Langenbeck's Archives of Surgery最新文献

{"title":"The usefulness of fluorescence in decision-making strategy during bariatric and metabolic surgery.","authors":"Mateusz Wityk, Michał R Janik, Maciej Bobowicz, Natalia Dowgiałło-Gornowicz","doi":"10.1007/s00423-025-03683-y","DOIUrl":"10.1007/s00423-025-03683-y","url":null,"abstract":"<p><strong>Purpose: </strong>Fluorescence is used in various surgical fields to detect tissue ischemia. However, its use in obesity surgery is still limited. This study aims to investigate whether fluorescence can change surgical decisions during metabolic and bariatric surgery. The primary objective was to determine the proportion of patients with abnormal blood flow assessed by fluorescence and changes in intraoperative strategy. The second outcome measured was the morbidity and mortality within 30 days.</p><p><strong>Methods: </strong>This single-centre, prospective observational study analysed patients who underwent primary metabolic and bariatric surgery. Data was collected from 66 consecutive patients who qualified for primary one anastomosis gastric bypass and Roux-en-Y gastric bypass procedures.</p><p><strong>Results: </strong>In total, improper blood supply was observed in two cases, and surgical strategy was changed in 5.8% of OAGB and 2% of RYGB. No leakage incidents were reported. One patient (1.5%) experienced non-ischemic-related complications. No mortality was observed 30 days after the surgical procedures. No complications related to ICG administration were observed.</p><p><strong>Conclusion: </strong>Despite the low incidence of tissue ischemia during metabolic and bariatric surgery, adding ICG fluorescence may potentially impact intraoperative surgical decisions due to ischemia detection during metabolic and bariatric surgery. However, this field lacks systematic data, and further research with a larger patient group is necessary to establish conclusive evidence.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"103"},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700789","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":"Reflections on the role of diaphragmatic resection techniques in cytoreductive surgery: indications, outcomes, and unresolved questions.","authors":"Juan José Segura-Sampedro, Andrea Craus-Miguel","doi":"10.1007/s00423-025-03646-3","DOIUrl":"10.1007/s00423-025-03646-3","url":null,"abstract":"","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"102"},"PeriodicalIF":2.1,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692691","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":"Performance and safety of Kangduo surgical robot versus da Vinci robotic system for urologic surgeries.","authors":"Yanan Liu, Fengjiao Wang, Xuexin Li","doi":"10.1007/s00423-025-03670-3","DOIUrl":"10.1007/s00423-025-03670-3","url":null,"abstract":"<p><strong>Objective: </strong>Kangduo (KD) surgical robot is a novel robotic system in China, and some animal experiments and single-arm clinical trials have indicated its effectiveness, feasibility, and safety for urologic surgeries. This study intended to compare the performance and safety of the KD surgical robot with the da Vinci (DV) robotic system in patients who received urologic surgeries.</p><p><strong>Methods: </strong>A total of 201 patients who received urologic surgeries were divided into the KD group (N = 60) and the DV group (N = 141) according to the actual surgical methods.</p><p><strong>Results: </strong>The median (range) operation time [180.0 (30.0-540.0) minutes vs. 130.0 (70.0-360.0) minutes] (P < 0.001) and indwelling time of abdominal drainage tube [5.0 (2.0-14.0) days vs. 3.0 (2.0-18.0) days] (P < 0.001) were longer, but the intraoperative blood loss [50.0 (10.0-200.0) mL vs. 50.0 (10.0-400.0) mL] (P < 0.001) was less in the KD group than the DV group. The median values of white blood cells at the 1st (P = 0.032) and 3rd (P = 0.022) day after surgery were decreased in the KD group compared to the DV group. The incidence of infection (11.7% vs. 29.1%) (P = 0.008) and fever (15.0% vs. 30.5%) (P = 0.023) was lower in the KD group compared to the DV group. Postoperative and follow-up parameters, including time of urinary incontinence improvement, administration of hemostatic, pain numeric rating scale score, Barthel's index score, and patient satisfaction, were not different between the two groups (all P > 0.05).</p><p><strong>Conclusion: </strong>The KD surgical robot unveils satisfactory surgical performance compared to the DV robotic system in patients receiving urologic surgeries.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"100"},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657640","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":"Systematic review on the use of artificial intelligence to identify anatomical structures during laparoscopic cholecystectomy: a tool towards the future.","authors":"Diletta Corallino, Andrea Balla, Diego Coletta, Daniela Pacella, Mauro Podda, Annamaria Pronio, Monica Ortenzi, Francesca Ratti, Salvador Morales-Conde, Pierpaolo Sileri, Luca Aldrighetti","doi":"10.1007/s00423-025-03651-6","DOIUrl":"10.1007/s00423-025-03651-6","url":null,"abstract":"<p><strong>Purpose: </strong>Bile duct injury (BDI) during laparoscopic cholecystectomy (LC) is a dreaded complication. Artificial intelligence (AI) has recently been introduced in surgery. This systematic review aims to investigate whether AI can guide surgeons in identifying anatomical structures to facilitate safer dissection during LC.</p><p><strong>Methods: </strong>Following PROSPERO registration CRD-42023478754, a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant systematic search of MEDLINE (via PubMed), EMBASE, and Web of Science databases was conducted.</p><p><strong>Results: </strong>Out of 2304 articles identified, twenty-five were included in the analysis. The mean average precision for biliary structures detection reported in the included studies reaches 98%. The mean intersection over union ranges from 0.5 to 0.7, and the mean Dice/F1 spatial correlation index was greater than 0.7/1. AI system provided a change in the annotations in 27% of the cases, and 70% of these shifts were considered safer changes. The contribution to preventing BDI was reported at 3.65/4.</p><p><strong>Conclusions: </strong>Although studies on the use of AI during LC are few and very heterogeneous, AI has the potential to identify anatomical structures, thereby guiding surgeons towards safer LC procedures.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"101"},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657641","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":"Effect of controlled hyperventilation on post-laparoscopic cholecystectomy shoulder pain: a prospective randomized controlled trial.","authors":"Ji Li, Huatang Zhao, Chen Sheng, Yingchao Liu, Ruijing Zhan","doi":"10.1007/s00423-025-03666-z","DOIUrl":"10.1007/s00423-025-03666-z","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated whether intraoperative controlled hyperventilation could reduce the incidence and severity of post-laparoscopic shoulder pain.</p><p><strong>Methods: </strong>In this prospective, randomized, double-blind controlled trial, 150 patients undergoing elective laparoscopic cholecystectomy were randomly assigned to either controlled hyperventilation (n = 75) or conventional ventilation (n = 75) groups. The hyperventilation group received mechanical ventilation with a tidal volume of 10 mL/kg and respiratory rate adjusted to maintain end-tidal CO₂ between 30 and 35 mmHg, while the control group received conventional ventilation (tidal volume 8 mL/kg, end-tidal CO₂ 35-45 mmHg). The primary outcome was the incidence and severity of shoulder pain during the first 48 postoperative hours. Secondary outcomes included intraoperative parameters, gas exchange values, surgical site pain, and patient satisfaction.</p><p><strong>Results: </strong>The hyperventilation group demonstrated significantly lower shoulder pain incidence (36.0% vs. 60.0%, P = 0.003), shorter pain duration (4.13 ± 6.25 vs. 9.24 ± 7.82 h, P < 0.001), and consistently lower pain intensity scores at all time points up to 48 h postoperatively. The intervention group also showed shorter operation time (50.01 ± 12.04 vs. 80.32 ± 34.23 min, P < 0.001), lower pneumoperitoneum pressure requirements (11.73 ± 1.19 vs. 33.72 ± 19.47 mmHg, P < 0.001), and improved patient satisfaction (73.33% vs. 42.67%, P < 0.001). No significant differences were observed in postoperative complications, time to first flatus, or length of hospital stay.</p><p><strong>Conclusion: </strong>Intraoperative controlled hyperventilation effectively reduces the incidence and severity of shoulder pain following laparoscopic cholecystectomy, while improving surgical conditions and patient satisfaction. This simple intervention provides a safe and cost-effective approach to enhancing postoperative outcomes in laparoscopic surgery.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"99"},"PeriodicalIF":2.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634097","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":"A nutrition-based nomogram for predicting intra-abdominal infection after D2 radical gastrectomy for gastric cancer.","authors":"Xinghao Ma, Xiaoyang Jiang, Hao Guo, Jiajia Wang, Tingting Wang, Xiuming Lu","doi":"10.1007/s00423-025-03660-5","DOIUrl":"10.1007/s00423-025-03660-5","url":null,"abstract":"<p><strong>Background: </strong>This study aims to construct a nutrition-based nomogram for predicting the risk of intra-abdominal infection (IAI) after D2 radical gastrectomy for gastric cancer (GC).</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data of 404 individuals who received D2 radical gastrectomy for GC. Four preoperative nutrition-related indicators, the nutritional risk screening (NRS) 2002 score, albumin (ALB), prognostic nutritional index (PNI), and controlling nutritional status (CONUT) score, were collected and calculated. Multivariate logistic regression analysis was utilized to screen the independent risk factors for IAI following D2 radical gastrectomy for GC. The area under the receiver operating characteristics (ROC) curve (AUROC) was computed. A nomogram was established to forecast postoperative IAI using the independent risk factors.</p><p><strong>Results: </strong>The NRS2002 score, ALB, PNI, CONUT score, fasting blood glucose (FBG), American Society of Anesthesiologists (ASA) score, type of resection, multi-visceral resection, perioperative blood transfusion, and the tumor, node, metastasis (TNM) stage were significantly associated with postoperative IAI. Considering the collinearity between these nutrition-related variables, four multivariate logistic regression analyses were separately performed, and four independent nutrition-based models were constructed. Of these, the best one was the model based on the three indicators of NRS2002 score, FBG, and multi-visceral resection, which had an AUROC of 0.744 (0.657-0.830), with a specificity of 75.6% and a sensitivity of 62.9%. Further, a nomogram was constructed to estimate the probability of IAI following D2 radical gastrectomy. The internal validation was carried out using the bootstrap method with self-help repeated sampling 1000 times, and the concordance index (c-index) was determined at 0.742 (95% CI = 0.739-0.745). The calibration curve revealed that the predictive results of the nomogram were in excellent concordance with the actual observations. The decision curve analysis (DCA) indicates that the nomogram has excellent clinical benefit.</p><p><strong>Conclusion: </strong>The nomogram constructed based on NRS2002 score, FBG, and multi-visceral resection has good predictive capacity for the incidence of IAI following D2 radical gastrectomy and provides a reference value for clinicians to assess the risk of IAI occurrence.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"98"},"PeriodicalIF":2.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11906490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625461","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":"Methodological flaws in study on transurethral holmium laser enucleation.","authors":"Sarah Mikael, Stefan Sauerland","doi":"10.1007/s00423-025-03628-5","DOIUrl":"10.1007/s00423-025-03628-5","url":null,"abstract":"","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"94"},"PeriodicalIF":2.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605611","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":"Evaluation of procalcitonin versus conventional inflammatory biomarkers for clinical severity grading in patients with intra-abdominal infection.","authors":"Cihan Ozen, Deniz Karasoy, Ali Yalcinkaya, Sine Huus Pedersen, Steen Kaare Fagerberg, Peter Hindersson, Peter Derek Christian Leutscher, Kathrine Holte","doi":"10.1007/s00423-025-03636-5","DOIUrl":"10.1007/s00423-025-03636-5","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to evaluate the utility of procalcitonin (PCT) as a biomarker for clinical severity grading of intra-abdominal infections (IAI) in hospital-admitted patients presenting with acute abdomen.</p><p><strong>Methods: </strong>In this retrospective study, median PCT values were compared with conventional inflammatory biomarkers, including leukocyte count (LC), neutrophil count (NC), and C-reactive protein (CRP), within the patient population.</p><p><strong>Results: </strong>Among the 245 patients included in the study, 58 (23.7%) were diagnosed with appendicitis, 54 (22.0%) with diverticulitis, 34 (13.9%) with calculous cholecystitis, and 21 (8.6%) with pancreatitis. Additionally, 60 (24.5%) were diagnosed with non-specific abdominal pain (NSAP), and 18 (7.3%) with gallstones without cholecystitis. Median PCT levels were significantly higher in patients with calculous cholecystitis (p < 0.0001) and pancreatitis (p < 0.0001) compared to those with NSAP. The proportion of patients with a PCT cut-off ≥ 0.04 µg/L was significantly higher across all IAI subgroups compared to the NSAP group. However, 18 (10.8%) of IAI patients exhibited PCT levels ≥ 0.5 µg/L, indicating systemic infection. Spearman's rho analysis revealed a significant correlation between PCT and LC, NC, and CRP in patients with IAI (p < 0.0001). Moreover, median PCT levels were significantly higher in perforation/abscess vs. gangrenous appendicitis (p < 0.01), complicated vs. uncomplicated diverticulitis (p = 0.048), and severe vs. mild cholecystitis (p < 0.001).</p><p><strong>Conclusion: </strong>PCT correlates strongly with conventional inflammatory biomarkers in patients with IAI. However, PCT appears to offer limited additional clinical value for guiding therapeutic decisions concerning the initial diagnosis and/or severity grading of IAI in patients admitted with acute abdomen. Further research is warranted to validate these findings.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"93"},"PeriodicalIF":2.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605604","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":"TIVS versus Non-TIVS management of limb vascular injury in limb salvage: systematic review and meta-analysis.","authors":"Dongchao Xiao, Feng Zhu, Sihong Li, Junjie Li, Miaozhong Li, Chenlin Lu, Jiadong Pan, Xin Wang","doi":"10.1007/s00423-025-03657-0","DOIUrl":"10.1007/s00423-025-03657-0","url":null,"abstract":"<p><strong>Background: </strong>To compare the postoperative complications between temporary intravascular shunts (TIVS) and non-TIVS management in limb salvage surgery for severe limb trauma, and to provide reference for clinical decision making.</p><p><strong>Methods: </strong>The literature on postoperative complications of limb salvage with and without TIVS was searched in PubMed, Cochrane Library, Embase and MEDLINE from January 2000 to December 2023. References were screened and extracted according to inclusion and exclusion criteria, and meta-analysis was performed using RevMan5.4 software.</p><p><strong>Results: </strong>8 studies were included, including 1375 cases, 329 of which used TIVS and 1046 of which did not. Compared with no TIVS group, TIVS group was associated with a lower rate of amputation (OR = 0.48, 95%CI: [0.29, 0.82], P = 0.007) and less limb ischemic time (SMD = -0.96, 95%CI: [-1.17, -0.74], P < 0.00001), the incidence of thrombosis (OR = 1.48, 95%CI: [0.46, 4.78], P = 0.51), fasciotomy (OR = 0.84, 95%CI: [0.30, 2.36], P = 0.75) and infection (OR = 0.88, 95%CI: [0.35, 2.19], P = 0.78) were not statistically significant.</p><p><strong>Conclusion: </strong>Compared with no TIVS group, TIVS group may reduce amputation rate and limb ischemia time, prospective multi-centre studies are needed for further evaluation.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"95"},"PeriodicalIF":2.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605653","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":"To drain or not to drain in minimal invasive ventral hernia surgery.","authors":"Stella Wilters, Fadl Alfarawan, Catharina Fahrenkrog, Maximilian Bockhorn, Nader El-Sourani","doi":"10.1007/s00423-025-03668-x","DOIUrl":"10.1007/s00423-025-03668-x","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the high prevalence of ventral hernias worldwide, intraoperative drain placement remains a controversial topic. The benefit in reducing postoperative complications has not yet been clearly demonstrated. This study investigates whether a drain prevents postoperative complications after minimally invasive ventral hernia repair using the extended-totally-extraperitoneal-(eTEP)-technique.</p><p><strong>Methods: </strong>This monocentric, retrospective cohort study included all patients who underwent eTEP between 2019 and 2024. Two comparison groups were formed (54 patients with drain,106 patients without) and analysed for potential differences.</p><p><strong>Results: </strong>There were no significant sociodemographic or clinical differences between the study groups. The defect size was larger in the drain group (drain: 13 cm² (64,5) †, no-drain: 6,5 cm² (21) †, p = 0,025). There were no significant differences regarding frequency of postoperative complications (drain: 13%, no-drain: 8,5%, p = 0,373), surgical site infections (SSI) (drain: 0%, no-Drain: 1,9%, p = 0,550), and surgical site occurrences (SSO) (drain: 13%, no-Drain: 4,7%, p = 0,108). A subgroup analysis showed that robotically operated patients were more frequently provided with drains (rob: 30 (47,6%), lap: 24 (24,7%), p = 0,003), had larger defect sizes (rob: 28 cm² (72)†, lap: 6 cm² (9,87)†, p < 0,001), and received Transversus-abdominis-releases (TAR) more often (rob: 14 (22,2%), lap: 5 (5,2%), p = 0,001).</p><p><strong>Conclusion: </strong>We found no significant differences between patients with and without drains after eTEP regarding the frequency of postoperative complications, SSOs and SSIs. Our findings do not suggest nor refute that wound drains prevent postoperative complications.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"97"},"PeriodicalIF":2.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605654","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}