (DEF) were calculated at these two time points. The primary outcome measured was the incidence of major pulmonary complications occurring within seven days after surgery, while secondary outcomes included the rate of diaphragm dysfunction, duration of hospitalization, oxygenation status, and pain scores on the first and second postoperative days.</p><p><strong>Results: </strong>Data from 151 patients were analyzed, revealing that 32 patients (21%) developed PPCs. Patients who developed PPCs exhibited a significantly lower postoperative diaphragm excursion during DB (2.27±0.59 <i>vs</i>. 3.31±0.99, P<0.001). They also showed a lower postoperative DED (0.94±0.44 <i>vs</i>. 1.94±0.91, P<0.001) and a higher DEF (0.59±0.13 <i>vs</i>. 0.44±0.12, P<0.001) compared to those without PPCs. In receiver operating characteristic curve analysis, the postoperative DED demonstrated a high sensitivity of 90.6% and a lower specificity of 64.7% for predicting PPCs, with an area under the curve (AUC) of 0.860 and a 95% confidence interval (CI) ranging from 0.788 to 0.926.</p><p><strong>Conclusions: </strong>After VATS, lower postoperative DED may serve as an additional marker. This can help predict the risk of pulmonary complications.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"908-920"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two versus three to four cycles of neoadjuvant immunochemotherapy for stage IB-IIIB non-small cell lung cancer: a real-world study.","authors":"Yuhong Yang, Hang Zhao, Jiacong Liu, Xuhua Huang, Jiayue Ye, Jinming Xu, Wang Lv, Linhai Zhu, Jian Hu","doi":"10.21037/jtd-2024-2256","DOIUrl":"10.21037/jtd-2024-2256","url":null,"abstract":"<p><strong>Background: </strong>No consensus exists regarding the optimal number of cycles of neoadjuvant immunochemotherapy for patients with stage IB-IIIB non-small cell lung cancer (NSCLC). In this study, we compared the efficacy and safety of 2 cycles of neoadjuvant immunochemotherapy in stage IB-IIIB NSCLC with those of 3-4 cycles.</p><p><strong>Methods: </strong>All patients with IB-IIIB NSCLC who received preoperative immunochemotherapy at the Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, from 2019 to 2022 were consecutively included in this retrospective study. Subsequently, 1:1 propensity score matching (PSM) according to baseline characteristics was performed to compare the efficacy and safety between the 2-cycle group and the 3 to 4-cycle group. The follow-up period was required to be at least 1 year after surgery or when the patient decided to abandon treatment.</p><p><strong>Results: </strong>Of the 184 patients with stage IB-IIIB NSCLC included in the analysis, 61 received 2 cycles of neoadjuvant immunochemotherapy while 123 received 3-4 cycles. After a 1:1 PSM, there were no significant differences in baseline clinicopathological characteristics among the108 patients (54 pairs) who received 2 cycles or 3-4 cycles of neoadjuvant immunochemotherapy. The objective response rate (ORR) in the 3 to 4-cycle group was significantly higher than that in the 2-cycle group (83.3% <i>vs.</i> 63.0%; P=0.01). The incidence of grade 3-4 adverse events (AEs) in the 3 to 4-cycle group was similar to that of the 2-cycle group (13.0% <i>vs.</i> 9.3%; P=0.54). About 90.7% (49/54) of patients in the 2-cycle group and 46.3% (25/54) in the 3 to 4-cycle group eventually underwent surgery. The rate of major pathological response (MPR) in the 3 to 4-cycle group and 2-cycle group was 68.0% and 69.4% (P=0.90), respectively. The rate of pathological complete response (pCR) in the 3 to 4-cycle group and 2-cycle group was 36.0% and 38.8% (P=0.82), respectively. The median disease-free survival (DFS) in the 3 to 4-cycle group and 2-cycle group was not reached (P=0.80). The 1-year DFS rate and 2-year DFS rate in the 2-cycle group were 87.8% and 77.6%, respectively, while those in the 3 to 4-cycle group were 80.0% and 76.0%, respectively. The median overall survival (OS) in the 2-cycle group was 42.4 months, and it was not reached in the 3 to 4-cycle group (P=0.42). The 1-year OS rate and 2-year OS rate in the 2-cycle group were 93.9% and 87.8%, respectively, while those in the 3 to 4-cycle group were 88.0% and 80.0%, respectively.</p><p><strong>Conclusions: </strong>Three to four cycles of neoadjuvant immunochemotherapy can result in more tumor regression in IB-IIIB NSCLC. Extending the number of cycles to 3-4 cycles may be feasible and safe in IB-IIIB NSCLC.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"1028-1041"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic utility of endobronchial ultrasound elastography for detecting benign and malignant lymph nodes: a retrospective study.","authors":"Xinyu Zhou, Yaqing Li","doi":"10.21037/jtd-24-1042","DOIUrl":"10.21037/jtd-24-1042","url":null,"abstract":"<p><strong>Background: </strong>The endobronchial ultrasound (EBUS) elastography is a diagnostic tool used for measuring the elasticity of intrathoracic lesions. It is still essential for discussions about how accurate elastography is at identifying benign and malignant mediastinal and hilar lymph nodes. The objective of this study was to investigate the diagnostic utility of EBUS elastography and to determine the variables affecting this procedure.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective study involving patients with suspected lung cancer who underwent EBUS elastography followed by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) at Zhejiang Cancer Hospital between October 2021 and March 2023. The pathological results of EBUS-TBNA, validated through a six-month follow-up, served as the gold standard. Each lymph node had its ultrasonic elastography indices recorded, including the elastography grading score, blue color ratio (BCR), blue color score, and short axis diameter. The diagnostic efficacy of elastography was assessed using the receiver operating characteristic (ROC) curve, which differentiated between benign and malignant lymph nodes. To investigate the factors impacting the elastography indices, multivariate logistic regression was used with multiple serological markers, lymph node location, and pathology.</p><p><strong>Results: </strong>Of the 168 patients, 322 lymph nodes were punctured, with 175 (54.3%) being malignant. The area under the ROC curve (AUC) for the combined index of elastography grading score and short-axis diameter was 0.702 [95% confidence interval (CI): 0.645-0.759]. While the pathology of the lymph nodes was found to influence the BCR, BCR was unable to distinguish between lymph nodes with benign conditions and those with small cell carcinoma.</p><p><strong>Conclusions: </strong>The use of elastography data alone may be inadequate for diagnosing metastatic lymph nodes. However, elastography can provide supplementary diagnostic information during EBUS-TBNA. Invasive EBUS-TBNA remains recommended as it aids in the identification of malignant lymph nodes when used in conjunction with pathological, radiological, and clinical findings.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"614-622"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic patient-reported outcome-based symptom management, a new era in surgical patient management.","authors":"Borja Aguinagalde, Iker Lopez, Jon Ander Lizarbe","doi":"10.21037/jtd-24-1427","DOIUrl":"10.21037/jtd-24-1427","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"531-534"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DeepSeek's impact on thoracic surgeons' work patterns-past, present and future.","authors":"Yutao Chen, Jianfei Shen, Dehua Ma","doi":"10.21037/jtd-2025b-04","DOIUrl":"10.21037/jtd-2025b-04","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"1114-1117"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presepsin, procalcitonin, interleukin-6, and high-sensitivity C-reactive protein for predicting bacterial DNAaemia among patients with sepsis.","authors":"Yan Zhou, Di Ren, Yanhong Chen, Sha Wen, Yiwen Zhang, Fei Song, Mei Yang, Michael Eisenhut, James O'Rourke, Ying Li, Shuiqing Gui","doi":"10.21037/jtd-24-1714","DOIUrl":"10.21037/jtd-24-1714","url":null,"abstract":"<p><strong>Background: </strong>Anti-infective therapy against pathogens is the key to treatment of sepsis. Metagenomic next-generation sequencing (mNGS) has higher sensitivity than blood culture. The aim of this study was to use mNGS to identify DNAaemia of pathogens and to assess the diagnostic accuracy of presepsin (PSEP), procalcitonin (PCT), interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hsCRP) in differentiating between bacterial and nonbacterial infections in patients with sepsis.</p><p><strong>Methods: </strong>This retrospective study included patients with sepsis from November 2020 to September 2022 in the Shenzhen Second People's Hospital. Blood samples were sent for blood culture and mNGS when the patients were diagnosed with sepsis. Plasma PSEP, PCT, and IL-6 levels were measured using whole blood specimens that were collected and analyzed after a diagnosis of sepsis. Area under the receiver operating characteristic curve (AUC) was used to evaluate the accuracy of PSEP, PCT, IL-6, and hsCRP for prediction of bacterial DNAaemia detected by mNGS in patients with sepsis.</p><p><strong>Results: </strong>This study included 230 patients with sepsis. The bacterial DNAaemia rate was 53.0% [Gram-positive DNAaemia (GPD), Gram-negative DNAaemia (GND), and fungi DNAaemia rate was 18.2%, 37.8%, and 10.9%, respectively]. Among GND, <i>Klebsiella</i> was the most common, followed by <i>Escherichia coli</i>; meanwhile, the GPD were mainly <i>Enterococcus</i>, and <i>Aspergillus</i> was identified in 5 patients with sepsis. The PSEP median values were significantly higher in GND than in non-GND [GND: 1,291 pg/mL, interquartile range (IQR) 456-3,502 pg/mL; non-GND: 707 pg/mL, IQR 332-2,417 pg/mL; P=0.035]. There was no significant difference in PSEP values between GPD and non-GPD groups, or between fungi DNAaemia and non-fungi DNAaemia groups. Receiver operating characteristics analysis indicated that the best cutoff values for PSEP, PCT, IL-6, and hsCRP were 869 pg/mL, 1.14 ng/mL, 85.5 pg/mL, and hsCRP 96.2 mg/L, respectively. Logistic regression indicated that PSEP, PCT, IL-6, and hsCRP had significant predictive value for GND in patients with sepsis. The levels of PCT and IL-6 were different between patients with GPD and those with non-GPD. Only PCT levels differed significantly between fungal DNAaemia and nonfungal DNAaemia.</p><p><strong>Conclusions: </strong>Bacterial-DNAaemia was detected in half of the patients with sepsis. PSEP, PCT, IL-6, and hsCRP demonstrated significant predictive value for GND, PCT and IL-6 levels demonstrated significant predictive value for GPD. Meanwhile, only PCT demonstrated significant predictive value for fungal DNAaemia.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"991-1001"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of pleurodesis for lung cancer patients with interstitial lung disease.","authors":"Hirokazu Iso, Akihiko Miyanaga, Yozo Sato, Yukari Shirakura, Kaoruko Shinbu, Tomoyasu Inoue, Atsuhiro Nagano, Kazuhito Misawa, Takehiro Tozuka, Akari Murata, Katsuyuki Higa, Susumu Takeuchi, Masaru Matsumoto, Koichiro Kamio, Kazuo Kasahara, Masahiro Seike","doi":"10.21037/jtd-24-1541","DOIUrl":"10.21037/jtd-24-1541","url":null,"abstract":"<p><strong>Background: </strong>Managing malignant pleural effusion (MPE) with pleurodesis is essential for symptom relief and minimizing the need for repeated thoracentesis. Interstitial lung disease (ILD) is one of the most common complications associated with advanced lung cancer. However, the efficacy and safety of pleurodesis for MPE secondary to lung cancer with ILD remains unclear. This study aimed to evaluate the efficacy and safety of pleurodesis in this population.</p><p><strong>Methods: </strong>This study was a single-center retrospective analysis. The cases of pleurodesis in patients with MPE secondary to lung cancer complicated with ILD at Nippon Medical School Hospital (Tokyo, Japan) between January 2010 and December 2022 were included.</p><p><strong>Results: </strong>Of the 26 lung cancer patients with ILD who underwent pleurodesis were analyzed. Fourteen patients received talc and 12 patients received minocycline, respectively. Talc was used in 10 out of 14 patients with drug-induced ILD and radiation-induced lung injury (RILI). In contrast, minocycline was used in 10 out of 12 patients with idiopathic interstitial pneumonias (IIPs). One month after pleurodesis, the efficacy for pleural adhesions was 64.3% and 50.0% in the talc and minocycline groups. The presence of a partially expanded lung before pleurodesis was a predictive factor for failure [odds ratio: 7.00, 95% confidence interval (CI): 1.20-40.83, P=0.04]. When excluding the patients presenting partially expanded lung, the efficacy rate was 77.8% and 71.4% in the talc and minocycline groups. One case of grade 5 acute respiratory distress syndrome (ARDS) was observed in each group. All cases developing ARDS had been treated with systemic prednisolone against ILDs presenting ground glass opacity and consolidation within 6 months before pleurodesis.</p><p><strong>Conclusions: </strong>Pleurodesis is considered to be one of the treatment options against MPE in patients with ILD. However, two cases of ARDS were observed; thus, clinicians should carefully consider the indication of pleurodesis in the patients who had the recent onset of ILD and were treated with systemic prednisolone.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"687-694"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The APPLE's core question-upfront osimertinib versus the sequential approach for <i>EGFR</i> mutated non-small cell lung cancer.","authors":"Joe Q Wei, Alexander Yuile, Aaron C Tan","doi":"10.21037/jtd-24-1785","DOIUrl":"10.21037/jtd-24-1785","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"524-527"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rise of DeepSeek: technology calls for the \"catfish effect\".","authors":"Jinlin Wu","doi":"10.21037/jtd-2025b-02","DOIUrl":"10.21037/jtd-2025b-02","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"1106-1108"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 infection and pulmonary sarcoidosis: a systematic review and meta-analysis of morbidity, severity and mortality.","authors":"Sue In Choi, Won Jai Jung, Yujin Jeong, Sanghoon Park, Byung-Keun Kim, Sang Yeub Lee, Hyonggin An, Eun Joo Lee","doi":"10.21037/jtd-24-1620","DOIUrl":"10.21037/jtd-24-1620","url":null,"abstract":"<p><strong>Background: </strong>The pandemic coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) influenced millions of lives, not only healthy subjects but also patients with various comorbidities. Of those, interstitial lung disease (ILD) is known to be specifically vulnerable to SARS-CoV-2, sometimes leading to a lethal outcome. Sarcoidosis, one of the ILDs, has been suggested to be more susceptible to COVID-19, but the results of previous studies are in disagreement.</p><p><strong>Methods: </strong>We performed a meta-analysis, attempting to explain the correlation between COVID-19 and sarcoidosis. Electronic databases were searched and selected for analysis under pre-established criteria. Risk ratio (RR) for incidence and odds ratio (OR) for severity, i.e., intensive care unit (ICU) admission and death, were calculated with (95%) confidence interval (CI) using R Statistical Software (version 4.3.1).</p><p><strong>Results: </strong>The RR of COVID-19 incidence on sarcoidosis patients was 5.86 (95% CI: 8.02-11.91). Admission of sarcoidosis patients to the ICU who were infected with SARS-CoV-2 was 2.48 (95% CI: 2.04-3.01). Death of sarcoidosis by COVID-19 was also significantly higher compared with healthy controls (OR =1.95, 95% CI: 1.58-2.41). Both morbidity and mortality due to COVID-19 was significantly higher in the sarcoidosis patients.</p><p><strong>Conclusions: </strong>Sarcoidosis patients are undeniably prone to SARS-CoV-2 infection, with increased severity, morbidity and greater mortality of COVID-19. Vaccination against SARS-CoV-2 for sarcoidosis therefore is beneficial, and may be a compulsory measure. Further studies regarding other factors are needed for a better understanding of the correlation between sarcoidosis and COVID-19.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 2","pages":"744-752"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}