Updates in Surgery最新文献

{"title":"Comment to: Preliminary experience in using the lateral single-incision laparoscopic totally extraperitoneal approach for inguinal hernia repair.","authors":"Abdullah Hilmi Yilmaz","doi":"10.1007/s13304-025-02068-6","DOIUrl":"10.1007/s13304-025-02068-6","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"589-590"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955715","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":"Synergistic effect of sarcopenia and ASA status in predicting mortality after emergency laparotomy: a systematic review and meta-analysis with meta-regression.","authors":"Ahmad Al-Sarireh, Hashim Al-Sarireh, Olivia Ambler, Shahin Hajibandeh, Shahab Hajibandeh","doi":"10.1007/s13304-025-02105-4","DOIUrl":"10.1007/s13304-025-02105-4","url":null,"abstract":"<p><p>The aim of this study was to investigate the relationship between sarcopenia and American Society of Anesthesiologists (ASA) status in predicting post-operative mortality after emergency laparotomy. A PRISMA-compliant systematic review and meta-analysis (using random effects modelling) was performed searching for studies reporting 30-day mortality risk in patients with sarcopenia undergoing emergency laparotomy. The ASA status of sarcopenic and non-sarcopenic patients was determined, and the effect of difference in ASA status on 30-day mortality in sarcopenic and non-sarcopenic patients was determined via a meta-regression model. The risk of bias and certainty was assessed using the QUIPS tool and the GRADE system, respectively. Seven studies comprising 2663 patients were included. Thirty-day mortality risk was 22.9% (95% CI 11.6-40.0%) in sarcopenic patients and 6.2% (95% CI 2.9-13.0%) in non-sarcopenic patients; the risk was significantly higher in sarcopenic patients (OR: 4.452, p = 0.016). In sarcopenic patients, ASA status IV-V increased the risk of mortality (Coefficient: 0.07612, p < 0.0001), while ASA status I-II (Coefficient: - 0.09039, p < 0.0001) or ASA status III (Coefficient: 0.01300, p = 0.344) did not. In non-sarcopenic patients, ASA status III (Coefficient: 0.06830, p < 0.0001) and ASA status IV-V (Coefficient: 0.17809, p < 0.0001) increased the risk of mortality, while ASA status I-II (Coefficient: - 0.05841, p < 0.0001) did not. The GRADE certainty was moderate. Sarcopenia and ASA status are two independent predictors of mortality after emergency laparotomy with no significant collinearity. Sarcopenia and ASA status synergistically increase the risk of mortality after emergency laparotomy. ASA status IV and ASA status III are critical thresholds for increased risk of mortality in sarcopenic and non-sarcopenic patients, respectively.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"591-603"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012417","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":"Surgical and oncological implications of the presence of hepatic artery anatomical variations in patients undergoing pancreaticoduodenectomy: a single center experience.","authors":"Laura Alberici, Claudio Ricci, Vincenzo D'Ambra, Carlo Ingaldi, Margherita Minghetti, Carlo Mazzucchelli, Riccardo Casadei","doi":"10.1007/s13304-025-02079-3","DOIUrl":"10.1007/s13304-025-02079-3","url":null,"abstract":"<p><p>The presence of an aberrant right hepatic artery (a-RHA) could influence the oncological and postoperative outcomes after pancreaticoduodenectomy (PD). A comparative study was conducted, including patients who underwent PD with a-RHA or with normal RHA anatomy. The primary endpoints were R1 resection in all margins (pancreatic, anterior, posterior, superior mesenteric artery, and portal groove), overall survival (OS), and disease-free survival (DFS). The secondary endpoints were morbidity, mortality, biliary leak (BL), postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), post pancreatectomy hemorrhage (PPH), length of stay (LOS), and operative time (OT). The selection bias was measured using the d-value and limited using entropy balancing analysis. Patients with arterial variants were 84 (37.5%), 39 (17.4%) of whom had a-RHA from SMA. The patients with a-RHA were more frequently symptomatic (d = 0.652), often affected by PDAC (d = 0.369), and judged borderline resectable (d = 0.588). Neoadjuvant therapy was more frequently proposed for patients with a-RHA (d = 0.465). The patients with a-RHA often had the Wirsung dilated compared to those without a-RHA (d = 0.336). After bias correction, the R1 resection rate on the superior mesenteric artery (SMA) margin was higher in the a-RHA group than in patients with normal RHA anatomy (OR 2.3; 1.1-5.2; P = 0.045). OS, DFS, morbidity, mortality, biliary leak (BL), postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), post pancreatectomy hemorrhage (PPH), length of stay (LOS), and operative time (OT) were similar in unmatched and matched population. The presence of a-RHA seems to increase the risk of R1 resection in the SMA margin.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"511-521"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068219","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":"Outcome prediction after emergency cholecystectomy: performance evaluation of the ACS-NSQIP surgical risk calculator and the 5-item modified frailty index.","authors":"Andrea Spota, Stefano Granieri, Amir Hassanpour, Eran Shlomovitz, Eisar Al-Sukhni","doi":"10.1007/s13304-025-02128-x","DOIUrl":"10.1007/s13304-025-02128-x","url":null,"abstract":"<p><p>Pre-operative risk assessment tools and frailty scores are increasingly common due to the growing number of elderly, comorbid and frail patients. This study aims to assess the performance of the ACS-NSQIP-SRC (American College of Surgeons- National Surgical Quality Improvement Program- Surgical Risk Calculator) and the 5mFI (5-items modified Frailty Index) in predicting clinical outcomes after emergency cholecystectomy. This is a retrospective cohort study of patients with acute calculous cholecystitis admitted at our tertiary care center from 2018 to 2023. We evaluated discrimination, calibration, and accuracy of the ACS-NSQIP-SRC and 5mFI in predicting any complication, mortality, length of hospital stay (LOS), need for readmission and supported discharge (30-day follow-up). Among 365/642 patients who underwent surgery, the 5mFI showed poor discrimination for all outcomes but good overall accuracy in the prediction of a supported discharge. In 198 operated patients with available data for the ACS-NSQIP-SRC, it underestimated complications and need for readmission while overestimated the need for supported discharge. There was no concordance between predicted and observed LOS. Among 277/642 patients undergoing non-operative management, 2/3 were frail or mild frail and had a predicted rate of any unfavorable outcome after surgery between 0 and 20%, being 95% above the average risk of each outcome. Mortality couldn't be studied because no death was reported. ACS-NSQIP-SRC and 5mFI performance in predicting outcomes after emergency cholecystectomy for acute cholecystitis was poor. In the emergency cholecystectomy setting, the ACS-NSQIP-SRC may be less informative, and the 5mFI may be excessively simplistic by neglecting the multidimensional nature of frailty.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"481-491"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493869","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":"Presentation and outcomes of surgery for choledochal cyst in children and adults: an experience of 329 cases.","authors":"Sukanta Ray, Hemabha Saha, Swapnil Sen, Suman Das, Somdatta Lahiri, Somak Das, Tuhin Subhra Mandal, Jayanta Biswas, Sujan Khamrui","doi":"10.1007/s13304-025-02138-9","DOIUrl":"10.1007/s13304-025-02138-9","url":null,"abstract":"<p><p>The purpose of this study is to report our experience in patients with choledochal cyst (CDC) and to evaluate whether there is any difference in the clinical presentation, cyst -related complications, and long-term biliary outcomes after surgery among children and adults. All the patients who underwent CDC excision between January 2008 and December 2023 were retrospectively reviewed. The patients were divided into two groups: children (< 18 years) and adults (≥ 18 years). There were 329 patients with CDC excision (77.5% were female, adult/children = 251/78). Abdominal pain was the predominant presenting symptom in both groups. Abdominal lump (10.3% vs 3.2%; p = 0.011) and the triad of CDC (9% vs 2.4%; p = 0.009) were more common in children. But, the preoperative biliary intervention (37.8% vs 15.4%; p =  < 0.001), previous biliary surgery (32.7% vs 3.8%; p =  < 0.001), and prevalence of gallstones (36.7% vs 3.8%; p =  < 0.001), cystolithiasis (56.6% vs 38.5%; p = 0.005), and intrahepatic stones (7.6% vs 1.3%; p = 0.054) were more common in adults. Most patients were presented with type I CDC (71.4%). Extrahepatic bile duct excision with Roux en-Y hepaticojejunostomy was performed in all the patients. Although overall postoperative complications were comparable between adults and children (31.1% vs 26.9%; p = 0.485), wound infection was more common in adults (19.9% vs 6.4%; p = 0.005) and bile leak was more common in children (12.8% vs 5.2%; p = 0.021). There was no operative mortality. Over a mean follow-up of 59 (40) months, 2 patients (0.78%) developed malignancy. Excellent or good Long-term biliary outcome was significantly better in children than adults (98.1% vs 90.5%; p = 0.010). Independent predictors for unsatisfactory biliary outcomes were type IVA cysts, postoperative bile leak, adult patients, and longer duration of follow-up. In conclusion, presentation and cyst-related complications differ between adults and children. Surgery offers excellent results in the vast majority of patients. Long-term biliary complications were more in adults. Long-term follow-up is recommended for the possibility of future development of hepato-biliary-pancreatic malignancy and delayed biliary complications.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"459-470"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543614","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":"HUGO™ system robotic eTEP technique for ventral hernia repair. A step-by-step medial bottom-up approach.","authors":"Valentina Ferri, Riccardo Caruso, Daniele Cerbo, Emilio Vicente","doi":"10.1007/s13304-025-02135-y","DOIUrl":"https://doi.org/10.1007/s13304-025-02135-y","url":null,"abstract":"<p><p>This study describes an innovative robotic extended totally extraperitoneal (eTEP) technique for ventral hernia repair via a medial bottom-up approach using the new HUGO^™ system. The surgical steps and a novel setup guide for this approach are detailed. A 78-year-old male with an incisional umbilical hernia and concomitant rectus diastasis was treated using the HUGO™ system. The system's modular design enabled a customized surgical approach. Robotic eTEP repair was performed via a medial bottom-up approach, and robotic trocars were placed in the hypogastric region. Single docking was sufficient. The procedure lasted 180 min, with no intraoperative complications. The patient's postoperative recovery was uneventful, and a normal diet was resumed on the first postoperative day. The postoperative hospital stay was 7 days. Satisfactory outcomes without complications were observed during follow-up. This study introduced a novel robotic eTEP approach for abdominal wall hernia repair using the HUGO^™ system, highlighting the medial bottom-up technique and an innovative docking configuration. The medial bottom-up robotic eTEP approach using the HUGO^™ system is a feasible and promising technique for abdominal wall hernia repair. To evaluate long-term outcomes and broader applicability among surgeons experienced in robotic and retromuscular hernia repair, further studies are warranted.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753829","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- and long-term outcomes following laparoscopic liver resection for hepatocellular carcinoma combined with type I/II portal vein tumor thrombus.","authors":"Haili Zhang, Hongwei Xu, Ningyuan Wen, Bo Li, Kefei Chen, Yonggang Wei","doi":"10.1007/s13304-025-02065-9","DOIUrl":"10.1007/s13304-025-02065-9","url":null,"abstract":"<p><strong>Background: </strong>Despite the expanding indications for laparoscopic liver resection (LLR), its role in hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) remains unclear. The aim of the current study is to compare the short- and long-term outcomes following LLR and open liver resection (OLR) for HCC with PVTT.</p><p><strong>Methods: </strong>All HCC patients with PVTT registered for surgery between April 2015 and May 2022 were enrolled. Patients were divided into LLR and OLR groups, and postoperative recovery and oncological outcomes were analyzed.</p><p><strong>Results: </strong>Twenty-eight patients in the LLR group and one hundred seventeen patients in the OLR group were included for comparison. The blood loss was less and the postoperative hospital stay was shorter in LLR group compared to OLR group both before and after propensity score matching. The median recurrence-free survival (RFS) time did not significantly differ between the two groups (8.0 months [95% CI 3.1-13.0] vs. 7.5 months [95% CI 6.0-9.1]; P = 0.845). In stratified analysis, both the recurrence pattern and the median RFS time were comparable between the LLR group and the OLR group in type I PVTT (7.23 [95% CI 0.35-14.12] vs. 7.17 months [95% CI 3.49-10.85]; P = 0.794) and type II PVTT (8.96 [95% CI 0-19.56] vs. 7.60 months [95% CI 5.98-9.22], P = 0.651), respectively. The multivariate regression analysis showed that the tumor size ≥ 10 cm, AFP > 200 ng/ml, and HBV-DNA > 1000 copies/ml were independent risk factors for RFS.</p><p><strong>Conclusion: </strong>LLR for HCC patients with type I/II PVTT could be safely performed with superior short-term recovery and similar long-term survival compared to OLR. Larger tumor size, higher AFP, and elevated HBV-DNA levels contribute to worse RFS.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"427-434"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979991","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":"Comparative study of cryorecanalisation and cryoablation using flexible bronchoscopy for the treatment of endobronchial tuberculosis.","authors":"Shao-Peng Hua, Xiu-Jie Jia, Xiao-Fang Hu, Hui Liu, Xin-Guo Zhao, Jia Mao","doi":"10.1007/s13304-024-02031-x","DOIUrl":"10.1007/s13304-024-02031-x","url":null,"abstract":"<p><p>To compare the efficacy and safety of cryorecanalisation and cryoablation using flexible bronchoscopy for the treatment of tumor-like endobronchial tuberculosis (EBTB). Patients with tumor-like EBTB (104) were randomly divided into a cryorecanalisation (54 patients) or cryoablation (50 patients) group to assess the differences in efficacy and complications between the treatments. The cryorecanalisation and cryoablation treatments' therapeutic efficacies were 81.5% and 48.0%, respectively (p = 0.000); in patients with less than moderate obstruction (≤ 50%), the therapeutic efficacies were 92.9% and 88.9%, respectively (p = 1.000). In patients with more than moderate obstruction (> 50%), cryorecanalisation and cryoablation's therapeutic efficacies were 77.5% and 25.0%, respectively (p = 0.000). The number of treatments in the cryorecanalisation and cryoablation groups were 2.46 ± 1.06 and 3.26 ± 0.75, respectively (p = 0.000). The main complication of the treatment protocol in both groups was bleeding, and the overall bleeding rate was 96.2% and 16.0% in the cryorecanalisation and cryoablation groups, respectively (p = 0.000). Cryorecanalisation via flexible bronchoscopy improved the outcome of patients with tumor-like EBTB and reduced the number of treatments required compared with cryoablation; however, it had a higher bleeding rate and the potential risk of severe bleeding.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"559-566"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819166","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":"A cross-sectional study to evaluate responses generated by two AI software programs for common patient queries about laparoscopic repair of inguinal hernia.","authors":"Meeran Banday, Kirat Kaur","doi":"10.1007/s13304-025-02158-5","DOIUrl":"10.1007/s13304-025-02158-5","url":null,"abstract":"<p><p>This study aimed to evaluate the quality and accuracy of responses provided by two user-interactive AI chatbots, namely ChatGPT and ChatSonic, in response to patient queries regarding laparoscopic repair of inguinal hernias, and additionally determine the suitability of these chatbots in addressing patient queries related to inguinal hernia repair. Ten questions regarding laparoscopic repair of inguinal hernias were developed and presented to ChatGPT 4.0 and ChatSonic. Responses were evaluated by two experienced surgeons blinded to the source, using the Global Quality Score (GQS) and modified DISCERN Score to gauge response quality and reliability. ChatGPT demonstrated high-quality responses (GQS = 4 & 5) for all ten questions according to one evaluator, and for seven out of ten questions according to the other. Similarly, ChatGPT showed high reliability (DISCERN = 4 & 5) for nine responses according to one evaluator, and for three responses according to the other, with only slight agreement between evaluators for both GQS (kappa = 0.20) and modified DISCERN scores (kappa = 0.08). ChatSonic also provided high-quality and reliable responses for a majority of questions, albeit to a lesser extent than ChatGPT, and both demonstrating limited concordance in responses (p > 0.05). Overall, Both ChatGPT and ChatSonic demonstrated potential utility in providing responses to patient queries about hernia surgery. However, due to inconsistencies in reliability and quality, ongoing refinement and validation of AI generated medical information remain necessary before widespread clinical adoption.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"583-588"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557739","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":"Immediate repair of the recurrent laryngeal nerve during thyroid surgery via a tension-free end-to-side anastomosis with the Vagus.","authors":"Sohail Bakkar, Angeliki Chorti, Theodosis Papavramidis","doi":"10.1007/s13304-025-02095-3","DOIUrl":"10.1007/s13304-025-02095-3","url":null,"abstract":"<p><p>The unprecedented technical and technological evolution in thyroid surgery has labelled it as an extremely safe and efficient procedure, and indeed \"typifies perhaps better than any other operation the supreme triumph of the surgeon's art.\"-William Halsted, 1852-1922. Surgeon's experience reflected by annual case load is the most important denominator in thyroid surgery. Nevertheless, even high-volume thyroid surgeons in high-volume centres are not immune to its complications. Despite the advances in surgical technology and techniques, recurrent laryngeal nerve (RLN) injury is still a wellknown complication of thyroid surgery. The considerable postoperative morbidity associated with it and its impact on the patient's overall quality of life make it a dreadful complication of thyroid surgery and a common cause of malpractice accusations. Intraoperative RLN reconstruction is not widely used in clinical practice, but the evidence so far makes it a viable and safe alternative to traditional techniques with better long-term results, as it prevents the occurrence of atrophy of the vocal cord and should be considered in the operating room if possible. Furthermore, immediate reconstruction of an intraoperatively detected RLN injury has been strongly recommended by the 2020 American Association of Endocrine Surgeons guidelines. After neurorrhaphy, RLN regeneration occurs but in a random, misdirected fashion resulting in simultaneous contraction of abductors and adductors. Therefore, normal vocal fold function/mobility is typically not restored. The objective of this technical note is to describe a novel immediate RLN repair technique that has a strong propensity to regenerate and reinnervate laryngeal muscles and potentially restore laryngeal mobility.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"363-365"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979989","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}