Translational andrology and urology最新文献

{"title":"Development and validation of multivariable biopsy-free nomograms to predict clinically significant prostate cancer in patients with prostate-specific antigen levels ≥20 ng/mL.","authors":"Mingzhe Chen, Shanqi Guo, Junxin Wang, Nan Wang, Simeng Wen, Hongtuan Zhang, Yong Wang, Ranlu Liu, Yong Xu, Xingkang Jiang","doi":"10.21037/tau-24-533","DOIUrl":"https://doi.org/10.21037/tau-24-533","url":null,"abstract":"<p><strong>Background: </strong>Elevated prostate-specific antigen (PSA) levels often lead to prostate biopsies, which can result in overdiagnosis and complications, thereby increasing preoperative anxiety. This study aimed to develop and validate a novel biopsy-free diagnostic nomogram for accurate detection of clinically significant prostate cancer (csPCa) in patients with PSA levels ≥20 ng/mL.</p><p><strong>Methods: </strong>The cohort of this retrospective analysis included patients with PSA levels ≥20 ng/mL who underwent evaluation including clinical variables, Prostate Imaging-Reporting and Data System (PI-RADS), prostate health index (PHI), and prostate-specific membrane antigen positron emission tomography-computed tomography (PSMA PET/CT). Nomogram performance was evaluated using the concordance index, calibration plot, decision curve analysis, and the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>Of 684 patients, 478 and 206 were randomly assigned to the diagnostic and validation cohorts, respectively. Multivariable predictors of csPCa included age, PSA density, PI-RADS, location of suspicious lesion, %PSA variation ratio, and acute urinary retention. The foundational nomogram achieved AUCs of 0.930 and 0.911 for the training and validation sets, respectively. By integrating both PHI and PSMA maximum standardized uptake value (SUVmax), the diagnostic accuracy of the advanced nomogram improved significantly, with AUCs of 0.951 and 0.935 for the training and validation sets, respectively. Limitations included the lack of external validation and potential selection bias.</p><p><strong>Conclusions: </strong>The biopsy-free nomogram presents a promising approach for accurate diagnosis of csPCa in patients with PSA levels ≥20 ng/mL. This non-invasive method can reduce unnecessary biopsies and enhance patient care by identifying those necessitating further evaluation and treatment.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"507-518"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of a continuing international partnership and multiple intensive hands-on workshops on the success rate of bulbar EPA urethroplasty in a low-middle income country: an early experience.","authors":"Valeerat Swatesutipun, Teerayut Tangpaitoon, Do Lenh Hung, Joel Gelman","doi":"10.21037/tau-2024-710","DOIUrl":"https://doi.org/10.21037/tau-2024-710","url":null,"abstract":"<p><strong>Background: </strong>Thailand has one of the 10 highest national rates of traffic accidents, leading to a high incidence of urethral stricture from bulbar straddle and pelvic fracture urethral injuries. Various treatment options are offered including urethroplasty; however, failure rates are high leading to a significant societal burden. Outreach relationships were established between the United States of America (USA), Vietnam, and Thailand by creating an intensive hands-on workshop and mentorship model to improve urethroplasty success. We aim to report the impact of this partnership and hands-on training on bulbar excision and primary anastomosis (EPA) success rates.</p><p><strong>Methods: </strong>The University of California, Irvine Medical Center (UC Irvine), USA, Binh Dan Hospital, Vietnam, and Thammasat University Hospital (TUH), Thailand developed partnerships in urethroplasty training since 2020. Urologists from Thailand seeking expertise in urethroplasty joined intensive hands-on workshops for two 2-week periods. An ongoing mentorship relationship subsequently developed. Important infrastructure similar to that at UC Irvine, a urethroplasty Center of Excellence, was established at TUH to include the purchase of identical urethroplasty and urethral imaging-specific equipment and supplies. Subsequent workshops were attended and hosted at TUH. A database was created to compare success rates before and 12 months after completing the workshops and establishing infrastructure. Cystoscopy 4 months after surgery was performed to assess anatomical success.</p><p><strong>Results: </strong>The study included 29 patients with bulbar urethral stricture who underwent bulbar EPA. There were 19 patients from before the establishment of the partnership that included workshops and infrastructure development. The overall success rate was 57.14%, whereas in comparison, success rates of over 98% were published at Centers of Excellence. After establishing the partnership, bulbar EPA was performed in 10 cases. The success rate increased to 90% (P=0.001) which included anatomical success defined as wide patency on cystoscopy 4 months after surgery and a subsequent absence of recurrent voiding symptoms. The patients who underwent urethroplasty during the workshop and learning period were excluded from this study.</p><p><strong>Conclusions: </strong>Developing and continuing international partnerships with a mentorship model and multiple intensive hands-on workshops, including established appropriate hospital infrastructure could improve the success rate of bulbar urethroplasty in countries seeking to develop a urethroplasty Center of Excellence.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"610-618"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost benefit micro-analysis of performing urine cultures as a mean to reduce post-flexible cystoscopy urosepsis: a comparative study between two centres.","authors":"Adib Rahman, Matthew Qiu, Kapilan Ravichandran, Devang Desai","doi":"10.21037/tau-24-417","DOIUrl":"https://doi.org/10.21037/tau-24-417","url":null,"abstract":"<p><strong>Background: </strong>In Australia, flexible cystoscopy is a key diagnostic tool in urology, employed to manage various conditions. However, it carries risks like urinary tract infections and urosepsis, which lead to significant healthcare expenses. This study evaluates the cost-effectiveness of pre-procedure urine cultures to prevent post-cystoscopy urosepsis.</p><p><strong>Methods: </strong>A retrospective analysis of data from regional Toowoomba Base Hospital and metropolitan Gold Coast University Hospital was conducted to assess the efficacy of urine cultures in reducing urosepsis following flexible cystoscopy. The study reviewed patient records, analysing both the incidence of post-procedure urosepsis and the associated economic impact.</p><p><strong>Results: </strong>The incidence of post-procedure urosepsis was found to be exceptionally low at 0.03%. Comparative analysis showed no significant reduction in urosepsis rates with the use of pre-procedure urine cultures (P=0.93). The financial analysis highlighted that the regional centre, which conducted urine cultures, incurred costs $ 26.14 per patient greater compared to the metropolitan centre that did not perform these cultures.</p><p><strong>Conclusions: </strong>The study indicates that the low incidence of urosepsis does not justify the routine use of pre-operative urine cultures, given the substantial costs involved. These findings support current guidelines that do not recommend routine pre-procedure cultures for cystoscopy due to lack of evidence of benefit.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"707-714"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Historic progression of prostatectomy techniques and associated outcomes.","authors":"Lauren Folgosa Cooley, Neal D Shore","doi":"10.21037/tau-2025-3","DOIUrl":"https://doi.org/10.21037/tau-2025-3","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"493-495"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical application of 4N-enhanced recovery after surgery in retroperitoneal laparoscopic resection of adrenal tumors.","authors":"Bingfeng Luo, Sucai Liao, Yuan Yuan, Yifei Zhu, Yaping Xing, Wei Liang, Xiang Yi, Ruidong Ji, Mingchi Wang, Xinliang Cai, Ruxi Tang, Yu Yang, Weide Zhong, Richard Lo, Zhenquan Lu","doi":"10.21037/tau-24-608","DOIUrl":"https://doi.org/10.21037/tau-24-608","url":null,"abstract":"<p><strong>Background: </strong>Enhanced recovery after surgery (ERAS) has been widely applied in various surgical fields to improve postoperative recovery and reduce complications. However, its application in retroperitoneal laparoscopic resection of adrenal tumors remains limited. This study aimed to evaluate the effect and value of the 4N-ERAS protocol, which includes no Foley catheter, no drainage, no antibiotics, and \"no pain\" management for the postoperative recovery of patients undergoing retroperitoneal laparoscopic adrenal tumors resection.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 85 patients with adrenal tumors who were treated in the Urology Department of The University of Hong Kong-Shenzhen Hospital from January 2019 to December 2023. Of them, 42 patients were treated with the 4N-ERAS protocol (4N-ERAS group) and 43 patients received traditional treatment (control group). We compared clinical characteristics, such as sex, age, mean body mass index (BMI), preoperative diagnosis, tumor size, tumor location, and postoperative outcomes, including time to first flatus, time to first ambulation, time to Foley catheter removal, time to retroperitoneal drainage tube removal, postoperative pain score [Numeric Rating Scale (NRS)], length of hospital stay, total hospitalization costs, and postoperative complications between the two groups.</p><p><strong>Results: </strong>There were no significant differences in terms of clinical characteristics between the two groups. Compared to the control group, the 4N-ERAS group exhibited shorter times for first flatus, first ambulation, Foley catheter removal, retroperitoneal drainage tube removal, lower postoperative pain scores (NRS), and shorter hospital stays (P<0.05). Furthermore, compared to the control group, the total hospitalization cost was significantly lower in the 4N-ERAS group (P<0.05). There were no significant differences in terms of postoperative complications between the two groups (P=0.19).</p><p><strong>Conclusions: </strong>The 4N-ERAS protocol for retroperitoneal laparoscopic resection of adrenal tumors may expedite postoperative recovery, reduce pain, and lower overall hospital costs. This preliminary study demonstrated the safety and feasibility of the 4N-ERAS protocol for retroperitoneal laparoscopic resection of adrenal tumors, warranting future multicenter prospective, randomized, controlled trials in this field.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"696-706"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features and prognosis of small cell carcinoma of the bladder: a single center retrospective analysis.","authors":"Zhaoyang Sheng, Maoyu Wang, Yang Xu, Jinshan Xu, Chen Zhang, Hui Zhang, Jinpeng Zhu, Shuxiong Zeng, Chuanliang Xu, Zhensheng Zhang","doi":"10.21037/tau-2024-645","DOIUrl":"https://doi.org/10.21037/tau-2024-645","url":null,"abstract":"<p><strong>Background: </strong>Small cell carcinoma of the bladder (SCCB) is a rare and aggressive subtype, usually diagnosed at advanced stages. Due to its rarity, the clinical features, prognostic factors, and treatment strategies are not well defined, and data on long-term outcomes are limited. This study aims to analyze the clinical characteristics, treatment options, and prognostic factors of SCCB to enhance clinical understanding and guide practice.</p><p><strong>Methods: </strong>A retrospective analysis of 41 SCCB cases treated at Changhai Hospital between 2006 and 2023 was conducted. Clinical, pathological, and treatment data were collected. The median follow-up duration was calculated as 41.0 months [95% confidence interval (CI): 31.3-50.7] using the reverse Kaplan-Meier method. Overall survival (OS) rates were estimated using the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were used to identify prognostic factors.</p><p><strong>Results: </strong>The median age was 71 years (range, 41-89 years). Pure SCCB accounted for 56.1% of cases, and 48.78% of tumors were located on the lateral bladder wall. Tumors ≥4 cm were found in 56.10% of cases. According to the tumor-node-metastasis (TNM) classification, 63.41% of patients underwent radical cystectomy, and 34.14% had lymph node or distant metastasis. None of the patients received neoadjuvant chemotherapy (NACT), while 41.03% underwent adjuvant chemotherapy post-surgery. The median OS was 30 months, with 1- and 3-year OS rates of 74.8% and 41.4%, respectively. Univariate analysis showed that T stage (P=0.002), lymph node metastasis (P<0.001), and distant metastasis (P<0.001) were associated with poor prognosis. Multivariate analysis confirmed T stage (P=0.04) and distant metastasis (P<0.001) as independent prognostic factors.</p><p><strong>Conclusions: </strong>SCCB is often diagnosed at a late stage with gross hematuria as the most common symptom, Neoadjuvant therapy and immunotherapy can extend OS. T stage and distant metastasis are critical prognostic factors. Early diagnosis and intervention are crucial for improving outcomes.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"529-539"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of perioperative and oncological outcomes between two different surgical procedures for the treatment of prostate cancer.","authors":"Takuya Koie, Keita Nakane, Koji Iinuma","doi":"10.21037/tau-2024-739","DOIUrl":"https://doi.org/10.21037/tau-2024-739","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"481-484"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing effectiveness, toxicity, and individualization: enfortumab vedotin in advanced urothelial cancer.","authors":"Nuowei Wang, Karl H Tully","doi":"10.21037/tau-2024-743","DOIUrl":"https://doi.org/10.21037/tau-2024-743","url":null,"abstract":"","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"503-506"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A modified Shang Ring circumcision surgical technique under local anesthesia for penile torsion in children.","authors":"Shimeng Zhao, Pengyu Jia, Hongchao Chai, Can Qi, Chaojun Xin, Yun Zhou","doi":"10.21037/tau-2024-698","DOIUrl":"https://doi.org/10.21037/tau-2024-698","url":null,"abstract":"<p><strong>Background: </strong>Penile torsion is a congenital condition characterized by the rotation of the penis along its longitudinal axis. This study aimed to describe a modified Shang Ring circumcision (SRC) surgical technique as a simple and effective approach for correcting penile torsion in children under local anesthesia.</p><p><strong>Methods: </strong>From July 2018 to August 2023, 20 male children with penile torsion underwent the modified SRC technique under local anesthesia, performed by the same surgeon (S.Z.). In our technique, the inner ring of the Shang Ring is placed over the glans penis, while the outer ring is positioned over the outer layer of the foreskin and secured by the first notch of the outer ring. The foreskin is held in place in a semi-locked state between the inner and outer rings. The frenulum is adjusted to achieve mild overcorrection, positioning the urethral opening between the 6 and 7 o'clock positions to correct penile torsion. A good surgical outcome is defined as a postoperative penile torsion angle of less than 30 degrees, while a poor surgical outcome is one with a postoperative penile torsion angle greater than 30 degrees.</p><p><strong>Results: </strong>All cases involved counterclockwise penile torsion, and surgeries, performed under local anesthesia, with an average surgical time of 8.55±1.61 minutes. The preoperative median angle of penile torsion was 45 [45, 60] degrees, with a maximum torsion angle of 60 degrees. The average time for the Shang Ring to fall off was 23.10±6.38 days. Three cases of the Shang Ring did not naturally fall off and were manually removed 30 days post-surgery. After the Shang Ring removal, the median penile torsion angle at follow-up was 10 [0, 10] degrees, with a median correction angle of 42.5 [35, 48.75] degrees. The average follow-up time was 2.06±0.74 years. At the last follow-up, the median penile torsion angle was 10 [0, 10] degrees, with a median correction angle of 42.5 [35, 50] degrees. No significant difference was observed in the postoperative torsion angle between the mild and moderate torsion patients, both after Shang Ring removal and at the last follow-up (P>0.05). All patients had good surgical outcomes.</p><p><strong>Conclusions: </strong>The modified SRC technique is feasible, safe, and effective for correcting mild to moderate penile torsion under local anesthesia, offering a new surgical option for children.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"602-609"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic factors and nomogram development for survival in renal cell carcinoma patients with multiple primary cancers: a retrospective study.","authors":"Man Tian, Jing Shen, Meng Liu, Xue-Fen Chen, Tie-Jun Wang, Yong-Sheng Sun","doi":"10.21037/tau-24-509","DOIUrl":"https://doi.org/10.21037/tau-24-509","url":null,"abstract":"<p><strong>Background: </strong>Patients with renal cell cancer have an increased risk of developing multiple primary cancers (MPCs) due to improved survival rates. The purpose of this study was to evaluate the clinicopathological features of MPCs and to generate a useful tool for predicting cancer-specific survival (CSS) in these patients.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on data from renal cell carcinoma (RCC) who were diagnosed with MPCs between 2001 and 2021 from the Surveillance, Epidemiology, and End Results (SEER) database. Patients with RCC meeting the criteria were selected for Kaplan-Meier (KM) survival analysis. The main outcome of this study was CSS, defined as the time from the initial diagnosis to either death due to cancer or the last follow-up. The Cox regression model was used to analyze the CSS factors of MPCs, the results of the multivariate analysis were displayed in a forest map, and the significant variables identified in the multivariate Cox analysis were used to construct the nomogram. Area under the curve (AUC) and calibration plots were used to evaluate the predictive performance of the nomogram.</p><p><strong>Results: </strong>A total of 2,078 cases of renal cancer with MPCs diagnosed between 2001 and 2021 were included. Age and grade were determined through both univariate and multivariate analyses to be independent prognostic factors affecting CSS. Based on clinical practice, the final nomogram was constructed using the variables: sex, age, grade, summary stage, tumor-node-metastasis (TNM) stage and tumor size to predict CSS at 60, 120, and 180 months. The concordance index (C-index) for the CSS nomogram was 0.670 [95% confidence interval (CI): 0.642-0.698]. The model demonstrated a good predictive performance. To assess the consistency between observed and predicted values, a calibration curve was developed.</p><p><strong>Conclusions: </strong>This study identified risk factors for CSS in patients with clear cell RCC (ccRCC) with MPCs and developed a nomogram to predict CSS in these patients. The model demonstrates strong clinical applicability and can serve as a valuable clinical decision-making tool for physicians and patients.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 3","pages":"685-695"},"PeriodicalIF":1.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}