Microsurgery最新文献

{"title":"The Sensate External Pudendal Artery Perforator (EPAP) Hemi-Scrotal Flap for the Circumferential Skin Defect of the Penile Shaft: A Case Report and Literature Review","authors":"Reiko Tsukuura,&nbsp;Toni Engmann,&nbsp;Toko Miyazaki,&nbsp;Takumi Yamamoto","doi":"10.1002/micr.70123","DOIUrl":"10.1002/micr.70123","url":null,"abstract":"<div>\u0000 \u0000 <p>Penile skin reconstruction is traditionally performed using a skin graft and/or local pedicled flap. The scrotal flap is one of the options. However, previous techniques sacrifice the bilateral external pudendal arteries which put the skin pedicle at risk of dyspareunia and stretching. To overcome this limitation, we used the external pudendal artery perforator (EPAP) hemi-scrotal flap with isolation of the pedicle perforator to elevate the perforator flap with a wider rotation arc, easier and safer inset without tension, and sufficient coverage of the defect. A 40 years old male with schizophrenia had circumferential penile skin defect after penile replantation. The sensate EPAP hemi-scrotal flap measuring 9 × 14 cm was designed using doppler ultrasound preoperatively and harvested above the deep fascia. The external pudendal artery perforator and the anterior scrotal nerve were isolated. The shaft skin defect was covered with the sensate EPAP flap and the donor site was closed primarily. Postoperative course was uneventful without any short-term complications. Seven months after the reconstructive surgery, the transferred flap showed good color match and sensation, and the donor site was inconspicuous. Its function recovered without the sensation of pain and stretching. According to current literature the scrotal flap is a suitable donor site because of its thin, pliable, pigmented, and sensate characteristics. Beyond this current approach, we believe that harvesting the scrotal flap specifically as a perforator flap may be a superior flap for penile skin coverage. A higher rotation arc and inconspicuous donor site scar are further beneficial features of this approach.</p>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239173","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":"Cephalic Vein Interposition Graft for Salvage of Compromised DIEP Flap in Breast Reconstruction","authors":"Nishant Kumar,&nbsp;Samyd S. Bustos,&nbsp;Scott K. Odorico,&nbsp;Aparna Vijayasekaran","doi":"10.1002/micr.70124","DOIUrl":"10.1002/micr.70124","url":null,"abstract":"<div>\u0000 \u0000 <p>The deep inferior epigastric perforator (DIEP) flap remains the preferred flap option for autologous breast reconstruction following mastectomy. This case report presents the novel use of the cephalic vein (CV) as an interposition graft to alleviate venous congestion in a patient undergoing DIEP flap reconstruction. A 42-year-old woman experienced venous congestion following her initial autologous reconstruction, attributed to thrombus formation from kinking of the vascular pedicle. Despite initial attempts to resolve the congestion, the condition persisted. Since the flap was based on a single perforator, we decided to attempt a CV turndown. The CV was noted to be attenuated and not feasible for use in turndown; therefore, venous salvage was completed by using the CV as an interposition graft to bypass the affected flap vena comitans. The procedure successfully restored venous flow, allowing for flap salvage and subsequent healing. This case underscores the potential of CV as an interposition graft in autologous breast reconstruction, particularly when traditional CV turndown is not possible due to vessel attenuation.</p>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213085","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":"Liposomal Bupivacaine in Transversus Abdominis Plane Block for Postoperative Pain Control After Autologous Breast Reconstruction: A Systematic Review and Meta-Analysis","authors":"Victor F. A. Almeida,&nbsp;Glaudir Donato,&nbsp;Andressa Alves de Carvalho,&nbsp;Wanessa Alves de Carvalho,&nbsp;Ammar Lakda,&nbsp;Yara Dias,&nbsp;Manoela Dantas,&nbsp;Pedro Danielian,&nbsp;Eliana F. R. Duraes","doi":"10.1002/micr.70126","DOIUrl":"10.1002/micr.70126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Autologous breast reconstruction using abdominally based flaps is common post-mastectomy, but donor-site pain often leads to prolonged opioid use. The transversus abdominis plane (TAP) block is a common regional anesthesia technique, with bupivacaine as the standard anesthetic. Liposomal bupivacaine (LB), a prolonged-release formulation, aims to extend pain relief and reduce opioid consumption, though its efficacy remains debated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This systematic review and meta-analysis compared LB versus plain bupivacaine (PB) in TAP blocks for autologous breast reconstruction, focusing on opioid consumption, pain scores, and hospital stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search identified randomized controlled trials and observational studies comparing LB (with or without PB) to PB in TAP blocks. Data were pooled using a random-effects model (<i>I</i>² ≥ 25%) or fixed-effects model (<i>I</i>² &lt; 25%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six studies (429 patients) met inclusion criteria. LB was associated with significant reduction in opioid consumption on postoperative days (POD) 1 (MD = −4.99 mg; 95% CI: [−8.42; −1.56], <i>p</i> &lt; 0.01, <i>I</i>² = 0%) and POD 2 (MD = −3.35 mg; 95% CI: [−5.74; −0.96], <i>p</i> &lt; 0.01, <i>I</i>² = 0%). Pain scores were significantly lower on POD 2 and POD 3. No difference in hospital stay was found (MD = −0.17; 95% CI: [−0.52; 0.18], <i>p</i> = 0.34, <i>I</i>² = 83.1%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LB reduced opioid consumption during the first 48 h postoperatively and modestly improved pain control on POD 2 and POD 3, but did not shorten hospital stay. Further large-scale RCTs are needed to validate its benefits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/micr.70126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213137","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":"DeBakey Forceps: The Quintessential Tool for Perforator Surgery?","authors":"James Macgregor,&nbsp;Miles Banwell,&nbsp;Richard Haywood","doi":"10.1002/micr.70122","DOIUrl":"10.1002/micr.70122","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review and Meta-Analysis of Treatment Outcomes Following Tongue Reconstruction With Neurotized Free Flaps.","authors":"O V Hovav, T Read, M David, D S Sparks","doi":"10.1002/micr.70120","DOIUrl":"10.1002/micr.70120","url":null,"abstract":"<p><strong>Background and objectives: </strong>The tongue is the most common site of oral malignancy, and surgical treatment may result in impaired feeding, swallowing, and speech. Free tissue transfer is the preferred method for reconstructing complex defects. Evidence remains unclear on whether sensory reinnervation improves function. The objective of this review is to evaluate the outcome of patients undergoing innervated versus noninnervated free flap reconstruction following tongue cancer surgery.</p><p><strong>Methods: </strong>A systematic review was performed to determine the role of sensory neurotization in lingual reconstruction. Only studies with comparative designs were eligible for inclusion. Primary outcome measures included static two-point discrimination (S2PD), pinprick sensation, swallowing, and speech. A meta-analysis was performed using key data analysis to calculate weighted effect sizes for reconstruction with or without neurotization using random-effects models. The statistical heterogeneity was determined using the Higgins' method.</p><p><strong>Results: </strong>Nine studies were included which produced 107 reinnervated flaps and 117 non-innervated flaps for pooled analysis. Objective measures of sensation were significant, favoring the reinnervation group for pinprick sensation and S2PD (p < 0.05), with the pooled difference in proportions being 0.25 and -13.88 (0.06-0.45, 95% CI, -26.66 mm to -1.11, 95% CI), respectively. Functional outcome measures revealed significantly improved speech in the reinnervated group (p < 0.05, non-weighted means 74.8 vs. 62.5%).</p><p><strong>Conclusions: </strong>This study found a strong association favoring the sensory neurotization for tongue reconstruction. Higher quality studies are required to further define the role of reinnervation for the restoration of swallow, relative differences between type of free flap selected, and measure changes in patients' quality of life.</p>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 7","pages":"e70120"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280508","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":"Double-Paddle Use of the Superficial Circumflex Iliac Artery Perforator Flap for Fournier's Gangrene: A Case Report.","authors":"Süleyman Çeçen, Menekşe Kastamoni Başkan, Selçuk Akin","doi":"10.1002/micr.70129","DOIUrl":"https://doi.org/10.1002/micr.70129","url":null,"abstract":"<p><p>Fournier's gangrene often leads to extensive perineogenital soft tissue loss, necessitating complex reconstruction. The superficial circumflex iliac artery perforator (SCIP) flap is known for its thin pliable skin and low donor site morbidity. We present a case of a 65-year-old male with Fournier's gangrene affecting both the mons pubis and scrotum. After multiple debridements, a double-paddle SCIP flap based solely on the superficial branch of the SCIA was designed with two independent skin paddles to reconstruct these adjacent but anatomically distinct areas. Preoperative CT angiography and intraoperative SPY imaging enabled flap design and ensured vascular reliability. A double-paddle SCIP flap was elevated with two skin paddles, each inset to separate regions. Through proximal-to-distal dissection, the superficial circumflex iliac artery and its superficial branch were identified and dissected. Upon confirming the origin of the arterial branching of the superficial branch, two flaps were designed-one superiorly and one inferiorly positioned-measuring 14 × 7 cm and 8 × 5 cm, respectively, with an approximate thickness of 10 mm and a pedicle length of 8 cm. The total operative time was approximately 55 min. Postoperative recovery was uneventful, with satisfactory healing and aesthetic outcome at 6 months. This case illustrates a novel use of a double-paddle SCIP flap based exclusively on the superficial branch of the SCIA to simultaneously reconstruct two separate anatomic regions affected by Fournier's gangrene. This approach provides a single-donor, dual-target solution that is both reliable and aesthetically favorable.</p>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 7","pages":"e70129"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308581","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":"Comments on the \"Impact of Vasopressors on Microvascular Free Flap Perfusion in Head and Neck Reconstruction\".","authors":"Georgios Karamitros, Gregory A Lamaris, William C Lineaweaver","doi":"10.1002/micr.70118","DOIUrl":"https://doi.org/10.1002/micr.70118","url":null,"abstract":"","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 7","pages":"e70118"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308631","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 Fingertip or Pulp Defects Using the Free Second Toe Tibial Flap With Plantar Vein.","authors":"Teng Xie, You Li, Liu Cao, Weiwei Du, Hailiang Liu, Ruixing Hou, Jihui Ju, Linfeng Tang","doi":"10.1002/micr.70127","DOIUrl":"https://doi.org/10.1002/micr.70127","url":null,"abstract":"<p><strong>Purpose: </strong>For patients with small-area emergency finger injuries and short venous defects, using the traditional second toe tibial free flap with dorsal toe veins would increase donor site damage and compromise the esthetic outcomes of both hands and feet. This study presents an innovative harvesting technique for the second toe tibial free flap, specifically designed for fingertip or volar pulp defect reconstruction.</p><p><strong>Methods: </strong>From March 2020 to June 2023, our institution managed 15 cases of finger pulp or fingertip defects using second toe tibial flaps with plantar vein grafts, involving 16 digits. The cohort comprised 10 males and 5 females aged 20-60 years mean 38 years. All patients underwent immediate reconstruction with free second toe tibial flaps. Surgical procedures included: anastomosis of the plantar artery to the digital proper artery, plantar vein to palmar vein, and plantar nerve to digital proper nerve.</p><p><strong>Results: </strong>Postoperative outcomes were assessed using two-point discrimination (2-PD), modified Vancouver Scar Scale (mVSS), Michigan Hand Outcome Questionnaire (MHOQ), and total active joint mobility (TAM). All 16 flaps survived without postoperative complications. The mean follow-up period was 11 months (range 6-18). Quantitative outcomes: Mean 2-PD: 9 mm (range 7-12). Donor site mVSS: 5 (range 4-7). Recipient site mVSS: 5 (range 4-7). MHOQ score: 8 (range 5-11). Thirteen patients reported complete satisfaction with reconstructed digit function and esthetics, while two expressed partial satisfaction. No prominent scarring was observed at foot donor sites. No secondary complications occurred during follow-up.</p><p><strong>Conclusions: </strong>The modified free second toe tibial flap technique demonstrates favorable clinical outcomes for digital pulp/tip reconstruction, achieving functional restoration with minimal donor site morbidity. This approach represents a valuable technique for widespread clinical adoption.</p>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 7","pages":"e70127"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308609","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":"Human Amnion-Derived Mesenchymal Stem Cells Prolong Graft Survival in a Rat Hind Limb Allotransplantation Model","authors":"Daichi Sakamoto,&nbsp;Ryosuke Ikeguchi,&nbsp;Tomoki Aoyama,&nbsp;Maki Ando,&nbsp;Koichi Yoshimoto,&nbsp;Terunobu Iwai,&nbsp;Kazuaki Fujita,&nbsp;Tetsuya Miyamoto,&nbsp;Takashi Noguchi,&nbsp;Shuichi Matsuda","doi":"10.1002/micr.70125","DOIUrl":"10.1002/micr.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recently, the immunomodulatory effects of mesenchymal stem cells have been reported in several studies. The purpose of this study was to evaluate the effect of the administration of human amnion–derived mesenchymal stem cells (hAm-MSCs) in a rat vascularized composite allotransplantation model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 18 Lewis (LEW) rats and 6 Brown-Norway (BN) rats were used. Sixteen LEW rats as recipients were divided randomly into four groups: Isograft (Iso), Untreated (UT), FK, and MSC groups (<i>n</i> = 4, each group). Hind limb transplantation was performed. In the Iso group, 2 LEW rats were used as donors. In the other groups, 6 BN rats were used as donors. In the UT group, no immunosuppressant was used. In the FK group, 0.2 mg/kg/day of FK506 (tacrolimus) was administered from day 0 to day 6. In the MSC group, 2 × 10⁶ hAm-MSCs were administered on day 7 after tacrolimus administration (day 0–6). Graft survival was assessed by daily inspection, histology, and immunohistology with the TUNEL (terminal deoxynucleotidyl transferase dUTP nick-end labeling) assay. Cytokine mRNA expression analysis using real-time, reverse transcription PCR (RT-PCR) of the grafts was analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Graft survival in the MSC group (14.8 days) was significantly prolonged compared with that of the FK group (13 days; <i>p</i> &lt; 0.05). Histology and immunohistology with the TUNEL assay showed a significant reduction of mononuclear cell infiltration and apoptotic cells in the MSC group compared with the FK group (<i>p</i> &lt; 0.05). RT-PCR analysis of cytokine mRNA expression showed a significant decrease of IL-2 and an increase of TGFβ in graft muscle (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>hAm-MSCs prolonged graft survival in the rat vascularized composite allotransplantation model. hAm-MSCs could be an alternative immunomodulatory agent to avoid the side effects of conventional immunosuppressant.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186267","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":"Investigating the Safety of Breast Reconstruction With the Deep Inferior Epigastric Flap in Patients With Connective Tissue Diseases","authors":"Sophia Arbuiso,&nbsp;Makayla Kochheiser,&nbsp;Albert Truong,&nbsp;Samuel J. Medina,&nbsp;Matthew W. Liao,&nbsp;Sarah Diaddigo,&nbsp;Gianni Thomas,&nbsp;Leslie Cohen,&nbsp;Jason A. Spector,&nbsp;David M. Otterburn","doi":"10.1002/micr.70092","DOIUrl":"10.1002/micr.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Connective tissue diseases (CTDs) are associated with impaired wound healing and hypercoagulability. There is currently a paucity of research examining postoperative outcomes in these patients following microsurgical procedures. We aimed to analyze postoperative outcomes in patients with CTDs following breast reconstruction with the deep inferior epigastric perforator (DIEP) flap.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-institution retrospective study was conducted consisting of all patients that underwent breast reconstruction with DIEP flaps between 2015 and 2023. Outcomes were assessed in the 90-day postoperative period, and Fisher's exact test was used to compare results between patients diagnosed with a CTD and patients who do not have CTDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five hundred ten DIEP flaps were performed on 286 patients. Eight of these patients, who underwent 13 DIEP flaps, were diagnosed with CTDs. The patients with and without CTDs were similar with respect to patient demographics. Patients with CTDs were not at increased risk of experiencing any major complication. However, patients with CTDs were at increased risk of experiencing fat necrosis, particularly of the breast (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our data suggests that breast reconstruction using DIEP flaps is a safe procedure for patients who have CTDs; however, they may be at increased risk for fat necrosis of the breast, which does not require significant intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18600,"journal":{"name":"Microsurgery","volume":"45 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137905","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}