Therapeutic hypothermia and temperature management最新文献

{"title":"Establishment and Identification of a Deep Second-Degree Frostbite Model in Mouse Skin.","authors":"Tianwei Li, Dongwen Gao, Wenwen Wang, Xiao Li, Mingfei Han, Jie Ma, Yunping Zhu","doi":"10.1089/ther.2025.0003","DOIUrl":"10.1089/ther.2025.0003","url":null,"abstract":"<p><p>The aim of this study is to address the limited research on skin frostbite models and the gaps in pathological identification of time-series injuries in frostbitten skin, which hinder comprehensive assessment of injury severity. A deep second-degree frostbite model was developed in BALB/c nude mice, and staining identification was performed at various stages, from the onset of frostbite to the healing process. Continuous observations at multiple time points provided a more accurate and comprehensive standard for comparison in frostbite treatment experiments. A deep second-degree frostbite model was developed using BALB/c nude mice. Histopathological examination was performed with hematoxylin-eosin (HE) staining, while Masson's Trichrome (MT) staining was used to observe collagen recovery. Additionally, immunofluorescence staining was conducted to analyze epidermal cells and dermal structures. A deep second-degree frostbite model was successfully developed in BALB/c nude mice. Histopathological characteristics of mouse skin tissue were examined through HE staining at various time points. MT staining highlighted changes in the morphology and thickness of the original fibers. Immunofluorescence staining offered a detailed evaluation of the damage and recovery of appendages, including hair follicles and sweat glands. The deep second-degree frostbite model in BALB/c nude mice establishes a standard for studying skin frostbite injuries and developing related treatments.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"59-66"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512531","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":"Therapeutic Efficacy of Craniocerebral Hypothermia Helmet Versus Arctic Sun Surface Cooling System in Post-Cardiac Arrest Syndrome: A Prospective Comparative Study.","authors":"Aydin Nadir, Mehmet Sari","doi":"10.1089/ther.2025.0006","DOIUrl":"10.1089/ther.2025.0006","url":null,"abstract":"<p><p>Therapeutic hypothermia is a critical intervention in post-cardiac arrest care, yet the optimal cooling method remains debatable. This prospective, single-center study compared the efficacy of a novel craniocerebral hypothermia helmet with the Arctic Sun 5000 surface cooling system in post-cardiac arrest patients. Thirty-four comatose survivors of cardiac arrest were randomized to receive either craniocerebral hypothermia (<i>n</i> = 17) or peripheral surface cooling (<i>n</i> = 17). Target temperature management (32-34°C) was initiated within 30-120 minutes of return of spontaneous circulation and maintained for 36-48 hours. Craniocerebral hypothermia demonstrated significantly faster cooling initiation (32.9 ± 13.5 vs. 238 ± 25.7 minutes, <i>p</i> < 0.001) compared with peripheral cooling, while both methods achieved similar target temperature maintenance. The craniocerebral group showed better preservation of renal function and electrolyte stability, with significantly lower increases in serum creatinine and urea levels (<i>p</i> < 0.001). Hospital stays were notably shorter in the craniocerebral group (13 ± 7 vs. 24.29 ± 31 days, <i>p</i> < 0.001). While both methods achieved comparable survival rates, the craniocerebral group exhibited a lower incidence of seizures (17.6% vs. 66.6%) and improved neurological outcomes based on Cerebral Performance Category scores though not reaching statistical significance. These findings suggest that craniocerebral hypothermia offers advantages in terms of rapid cooling initiation, physiological stability, and reduced hospital stay, representing a promising alternative for targeted temperature management in post-cardiac arrest care. The enhanced practicality and comparable efficacy of this approach warrant further investigation through larger multicenter trials.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"51-58"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626020","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 Effect of Temperature Chain Management Scheme During Gynecological Laparoscopic Surgery Under General Anesthesia.","authors":"Lanxia Pan, Yuelei Dong, Fengxia Chen","doi":"10.1177/21537658251372312","DOIUrl":"10.1177/21537658251372312","url":null,"abstract":"<p><p>This study aimed to explore the effect of the temperature chain management scheme on inadvertent perioperative hypothermia (IPH) during gynecological laparoscopic surgery. A total of 48 female adult patients who underwent elective gynecological laparoscopic surgery under general anesthesia from November 2023 to April 2024 in a teaching hospital were enrolled and randomized to receive either intraoperative prewarming fluid alone (Group C) or temperature chain management (Group T). Comparing the perioperative core and peripheral temperatures, IPH rates, shivering in postanesthesia care unit (PACU), and thermal comfort in two groups, perioperative core temperature of Group T was higher than that of Group C (<i>p</i> < 0.05); IPH rates and the incidence of shivering in PACU of Group T were lower than that of Group C (<i>p</i> < 0.05); Group T scored higher in thermal comfort than Group C when entering PACU (<i>p</i> < 0.05). This study reports that the use of intraoperative prewarming fluid alone does not sufficiently warm the patients. The optimal temperature management is achieved when using temperature chain management during gynecological laparoscopic surgery.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"67-72"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970315","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":"Heated High-Flow Nasal Cannula for the Treatment of Unintended Perioperative Hypothermia: A Feasibility Study.","authors":"Kirklen Petersen, Spencer Rice, Kenneth Potter, Shannon Boylan, Kristina Clark, Megan McCartney, Laura Lahaye","doi":"10.1089/ther.2025.0010","DOIUrl":"10.1089/ther.2025.0010","url":null,"abstract":"<p><p>There are many established strategies to target normothermia in the perioperative period; however, hypothermia remains a common occurrence and can have significant impacts on patient outcomes, unanticipated admissions, and postanesthesia care unit (PACU) throughput. This pilot study serves to shed light on the effectiveness of using high-flow nasal cannula (HFNC) as an alternative to a Bair Hugger (BH). This pilot study compares 10 patients warmed to normothermia with HFNC in the PACU with 15 patients warmed with traditional BH. Patients in the HFNC group reached the goal temperature of 36°C 9.1 minutes faster than the BH group. However, these findings were not statistically significant (mean time: 72.1 minutes vs 81.2; <i>p</i> = 0.247). In addition, phase 1 recovery times were about 8 minutes longer in the HFNC group compared with the BH group but were also not statistically significant (mean time: 180.8 minutes vs 172.4; <i>p</i> = 0.338). Based on the initial data, HFNC may play an important role in the future by making PACU rewarming more efficient and therefore having a huge impact on PACU discharge times, unanticipated hospital admissions, delayed emergence from anesthesia, and morbid cardiac events. Further large scale, randomized control studies need to be done to investigate HFNC as an alternative rewarming method for hypothermic patients in the PACU.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"73-77"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049058","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":"Intranasal Temperature Modulation Device in Awake Healthy Volunteers: A First In-Human Safety and Tolerability Study.","authors":"Alan S Nova, Neeraj Badjatia","doi":"10.1177/21537658261415906","DOIUrl":"10.1177/21537658261415906","url":null,"abstract":"<p><p>Fever after brain injury is a known contributor to poor outcomes; however, temperature-modulating devices (TMDs), such as surface and intravascular systems, face significant limitations, including delayed deployment, invasiveness, patient discomfort, skin integrity issues, frequent induction of shivering, and the need for sedation, all of which hinder timely neuroprotective therapy and confound neurological assessments. This first in-human study evaluated the safety and tolerability of an intranasal TMD, which delivers thermoelectrically temperature-regulated air via a nasal cannula to affect the core temperature. Five healthy, awake adult volunteers (median age 34 years old, 57.1% men) underwent intranasal cooling with 5°C cooled air delivered at flow rates between 15 and 58 liters per minute. The primary endpoints were safety and tolerability. The reduction in core body temperature was recorded using an esophageal temperature probe. No pharmacological agents or sedatives were administered to the patient. All participants exhibited a consistent downward trend in core body temperature, with an average reduction of 0.7°C at 30 minutes and 1.2°C at 60 minutes. Notably, no shivering or adverse events related to the intranasal TMD were reported. Cooling was well-tolerated, with esophageal probe placement being the only limiting factor for full protocol completion in some subjects. Participants remained fully conscious and communicative throughout the therapy. This intranasal TMD achieved clinically relevant core cooling without triggering shivering or requiring sedation, thereby addressing the key barriers associated with traditional TMDs. These promising early results support further investigation of this intranasal TMD in patients with acute neurological injury. Future studies should explore its performance in critical care and prehospital environments, where time-sensitive neuroprotection is most impactful.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"78-81"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030923","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":"Cryotherapy Is Effective in Nulliparous Women with Primary Dysmenorrhea: A Randomized Controlled Trial.","authors":"Borja Perez-Dominguez, Lucia Gonzalez-Ruiz, Sara Muñoz-Ibañez, Maria Blanco-Diaz, Esther Diaz-Mohedo","doi":"10.1089/ther.2025.0008","DOIUrl":"10.1089/ther.2025.0008","url":null,"abstract":"<p><p>Primary dysmenorrhea is a prevalent condition causing severe menstrual pain in nulliparous women, negatively impacting daily functioning and well-being. This randomized controlled trial investigated the efficacy of cryotherapy in alleviating pain and enhancing secondary outcomes such as sleep quality, quality of life, and physical activity. Fifty-eight nulliparous women were randomly assigned to a cryotherapy group or a control group. Pain intensity was measured using the Numeric Rating Scale, whereas secondary outcomes were evaluated with the Pittsburgh Sleep Quality Index, World Health Organization Quality of Life-Brief Version, and the International Physical Activity Questionnaire. Socioeconomic factors, including household income, education, and occupation, were also assessed. Cryotherapy significantly reduced pain intensity from a baseline of 7.1 ± 1.4 to 1.8 ± 1.7 (<i>p</i> < 0.001) compared with a modest reduction in the control group (5.9 ± 1.9-5.4 ± 2.1). Sleep quality improved more in the cryotherapy group (6.90 ± 3.0 to 5.03 ± 2.5) than in the control group (6.88 ± 3.6 to 5.68 ± 2.8). However, no statistically significant changes were observed in the quality of life or physical activity levels, likely because menstrual pain alone may not sufficiently influence these domains, which are affected by broader psychosocial and behavioral factors. These findings demonstrate that cryotherapy is a simple, cost-effective intervention for managing primary dysmenorrhea, providing substantial pain relief and modest improvements in sleep quality. Further research is recommended to evaluate its long-term benefits and potential for broader applications in menstrual health management.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"ther20250008"},"PeriodicalIF":1.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019794","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":"Therapeutic Hypothermia in Neonates with Hypoxic-Ischemic Encephalopathy-Drift in Clinical Practice in Swiss Neonatal (Intensive Care) Units?","authors":"Charlotte Lengauer, Mark Adams, Barbara Brotschi, Michael Kleber, Vera Bernet, Maren Tomaske, Dirk Bassler, Beate Grass","doi":"10.1089/ther.2025.0019","DOIUrl":"10.1089/ther.2025.0019","url":null,"abstract":"<p><p>The objective of this study was to assess the adherence to inclusion criteria for therapeutic hypothermia (TH) in neonates with hypoxic-ischemic encephalopathy (HIE) and to survey current attitudes on TH. This multicenter observational study therefore combined a retrospective analysis of the Swiss National Asphyxia and Cooling Register (2011-2023) and a prospective survey (2024) among neonatologists in the Canton of Zurich, Switzerland. A total of 456 neonates with HIE were registered in the Swiss National Asphyxia and Cooling Register in the Canton of Zurich, Switzerland, between 2011 and 2023. The rate of TH (52.6% [2011-2017] versus 52.0% [2018-2023]) as well as the incidence of off-protocol cooling remained stable over time (<i>p</i> = 0.614). The survey response rate was 69.5% (57/82). Difficulties with clinical grading of encephalopathy were identified. Subjectively, respondents considered themselves more generous to initiate TH. In conclusion, register data reflected good adherence to inclusion criteria for TH. The survey confirmed willingness to consider TH in milder HIE cases. However, there was no drift in clinical practice-yet?</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"ther20250019"},"PeriodicalIF":1.0,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080545","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 Practice of Target Temperature Management in Acute Brain Injury: Associations with Coagulopathy and In-Hospital Mortality.","authors":"Young Ju Lee, Jihye Song, Yong Cheol Lim","doi":"10.1177/21537658261437622","DOIUrl":"https://doi.org/10.1177/21537658261437622","url":null,"abstract":"<p><p>Target temperature management (TTM) is a neuroprotective strategy widely used in acute brain injury. However, its real-world implementation remains highly heterogenous and the clinical implications of different temperature targets and treatment durations are not well defined. This study aimed to describe real-world TTM practices and to explore associations between TTM characteristics, coagulopathy, and in-hospital mortality in patients with acute brain injury. We retrospectively analyzed 180 patients who underwent TTM between January 2011 and December 2024 at a single tertiary medical center. Patients diagnosed with acute brain injury, including aneurysmal subarachnoid hemorrhage, traumatic brain injury (TBI), intracerebral hemorrhage, or acute infarction, were included. Clinical variables, TTM parameters, complications, comorbidities, and in-hospital outcomes were analyzed. Univariable and multivariable analyses were conducted to identify factors associated with in-hospital mortality and TTM-related coagulopathy. In-hospital mortality occurred in 78 patients (43.3%). In multivariable analysis, post-cardiac arrest state (odds ratio [OR] = 3.99, <i>p</i> = 0.003) and coagulopathy during TTM (OR = 5.31, <i>p</i> = 0.005) were significantly associated with increased in-hospital mortality. Coagulopathy occurred in 21 (11.7%) patients and was significantly associated with type of injury, which showed it was most prevalent in TBI. Prolonged duration of TTM was not associated with an increased risk of coagulopathy and was associated with lower in-hospital mortality (OR = 0.30, <i>p</i> < 0.001). Injury subtype demonstrated significant heterogeneity in mortality risk and was retained as a covariate in the final multivariable model. In this real-world cohort, TTM practices varied substantially across acute brain injury subtypes. Coagulopathy was associated with increased in-hospital mortality and occurred more frequently in patients with TBI. Prolonged TTM was associated with lower in-hospital mortality. However, this finding should be interpreted cautiously given the potential for survivorship bias. Mortality risk differed across injury subtypes. These findings suggest that the clinical context and underlying injury type should be considered when applying TTM in patients with acute brain injury.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"21537658261437622"},"PeriodicalIF":1.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514882","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 Effect of Therapeutic Hypothermia on the QT Interval in Postcardiac Arrest Cases.","authors":"Aydin Nadir, Mehmet Sari","doi":"10.1089/ther.2025.0005","DOIUrl":"10.1089/ther.2025.0005","url":null,"abstract":"<p><p>Postcardiac arrest (PCA) syndrome is associated with high cardiovascular morbidity and mortality. Prolongation of the QT interval can lead to life-threatening ventricular arrhythmias and sudden cardiac death. Therapeutic hypothermia (TH) is widely used to improve neurological outcomes in PCA patients, but its effects on the QT interval remain a subject of investigation. This study aimed to evaluate the impact of TH on corrected QT (QTc) intervals in PCA patients. A total of 48 patients (mean age 63.2 ± 11.3 years) who survived cardiac arrest and underwent TH were included. Standard 12-lead electrocardiograms (ECGs) and serum electrolyte levels were assessed before and after TH. The QT and QTc intervals were measured using Bazett's formula, and QT dispersion (QTd) was calculated as the difference between the maximum and minimum QT intervals. Following TH, a significant increase in RR intervals was observed (480.75 ± 91.75 ms vs. 660.43 ± 97.35 ms, <i>p</i> < 0.05). QTc intervals increased significantly from 397.13 ± 12.45 ms to 449.25 ± 21.40 ms (<i>p</i> < 0.05). Similarly, QTd increased from 55.48 ± 12.45 ms to 67.41 ± 13.42 ms (<i>p</i> < 0.05). The prolongation of the QT interval was associated with a significant decrease in serum potassium and calcium levels. In conclusion, TH leads to a significant prolongation of the QT and QTc intervals and an increase in QTd. These findings suggest that close ECG monitoring is essential in PCA patients undergoing TH, particularly in those with predisposing factors for arrhythmias.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"30-34"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Depth-Dependent Cytoprotection with Therapeutic Hypothermia for Cerebral Ischemia.","authors":"Marin R Parranto, Tiffany F C Kung, Lane J Liddle, Tayyaba Khalid, Aline B Thorkelsson, Ana C Klahr, Mohammed Almekhlafi, Frederick Colbourne","doi":"10.1177/21537658251377958","DOIUrl":"10.1177/21537658251377958","url":null,"abstract":"<p><p>Preclinical studies show that therapeutic hypothermia (TH) effectively reduces cerebral ischemic injury. In contrast, TH has not been consistently beneficial in clinical trials of stroke and cardiac arrest, perhaps from suboptimal dosing (e.g., delay, depth, and duration), among other factors. This systematic review aimed to find an optimal depth of TH from <i>in vivo</i> adult preclinical studies of global and focal ischemia. To study depth, without other confounds, we examined studies that compared ≥2 depths of TH versus normothermic controls. Our primary outcomes were infarct size (focal ischemia) and hippocampal cell death (global ischemia), while secondary outcomes were behavior, edema, and striatal cell death. Studies were assessed with the SYRCLE Risk of Bias tool (e.g., use of blinding) and additional indices of translational rigor (e.g., use of aged animals). Thirty studies were included from a search of the PubMed database in 2025. Many studies were rated as exhibiting a high risk of bias with low translational rigor. Overall, TH provided considerable protection on all endpoints, sometimes up to 100%, but no consistent dose-response patterns emerged, nor was an optimal depth of cooling readily evident. To explore the latter finding, specifically sampling variability, we conducted Monte Carlo simulations using the pooled standard deviation of the preclinical studies to generate three populations based upon a theoretical 5% protection per 1°C relationship (37°C vs. 32°C vs. 27°C groups run 75 times). Dose-dependent effects were statistically detectable in only 36% of comparisons, which showed comparably noisy patterns of protection. Thus, the variable dose-dependent effects in the reviewed animal studies likely arise, at least partially, from sampling error owing to using small samples from variable populations (average <i>n</i> = 8/group in focal ischemia). Overall, these findings highlight weaknesses in the extant dose-response literature that limit our ability to precisely guide clinical trials.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"1-15"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076040","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}