Updates in Surgery最新文献

{"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":"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":"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}

{"title":"Long-term outcomes of surgical management in post-intubation tracheal stenosis: a retrospective analysis of tracheal resection and reconstruction.","authors":"Ahmet Ulusan, Ibrahim Emre Tunca, Bekir Elma, Maruf Sanli, Ahmet Feridun Isik","doi":"10.1007/s13304-024-02040-w","DOIUrl":"10.1007/s13304-024-02040-w","url":null,"abstract":"<p><p>Post-intubation tracheal stenosis (PITS) is a serious complication of prolonged intubation, often requiring surgical intervention. This study aims to present the long-term outcomes of patients with PITS who underwent tracheal resection and reconstruction, as well as to discuss the efficacy of these surgical methods in comparison to stenting. This retrospective study included patients treated for PITS at our center between October 2005 and October 2022. Patients were divided into two groups: those who underwent tracheal resection and reconstruction (n = 29) and those treated with stenting (n = 47). The clinical characteristics, surgical techniques, complications, and long-term outcomes were recorded and analyzed. The mean age of the patients was 41.3 years, with 40.0% aged between 40 and 60 years. The mean intubation duration was 16.8 days. In the resection group, 22 of 29 patients (75.8%) showed no recurrence or complications during long-term follow-up. The overall success rate for surgical treatment was 93.1%, with a mortality rate of 6.8%. In the stenting group, successful stent removal was achieved in 9 of 47 cases, with a mean stent removal time of 26 months. Granulation tissue formation and restenosis were more frequently observed in stented patients compared to those who underwent surgery. Tracheal resection and end-to-end anastomosis remain the gold standard treatment for PITS, with a lower recurrence rate and fewer long-term complications compared to stenting. However, stenting may be a viable option for patients who are not suitable candidates for surgery. Careful preoperative evaluation and long-term follow-up are essential to optimize patient outcomes.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"533-540"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695831","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":"Colon and rectal peritoneal carcinomatosis: are we mixing apples with oranges? A propensity score-matched analysis.","authors":"Carlo Vallicelli, Daniele Morezzi, Daniele Perrina, Paola Fugazzola, Jean Pinson, Gabriele Vigutto, Ahmed Ghaly, Jacopo Viganò, Matteo Tomasoni, Luca Ansaloni, Jean-Jacques Tuech, Fausto Catena","doi":"10.1007/s13304-025-02104-5","DOIUrl":"10.1007/s13304-025-02104-5","url":null,"abstract":"<p><p>Rectal cancer is universally considered a different disease entity as compared to colon cancer, except when dealing with colorectal peritoneal carcinomatosis (PC), in which the two cancers are deemed as the same one. The present study aims to investigate the influence of primary tumor location (colon vs. rectum) on oncologic outcomes in patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for colorectal peritoneal metastases. Data from three referral centers undergoing CRS plus HIPEC for PC of colorectal origin were prospectively collected. The primary outcomes were overall survival (OS) and disease-free survival (DFS) according to primary tumor location (colic vs. rectal). Univariate and multivariate analyses were performed using the Cox proportional hazard model first on the total number of patients. Then, a propensity score matching using the nearest-neighbour method with a 1:1 ratio was performed. The study included 167 patients: 126 colic and 41 rectal PC. After propensity score matching, rectal primary tumor location was independently predictive of a lower DFS (HR 1.91; 95%CI 1.06-3.45; p = 0.031) but not of a lower OS (HR 1.12; 95%CI 0.57-2.21; p = 0.73). Post-matching 3-year DFS rates were 49.2% (95%CI 34,3-70,5%) and 19.4% (95%CI 9,4-40,2%) for colic and rectal PC, respectively. The present study shows a significantly worse DFS for rectal cancer PC undergoing CRS and HIPEC compared to colon cancer PC, suggesting a possible need for dedicated pathways for rectal PC patients and posing a question for rectal PC to be considered as a unique disease entity.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"277-285"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012128","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":"Resection of the paracaval portion of the caudate lobe of the liver through complete right approach: advantages of a laparoscopic perspective.","authors":"Ya Yang, Jiahong Liang, Xingru Wang, Jianwei Li","doi":"10.1007/s13304-025-02134-z","DOIUrl":"10.1007/s13304-025-02134-z","url":null,"abstract":"<p><p>The lesions in the paracaval portion are situated in deep locations and adjacent to vital blood vessels. Existing reports regarding the resection of the paracaval portion through a complete right laparoscopic approach are limited. We present a case of a hepatic mass resection in the paracaval portion using a complete right laparoscopic approach. This study documents detailed surgical procedures and postoperative outcomes. The operative time was 160 min, with an intraoperative blood loss of 100 mL. The patient was discharged on postoperative day 5 without experiencing any complications. The postoperative pathological result indicated a hepatic hemangioma. In conclusion, the complete right laparoscopic approach for paracaval portion resection is a safe and effective technique. However, it poses challenges and should be performed in specialized centers equipped with advanced laparoscopic technology.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"455-458"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543616","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":"Analysis of survival and prognostic factors in appendix adenocarcinoma and mucinous carcinoma.","authors":"Bilal Turan, Ahmet Necati Sanli, Serdar Acar","doi":"10.1007/s13304-025-02103-6","DOIUrl":"10.1007/s13304-025-02103-6","url":null,"abstract":"<p><p>This study aimed to compare mucinous carcinoma and adenocarcinoma of the appendix in terms of survival and investigate the risk factors influencing survival. The data for this study were retrieved from the SEER database (SEER Research Plus 17 registries). Patients diagnosed with appendix cancer between 2004 and 2019 were included. Demographic data, such as age, gender, marital status, and year of diagnosis, along with oncological variables like stage, surgery, chemotherapy, radiotherapy, and survival time, were extracted from the SEER database. Pathological subtypes were classified as adenocarcinoma (AC) and mucinous adenocarcinoma (MAC) based on the College of American Pathologists guidelines. Patients with other pathological subtypes or missing data were excluded from the study. This study included 4524 patients, with 2118 (46.8%) classified as AC and 2406 (53.2%) as MAC. There was no significant difference in mean age between AC and MAC groups (63.22 ± 14.30 vs. 59.46 ± 14.07, p = 0.483). AC was more common in males, while MAC was more prevalent in females (46.8% vs. 53.2%; 55.6% vs. 44.4%, p < 0.001, respectively). Married status was high in both groups (p = 0.001). While no difference was found in white race distribution, the black race was more prevalent in the AC group (57.1% vs. 42.9%, p < 0.001). Grade 1 tumors were more frequent in the AC group, whereas Grades 2 and 3 were more common in the MAC group (p < 0.001). Stages 1, 2, and 3 were more prevalent in the AC group, while the majority of MAC cases were at Stage 4. Surgery rates were higher in the AC group (98.6% vs. 96.4%, p < 0.001). Chemotherapy was used more frequently in the MAC group (50.9% vs. 40.6%, p < 0.001), while radiotherapy rates were similar in both groups (p = 0.498). The mean follow-up period was 55.70 ± 47.2 months. Five- and ten-year survival rates for the MAC group were 64.4% and 50.2%, respectively, higher than the AC group's rates of 54.2% and 39.7% (p < 0.001). The overall risk of mortality was 1.4 times higher in the AC group compared to the MAC group (p < 0.001, HR: 1.377 [CI 95% 1.259-1.507]). While adenocarcinomas and mucinous adenocarcinomas have similar incidences, non-metastatic adenocarcinomas were more frequently observed. In contrast, mucinous adenocarcinomas often exhibited distant metastases. Nevertheless, the survival rate was higher in mucinous adenocarcinomas.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"327-332"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011500","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":"Omental patch as prevention for bile leak in patients undergoing subtotal cholecystectomy: a propensity score analysis.","authors":"Camilo Ramírez-Giraldo, Violeta Avendaño-Morales, Alejandro González-Muñoz, Isabella Van-Londoño, Juan Felipe Díaz-Castrillón, Andrés Isaza-Restrepo","doi":"10.1007/s13304-025-02129-w","DOIUrl":"10.1007/s13304-025-02129-w","url":null,"abstract":"<p><p>Subtotal cholecystectomy is one of the most frequent bail-out procedures performed during difficult cholecystectomy. A common complication to this procedure is bile leak, and thus multiple strategies have been created to avoid its appearance. This study aims to evaluate the effectivity of using an omental patch as bile leak prevention in patients undergoing subtotal cholecystectomy. A retrospective cohort study including patients who underwent subtotal cholecystectomy between 2014 and 2022 was performed. 17 patients had an omental patch, while 378 did not; the latter were included to evaluate surgical outcomes with bile leak as a primary outcome using a propensity score matching analysis (PSM). Patients' median age in both groups after PSM was 71.00 (IQR: 59.00-81.00) and 69.00 (IQR: 61.75-80.25) years, respectively. The dominant sex in both groups was male. In most cases surgical procedure indication was cholecystitis. Patients who had an omental patch did not present statistically significant differences for bile leak rates compared to patients who did not (29.4% versus 17.6%, p = 0.456, respectively). Similar results were observed when evaluating the need for postoperative ERCP for bile leak management (23.5 versus 5.9%, p = 0.078). A statistically significant higher proportion of major complications were observed in patients who had an omental patch (47.1% versus 19.1%, p = 0.038). Pedicled omental patch was not an effective measure for preventing bile leak, and it even presented a higher rate of complications. It is thus imperative to continue evaluating other strategies for the prevention of bile leak during subtotal cholecystectomy.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"501-509"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400061","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":"Exploration of laparoscopic day surgery mode for pediatric inguinal hernia: a large cohort study.","authors":"Shuhao Zhang, Duote Cai, Yi Jin, Wenjuan Luo, Qingjiang Chen, Xiaoyan Fan, Zhigang Gao","doi":"10.1007/s13304-025-02141-0","DOIUrl":"10.1007/s13304-025-02141-0","url":null,"abstract":"<p><p>The pediatric day surgery has experienced a rapid development in recent years. This study aims to investigate the prospects of day surgery in pediatric hospitals. A total of 17,549 pediatric patients with inguinal hernia (IH) treated between July 2018 and August 2023 were included. The patients were divided into four groups: group A1 (open IH repair [OIHR] in the traditional ward), A2 (laparoscopic IH repair [LIHR] in the traditional ward), B1 (OIHR in the day ward), and B2 (LIHR in the day ward). A retrospective analysis was conducted based on clinical data, satisfaction and prognosis. The present study showed that the operative time between groups A2 and B2 showed no significant difference (p = 0.1205). However, the total time from entering to exiting the operating room was significantly longer in group A2 compared to group B2 (p < 0.0001). Hospitalization costs were significantly lower for patients in the day ward compared to the traditional ward (p < 0.0001). There was no significant difference in the recurrent IH rate between groups A2 and B2 (p = 0.977) or in incision infection rates between the day and traditional wards. The recurrent IH rate was significantly higher after OIHR compared to LIHR (p < 0.0001). The parent satisfaction in the day ward is higher than the traditional ward. The day surgery model of LIHR is a safe, reliable, and economically beneficial surgical management model that is highly recommended for pediatric hospitals.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":"575-582"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587202","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}