Thoracic and Cardiovascular Surgeon最新文献_第2页

Ebstein repair at high altitude setting ≥ 2,500 m - First experience from Bolivia. 在海拔≥2500米的高空修理Ebstein -玻利维亚的首次经验。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-05-26 DOI: 10.1055/a-2620-3643

Sven Weber, Inge von Alvensleben, Valentin Vadiunec, Andre Iben, Felix Berger, Hannes Sallmon, Joachim Photiadis

{"title":"Ebstein repair at high altitude setting ≥ 2,500 m - First experience from Bolivia.","authors":"Sven Weber, Inge von Alvensleben, Valentin Vadiunec, Andre Iben, Felix Berger, Hannes Sallmon, Joachim Photiadis","doi":"10.1055/a-2620-3643","DOIUrl":"https://doi.org/10.1055/a-2620-3643","url":null,"abstract":"Background: Contemporary surgical approaches for Ebstein anomaly are based on a paradigm shift towards earlier surgery in order to avoid the deleterious effects of chronic right ventricular (RV) volume overload. In addition, RV dysfunction may worsen in the setting of high altitude and, to date, no results on Ebstein anomaly surgery have been reported from a high altitude setting.Methods: We herein present first postoperative results from Ebstein anomaly patients who underwent cone reconstruction (with or without bi-directional Glenn anastomosis) in Cochabamba, Bolivia (> 2,500 m above sea level) using a specific high altitude protocol for prophylactic medical treatment of presumed pulmonary hypertension including sildenafil, iloprost, and higher FiO2.Results: Four patients underwent surgical correction of Ebstein anomaly (median age 9 years, range 4 to 12 years, all female). Ebstein anomaly was classified as Carpentier type C in three and as Carpentier Type B in one patient. All patients showed some degree of atrial shunting while one patient exhibited an additional perimembranous ventricular septal defect. All underwent cone reconstruction of the tricuspid valve. Due to massive intraoperative bleeding, which required re-thoracotomy subsequently causing impaired RV function, one patient underwent concomitant \"one and half ventricle\" repair. All other patients showed an uncomplicated postoperative course and all were alive with a good and/or improved RV function and only minimal-to-mild tricuspid regurgitation after 1 year.Discussion: Cone reconstruction in children with Ebstein anomaly is feasible in a high altitude setting when using a dedicated protocol to prophylactically manage pulmonary hypertension.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151790","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}

引用次数: 0

Experimental comparison of esmolol- and blood-based cardioplegia for long aortic clamping times. 艾司洛尔与血基心脏停搏术治疗长主动脉夹紧时间的实验比较。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-05-22 DOI: 10.1055/a-2618-4744

Zulfugar T Taghiyev, Balli Chapugi, Martina Heep, Ulrich Gärtner, Bernd Niemann, Andreas Böning

{"title":"Experimental comparison of esmolol- and blood-based cardioplegia for long aortic clamping times.","authors":"Zulfugar T Taghiyev, Balli Chapugi, Martina Heep, Ulrich Gärtner, Bernd Niemann, Andreas Böning","doi":"10.1055/a-2618-4744","DOIUrl":"https://doi.org/10.1055/a-2618-4744","url":null,"abstract":"Objectives: Various cardioplegia solutions aim to protect the myocardium during cardiac surgery. This study compares hemodynamic performance, myocardial metabolism, and ultrastructural preservation in rat hearts after applying esmolol crystalloid cardioplegia(ECCP) or Calafiore blood cardioplegia(Cala).Materials and methods: Hearts from 18 Wistar rats were perfused in a Langendorff system. Following 120 min of ischemia at 36°C, hearts received either ECCP at 32°C for 3 min or Cala at 36°C for 2 min every 20 min. During 90 min of reperfusion, coronary blood flow(CF), left ventricular developed pressure(LVDP), and contraction/relaxation velocities (+/-dp/dt) were recorded. Myocardial oxygen consumption, lactate production, and troponin I levels were measured. Electron microscopy was used for ultrastructural assessment.Results: Baseline(BL) values of LVDP, CF and +/-dp/dt were similar between the two groups. After 90 min of reperfusion, CF was significantly higher in the ECCP group: 85±43% of BL in the ECCP group vs. 42±24% of BL in the Cala group(p=0.002). At the end of reperfusion, hearts exposed to ECCP had higher LVDP (91±40%) values than Cala (43±10%), indicating improved cardiac recovery with ECCP. Myocardial contraction and relaxation were notably better in the ECCP group: dLVP/dt max was 111 ±40% vs. 59±13% in the Cala group(p=0.002); dLVP/dt min 88±34% vs. 40±7%(p=0.001). Troponin I levels measured in Cala hearts at the end of reperfusion were higher than in ECCP hearts (Cala 1102.6 ±361.3]ng/ml vs. ECCP442.3 ±788.4]ng/ml,p=0.036).Conclusion: In rat hearts, ECCP offers better hemodynamic recovery and protects the myocardium from ischemia/reperfusion-related damage better than Cala blood cardioplegia even with aortic clamping times of 12.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128809","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}

引用次数: 0

Impact of SGLT2 inhibitor therapy on patients undergoing cardiac surgery. SGLT2抑制剂治疗对心脏手术患者的影响。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-05-20 DOI: 10.1055/a-2616-4962

Zulfugar T Taghiyev, Lili-Marie Beier, Carina Leweling, Sophia Gunkel, Kevin Mike Sadowski, Birgit Assmuß, Andreas Böning

{"title":"Impact of SGLT2 inhibitor therapy on patients undergoing cardiac surgery.","authors":"Zulfugar T Taghiyev, Lili-Marie Beier, Carina Leweling, Sophia Gunkel, Kevin Mike Sadowski, Birgit Assmuß, Andreas Böning","doi":"10.1055/a-2616-4962","DOIUrl":"https://doi.org/10.1055/a-2616-4962","url":null,"abstract":"Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are nephroprotective in patients with recompensated acute and chronic heart failure (HF) and chronic kidney disease, but their potential influence during cardiac surgery is unclear. Currently, discontinuation of SGLT2i at least two days before surgery is recommended.Methods: Between March 2022 and December 2023, 53 cardiac surgical patients on SGLT2i therapy in addition to standard medical treatment for HF (LVEF >40%) were compared with 447 other HF patients from the same period. After 1:1 covariate adjustment, 33 patients with SGLT2i treatment were matched with 33 controls. The primary endpoint was a change in estimated glomerular filtration rate (eGFR) 36 h after surgery. Secondary endpoints were changes in eGFR, cumulative urine output, diuretic efficacy, and albuminuria over seven postoperative days.Results: Mean baseline eGFR was similar between the groups (p=0.973). Thirty-six hours postoperatively, eGFR was significantly higher in the SGLT2i group by a mean difference (MD) of 11.8 mL/min (95%CI[3.12 to 20.44];p=0.009) compared with the control group. The mean urinary albumin level was 18.1 mg/ml lower in the SGLT2i group (95%CI[-42.5 to 6.33];p=0.143). There were numerically positive changes in urine output and diuretic efficacy in the SGLT2i group without significant difference: MD131.4 mL/24 h (95%CI[-366.7 to 629.5];p=0.600) and MD11.3 mL/mg (95%CI[-12.2 to 34.7];p=0.301), respectively, although the dosage of diuretics was higher in controls (30.6±43.7 vs. 51.3±130.1 mg/24h;p=0.268,respectively).Conclusion: SGLT2 inhibitors may have nephroprotective effects in patients undergoing heart surgery with extracorporeal circulation. More evidence is needed to determine whether SGTL2i needs to be discontinued before surgery.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111994","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}

引用次数: 0

Population-level Outcomes of Ex-Vivo Lung Perfusion (EVLP) in Lung Transplantation. 肺移植中离体肺灌注（EVLP）的人群水平结果。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-05-20 DOI: 10.1055/a-2587-6756

Pablo Perez-Castro, Errol Bush, Elliott Haut, John McGready, Betsy King

{"title":"Population-level Outcomes of Ex-Vivo Lung Perfusion (EVLP) in Lung Transplantation.","authors":"Pablo Perez-Castro, Errol Bush, Elliott Haut, John McGready, Betsy King","doi":"10.1055/a-2587-6756","DOIUrl":"10.1055/a-2587-6756","url":null,"abstract":"Ex-vivo lung perfusion (EVLP) is a novel organ preservation technique introduced to assess extended lung donors and determine their suitability for human use.This retrospective cohort study analyzed lung transplant recipients in the U.S. from 2011 to 2021, using data from the Scientific Registry of Transplant Recipients (SRTR). Kaplan-Meier curves were used for time-to-event survival analysis, and the Cox proportional hazards model was used to determine hazard ratios for overall survival.Of 23,261 patients, 608 had EVLP-donor lungs. The 5-year survival was similar across groups. Centers with EVLP access had median wait times of 48 days (SD 260.80) versus 68 days (SD 273.73) at other centers. Cox proportional hazards model showed no significant disparity in 5-year survival with EVLP (HR 1.14, p 0.08), gender (HR 1.04, p 0.07), and high volume (HR 0.8, p 0.07). Perioperative extracorporeal membrane oxygenation (ECMO) (HR 1.29, p < 0.01) and black recipient race (HR 1.15, p < 0.01) influenced survival; there were no statistical differences in any other race. Black EVLP-assessed recipients showed a nonsignificant trend toward a survival benefit (p = 0.26) with a 14.2% higher 5-year survival (95% CI 2.7-28.7).EVLP has not adversely affected 5-year survival rates in lung transplantation recipients and is associated with shorter wait times. A survival advantage in black recipients with EVLP-assessed lungs needs further research.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000291","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}

引用次数: 0

P-wave indices: manifest atrial fibrillation after postoperative atrial fibrillation? p波指标：术后房颤是否表现为房颤？

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-05-20 DOI: 10.1055/a-2616-3919

Christian Peter Erich Rau, Miriam Salzmann-Djufri, Andreas Böning, Susanne Rohrbach, Bernd Niemann

{"title":"P-wave indices: manifest atrial fibrillation after postoperative atrial fibrillation?","authors":"Christian Peter Erich Rau, Miriam Salzmann-Djufri, Andreas Böning, Susanne Rohrbach, Bernd Niemann","doi":"10.1055/a-2616-3919","DOIUrl":"https://doi.org/10.1055/a-2616-3919","url":null,"abstract":"Objectives: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery. We investigated how POAF affects the manifestation of atrial fibrillation (AF) during long-term follow-up.Methods: We conducted a prospective all-comers investigation involving patients undergoing cardiac surgery. In propensity score matched cohorts (POAF vs sinus rhythm), ECGs were evaluated regarding P-wave duration, amplitude, morphology, variability and their dynamics preoperatively pre-POAF and at follow-up. Predictive value of these parameters regarding development of manifest AF after POAF was analyzed.Results: From 212 patients included, 50 patients (23.6 %) developed POAF. Ninety patients underwent PSM, 64 (71 %) participated in follow-up, 21 (23 %) died prior to follow up (POAF: 13 vs. SR: 8), and 5 (6 %) withdrew consent. No patient developed persistent AF. In 9 patients paroxysmal AF events were detected (POAF: 6 vs. SR: 3). P-wave duration, P-dispersion, P-amplitude and interatrial block differed between POAF and SR. From pre- to postoperative ECGs, P-dispersion and PWPT increased and P-amplitude decreased in these. Preoperative beta-blockers had only minor modulating potency. P-wave modulation was pronounced in POAF patients.Conclusion: Patients with POAF are prone to episodes of paroxysmal AF. P-wave indices and perioperative dynamics of these indices may indicate a higher risk of manifest AF initiation among POAF patients.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111995","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}

引用次数: 0

Single-Port Subcostal Robot-Assisted Minimally Invasive Esophagectomy-How to Do It? 单端口肋下机器人辅助微创食管切除术。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-05-14 DOI: 10.1055/a-2587-6701

Edin Hadzijusufovic, Vladimir J Lozanovski, Luca Bellaio, Evangelos Tagkalos, Eren Uzun, Eva-Verena Griemert, Hauke Lang, Peter P Grimminger

引用次数: 0

Retrograde Simultaneous Ligation of Apico-ventral Vessels during VATS RUL. VATS RUL术中顶腹血管逆行同时结扎。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-05-02 DOI: 10.1055/a-2526-0828

Alfonso Fiorelli, Vincenzo Di Filippo, Giuseppe Vicario, Francesca Capasso

引用次数: 0

Normothermic Circulatory Arrest with Antegrade Cerebral Perfusion for Type A Aortic Dissection. 正常循环停止伴顺行脑灌注治疗A型主动脉夹层。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-05-02 DOI: 10.1055/a-2576-7627

Laura Rings, Rasha Boulos, Vasileios Ntinopoulos, Achim Haeussler, Hector Rodriguez Cetina Biefer, Omer Dzemali

{"title":"Normothermic Circulatory Arrest with Antegrade Cerebral Perfusion for Type A Aortic Dissection.","authors":"Laura Rings, Rasha Boulos, Vasileios Ntinopoulos, Achim Haeussler, Hector Rodriguez Cetina Biefer, Omer Dzemali","doi":"10.1055/a-2576-7627","DOIUrl":"https://doi.org/10.1055/a-2576-7627","url":null,"abstract":"Deep hypothermic circulatory arrest is the standard approach for the surgical repair of acute type A aortic dissection. This study aimed to evaluate the feasibility and outcomes of normothermic circulatory arrest using antegrade cerebral perfusion as an alternative technique.A retrospective propensity score-matched analysis was conducted on patients undergoing surgery for acute type A aortic dissection between 2007 and 2023 at a single center. Outcomes were compared between patients who underwent normothermic (>35°C) versus mild hypothermic (28-34°C) circulatory arrest. The primary outcomes were 30-day mortality, new neurological deficits, and the intraoperative and postoperative parameters.After propensity score matching, 20 pairs were analyzed. The normothermic group (NTCA) had significantly shorter aortic cross-clamp times (47.5 vs. 66.5 minutes, p = 0.013) and trends toward shorter cardiopulmonary bypass times (68 vs. 95 minutes, p = 0.066), ICU stays (4.5 vs. 5 days, p = 0.4), and intubation times (6 vs. 8 hours, p = 0.4). There were no significant differences in new neurological deficits (n = 6 [NTCA] vs. 4, p = 0.7), delirium (n = 5 [NTCA] vs. 6, p = 0.6), or mortality (n = 1 [NTCA] vs. 3, p = 0.6) between the groups. The normothermic group required less prothrombin complex concentrate (p = 0.0012).In this pilot study, NTCA with antegrade cerebral perfusion appears feasible and safe for hemiarch repair in acute type A aortic dissection, with potential benefits of shorter operative times and improved coagulation profiles compared with mild hypothermia. Larger prospective studies are needed to confirm these findings.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050480","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}

引用次数: 0

Research Progress in Pediatric Lung Transplantation: A Bibliometric Analysis. 儿童肺移植研究进展：文献计量学分析。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-04-30 DOI: 10.1055/a-2572-6428

Quan Yuan, Zixiong Shen, Zhiqin Li

{"title":"Research Progress in Pediatric Lung Transplantation: A Bibliometric Analysis.","authors":"Quan Yuan, Zixiong Shen, Zhiqin Li","doi":"10.1055/a-2572-6428","DOIUrl":"https://doi.org/10.1055/a-2572-6428","url":null,"abstract":"Pediatric lung transplantation is considered to be an effective treatment for end-stage lung disease in children, and this study mainly conducts a bibliometric analysis in the field of pediatric lung transplantation.We used the web of science databases to perform a bibliometric analysis of the progress of research in the field of pediatric lung transplantation from 1996 to 2024. In addition, we used VOSviewer software and the \"bibliometrix\" package in R to visualize and analyze the authors, countries, journals, institutions, and keywords of the literature.We identified 359 literature studies related to pediatric lung transplantation, which were cited 6,387 times by 1,400 journals. The journal with the highest number of average citations was the \"New England Journal of Medicine,\" while the journals with the highest number of publications were the \"Journal of Heart and Lung Transplantation and Pediatric Transplantation.\" The United States was the country with the highest number of publications (64.3%), followed by the United Kingdom (11.1%) and Canada (8.08%).Research in the field of pediatric lung transplantation is currently on the rise, while research is still dominated by developed countries, with most developing countries in their infancy. Against the background of COVID-19 and global health challenges, the unique need for pediatric lung transplantation is becoming a trend.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987184","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}

引用次数: 0

Uniportal Video-Assisted Anatomical Lung Volume Reduction Surgery in Severe Emphysema. 单门视频辅助解剖肺减容术治疗肺气肿。

IF 1.3 4区医学

Thoracic and Cardiovascular Surgeon Pub Date : 2025-04-30 DOI: 10.1055/a-2572-6755

Hayan Merhej, Akylbek Saipbaev, Tomoyuki Nakagiri, Alaa Selman, Heiko Golpon, Tobias Goecke, Patrick Zardo

{"title":"Uniportal Video-Assisted Anatomical Lung Volume Reduction Surgery in Severe Emphysema.","authors":"Hayan Merhej, Akylbek Saipbaev, Tomoyuki Nakagiri, Alaa Selman, Heiko Golpon, Tobias Goecke, Patrick Zardo","doi":"10.1055/a-2572-6755","DOIUrl":"10.1055/a-2572-6755","url":null,"abstract":"Lung volume reduction surgery (LVRS) is an important treatment option for patients with advanced emphysema and is typically performed in a non-anatomical fashion. This study reports the outcome of anatomical LVRS by means of uniportal video-assisted thoracoscopic surgery (VATS).We retrospectively evaluated patients who underwent anatomical LVRS between June 2017 and September 2023 at our institution. Patient characteristics, including demographic data, lung function, as well as morbidity and mortality, were extracted from hospital records.A total of 44 patients (17 males, 38.6%) underwent anatomical LVRS at our institution during the observation period. The preoperative forced expiratory volume per second (FEV1) and FEV1% were 35.4 ± 20.0% and 45.7 ± 18.2%, respectively. Lobectomy was performed in 37 patients (84.1%), while segmentectomy was performed in 10 patients (22.7%, duplicated). Postoperative FEV1 and FEV1% significantly improved compared to preoperative values at the initial follow-up (11.8 ± 6.9 months after the operation): 38.3 ± 19.5%, p < 0.002 and 49.4 ± 18.4%, p < 0.01, respectively. Unfortunately, two patients (4.5%) died within 30 days postoperation. A further follow-up lung function test was performed in 25 patients (56.8%) at 33.1 ± 13.8 months after the operation, showing that FEV1 and FEV1% remained similar to the preoperative values (33.9 ± 20.7%, p = 0.10 and 45.3 ± 18.1%, p = 0.06, respectively).Anatomical lung resection via uniportal VATS is an effective procedure for LVRS in patients with severe emphysema and is associated with acceptable morbidity and mortality.","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781218","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}

引用次数: 0