Thoracic and Cardiovascular Surgeon最新文献

{"title":"Conflicts of Interest-From \"Jein\" to Transparency.","authors":"Andreas Böning","doi":"10.1055/a-2862-1522","DOIUrl":"https://doi.org/10.1055/a-2862-1522","url":null,"abstract":"","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":"74 4","pages":"273"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056966","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":"Three-Year Outcomes Following Mitral Valve-in-Ring and Valve-in-Valve Procedures.","authors":"Daniel Maldonado Gaekel, Lara Waldschmidt, Sebastian Ludwig, Daniel Kalbacher, Johannes Schirmer, Stefan Blankenberg, Hermann Reichenspurner, Niklas Schofer, Andreas Schaefer","doi":"10.1055/a-2679-5606","DOIUrl":"10.1055/a-2679-5606","url":null,"abstract":"<p><strong>Background: </strong>In patients at elevated risk for redo mitral valve surgery, transcatheter mitral valve replacement (TMVR) can be taken into consideration as a less invasive alternative. However, long-term outcome data on mitral valve-in-ring (ViR) and valve-in-valve (ViV) procedures are scarce. We herein report the 3-year outcomes following these interventions.</p><p><strong>Methods: </strong>Between 2014 and 2023, 51 consecutive patients received ViR/ViV TMVR at our center. Baseline, periprocedural, and 3-year outcome parameters were analyzed according to M-VARC criteria.</p><p><strong>Results: </strong>Among 51 patients (70.9 ± 13.6 years, Society of Thoracic Surgeons (STS) score 3.3 ± 2.3%, left ventricular ejection fraction (LVEF) 50 ± 12%), 19 underwent ViR and 32 underwent ViV TMVR. Follow-up ranged from 1 to 71 months. The 30-day mortality rate was 5.9% (3/51 patients). Over time, access shifted from transapical to transseptal (<i>p</i> for trend <0.01). Rehospitalization, neurological events, and myocardial infarction occurred in 2.0% (1/51 patients), 2.0% (1/51 patients), and 0.0% of the cases, respectively. No structural valve failure was observed. Functional failure was 3.9% of cases due to significant residual mitral valve regurgitation (MR). Most paravalvular leak occluder implantations were performed in ViR patients (6/9, 66.7%; four rigid rings and two semirigid rings). Three-year survival was 87.5% for ViR and 83.4% for ViV, with no difference between groups.</p><p><strong>Conclusion: </strong>Mitral ViR and ViV procedures demonstrate acceptable safety and clinical efficacy up to 3 years. Rigid annuloplasty rings are associated with an increased risk of significant residual regurgitation. Over the last decade, a clear transition from the transapical to the transseptal access has been observed, further reducing procedural trauma in this high-risk subset of patients.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"332-340"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822624","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":"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":"10.1055/a-2576-7627","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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, <i>p</i> = 0.013) and trends toward shorter cardiopulmonary bypass times (68 vs. 95 minutes, <i>p</i> = 0.066), ICU stays (4.5 vs. 5 days, <i>p</i> = 0.4), and intubation times (6 vs. 8 hours, <i>p</i> = 0.4). There were no significant differences in new neurological deficits (<i>n</i> = 6 [NTCA] vs. 4, <i>p</i> = 0.7), delirium (<i>n</i> = 5 [NTCA] vs. 6, <i>p</i> = 0.6), or mortality (<i>n</i> = 1 [NTCA] vs. 3, <i>p</i> = 0.6) between the groups. The normothermic group required less prothrombin complex concentrate (<i>p</i> = 0.0012).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"283-295"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","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}

{"title":"Midterm Outcomes of Transcatheter Closure of Anastomotic Leak after Ascending Aortic Surgery.","authors":"Cheng-Wei Yang, Wei-Guo Ma, Hao Liu, Xin Li, Ming-Liang Peng, Lian-Jun Huang, Li-Zhong Sun","doi":"10.1055/a-2641-6468","DOIUrl":"10.1055/a-2641-6468","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the safety and durability of transcatheter closure of anastomotic leak (AL) after ascending aortic (AAo) surgery.</p><p><strong>Methods: </strong>From 2016 to 2021, we performed transcatheter closure for 22 patients aged 56.9 ± 12 years (19 male, 86.4%) who sustained anastomotic leak in the ascending aorta (AAoAL) after AAo surgery. Access and device were selected according to the presence of a patent Cabrol (perigraft-to-right atrium) shunt (<i>n</i> = 16, 72.7%) and leak size.</p><p><strong>Results: </strong>Fifteen patients had tricuspid regurgitation (TR; 68.2%), 13 were symptomatic (59.1%), and 11 were in the New York Heart Association (NYHA) functional class III/IV (50%). Mean AAoAL diameter was 3.3 ± 1.5 mm. Mean procedural time was 141 ± 53 minutes. Procedural success rate was 86.4% (19/22, 14 with Cabrol shunt). AAoAL was directly closed or coiled in 12 patients. Follow-up was complete in 100% at a mean duration of 4.9 ± 1.1 years (range 3.6-8.1). All patients were alive, and two underwent reoperation. Freedom from death and reoperation was 94.7% at 2 years and 89.5% through 8 years. AAoAL was obliterated in 11, while a trace residual shunt was seen in 8 patients. The aorta at the leak shrank significantly in all (49.1-41.4 mm, <i>p</i> = 0.010). Patients with Cabrol shunt showed a significant shrinkage of the right atrium (46.9 ± 8.8 mm vs. 39.1 ± 8.2 mm, <i>p</i> = 0.030) and right ventricle (41.4 ± 4.7 mm vs. 30.4 ± 6.2 mm, <i>p</i> < 0.001), along with improved heart function (NYHA class III 4/12, IV 5/12 vs. class III 4/12, IV 0/12, <i>p</i> = 0.032) and alleviation of TR (moderate 6/14, severe 3/14 vs. moderate 2/14, severe 1/14, <i>p</i> = 0.081).</p><p><strong>Conclusion: </strong>Transcatheter closure may be a feasible, safe, and effective approach to anastomotic leak after ascending aortic surgery in selected patients, which can achieve favorable short- to midterm outcomes.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"296-304"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485851","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 Novel Sheath Aligning Method of Left Subclavian Artery Revascularization in TEVAR.","authors":"Yu Zhang, Heng Wang, Jidong Liu, Song Xue","doi":"10.1055/a-2607-6327","DOIUrl":"10.1055/a-2607-6327","url":null,"abstract":"<p><strong>Abstract: </strong>Concomitant left subclavian artery (LSA) fenestration is recommended in thoracic endovascular aortic repair (TEVAR) for revascularization when the LSA is covered. However, the sheath alignment lacks an accurate and efficient positioning method due to the angulation of LSA anatomy. We developed a novel method for sheath aligning characterized by the guiding catheter's front junction (J.) with the graft stent and descending (D.) aorta proceeding. It forms a curved traction system that drags the puncture needle to the center of LSA orifice. A 93.8% endoleak-free rate was observed during the 9.0 (4.0-17.5) months follow-up in 137 patients. No reintervention or mortality was observed. Our sheath aligning method can be safely performed in LSA fenestration, which simplifies the surgical procedure and may help to avoid iatrogenic complications.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"312-315"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216944","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":"Transcatheter Mitral Valve Implantation Compared to Surgery: One-Year Clinical Outcome.","authors":"Hendrik Ruge, Melchior Burri, Magdalena Erlebach, Stephanie S Voss, Nazan Puluca, Caterina Campanella, Felix Wirth, Erion Xhepa, Andreas Stein, Markus Krane","doi":"10.1055/a-2650-7092","DOIUrl":"10.1055/a-2650-7092","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter mitral valve implantation (TMVI) is an evolving technology, expanding therapeutic options for patients at higher operative risk. Data comparing TMVI to surgical mitral valve replacement (SMVR) are lacking.</p><p><strong>Methods: </strong>Clinical outcomes after TMVI with the Tendyne mitral valve and SMVR were compared utilizing propensity score matching, including seven variables. The current study reports 1-year clinical outcomes after TMVI and 1-year mortality in both cohorts.</p><p><strong>Results: </strong>Forty TMVI patients were compared to 80 SMVR patients. Baseline characteristics included in the matching protocol were well balanced: Age (78 years [interquartile range, IQR 75; 80] vs. 78 years [IQR 73; 80], <i>p</i> = 0.797), female sex (60% vs. 60% [<i>p</i> = 1.0]), atrial fibrillation (68% vs. 64% [<i>p</i> = 0.839]), previous coronary artery bypass grafting (CABG) or surgical aortic valve replacement (25% vs. 25% [<i>p</i> = 1.0]), body mass index (kg/m²; 26 ± 4 vs. 25 ± 4 [<i>p</i> = 0.723]), mitral valve pathology (regurgitation 70% vs. 74%, stenosis 7.5% vs. 4%, and mixed disease 22.5% vs. 23% [<i>p</i> = 0.649]), and concomitant tricuspid regurgitation (35% vs. 30% [<i>p</i> = 0.678]). Thirty-day mortality was similar in both groups (TMVI, <i>n</i> = 1, 2.5%; SMVR, <i>n</i> = 3, 3.75%, <i>p</i> = 0.47). Kaplan-Meier estimated survival at 1 year was comparable after TMVI (80 ± 6% [95% CI 69-93%]) and SMVR (86 ± 4% [95% CI 79-94%], <i>p</i> = 0.18) with seven additional deaths beyond 30 days in the TMVI group and eight in the SMVR group. In the TMVI group, two were non-cardiovascular deaths for encephalitis and sepsis after hip replacement, and five were cardiovascular deaths. In the SMVR group, one patient died due to intestinal ischemia, and in seven patients, the cause of death is unknown. At 1 year, in all TMVI patients, echocardiography showed ≤mild paravalvular regurgitation. Within 1 year after TMVI, 21 patients (52.5%) required rehospitalization for heart failure symptoms.</p><p><strong>Conclusion: </strong>TMVI and SMVR in a propensity score-matched cohort displaying an intermediate surgical risk resulted in similar 1-year survival. TMVI achieved a sustained MR elimination at 1 year, and 80% of patients presented in the New York Heart Association (NYHA) class I or II.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"316-323"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668568","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 Use of Intra-Aortic Balloon Pumping in Cardiac Surgery.","authors":"Philippe Grieshaber, Adrian Bauer, Andreas Böning, Heinrich Volker Groesdonk, Matthias Heringlake, Oliver Miera, Ismail Özlü, Sebastian Schmitt, Thomas Schmitz-Rixen, Georg Trummer","doi":"10.1055/a-2812-7835","DOIUrl":"https://doi.org/10.1055/a-2812-7835","url":null,"abstract":"","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":"74 S 04","pages":"S99-S144"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206230","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":"\"Vetus Sed Utilis\": Open Window Thoracostomy after Lung Surgery.","authors":"Antonio Mazzella, Claudia Bardoni, Luca Bertolaccini, Monica Casiraghi, Lara Girelli, Giorgio Lo Iacono, Lorenzo Spaggiari","doi":"10.1055/a-2616-5012","DOIUrl":"10.1055/a-2616-5012","url":null,"abstract":"<p><strong>Introduction: </strong>Open window thoracostomy (OWT) is an ancient surgical intervention, born for managing chronic thoracic infectious diseases. Our goal is to report our 25-year experience in the management of these patients, focusing on its feasibility and usefulness in our modern era.</p><p><strong>Methods: </strong>We retrospectively reviewed our database (1999-2024), reporting all clinical preoperative, intraoperative, and postoperative data of patients undergoing OWT for treating chronic empyema, linked to broncho-pleural fistula after lung resection, or not. Data were collected on the type of original surgical intervention, perioperative and postoperative management, 30- and 90-day mortality, overall survival, and following reintervention to close OWT.</p><p><strong>Results: </strong>Sixty-six OWTs were performed to treat acute and chronic septic complications due to original lung intervention for cancer. OWT was performed for treating a late broncho-pleural fistula after pneumonectomy (56 cases; 85%) or after lobectomy (8 cases; 12%) or pleural chronic empyema (2 cases; 3%). Thirty- and 90-day mortality after OWT following pneumonectomy was 3% (2 patients) and 6% (4 patients), respectively. No 30- and 90-day death was observed in the other patients. In 15 out of 66 patients (22.7%), OWT was closed by muscle, skin, or omentum flaps. No statistical differences were observed comparing the survival of the patients undergoing or not undergoing OWT closure, after pneumonectomy (<i>p</i> = 0.59).</p><p><strong>Conclusion: </strong>OWT is a safe, feasible, and sometimes mandatory technique for the management of chronic infectious issues linked to broncho-pleural fistula (BPF) after lung surgery. It is well tolerated by guaranteeing an appropriate quality of life.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":"341-347"},"PeriodicalIF":1.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235266","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":"Ten-Year Outcomes of Off-Pump Coronary Revascularization Using Bilateral Internal Mammary Arteries versus Hybrid Coronary Revascularization.","authors":"Ibrahim Gadelkarim, Jagdip Kang, Philipp Kiefer, Alaa Abd El Al, Alexey Dashkevich, Piroze Davierwala, David Holzhey, Suzanne de Waha, Michael Borger, Alexander Verevkin","doi":"10.1055/a-2839-7647","DOIUrl":"10.1055/a-2839-7647","url":null,"abstract":"<p><strong>Background: </strong>The study compared long-term outcomes between off-pump coronary artery bypass grafting (OPCAB) using bilateral internal mammary arteries (BIMA) and hybrid coronary revascularization (HCR).</p><p><strong>Methods: </strong>We included patients who underwent OPCAB with BIMA (2002-2012) and HCR (2002-2020). Emergency procedures, patients in critical preoperative condition, and on-pump surgery cases were excluded. Propensity score matching with a 2:1 ratio was performed to minimize confounding factors. The primary outcome was 10-year survival.</p><p><strong>Results: </strong>Of 687 patients, 552 patients underwent OPCAB with BIMA, and 135 patients received HCR. In-hospital mortality was comparable between groups (BIMA: 1.1% vs. HCR: 3.0%, <i>p</i> = 0.11). The HCR group had higher rates of incomplete revascularization (27.2% vs. 15.2%, <i>p</i> = 0.001) and revision for bleeding (6.7% vs. 1.8%, <i>p</i> = 0.005). After propensity score matching, 10-year survival (BIMA: 71.2% vs. HCR: 69.7%, <i>p</i> = 0.81) was similar between groups, while freedom from repeat revascularization was higher in the BIMA group (89.7% vs. 76.3%, <i>p</i> = 0.003).</p><p><strong>Conclusion: </strong>Complete surgical revascularization using BIMA should be preferred when feasible. However, HCR offers comparable survival and represents a viable option for select patients.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582051","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":"Is Redo Complete Valved Pulmonary Trunk Replacement a Safe and Effective Approach?","authors":"Tomislav Cvitkovic, Murat Avsar, Theresa Holst, Elena Petena, Dietmar Boethig, Samir Sarikouch, Dmitry Bobylev, Alexander Horke","doi":"10.1055/a-2872-7647","DOIUrl":"10.1055/a-2872-7647","url":null,"abstract":"<p><strong>Background: </strong>Surgical pulmonary valve replacement (PVR) is the most common cardiac operation in adults with congenital heart disease (ACHD). Nearly one-quarter of all cardiac procedures in this population are PVRs, and approximately 96% are redo surgeries. This study aimed to compare operative and early postoperative outcomes in patients undergoing first-, second-, and third-time, or more, PVR.</p><p><strong>Methods: </strong>We retrospectively analyzed 104 consecutive adult patients with repaired congenital heart disease who underwent total valved pulmonary trunk replacement at our institution between January 2014 and March 2022.</p><p><strong>Results: </strong>A total of 53 patients underwent first-time PVR, 31 second-time PVR, and 20 third-time, or more, PVR. All patients had at least one previous sternotomy. In all redo procedures, extended resection of the degenerated pulmonary valve graft was performed. Operative complexity increased with the number of previous PVRs, reflected by significantly longer cardiopulmonary bypass times (134 versus 185 versus 222 minutes) and aortic cross-clamp times (68 versus 91 versus 114 minutes; <i>p</i> < 0.001). Postoperative length of stay was also longer with increasing number of prior PVRs (7 versus 10 versus 8 days; <i>p</i> = 0.012). Despite increased surgical complexity, no significant differences (<i>p</i> > 0.05) were observed in intraoperative or postoperative complications, postoperative peak transvalvular gradients, or relevant valve regurgitation. Overall mortality was low. Three patients died, two of whom had a history of endocarditis.</p><p><strong>Conclusion: </strong>Patients undergoing multiple PVRs demonstrate early clinical outcomes comparable to those undergoing first-time PVR despite increased surgical complexity. Endocarditis remains a major risk factor in redo PVR surgery.</p>","PeriodicalId":23057,"journal":{"name":"Thoracic and Cardiovascular Surgeon","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147933687","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}