Surgery Today最新文献

{"title":"Morphological characteristics and outcomes of aortic repair of acute type A aortic dissection occurring in patients with aortic arch branching variants.","authors":"Takahiro Yamamoto, Naoyuki Kimura, Daijiro Hori, Makiko Mieno, Manabu Shiraishi, Homare Okamura, Koji Kawahito, Atsushi Yamaguchi","doi":"10.1007/s00595-024-02919-6","DOIUrl":"https://doi.org/10.1007/s00595-024-02919-6","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the morphological characteristics and operative outcomes of acute type A aortic dissection (ATAAD) in patients with aortic arch variants.</p><p><strong>Methods: </strong>Of 616 patients with ATAAD, 97 (15.7%) had aortic arch variants, including bovine aortic arch (BAA, n = 66), isolated left vertebral artery (ILVA, n = 25), and aberrant subclavian artery (ASA, n = 6). The characteristics and outcomes were compared between the normal branching group (control, n = 519) and the total/individual arch variant groups.</p><p><strong>Results: </strong>Compared to the control group, arch entry was more prevalent in the BAA (18.5% vs. 31.8%) and ILVA groups (44%) (both, P < 0.05), and right common carotid arterial occlusion was less common in the arch variant group (6.7% vs. 0%, P = 0.017). The in-hospital mortality (9.2% vs. 9.3%), new-onset stroke (7.3% vs. 7.2%), and 5-year survival (81.7% vs. 78.8%) did not differ markedly between the control and arch variant groups. Arch repair was performed in 28.9% (28/97) of the arch variant group using 3-4 vessel antegrade cerebral perfusion, with 3.8% in-hospital mortality and a 15.4% stroke rate, which were comparable to those of the control group.</p><p><strong>Conclusions: </strong>Aortic arch variants may influence tear location and involvement of the supra-arch vessels but may not affect postoperative outcomes.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354205","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":"Survival after surgery for lung cancer among patients with autoimmune diseases.","authors":"Masaaki Nagano, Yue Cong, Keita Nakao, Mitsuaki Kawashima, Chihiro Konoeda, Masaaki Sato","doi":"10.1007/s00595-024-02917-8","DOIUrl":"https://doi.org/10.1007/s00595-024-02917-8","url":null,"abstract":"<p><strong>Purpose: </strong>While patients with autoimmune diseases (ADs) are at high risk for developing specific malignancies, including lung cancer, ADs may protect against the development of cancer through increased immune cell activity in tumors. This study aimed to investigate whether the presence of ADs affects surgical outcomes and survival after surgery for lung cancer.</p><p><strong>Methods: </strong>The medical records of 1236 patients who underwent surgery for non-small cell lung cancer between 2007 and 2018 were retrospectively reviewed. Perioperative and long-term outcomes were compared between patients with and without ADs using propensity score matching.</p><p><strong>Results: </strong>Among the included patients, 115 with ADs and 1121 without ADs underwent surgery. Using 1-to-1 propensity score matching, 114 pairs were selected. Although there were no significant differences in the perioperative outcomes of the two groups, the overall and relapse-free survival rates were significantly lower in the group with ADs than in the group without ADs.</p><p><strong>Conclusions: </strong>Surgery for lung cancer can be performed without increasing the complications in patients with ADs. However, the long-term outcomes were significantly worse in patients with ADs than in those without ADs, suggesting that close follow-up for lung cancer and careful whole-body examination might be needed for patients with ADs.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354206","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":"Clinical validation of preoperative serum markers for liver fibrosis in living donor liver transplantation recipients.","authors":"Takahiro Tomino, Shinji Itoh, Takeo Toshima, Shohei Yoshiya, Yuki Bekki, Norifumi Iseda, Takuma Izumi, Yuriko Tsutsui, Katsuya Toshida, Tomoharu Yoshizumi","doi":"10.1007/s00595-024-02941-8","DOIUrl":"https://doi.org/10.1007/s00595-024-02941-8","url":null,"abstract":"<p><strong>Purpose: </strong>To validate the reliability of fibrosis markers as predictors of graft survival in living donor liver transplantation (LDLT) recipients.</p><p><strong>Methods: </strong>We reviewed data retrospectively, from 163 patients who underwent adult LDLT with preoperative measurements of type IV collagen (CIV), Mac-2 binding protein glycosylation isomer (M2BPGi), and hyaluronic acid (HA). Patients were divided into high and low groups for each biomarker, based on optimal cutoff values, and graft loss within 6 months was evaluated in each group.</p><p><strong>Results: </strong>The high CIV level group showed significantly lower 6-month graft survival rates and significantly higher rates of postoperative sepsis and sepsis from pneumonia. However, the groups with high and low M2BPGi levels and those with high and low HA levels did not show significant differences in 6-month graft survival rates or rates of postoperative sepsis. Multivariate analysis revealed that a CIV level ≥ 590 was a significant predictor of graft loss within 6 months, postoperative sepsis, and sepsis from pneumonia.</p><p><strong>Conclusion: </strong>Unlike other fibrosis markers, preoperative CIV levels can predict graft survival, postoperative sepsis, and sepsis from pneumonia after LDLT.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354203","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":"Minimally invasive autologous pericardial patch reconstruction of the pulmonary artery for locally advanced lung cancer following neoadjuvant treatment.","authors":"Ze-Rui Zhao, Shou-Cheng Feng, Jia-Di Wu, Jing-Bo Zhang","doi":"10.1007/s00595-024-02940-9","DOIUrl":"https://doi.org/10.1007/s00595-024-02940-9","url":null,"abstract":"<p><p>Pulmonary arterioplasty with an autologous pericardial patch helps avoid having to perform pneumonectomy in patients with locally advanced non-small cell lung cancer. However, a minimally invasive procedure for this technique has rarely been reported because the patch usually shrinks and recoils after retrieval, complicating the suturing procedure. We describe our experience with performing autologous pericardial patch arterioplasty without glutaraldehyde fixation using video-assisted thoracoscopic surgery in a patient who received neoadjuvant immunotherapy. The pulmonary bloodstream was temporarily controlled by an endoscopic tourniquet placed at the pulmonary artery proximal to the ligamentum arteriosum as well as at the inferior pulmonary vein. A pericardial patch harvested anterior to the phrenic nerve was used to repair the hemi-circumferential pulmonary artery defect. Patch angioplasty was performed using a running suture with a 5-0 nonabsorbable monofilament thread, with the epicardial layer facing inside. No graft-related complications including stenosis occurred during the follow-up period.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296030","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":"Radiographical consolidation tumor size and preoperative clinical characteristics are significantly correlated with the postoperative survival of patients with part-solid and pure-solid adenocarcinomas: a propensity score-matched analysis.","authors":"Haruaki Hino, Natsumi Maru, Takahiro Utsumi, Hiroshi Matsui, Yohei Taniguchi, Tomohito Saito, Katsuyasu Kouda, Tomohiro Murakawa","doi":"10.1007/s00595-024-02939-2","DOIUrl":"https://doi.org/10.1007/s00595-024-02939-2","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with part-solid adenocarcinomas treated by surgery generally have more favorable outcomes than those with pure-solid adenocarcinomas. We conducted this study to understand the effects of the lepidic components and preoperative characteristics on the postoperative survival of patients with part-solid adenocarcinomas.</p><p><strong>Methods: </strong>The subjects of this retrospective study were 313 patients with stage 1 part-solid adenocarcinomas and 634 patients with pure-solid adenocarcinomas, treated at our institution between 2006 and 2020. Propensity score matching was performed to analyze survival in an unmatched cohort (PSM0, n = 313 vs. 634); a matched cohort based on the consolidation diameter (PSM1, n = 217 each); and a matched cohort based on 11 clinical characteristics (PSM2, n = 103 each). Multivariate analysis was also performed.  RESULTS: The 5-year overall/recurrence-free survival rates for part-solid and pure-solid adenocarcinomas were 90.2%/79.3% and 80.8%/66.0% in the PSM0 cohort (P < 0.0001), 87.4%/79.2% and 76.3%/68.6% in the PSM1 cohort (P < 0.05), and 91.6%/92.1% and 76.6%/79.0% in the PSM2 cohort (P > 0.05), respectively. Multivariate analysis revealed that male sex (P = 0.04) and the carcinoembryonic antigen value (P < 0.0001) were significant factors affecting overall survival, while the carcinoembryonic antigen value (P = 0.0002) and consolidation tumor size (P = 0.002) affected recurrence-free survival. The lepidic component was not related to overall (P = 0.45) or recurrence-free (P = 0.78) survival.</p><p><strong>Conclusions: </strong>Preoperative factors are strongly associated with \"consolidation size\", which could be the \"representative factor\" indicating the malignant potential in adenocarcinomas being consistent with the current eighth edition of the TNM.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296031","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":"Lobar shifting after lobectomy other than left upper lobectomy has a beneficial impact on postoperative pulmonary function","authors":"Sanae Kuroda, Nahoko Shimizu, Megumi Nishikubo, Wataru Nishio","doi":"10.1007/s00595-024-02915-w","DOIUrl":"https://doi.org/10.1007/s00595-024-02915-w","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Occasionally, lobes displace after lobectomy, which is referred to as “lobar shifting”. This study aimed to evaluate the effect of lobar shifting on postoperative pulmonary function.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We analyzed the records of 761 patients who underwent lobectomy between 2012 and 2022. The patients were categorized based on three-dimensional computed tomography (3D-CT) images into those with (shift group: <i>n</i> = 510) and those without (non-shift group: <i>n</i> = 251) their postoperative subject bronchus shifting toward the head or dorsal side. The preservation rate of forced expiratory volume in one second (FEV1.0) was compared between the two groups. Several factors were investigated to identify the cause of lobar shifting.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>FEV1.0 preservation rates, excluding left upper lobectomy, were significantly better in the shift group than in the non-shift group (all patients: 87.9% vs. 84.9%, <i>p</i> &lt; 0.001; right upper lobectomy: 90.1% vs. 85.4%, <i>p</i> = 0.002; right lower lobectomy: 90.0% vs. 84.5%, <i>p</i> = 0.002; left upper lobectomy: 82.0% vs. 83.9%, <i>p</i> = 0.43; left lower lobectomy: 90.0% vs. 85.2%, <i>p</i> = 0.01). Factors that correlated with lobar shifting included age (<i>p</i> &lt; 0.001), adhesions (<i>p</i> &lt; 0.001), and lobulation (<i>p</i> = 0.001).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Lobar shifting may benefit postoperative pulmonary function, excluding after left upper lobectomy. Morphological factors contribute to lobar shifting.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253214","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":"Efficacy and long-term outcomes of abdominoperineal resection using transperineal total mesorectal excision approach for rectal cancer","authors":"Takeru Matsuda, Kimihiro Yamashita, Hiroshi Hasegawa, Ryuichiro Sawada, Yasufumi Koterazawa, Hitoshi Harada, Naoki Urakawa, Hironobu Goto, Shingo Kanaji, Yoshihiro Kakeji","doi":"10.1007/s00595-024-02937-4","DOIUrl":"https://doi.org/10.1007/s00595-024-02937-4","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Although abdominoperineal resection (APR) is essential for a certain population of patients with low rectal cancer, it is technically difficult and sometimes contains oncological disadvantages. Thus, the use of the transperineal total mesorectal excision (TpTME) approach might overcome such concerns regarding APR.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>In total, 27 patients who underwent conventional APR (conventional group) and 49 patients who underwent APR using the TpTME approach (TpTME group) for low rectal cancer were included. After propensity score matching, the outcomes of the 25 matched cases were compared between groups.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The operative time was significantly shorter in the TpTME group than in the conventional group (452 vs. 565 min, <i>P</i> = 0.039). Intraoperative blood loss and transfusion rates were also significantly lower in the TpTME group than in the conventional group (25 mL vs. 200 mL, <i>P</i> &lt; 0.001 and 0% vs. 28.0%, <i>P</i> = 0.015, respectively). Although the incidence of postoperative complications did not differ significantly, the postoperative hospital stay was significantly shorter in the TpTME group than in the conventional group (24 vs. 36 days, <i>P</i> = 0.001). The 5 year relapse-free survival rates in the TpTME and conventional groups were 62.0% and 57.6%, respectively (<i>P</i> = 0.648).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>APR using the TpTME approach for the treatment of low rectal cancer is feasible and can achieve favorable oncological outcomes.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253211","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":"Prior coronary stent does not exclude major pulmonary resection regardless of antiplatelet therapy.","authors":"Isamu Watanabe, Aritoshi Hattori, Mariko Fukui, Takeshi Matsunaga, Kazuya Takamochi, Kenji Suzuki","doi":"10.1007/s00595-024-02933-8","DOIUrl":"https://doi.org/10.1007/s00595-024-02933-8","url":null,"abstract":"<p><strong>Purpose: </strong>We assessed the safety of general thoracic surgery in patients with prior coronary stents undergoing lung resection, based on differences in perioperative antiplatelet therapy management.</p><p><strong>Methods: </strong>We retrospectively examined 150 patients with coronary artery stents who underwent pulmonary resection between July 2009 and July 2018. The impact of the antiplatelet agent on thoracic surgery safety was assessed by comparing perioperative outcomes, including major adverse cardiac and cerebrovascular events, among the discontinued antiplatelet therapy (group D), heparin bridging (group H), and continuous antiplatelet therapy (group C) groups.</p><p><strong>Results: </strong>Groups D, H, and C included twenty-four, eighty-four, and forty-two patients, respectively. Second-generation drug-eluting stents were used in > 50% of the patients. No significant differences were found in the estimated blood loss, transfusion rate, or operative duration. Major adverse cardiac and cerebrovascular events occurred in four (2.7%) patients, which was comparable among the groups. In group H, postoperative heart failure and transient ischemic attack with stroke occurred in one patient each. Major bleeding occurred in two (4.7%) patients in group C.</p><p><strong>Conclusions: </strong>Pulmonary resection surgical outcomes in patients with coronary artery stents were feasible regardless of antiplatelet therapy continuation. However, discontinuing dual-antiplatelet or single-antiplatelet therapy in such patients may be reasonable because this generation of drug-eluting stents has a higher safety profile than bare-metal and first-generation drug-eluting stents.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154977","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":"Real-world outcomes of stage II and III colorectal cancers treated by postoperative adjuvant chemotherapy based on the mismatch repair status.","authors":"Yoshinori Iwata, Chihiro Tanaka, Shinya Ohno, Tomonari Suetsugu, Hideharu Tanaka, Taku Watanabe, Shuji Komori, Narutoshi Nagao, Masaki Katayama, Masahiko Kawai","doi":"10.1007/s00595-024-02932-9","DOIUrl":"https://doi.org/10.1007/s00595-024-02932-9","url":null,"abstract":"<p><strong>Purpose: </strong>In Japan, immunohistochemistry for mismatch repair (MMR) proteins targeted at stage II and III colorectal cancers (CRCs) has been covered by national insurance since October, 2022. This study aimed to clarify the long-term outcomes of patients with stage II and III CRCs receiving postoperative adjuvant chemotherapy based on their MMR status.</p><p><strong>Methods: </strong>The outcomes of 640 patients who underwent radical surgery for stage II and III CRCs were analyzed retrospectively.</p><p><strong>Results: </strong>Deficient MMR (dMMR) was diagnosed in 41 (13.3%) patients with stage II and 28 (9.1%) patients with stage III CRC. The overall survival and recurrence rates were not significantly different between the patients with stage II and those with stage III CRC. The risk factors for recurrence among those with stage II CRC were tumors on the left side, T4 disease, and the presence of BRAF wild type. The recurrence rates were lower in the stage II CRC patients with sporadic dMMR than in those with suspected Lynch syndrome (LS). The first site of recurrence was more frequently the peritoneum or distant lymph node in patients with dMMR.</p><p><strong>Conclusions: </strong>Stage II CRC patients with sporadic dMMR were found to have a very good prognosis. On the other hand, peritoneal dissemination or distant lymph node metastasis tended to develop in patients with dMMR.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154978","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 outcomes and cost analysis of open repair and endovascular aneurysm repair for abdominal aortic aneurysms: a single-center experience in Japan.","authors":"Yasumi Maze, Toshiya Tokui, Ryotaro Inoue, Tomotake Sekoguchi, Takahiro Narukawa, Masahiko Murakami, Ryosai Inoue, Koji Hirano, Shuji Chino, Ken Nakajima, Noriyuki Kato, Hisato Ito","doi":"10.1007/s00595-024-02934-7","DOIUrl":"https://doi.org/10.1007/s00595-024-02934-7","url":null,"abstract":"<p><strong>Purpose: </strong>Japan has adopted its own reimbursement system, which differs from other countries in terms of its diagnostic procedure combination (DPC) methods. However, there are few reports on the cost analysis of open repair and endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms in Japan. We aimed to evaluate the long-term outcomes and cost-effectiveness of these two procedures.</p><p><strong>Methods: </strong>This study included patients who underwent open repair (n = 224) and EVAR (n = 87) between January 2012 and December 2022. After propensity score matching, we compared the two groups.</p><p><strong>Results: </strong>The drug and blood products, procedures, and DPC costs were significantly higher in the open repair group (p < 0.001) than in the EVAR group. The surgical equipment and total costs were significantly higher in the EVAR group than in the open repair group (p < 0.001). There was no significant difference in the 5-year survival rate (88.5% in the open repair group vs. 72.0% in the EVAR group; p = 0.33) and freedom from re-intervention rate at 5 years (93.1% in the open repair group vs. 89.9% in the EVAR group; p = 0.15) between the two groups.</p><p><strong>Conclusions: </strong>Open repair is more cost-effective than EVAR. The cost-effectiveness of EVAR may therefore depend on the cost of the endograft.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126786","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}