Orthopedics最新文献

{"title":"Increased 90-Day Morbidity and Mortality Among Patients With Hip Fracture During the COVID-19 Pandemic.","authors":"Megan M Mizera, Danielle Putur, Anna Tarasova, Edina Gjonbalaj, Zeynep Seref-Ferlengez, Andrea M Muñoz, Noel O Akioyamen, Mani Kahn","doi":"10.3928/01477447-20240826-03","DOIUrl":"10.3928/01477447-20240826-03","url":null,"abstract":"<p><strong>Background: </strong>When coronavirus disease 2019 (COVID-19) first spread to the United States, our institution was at the outbreak's epicenter. Despite limited understanding of COVID-19's long-term effects, we continued performing surgical fixation of geriatric hip fractures under strict guidelines. This study examined the outcomes of these patients during the pandemic compared with those of patients treated pre-pandemic.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study of patients with hip fractures between December 2019 and June 2020, the peak of the pandemic in our region. Outcomes of patients treated with surgical fixation (2020 cohort) were compared with those of a historical control group (2019 cohort). The primary outcome was 90-day mortality, with secondary outcomes including pneumonia, thromboembolic events, emergency department visits, readmission, and cardiac events.</p><p><strong>Results: </strong>The 2020 cohort (n=64) and 2019 cohort (n=78) had similar baseline characteristics. The 2020 cohort had a 4.27 times higher risk (95% CI, 1.30-13.98) of developing pneumonia compared with the pre-pandemic cohort but had no other differences in 90-day complications. Patients with COVID-19 in the 2020 cohort had a 5.09 times higher risk (95% CI, 1.35-19.20) of developing pneumonia and a 5.38 times higher risk (95% CI, 1.13-25.64) of postoperative mortality. There was no increased risk for thromboembolism between the 2020 and 2019 cohorts, even among COVID-19 cases, as all patients received anticoagulation with heparin.</p><p><strong>Conclusion: </strong>Our study demonstrates that hip fracture surgery remained safe during the peak of the US COVID-19 pandemic, with an expected increase in pneumonia and mortality risk for patients with hip fracture with COVID-19. [<i>Orthopedics</i>. 2024;47(6):359-364.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"359-364"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110500","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":"Primary Open Latarjet Procedure Versus Revision to Open Latarjet Procedure for Anterior Shoulder Instability.","authors":"Rashad Madi, Ryan Lopez, Holt S Cutler, C Lucas Myerson, Alexander Lee, Cody Hansen, David L Glaser, G Russell Huffman, John D Kelly, John G Horneff","doi":"10.3928/01477447-20240826-06","DOIUrl":"10.3928/01477447-20240826-06","url":null,"abstract":"<p><strong>Background: </strong>Although the Latarjet operation may be performed as a revision surgery for anterior shoulder instability, the high recurrence rate of anterior shoulder instability after arthroscopic Bankart repair (ABR) has led some to advocate for performing the Latarjet procedure as a primary stabilization surgery. The purpose of this study was to compare the intermediate-term outcomes after primary open Latarjet (PLJ) and revision to open Latarjet (RLJ).</p><p><strong>Materials and methods: </strong>This was a single-institution retrospective analysis of patients who underwent either PLJ or RLJ procedures for anterior shoulder instability between 2014 and 2023. Patients with less than 1 year of follow-up, seizure history, multidirectional instability, concurrent rotator cuff repair, or the absence of preoperative imaging were excluded. Glenoid bone loss (GBL), the width of Hill-Sachs lesions, recurrent dislocations, and reoperations were assessed.</p><p><strong>Results: </strong>The study included 29 patients, with 12 undergoing PLJ procedures and 17 undergoing RLJ procedures. The mean duration of follow-up was similar for the two groups (4.7 vs 4.6 years, <i>P</i>=.854). Patients undergoing PLJ procedures demonstrated a higher mean GBL (18.4%) compared with patients undergoing revision (10.5%; <i>P</i>=.035); however, there was no significant difference in Hill-Sachs lesion size (14.2 vs 10.4 mm, <i>P</i>=.374). After stratifying according to GBL, the groups undergoing PLJ and RLJ procedures had similar recurrent dislocation rates (8.3% and 11.8%, respectively; <i>P</i>=1.0) and reoperation frequency (25.0% and 23.5%, respectively; <i>P</i>=1.0).</p><p><strong>Conclusion: </strong>The PLJ and RLJ groups had comparable rates of recurrent dislocations, complications, and reoperations, emphasizing the value of considering Latarjet procedures as revision surgery after unsuccessful primary arthroscopic stabilization. [<i>Orthopedics</i>. 2024;47(6):343-348.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"343-348"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110501","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 \"Site of Service Disparities Exist for Total Joint Arthroplasty\".","authors":"","doi":"10.3928/01477447-20241111-01","DOIUrl":"https://doi.org/10.3928/01477447-20241111-01","url":null,"abstract":"","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"47 6","pages":"331"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686962","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":"A Cost Analysis of Traditional Versus Robotic Total Knee Arthroplasty Performed With an Imageless, Second-generation Robotic System.","authors":"Justin Leal, Niall H Cochrane, Billy I Kim, Christopher T Holland, Rhett Hallows, Thorsten Seyler","doi":"10.3928/01477447-20240809-05","DOIUrl":"10.3928/01477447-20240809-05","url":null,"abstract":"<p><strong>Background: </strong>This study compared perioperative outcomes as well as encounter and 90-day costs between patients undergoing traditional vs robotic total knee arthroplasty (rTKA).</p><p><strong>Materials and methods: </strong>A total of 430 TKAs (215 rTKAs, 215 traditional) were retrospectively reviewed. All rTKAs were performed with an imageless, second-generation robotic system. Cohorts were propensity score matched by age, sex, body mass index, and American Society of Anesthesiologists score. Perioperative data and 90-day complications were subsequently compared. Cox regression analyses evaluated survival to all-cause revisions. Univariable analyses compared total cost of care for the initial encounter and 90-day postoperative period. Multivariable regression analyses were then performed to evaluate associations with increased encounter and 90-day costs.</p><p><strong>Results: </strong>Patients undergoing rTKA had a higher incidence of discharge home (86.5% vs 60.0%; <i>P</i><.001). The rTKA cohort trended toward a lower incidence of 90-day emergency department visits, and there was a significantly lower percentage of 90-day readmissions (4.2% vs 13.5%; <i>P</i>=.001). Cox hazard ratio demonstrated no difference in survival to all-cause revisions (hazard ratio, 1.3; 95% CI, 0.5-3.7; <i>P</i>=.64). The cost of surgery was significantly higher in the rTKA cohort ($9292 vs $8392; <i>P</i><.001); however, there was no difference in cost of encounter ($10,356.86 vs $10,396.44; <i>P</i>=.110) or at 90 days postoperatively ($11,103.89 vs $11,040.13; <i>P</i>=.739). rTKA did not have a significant association with increased cost at 90 days postoperatively (odds ratio, 0.96; 95% CI, 0.90-1.02; <i>P</i>=.180).</p><p><strong>Conclusion: </strong>rTKA had a higher intraoperative cost compared with traditional TKA. However, with increased home discharges and fewer 90-day readmissions, rTKA was not associated with increased cost at 90 days. [<i>Orthopedics</i>. 2024;47(6):365-371.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"365-371"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009178","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 Obesity, Smoking, and Age on 30-Day Postoperative Outcomes of Patients Undergoing Arthroscopic Meniscus Surgery.","authors":"Brian T Ford, Ryan Kong, Ian J Wellington, Frank A Segreto, David H Mai, Jack Zhou, William Urban","doi":"10.3928/01477447-20240826-04","DOIUrl":"10.3928/01477447-20240826-04","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to evaluate the impact that obesity, smoking, and older age have on 30-day postoperative complications, reoperations, and readmissions of patients undergoing arthroscopic meniscectomy or meniscus repair.</p><p><strong>Materials and methods: </strong>The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was queried to identify meniscus surgeries and operative outcomes between 2008 and 2016. Controlled regression analysis was then performed to evaluate for an association between obesity, age, and smoking and these outcomes.</p><p><strong>Results: </strong>While obesity showed no influence on adverse postoperative complications or reoperations, class I obesity was associated with a lower rate of readmission. Older age, smoking, and comorbidity burden were significant predictors of postoperative complications, reoperations, and/or readmissions. Age 80 years or older was particularly predictive of 30-day complications (odds ratio, 3.5; <i>P</i><.001) and readmissions (odds ratio, 2.5; <i>P</i>=.004).</p><p><strong>Conclusion: </strong>Obesity is not a major risk factor for complications when undergoing meniscus surgery, while age older than 70 years predicts negative short-term postoperative outcomes. [<i>Orthopedics.</i> 2024;47(6):332-336.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"332-336"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110498","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":"Epidemiology of Lumbar Spine Fractures: Twenty-Year Assessment of Nationwide Emergency Department Visit Data.","authors":"Michael J Kuharski, Mohammad Daher, Jack J Zhou, Chibuokem P Ikwuazom, Carolyn Andrews, Juhayer Alam, Ryan C Scheer, Mary Lou, Daniel Alsoof, Mariah Balmaceno-Criss, Neil V Shah, Jad Bou Monsef, Bassel G Diebo, Carl B Paulino, Alan H Daniels","doi":"10.3928/01477447-20240918-02","DOIUrl":"10.3928/01477447-20240918-02","url":null,"abstract":"<p><strong>Background: </strong>Lumbar spine fractures are common injuries associated with substantial morbidity for patients and socioeconomic burden. This study sought to epidemiologically analyze lumbar spine fractures by mechanism of injury and identify temporal trends in patient demographics and disposition, which few studies have previously evaluated.</p><p><strong>Materials and methods: </strong>A retrospective analysis was done of the US National Electronic Injury Surveillance System (NEISS) database between 2003 and 2022. The sample contained all patients 2 to 101 years old with product-related lumbar fractures presenting to participating institutions' emergency departments. A total of 15,196 unweighted injuries (642,979 weighted injuries) were recorded.</p><p><strong>Results: </strong>Overall, there was a 20-year incidence rate of 10.14 cases per 100,000 person-years with a 2-fold increase in fracture incidence. Females were more prone to lumbar fracture than males (<i>P</i>=.032). Injuries primarily stemmed from a fall (76.6%). The incidence of lumbar fracture increased most significantly in older patients, with patients 80 years and older showing the greatest annual increase (β=8.771, <i>R</i>²=0.7439, <i>P</i><.001) and patients 60 to 69 years showing the greatest percent increase with a 3.24-fold increase in incidence. Most (58.9%) of the fractures occurred at home. Females were more often injured at home compared with males (<i>P</i><.001), who more often sustained lumbar fractures during recreational or athletic activity (<i>P</i><.001). All patients older than 40 years showed at least a doubling in incidence rate of lumbar fracture between 2003 and 2022.</p><p><strong>Conclusion: </strong>These data demonstrate the pressing need to address poor bone health in the aging population, shown here to have an increasing fracture burden. [<i>Orthopedics</i>. 2024;47(6):e297-e302.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e297-e302"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308260","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":"Mental Health Disorders and Surgical Outcomes in Patients With Bone and Soft Tissue Sarcoma.","authors":"MaKenzie M Chambers, Caroline T Gutowski, Pietro Gentile, Krystal Hunter, Tae Won B Kim, Christina J Gutowski","doi":"10.3928/01477447-20240809-04","DOIUrl":"10.3928/01477447-20240809-04","url":null,"abstract":"<p><strong>Background: </strong>We conducted a study to investigate the relationship between a mental health diagnosis (MHD) and postoperative outcomes in orthopedic patients with bone and soft tissue sarcoma. We hypothesized that patients with sarcoma with a preoperative MHD would have worse outcomes and more postoperative complications.</p><p><strong>Materials and methods: </strong>A retrospective review was performed of 356 patients who underwent surgical treatment for bone or soft tissue sarcoma. Patients were divided into two groups: those with a diagnosis of depression, anxiety, bipolar disorder, and/or schizophrenia and those with no previous MHD. Statistical analysis was performed using independent <i>t</i>, Mann-Whitney <i>U</i>, and chi-square tests.</p><p><strong>Results: </strong>Statistical analysis demonstrated significant differences between the MHD group and the control group in three outcomes: length of stay, 90-day readmission rate, and incidence of surgical site infections. Subgroup analysis of the MHD group yielded significantly higher 90-day readmission rates for patients who were diagnosed during sarcoma treatment.</p><p><strong>Conclusion: </strong>Patients with sarcoma and an MHD had a longer postoperative hospital stay, an increased 90-day readmission rate, and a greater risk of surgical site infection. Given the rising prevalence of mental health disorders nationwide, orthopedic surgeons should be aware of differences in postoperative outcomes between patients with sarcoma with and without mental illness. [<i>Orthopedics.</i> 2024;47(6):337-342.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"337-342"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009111","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":"An Eponymous History of Hemostatic, Tissue, and Reduction Clamps in Orthopedic Surgery.","authors":"Kendall H Derry, Isaac Dayan, Allison M Morgan, Kevin Lehane, Nina D Fisher, Andrew S Bi","doi":"10.3928/01477447-20241104-01","DOIUrl":"10.3928/01477447-20241104-01","url":null,"abstract":"<p><p>Eponyms are widely used in the field of orthopedic surgery, including for surgical instruments. Although their use is at times controversial, an appreciation of the history behind eponymous terms allows one to both recognize the shortcomings of the past and simultaneously be inspired by ingenious inventors. The primary purpose of this review is to provide a historical perspective of clamps and forceps commonly used in orthopedic surgery, to better appreciate the evolution of their use over time, and to inspire innovation to constantly improve upon surgical instrumentation as the field of orthopedic surgery advances. [<i>Orthopedics</i>. 2024;47(6):e287-e291.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e287-e291"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604041","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":"Trends in Location of Death for Individuals With Primary Bone Tumors in the United States.","authors":"Bhav Jain, Tejas C Sekhar, Samuel S Rudisill, Alessandro Hammond, Urvish Jain, Lorenzo D Deveza, Troy B Amen","doi":"10.3928/01477447-20241028-02","DOIUrl":"https://doi.org/10.3928/01477447-20241028-02","url":null,"abstract":"<p><strong>Background: </strong>Given the significant morbidity and mortality associated with primary bone cancer, provision of high-quality end-of-life care concordant with patient preferences is critical. This study aimed to evaluate trends in use of dedicated end-of-life care settings and investigate sociodemographic disparities in location of death among individuals with primary bone cancer.</p><p><strong>Materials and methods: </strong>A retrospective, population-based review of patients who died of primary bone cancer-related causes was performed using the Underlying Cause of Death public use record from the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research (WONDER) database for the years 2003 through 2019. A total of 24,557 patients were included.</p><p><strong>Results: </strong>Over the study period, the proportion of primary bone cancer-related deaths occurring at home and in hospice increased, whereas those occurring in hospital, nursing home, and outpatient medical facility/emergency department settings decreased. Several sociodemographic factors were found to be associated with location of death, including age, marital status, and level of education. Moreover, patients of racial and ethnic minority groups were at significantly lower risk of experiencing death at home or in outpatient medical facility/emergency department settings relative to a hospital compared with White patients.</p><p><strong>Conclusion: </strong>Although rates of in-hospital death from primary bone cancer are decreasing, marked racial and ethnic disparities in use of dedicated end-of-life care settings exist. These gaps must be addressed to ensure all patients with primary bone cancer have equitable access to high-quality end-of-life care regardless of racial, ethnic, or socioeconomic status. [<i>Orthopedics</i>. 202x;4x(x):xx-xx.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"1-7"},"PeriodicalIF":1.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568587","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":"The Relationship Between Surgeon Volume and Major Surgical Complications After Total Shoulder Arthroplasty: An Evaluation of 3177 US Orthopedic Surgeons.","authors":"Kevin C Liu, Cory K Mayfield, Mary K Richardson, Ioanna K Bolia, Jacob L Kotlier, Nathanael D Heckmann, Seth C Gamradt, Alexander E Weber, Joseph N Liu, Frank A Petrigliano","doi":"10.3928/01477447-20241028-03","DOIUrl":"https://doi.org/10.3928/01477447-20241028-03","url":null,"abstract":"<p><strong>Background: </strong>Total shoulder arthroplasty (TSA), which includes anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA), is a technically demanding procedure and limited data exist on the relationship between case volume and complications. We sought to identify volume thresholds for TSA, aTSA, and rTSA at which risk of a major surgical complication decreased and to compare complications of patients treated by high-volume surgeons with those of patients treated by low-volume surgeons.</p><p><strong>Materials and methods: </strong>Primary, elective TSAs (aTSA and rTSA) from January 1, 2016, to December 31, 2019, were identified in the Premier Healthcare Database. Multivariable logistic regression with restricted cubic splines modeled the relationship between annual TSA, aTSA, and rTSA surgeon volume and 90-day risk of major surgical complications. The 90-day complications of patients treated by high- and low-volume surgeons were compared.</p><p><strong>Results: </strong>From 2016 to 2019, 3177 surgeons performed 78,639 TSAs. Increasing annual volume was associated with decreasing major surgical complication risk (thresholds: 50 TSAs, 25 aTSAs, and 36 rTSAs). High- and low-volume surgeons performed 24,595 and 54,044 TSAs, respectively. Patients of high-volume surgeons had lower risk of major surgical complications (adjusted odds ratio [aOR], 0.69; 95% CI, 0.56-0.84), myocardial infarction (aOR, 0.59; 95% CI, 0.36-0.97), and readmission (aOR, 0.71; 95% CI, 0.62-0.81). Importantly, 74.9% of high-volume and 93.0% of low-volume surgeon-year units had major surgical complication rates below the mean of all recorded surgeons.</p><p><strong>Conclusion: </strong>While most high- and low-volume surgeons had major surgical complication rates below the cohort average, increasing TSA volume was associated with a decreased risk of complications. [<i>Orthopedics</i>. 202x;4x(x):xx-xx.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"1-7"},"PeriodicalIF":1.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568567","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}