Updates in Surgery最新文献

{"title":"Comparative clinical outcomes of ventral rectopexy versus STARR in the management of obstructed defecation syndrome: a clinical review.","authors":"Michele Schiano di Visconte","doi":"10.1007/s13304-025-02314-x","DOIUrl":"https://doi.org/10.1007/s13304-025-02314-x","url":null,"abstract":"<p><p>Obstructed defecation syndrome (ODS) is a multifactorial pelvic floor disorder commonly affecting women, characterized by straining, incomplete evacuation, and dependence on manual maneuvers. Among various surgical options, stapled transanal rectal resection (STARR) and laparoscopic or robotic ventral mesh rectopexy (LVMR/RVMR) are frequently employed. However, the comparative effectiveness of these procedures remains debated. This narrative review synthesizes evidence from 43 studies including randomized trials, cohort studies, registries, and systematic reviews published between 2004 and 2025. Clinical outcomes assessed include symptom relief, recurrence, quality of life (QoL), complications, and cost-effectiveness. The methodological quality of included studies was evaluated using the SANRA tool. Both STARR and LVMR/RVMR provide significant early symptom relief in ODS. STARR shows 70-90% short-term improvement, but recurrence rates up to 40% have been reported at 10 years. LVMR achieves durable functional outcomes with recurrence rates < 10%, superior QoL metrics, and fewer anatomical relapses. Mesh-related complications after LVMR are rare (~ 1.4%), but require long-term monitoring. Economically, while STARR has lower initial costs, LVMR/RVMR demonstrates greater long-term cost-effectiveness due to reduced reoperations. RVMR may enhance surgical precision, but increases upfront expenses. STARR remains a valid option for isolated rectocele or low-grade intussusception, whereas LVMR/RVMR is preferable for complex pelvic floor dysfunction. Current evidence favors ventral rectopexy for sustained outcomes, although methodological heterogeneity limits definitive conclusions. Prospective, standardized, long-term comparative trials are essential to optimize surgical strategies for ODS.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529651","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":"Research status, hotspots and perspectives of artificial intelligence applied to pain management: a bibliometric and visual analysis.","authors":"Feng Li, ChangHao Hu, Xu Luo","doi":"10.1007/s13304-025-02296-w","DOIUrl":"https://doi.org/10.1007/s13304-025-02296-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;With the advent of big data, artificial intelligence (AI) is rapidly emerging as a promising avenue for pain management research. Integrating big data analytics, machine learning, and intelligent algorithms within AI can facilitate several significant advancements in healthcare. These include the ability to provide clinical diagnoses of pain, risk prediction, and the development of precision medicine. The number of articles on the application of AI to pain management is on the rise. However, there needs to be more information regarding the quality of the research output in this area, as well as the current hotspots and trends in research. At the same time, no bibliometric metrics have been identified that assess scientific progress in this area. In order to gain an understanding of the current status and potential future directions in the application of AI within the field of pain management, it is first necessary to undertake a visual and analytical study of the relevant research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;A bibliometric and visual analysis was conducted to identify research hotspots and trends in the application of AI in pain management over the past 30 years.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The data information source was the SCI-EXPANDED subset database of the WOS database. A manual search was conducted of all articles and reviews from the database's inception to June 29, 2024. The search was limited to English language sources. A bibliometric analysis was conducted using VOSviewer, CiteSpace, and Bibliometrix (an R-Tool of R-Studio). The analysis encompassed a range of aspects related to the global publication status of papers in the field, including countries and regions, institutions, authors, journals, keywords, and co-cited references.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 970 published papers were obtained for this study. The articles were published in 496 journals by 5679 authors affiliated with 2030 academic institutions in 84 countries or regions. From 2014 to 2024, there was a gradual increase in the number of papers published within this field, with 97% of the total published papers. The United States and China contribute the most to this growth. The most prominent research institutions are Harvard University, the University of California system, and Harvard Medical School. At the author level, Mork, Paul Jarle, Bach, and Kerstin of the Norwegian University of Science & Technology (NTNU) were identified as the authors with the highest research output. Breiman, L. of the University of California, Berkeley, emerged as the most influential author, exhibiting the highest co-citation frequency. From the perspective of journals, the Journal of Medical Internet Research, Scientific Reports, PAIN, PLOS ONE, and SPINE are the primary core journals in the field. They have a high number of published papers and co-citation frequency. Furthermore, of the 46,170 co-cited references, Loetsch J's \"Mach","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529666","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":"Preoperative serum protein concentration as a predictor of staple-line leak after sleeve gastrectomy: a retrospective cohort study.","authors":"Simone Arolfo, Serena Mantova, Roberto Passera, Nicola Leone, Mario Morino","doi":"10.1007/s13304-025-02281-3","DOIUrl":"https://doi.org/10.1007/s13304-025-02281-3","url":null,"abstract":"<p><strong>Background: </strong>Staple-line leak is the most frequent post-operative complication after sleeve gastrectomy (SG). Low serum protein concentration (SPC), a condition associated with malnutrition, is common among people with obesity. Whether low SPC represents a risk factor for staple-line leak has been actually not extensively investigated. The objective of this study is to assess the relationship between low SPC and staple-line leak in patients undergoing SG.</p><p><strong>Methods: </strong>A prospectively collected database was queried for consecutive patients who underwent SG between January 1st 2010 and December 31st 2022 at a single institution.</p><p><strong>Primary endpoint: </strong>to investigate the relationship between low pre-operative SPC and staple-line leak occurred within 30 days. Secondary endpoint: to investigate other patients' and surgeon's related risk factors for leak.</p><p><strong>Results: </strong>1669 patients were included in the study. Staple-line leak occurred in 53 patients (3.2%). Patients with staple-line leak had a significantly lower SPC than patients with a normal post-operative course (median 6.8 vs. 7.1 g/L; p < 0.001). High values of SPC significantly reduced the risk of leak (OR 0.20; 95% CI 0.09-0.45; p = 0.001). Major intraoperative bleeding and need of blood transfusions were significantly associated with a higher rate of leak (OR 3,58, 95% CI 1,45-8,86; p = 0,006; OR 9,79, 95% CI 3,66-26,22; p < 0,001) at a multivariable analysis.</p><p><strong>Conclusion: </strong>The occurrence of staple-line leak after SG is directly related to pre-operative low SPC, an index of malnutrition. Nutritional assessment and optimization of protein intake could potentially reduce the rate of leak.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529665","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":"SICOB Italian Clinical Practice GRADE-based guidelines for the endobariatric treatment of overweight, obesity, and obesity-associated diseases.","authors":"Maurizio De Luca, Amanda Belluzzi, Monica Zese, Andrea Anderloni, Rosario Bellini, Rossana Daniela Berta, Ivo Boskoski, Maria Grazia Carbonelli, Rita Cataldo, Maria Rosaria Cerbone, Marco Chianelli, Rita Conigliaro, Carla Micaela Cuttica, Corrado De Martino, Carla Destro, Carlo De Werra, Nicola Di Lorenzo, Massimo Di Simone, Ludovico Docimo, Enrico Facchiano, Mirto Foletto, Pietro Forestieri, Diego Foschi, Giuseppe Gagliardi, Giovanni Galasso, Giuseppe Galloro, Paolo Gentileschi, Ilenia Grandone, Arianna Goracci, Francesca Clemente Gregoris, Valentina Lorenzoni, Raffaele Manta, Mario Musella, Paolo Marzullo, Gerardo Medea, Giuseppe Navarra, Monica Ortenzi, Barbara Paolini, Emanuela Paone, Luigi Piazza, Vincenzo Pilone, Debora Porri, Marco Raffaelli, Farnaz Rahimi, Andrea Rizzi, Simone Rugolotto, Giuliano Sarro, Caterina Scalamogna, Andrea Sanna, Giovanni Sarnelli, Luca Sessa, Simone Targa, Iris Zani, Benedetta Ragghianti, Giulia Bandini, Anna Lo Cricchio, Antonio Silverii, Marco Antonio Zappa, Monami Matteo","doi":"10.1007/s13304-025-02304-z","DOIUrl":"https://doi.org/10.1007/s13304-025-02304-z","url":null,"abstract":"<p><p>Obesity is a chronic disease associated with increased morbidity and mortality and reduced quality of life. Pharmacotherapy can be associated with life style interventions aiming at increasing and maintaining weight loss and ameliorating obesity-related medical conditions. In patients affected by obesity and uncontrolled obesity-associated complications or high degree of BMI (> 40 kg/m²), metabolic bariatric surgery (MBS) can be a feasible therapeutic option. Many different types of surgical procedures have been developed in last decades, mainly performed via laparoscopic approaches. However, clinical indications for MBS and the selection of the most appropriate type of procedure have not been clarified so far. The Italian Society of Bariatric and Metabolic Surgery for Obesity (Società Italiana di Chirurgia dell'Obesità e delle Malattie Metaboliche-SICOB) decided to design and develop the updated version of the Italian guidelines aimed at assisting healthcare professionals in the choice of the surgical option for the treatment of obesity and related medical conditions. Between June and October 2022, a panel of 24 experts and an evidence review team (ERT, 10 members), participated in the definition of clinical questions, outcomes, and recommendations and collected and analyzed all the available evidence on the basis of pre-specified search strategies. GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology and PICO (Patient, Intervention, Comparison, Outcome) conceptual framework have been adopted for the development of the present guidelines. The aim of the present guideline is to verify indications to bariatric surgical endoscopy with respect to the presence of comorbid conditions, evaluate the different types of endoscopic bariatric procedure and revise indication to revisional bariatric endoscopy and postoperative procedures.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529667","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 choice of extraction site modulates the incidence of incisional hernia in colorectal surgery: a cohort analysis.","authors":"Marie Burgard, Emilie Liot, Guillaume Meurette, Pierre-Alexandre Poletti, Christian Toso, Frédéric Ris, Jeremy Meyer","doi":"10.1007/s13304-025-02272-4","DOIUrl":"https://doi.org/10.1007/s13304-025-02272-4","url":null,"abstract":"<p><p>Although minimally invasive surgery has significantly reduced the incidence of incisional hernia (IH) in colorectal procedures, the choice of specimen extraction site continues to pose a risk. This study explores how the location of extraction site influences the occurrence of IH in patients undergoing minimally invasive colorectal resections. We conducted a retrospective observational cohort study involving consecutive patients who underwent minimally invasive colorectal resection for colorectal cancer from 2013 to 2021. Patients with open surgery, previous hernia repair, reoperations during the study period or without imaging follow-up were excluded. The primary outcome measured was the CT-proven incidence of IH at the extraction site. A total of 191 patients were analyzed. Among them, 113 patients (59.2%) had a midline extraction site, while and 78 patients (40.8%) had an off-midline extraction. Midline extraction was preferably used during right and transverse colectomy (98% and 100% respectively), whereas off-midline were preferred in left hemicolectomy, sigmoidectomy, and anterior resection (55%, 88%, 95% respectively). Remarkably, the overall incidence of IH at the extraction site was 30.9% for midline extractions compared to 0% for off-midline extractions (p value < 0.001). The mean follow-up duration was of 3.3 ± 2.1 years. Multivariate logistic regression analysis revealed midline extraction as a significant risk factor for IH with a relative risk of 29.1 (95% CI 3.8-220.5, p value < 0.001). The findings highlight a substantial increase in the risk of IH associated with midline extraction sites. As such, it is crucial to advocate for fully minimally invasive colorectal resection using off-midline incision to enhance patient outcomes and reduce the risk of incisional hernias.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512555","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":"Operative versus nonoperative treatment of thrombosed external hemorrhoids: a systematic review and meta-analysis.","authors":"Marcelo Albuquerque Barbosa Martins, Luiz Felipe Costa de Almeida, Anelise Poluboiarinov Cappellaro, Luís Fernando Rosati Rocha, Rachid Eduardo Noleto da Nobrega Oliveira","doi":"10.1007/s13304-025-02302-1","DOIUrl":"https://doi.org/10.1007/s13304-025-02302-1","url":null,"abstract":"<p><p>Thrombosed external hemorrhoids are a complication of hemorrhoids characterized by severe pain, swelling, and lump formation due to acute venous engorgement. Treatment options remain controversial, with limited evidence guiding the choice between surgical and conservative approaches. PubMed, Embase, and Cochrane Library databases were searched from inception to December 2024 to identify clinical trials comparing surgery with conservative treatment in thrombosed external hemorrhoids. Statistical analyses were performed using Review Manager 5.4.1 with a random-effects model. Heterogeneity was assessed using the I² test. We included six studies with a total of 851 patients, of whom 390 (45.8%) underwent surgical treatment. Surgical treatment was associated with a lower risk of recurrence compared to conservative management (RR 0.49; 95% CI 0.26-0.91; P < 0.05; I² = 54%). However, there were no significant differences in the risk of bleeding between the groups (RR 0.96; 95% CI 0.27-3.44; P = 0.95; I² = 60%). Subgroup analyses of the excision surgery group revealed no differences between approaches. Our main findings indicated no significant difference in bleeding between surgery and conservative treatment groups. However, operative management is associated with significantly lower recurrences, which should be the preferred choice.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508441","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":"Effectiveness of a stepwise implementation of enhanced recovery after bariatric surgery: our experience.","authors":"S Nigro, A Gioffrè, S Ursino, F Guccione, V Bartolo, A Barbera, G Navarra","doi":"10.1007/s13304-025-02206-0","DOIUrl":"https://doi.org/10.1007/s13304-025-02206-0","url":null,"abstract":"<p><p>This study evaluates the impact of enhanced recovery after bariatric surgery (ERABS) on length of hospital stay (LoS), postoperative pain, postoperative nausea and vomiting (PONV), adherence to ERABS protocol, postoperative complications, and readmission rates via gradual stepwise implementation. Between January 2017 and December 2018, an observational, controlled, prospective study was performed, enrolling consecutively followed patients who underwent sleeve gastrectomy. Patients were divided into two groups treated with an ERABS protocol which was implemented in two steps. In 2017, this included 12 items (subgroup B1); in 2018, two more items were introduced (subgroup B2). These results were then compared retrospectively to a control group of patients who underwent the same procedure from 2015-2016 whilst adhering to the 'traditional' treatment approach (group A). 367 patients were included. 146 patients in group A, 99 in subgroup B1 and 122 in subgroup B2. The median LoS was 4.5 days in group A, 3.8 days in B1, and 2.3 days in B2. Postoperative pain was 35.7% in group A, 35.6% in B1, and 25% in B2 (p = 0.18). The PONV rate was significantly lower in group B than in group A. Adherence to the ERABS protocol increased from 67% in group B1 to 80% in B2. No statistical difference in terms of 30-day postoperative complications rate and 30-day readmission rate was found. ERABS protocol showed significant improvement in LoS, postoperative pain, and PONV without increasing postoperative complications and readmissions, showing progressively better outcomes with a stepwise implementation.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508440","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":"Correction: Current state-of-the-art of adrenal surgery in Italy: the cancer risk in surgical adrenal lesions (CRISAL) survey.","authors":"Diletta Corallino, Roberto Passera, Marco Inama","doi":"10.1007/s13304-025-02306-x","DOIUrl":"https://doi.org/10.1007/s13304-025-02306-x","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498109","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":"First impressions, second chances in esophageal perforations: treatment pathways and outcome prediction.","authors":"Vladimir Tverskov, Ory Wiesel, Samantha Schiller, Idan Carmeli, Nir Tsur, Hanoch Kashtan, Daniel Solomon","doi":"10.1007/s13304-025-02285-z","DOIUrl":"https://doi.org/10.1007/s13304-025-02285-z","url":null,"abstract":"<p><p>Benign esophageal perforations present a significant clinical challenge due to their high morbidity and potential for fatal outcomes. The complex nature of these perforations demands prompt diagnosis and effective management to mitigate the associated risks. This study aims to evaluate the clinical outcomes of various management strategies for esophageal perforations, focusing on the effectiveness of organ-preserving approaches. We retrospectively analyzed patients diagnosed with benign esophageal perforation between January 2011 and December 2021. Patients were stratified into two groups: those who underwent resection and those who did not. Subgroup analysis was performed on patients managed initially without resection to assess the success of organ-preserving strategies (successful organ preservation, SOP) vs. either salvage resection or death (unsuccessful organ preservation, UOP). Forty-two patients were included: 22 underwent esophageal resection, while 20 were managed non-operatively. The overall 90-day mortality rate was 26%, with higher mortality observed in the resection group. In patients managed initially without resection, 62.1% had successful outcomes, while 37.9% required salvage esophagectomy or died within 90 days. The Pittsburgh Severity Score (PSS) did not significantly predict the need for resection. Distal perforations underwent resection more frequently (p < .001). Overall 90-day mortality was high both among patients who underwent initial resection (5/13, 38.5%) and salvage esophagectomy (3/8, 37.5%). Twenty-nine patients did not initially undergo resection, of which n = 18 (62.1%) were categorized as SOP and n = 11 (37.9%) as UOP. Among the latter, n = 3 (10.3%) died within 90 days and n = 8 (27.6%) underwent salvage esophagectomy. On subgroup analysis on initially unresected patients, delayed diagnosis ≥ 24 h was higher among UOP than SOP patients (n = 5, 45.5% vs. n = 2, 11.1%, p = 0.49). Our findings underscore the importance of early diagnosis and the feasibility of a step-up approach in a select group of patients presenting with favorable variables.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498111","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":"Correction: Esophagectomy in patients with liver cirrhosis: systematic review and meta-analysis of short-term outcomes.","authors":"Andrea Sozzi, Alberto Aiolfi, Gianluca Bonitta, Davide Bona, Luigi Bonavina","doi":"10.1007/s13304-025-02223-z","DOIUrl":"https://doi.org/10.1007/s13304-025-02223-z","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498110","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}