Neurologia i neurochirurgia polska最新文献

{"title":"Recommendations of Multiple Sclerosis and Neuroimmunology Section of Polish Neurological Society and Immuno-oncology Section of Polish Society of Oncology on oncological risk in patients with multiple sclerosis undergoing immunomodulatory therapy.","authors":"Iwona Rościszewska-Żukowska, Alina Kułakowska, Alicja Kalinowska, Halina Bartosik-Psujek, Dagmara Mirowska-Guzel, Mariusz Stasiołek, Beata Zakrzewska-Pniewska, Waldemar Brola, Sławomir Wawrzyniak, Marek Gołębiowski, Jacek Mackiewicz, Grażyna Kamińska-Winciorek, Anna M Czarnecka, Adam Maciejczyk, Sebastian Giebel, Piotr Rutkowski, Bożena Cybulska-Stopa, Monika Adamczyk-Sowa","doi":"10.5603/pjnns.101995","DOIUrl":"10.5603/pjnns.101995","url":null,"abstract":"<p><p>Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system (CNS) that is usually diagnosed between the ages of 20 and 40. Changes in the immune system also observed in cancer may suggest a higher prevalence of cancer in the MS patient population. In recent years, many highly effective immunosuppressive drugs have been introduced into disease-modifying therapy (DMT) which may be associated with a higher risk of cancer development in patients with MS. This paper presents current data on the oncological risk of individual drugs. In addition, it provides recommendations on the management for qualifying for DMT and monitoring the safety of the therapy from anoncological perspective.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"20-32"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parkinson's Disease and glucose dysregulation: shared pathophysiological mechanisms and clinical implications.","authors":"Tomasz Chmiela, Zbigniew K Wszolek, Jessica R Wilson","doi":"10.5603/pjnns.104405","DOIUrl":"10.5603/pjnns.104405","url":null,"abstract":"<p><strong>Introduction: </strong>The relationship between Parkinson's Disease (PD) and type 2 diabetes mellitus (T2DM) is attracting increasing research interest. Epidemiological data shows a remarkable association between these two age-related diseases. Evidence is emerging to suggest a common pathological pathway linking PD and T2DM, involving factors such as altered insulin signalling, insulin resistance, oxidative stress, mitochondrial dysfunction, neuroinflammation, and misfolded protein accumulation. The precise mechanisms underlying this interplay, however, remain less clear, and are likely to be bidirectional. The aim of this review was to examine the epidemiological association between PD and T2DM, summarise potential common mechanisms, and evaluate the role of antidiabetic medications in the treatment and prevention of PD progression.</p><p><strong>Clinical implications: </strong>A deeper understanding of the shared pathophysiological pathways between PD and T2DM may pave the way for novel therapeutic approaches for patients with both diseases. Research into antidiabetic drugs, particularly GLP-1 receptor agonists, shows promise in potentially modifying the progression of PD.</p><p><strong>Future directions: </strong>Investigation of the common pathophysiological mechanisms of PD and T2DM may lead to new treatment strategies for both diseases. Ongoing studies of the efficacy and safety of antidiabetic drugs in PD, particularly in larger populations, are essential to validate their long-term benefits and therapeutic potential.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"385-395"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Parkinson's Disease clinical subtypes really exist?","authors":"Marta Filidei, Luca Marsili, Carlo Colosimo","doi":"10.5603/pjnns.103572","DOIUrl":"10.5603/pjnns.103572","url":null,"abstract":"<p><strong>Introduction: </strong>Parkinson's Disease (PD) is a highly heterogeneous entity in terms of clinical manifestations, progression, and treatment response. This variability has given rise to the hypothesis that different clinical subtypes of the disease exist.</p><p><strong>State of the art: </strong>To date, several clinical subtypes have been described, mostly based on different clinical features, and sometimes with the support of biomarkers, either fluid, neuroimaging, or neurophysiological. The most homogeneous subtypes detected are a 'benign subtype', characterised by younger age at onset, mild non-motor symptoms, and a slower rate of disease progression, and a 'malignant subtype', which features an older age at onset, a higher burden of non-motor symptoms, and faster disease progression.</p><p><strong>Clinical implications: </strong>Despite extensive research, none of the subtypes identified so far seem to be biologically supported, so clinical subtyping does not elucidate PD aetiology and does not allow for the prediction of prognosis or treatment response. This study was aimed to review the literature on this topic and to examine the studies on PD subtyping. We also reviewed the proposed biomarkers for a biological classification of PD, and outlined the role of genetics and pathology within this context.</p><p><strong>Future directions: </strong>In light of the recent proposal of a biological classification of PD, which might overcome the limits of the clinical diagnosis, PD subtyping should hopefully shepherd researchers towards a biological approach, also aided by recent advances in the field of biomarkers.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"127-143"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring multifidus muscles atrophy after midline lumbar fusion with cortical bone trajectory screws due to spinal instability and spondylolisthesis: a retrospective case series.","authors":"Albert Sterba, Aline Veiga, Pavel Haninec, Petr Waldauf, Petr Linzer, Michal Filip, Filip Samal","doi":"10.5603/pjnns.101672","DOIUrl":"10.5603/pjnns.101672","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to assess the impact of midline lumbar fusion with cortical bone trajectory screws (MIDLF/CBT) on the multifidus muscles, focusing on the evaluation of their postoperative atrophy.</p><p><strong>Clinical rationale for the study: </strong>MIDLF/CBT is a relatively new technique increasingly used to treat spinal instability. Despite its reduced invasiveness compared to traditional posterior lumbar interbody fusion with traditional pedicle screws (PLIF/TP), concerns remain about potential damage to the multifidus muscles that are crucial for spinal stability. Understanding the extent of muscular atrophy post-MIDLF/CBT is vital for improving surgical outcomes, and potentially patient rehabilitation strategies.</p><p><strong>Material and methods: </strong>This study retrospectively analysed preoperative and postoperative MRI scans of patients who underwent MIDLF/CBT for degenerative segmental spondylolisthesis. The bilateral width of the multifidus muscles at the operated segment and adjacent segments was measured using axial T2-weighted MRI scans. Statistical comparisons were made using a paired t test, with significance set at p < 0.05.</p><p><strong>Results: </strong>The study included 16 patients with an average age of 57 ± 10 years, 10 of whom (62.5%) were women, and featured a mean follow-up period of 37 ± 25 months. Postoperative measurements showed a significant reduction in the width of the multifidus muscles at the operated segment (mean difference -3.3mm, p = 0.02) and the inferior adjacent segment (-7.4 mm, p < 0.01). A decrease in muscle width at the superior adjacent segment was also observed, although this was not statistically significant.</p><p><strong>Conclusions and clinical implications: </strong>Our study concluded that MIDLF/CBT results in significant multifidus muscle atrophy at and below the operated segment, potentially impacting postoperative rehabilitation and recovery. These findings highlight the need for further research comparing MIDLF/CBT to other spinal stabilisation techniques. Additionally, incorporating functional electromyographic assessments of paraspinal muscles could provide deeper insights into the long-term consequences of spinal surgeries and helpdevelop new approaches and strategies to mitigate paravertebral muscles atrophy, thus enhancing patient outcomes.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"41-48"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances in epilepsy diagnosis and treatment.","authors":"Halina Sienkiewicz-Jarosz","doi":"10.5603/pjnns.106590","DOIUrl":"https://doi.org/10.5603/pjnns.106590","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":"59 3","pages":"193-198"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequence of language acquisition as a factor determining language comprehension centre location in cerebral cortex in sequential multilinguals.","authors":"Tomasz Wolak, Julia M Nowak, Iwona Chaberska, Radosław Kuliński, Andrzej Friedman","doi":"10.5603/pjnns.104340","DOIUrl":"10.5603/pjnns.104340","url":null,"abstract":"<p><strong>Aim of study: </strong>The objective of this study was to identify cerebral regions specifically involved in speech comprehension for each sequentially acquired language (L1, L2, L3, L4) in multilingual individuals, and to explore the relationship between the sequence of language acquisition and its cortical representation.</p><p><strong>Clinical rationale for study: </strong>Multilingualism is increasingly prevalent worldwide. However, the cortical representation of sequentially acquired languages remains inadequately explored. Currently, there are no established guidelines for the perioperative neurosurgical management of multilingual patients, presumably due to a lack of research on this topic.</p><p><strong>Material and methods: </strong>Participants with a high communicative proficiency in at least three sequentially acquired foreign languages, learned after the age of three, were recruited. A passive listening paradigm was applied for this study. Brain anatomy was visualized using T1-weighted MRI, while functional brain activity (BOLD signal) was measured using echo-planar imaging. Cortical activity elicited by foreign languages (L2, L3, L4) was compared with native language (L1) and an 'unknown' (LN). Data processing and statistical analysis were conducted using SPM12 software.</p><p><strong>Results: </strong>Twenty multilingual participants were included. A gradual decrease in left-hemisphere dominance was observed from L1 through L4. Compared to L1, L2 demonstrated increased cortical activation in the right middle temporal gyrus and left middle occipital gyrus, whereas L3 showed higher activation in the left fusiform gyrus. No areas of greater activation were identified for L4 compared to L1. Conversely, L1 showed numerous regions of heightened activation relative to subsequently acquired languages. When compared to LN, both L2 and L3 exhibited increased activity in the right insula. Additionally, L3 and L4 displayed elevated activity in the right hippocampus compared to LN.</p><p><strong>Conclusions and clinical implications: </strong>Our study found distinct cortical localizations for sequentially acquired languages. We recommend routine perioperative cortical mapping for languages L2 and L3, in addition to L1. Mapping for L4 should be considered on a case-by-case basis. Further research into cortical areas involved in multilingual speech production is warranted.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"292-299"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and neuroradiological red flags in differential diagnosis of pituitary metastases and PitNETs (adenomas): a surgeon's experience and systematic literature review.","authors":"Riccardo Antonio Ricciuti, Riccardo Paracino, Fabrizio Mancini, Pierfrancesco De Domenico, Vittorio Ricciuti, Francesca Romana Barbieri, Matteo Maria Ottaviani, Serena Pagano, Daniele Marruzzo","doi":"10.5603/pjnns.103406","DOIUrl":"10.5603/pjnns.103406","url":null,"abstract":"<p><strong>Introduction: </strong>Pituitary metastases (PMs) are rare malignancy manifestations, generally deemed to have an extremely poor prognosis. Differential diagnosis from primary pituitary lesions is often difficult, as their features can mimic those of pituitary neuroendocrine tumours (PitNETs). This study aimed to report a single surgeon's experience in managing PMs and to gather the existing evidence on their clinical and neuroradiological presentation to build a model of 'red flags' that help raise the suspicion of PMs in the context of sellar lesions.</p><p><strong>Material and methods: </strong>We retrieved an original 10-year surgical series of patients undergoing endoscopic transsphenoidal (TNS) surgery for suspected PitNETs, and we additionally conducted a systematic review of case reports or series of patients with PMs.</p><p><strong>Results: </strong>The local series consisted of n = 6 PMs. The literature review yielded n = 149 works reporting n = 340 PMs. Overall, the clinical presentation and neuroradiological features of n = 346 PMs were analysed and compared to data retrieved from n = 361 PitNETs from our original cohort. Primary features associated with PMs were: the presence of headaches (OR 1.24, p = 0.001), visual field deficits (OR 1.19, p = 0.02), extraocular nerve palsies (OR 1.23, p = 0.001), diabetes insipidus (OR 2.13, p < 0.001), MRI features of pituitary stalk/infundibular involvement (OR 1.98, p = 0.001), cavernous sinus invasion (OR 1.57, p = 0.004), and T2w flow voids (OR 1.13, p = 0.001). An incidental diagnosis (OR 0.49, p < 0.001) and cystic changes (OR 0.77, p = 0.02) were less common among PMs. Secondary features involved an acute onset of symptoms (OR 1.25, p = 0.001), the presence of oncological history (OR 1.89, p = 0.001), sellar walls erosion (OR 1.55, p = 0.002), and gross appearance of a firm (OR 2.01, p < 0.001) and easily bleeding lesion (OR 1.99, p < 0.001). Sellar enlargement predicted a lower risk of PMs (OR 0.54, p = 0.001).</p><p><strong>Conclusion: </strong>We have compiled a list of primary and secondary red flags, including clinical and neuroradiological features, to serve as a guiding tool for clinicians to raise suspicion of PMs and aid in the differential diagnosis of various lesions centered in the sella.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"254-271"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for PRKN and PINK1 mutations in Ecuadorian patients with early-onset Parkinson's Disease.","authors":"Tobias M Franz, Rohitha K Punathil, Alexandra I Soto-Beasley, Audrey Strongosky, Ronald L Walton, Sarah Kim-Hellmuth, Wolfdieter Springer, Jaroslaw Dulski, Owen A Ross, Gabriela Jaramillo-Koupermann, Fernando Alarcon, Zbigniew K Wszolek","doi":"10.5603/pjnns.104123","DOIUrl":"10.5603/pjnns.104123","url":null,"abstract":"<p><strong>Introduction: </strong>Early-onset Parkinson's Disease (EOPD) is a neurodegenerative disease with the clinical manifestation of movement symptoms before the age of 50. Patients with EOPD frequently have a positive family history of disease, with bi-allelic loss of function mutations in PRKN and PINK1 as the most common genetic cause. To date, the majority of genetic studies have been conducted on patients with European ancestry, limiting the understanding of the genetic heterogeneity of EOPD across populations. The aim of this study was to screen the PRKN and PINK1 genes in an Ecuadorian EOPD cohort, and improve the understanding of the genetic profile of patients in this population.</p><p><strong>Material and methods: </strong>Seventy unrelated patients with EOPD and with an average age at onset of 42.6 ± 5.6 years were recruited at the Hospital Eugenio Espejo in Quito, Ecuador, and screened for the presence of PRKN and PINK1 single nucleotide and copy number variations.</p><p><strong>Results: </strong>Sanger sequencing identified six PRKN variants, and five resulted in nonsynonymous amino acid substitutions. Seven PINK1 variants were identified: four nonsynonymous, and three common (MAF > 1%), among the EOPD cohort. Multiplex ligation-dependent probe amplification (MLPA) identified three carriers with PRKN copy number variants. Overall, across the series, two patients carried pathogenic homozygous deletions of exons 3 and 4.</p><p><strong>Discussion: </strong>Gaining insights into the genetics of EOPD in Latin America is important. In this study, we have identified two carriers of pathogenic PRKN copy number variants in a relatively large group of Ecuadorian patients with EOPD. Additional, familial, early-onset and sporadic PD studies are warranted to further expand the knowledge base regarding Latin American populations.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":"59 1","pages":"56-61"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of neuroinflammation factors as potential biomarkers of epilepsy: a narrative review.","authors":"Marta Zawadzka, Marta Pietruszka, Magdalena Krygier, Maria Mazurkiewicz-Bełdzińska","doi":"10.5603/pjnns.102426","DOIUrl":"10.5603/pjnns.102426","url":null,"abstract":"<p><p>Epilepsy is a common neurological condition with a significant socioeconomic impact. Approximately one in three patients is resistant to the available therapies, and the mechanisms of this resistance are often unclear. Neuroinflammation, recognised as a potential cause of drug-resistant epilepsy, plays a key role in modulating synaptic transmission and hyperexcitability. In this narrative review, we explore the molecular basis of neuroinflammation in epilepsy and its potential as a source of biomarkers for diagnosis and treatment. Evidence from human and animal studies indicates a strong association between neuroinflammation and epilepsy, with significant involvement of pro-inflammatory molecules and blood-brain barrier dysfunction. We highlight the roles of microglia, astrocytes and inflammatory molecules in epilepsy, suggesting that targeted anti-inflammatory therapies could be promising for treatment. Further research is needed to fully understand the role of neuroinflammation in epilepsy and to develop new therapeutic approaches.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"210-220"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of short percutaneous fixation in AO3 and AO4 lumbar fractures: a single-centre experience of 35 cases.","authors":"Pierfrancesco De Domenico, Riccardo Paracino, Domenico Cassitto, Marilena Rolli, Alessandro Melatini","doi":"10.5603/pjnns.99238","DOIUrl":"10.5603/pjnns.99238","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal fractures with subsequent bone fragment dislocation are among the injuries most feared by patients and physicians. The surgical strategy is tailored to the individual patient's characteristics and often consists of pedicle instrumentation with rod-screw systems. Short instrumentation has been associated with worse spinal correction and increased complications. However, recent studies have suggested similar results in terms of kyphosis correction and the maintenance of sagittal alignment compared to longer instrumentation.</p><p><strong>Material and methods: </strong>This single-center retrospective study was conducted between January 2018 and April 2021. We included 35 single lumbar burst fractures AO Spine grade A3 or A4 with evidence of intra-canal fragments. Patients underwent minimally invasive percutaneous posterior lumbar instrumentation with pedicle screws. Patients received short segmental fixation involving only one level above and below the fractured vertebra.</p><p><strong>Results: </strong>An immediate postoperative computed tomography (CT) scan demonstrated a significant reduction in vertebral kyphotic deformation (11.7° ± 1.6 vs 16.7° ± 5, p<0.001) and sagittal Cobb angle (9.8° ± 1.3 vs 11.7° ± 1.5, p < 0.001). The correction was slightly reduced but remained significant at 12 months for both kyphotic (12.3° ± 1.4, p = 0.03) and sagittal Cobb (10.3° ± 0.9, p = 0.04). Upper lumbar vertebrae showed even larger correction indices compared to lower lumbar segments. No implant failure or screws pullout was seen at the last follow-up.</p><p><strong>Conclusions: </strong>Short spinal fixation is a safe and effective treatment of complete and incomplete burst fractures with posterior bone fragment dislocation. All included patients fared well and achieved good kyphotic correction with no perioperative or long-term complications.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"49-55"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}