Urologia Internationalis最新文献

{"title":"Focus on the Blind Spot of Stone Disease: Analysis of Lower Urinary Tract Stone Interventions from 2006 to 2020 Using German Nationwide Inpatient Data.","authors":"Roman Herout, Juliane Putz, Angelika Borkowetz, Martin Baunacke, Rainer Koch, Christian Thomas, Johannes Huber, Christer Groeben","doi":"10.1159/000542750","DOIUrl":"10.1159/000542750","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to analyze contemporary treatment trends in bladder stone management in Germany over a 15-year period.</p><p><strong>Methods: </strong>We analyzed data from the nationwide German hospital billing database from 2006 to 2020. The significance of changes over time was evaluated via linear regression analysis.</p><p><strong>Results: </strong>Total case numbers of therapeutic interventions for lower urinary tract calculi increased from 6,770 in 2006 to 9,037 in 2020 (p < 0.001). Transurethral cystolithotripsy (TUCL) was the predominant procedure with increasing case numbers from 5,552 in 2006 to 7,699 in 2020 (p < 0.001). Also, the share of TUCL increased by 4% during the study period. TUCL with laser fragmentation was coded in 82 cases in 2006 and in 1,527 cases in 2020 (p < 0.001). Case numbers of percutaneous cystolithotripsy also increased over time from 406 to 430 cases (p = 0.005), but the share decreased by 20%. Inpatient shock wave lithotripsy is very rarely performed for bladder calculi with an average of 22 cases per year in all hospitals in Germany. Case numbers of open cystolithotomy (OCL) also increased from 614 cases in 2006 to 692 cases in 2020 (p = 0.006), but the share decreased by 15.5%. On average, 164 cases of stone removal from neobladders per year were performed, mainly transurethrally (47%) or via an open approach (21%). Case numbers of TUCL combined with transurethral resection of the prostate (TUR-P) declined from 1,712 in 2006 to 1,450 in 2020 (p = 0.014). However, this might be attributed to the concomitant rise of laser enucleation of the prostate with steadily increasing case numbers in Germany.</p><p><strong>Conclusion: </strong>We present contemporary population-based data on bladder stone treatment in Germany. TUCL is the predominant therapeutic modality with increasing case numbers, but OCL is still performed frequently. TUR-P is the procedure that is most often combined with TUCL.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-7"},"PeriodicalIF":1.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Application Value of 3D Model in Partial Nephrectomy of Varying Complexity.","authors":"Yajie Li, Qifei Zhou, Weihao Li, Jiahui Cao, Kangjie An, Shuhui Liu, Yanping Ma, Bo Tao, Ning Wang, Yaodong Jia, Lihong Nie, Ruining Zhao","doi":"10.1159/000542846","DOIUrl":"10.1159/000542846","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to explore the application value of three-dimensional (3D) model in partial nephrectomy across varying RENAL scores.</p><p><strong>Methods: </strong>A total of 126 patients were enrolled, divided into three groups: 25 cases in the 3D-partial nephrectomy (3D-PN), 86 cases in the 2D-partial nephrectomy (2D-PN), and 15 cases in the 3D-robot-assisted PN (3D-RAPN). Preoperative basic data were collected, including age, gender, neutrophil ratio, platelet count, blood glucose, GFR of the kidney, tumor diameter, tumor staging, RENAL score, Mayo Adhesive Probability (MAP) score, surgical time, warm ischemia time, intraoperative bleeding, postoperative drainage volume, postoperative hospital stay, change in creatinine level at 3 months postoperatively, and pathological results. Perioperative data between 3D-PN and 2D-PN, between the RENAL score 4-6 subgroup of 3D-PN and 2D-PN, between the RENAL score ≥7 subgroup of 3D-PN and 2D-PN, and between the 3D-PN and 3D-RAPN were compared. Statistical analysis was performed using SPSS version 26.0.</p><p><strong>Results: </strong>The 3D-PN showed statistically significant differences compared to the 2D-PN in warm ischemia time, intraoperative bleeding volume, postoperative drainage volume, and postoperative hospital stay (p < 0.05). In the RENAL score 4-6 subgroup, the 3D-PN showed statistically significant differences in intraoperative bleeding volume compared to the 2D-PN (p < 0.05). In the RENAL score ≥7 subgroup, the 3D-PN showed statistically significant differences compared to the 2D-PN in surgical time, warm ischemia time, postoperative drainage volume, and postoperative hospital stay (p < 0.05). There were statistically significant differences between the 3D-PN and the 3D-RAPN in warm ischemia time, intraoperative bleeding volume, and postoperative hospital stay (p < 0.05).</p><p><strong>Conclusion: </strong>Patients with RENAL score ≥7 benefit more from preoperative evaluation with 3D model. The combination of 3D model and RARP can further enhance the advantages and expand the convenience of surgery.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-9"},"PeriodicalIF":1.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application Value of Ureteral Stents in Adjunctive Treatment for Renal Tuberculosis.","authors":"Yeqiang Wang, Sida Hao, Pengju Liu, Guofeng Cai, Yong Qin","doi":"10.1159/000542780","DOIUrl":"10.1159/000542780","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to assess and enhance the application value of ureteral stents in the adjunctive treatment of renal tuberculosis, thus providing a robust evidence-based framework for guiding clinical management strategies.</p><p><strong>Methods: </strong>A total of 360 patients diagnosed with renal tuberculosis between January 2019 and December 2023 were meticulously selected for this study. Utilizing a random number table, the patients were stratified into a control group and a study group, with 180 patients in each cohort. The control group received standard antituberculosis treatment, while the study group underwent adjunctive treatment with ureteral stents. A comparative analysis was conducted to evaluate the differential clinical efficacy, renal excision rate, renal function, degree of renal pelvis separation, and renal parenchymal thickness between the two groups.</p><p><strong>Results: </strong>The study group showed significantly better clinical cure rates and effectiveness compared to the control group. While the 12-month renal excision rate was similar between groups, the 18-month rate was significantly lower in the study group. The study group also had lower posttreatment BUN and serum creatinine levels, reduced renal pelvis separation, and greater renal parenchymal thickness. At 3 and 9 months, complications were significantly fewer in the study group (p < 0.001, p < 0.05), with no severe complications reported. Additionally, the study group had higher overall SF-36 scores (p < 0.001), indicating better quality of life. The treatment success rate (87.2% vs. 70.6%, p < 0.001), renal function preservation (76.7% vs. 60.6%, p = 0.001), and lower recurrence rate (16.1% vs. 26.1%, p = 0.028) further highlighted the benefits of ureteral stenting.</p><p><strong>Conclusion: </strong>The adjunctive use of ureteral stents in the treatment of renal tuberculosis presents a significantly enhanced application value. It not only improves clinical efficacy but also diminishes the need for renal excision, effectively preserves renal function, reduces the degree of renal pelvis separation, and maintains optimal renal parenchymal thickness. Thus, advocating for the widespread implementation of ureteral stents as an adjunctive therapeutic modality for managing renal tuberculosis is strongly recommended.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Unique Case of Bilateral Testicular Tumours: Nonseminomatous Germ Cell Tumour and Contralateral Spermatocytic Tumour 27 Years Apart.","authors":"Klaus-Peter Dieckmann, Alexander Harms, Gazanfer Belge, Christian Wülfing","doi":"10.1159/000542748","DOIUrl":"10.1159/000542748","url":null,"abstract":"<p><strong>Introduction: </strong>Bilateral testicular tumours occur in 3-5% of all cases with testicular neoplasms. In the majority of cases, histology of the two new growths is identical. The time interval between the two neoplastic events rarely exceeds 10 years.</p><p><strong>Case presentation: </strong>A 29-year-old man of Caucasian descent underwent right-sided orchiectomy for a nonseminomatous germ cell tumour (GCT). Postoperatively, he received adjuvant chemotherapy with 2 cycles of a cisplatin based regimen for clinical stage 1 disease. Twenty-seven years later when aged 56 years, he developed a lump in the left testis. Serum tumour markers including microRNA-371a-3p were within normal limits. Orchiectomy was performed. Histology revealed a spermatocytic tumour with positive stainings of SALL4, NUT, and CD117. No germ cell neoplasia in situ (GCNis) was detected in the tumour-surrounding tissue.</p><p><strong>Conclusion: </strong>Histogenetically, testicular GCTs are thought to derive from the precursor GCNis, while spermatocytic tumours directly derive from adult spermatogonia. This case is exceptional, firstly because of the very long interval of 27 years between the two neoplastic events, and secondly because of the unprecedented occurrence of two testicular neoplasms with different pathogenetic origins in 1 individual patient.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-4"},"PeriodicalIF":1.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who Changes Indwelling Urinary Catheters in Male Nursing Home Residents and Where? Results from a Nationwide Cross-Sectional Survey in Germany.","authors":"Jonas Czwikla, Guido Schmiemann, Tanja Schleef, Stephanie Stiel, Falk Hoffmann","doi":"10.1159/000542430","DOIUrl":"10.1159/000542430","url":null,"abstract":"<p><strong>Introduction: </strong>We examined the practice and variability of indwelling urinary catheter changes in male nursing home residents.</p><p><strong>Methods: </strong>Cross-sectional data from a nationwide survey conducted in a representative sample of German nursing homes in 2023 were analyzed. The professions conducting most transurethral/suprapubic catheter changes in men were identified, and proportions for whom respective catheters are changed in nursing homes were determined. Associations between these proportions and nursing home characteristics were investigated via multivariable logistic regressions.</p><p><strong>Results: </strong>Of 1,369 invited facilities, 330 (24.1%) participated. Urologists changed most catheters in 72.8% (transurethral catheters) and 88.3% (suprapubic catheters) of the facilities. The median proportion of men whose catheters were changed in nursing homes was 8.5% (transurethral catheters; interquartile range 0.6%-100.0%) and 1.0% (suprapubic catheters; interquartile range 0.0-100.0%). Facilities in which urologists changed most catheters were less likely to have a high proportion (≥90%) of in-home catheter changes compared to the reference group (odds ratio 0.44 [transurethral catheters; 95% confidence interval 0.24-0.82] and 0.30 [suprapubic catheters; 0.12-0.76]).</p><p><strong>Conclusion: </strong>The proportion of men whose catheters were changed in nursing homes varied considerably between facilities and was lower where urologists were involved.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-7"},"PeriodicalIF":1.5,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-Specific Differences in Urethral Swabs: A Retrospective Single-Centre Analysis.","authors":"Katharina Raude, Claudia Röbel, Stefan Schmidt, Jens-Uwe Stolzenburg, Henrike Beverungen","doi":"10.1159/000542457","DOIUrl":"10.1159/000542457","url":null,"abstract":"<p><strong>Introduction: </strong>Sexually transmitted infections (STIs) are on the rise globally, yet accurate data regarding infection rates remain scarce. There is the assumption that STIs among women with chronic urinary tract infections (UTIs) have been underestimated. This may arise from the reliance on specialised cultivation or nucleic acid amplification techniques for detection, which are more costly than standard urine culture and are typically only conducted by specialists like urologists.</p><p><strong>Methods: </strong>A retrospective, observational, single-centre study using medical records of patients who received a urethral swab in a German urological practice in the past 5 years has been conducted.</p><p><strong>Results: </strong>55% of patients had a STI requiring treatment. People with recurrent UTIs had a STI in 35% of the cases. Younger age is associated with the detection of STIs. The female gender is significantly associated with a positive swab result.</p><p><strong>Conclusion: </strong>Distinguishing between cystitis and urethritis, particularly in women with recurrent UTIs experiencing dysuria, presents a clinical challenge. The prevalence of asymptomatic infections suggests that the true burden of urethritis, particularly STIs, may be substantially higher in the general population than currently reported. This underscores the urgency of establishing guidelines for referral and diagnostic evaluation as delayed or inadequate treatment may contribute to escalating infection rates and antibiotic resistance.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Programmatic Approach to En Bloc Transurethral Enucleation of the Prostate with Bipolar System: A Single-Center Retrospective Report.","authors":"Peng Lai, Ying Lu, Weihong Lu, Fan Chao, Jianping Zhang","doi":"10.1159/000542514","DOIUrl":"10.1159/000542514","url":null,"abstract":"<p><strong>Introduction: </strong>This study presents a systematic approach for en bloc transurethral enucleation of the prostate utilizing a bipolar system (TUEB), evaluating its effectiveness and safety. Furthermore, the research aims to pinpoint risk factors contributing to early stress urinary incontinence (SUI) after undergoing en bloc TUEB.</p><p><strong>Methods: </strong>The en bloc TUEB procedure is visually demonstrated through images and videos. A retrospective analysis was conducted based on the data of 88 patients diagnosed with benign prostatic hyperplasia (BPH) who underwent en bloc TUEB between January 2018 and April 2023. Detailed perioperative and follow-up clinical data were collected and analyzed. Patients were categorized based on the occurrence of SUI, and their clinical characteristics were analyzed.</p><p><strong>Results: </strong>The mean surgical duration was 113.1 ± 50.0 min, resulting in an excised prostate gland weighing 58.0 ± 34.3 g and a hemoglobin drop of 14.3 ± 11.2 g/L. The average enucleation rate was 79.00 ± 11.01%, enucleation efficiency was 0.54 ± 0.26 g/min and prostate-specific antigen reduction rate was 42.08 ± 22.85%. There were no major complications during operation. Twenty-three patients (26.13%) developed early SUI after catheter removal, and 74% of them were in remission within 1 month. Importantly, no cases of persistent SUI were observed. Lower urinary tract symptoms (LUTSs) duration was significantly different between patients with and without postoperative SUI. Residual urine volume, International Prostate Symptom Score (IPSS), and Quality of Life (QoL) score were significantly improved in BPH patients after surgery (p < 0.05). Twelve months after surgery, only 2 patients (2.27%) had urethral stricture, although it recovered after transurethral dilation.</p><p><strong>Conclusions: </strong>En bloc TUEB is proven to be effective, practical, efficient, and safe with minimal complications. This procedure could be standardized and widely adopted. LUTS duration can predict the risk of early SUI.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-Specific Differences in Recurrence and Progression following Bacillus Calmette-Guérin Instillation for Non-Muscle-Invasive Bladder Cancer.","authors":"Laila Schneidewind, Bernhard Kiss, Jennifer Kranz, Friedemann Zengerling, Angelika Borkowetz, Sebastian Graf, Annabel Graser, Annemarie Uhlig","doi":"10.1159/000542473","DOIUrl":"10.1159/000542473","url":null,"abstract":"<p><strong>Introduction: </strong>To assess gender-specific differences in recurrence-free survival (RFS), progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS) among patients with intermediate or high-risk non-muscle-invasive bladder cancer (NMIBC) receiving BCG was the primary aim of this systematic review and meta-analysis.</p><p><strong>Methods: </strong>In July 2023, we performed a literature search using MEDLINE, Embase, and the Cochrane Library. This study was prospectively registered at PROSPERO (CRD 2023443269). The detailed review protocol is accessible via CRD.</p><p><strong>Results: </strong>The systematic literature search identified 6,723 studies, of which 38 fulfilled the inclusion criteria. Random-effect meta-analysis for RFS, based on data from 24 studies, revealed no statistically significant gender-specific difference (HR comparing males to females = 0.9618, 95% CI: 0.8408-1.1003, p = 0.5707). Similarly, for PFS, incorporating data from 14 studies, no statistically significant difference (HR = 0.9540, 95% CI: 0.7709-1.1805, p = 0.6648), for CSS, analysis of data from three studies yielded no statistically significant difference (HR = 0.9228, 95% CI: 0.6196-1.3743, p = 0.6925), and for OS, based on data from two studies, no statistically significant difference was observed (HR = 1.1436, 95% CI: 0.5092-2.5684, p = 0.7452). The risk of bias assessment indicated an overall moderate to high risk of bias.</p><p><strong>Conclusion: </strong>The findings indicate no association between gender and oncologic outcomes following BCG.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-13"},"PeriodicalIF":1.5,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction Statement.","authors":"","doi":"10.1159/000542387","DOIUrl":"https://doi.org/10.1159/000542387","url":null,"abstract":"","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1"},"PeriodicalIF":1.5,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Reflux Ureteroileal Anastomosis for Orthotopic Ileal Neobladder Using Wallace Technique in a Single Trough.","authors":"Karim ElSaeed, Hany Moustafa, Sherif Abdelghani, Hossam ElAwady","doi":"10.1159/000541952","DOIUrl":"10.1159/000541952","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the modification of the subserous extramural tunnel for non-refluxing ureteroileal anastomosis in U-shaped pouches using the Wallace technique with a single trough.</p><p><strong>Methods: </strong>This prospective study was conducted from 2017 to 2022 in a single tertiary center after approval from the Research Ethics Committee of our institution (approval number: FWA 000017585). 45 patients' candidates for radical cystectomy and orthotopic urinary diversion were included in this study. The patients were diverted using a U-shaped pouch with ureteroileal anastomosis, combining the extramural serous-lined tunnel and Wallace techniques in a single trough. Operative time and complications, including ureteric obstruction, reflux, and renal function, were recorded within 1 year.</p><p><strong>Results: </strong>The modified ureteroileal anastomosis combined with the extramural serous-lined tunnel and Wallace techniques had a relatively short operative time (mean 132.2 ± 18.3 min) and short bowel segment incorporation (30 cm). In 43 patients, vesicoureteral reflux occurred in only 2 patients (4.7%). One case of anastomotic stricture was diagnosed (2.3%), which increased to 2 cases (4.7%) after 1 year. Three patients (7%) developed pyelonephritis during the year. The mean serum creatinine level of the patients before the operation was 1.2 mg/dL, which increased to 1.4 mg/dL 6 months postoperatively.</p><p><strong>Conclusion: </strong>A modification of the subserous extramural tunnel for non-refluxing ureteroileal anastomosis in U-shaped pouch appears to be a good simple alternative that is less time consuming and using a shorter segment of bowel for orthotopic diversion with a comparable complication rate.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-7"},"PeriodicalIF":1.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}