Langenbeck's Archives of Surgery最新文献

{"title":"The medial versus posterior internal plate fixation in the treatment of closed humeral shaft fracture: a retrospective study.","authors":"Alimu Keremu, Maimaitiaili Abulikemu, Pazila Aila, Zhilin Liang, Hanikezi Moming, Aikebaier Tuxun","doi":"10.1007/s00423-025-03830-5","DOIUrl":"10.1007/s00423-025-03830-5","url":null,"abstract":"","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"241"},"PeriodicalIF":1.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821957","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":"Age as a non-contraindication for surgical intervention in patients with abdominal wall incisional hernia: an exploration and analysis.","authors":"Haonan Huang, Ning Ma, Zehui Hou, Fuxin Tang, Taicheng Zhou","doi":"10.1007/s00423-025-03828-z","DOIUrl":"10.1007/s00423-025-03828-z","url":null,"abstract":"<p><strong>Background: </strong>Surgery is the only potential curative option in patients presenting with abdominal wall incisional hernia (IH). The approach clearly enhances patients' quality of life and reduces complications, however, the management of patients over 60 years old presents significant challenges, primarily due to the comorbidities and the complexities associated with postoperative recovery. The objective of this study was to examine postoperative outcomes in the age group over 60 years and the age group under 60 years.</p><p><strong>Methods: </strong>The study included a retrospective analysis of all patients who underwent surgical treatment for IH between December 2018 and March 2023. The patient cohort was divided into two age groups: <60 years old and ≥ 60 years old. A comparison was made between the two groups in terms of baseline and intraoperative characteristics, as well as postoperative complications and recurrence.</p><p><strong>Results: </strong>During the study period, a total of 304 patients were enrolled, with 86 (28.3%) in the < 60 years age group and 218 (71.7%) in the ≥ 60 years age group. Baseline characteristics were comparable between the two groups, except for a higher prevalence of high blood pressure and ASA score among older patients. The intraoperative characteristics did not show any statistically significant differences between the two groups. In the < 60 age group, the incidence of postoperative intestinal fistula and the 1-year recurrence rate were both zero, indicating a complete absence of these complications. Apart from the duration of hospitalization, there was no statistically significant difference in postoperative outcomes between the two age groups. Notably, patients aged ≥ 60 years experienced a longer length of hospital stay (p = 0.009).</p><p><strong>Conclusion: </strong>The postoperative complications and recurrence rate of patients with IH appear to be independent of age, thus advocating for surgical intervention regardless of the patient's age whenever feasible.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"240"},"PeriodicalIF":1.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821955","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":"Robotic placement of experimental prototypes for wireless gastric electrical stimulation.","authors":"Jonas F Schiemer, Karen Stumm, Yves Olsommer, Hauke Lang, Nadine Baumgart, Jan Baumgart, Werner Kneist","doi":"10.1007/s00423-025-03834-1","DOIUrl":"10.1007/s00423-025-03834-1","url":null,"abstract":"<p><strong>Introduction: </strong>Gastric electrical stimulation (GES) is an effective treatment for gastroparesis. However, the available devices are equipped with bulky batteries that need to be replaced regularly by surgery.</p><p><strong>Methods: </strong>Our new implantable system consists of only 6 passive components in addition to a diode and does not require a battery. Two acute porcine experiments were carried out with a robotic surgical system for placement of the prototypes. The stimulation parameters were set with an extracorporeal unit and GES was performed. The recorded electromyography (EMG) signal was subjected to a multiresolution analysis.</p><p><strong>Results: </strong>The robot-assisted placement of the prototypes was successful. The inductive energy transfer was confirmed to be functional and EMG analysis revealed changes in gastric electrical activity.</p><p><strong>Conclusions: </strong>Further technological and rapid regulatory solutions are being sought in order to start a clinical trial with the next generation devices in the near future.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"242"},"PeriodicalIF":1.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821956","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":"Suturing under tension in minimally invasive surgery: A comparison of three intracorporeal knot types : Philipp Romero₁, Hans Kessler₁, Juri Fuchs_1, Estelle Willuth₁, Frank Pianka₂, Patrick Günther₁.","authors":"Philipp Romero, Hans Kessler, Juri Fuchs, Estelle Willuth, Frank Pianka, Patrick Günther","doi":"10.1007/s00423-025-03829-y","DOIUrl":"10.1007/s00423-025-03829-y","url":null,"abstract":"<p><strong>Purpose: </strong>Intracorporeal knot tying (ICKT) and suturing under tension are essential skills for performing advanced minimally invasive surgery (MIS) procedures. Over recent years, various intracorporeal knot types with specific properties have been developed. The classical surgical square knot (CSK) continues to be used as the standard knot in MIS. Previously published studies suggested that the security of the surgical square knot improves when the knot throw combination is adjusted from four wraps (2W1W1W) to five wraps (3W1W1W). Additionally, the intracorporeal slipping knot (SLK) has been found to be superior to the CSK in sutures under tension. This study aimed to compare ICKT of the CSK, a modified square knot (MSK) and the SLK during simulated suture placement under tension.</p><p><strong>Methods: </strong>A laparoscopic box trainer and a standardized silicone suture pad was utilized for ICKT. The participants consisted of medical students, surgical residents and senior physicians. A standardized video demonstrating the ICKT variants was shown to all participants before evaluation. The procedural implementation, knot quality, total task time and accuracy were evaluated.</p><p><strong>Results: </strong>A total of 267 knots were included in the study. Compared to the CSK, the MSK showed significantly better results across the entire group in terms of time, knot quality, and procedural implementation score.  CONCLUSION: In the evaluation of all participants' knots, the MSK showed significantly better results for all variables except accuracy compared to the CSK. The MSK showed similarly good results to the SLK. Both the MSK and SLK appear particularly well-suited for tension sutures.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"238"},"PeriodicalIF":1.8,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789509","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":"Impact of COVID-19 lockdown on weight loss after bariatric surgery: a retrospective single-center study with a follow-up of 3 years.","authors":"Felix Hönes, André L Mihaljevic, Daniel Wulff, Rami Archid, Ivan Capobianco","doi":"10.1007/s00423-025-03755-z","DOIUrl":"10.1007/s00423-025-03755-z","url":null,"abstract":"","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"239"},"PeriodicalIF":1.8,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789508","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 prognostic score based on early recurrence-related factors for hepatocellular carcinoma patients with microvascular invasion after hepatectomy.","authors":"Hongyu Li, Junyi Shen, Tianfu Wen","doi":"10.1007/s00423-025-03823-4","DOIUrl":"10.1007/s00423-025-03823-4","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to construct a simple risk score to stratify individuals with distinguished prognosis for HCC patients with microvascular invasion (MVI).</p><p><strong>Methods: </strong>265 qualified patients were retrospectively analyzed. A prognostic score was constructed using predictors associated with early recurrence (ER). Based on the HR value, AFP > 400 ng/ml and hepatitis B viral e antigen (HBeAg) positivity were assigned as 1 point, satellite nodule was assigned 2 points. There were five subgroups (score 0/1/2/3/4). Due to similar RFS in score 2/3/4 subgroups, we merged these into a single cohort (group C), while maintaining score 0 as group A and score 1 as group B.</p><p><strong>Results: </strong>MVI (+) HCC patients who developed ER had dramatically decreased overall survival (OS) compared with those who did not(P < 0.001). Based on the result of multivariable analysis, MVI (+) HCC patients with satellite nodules, positive HBeAg or serum alpha-fetoprotein above 400ng/ml were more likely to developed ER. The 3-year recurrence free survival rates for the group A, group B and group C were 42.7%, 26.4% and 9.3%, respectively. The 3-year OS rates for group A, group B and group C were 65.4%, 48.7% and 26.9%, respectively (p < 0.001). A higher score was correlated with significantly worse prognosis (p < 0.001). Furthermore, the prognostic score distinguished the prognosis of MVI (+) HCC patients independently of liver cirrhosis (p < 0.001).</p><p><strong>Conclusions: </strong>The prognostic score consisted of ER-related factors effectively predict prognosis for MVI (+) HCC patients after hepatectomy.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"237"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760484","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":"Is the ¹⁸F-choline PET-CT more cost-effective than standard protocol for locating a parathyroid adenoma?","authors":"Joaquín Ortega-Serrano, Santiago Serrano-López, Raquel Alfonso-Ballester, Rosa Martí-Fernández, María Lapeña-Rodríguez, Rafael Díaz Expósito, Norberto Cassinello-Fernández","doi":"10.1007/s00423-025-03824-3","DOIUrl":"10.1007/s00423-025-03824-3","url":null,"abstract":"<p><strong>Purpose: </strong>The most common cause (> 80% of cases) of primary hyperparathyroidism (PHPT) is parathyroid adenoma. Its diagnosis is conventionally made by cervical ultrasound and ^99mTc-MIBI scintigraphy. However [¹⁸F-Choline PET-CT ( [¹⁸F-FCh PET-CT) offers greater sensitivity and specificity, although at a high cost, which prevents it from being a first-line diagnostic method.</p><p><strong>Methods: </strong>Observational retrospective cohort study of 100 consecutive patients operated on for PHPT by parathyroidectomy in a tertiary hospital. Patients were divided into two groups: Group 1, patients with successful diagnosis using conventional tests (42 patients) and Group 2, patients with an initial failed diagnosis who required ¹⁸F-FCh PET-CT (52 patients). A group with an ideal diagnostic strategy using only ¹⁸F-FCh PET-CT was simulated and the costs were compared with the groups in the sample.</p><p><strong>Results: </strong>The sample finally analyzed 94 patients, 78.7% female, mean age 61.73 years. 55,3 % of the patients required a ¹⁸F-FCh PET-CT for the location diagnosis. The group 2 required more consultations, more complementary tests and a longer interval between the first consultation and the intervention. The ideal diagnostic strategy (€1,399.77/patient) represents a lower cost than the other strategy (€1,730.61/patient).</p><p><strong>Conclusion: </strong>The diagnosis of location of a parathyroid adenoma with ¹⁸F-FCh PET-CT required fewer complementary tests and consultations, reducing the interval until surgical intervention, with no difference in surgical results. The costs if ¹⁸F-Ch PET-CT is performed as the only location diagnostic test are lower when a group of patients is studied, so its use is recommended as a first line diagnostic tool.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"235"},"PeriodicalIF":1.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753729","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":"Incidence and clinical predictors of postoperative ileus following non-abdominal surgery in Ethiopia: a prospective cohort study.","authors":"Habtie Bantider Wubet, Negesse Zurbachew Gobezie, Temesgen Birlie Asmare, Getachew Mekete Diress, Moges Kefale Alachew, Kaletsidk Desalegn Mossie, Begizew Yimenu Mekuriaw, Alemie Fentie Mebratie, Kidist Hunegn Setargew, Diriba Teshome","doi":"10.1007/s00423-025-03808-3","DOIUrl":"10.1007/s00423-025-03808-3","url":null,"abstract":"<p><strong>Background: </strong>Postoperative ileus (POI) is a common consequence following abdominal surgeries; however, its incidence and risk factors in non-abdominal procedures remain unknown. Identifying clinical indicators of POI in this population is essential for early detection and treatment.</p><p><strong>Objective: </strong>This study aims to assess the incidence and determinants of postoperative ileus (POI) in patients undergoing non-abdominal surgeries at Debre Tabor Comprehensive Specialized Hospital.</p><p><strong>Methods: </strong>A prospective cohort study was conducted between September 1, 2024, and January 30, 2025. Demographic characteristics, comorbidities, surgical details, and perioperative parameters were recorded. Data were analyzed using SPSS version 27, with continuous and categorical variables summarized using descriptive statistics. Independent predictors of postoperative ileus (POI) were identified through bivariate and multivariate logistic regression analyses.</p><p><strong>Results: </strong>Among the 400 patients who underwent elective non-abdominal surgery, 31 (7.75%) developed postoperative ileus (POI). Significant predictors included opioid use (OR = 3.28 [95% CI, 2.25-7.12], P < 0.01), neuromuscular blockers (OR = 2.33 [95% CI, 2.01-5.12], P < 0.01), poor postoperative functional status (OR = 5.67 [95% CI, 3.41-8.91], P < 0.01), and delayed postoperative mobility (OR = 4.45 [95% CI, 2.05-8.17], P < 0.01).</p><p><strong>Recommendation and conclusion: </strong>POI occurs in a significant proportion of patients undergoing non-abdominal surgery. Implementing targeted perioperative strategies may reduce the incidence of POI and enhance postoperative outcomes.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"236"},"PeriodicalIF":1.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753728","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":"Long-term functional outcome and quality of life after ileal pouch anal anastomosis: retrospective, tertiary-center study, over 19 years.","authors":"Nouha Dammak, Mehdi Ben Latifa, Ala Eddine Baccouch, Mohamed Amine Said, Sana Bhiri, Amal Bouazzi, Sami Lagha, Houssem Ammar, Fathia Harrabi, Abdelkader Mizouni, Mohamed Ben Mabrouk, Ali Ben Ali","doi":"10.1007/s00423-025-03825-2","DOIUrl":"10.1007/s00423-025-03825-2","url":null,"abstract":"<p><strong>Purpose: </strong>Restorative proctocolectomy with ileal pouch anal anastomosis (IPAA) is a well codified procedure with low morbi-mortality and increasingly satisfactory functional results. We aimed to evaluate long-term quality of life and functional outcome of this procedure.</p><p><strong>Methods: </strong>Retrospective, descriptive study of IPAA cases carried out over a period of 19 years [2001-2019], in the visceral and digestive surgery department of Sahloul Hospital. Anal incontinence was assessed using the St. Mark's Incontinence Score (SMIS). We evaluated functional outcome using the Öresland Score (OS) and the Pouch Functional Score (PFS), and quality of life (QoL) using Cleveland Global Quality of Life (CGQL).</p><p><strong>Results: </strong>125 patients (50,4% females) with a median age at surgery of 40.5 ± 14.9 years. Response rate to the questionnaires was 91,2% (n = 114). Only the \"J\" shaped ileal pouch was made. The global postoperative morbidity was 36%. Most patients had a good functional outcome with a median OS of 5.3 ± 3.6 and a median PFS of 7,3 ± 6,1. The average diurnal bowel mouvement is 5 ± 2.1, while 83,3% (n = 96) had less than 7 diurnal bowel movements. The average of nocturnal bowel movement is 2.14 ± 1.59 while 70,1% (n = 80) had less than 2 nocturnal bowel movements. Most patients had a good QoL with a median CGQL of 18,4 ± 4,3.</p><p><strong>Conclusion: </strong>The IAA with « J » shaped ileal pouch is a procedure ensuring sphincter function compatible with normal life. Future sexual and quality of life studies will need to elicit preoperative baselines.</p><p><strong>Trial registration number: </strong>Research registry 9509.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"234"},"PeriodicalIF":1.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753730","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":"Influence of intercostal nerve block preemptive analgesia and incisional infiltration anesthesia on postoperative pain in patients undergoing laparoscopic cholecystectomy.","authors":"Ling Zhao, Yuxin Zhang, Xinde Chen, Chunyuan Zhang","doi":"10.1007/s00423-025-03816-3","DOIUrl":"10.1007/s00423-025-03816-3","url":null,"abstract":"<p><strong>Objective: </strong>This study is aiming at analyzing the effects of intercostal nerve block preemptive analgesia and incisional infiltration anesthesia on postoperative pain in patients undergoing laparoscopic cholecystectomy.</p><p><strong>Methods: </strong>Ninety patients who underwent laparoscopic cholecystectomy were retrospectively selected. According to different anesthesia methods, they were allocated into an intervention group and a control group, with 45 patients in each. The control group received incisional infiltration anesthesia alone, while the intervention group received intercostal nerve block with preemptive anesthesia combined with incisional infiltration. Pain intensity was assessed using the Visual Analogue Scale (VAS) at 4, 8, 12, and 24 h postoperatively at rest, and during mobilization at 8, 12, and 24 h. Postoperative analgesia conditions, as well as the operative time, length of hospital stay, time to first ambulation, and awakening time of the two groups, were compared. The incidence of adverse events was also compared.</p><p><strong>Results: </strong>The intervention group reported lower resting VAS scores at 4, 8, 12, and 24 h and lower movement-related VAS scores at 8, 12, and 24 h (all P < 0.05). The number of cases with VAS ≥ 4 at 4 h, 8 h, 12 h, and 24 h postoperatively in the control group was higher than that in the intervention group (P = 0.020, 0.033, 0.034, 0.019). Moreover, the proportion of patients who did not receive additional tramadol in the intervention group was higher at 4 h, 8 h, 12 h, and 24 h postoperatively [2/13 (15.38%) vs. 2/24 (8.33%); 5/16 (31.25%) vs. 3/28 (10.71%); 7/13 (53.85%) vs. 4/26 (15.38%); 4/10 (40.00%) vs. 3/22 (13.64%)]. There was no significant difference in the operative time between the two groups (P = 0.065). The length of hospital stay, time to first ambulation, and awakening time in the intervention group were all shorter than those in the control group (P < 0.05). The incidence of adverse events did not differ significantly between groups (8.89% vs. 13.33%, P = 0.739).</p><p><strong>Conclusion: </strong>Preemptive analgesia with intercostal nerve block & incisional infiltration anesthesia offers effective pain control in laparoscopic cholecystectomy, reducing the use of postoperative drugs, with a favorable safety profile.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"233"},"PeriodicalIF":1.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742436","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}