Resuscitation最新文献

{"title":"A warning shot for mechanical ventilation during cardiopulmonary resuscitation – Lessons from a cadaver study on Chest Compression Synchronized Ventilation","authors":"Johannes Wittig, Kasper Glerup Lauridsen","doi":"10.1016/j.resuscitation.2025.110834","DOIUrl":"10.1016/j.resuscitation.2025.110834","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"216 ","pages":"Article 110834"},"PeriodicalIF":4.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure targets after return of circulation following cardiac arrest in infants and children: a systematic review and meta-analysis","authors":"Gabrielle Nuthall ,&nbsp;Andrea Christoff ,&nbsp;Laurie J. Morrison ,&nbsp;Jason Acworth ,&nbsp;James M. Gray ,&nbsp;Joseph Rossano ,&nbsp;Barnaby R. Scholefield","doi":"10.1016/j.resuscitation.2025.110825","DOIUrl":"10.1016/j.resuscitation.2025.110825","url":null,"abstract":"<div><h3>Aim</h3><div>To systematically review the literature examining optimal blood pressure targets following in-hospital or out-of-hospital cardiac arrest in infants and children. (PROSPERO ID CRD42023483865).</div></div><div><h3>Methods</h3><div>We searched Medline, EMBASE, and Cochrane Controlled Register of Trials (CENTRAL) for randomised controlled trials and non-randomised studies for all years up to March 19, 2025. Risk of bias and certainty of evidence was assessed using Newcastle-Ottawa and GRADE. Critically important outcomes survival to hospital discharge and survival with favourable neurological outcome.</div></div><div><h3>Results</h3><div>We identified 11 observational studies, including 2855 cardiac arrest events in infants and child. No randomised clinical trials were found. Patients exposed to a systolic blood pressure (SBP) greater than 5th percentile for age within six hours of return of circulation, compared to less than 5th percentile had a higher risk of survival to hospital discharge (RR 1.41; 95 % CI [1.2–1.6]; <em>P</em> = 0.01) and better survival with favourable neurological outcome at hospital discharge (RR1.25; 95 % CI [1.11–1.64]; <em>P</em> = 0.01). Exposure to a SBP greater than 10th centile for age was also associated with increased survival at hospital discharge and survival with favourable neurological outcome at hospital discharge (RR 1.21; 95 % CI [1.00–1.33}; <em>P</em> &lt; 0.01 and RR 1.22; 95 % CI [1.10–1.35}; <em>P</em> &lt; 0.01 and RR respectively). Mean Blood Pressure targets (&gt;10th percentile) and diastolic blood pressure targets (&gt;50th percentile) were also reported and associated with improved critical outcomes. However, variation in time points, blood pressure definitions and outcome assessment limited pooled analysis. Risk of bias was low, and the certainty of evidence was very low.</div></div><div><h3>Conclusion</h3><div>Early hypotension after return of circulation post cardiac arrest is associated with worse outcomes in infants and children after cardiac arrest. Patients exposed to systolic or mean arterial blood pressure targets greater than fifth and tenth percentile for age have improved risk of survival to hospital discharge and survival with favourable neurologic outcomes at hospital discharge.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"216 ","pages":"Article 110825"},"PeriodicalIF":4.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the COVID-19 pandemic on adult out-of-hospital cardiac arrest incidence, community response, and outcomes in England: An interrupted time series analysis.","authors":"Abraham Contreras, William McIver, Terry Brown, Chen Ji, Scott Booth, Rachael Fothergill, Gavin D Perkins, Keith Couper","doi":"10.1016/j.resuscitation.2025.110823","DOIUrl":"10.1016/j.resuscitation.2025.110823","url":null,"abstract":"<p><strong>Aim of the study: </strong>The COVID-19 pandemic had an important effect on the incidence, treatment, and outcomes from out-of-hospital cardiac arrest. Previous studies have focused on the immediate impact of the pandemic. We aimed to explore key changes in out-of-hospital cardiac arrest epidemiology in England over the time-course of the COVID-19 pandemic.</p><p><strong>Methods: </strong>We extracted data from the UK Out-of-Hospital Cardiac Arrest Outcomes registry on adult out-of-hospital cardiac arrest patients between January 2019 and November 2021 who were treated by an English Emergency Medical Service (EMS). We segmented data into five epochs, of which two epochs were identified as COVID-19 peaks. We explored changes over time in a multiple interrupted-time series model. Pre-specified outcomes were EMS-treated cardiac arrest incidence (per 100,000 population), rate of bystander cardiopulmonary resuscitation, rate of shockable rhythm, and survival rate.</p><p><strong>Results: </strong>We included 86,891 cases from 10 English Emergency Medical Service systems. There were immediate step changes with increased rates of incidence and bystander cardiopulmonary resuscitation and decreased rates of shockable rhythms and survival at the start of the first peak in March 2020. Subsequently, trend changes within epochs and at each epoch change were variable across the four outcomes. Between peaks and following the second peak, outcomes tended to normalise towards pre-pandemic level.</p><p><strong>Conclusion: </strong>In England, COVID-19 peaks were associated with an immediate effect on key outcomes. At the end of each peak, rates seemed to return toward baseline levels.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110823"},"PeriodicalIF":4.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cost-effectiveness of extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest: A systematic review.","authors":"Amani Alenazi, Bashayr Alotaibi, Jason Madan, Joyce Yeung, Samantha Johnson, Keith Couper","doi":"10.1016/j.resuscitation.2025.110822","DOIUrl":"10.1016/j.resuscitation.2025.110822","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used for refractory cardiac arrest across the world, but its cost-effectiveness remains uncertain. We conducted this systematic review to assess the available date on the cost-effectiveness of ECPR compared with the standard care in patients with cardiac arrest.</p><p><strong>Methods: </strong>We searched MEDLINE ALL (Ovid), EMBASE (Ovid), the Tufts Cost-Effectiveness Analysis (CEA) registry, and the Web of Science databases from database inception to 3rd February 2025 for all economic evaluations that reported the cost-effectiveness of ECPR for refractory cardiac arrest in adults. We undertook backward and forward citation tracking to identify any additional relevant articles. We used the Evers checklist, Philips checklist, and the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist to assess the quality of the included study and the completeness of reporting. All reported costs were translated into 2025 US dollars (US$) to aid comparability.</p><p><strong>Results: </strong>We included 15 studies. Of these, 12 (80 %) reported a high probability of ECPR being cost-effective, 1 (7 %) reported a low probability, 1 (7 %) suggested ECPR was potentially cost-effective, and 1 (7 %) concluded no probability of cost-effectiveness. Notably, the latter study specifically evaluated ECPR in patients with acute aortic dissection. The adjusted incremental cost-effectiveness ratios (ICERs) ranged from $2,564 to $276,307. When using these ICERs, ECPR remained cost-effective in 10 studies using the US willingness to pay threshold ($150,000), and in 7 studies using alternative thresholds ($40,000).</p><p><strong>Conclusion: </strong>ECPR may be cost-effective in some settings, but there is marked variability in the reported cost-effectiveness of ECPR across current studies. This reflects differences in methodology, survival assumptions, and willingness to pay thresholds. Economic evaluation for appropriate implementation of ECPR across various healthcare settings remains heterogenous, highlighting the imminent need for standardised reporting in this domain.</p><p><strong>Review registration: </strong>PROSPERO (CRD42024582408).</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110822"},"PeriodicalIF":4.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whose \"good outcome\" is it anyway? Integrating patient values and family perspectives into post-arrest neuroprognostication.","authors":"Hongyu Su, Yuan Liu","doi":"10.1016/j.resuscitation.2025.110828","DOIUrl":"10.1016/j.resuscitation.2025.110828","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110828"},"PeriodicalIF":4.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of dispatcher-assisted cardiopulmonary resuscitation policy on outcomes following out-of-hospital cardiac arrest: an interrupted time series analysis","authors":"Qian Li ,&nbsp;Zhifeng Zhang ,&nbsp;Xiaoyan Ding ,&nbsp;Lihua Li ,&nbsp;Xiaoxue Ma ,&nbsp;Yuqing Shao ,&nbsp;Jingyu Li ,&nbsp;Yanhong Gao ,&nbsp;Xuanjing Li ,&nbsp;Xiang Gao ,&nbsp;Shan Zhao ,&nbsp;Yan Li ,&nbsp;Yanhong Zhu ,&nbsp;Yipeng Lv","doi":"10.1016/j.resuscitation.2025.110829","DOIUrl":"10.1016/j.resuscitation.2025.110829","url":null,"abstract":"<div><h3>Background</h3><div>Despite the increasing adoption of dispatcher-assisted Cardiopulmonary Resuscitation (DA-CPR), evidence on its efficacy remains relatively scarce in developing countries. This interrupted time-series study assessed the impact of the DA-CPR policy on Out-of-hospital cardiac arrest (OHCA) outcomes in Shanghai, with the aim of informing evidence-based improvements in emergency care systems.</div></div><div><h3>Methods</h3><div>This study analyzed OHCA data reported by the Shanghai Medical Emergency Center from January 2019 to July 2024. Joinpoint regression analysis was used to identify and adjust for the impact of COVID-19 on OHCA outcomes. A modified autoregressive integrated moving average (ARIMA) model was used to quantify changes in outcomes before and after the implementation of the DA-CPR policy. Counterfactual analysis simulated OHCA outcomes trajectories without the policy, providing visual demonstration of the policy’s effects.</div></div><div><h3>Results</h3><div>Among 75,628 OHCA cases (median age 85), annual OHCA incidence ranged from 144 to 287 per 100,000 population, with age-standardized rates of 60 to 105. The average bystander CPR rate was 4.643% (age-standardized: 10.554%), the average ROSC rate was 2.914% (age-standardized: 4.799%), and the 30-day survival rate was 0.376% (age-standardized: 1.379%). Time-series analysis showed a significant post-policy level increase of 3.553 percentage point in bystander CPR (95% CI 1.227–5.879, <em>P</em> &lt; 0.05), 2.215 percentage point in ROSC (95% CI 1.052–3.380, <em>P</em> &lt; 0.001) and 0.461 percentage point in 30-day survival (95% CI 0.025–0.898, <em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>DA-CPR implementation substantially improved OHCA outcomes in Shanghai, supporting its adoption in developing countries to optimize emergency care outcomes.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"216 ","pages":"Article 110829"},"PeriodicalIF":4.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative effect of public health interventions on time interval to first chest compression and survival outcomes in out-of-hospital cardiac arrest","authors":"Yue Li ,&nbsp;Nur Shahidah ,&nbsp;Robert W. Neumar ,&nbsp;Dehan Hong ,&nbsp;Alexander E. White ,&nbsp;Yih Yng Ng ,&nbsp;Benjamin S.H. Leong ,&nbsp;Michael Y.C. Chia ,&nbsp;Han Nee Gan ,&nbsp;Desmond R Mao ,&nbsp;Wei Ming Ng ,&nbsp;Nausheen E Doctor ,&nbsp;Haojun Fan ,&nbsp;Chunxia Cao ,&nbsp;Marcus E.H. Ong","doi":"10.1016/j.resuscitation.2025.110827","DOIUrl":"10.1016/j.resuscitation.2025.110827","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the cumulative effect of multiple interventions on time interval to first chest compression and survival outcomes of out-of-hospital cardiac arrest (OHCA).</div></div><div><h3>Methods</h3><div>We conducted a secondary analysis of a prospective national cohort study on adult, non-traumatic OHCA in Singapore. Six nationwide interventions were implemented sequentially, including the introduction of fire-bikers, dispatch-assisted cardiopulmonary resuscitation, a first responder public cardiopulmonary resuscitation training program, the myResponder phone application, the Save-A-Life public access defibrillation program and first responder high-performance cardiopulmonary resuscitation training, dividing the study period into seven distinct time periods. The outcomes were system-level estimate of time interval to first chest compression and survival outcomes.</div></div><div><h3>Results</h3><div>The time interval to first chest compression for OHCA patients was 10.6 (8.5, 13.4), 10.9 (8.8, 13.9), 7.5 (0.0, 11.9), 5.0 (0.0, 12.1), 5.0 (2.4, 11.9), 4.3 (2.0, 10.5) and 4.5 (2.1, 11.3) minutes from period 1 to 7, respectively. Interventions were significantly associated with reduced time interval to first chest compression (β-estimate −4.09, 95 % confidence interval (CI): −4.81, −3.37), and increased likelihood of survival to hospital discharge (odds ratio (OR) 2.09; 95 % CI, 1.39–3.14) and survival with favorable neurological outcomes (OR 3.06; 95 % CI, 1.79–5.25) after implementation of the six nationwide interventions, compared with pre-intervention. The time interval to first chest compression significantly explained 21.17 % and 22.67 % of the relationship between interventions and survival to discharge and favorable neurological outcomes, respectively.</div></div><div><h3>Conclusion</h3><div>The implementation of cumulative multiple interventions was significantly associated with reduced time to first chest compression and improved OHCA survival outcomes.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"216 ","pages":"Article 110827"},"PeriodicalIF":4.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of AEDs and Training of Smartphone Activated Volunteers in Residential Areas on OHCA: A Nationwide Stepped-Wedge Implementation Trial.","authors":"Pin Pin Pek, Stephanie Man Chung Fook-Chong, P Sudharshan, Yao Ge, Yih Yng Ng, Benjamin Sieu-Hon Leong, Desmond Renhao Mao, Michael Yih Chong Chia, Wei Ming Ng, Han Nee Gan, Nausheen Edwin Doctor, Lai Peng Tham, Nur Shahidah, Alexander Elgin White, Dehan Hong, Marcus Eng Hock Ong","doi":"10.1016/j.resuscitation.2025.110826","DOIUrl":"https://doi.org/10.1016/j.resuscitation.2025.110826","url":null,"abstract":"<p><strong>Background: </strong>Early bystander interventions can improve out-of-hospital cardiac arrest (OHCA) survival rates. We hypothesized that an interventional bundle including automated external defibrillator (AED) installation in residential areas and training smartphone activated volunteers would increase bystander intervention and survival rates.</p><p><strong>Methods: </strong>We conducted a stepped-wedge cluster non-randomized study between 1 April 2010 and 31 December 2020 in Singapore. AEDs were installed sequentially over eight \"wedges\", with one AED installed at every two housing blocks. Cardiopulmonary resuscitation (CPR)/AED training was conducted for residents including enrolling them as smartphone activated volunteers. Primary outcome was bystander AED application. Secondary outcomes were bystander CPR application, prehospital return of spontaneous circulation (ROSC), survival to discharge/30^th day/with favorable neurological function. Using generalized estimating equation, we compared outcomes between intervention and control groups, accounting for clustering effects and confounders. A stratified analysis by location of arrest was also conducted.</p><p><strong>Results: </strong>18,086 OHCAs were analysed (Intervention: n=8,180; Control: n=9,906). We found increased odds of bystander AED application in the intervention compared to control group (aOR 3.94 [95%CI 3.28, 4.74]; p<0.05). The effect of the intervention on bystander AED application was greater for OHCAs occurring in residential (aOR 10.31 [95%CI 6.94, 15.33]) than those in public locations (aOR 2.84 [95%CI 2.24, 3.59]).</p><p><strong>Conclusions: </strong>The implementation of AED installation in residential areas and training of smartphone activated volunteers increased bystander AED application; the impact was higher for OHCAs occurring in residential compared to public locations. This may be a promising strategy for increasing bystander AED use in densely populated residential areas.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110826"},"PeriodicalIF":4.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of resuscitation duration on 12-month functional recovery following out-of-hospital cardiac arrest with initially shockable rhythms","authors":"Abdulrahman Alhenaki ,&nbsp;Zainab Alqudah ,&nbsp;Ashanti Dantanarayana ,&nbsp;Brett Williams ,&nbsp;Emily Nehme ,&nbsp;Ziad Nehme","doi":"10.1016/j.resuscitation.2025.110824","DOIUrl":"10.1016/j.resuscitation.2025.110824","url":null,"abstract":"<div><h3>Aim</h3><div>To describe the impact of cardiopulmonary resuscitation (CPR) duration on the 12-month functional recovery and health-related quality of life (HRQoL) outcomes of out-of-hospital cardiac arrest (OHCA) patients with initially shockable rhythms.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis of adults (aged ≥18 years) who had an emergency medical service (EMS) attempted resuscitation with an initially shockable rhythm between 2015 and 2024. We excluded paediatric cases, traumatic aetiology and EMS witnessed OHCA. Survivors to hospital discharge were followed up 12 months post-arrest to assess functional recovery according to the Glasgow Outcome Scale-Extended. CPR duration was defined as the total cumulative EMS resuscitation time until either return of spontaneous circulation or resuscitation termination.</div></div><div><h3>Results</h3><div>Of the 7922 OHCA with an initially shockable rhythm, 6371 met the inclusion criteria. 2054 (32.6 %) patients survived to hospital discharge. Of those, 1769 (86.1 %) patients were confirmed alive at 12-months, and 1429 responded to follow-up. The 50th, 90th, and 99th percentiles of CPR duration for those who survived to 12 months with favourable functional recovery were 8, 25, and 69 min, respectively. Among all patients with initially shockable rhythms, each minute increase in CPR duration was associated with reduced risk-adjusted odds of 12-month favourable functional recovery (AOR = 0.905, 95 %CI 0.899–0.911) and HRQoL. Among 12-month responders only, increasing CPR duration was associated with lower odds of favourable recovery (AOR = 0.989, 95 %CI 0.980–0.998) and living at home without care.</div></div><div><h3>Conclusion</h3><div>In OHCA with an initially shockable rhythm, increasing CPR duration is associated with poorer long-term functional recovery and quality-of-life.</div></div>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":"216 ","pages":"Article 110824"},"PeriodicalIF":4.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-time cerebral oximetry and outcomes during out-of-hospital resuscitation.","authors":"Julia King, Jenny Shin, Robert Walker, Thomas Rea","doi":"10.1016/j.resuscitation.2025.110811","DOIUrl":"10.1016/j.resuscitation.2025.110811","url":null,"abstract":"","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110811"},"PeriodicalIF":4.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}