Plastic and reconstructive surgery最新文献

{"title":"Factors Impacting Delays in Prosthesis Acquisition Following Major Lower Extremity Amputations: A Retrospective Cohort Review.","authors":"Julien Js Levy, Aleksandra Zarska, Kelly Beharry, Kian Pourak, Niki Matusko, Widya Adidharma, Stephen Kemp, Rachel Hooper","doi":"10.1097/PRS.0000000000013166","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013166","url":null,"abstract":"<p><strong>Background: </strong>Timely prosthesis acquisition is critical for optimizing functional recovery, reducing healthcare costs, and improving quality of life following major lower extremity amputation. However, delays in prosthesis acquisition remain poorly understood. This study aimed to evaluate the factors contributing to delays and disparities in prosthesis acquisition at a single academic institution.</p><p><strong>Methods: </strong>A retrospective chart review was conducted for 623 patients who underwent major lower extremity amputations between January 2014 and April 2022 at a quaternary referral center. Exclusion criteria included patients under 18 years, those with concurrent amputations, and patients deceased within one year of surgery. Patient demographics, surgical details, insurance types, and prosthesis acquisition timelines were analyzed using Kaplan-Meier survival estimates and multivariable regression. The primary outcomes were prosthesis acquisition and time to acquisition.</p><p><strong>Results: </strong>Only 52.8% of patients acquired a prosthesis, with a median time to acquisition of 142 days. Amputations performed by vascular surgeons were associated with the longest delays (158 days, p < 0.001), while those performed by orthopedic and plastic surgeons had shorter acquisition times (136 and 128 days, respectively). Below-knee amputations (BKA) and Medicaid insurance were linked to faster acquisition compared to above-knee amputations. System-level barriers, including insurance pre-approvals and transportation challenges, contributed to prolonged delays.</p><p><strong>Conclusions: </strong>Surgical subspecialty of the performing surgeon, amputation type, and other systemic factors impact prosthesis acquisition following major lower extremity amputation. Multidisciplinary care models and targeted interventions are needed to address these delays and improve equitable access to prosthetic rehabilitation.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"The Role of Transorb, a Unilaterally Adhesive Mesh, in Alloplastic Breast Reconstruction\".","authors":"Chase Clark, Jordan D Frey","doi":"10.1097/PRS.0000000000013155","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013155","url":null,"abstract":"<p><p>Mesh has been used for structural support in implant-based breast reconstruction (IBBR) for over 20 years with similar outcomes reported across materials. During immediate direct-to-implant breast reconstruction, securing the mesh to the chest wall to maintain the implant in an anatomic and aesthetically pleasing position within the breast pocket is imperative. Use of conventional mesh typically requires additional fixation which can be cumbersome and technically challenging, particularly in nipple-sparing mastectomy (NSM) techniques with smaller incisions. Transorb is a unilaterally adhesive synthetic mesh used in our practice to support implants. We report our technique using Transorb mesh as an adjunct in immediate one-stage IBBR.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-Stage Bilobed Mucosal Flap for Post-Hemangioma Lip Deformities: A Viewpoint on Technique and Clinical Pearls.","authors":"Silei Li, Menghao Deng, Di Wu, Ningbei Yin, Yongqian Wang","doi":"10.1097/PRS.0000000000013165","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013165","url":null,"abstract":"","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Breast Implants Characteristics and Replacements in BIA-ALCL Onset: A Multicenter Case-Control study.","authors":"Fabio Santanelli di Pompeo, Demosthenes Panagiotakos, Mark Warren Clemens, Guido Firmani, Jerzy Kolasiński, Michail Sorotos","doi":"10.1097/PRS.0000000000013162","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013162","url":null,"abstract":"<p><strong>Background: </strong>Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is an uncommon malignancy caused by textured implants. Specific implant characteristics or replacement patterns were investigated in relation to BIA-ALCL onset.</p><p><strong>Methods: </strong>In this multicenter, retrospective case-control study, data were collected from 327 women (39±13 years) with breast implants and no malignancy, and 94 age-matched BIA-ALCL cases (1:4 matching), across one U.S. and two European centers. Surgery indication, implant manufacturer, volume, surface texture, indwelling time, and history of replacements were analyzed. Associations with BIA-ALCL were assessed using conditional logistic regression analysis.</p><p><strong>Results: </strong>All BIA-ALCL cases were linked to implant roughness >10µm. Implant volume was positively associated with 81% higher likelihood of BIA-ALCL (OR per 100cc= 1.81, 95%CI [1.35, 2.44]). Breast reconstruction was associated with 47% lower odds of BIA-ALCL compared to cosmetic augmentations (OR= 0.53, 95%CI [0.33, 0.85]). One implant replacement was associated with 82% lower likelihood of BIA-ALCL compared to no replacement (OR= 0.18, 95%CI [0.10, 0.31]). Replacing from textured to smooth (OR= 0.06; 95% CI [0.013, 0.303]) or smooth to textured implants (OR= 0.06; 95% CI [0.013, 0.303]) had significantly lower likelihood of BIA-ALCL, compared to receiving another textured implant.</p><p><strong>Conclusion: </strong>Study findings of no BIA-ALCL association to specific manufacturers or to implant roughness <10µm, support the evidence that surgeons and patients should consider breast implant roughness in treatment decisions among primary or secondary asymptomatic patients.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic Surgery for Gynecologic Cancer-Related Lower Extremity Lymphedema.","authors":"Hyung Hwa Jeong, Jin Geun Kwon, Tae Hyung Kim, HyunSuk Peter Suh, ChangSik John Pak, DaeYeon Kim, Joon Pio Hong","doi":"10.1097/PRS.0000000000013163","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013163","url":null,"abstract":"<p><strong>Background: </strong>Lower extremity lymphedema (LEL) is a frequent and debilitating complication following gynecologic cancer surgery. While prophylactic lymph node-to-vein anastomosis (LNVA) may offer a preventive strategy, its efficacy has not been well established.</p><p><strong>Methods: </strong>In this controlled study, 26 gynecologic cancer patients undergoing lymph node clearance received simultaneous prophylactic LNVA (prospective intervention group) from July 2022 to January 2024. A retrospective control group comprised 88 patients who underwent radical lymphadenectomy between April 2018 and February 2019. Patients were evaluated over an average of two-year follow-up using limb circumference, imaging-based measurements of subcutaneous thickness, and bioimpedance analysis to assess the incidence of LEL.</p><p><strong>Results: </strong>Baseline demographics were similar between the control group and the LNVA group, except for a higher proportion of patients who received adjuvant radiotherapy in the LNVA group and a higher cancer recurrence rate in the control group. At the one-year follow-up, the incidence of lymphedema was significantly lower in the LNVA group compared with the control group (8% vs. 49%; p<0.001). Additionally, the LNVA group exhibited minimal changes in limb volume and bioimpedance values during the one-year follow-up, suggesting preservation of lymphatic drainage.</p><p><strong>Conclusions: </strong>Prophylactic LNVA performed concurrently with gynecologic cancer surgery was associated with a markedly reduced incidence of lower extremity lymphedema over an average of 2-year period. This preventive strategy may improve patient outcomes by mitigating LEL, a frequent and life-long complication of cancer treatment.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Trends in wRVU and Reimbursement for Free Flap and Implant-Based Breast Reconstruction: A 13-Year Valuation Analysis.","authors":"Francis D Graziano, Jacob Levy, Jenny Chen, Ronnie L Shammas, Lillian Boe, Robert J Allen, Babak J Mehrara, Jonas A Nelson, Danielle Rochlin, Evan Matros","doi":"10.1097/PRS.0000000000013164","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013164","url":null,"abstract":"<p><strong>Background: </strong>The work relative value unit (wRVU) system influences Medicare reimbursement by quantifying procedural complexity and physician effort. There are known disparities in wRVU and reimbursement per hour between implant and autologous breast reconstruction, however studies analyzing temporal changes in this relationship are limited. This study evaluates 13-year trends in wRVU/hour, reimbursement/hour, and complexity measures between implant-based and free flap breast reconstruction. We hypothesize that implant-based reconstruction maintains higher wRVUs and reimbursement per hour, but valuation for free flap reconstruction has improved.</p><p><strong>Methods: </strong>A retrospective study was conducted using the NSQIP database (2009-2021) to analyze operative times and complication rates for unilateral breast reconstruction procedures: implant-based (CPT 19340, 19342, 19357) and free flap (CPT 19364). Annual wRVU and Medicare reimbursement were sourced from the CMS. Temporal trends in wRVU/hour and reimbursement/hour were analyzed and compound annual growth rates were calculated.</p><p><strong>Results: </strong>Among 27,106 cases, implant-based reconstruction had significantly shorter median operative times (1.4 hours) and higher median wRVUs per hour (11.94) compared to free flap reconstruction (6.77 hours, 6.29 wRVUs/hour; p < 0.001). Over time, immediate reconstruction CPT 19357 demonstrated increasing operative times alongside declining wRVUs/hour and reimbursement/hour (p<0.01). In contrast, immediate and delayed CPT 19364 showed a significant increase in reimbursement/hour, largely driven by decreased operative time (p<0.01).</p><p><strong>Conclusions: </strong>Although wRVU and reimbursement per hour has increased for free flap reconstruction and declined for immediate tissue expander reconstruction, free flap breast reconstruction remains undervalued. This disparity in valuation may disincentivize microsurgical reconstruction, affecting institutional support and patient access.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Nerve Integrity Monitoring (NIM) in Facelifts.","authors":"Apinut Wongkietkachorn, Wilbur Wai Hung Hah, Nuttapone Wongkietkachorn","doi":"10.1097/PRS.0000000000013167","DOIUrl":"https://doi.org/10.1097/PRS.0000000000013167","url":null,"abstract":"<p><p>The growing popularity of filler injections, thread lifts, and energy-based devices for facial rejuvenation poses new challenges for deep plane or subSMAS facelifts. The use of a nerve integrity monitor (NIM) may help address these challenges. However, data on the application of NIM in facelift procedures remains limited. This study aims to describe the use of NIM in facelifts and to compare outcomes between procedures performed with and without NIM assistance. This was a prospective study conducted from January 2024 to August 2025. Patients undergoing extended subSMAS facelift who had previously received filler injections, thread lifts, or facelifts were eligible for inclusion. Participants were divided into either the NIM or non-NIM group. A step-by-step dissection algorithm using NIM during facelift surgery is presented. A total of 200 patients were included in the final analysis. The incidence of neurapraxia was significantly lower in the NIM group 0 (0%) compared to the non-NIM group 6 (6%), p = 0.029. Dissection time was also significantly reduced in the NIM group (32.86 [26.25, 38.00] minutes) compared to the non-NIM group (63.5 [55.0, 75.0] minutes), p < 0.001. The use of a nerve integrity monitor in facelift surgery was found to reduce both the rate of neurapraxia and operative time.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modulating the Infiltrate-to-Total Aspirate Volume Ratio to Optimize Outcomes in Liposuction Surgery.","authors":"Xiang-Bin Li, Shi-Yue Cui, Chun-Yu Kang, Xi Tao, Xue-Feng Zhang, Hai-Peng Yu, Lei Yang","doi":"10.1097/PRS.0000000000012509","DOIUrl":"10.1097/PRS.0000000000012509","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to explore the impact of varying ratio of infiltration fluid doses and the total aspirate mixture (I/A) on the outcomes of liposuction surgery.</p><p><strong>Methods: </strong>Patients who have undergone liposuction were randomly divided into 5 groups; the proportion of the planned infusion dose and the total amount of aspirated mixture was 0.3 to 0.5, 0.5 to 0.8, 0. to 1.1, 1.1 to 1.4, and 1.4 to 1.7, respectively. The intraoperative conditions of the 5 groups were recorded, and the I/A was calculated; the A, B, C, D, and E of the 5 groups were finally determined according to the different proportions. The postoperative satisfaction and complications of the 5 groups were compared, and the differences between the groups were analyzed statistically.</p><p><strong>Results: </strong>The operation time and blood volume in the liposuction bottle were closely related to the I/A ratio. The number of dressing changes; length of hospital stay; and degree of bruising, swelling, and pain in groups B and C were less than in the other groups during the hospitalization. At the same time, the I/A ratio also affected the postoperative satisfaction of patients.</p><p><strong>Conclusion: </strong>An I/A ratio in the range of 0.8 to 1.1 can achieve a satisfactory surgical effect, and when it is approximately 0.9, it is the best ratio, which can provide a reference scheme for clinical practice.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"689e-697e"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prepectoral versus Subpectoral Implant-Based Breast Reconstruction: Evaluating the Shift.","authors":"Holly Cordray, Salman Khan, Malia Voytik, Justus Zemberi, Gustavo Capone, Ashley E Chang, Robyn B Broach, Saïd C Azoury","doi":"10.1097/PRS.0000000000012480","DOIUrl":"10.1097/PRS.0000000000012480","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated trends in implant-based breast reconstruction, anticipating a shift toward prepectoral implants instead of subpectoral implants, and correlated these shifts with clinical outcomes.</p><p><strong>Methods: </strong>The cohort included adult patients who received implant-based breast reconstruction at the University of Pennsylvania Health System from 2018 through 2024. Analyses used linear regression to trend implant plane selection over time, and chi-square/Fisher tests with relative risk (RR) to compare postoperative complications by reconstructive approach.</p><p><strong>Results: </strong>Among 686 patients, reconstructions were subpectoral (301 cases) or prepectoral (385 cases). Prepectoral reconstructions rose significantly across the study period ( P = 0.001), from 4.0% of cases in 2018 to 90.2% in 2024. Prepectoral reconstructions showed significantly lower incidence of postoperative fat necrosis (RR, 0.3; 95% CI, 0.1 to 0.9), nipple-areola complex necrosis (RR, 0.2; 95% CI, 0.1 to 0.5), and chronic pain (RR; 0.3; 95% CI, 0.1 to 0.8). Prepectoral reconstructions showed significantly higher incidence of infection (RR, 3.3; 95% CI, 2.0 to 5.5), delayed healing/dehiscence (RR, 2.0; 95% CI, 1.3 to 2.9), readmission (RR, 2.1; 95% CI, 1.2 to 3.6), and reoperation for complications (RR, 2.0; 95% CI, 1.5 to 2.8). Prepectoral reconstructions showed higher reoperation rates for threatened prosthetic loss (RR, 2.9; 95% CI, 1.7 to 4.9) and prosthetic failure rates (RR, 2.8; 95% CI, 1.5 to 5.2).</p><p><strong>Conclusions: </strong>Implant plane preference reversed across 2018 to 2024, from subpectoral to prepectoral. Despite certain advantages, prepectoral (versus subpectoral) reconstructions showed twice the risk of readmission and reoperation, including a nearly 3-fold risk of reoperation for threatened prosthetic loss and ultimate failure. These results warrant further study to determine ways to improve outcomes following prepectoral reconstruction or whether surgeons should revisit subpectoral placement in predetermined high-risk cases.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"787-797"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost of Care and Surgical Outcomes between Direct-to-Implant and Staged Tissue Expander Breast Reconstruction.","authors":"Anindyo Chakraborty, Gabriel C Bouhadana, Mitchell Bernstein, Peter Davison, Evan Matros, Joshua Vorstenbosch","doi":"10.1097/PRS.0000000000012550","DOIUrl":"10.1097/PRS.0000000000012550","url":null,"abstract":"<p><strong>Background: </strong>Implant-based breast reconstruction (IBBR) can be performed in a single stage (direct to implant [DTI]) or 2 stages using a tissue expander (TE). Fixed costs and postoperative complications can incur a significant financial burden. In this article, we compare direct costs of DTI to TE IBBR and determine price drivers to ascertain their relative costs.</p><p><strong>Methods: </strong>A retrospective chart review and analysis of specific cost data provided by the authors' institutional finance department of patients who underwent IBBR was conducted to evaluate differences in costs during an episode of care (EOC). Multivariable regression analysis and 1-way sensitivity analysis were conducted to determine key price drivers for each operation.</p><p><strong>Results: </strong>A total of 205 patients (310 breasts) undergoing DTI ( n = 167 [54%]) or staged TE ( n = 143 [46%]) reconstruction were evaluated over their entire EOC. The DTI cohort had a lower rate of major complications (13% versus 22%; P = 0.033) but similar rates of aesthetic revisions (18% versus 19%; P = 0.835). The average cost of a DTI reconstruction ($13,719.39 ± $5499) was significantly lower than for staged TE patients ($16,589.54 ± $6586.95; P < 0.001), with lower operative costs ($10,460.2 ± $4059.81 and $12,242.87 ± $4403.81; P = 0.002) and number of postoperative visits (13.27 ± 7.76 and 23.03 ± 9.05; P < 0.001). There were no differences in operative costs from complications and aesthetic revisions. The cost of a DTI reconstruction is most sensitive to the rate of bilateral operations. For staged TE reconstruction, the episodic cost is most sensitive to the incorporation of acellular dermal matrices.</p><p><strong>Conclusion: </strong>DTI breast reconstruction incurs lower cost over an EOC compared with staged TE reconstruction, because of greater planned operative costs and number of postoperative follow-ups in the TE group.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"803-810"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}