Pediatric Surgery International最新文献

{"title":"Hydrostatic reduction of intussusception: the impact of high enema pressure on success rates.","authors":"Bingjie Wang, Ziwei Jian, Weicheng Huang, Beilei Huang, Fengguang Ye, Jinrong Chen, Wenyou Chen","doi":"10.1007/s00383-024-05919-2","DOIUrl":"10.1007/s00383-024-05919-2","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to analyze the effect of increasing enema pressure on enema outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective study to compare the effect of increasing enema pressure on enema outcomes. The primary outcome was the success rate of reduction, while secondary outcomes included intestinal perforation and recurrence rate.</p><p><strong>Results: </strong>From May 2017 to April 2021, a total of 531 intussusceptions in 499 patients (Group A 247 patients, Group B 252 patients) were collected. The overall success reduction rate was 97.00%. The success reduction rate in Group A was 99.20% (245/247) and 94.8% (239/252) in Group B (P = 0.004). The overall recurrence rate within 48 h after the initial enema reduction was 8.02%, and beyond 48 h was 6.41%. The recurrence rates within 48 h and beyond 48 h were 9.39% and 6.53% in group A and 7.11% and 6.69% in group B, respectively (P = 0.526). No complications were associated with the enema reduction procedure.</p><p><strong>Conclusion: </strong>Our study has shown that using a hydrostatic pressure of 130 mmHg for enema reduction is both effective and safe, with a higher success rate and no increased risk of complications.</p><p><strong>Level of evidence: </strong>Therapeutic study, III.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"23"},"PeriodicalIF":1.5,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795009","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":"Health literacy in parents of children with Hirschsprung disease: a novel study.","authors":"Signe Olsbø, Sara George Kiserud, Åsmund Hermansen, Marie Hamilton Larsen, Kristin Bjørnland","doi":"10.1007/s00383-024-05917-4","DOIUrl":"10.1007/s00383-024-05917-4","url":null,"abstract":"<p><strong>Purpose: </strong>To explore health literacy (HL) among parents of children with Hirschsprung disease (HD).</p><p><strong>Methods: </strong>Norwegian-speaking parents of children under 16 who underwent HD surgery at a tertiary center were surveyed using the Health Literacy Questionnaire-Parent, electronic Health Literacy Scale, General Self-efficacy Scale, and a study-specific questionnaire. Demographics were collected and ethical approval was obtained.</p><p><strong>Results: </strong>Among 132 parents (77 mothers) of 91 children (median age 8 years), high HL scores appeared in the domains \"understanding health information\" and \"active engagement\", with lower scores in \"provider support\", \"health information appraisal\", and \"social support\". Higher HL correlated with parents aged over 40 and higher education. Lower scores were seen with non-exclusive Norwegian use at home and not living with the child's other parent. High electronic HL scores were common (mean 3.6, maximum score 5). 69% had high self-efficacy scores (score > 2, maximum score 4). Self-efficacy correlated strongly with higher HL scores.</p><p><strong>Conclusion: </strong>Parents of children with HD feel healthcare providers lack understanding of their child's challenges, experience limited social support and struggle with interpreting health information. We suggest targeted HL interventions for young, lower-educated, non-cohabitating parents and those not primarily speaking the official language at home.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"21"},"PeriodicalIF":1.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780545","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":"Predictors of outcomes in infants with gastroschisis treated with a preformed silo.","authors":"Rebecca Lee, Theodore Dassios, Niyi Ade-Ajayi, Mark Davenport, Ann Hickey, Anne Greenough","doi":"10.1007/s00383-024-05922-7","DOIUrl":"10.1007/s00383-024-05922-7","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the outcomes of infants with gastroschisis treated with a preformed silo (PFS) and determine whether routinely measured early physiological parameters, sepsis (blood culture positive), gastroschisis complexity or location of birth influenced the length of stay (LOS) and duration of parenteral nutrition (PN).</p><p><strong>Methods: </strong>Infants cared for in a tertiary surgical neonatal intensive care unit during a 10-year period were identified.</p><p><strong>Results: </strong>Seventy-seven infants were assessed [median gestational age 36 + 6 (IQR 35 + 3 to 38 + 0)] weeks. All survived; 82% were inborn. The median LOS was 37 (IQR 28-76.5) days and duration of PN was 28 (IQR 21-53) days. In the first 72 h, the worst median lactate, base excess and 'toe-core' gap were 4.2 (IQR 3.0-5.8) mmol/l, -7.0 (IQR - 5.55 to - 9.35), 3.4 (IQR 3.0-4.2) °C respectively. There were no significant correlations between early physiological parameters or place of birth and LOS or PN days, but sepsis (n = 18 infants) and complex gastroschisis (n = 13 infants) were associated with an increased LOS and PN duration (both p < 0.001).</p><p><strong>Conclusions: </strong>Survival was 100% in infants with gastroschisis who were managed with PFS, sepsis and gastroschisis complexity were associated with a longer hospital stay and duration of parenteral nutrition. Level of Evidence (I-V): IV.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"22"},"PeriodicalIF":1.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785817","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":"Thoracoscopy in paediatric patients with mediastinal lymphangiomas: 10 years of surgical experience in a single centre.","authors":"Yujia Wu, Qi Zeng, Chenghao Chen, Jie Yu, Na Zhang","doi":"10.1007/s00383-024-05906-7","DOIUrl":"https://doi.org/10.1007/s00383-024-05906-7","url":null,"abstract":"<p><strong>Objectives: </strong>To summarize the clinical features of mediastinal lymphangiomas in paediatric patients and to compare the outcomes of open and minimally invasive surgical techniques.</p><p><strong>Methods: </strong>The clinical data of 65 patients with mediastinal lymphangiomas who were hospitalized at the Department of Thoracic Surgery of Beijing Children's Hospital, Capital Medical University and underwent tumour resection between January 2013 and December 2023 were retrospectively analysed. Patient age, sex, tumour size, tumour location, tumour classification, tumour morphology, operative time, estimated bleeding volume, duration of hospitalization, number of postoperative days with a chest tube, average daily chest tube drainage volume, postoperative complications and follow-up conditions were summarized.</p><p><strong>Results: </strong>Sixty-five patients, including 39 males and 26 females, ranging from age 2 months to 10 years (mean age 3.90 years) were included. Twenty-three patients underwent open surgery, and 42 underwent minimally invasive surgery. Five patients required conversion to open surgery. Compared with open surgery, minimally invasive surgery was associated with a significantly shorter operation time, a lower estimated bleeding volume, and fewer hospitalization days. There was no significant difference in postoperative complication rates, number of postoperative days with a chest tube or average daily chest drainage volume.</p><p><strong>Conclusions: </strong>Mediastinal lymphangiomas are uncommon mediastinal tumours, and most patients present with respiratory symptoms; however, others have no symptoms. The proper use of preoperative imaging data could aid the differential diagnosis of the tumours. Surgical treatment is both practical and safe. Minimally invasive surgery can successfully reduce surgical trauma and should be encouraged since the view of the operative field is wider and clearer, which makes tumour separation easier.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"20"},"PeriodicalIF":1.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770867","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":"Mechanical distraction enterogenesis utilizing springs has equal effectiveness in adult and juvenile pigs.","authors":"Talha A Rafeeqi, Anne-Laure Thomas, Fereshteh Salimi-Jazi, Modupeola Diyaolu, Nolan Lopez, James C Y Dunn","doi":"10.1007/s00383-024-05923-6","DOIUrl":"https://doi.org/10.1007/s00383-024-05923-6","url":null,"abstract":"<p><strong>Purpose: </strong>We aim to apply our spring-mediated intestinal lengthening technique to adults and children with short bowel syndrome. We hypothesized that spring-mediated intestinal lengthening would be achieved in adult and juvenile pigs.</p><p><strong>Methods: </strong>Adult and juvenile pigs underwent insertion of a compressed spring into the jejunum. Jejunum was plicated proximal and distal to the capsule for fixation and control jejunum was marked. Pigs were fed a liquid diet for one week. Spring and control segment lengths were compared using Brown-Forsythe and Welch ANOVA test.</p><p><strong>Results: </strong>Three adult pigs weighing 30.4 ± 2.1 kg and three juvenile pigs weighing 8.9 ± 1.2 kg underwent spring insertion without complications. Springs were compressed from 7.5 to 2 cm and had an average spring constant of 9.7 ± 1.2 N/m in adults and 5.4 ± 1.5 N/m in juveniles. Springs of 1.3 cm diameter were implanted in adults and springs of 1.0 cm diameter were implanted in juveniles. Spring segments lengthened on average by 86 ± 33% in adults (p = 0.04) and 123% in juveniles (p < 0.01) when compared to the initial length. There was no statistically significant difference in lengthening between juvenile and adult pigs (p = 0.2).</p><p><strong>Conclusion: </strong>Intestinal lengthening was feasible in adult pigs but required a higher force for their larger diameter intestine compared to juvenile pigs.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"18"},"PeriodicalIF":1.5,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771222","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":"Artificial intelligence and pediatric surgery: where are we?","authors":"Yuichiro Miyake, Giuseppe Retrosi, Richard Keijzer","doi":"10.1007/s00383-024-05921-8","DOIUrl":"https://doi.org/10.1007/s00383-024-05921-8","url":null,"abstract":"<p><p>Here, we explore the transformative effects of artificial intelligence (AI) and large language models (LLMs), such as ChatGPT and GEMINI, on pediatric surgery, including preoperative, intraoperative, and postoperative care, as well as their influence on medical education and patient communication. We discuss the role of AI in enhancing surgical precision, facilitating personalized care strategies throughout all surgical phases, and improving learning for healthcare professionals and students. AI's application in intraoperative settings, providing real-time decision support and augmenting surgical accuracy, underscores how AI can contribute to safer surgical outcomes. LLMs ability to explain medical terms and create easy-to-understand educational materials demonstrates its potential in medical education and patient communication. We also acknowledge the challenges of using AI, including ethical issues, data privacy concerns, and the imperative for human oversight. Despite these challenges, AI holds the potential to significantly enhance pediatric surgery, healthcare education, and patient care, and we recommend a careful but optimistic approach to its adaptation.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"19"},"PeriodicalIF":1.5,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771220","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":"Megameatus intact prepuce: a systematic review of surgical techniques and long-term outcomes.","authors":"Abubakr Elawad, Ahmed Haroon, Jamil Ahmad, Jude Alsbeti, Sami Cherigui, Seem Arar, V V S Chandrasekharam, Tariq O Abbas","doi":"10.1007/s00383-024-05898-4","DOIUrl":"10.1007/s00383-024-05898-4","url":null,"abstract":"<p><p>Megameatus intact prepuce (MIP) presents with diverse phenotypes that complicate the management of this rare but complex hypospadias variant. Current data on optimal treatment methods and patient outcomes are sparse, unintegrated, and therefore challenging to implement clinically. A comprehensive systematic review of the existing literature on MIP was conducted according to PRISMA guidelines. Electronic databases including PubMed, Embase, and Scopus were searched for relevant articles published up to [2024]. Key aims were to assess the safety and efficacy of different surgical interventions, and synthesize corresponding outcomes reported in the literature. The search yielded 18 articles meeting the inclusion criteria, representing a total of 524 enrolled patients across multiple geographic regions. Diagnosis of MIP typically involves clinical examination, imaging studies, and urological evaluation. Surgical management options included preputial reconstruction, urethroplasty, and meatal advancement with glanuloplasty. Reported outcomes varied, with success rates ranging from [77.1-100%]. Long-term follow-up data on functional and cosmetic outcomes were limited. Megameatus intact prepuce presents diagnostic and management challenges due to low prevalence and variable presentation. This systematic review presents a current understanding of MIP diagnosis, surgical techniques, and patient outcomes. Future studies should assess the long-term functional outcomes of different surgical approaches, and investigate the underlying genetic and environmental factors contributing to the diverse clinical manifestations of MIP.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"17"},"PeriodicalIF":1.5,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11614969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771194","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":"Bowel perforation in neonates with Hirschsprung disease: a case series and literature review.","authors":"Zhaozhou Liu, Yanan Zhang, Dayan Sun, Yongwei Chen, Weihong Guo, Jingbin Du, Jinshi Huang","doi":"10.1007/s00383-024-05907-6","DOIUrl":"https://doi.org/10.1007/s00383-024-05907-6","url":null,"abstract":"<p><strong>Background: </strong>Bowel perforation is a severe complication of Hirschsprung disease (HD) that necessitates prompt diagnosis and aggressive management to reduce mortality and morbidity. This study aimed to provide insights into the clinical management of neonatal HD cases complicated by bowel perforation.</p><p><strong>Methods: </strong>A retrospective review was conducted on neonates diagnosed with HD and bowel perforation at Beijing Children's Hospital from January 2007 to January 2024. Inclusion criteria included neonates ≤ 28 days old with confirmed HD diagnosis based on postoperative histology. Data collected included perinatal history, patient characteristics, HD classification, clinical presentations, surgical interventions, and outcomes. Statistical analysis was performed using SPSS 26.0.</p><p><strong>Results: </strong>Among 300 neonates diagnosed with HD, 18 (6.0%) developed preoperative bowel perforation. Most perforations were in the proximal ganglionic bowel, with short-segment HD (7/18, 38.9%) and long-segment HD (9/18, 50.0%) being most common. All patients received timely surgical intervention upon the discovery of bowel perforation, with 94.4% (17/18) requiring stoma creation. Postoperative complications included stoma retraction, Hirschsprung disease-associated enterocolitis, and adhesive bowel obstruction, but no mortality was reported.</p><p><strong>Conclusion: </strong>The incidence of preoperative bowel perforation in neonates with HD was 6.0%, primarily in cases of short-segment and long-segment HD. Perforations were mainly located in the proximal ganglionic segments. Prompt surgical intervention, particularly stoma creation, resulted in favorable outcomes for most patients.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"15"},"PeriodicalIF":1.5,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771221","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":"Yes-associated protein is dysregulated in human congenital diaphragmatic hernia patients during mid and end gestation.","authors":"Yuichiro Miyake, Marietta Jank, Daywin Patel, Arzu Ozturk, Ophelia Aubert, Xingbin Ai, Atsuyuki Yamataka, Richard Keijzer","doi":"10.1007/s00383-024-05912-9","DOIUrl":"https://doi.org/10.1007/s00383-024-05912-9","url":null,"abstract":"<p><strong>Background: </strong>Yes-associated protein (YAP) is implicated in congenital diaphragmatic hernia (CDH). This study aims to investigate the abundance of YAP and its inactive form, phosphorylated YAP (p-YAP), in fetal human lung tissues from CDH cases compared to control cases at mid-gestation and end-gestation.</p><p><strong>Methods: </strong>Immunofluorescence was performed to assess the abundance of YAP and p-YAP in lung tissues from human CDH and control fetuses who died from causes other than CDH. Additionally, the impact on cellular differentiation was evaluated by assessing the expression of Homeodomain-only protein X (HOPX) and Surfactant protein C (SPC).</p><p><strong>Results: </strong>Immunostaining revealed a higher abundance of YAP and p-YAP in both mid-gestation and end-gestation lung tissues. Notably, the abundance of p-YAP was increased in CDH tissues compared to controls, indicating higher levels of the inactive form of YAP in CDH. HOPX and SPC staining showed CDH tissues had a higher number of SPC-positive cells and fewer HOPX-positive cells at end-gestation.</p><p><strong>Conclusions: </strong>Our findings suggest that in CDH, YAP is predominantly present in its inactive form, p-YAP, potentially disrupting normal lung development and differentiation. This underscores the potential involvement of YAP dysregulation in the pathogenesis of CDH.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"16"},"PeriodicalIF":1.5,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770874","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":"Predicting risk factors for postoperative intestinal stenosis in neonates with necrotizing enterocolitis: development and assessment of a predictive nomogram.","authors":"Yang Chen, Ling Zhou, Qianghui Liao, Dong Xiao, Ledao Zhu, Jinlong Yao, Jiashu Liu, Xuling Zhang, Xiaopeng Ma, Feng Ren, Zhiyong Wang","doi":"10.1007/s00383-024-05916-5","DOIUrl":"https://doi.org/10.1007/s00383-024-05916-5","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to develop and validate an intestinal stenosis prediction model for postoperative newborns with neonatal necrotizing enterocolitis (NEC).</p><p><strong>Methods: </strong>Clinical information was collected on neonates who had undergone anastomosis or enterostomy because of NEC. The least absolute shrinkage and selection operator regression was applied to identify risk factors included in the model for postoperative intestinal stenosis. Multivariate logistic regression analysis was used to develop a predicting model regression based on the selected variables. Then internal validation was assessed using the bootstrapping validation. The accuracy and applicability of the model are assessed by C-index, calibration and decision curve.</p><p><strong>Results: </strong>Predictors incorporated into the model were a weight on admission, hematochezia, duration of abnormal C-reactive protein, lactate, intestinal peristalsis vanish, operation methods and duration of surgery. The regression equation was logit (P) = -0.001X₁ + 1.566X₂ + 0.185X₃ + 0.304X₄ + 1.34X₅ - 2.932X₆ + 0.015X₇ - 3.193, where X₁ was weight on admission (g), X₂ was hematochezia (yes = 1, no = 0), X₃ was duration of abnormal C-reactive protein (days), X₄ was lactate (mmol/L), X₅ was intestinal peristalsis vanish (yes = 1, no = 0), X₆ was primary anastomosis (yes = 1, no = 0), X₇ was duration of surgery (min). The model displayed good discrimination with a C-index of 0.879 (0.827,0.932) by random sampling for 1000 times. The calibration curve excluded the overfitting performance, and the decision curve confirmed the clinical application capacity of the model.</p><p><strong>Conclusion: </strong>This nomogram of intestinal stenosis incorporating the use of weight on admission, hematochezia, duration of abnormal C-reactive protein, lactate, intestinal peristalsis vanish, operation methods and duration of surgery could be conveniently used to facilitate the intestinal stenosis risk prediction in postoperative-NEC-patients.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"14"},"PeriodicalIF":1.5,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769964","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}