Microsurgery最新文献

{"title":"Assessment of Aesthetic Outcomes in Autologous Breast Reconstruction Using Profunda Femoris Artery Perforator Flap","authors":"Chika Gon,&nbsp;Ryo Karakawa,&nbsp;Hidehiko Yoshimatsu,&nbsp;Yuma Fuse,&nbsp;Rei Ogawa,&nbsp;Tomoyuki Yano","doi":"10.1002/micr.70085","DOIUrl":"https://doi.org/10.1002/micr.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>While autologous breast reconstruction using the profunda femoris artery perforator (PAP) flap is becoming increasingly popular, no aesthetic evaluation has been reported. The aim of this study is to evaluate the reconstructed breast using the PAP flap quantitatively and to clarify which factors contribute to the aesthetically favorable results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We identified 127 patients who underwent breast reconstructions using the vertically designed PAP flap for unilateral breast cancer between April 2018 and December 2021. The PAP flap was elevated vertically to avoid disrupting lymphatic pathways and was inserted between the pectoralis major muscle and the subcutaneous fat after the anastomoses. We classified cases into two groups: the “Favorable cosmesis group” and the “Unfavorable cosmesis group” based on aesthetic evaluations using the vectra three-dimensional (3D) imaging system. Patient characteristics and outcomes between two groups were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 127 patients, 15 were excluded: three with stacked PAP flaps, two with flap necrosis, and 10 with missing aesthetic outcome data. Among the remaining 112 patients, 18 were classified in the “Favorable cosmesis group” and 94 in the “Unfavorable cosmesis group.” Comparative analysis revealed that the “Favorable cosmesis group” showed significantly higher ratio with small volume in the upper pole of the unaffected side (21% vs. 72%, <i>p</i> &lt; 0.01) and had a smaller final inset flap weight (147 vs. 190 g, <i>p</i> = 0.028) compared to the “Unfavorable cosmesis group.” All 112 patients were evaluated using vectra 3D system at 12 months postoperatively, and their postoperative flap courses were uneventful.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In our study, inherent small volume of the upper pole and smaller flap inset weight contribute to more favorable outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367323","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":"Free Flap Reconstruction in Burns: A Systematic Review of Current Practices and Evidence","authors":"Christopher Fan,&nbsp;Faraaz Azam,&nbsp;Chandler Hinson,&nbsp;Matthew Sink,&nbsp;Danielle Jamison,&nbsp;Cyril Awaida,&nbsp;Mark Fisher,&nbsp;Andrei Odobescu","doi":"10.1002/micr.70086","DOIUrl":"https://doi.org/10.1002/micr.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The use of microsurgery remains extremely limited in burn management despite offering an alternative in cases where conventional burn reconstruction techniques fall short. This systematic review aims to evaluate the success of microsurgical burn reconstruction in both acute and chronic burn patients and compare it to other surgical modalities as reported in current literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adhering to PRISMA guidelines, a systematic literature search was conducted across Ovid Medline, Embase, PubMed/Google Scholar databases, spanning publications from 2005 to 2023. Thirteen studies met inclusion criteria. Data were sorted into categories such as study details, patient demographics, burn information, surgical management, and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The studies encompassed 396 microsurgical reconstructions with a wide age range and varied anatomical regions for both primary and secondary reconstruction. The most common burn etiology was flame, and most acute burn surgeries were performed five to 22 days after injury. The most common acute and nonacute complications were partial necrosis and hematomas, respectively. Findings revealed an average success rate per flap of 92.7% and 95.7% for acute and reconstructive free flaps, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Microsurgery offers a promising alternative for complex burn injuries where conventional reconstructive options are exhausted or fall short. However, its success is contingent on patient selection, timing of intervention, and perioperative patient care. The success rate and complication profile of acute microsurgical burn reconstruction are similar to that seen in trauma reconstruction. Secondary microsurgical burn reconstructions have similar success rates to those seen in other elective flaps, such as breast reconstruction. Current usage of microsurgery in burns is low, yet the majority of literature supports expanding its application in the field.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/micr.70086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367321","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":"Comment on “Anatomical Study of SCIAP (Superficial Circumflex Iliac Artery Perforator) and SIEA (Superficial Inferior Epigastric Artery) Flaps for Flap Harvest Training in the Swine Model”","authors":"Venkata Dileep Kumar Veldi,&nbsp;Rachana Mehta,&nbsp;Ranjana Sah","doi":"10.1002/micr.70083","DOIUrl":"https://doi.org/10.1002/micr.70083","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367322","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":"Visualize and Identify Perforators With a Novel Three Dimensional-Computed Tomography Viewer","authors":"Kenji Shinmi,&nbsp;Makoto Shiraishi,&nbsp;Shimpei Miyamoto,&nbsp;Hakuba Takeishi,&nbsp;Daichi Kurita,&nbsp;Kou Fujisawa,&nbsp;Mutsumi Okazaki","doi":"10.1002/micr.70081","DOIUrl":"https://doi.org/10.1002/micr.70081","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315222","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":"The Application of Augmented Reality Technology in Free Flap Reconstruction: A Systematic Review","authors":"Thao T. Wolbert,&nbsp;Anna E. White,&nbsp;Joohee Han,&nbsp;Shalmali Mirajkar,&nbsp;John A. Van Aalst,&nbsp;Perry J. Johnson,&nbsp;Shannon L. Wong,&nbsp;Sean C. Figy","doi":"10.1002/micr.70080","DOIUrl":"https://doi.org/10.1002/micr.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Augmented reality (AR) is an emerging technology in microsurgery for free flap reconstruction. AR allows surgeons to superimpose preoperative CT images onto the patient, providing real-time insight into the underlying anatomy and aiding in the decision-making process; however, there is limited empirical evidence supporting the effectiveness of this modality. We conducted a systematic review to investigate whether the use of AR devices in free flap reconstruction correlates with improved outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search of PubMed, Embase, and Scopus was performed on February 19, 2025. Our search included retrospective and prospective articles that demonstrated the use of AR technology intraoperatively and reported surgical outcomes in any type of free flap reconstruction. The initial search yielded 158 articles, with 8 ultimately included in the study. Articles were reviewed for technical accuracy, surgeon ease of use, operative time, complications, and operative costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AR can guide surgeons, particularly those with less experience. As surgeons gain a better understanding of perforator locations, they operate with increased confidence and efficiency. AR outperformed Doppler ultrasound in perforator identification, demonstrating higher accuracy during flap planning and dissection. The time required to harvest flaps was significantly shorter when AR was used compared to traditional flap dissection techniques. Compared to computer-aided design and computer-aided manufacturing (CAD/CAM) navigation systems, AR surgical guidance exhibited greater accuracy and required significantly less time for flap design. AR devices surpassed cutting guides in various aspects, including cost savings, reduced preparation time, increased flexibility in surgical plan modification, intraoperative tissue drift, and a more favorable effect on hand-eye coordination. No conclusive postoperative complications were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The majority of the literature about AR in free flap surgery comes from small clinical studies. Widescale, multi-center studies are necessary to determine the true clinical impact of AR technology in microsurgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308683","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":"The Perfusion Territory of the Superficial Branch of the Superficial Circumflex Iliac Artery: It Might Extend More Medially Than Expected","authors":"Federica Martini,&nbsp;Matteo Meroni,&nbsp;Mario F. Scaglioni","doi":"10.1002/micr.70082","DOIUrl":"https://doi.org/10.1002/micr.70082","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273205","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":"Reconstruction of Tongue Malignancy Defects: A Systematic Review and Treatment Algorithm","authors":"Peter F. Gearing,&nbsp;Maxim Devine,&nbsp;Felix Sim,&nbsp;Lauren Davies,&nbsp;Anand Ramakrishnan","doi":"10.1002/micr.70071","DOIUrl":"https://doi.org/10.1002/micr.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The tongue is the most common site of oral malignancies, with surgical resection the mainstay of treatment. Tongue cancer resections have significant functional impacts. Ideal reconstruction would restore speech intelligibility, facilitate swallowing of liquids and solids without significant dysphagia, and have minimal morbidity. We aimed to review and synthesize published outcomes of tongue reconstructive methods into a useful clinical treatment algorithm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic electronic search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Medline (OVID), Embase (OVID), PubMed, and the Cochrane Central Register of Controlled Trials (CENTRAL) were reviewed for all studies published prior to October 12th, 2024. Conference abstracts, case reports, case series, and review papers were excluded. Quantitative data were extracted and tabulated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After screening 1268 abstracts and 321 full-text articles, 113 papers were included. Multiple free and locoregional flap reconstructive methods, skin grafting techniques, and tissue substitutes were identified. The anterolateral thigh (ALT) free flap and radial forearm free flap (RFFF) were the most common reconstructive methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A treatment algorithm is proposed to facilitate structured surgical planning and intra-operative reconstructive decision-making for tongue malignancy defects.</p>\u0000 \u0000 <p><b>PROSPERO Registration:</b> CRD420223818875.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264453","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":"The Great Auricular Nerve as a Nerve Graft Donor: An Anatomical and Clinical Study of the Maximum Harvestable Length and Branches","authors":"Mayu Ueno,&nbsp;Kentaro Tanaka,&nbsp;Kyoichi Murakami,&nbsp;Naoya Ishida","doi":"10.1002/micr.70078","DOIUrl":"https://doi.org/10.1002/micr.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>For immediate facial nerve reconstruction during head and neck tumor resection, a great auricular nerve (GAN) graft can be potentially harvested in the same surgical field during tumor resection. However, it is often avoided because a GAN graft is only approximately 5 cm long without any branches, and a sural nerve graft is recommended for larger defects. We investigated the length of the GAN that can be harvested in 18 patients, along with the evaluation of postoperative facial nerve palsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 18 cases of immediate facial nerve reconstruction using the GAN from 2018 to 2023 at our hospital. In most cases, we traced the GAN to the back surface of the sternocleidomastoid and harvested the nerve graft immediately before the loops of the cervical nerve plexus or bifurcation into the phrenic nerve. This tracing method allowed the collection of a longer nerve graft with more branches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean length of the harvested GAN was 8.16 cm (95% confidence interval 7.42–8.89 cm), with the longest graft being 10.5 cm. The GAN grafts had an average of 1.83 branches and were 1.76–2.23 mm in diameter. Three patients had two peripheral transected edges of the facial nerve, each of which was sutured with a branch of the GAN graft. Three patients had five–six peripheral edges and required additional nerve grafts, such as the sural nerve. Postoperative facial nerve palsy was grade III or IV by House–Brackmann and FNGS 2.0 in all cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>For immediate facial nerve reconstruction, the GAN can be harvested in a length of at least 8 cm and few branches by sufficient dissection of the back surface of the sternocleidomastoid muscle, including its branches and other sensory nerves, with few complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/micr.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232306","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":"Reconstruction of a Large Perineal Defect After Radical Oncological Pelvic Exenteration in a Patient With Anal Cancer: An Interdisciplinary Approach and Literature Review","authors":"Mohammadsadegh Sabagh,&nbsp;Tomke Cordts,&nbsp;Nastaran Sabetkish,&nbsp;Georgios Polychronidis,&nbsp;Philipp Erhart,&nbsp;Arne Boecker,&nbsp;Julian Vogelpohl,&nbsp;Mohammed Al-Saeedi","doi":"10.1002/micr.70073","DOIUrl":"https://doi.org/10.1002/micr.70073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Recurrent anal cancer (AC) often requires surgical intervention, especially when large perineal defects must be reconstructed. These cases are complicated by poor tissue vascularity and comorbid conditions such as peripheral arterial disease (PAD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We report the case of a 64-year-old male with PAD and recurrent AC, presenting with a large perineal defect following radical pelvic exenteration. Preoperative iliac artery stenting was performed to ensure adequate perfusion. Surgical reconstruction was conducted in two stages: first, a vertical rectus abdominis myocutaneous (VRAM) flap (7 × 15 cm) for pelvic floor coverage, followed by a free latissimus dorsi (LD) flap (17 × 30 cm) anastomosed to the superior gluteal vessels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Postoperative recovery was uneventful. Three vacuum-assisted closures were performed, and the patient was discharged 6 weeks postoperatively. At 6-month follow-up, the flap remained stable with no complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case underscores the importance of preoperative vascular optimization and a staged surgical strategy when addressing large, complex perineal defects. Multidisciplinary collaboration is critical for achieving optimal outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197212","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":"Successful Testis Replantation After Bilateral Traumatic Testis Amputation With a 15-Year Follow-Up of Functional Testis: A Case Report","authors":"Ali Rıza Erçöçen,&nbsp;Umut Zereyak","doi":"10.1002/micr.70074","DOIUrl":"https://doi.org/10.1002/micr.70074","url":null,"abstract":"<div>\u0000 \u0000 <p>Bilateral traumatic amputation of the testis is a very rare condition. It is important to preserve the reproductive and endocrine functions of the testis after replantation. In this paper, we report on an 18-year-old male patient with a history of a tractor accident who had a crush avulsion-amputation injury of both testes and lacerations on both sides of the scrotum. The left testicle could not be replanted due to severe damage to the vascular structures, but the right testicle was found to be suitable for replantation. After dissection of the recipient vessels in both inguinal canals under the appropriate magnification of the operating microscope, the testicular artery in the right spermatic cord and the internal spermatic vein of the pampiniform plexus were prepared as recipient vessels; at the same time, after dissection of the right vas deferens, microanastomosis of the artery, vein, and vas deferens was performed using the end-to-end microsurgical technique, and the right testis was successfully replanted orthotopically. No postoperative complications were observed; early (1–3 months) and late (1–15 years) follow-up were uneventful, and functional (endocrine and reproductive) recovery was confirmed based on clinical, laboratory, radiologic, and histopathologic evaluations. Although partial endocrine recovery after testicular replantation in traumatic testicular amputation has been reported in the literature, no case with preserved reproductive function has been reported. In this article, we review the literature and discuss that unilateral and bilateral as well as traumatic and self-mutilating (psychotic) conditions should be considered when deciding the indication for testicular replantation, and the critical ischemia period should not be exceeded. Our case of bilateral traumatic testicular amputation in which only one testicle could be replanted is a good example to show that both endocrine and reproductive testicular function can be fully preserved if the critical ischemia period is not exceeded.</p>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 5","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197514","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}