Orthopedics最新文献

{"title":"Convolutional Neural Network Performs Similarly to Orthopedic Surgeons in Radiographic Grading of Knee Osteoarthritis.","authors":"Sarah L Lu, Michael Fei, Joseph G Elsissy, Brian A Schneiderman","doi":"10.3928/01477447-20260720-01","DOIUrl":"https://doi.org/10.3928/01477447-20260720-01","url":null,"abstract":"<p><strong>Background: </strong>Convolutional neural networks (CNNs) have shown promise in automated grading of knee osteoarthritis (OA) using the Kellgren-Lawrence (KL) scale. This study aimed to externally validate a CNN model against KL grading by fellowship-trained orthopedic surgeons.</p><p><strong>Materials and methods: </strong>CNN architectures (VGG16, ResNet34, DenseNet196, EfficientNetV2) were trained on 8,260 knee radiographs. Model performance was evaluated using accuracy, area under the curve (AUC) on a receiver operating curve, and F1 score. External validation was performed by comparing model outputs to KL grades assigned by 20 orthopedic surgeons using a blinded survey of 10 radiographs. Agreement was assessed using intra-class correlation coefficients (ICC) and Bland-Altman analysis.</p><p><strong>Results: </strong>EfficientNetV2 demonstrated the highest performance (AUC: 0.83; accuracy: 71%). The model achieved a mean absolute error of 0.58 KL grades relative to the average physician score and performed best at identifying KL0 and KL4 cases, with reduced performance for intermediate grades, particularly KL1. Average physician and model KL scores did not differ significantly (<i>P</i> = .23). Agreement between physicians and the model was high for both good-performing (ICC 0.93) and poor-performing images (ICC 0.94), exceeding inter-physician agreement (ICC 0.74 and 0.72, respectively). Bland-Altman analysis demonstrated minimal bias (-0.25 KL grades), indicating that physicians graded more conservatively than did the model.</p><p><strong>Conclusion: </strong>CNN-based grading demonstrated performance comparable to orthopedic surgeons, supporting its potential role as a screening or triage tool to improve consistency and efficiency in clinical workflows.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 4","pages":"e337-e342"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796356","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":"Declining Overall Use of Cervical Disk Arthroplasty in Medicare Beneficiaries Despite Outpatient Migration, 2016 to 2022.","authors":"Mitchell K Ng, Paul G Mastrokostas, Aaron B Lavi, Luke B Schwartz, Leonidas E Mastrokostas, Jonathan Dalton, Yulia Lee, William Green, Yasmine Eichbaum, Gregorio Baek, Joshua Mathew, Morgan Hitchner, Alexander Kucherina, Alec Giakas, Pemla Jagtiani, Jad Bou Monsef, Afshin E Razi, Thomas D Cha, Mark F Kurd, Zachary Wilt, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Christopher K Kepler, Gregory D Schroeder","doi":"10.3928/01477447-20260608-02","DOIUrl":"10.3928/01477447-20260608-02","url":null,"abstract":"<p><strong>Background: </strong>Cervical disk arthroplasty (CDA) has gained popularity as a motion-preserving alternative to anterior cervical diskectomy and fusion (ACDF) for treating cervical degenerative disk disease. The aim of this study was to evaluate national trends in Medicare use and reimbursement for CDA across settings, provider types, and geographic regions.</p><p><strong>Materials and methods: </strong>This is a retrospective national database analysis using Centers for Medicare and Medicaid Services Medicare Part A and Part B claims from 2016 to 2022. Single- and multilevel CDA procedures were identified using Current Procedural Terminology and Medicare Severity Diagnosis Related Group codes. Inflation-adjusted payments and procedure counts were analyzed using descriptive statistics, linear regression, analysis of variance, and <i>t</i> tests. Subgroup comparisons included region, provider type, and core-based statistical area classification. Statistical significance was set at the <i>P</i> < .05 level.</p><p><strong>Results: </strong>Outpatient single-level CDA volume increased by 1,016.0% from 2016 to 2022, whereas inpatient CDA volume decreased by 90.3%. Outpatient reimbursement rose from $1,459 to $3,143 (<i>P</i> = .011), whereas inpatient reimbursement increased from $24,956 to $32,679 (<i>P</i> = .025). Reimbursement was significantly higher in ambulatory surgical centers than for surgeon-only claims ($11,869 vs $1,219; <i>P</i> < .001), and in inpatient settings compared to surgeons (<i>P</i> < .001). Regional and rural-urban variation was observed, with the West consistently demonstrating higher reimbursement and volume for both outpatient and inpatient CDA.</p><p><strong>Conclusion: </strong>CDA procedures have shifted dramatically toward outpatient care, with marked differences in Medicare reimbursement across provider types and regions.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e310-e316"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397123","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":"Unilateral Biportal Endoscopic Diskectomy Versus Percutaneous Endoscopic Lumbar Diskectomy for Lumbar Disk Herniation: A Systematic Review and Meta-analysis.","authors":"Chen Wang, Weiyi Lin, Fenglang Li, Zhixing Lin, Yu Song, Peng Xiu","doi":"10.3928/01477447-20260625-01","DOIUrl":"10.3928/01477447-20260625-01","url":null,"abstract":"<p><strong>Background: </strong>This meta-analysis compared the clinical efficacy of unilateral biportal endoscopic diskectomy (UBE) and percutaneous endoscopic lumbar diskectomy (PELD) for lumbar disk herniation.</p><p><strong>Materials and methods: </strong>A systematic search of PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, and Wanfang was conducted from inception to May 2025. Comparative studies in adults undergoing UBE or PELD were included. Outcomes included operative and recovery parameters, complications, reoperation, Macnab outcomes, visual analog scale (VAS) scores, Oswestry Disability Index (ODI), fluoroscopy exposure, and total cost. Pooled effects were calculated as mean differences or odds ratios with 95% confidence intervals. Prespecified subgroup analyses (PELD approach and operative level) and sensitivity analyses (leave-one-out/model switching) were performed. Clinical relevance was interpreted using commonly cited minimal clinically important difference thresholds for VAS and ODI.</p><p><strong>Results: </strong>A total of 25 studies involving 2,087 patients were included. Compared with PELD, UBE was associated with longer operative time, greater intraoperative blood loss, larger incisions, longer hospital stays, and higher hospitalization costs, but significantly fewer intraoperative fluoroscopy exposures. No significant differences were observed in complication or reoperation rates. Although some statistically significant differences were detected in early perioperative metrics, all between-group differences in VAS pain and ODI functional scores were far below the minimal clinically important difference thresholds, confirming clinically equivalent mid-term outcomes. Subgroup analyses identified that PELD approach and operative level were key contributors to between-study heterogeneity, and sensitivity analyses confirmed that our main conclusions remained stable.</p><p><strong>Conclusion: </strong>Both UBE and PELD are safe and effective minimally invasive strategies for lumbar disk herniation, with comparable clinical efficacy. PELD offers advantages in lower surgical trauma and cost effectiveness, whereas UBE reduces intraoperative radiation exposure. Surgical selection should be individualized based on patient pathology and surgeon expertise.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 4","pages":"e275-e283"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796416","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":"Identifying Drivers of Implant Cost Variation in Distal Radius Fracture Open Reduction and Internal Fixation.","authors":"Christy Zheng, Leah Demetri, Philip Blazar, Brandon E Earp, Dafang Zhang","doi":"10.3928/01477447-20260723-01","DOIUrl":"https://doi.org/10.3928/01477447-20260723-01","url":null,"abstract":"<p><strong>Background: </strong>Volar locking plates are widely used for open reduction and internal fixation (ORIF) of distal radius fractures; however, variation exists in implant selection, construct complexity, and overall cost.</p><p><strong>Materials and methods: </strong>Patients who underwent ORIF with a volar locking plate for distal radius fractures between January 2023 and December 2024 were identified using current procedural terminology codes 25607, 25608, and 25609. Demographic and clinical variables were extracted from the electronic health record. Implant, supply, and total material costs were obtained from cost reports, and screw counts were verified on radiographs. Bivariate analyses of costs and explanatory variables were performed using Student's <i>t</i> test, Mann-Whitney U test, or chi-squared tests.</p><p><strong>Results: </strong>In a cohort of 496 patients, median age was 63 years and 81.9% were women. The median implant cost was $1,641 (interquartile range: $1,417 to $1,944), and the median total material cost was $1,830 (interquartile range: $1,633 to $2,264). A mean of 8.7 ± 1.4 screws were used per case. Both implant costs and total costs were significantly associated with implant manufacturer, total screw count, bone allograft use, fracture type, and operating time (all <i>P</i> < .05). Costs were not associated with age, sex, body mass index, race, diabetes, smoking status, dominant hand fracture, open fracture, surgeon subspeciality, or surgical assistant type (<i>P</i> > .05).</p><p><strong>Conclusion: </strong>Implant costs for distal radius ORIF are largely influenced by variables related to fracture complexity, such as screw count, bone allograft use (and usage), and operation time, as well as system-level variables, such as implant manufacturer.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 4","pages":"e343-e350"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796363","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":"Erratum for \"Primary Total Ankle Replacement for Acute Comminuted Pilon Fractures in Older Adults: Proposed Indications and a Report of 29 Cases\".","authors":"","doi":"10.3928/01477447-20260805-01","DOIUrl":"https://doi.org/10.3928/01477447-20260805-01","url":null,"abstract":"","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 4","pages":"e274"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796424","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":"Intra-Articular Vancomycin Powder in Primary Total Knee Arthroplasty: A Retrospective Observational Study.","authors":"Kemal Şibar, Vedat Biçici, Ezgi Gizem Şibar, Yasin Erdoğan, Erkan Akgün, Hanife Uzar, Ahmet Firat","doi":"10.3928/01477447-20260615-01","DOIUrl":"10.3928/01477447-20260615-01","url":null,"abstract":"<p><strong>Background: </strong>Periprosthetic joint infection (PJI) is one of the most serious complications following total knee arthroplasty (TKA). Vancomycin powder has been proposed as a low-cost adjunct to reduce infection by providing high local antibiotic concentrations with minimal systemic exposure; however, clinical evidence remains inconsistent. This study aimed to evaluate the effect of intra-articular vancomycin powder on PJI, aseptic wound complications, and renal function in primary TKA.</p><p><strong>Materials and methods: </strong>Patients who underwent primary TKA between 2022 and 2024 with at least 1 year of follow-up were retrospectively analyzed. A total of 661 patients were included: 247 received 1 g intra-articular vancomycin powder and 414 served as controls. All procedures were performed with standardized perioperative protocols. Demographics, comorbidities, and high-risk status were recorded. Outcomes included PJI, aseptic wound complications, and acute kidney injury.</p><p><strong>Results: </strong>PJI occurred in 7 patients (1.1%): 6 in the control group (1.4%) and 1 in the vancomycin group (0.4%), with no significant difference (<i>P</i> = .266). Aseptic wound complications were observed in 28 patients (4.2%), including 20 control patients (4.8%) and 8 vancomycin patients (3.2%) (<i>P</i> = .326). Acute kidney injury occurred in 12 patients (1.8%), with comparable rates between groups (<i>P</i> = 1.000).</p><p><strong>Conclusion: </strong>Intra-articular vancomycin powder did not result in a statistically significant reduction in PJI rates, while demonstrating a favorable safety profile. Although safe, routine use may not provide additional measurable benefit in optimized surgical settings with low baseline infection rates. Larger, well-designed randomized trials are required to identify patient subgroups who may benefit from selective application.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e324-e329"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318368","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":"Understanding One-year Mortality Rates and Comorbidity Burden in Older Adults Following Hip Fracture.","authors":"Chris Sun, Eric R Tecce, Kimberly Dong, Alec M Giakas, William Ryan, Asif M Ilyas","doi":"10.3928/01477447-20260608-01","DOIUrl":"10.3928/01477447-20260608-01","url":null,"abstract":"<p><strong>Background: </strong>Hip fractures impose substantial patient morbidity and burden to health care systems globally, with potentially high and variable 1-year mortality rates. To improve shared decision making when guiding treatment for patients, this study evaluated 1-year mortality rates following hip fractures in the older adult population using a large multicenter live database. The study goal was to determine the recent 1-year mortality rate with contemporary orthogeriatric care strategies.</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted using the TriNetX Research Network. Patients aged 65 to 90 years with an incident hip fracture were identified, excluding those with same-day mortality or previous hip fractures. Cohorts were stratified by sex and 5-year age intervals. One-year all-cause mortality rates following hip fracture and Kaplan-Meier survival (KM) estimates, with log-rank tests, were calculated. Pre-fracture demographic and clinical characteristics were compared between those who succumbed within 1 year and those who survived beyond 1 year.</p><p><strong>Results: </strong>Among 197,222 included patients, the 1-year mortality rate was 11.6%, with an 86.7% KM estimate of survival. One-year mortality increased with age and was higher in men across all age strata. Patients with 1-year mortality demonstrated a higher baseline comorbidity burden, including neurocognitive, cardiovascular, metabolic, renal, hepatic, and pulmonary diseases and malignancies. Although women succumbing within 1 year had higher rates of certain neurocognitive and metabolic disorders, men had higher rates of chronic ischemic heart disease and chronic kidney disease.</p><p><strong>Conclusion: </strong>One-year mortality following hip fractures was approximately 12%. Continued monitoring and optimization of multidisciplinary orthogeriatric models and postoperative care may further improve outcomes and survival.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e284-e292"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397237","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":"Impact of Non-Tobacco Nicotine Dependence on Outcomes Following Arthroscopic Partial Meniscectomy.","authors":"Ankit Hirpara, Ansh Shah, Logan Good, Andrew Moyal, Davison Beenfeldt, James E Voos, Jacob G Calcei","doi":"10.3928/01477447-20260710-01","DOIUrl":"https://doi.org/10.3928/01477447-20260710-01","url":null,"abstract":"<p><strong>Background: </strong>Non-tobacco nicotine dependence (NTND) from products like electronic cigarettes and pouches is rapidly rising. Smoking can negatively impact outcomes following arthroscopic partial meniscectomy (APM), but literature on NTND is sparse. The purpose of this study was to compare outcomes following APM in patients with and without NTND.</p><p><strong>Materials and methods: </strong>The TriNetX database was queried to identify patients older than 18 years who underwent isolated primary APM. Patients were stratified into 2 cohorts based on NTND history and underwent 1:1 propensity score matching on demographics, substance use, and comorbidities. Outcomes included (1) postoperative complications and health care use within 90 days, (2) opioid prescriptions within 1 year, and (3) subsequent knee surgery within 2 years. Subgroup analyses compared ipsilateral revision meniscus surgery rates and opioid prescriptions in opioid-naive patients.</p><p><strong>Results: </strong>Within 90 days, patients with NTND (n = 9,594), compared to those without (n = 9,594), had higher rates of emergency department visits (<i>P</i> < .001), outpatient visits (<i>P</i> = .015), and pneumonia (<i>P</i> = .011). More patients with NTND were prescribed opioids at all time points within 1 year (<i>P</i> < .001), and they received more prescriptions starting at 1 month (all <i>P</i> ≤ .006). More opioid-naive patients with NTND were prescribed opioids starting at 1 month postoperatively (<i>P</i> < .05). Patients with NTND had higher rates of subsequent meniscus surgery at 1 year (<i>P</i> = .004) and 2 years (<i>P</i> < .001) but no differences in revision rates.</p><p><strong>Conclusion: </strong>NTND is associated with higher rates of health care use, complications, subsequent meniscus surgery, and opioid prescriptions, including among opioid-naive patients, following APM. Preoperative nicotine screening and patient education are warranted.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 4","pages":"e359-e367"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796404","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 Intra-Articular Injection of Umbilical Cord-Derived Extracellular Vesicles in Patients With Knee Osteoarthritis: A Retrospective Study.","authors":"Naomasa Yokota, Takeo Kambayashi, Yu Tanabe","doi":"10.3928/01477447-20260721-01","DOIUrl":"https://doi.org/10.3928/01477447-20260721-01","url":null,"abstract":"<p><strong>Background: </strong>Extracellular vesicles derived from the umbilical cord (UCEVs) have emerged as a potential biological therapy for knee osteoarthritis (KOA). However, their clinical efficacy remains unknown. The purpose of this study was to evaluate the safety and efficacy of intra-articular injections of umbilical cord stem cell-derived UC-EVs in patients with KOA.</p><p><strong>Materials and methods: </strong>A total of 29 patients (33 knees) with KOA received 6 intra-articular injections of UC-EVs (1 × 10¹¹ particles per dose) every 2 weeks. Clinical outcomes were assessed at 3, 6, and 12 months using the Knee Injury and Osteoarthritis Outcome Score (KOOS), visual analog scale (VAS), and Outcome Measures in Rheumatology and Osteoarthritis Research Society International (OMERACT-OARSI) responder criteria.</p><p><strong>Results: </strong>Significant improvements in all KOOS subscale scores and VAS for pain were observed at all follow-up time points compared with baseline (<i>P</i> < .01), with all scores exceeding predefined minimal clinically important difference thresholds. VAS for pain decreased by a mean of 38.8 ± 25.5 mm, and the greatest KOOS improvement was seen in quality of life (32.8 ± 21.9) and sport and recreation function (28.6 ± 25.2). The OMERACT-OARSI responder rate was 66.7% overall (22/33 knees), with rates of 83.3%, 66.7%, and 44.4% for Kellgren-Lawrence grades 2, 3, and 4, respectively. No serious adverse events were observed.</p><p><strong>Conclusion: </strong>Intra-articular injection of UC-EVs demonstrated meaningful clinical benefits in patients with KOA, including reductions in VAS pain scores and improvements across all KOOS domains. Patients with Kellgren-Lawrence grade 2 or 3 showed greater treatment responses compared with grade 4. These findings suggest that intra-articular UC-EVs therapy may represent a promising next-generation treatment option for KOA.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 4","pages":"e351-e358"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796377","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":"Erratum for \"A Comparative Analysis of Suture-Button and InternalBrace Fixation for Purely Ligamentous Lisfranc Injuries\".","authors":"","doi":"10.3928/01477447-20260805-02","DOIUrl":"https://doi.org/10.3928/01477447-20260805-02","url":null,"abstract":"","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 4","pages":"e292"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796393","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}