World Journal of Pediatric Surgery最新文献

{"title":"Clinical characteristics and surgical outcomes of neonates with congenital duodenal obstruction: a 10-year experience of trans-anastomotic tube use at a tertiary center in Oman.","authors":"Taif Juma Al Amri, Abdulrahman Al Jabri, Ruqaiyah Aamer Al Rahbi, Khalil Saltoun, Humaid Suliman Al Adawi, Alghalya Khalid Al Maawali","doi":"10.1136/wjps-2025-001120","DOIUrl":"https://doi.org/10.1136/wjps-2025-001120","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the demographic and clinical characteristics of neonates with congenital duodenal obstruction (CDO) and to describe postoperative outcomes of intraoperative trans-anastomotic feeding tube (TAT) placement.</p><p><strong>Methods: </strong>We included a retrospective cohort of infants diagnosed (≤1 month of age) with CDO at the Royal Hospital, Oman, between January 2012 and December 2022. Descriptive statistics were used to summarize numerical and categorical data. A subgroup analysis compared outcomes between infants with TAT (Group 1) and without TAT (Group 2). Data were analyzed using independent sample t-test, Mann-Whitney U test, analysis of variance, and χ² test as appropriate.</p><p><strong>Results: </strong>Forty-two infants were included; 24 were born ≥38 weeks, 23 were female and 24 had birth weight ≥2.5 kg. Intrinsic CDO was the most common presentation (<i>n</i>=21). Cardiac anomalies were present in 19 infants, and syndromes in 18 infants, mainly trisomy 21 (<i>n</i>=11). In subgroup analysis, Group 1 (<i>n</i>=13) had a longer median hospital stay than Group 2 (<i>n</i>=18), but this failed to reach statistical significance (22 <i>vs.</i> 16 days, <i>p</i>=0.13). Rates of central line insertion (69.2% <i>vs.</i> 66.7%, <i>p</i>=0.88), parenteral nutrition (76.9% <i>vs</i>. 83.3%, p=0.65), duration of total parenteral nutrition (12.5 <i>vs.</i> 11 days, <i>p</i>=0.96), time to start enteral feeds (4 <i>vs.</i> 4 days, <i>p</i>=0.93) and time to full enteral feeds (10 <i>vs.</i> 12 days, <i>p</i>=0.32) were similar between groups. Overall complication rate was 19.4% (6/31), with no TAT-related complications.</p><p><strong>Conclusion: </strong>Demographic and clinical characteristics were comparable with international findings. TAT insertion was safe but did not improve postoperative outcomes.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 5","pages":"e001120"},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric pancreatic pseudocysts in a resource-limited setting: a multicenter cohort study from Sudan.","authors":"Abdelrahman S Elnour, Ryan Elhag Elnoor, Faisal Nugud, Osman Taha","doi":"10.1136/wjps-2026-001260","DOIUrl":"https://doi.org/10.1136/wjps-2026-001260","url":null,"abstract":"<p><strong>Background: </strong>Pediatric pancreatic pseudocysts (PPCs) are uncommon complications of pancreatic injury or pancreatitis; evidence from resource-limited settings remains scarce. This study aimed to describe the etiology, clinical presentation, management, and short-term outcomes of pediatric PPCs across tertiary pediatric surgery centers in Sudan.</p><p><strong>Methods: </strong>A multicenter retrospective cohort study was conducted across seven tertiary pediatric surgery centers in Sudan between March 2022 and February 2023. Patients younger than 18 years with radiologically confirmed PPCs were included. Demographic, clinical, radiological, management, and in-hospital outcome data were retrospectively extracted from medical records.</p><p><strong>Results: </strong>Totally, 38 children were included; 27 were male, and 18 were aged 6-10 years. Trauma accounted for 28 cases, most commonly donkey-drawn water cart-related injuries (<i>n</i>=10) and handlebar injuries (<i>n</i>=7). Epigastric pain (<i>n</i>=33) and vomiting (<i>n</i>=31) were the most frequent presenting symptoms, with a median interval of approximately 8 weeks between the initial insult and presentation. Most PPCs measured 6-10 cm (<i>n</i>=24). Open cystogastrostomy (<i>n</i>=17) and ultrasound-guided percutaneous external drainage (<i>n</i>=13) were the predominant interventions; five patients were managed conservatively. Recurrence occurred in one patient, and two patients required reintervention. Two children with severe underlying comorbidities died during hospitalization; neither death was considered directly attributable to the PPC. Non-traumatic PPCs were associated with a significantly different distribution of hospital stay, with a greater proportion requiring prolonged hospitalization (<i>p</i>=0.008).</p><p><strong>Conclusions: </strong>Pediatric PPCs in Sudan were predominantly trauma related and frequently required intervention. Management should be individualized according to clinical presentation, pseudocyst characteristics, and locally available expertise and resources.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 5","pages":"e001260"},"PeriodicalIF":2.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with first recurrence of accidental foreign body incidents: a retrospective cohort study in children.","authors":"Jianfeng Liang, Litou Zhou, Yan Xu","doi":"10.1136/wjps-2026-001241","DOIUrl":"https://doi.org/10.1136/wjps-2026-001241","url":null,"abstract":"<p><strong>Background: </strong>Foreign body incidents are common pediatric emergencies, but evidence on factors associated with first recurrence is limited. This study aims to identify risk factors for first recurrence using large single-center data.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 48 197 children at a tertiary hospital (2020-2025). Kaplan-Meier analysis and multivariate Cox regression were performed. Schoenfeld residuals assessed the PH assumption; piecewise Cox models served as sensitivity analyses for age group and anatomical location, which violated it.</p><p><strong>Results: </strong>In a large single-center retrospective cohort of 48 197 children (median follow-up 1096 days), 3469 (7.2%) experienced a first recurrence. Adjusted recurrence hazards were higher for children aged 3 to <7 years (hazard ratio (HR)=1.19, 95% confidence interval (CI) 1.08 to 1.31), 1 to <3 years (HR=1.51, 95% CI 1.37 to 1.66) and <1 year (HR=1.30, 95% CI 1.10 to 1.55) than for children aged ≥7 years. Compared with the location of respiratory tract incidents, hazards were higher for the urogenital tract (HR=5.13, 95% CI 4.29 to 6.14) and soft-tissue incidents (HR=1.39, 95% CI 1.20 to 1.61), but lower for the digestive tract (HR=0.86, 95% CI 0.79 to 0.94) and nasal incidents (HR=0.85, 95% CI 0.77 to 0.95). Piecewise Cox regression in follow-up-window analyses showed that associations with age and anatomical location varied over time.</p><p><strong>Conclusions: </strong>Recurrence risk after a first foreign-body event in children varies during follow-up. These findings may help clinicians identify children, particularly younger children and those with urogenital foreign-body events, who could benefit from targeted caregiver counseling and early follow-up. Risk-stratified prevention strategies could account for the time-varying nature of risk recurrence.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 5","pages":"e001241"},"PeriodicalIF":2.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral and maxillofacial malignancies in children and adolescents: a 17-year single-center retrospective study.","authors":"Ling Bi, Huiyong Zhu, Dong Wei","doi":"10.1136/wjps-2026-001242","DOIUrl":"https://doi.org/10.1136/wjps-2026-001242","url":null,"abstract":"<p><strong>Objective: </strong>The primary purpose of this study was to delineate the clinical and pathological characteristics of oral and maxillofacial malignancies in children and adolescents.</p><p><strong>Methods: </strong>This retrospective study included patients who were hospitalized and treated between January 2009 and December 2025. Sex, age at presentation, tumor site, histopathological diagnosis, and treatment data were collected. Descriptive statistics and cluster analyses of clinical and pathological characteristics were conducted using R software.</p><p><strong>Results: </strong>Totally, 52 patients were included in this study; 31 were male, and 21 were female. The median age at presentation was 12.9 years (range 1.8 to 17.7 years). The most common site was the salivary glands (<i>n</i>=27), and the most common pathological type was mucoepidermoid carcinoma (<i>n</i>=16). Among the 52 patients recruited, 47 underwent surgical treatment. The most common treatment was surgery alone (<i>n</i>=36), and the rates of tumor resection alone, neck lymph node dissection, and bone resection/reconstruction differed significantly by pathological type (<i>p</i><0.001, <i>p</i>=0.018, and <i>p</i>=0.004, respectively). Exploratory cluster analysis suggested potential associations between age at presentation and pathological type, though these findings require independent validation.</p><p><strong>Conclusion: </strong>For oral and maxillofacial malignancies in children and adolescents, individualized treatment based on pathological type, delivered via a multidisciplinary team (MDT) framework, is essential to achieve tumor eradication while preserving normal growth and developmental capacity.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 5","pages":"e001242"},"PeriodicalIF":2.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathogenesis of necrotizing enterocolitis: mechanisms and mediators.","authors":"Makenna Laffey, Jonathan Guevara, Lena Bode, Raina Parikh, David J Hackam","doi":"10.1136/wjps-2026-001216","DOIUrl":"https://doi.org/10.1136/wjps-2026-001216","url":null,"abstract":"<p><p>Necrotizing enterocolitis (NEC) is the most common gastrointestinal disease of preterm neonatal infants. The hallmarks of the disease include severe intestinal necrosis and systemic inflammation leading to overwhelming sepsis. There remains significant morbidity and mortality attributed to NEC, raising the urgency to investigate potential causative mechanisms in order to treat and potentially prevent the disease. This review will summarize the established and emerging mechanisms leading to NEC, including toll-like receptor 4 activation by gram-negative bacteria, microbial dysbiosis, a maladapted immune response, impairment in the enteric nervous system and mitochondrial damage. Overriding each of these factors are potential genetic and epigenetic modulators, which may drive each of the above processes. Importantly, results of experiments from a variety of laboratories have suggested that an understanding of processes may lead to the development of novel preventative or treatment modalities, including small molecules and stem cells that can interfere with the deleterious pathways. By summarizing the latest mechanistic and therapeutic advances, this review hopes to provide insights into the ultimate goal of improving outcomes for patients with this devastating disease.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 5","pages":"e001216"},"PeriodicalIF":2.1,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative outcomes following institutional antibiotic protocol changes in complicated pediatric appendicitis.","authors":"Jhon Camacho-Cruz, Pablo Vásquez-Hoyos, María Luisa Beltran-Echeverry, William Bachiller-Tuta, Nestor Julian Tinoco Guzman, Alejandra Perdomo-Menjura, Laura Hoyos-Gómez, Daniela Mendoza-Castillo, Daniela Ferro-Martinez","doi":"10.1136/wjps-2026-001178","DOIUrl":"https://doi.org/10.1136/wjps-2026-001178","url":null,"abstract":"<p><strong>Introduction: </strong>Complicated pediatric appendicitis carries substantial morbidity, including intra-abdominal abscess formation, surgical reintervention, and prolonged hospitalization. Empirical antibiotic therapy is a core component of management, yet when compared with disease severity its relative contribution to outcomes is poorly characterized in institutional practice settings.</p><p><strong>Methods: </strong>This retrospective before-after observational study was conducted at a tertiary hospital in Bogotá, Colombia. Pediatric patients with complicated appendicitis were compared across two sequential first-line empirical antibiotic protocol periods: amikacin plus metronidazole (period 1) changed to ampicillin-sulbactam (period 2). A multivariable logistic regression model was used to identify factors associated with intra-abdominal abscess formation.</p><p><strong>Results: </strong>A total of 220 patients were included (period 1, <i>n</i>=117; period 2, <i>n</i>=103). Despite differences in disease severity between periods, management during period 2 was not associated with intra-abdominal abscess formation (OR=0.72; 95% CI 0.34 to 1.51; <i>p</i>=0.384) or with individual secondary outcomes. Generalized peritonitis was the dominant predictor of abscess formation (OR=3.13; 95% CI 1.48 to 6.62; <i>p</i>=0.003).</p><p><strong>Conclusions: </strong>No differences in postoperative outcomes were observed between institutional antibiotic protocol periods. Disease severity, particularly generalized peritonitis, was the main factor associated with intra-abdominal abscess formation. These findings support prioritizing early severity assessment and source control over modifications in empirical antibiotic selection.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 5","pages":"e001178"},"PeriodicalIF":2.1,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and perinatal risk factors for necrotizing enterocolitis.","authors":"Jonathan Tokonjay Davies, Yumiko Gely, Venkata Yeramilli, Colin Martin","doi":"10.1136/wjps-2026-001205","DOIUrl":"10.1136/wjps-2026-001205","url":null,"abstract":"<p><p>Necrotizing enterocolitis (NEC) remains among the most devastating complications of prematurity, carrying significant mortality and lifelong morbidity despite decades of mechanistic and translational research. Although NEC is classically framed as an inflammatory disease of intestinal immaturity, driven by microbial dysbiosis and exaggerated immune signaling, this model does not fully explain the uneven distribution of disease burden across infants, hospitals and communities. In this review, we reframe NEC within a broader maternal-perinatal systems context grounded in the Developmental Origins of Health and Disease (DOHaD) framework. This review synthesizes evidence linking maternal psychosocial stress to activation of the hypothalamic-pituitary-adrenal axis. This alters placental signaling and disrupts fetal gut development and microbiome establishment. This is further compounded by paternal stress-related epigenetic mechanisms, suboptimal maternal nutrition, poor metabolic health and environmental pollutants that disproportionately affect socioeconomically disadvantaged neighborhoods. These prenatal influences intersect with postnatal modifiers within neonatal intensive care units and health systems. Social and structural determinants of health further affect prenatal exposures and the delivery of neonatal care. This framework does not replace traditional pathogenesis models of NEC but rather contextualizes them within broader developmental and health systems. This perspective may help identify earlier targets for prevention while supporting more equitable and multidisciplinary approaches to reducing the burden of NEC.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 5","pages":"e001205"},"PeriodicalIF":2.1,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Digital impressions' for use in pediatric patients with cleft lip and palate.","authors":"Salvador Reyes-Fernández, Daniel Sandoval-Guevara, Alicia García-Verónica, Natalia Hernández-Treviño, Aldahir Gaona-Bracamontes, Rafael Luna-Aguilar, Norma Samanta Romero-Castro","doi":"10.1136/wjps-2026-001207","DOIUrl":"10.1136/wjps-2026-001207","url":null,"abstract":"","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 5","pages":"e001207"},"PeriodicalIF":2.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing of diagnosis and factors associated with delayed detection of structural birth defects in children: a multicenter cross-sectional study from Addis Ababa, Ethiopia.","authors":"Hana Abebe Gebreselassie","doi":"10.1136/wjps-2026-001186","DOIUrl":"https://doi.org/10.1136/wjps-2026-001186","url":null,"abstract":"<p><strong>Background: </strong>Congenital birth defects contribute substantially to child mortality in the Global South. From the caregiver perspective, we aim to describe the timing of diagnosis of children with structural birth defects, where diagnosis is delayed, and the underlying reasons.</p><p><strong>Methods: </strong>A cross-sectional study of children with structural birth defects at three public hospitals in Addis Ababa was conducted using caregiver interviews and clinical chart review. Data were analyzed using SPSS V.26. Binary and multivariable logistic regression was used to identify factors related to the delayed diagnosis.</p><p><strong>Results: </strong>Totally, 423 children with structural birth defects were enrolled; 358 (84.6%) were male. Median age at the time of data collection was 2.12 years (interquartile range (IQR), 0.8-5.0 years). Among 441 diagosed defects, the three most frequent structural birth defects were hypospadias (133, 30.2%), undescended testes (95, 21.5%), and anorectal malformation (38, 8.6%). Among 77 children with prenatally detectable defects, 32 were diagnosed antenatally. A total of 411 (97.2%) of the mothers had antenatal follow-up. Among 362 facility-born children with externally visible or clinically detectable defects, 104 (28.7%) were diagnosed before discharge. Overall, the diagnosis of a structural birth defect was delayed in 274 (64.8%) children. The main reasons for this delay were lack of awareness, delayed referral, and false reassurance by a health professional. Being delivered at a health center (<i>p</i><0.001, adjusted odds ratio (<i>aOR</i>)=2.17) was associated with a delayed diagnosis.</p><p><strong>Conclusion: </strong>There is a significant delay in diagnosing structural birth defects during both the antenatal and postnatal periods. These missed opportunities can be addressed through comprehensive screening programs, capacity-building sessions for healthcare workers, and raising public awareness.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 4","pages":"e001186"},"PeriodicalIF":2.1,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric physeal fractures and growth disturbance: current concepts and surgical approaches.","authors":"Mary Lou, Ashley Knebel, Jacob Eberson, Craig Eberson","doi":"10.1136/wjps-2026-001187","DOIUrl":"10.1136/wjps-2026-001187","url":null,"abstract":"<p><p>Physeal fractures account for a significant percentage of pediatric fractures and carry a unique risk of resultant limb deformity due to their potential to disrupt normal bone growth. While most of these fractures heal without consequence, up to 10% result in growth disturbances that can cause limb length discrepancy or angular deformity. Surgical strategies for managing these deformities include physeal bar excision, epiphysiodesis, and corrective osteotomies. These interventions aim to restore limb alignment and preserve function. In this review, we provide an overview of the growth plate physiology, classification systems for physeal fractures, and the spectrum of complications that may arise following growth plate injury. We also present an overview of surgical strategies and demonstrate their applications through several case examples.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"9 4","pages":"e001187"},"PeriodicalIF":2.1,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13436197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}