Updates in Surgery最新文献

{"title":"Ultrasound-guided radiofrequency ablation for isthmus papillary thyroid microcarcinoma: a prospective 2 years of follow-up study.","authors":"Chen Wang, Yue Niu, Li Zhang, Ting Zhang, Jianping Bai","doi":"10.1007/s13304-025-02085-5","DOIUrl":"https://doi.org/10.1007/s13304-025-02085-5","url":null,"abstract":"<p><p>To explore the safety and clinical efficacy of radiofrequency ablation (RFA) for papillary thyroid microcarcinoma (PTMC) located in the isthmus. This prospective study enrolled patients with single isthmus PTMC admitted to General Surgery Department of 983rd Hospital of Joint Logistic Support Force of PLA from 2017 to 2022. After ablation, the ultrasound and contrast-enhanced ultrasound (CEUS) were performed to follow up the outcomes at 1, 3, 6, 12, 18, and 24 months. The volume reduction rates (VRR), disappearance rates (DR), incidence of complications, recurrence, and lymph node metastasis were recorded. A total of 135 patients were enrolled in this study, including 26 men and 109 women. The average age was 41.07±13.60 years old. The average diameter of PTMC was 0.68 ±0.17cm. After ablation, the DRs at 1, 3, 6, 12, 18 months, and 24 months were 0.0% (0/135), 10.4% (14/135), 52.6% (71/135), 81.5% (110/135), 100% (135/135), and 100% (135/135), and the VRRs at 1, 3, 6, 12, 18 months, and 24 months were 66.18±12.57%, 82.42±12.01%, 93.33±8.70%, 98.58±3.71%, 100.00±0.00%, 100.00±0.00%. Two patients suffered recurrence of PTMC in the thyroid at 6 and 12 months after ablation, and one patient suffered cervical lymph node metastases at 18 months after ablation. No patient had serious complications, including death, hemorrhage, or thermal injury to peripheral organs. RFA was a safe and effective treatment for isthmus PTMC, which may add new choices to the treatment strategy for patients.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 laparoscopic cholecystectomy combined with laparoscopic transcystic common bile duct exploration in treatment of cholecystolithiasis combined with choledocholithiasis.","authors":"Song Xu, Chuanmin Deng, Kaikai Tang, Gang Nian, Zhongran Man, Song Yang, Ming Xu","doi":"10.1007/s13304-025-02110-7","DOIUrl":"https://doi.org/10.1007/s13304-025-02110-7","url":null,"abstract":"<p><p>This study aims to compare the efficacy of laparoscopic cholecystectomy combined with laparoscopic transcystic common bile duct exploration (LTCBDE), laparoscopic common bile duct exploration (LCBDE), and endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of gallbladder stones with common bile duct stones. We conducted a retrospective comparative analysis based on surgical time, intraoperative blood loss, postoperative recovery metrics, total hospitalization costs, gastrointestinal quality of life index (GIQLI) before and after surgery, and the incidence of postoperative complications. No significant differences were found among the three groups in terms of the surgical success rate, first stone clearance rate, intraoperative blood loss, incidence of postoperative complications, and stone recurrence rate (p > 0.05). The LTCBDE group had shorter surgical time, earlier time to get out of bed, earlier first flatus time, shorter postoperative hospital stays, and earlier removal of abdominal drainage tube compared to the LCBDE and the ERCP + LC groups (all p < 0.05). The average hospitalization cost was also lower in the LTCBDE group (p < 0.05). LTCBDE for the treatment of gallbladder stones with common bile duct stones leads to faster recovery and improved quality of life. It is safe and effective, making it a method worthy of promotion.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statistical models versus machine learning approach for competing risks in proctological surgery.","authors":"Lucia Romano, Andrea Manno, Fabrizio Rossi, Francesco Masedu, Margherita Attanasio, Fabio Vistoli, Antonio Giuliani","doi":"10.1007/s13304-025-02109-0","DOIUrl":"https://doi.org/10.1007/s13304-025-02109-0","url":null,"abstract":"<p><p>Clinical risk prediction models are ubiquitous in many surgical domains. The traditional approach to develop these models involves the use of regression analysis. Machine learning algorithms are gaining in popularity as an alternative approach for prediction and classification problems. They can detect non-linear relationships between independent and dependent variables and incorporate many of them. In our work, we aimed to investigate the potential role of machine learning versus classical logistic regression for the preoperative risk assessment in proctological surgery. We used clinical data from a nationwide audit: the database consisted of 1510 patients affected by Goligher's grade III hemorrhoidal disease who underwent elective surgery. We collected anthropometric, clinical, and surgical data and we considered ten predictors to evaluate model-predictive performance. The clinical outcome was the complication rate evaluated at 30-day follow-up. Logistic regression and three machine learning techniques (Decision Tree, Support Vector Machine, Extreme Gradient Boosting) were compared in terms of area under the curve, balanced accuracy, sensitivity, and specificity. In our setting, machine learning and logistic regression models reached an equivalent predictive performance. Regarding the relative importance of the input features, all models agreed in identifying the most important factor. Combining and comparing statistical analysis and machine learning approaches in clinical field should be a common ambition, focused on improving and expanding interdisciplinary cooperation.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating human ability to distinguish between ChatGPT-generated and original scientific abstracts.","authors":"Kylie J Nabata, Yasir AlShehri, Abdullah Mashat, Sam M Wiseman","doi":"10.1007/s13304-025-02106-3","DOIUrl":"https://doi.org/10.1007/s13304-025-02106-3","url":null,"abstract":"<p><p>This study aims to analyze the accuracy of human reviewers in identifying scientific abstracts generated by ChatGPT compared to the original abstracts. Participants completed an online survey presenting two research abstracts: one generated by ChatGPT and one original abstract. They had to identify which abstract was generated by AI and provide feedback on their preference and perceptions of AI technology in academic writing. This observational cross-sectional study involved surgical trainees and faculty at the University of British Columbia. The survey was distributed to all surgeons and trainees affiliated with the University of British Columbia, which includes general surgery, orthopedic surgery, thoracic surgery, plastic surgery, cardiovascular surgery, vascular surgery, neurosurgery, urology, otolaryngology, pediatric surgery, and obstetrics and gynecology. A total of 41 participants completed the survey. 41 participants responded, comprising 10 (23.3%) surgeons. Eighteen (40.0%) participants correctly identified the original abstract. Twenty-six (63.4%) participants preferred the ChatGPT abstract (p = 0.0001). On multivariate analysis, preferring the original abstract was associated with correct identification of the original abstract [OR 7.46, 95% CI (1.78, 31.4), p = 0.006]. Results suggest that human reviewers cannot accurately distinguish between human and AI-generated abstracts, and overall, there was a trend toward a preference for AI-generated abstracts. The findings contributed to understanding the implications of AI in manuscript production, including its benefits and ethical considerations.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive evaluation of the ramification patterns of hepatic vascular anatomy based on three-dimensional visualization technology.","authors":"Zhicheng Liu, Feng Xia, Bin Guo, Chao Leng, Erlei Zhang, Lei Xu, Xiaoping Chen, Peng Zhu","doi":"10.1007/s13304-025-02064-w","DOIUrl":"https://doi.org/10.1007/s13304-025-02064-w","url":null,"abstract":"<p><p>The liver segmentation method proposed by Couinaud is widely accepted by surgeons because of its convenience and practicality. However, this conventional eight-segment classification does not reflect realistic details of the liver and thus requires further adjustments to promote improvements in surgical strategies. This study aimed to explore the ramification patterns of the hepatic vasculature comprehensively. A total of 197 eligible patients meeting the study criteria were enrolled for three-dimensional reconstruction analysis. In the left hemiliver, the portal vein bifurcated into P2 and umbilical portion (UP) in 172 (98.3%) patients. The P4b of 103 patients (103/172, 59.9%) whose P4b branched from the right horn of the left portal vein (LPV) diverged from the main trunk of the UP. In the right paramedian sector (RPMS), the entire portal trunk directly bifurcates into P8vent and P8dor. Simple branching of P5 off the trunk of the RPMS was observed in 78 patients (78/130, 60%). The anterior fissure vein (AFV) was identified in 86 (86/148, 58.1%) patients. V8d entered the right hepatic vein (RHV) in all the patients. In 75.3% (113/150) of all the patients, V5d joined the RHV. In the right lateral sector (RLS), more than half (71/133, 53.4%) of the patients had an arch-like type. We summarize different patterns of liver vascular branches, providing a valuable reference for clinical surgery and liver transplantation. Cranio-caudal segmentation is more common than ventral-dorsal segmentation. The AFV can be regarded as a reliable anatomical landmark for subsegmentation in segment 8. In addition, the absence of AFV was associated with the P8 pattern.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term outcomes of low anterior resection with and without ileostomy for low, mid and upper rectal cancers.","authors":"Vincent Xu, Kristina La, Rachel Ma, Paola Solis-Pazmino, Abbas Smiley, Moshe Barnajian, Joshua Ellenhorn, Roberto Bergamaschi, Yosef Nasseri","doi":"10.1007/s13304-025-02088-2","DOIUrl":"https://doi.org/10.1007/s13304-025-02088-2","url":null,"abstract":"<p><p>Although the addition of an ileostomy to low anterior resection (LAR) may often be considered preventative of anastomotic leakage (AL), evidence that clearly demonstrates such benefit is lacking. This study aimed to identify the impact of adding an ileostomy upon AL and organ-space surgical site infection (SSI) rates in patients with lower, middle, or upper rectal cancer. This case-control study included rectal cancer patients who had undergone elective LAR in the American College of Surgeons-National Surgical Quality Improvement Program dataset between 2016 and 2022. Patients with lower, middle, and upper tumors were identified and analyzed according to whether an ileostomy was added or not. Patients' pre-, intra-, and short-term post-operative data were compared using univariable and multivariable methods. A total of 4048 patients (61.6% males) with a mean age of 60 years, whereof 1166 with lower, 1836 with middle, and 1046 with upper tumors were identified. An ileostomy was added in 2804 (69.3%) patients. Patients with upper tumors had an ileostomy added less frequently (78.5%vs 74.5% vs 49.9%, p < 0.001). The overall AL and organ-space SSI rates were 4.3% and 6.7%. There were no statistically significant differences in AL and organ-space SSI rates (requiring or not requiring re-intervention or re-operation) between patients with and without ileostomy regardless of tumor location. Multivariable logistic regression controlling for confounding variables showed no association between adding an ileostomy and AL and organ-space SSI rates (requiring or not requiring re-intervention or re-operation) regardless of tumor location. This case-control study did not find any evidence in support of a preventative impact upon AL and organ-space SSI rates of adding an ileostomy to LAR in patients with lower, middle, or upper rectal cancer.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term durability and temporal pattern of revisional surgery of laparoscopic large hiatal hernia repair.","authors":"Elettra Ugliono, Fabrizio Rebecchi, Caterina Franco, Mario Morino","doi":"10.1007/s13304-025-02070-y","DOIUrl":"https://doi.org/10.1007/s13304-025-02070-y","url":null,"abstract":"<p><p>Laparoscopic repair is the preferred surgical treatment for symptomatic Large Hiatal Hernia (LHH). However, data on long-term outcomes are limited. This study aims to evaluate the 20-year follow-up results of laparoscopic LHH repair in a high-volume experienced tertiary center. Retrospective analysis of patients who underwent elective laparoscopic LHH repair between 1992 and 2008. Preoperative and perioperative data were collected. The primary endpoint was the long-term reoperation rate. Survival analyses were calculated according to the Kaplan-Meier method and compared with the log-rank test. A Cox proportional hazard model was used to investigate predictive factors of the need for revisional surgery. A total of 176 patients were included. All the procedures were performed laparoscopically, and in 5 cases (3.0%) with a robot-assisted approach. Mesh-augmented cruroplasty was performed in 26 patients (15.8%). A fundoplication was added in all patients: Nissen in 158 (89.8%), Toupet in 5 (2.8%), and Collis-Nissen in 13 (7.4%). Postoperative mean follow-up was 224.6 ± 83.3 months. Clinically significant hiatal hernia recurrence occurred in 27 (16.2%), and 18 patients (10.2%) underwent surgical revision. The median time-to-redo was 12 months (IQR 6-42 months). Overall durability without revisional surgery at 20-year follow-up was 90%. The rate of revisional surgery after LHH repair is low and is generally required within 12 months from primary surgery. Our results highlight the long-lasting effects of LHH repair at 20-year follow-up.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An optimal protective ventilation strategy in lung resection surgery: a prospective, single-center, three-arm randomized controlled trial.","authors":"Seihee Min, Susie Yoon, Hyun Woo Choe, Haesun Jung, Jeong-Hwa Seo, Jae-Hyon Bahk","doi":"10.1007/s13304-025-02091-7","DOIUrl":"https://doi.org/10.1007/s13304-025-02091-7","url":null,"abstract":"<p><p>Protective ventilation reduces ventilator-induced acute lung injury postoperatively; however, the optimal strategy for one-lung ventilation (OLV) remains unclear. This study compared three protective ventilation strategies with a postoperative partial pressure of oxygen (PaO₂)/fraction of inspired oxygen (FiO₂) ratio to reduce the incidence of immediate postoperative pulmonary complications (PPCs) in patients undergoing lung resection surgery. Eighty-seven patients with ASA physical status I-III requiring OLV for lung resection surgery were randomized into three groups according to the applied ventilation strategies: low tidal volume (V_T) of 4 mL/kg of predicted body weight (PBW) (LV group), medium V_T of 6 mL/kg of PBW (MV group), and high V_T of 8 mL/kg of PBW (HV group). All patients received 5 cmH₂O of positive end-expiratory pressure (PEEP). The primary outcome was the mean difference of PaO₂/FiO₂ ratio after surgery. The radiologic findings of acute lung injuries were also evaluated. The incidence of immediate PPCs was determined by PaO₂/FiO₂ ratio of < 300 mmHg and/or newly developed radiological findings within 72 h after surgery. The MV group showed the highest PaO₂/FiO₂ ratio at 6 h postoperatively (P = 0.010). There were no significant among-group differences in radiological findings in 3 postoperative days. The MV group showed the lowest incidence of immediate PPCs among the three groups (P = 0.007). During OLV in lung resection surgery, protective ventilation at a V_T of 6 mL/kg with PEEP of 5 cmH₂O may achieve a higher postoperative PaO₂/FiO₂ ratio, reducing the incidence of immediate PPCs.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thromboembolic prophylaxis in bariatric and metabolic surgery: state-of-the-art according to the results of a nationwide registry study.","authors":"Omar Thaher, Elisabeth Wendt, Martin Hukauf, Roland S Croner, Christine Stroh","doi":"10.1007/s13304-025-02073-9","DOIUrl":"https://doi.org/10.1007/s13304-025-02073-9","url":null,"abstract":"<p><p>The present study employed a large scaled multicenter nationwide study data analysis to elucidate the impact of thromboembolism prophylaxis (TEP) in the context of bariatric and metabolic surgery and to investigate the peri- and postoperative complications associated with TEP. A total of 63,909 patients who underwent primary bariatric surgery between 2005 and 2020 were included in the analysis. The data were collected prospectively and multicentrically in the German Bariatric Surgery Registry (GBSR) and subsequently analyzed retrospectively. A p value of ≤ 0.05 was deemed to correspond to a significant result. 96.65% of patients were prophylactically anticoagulated postoperatively. 99.3% of the anticoagulated patients received low molecular weight heparin on a median of 7 days. With regard to postoperative complications, a significantly higher incidence of transfusion (p < 0.001) or postoperative bleeding requiring surgery (p = 0.002) was observed in the group of patients who underwent TEP. At 0.67% and 0.87% respectively, these were nevertheless rare complications. The incidence of deep vein thrombosis (DVT) (TEP n = 46, no TEP n = 1; p = 0.642) and pulmonary artery embolism (PAE) was 0.1% each (TEP n = 57, no TEP n = 2; p = 0.985). The surgical technique was associated with a minimal risk of consequences for DVT. Here was the occurrence of DVT following surgical procedures in patients with TEP 0.1% for gastric banding (GB) and sleeve gastrectomy (SG), and less than 0.1% for Roux-Y gastric bypass (RYGB). The mortality rate was between patients with TEP and patients without TEP not significantly different (n [TEP] = 102; 0.17%, n [no TEP] = 6; 0.28%) (p = 0.198). The study's findings validate the efficacy of TEP in bariatric surgery. However, to prevent adverse TEP consequences, like hemorrhage, the dosage and timing of prophylactic medication must be appropriately modified. However, it is evident that randomized controlled trials are necessary to establish uniform, high-quality recommendations on TEP.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative risk factors for overall survival of patients with pancreatic ductal adenocarcinoma underwent laparoscopic pancreaticoduodenectomy.","authors":"Jing Zhang, He Cai, Man Zhang, Yunqiang Cai, Bing Peng","doi":"10.1007/s13304-025-02081-9","DOIUrl":"https://doi.org/10.1007/s13304-025-02081-9","url":null,"abstract":"<p><p>The postoperative overall survival of patients with pancreatic ductal adenocarcinoma is not optimal. The aim of this study was to explore the perioperative risk factors for overall survival after laparoscopic pancreaticoduodenectomy (LPD) in patients with pancreatic ductal adenocarcinoma (PDAC). From January 2015 to January 2022, consecutive patients who underwent LPD with a pathological diagnosis of PDAC at our center were included in the study. LASSO regression and multivariate Cox regression were used to explore perioperative risk factors associated with overall survival. A total of 159 patients were included in the study. The median overall survival was 21 months. In the multivariate analysis, the level of direct bilirubin in serum (HR: 1.01, 95% CI 1.00-1.02, P = 0.043), postoperative pancreatic fistula (HR: 0.36, 95% CI 0.18-0.86, P = 0.010), and adjuvant therapy after surgery within 12 weeks (HR: 0.53, 95% CI 0.34-0.83, P = 0.001) were identified as independent risk factors associated with overall survival. A high level of direct bilirubin in the serum, happened with postoperative pancreatic fistula and delayed postoperative adjuvant therapy are prognostic risk factors affecting the overall survival of patients with PDAC after LPD.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}