World neurosurgery最新文献

{"title":"Stereotactic Radiosurgery for Choriocarcinoma Brain Metastases: Illustrative Case Presentation and Systematic Review.","authors":"Amirhossein Akhavan-Sigari, Yusuke S Hori, Paul M Harary, Amit R L Persad, Rodas Kassu, Armine Tayag, Louisa Ustrzynski, Sara C Emrich, David J Park, Steven D Chang","doi":"10.1016/j.wneu.2024.10.116","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.116","url":null,"abstract":"<p><strong>Background: </strong>Choriocarcinoma (CC) is a rare and aggressive form of germ cell tumor. There is limited evidence reporting outcomes in patients with primary CC and brain metastases (BM). To date, only a few single case reports have documented the use of SRS for CC BM.</p><p><strong>Methods: </strong>We retrospectively assessed patients who were treated with SRS for pure CC BM from 1998-2024. Lesion follow-up sizes and local tumor control status were evaluated after SRS treatment using RECIST criteria. A comprehensive literature search was performed for CC BM in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</p><p><strong>Results: </strong>In our series, 3 patients with 7 CC BM underwent SRS. Two were male with testicular CC and one was female with gestational CC. The median diameter of the lesions was 8 mm with a median volume of 0.14 cm³ at treatment. The MRIs at 3 and 6 months demonstrated reductions in median diameters to 6 mm and 4 mm, respectively. At the last follow-up visits, one lesion had local progression at 15 months after SRS and one lesion had sustained complete response. Our systematic review yielded 249 articles. After screening, a total of 18 reports were identified for CC BM. Among these, only three single cases documented the use of SRS for CC BM.</p><p><strong>Conclusion: </strong>SRS is a feasible and viable approach for CC BM, particularly in cases where immediate surgical management is not necessary. This is yet the largest report evaluating the outcome of CC BM treated with SRS.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569738","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":"Clinical Outcomes at Two-Year Follow-Up Comparing Open Surgery and Percutaneous Laser Disc Decompression for Radicular Sciatic Pain Patients.","authors":"Amir Saied Seddighi, Afsoun Seddighi, Seyedmorteza Hosseini","doi":"10.1016/j.wneu.2024.10.121","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.121","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569677","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":"Advancements of Endoscopic Surgery for Spontaneous Intracerebral Hemorrhage.","authors":"Haiyang Ma, Weicheng Peng, Sheng Xu, Xin Liang, Rui Zhao, Meng Lv, Feng Guan, Guangtong Zhu, Beibei Mao, Zhiqiang Hu","doi":"10.1016/j.wneu.2024.10.107","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.107","url":null,"abstract":"<p><strong>Objectives: </strong>Spontaneous intracerebral hemorrhage (sICH) is a severe cerebrovascular disease with high mortality and disability. And its treatment strategies have always been a hotspot in clinical research. Endoscopic surgery (ES) is widely used for treating sICH. A comprehensive review of ES for sICH is warranted to provide better understanding and guidance for clinicians. We provide an updated overview of the surgical equipment, surgical indications and timing, and technical advancements, as well as therapeutic effect and future directions.</p><p><strong>Materials and methods: </strong>A narrative review of current literature in ES for sICH was performed based on publications from the databases of PubMed, Scopus and Google Scholar databases up to December, 2023.</p><p><strong>Results: </strong>ES has shown promising safety and efficacy, emerging as a favorable minimally invasive alternative to conventional craniotomy. It reduces peri-operative risks associated with long procedures and significant intra-operative bleeding. Recent advancements in ES techniques have led to superior outcomes in mortality reduction and functional recovery. Scholars' systematic studies and summaries underscore ES's role in improving long-term outcomes for sICH patients. However, its limitations, including reduced depth perception, difficulty in managing deep hematomas, and reduced ability to control rapid bleeding control, should be noted.</p><p><strong>Conclusions: </strong>ES represents a significant advancement in the treatment of sICH. Its minimally invasive features, coupled with continuous methodological refinement, contribute to lower mortality rate and better functional recovery compared to traditional methods. ES should be considered a significant option in the surgical management of sICH, necessitating further research and standardization to enhance patient care and outcomes.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569671","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":"Surgical management and prognostic factors for Endolymphatic Sac Tumor: a single-institute experience with a systematic review.","authors":"Jiancong Weng, Xiaotian Wen, Da Li, Honghong Li, Huan Li","doi":"10.1016/j.wneu.2024.10.113","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.113","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical features, surgical outcomes, and predictors of progression-free survival (PFS) in patients with Endolymphatic Sac Tumors (ELSTs).</p><p><strong>Methods: </strong>This retrospective study analyzed 15 cases from Beijing Tiantan Hospital and 237 from literature (1988-2023), focusing on patients with pathologically confirmed intracranial or skull ELSTs who had comprehensive treatment and follow-up records. Univariate and multivariate Cox regression analyses were employed to identify factors influencing PFS.</p><p><strong>Results: </strong>Cases from our institute comprised 10 males and 5 females with an average age of 39.1 years. Among these, 86.7% underwent gross total resection (GTR). During the follow-up period, two patients (13.3%) were lost to follow-up. After a mean follow-up of 74.9 months, one patient experienced recurrence and another died from unrelated causes. A review of literature identified 237 additional patients, including 134 females (56.5%), with an average age of 39.8 years; 22.8% of these patients had von Hippel-Lindau disease. The GTR rate was 69.2%. After a mean follow up of 53.2 months, 33 recurrences occurred, and the median PFS was 48 months. Additionally, eight patients died during the follow-up period, none of the deaths were attributed to ELSTs. Multivariate analysis identified GTR (HR 0.279, 95% CI 0.086-0.903, p = 0.033) as a significant protective factor against recurrence among the pooled cases.</p><p><strong>Conclusions: </strong>GTR is crucial for improving PFS in ELST patients, emphasizing the need for advanced surgical techniques and long-term follow-up due to potential recurrences.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569740","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":"Decompression without fusion in low-grade degenerative spondylolisthesis and stenosis patients: long-term patient-reported outcome.","authors":"Judith M P van Grafhorst, Wilco C Peul, Carmen L A Vleggeert-Lankamp","doi":"10.1016/j.wneu.2024.10.123","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.123","url":null,"abstract":"<p><strong>Background: </strong>One-third of patients suffering from neurogenic claudication due to lumbar spinal stenosis have low-grade degenerative spondylolisthesis. Decompression in these patients is considered a risk factor for instability, and it remains unclear whether instrumented fusion should be added. This study aims to assess the long-term clinical outcomes of decompressive surgery without instrumented fusion in symptomatic spinal stenosis patients regardless of low-grade degenerative spondylolisthesis.</p><p><strong>Methods: </strong>In this retrospective cohort study, lumbar spinal stenosis patients with or without spondylolisthesis undergoing decompressive surgery were studied, 9 years postoperatively. Pain, functionality, and satisfaction questionnaires were sent to 250 spondylolisthesis and 200 randomly selected stenosis patients. Demographic characteristics, surgical technique, reoperation indication and incidence, and patient-reported outcome measures were assessed.</p><p><strong>Results: </strong>At long-term follow-up, the mean Oswestry Disability Index was 23.6 ±20.15 in the spondylolisthesis group and 23.4 ±20.9 (p=0.957) in the stenosis group. The EuroQol-5D was 0.74±0.28 and 0.75 ±0.24 (p=0.793) respectively. The Zurich Claudication Questionnaire score was 48.2% ±18.8 and 49.6% ±18.5 (p=0.646) respectively. After nine years of follow-up, comparable satisfaction rates are reported (69% of spondylolisthesis patients and 68% of stenosis patients (p=0.855). Reoperation rates were comparable in the spondylolisthesis and stenosis group (7 versus 6%).</p><p><strong>Conclusion: </strong>This cohort study demonstrated comparable satisfaction and clinical outcomes after decompressive surgery for symptomatic spinal stenosis in patients with and without grade 1 degenerative spondylolisthesis. Decompressive surgery can, therefore, be considered an effective treatment for symptomatic lumbar spinal stenosis, even if it is accompanied by degenerative spondylolisthesis. Therefore, routinely adding instrumented spondylodesis is not deemed necessary.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569680","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":"Mesenchymal-Type Genetic Mutations Are Likely Prerequisite for Glioblastoma Multiforme to Metastasize Outside the Central Nervous System: An Original Case Series and Systematic Review of the Literature.","authors":"Bryce J Laurin, Randall Treffy, Jennifer M Connelly, Michael Straza, Wade M Mueller, Max O Krucoff","doi":"10.1016/j.wneu.2024.09.138","DOIUrl":"10.1016/j.wneu.2024.09.138","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma multiforme (GBM) is the most aggressive and prevalent type of malignant brain tumor, yet it metastasizes outside the central nervous system (CNS) in only 0.4% of cases. Little is known about what enables this subset of GBMs to take root outside the CNS, but genetic mutations likely play a role.</p><p><strong>Methods: </strong>We conducted a PRISMA-compliant systematic review of metastatic GBM wherein we reviewed 3579 search results and 1080 abstracts, analyzing data from 139 studies and 211 unique patients. In addition, we describe 4 cases of patients with pathologically confirmed GBM metastases outside the CNS treated at our institution.</p><p><strong>Results: </strong>We found that metastases were discovered near previous surgical sites in at least 36.9% of cases. Other sites of metastasis included bone (47.9%), lung (25.6%), lymph nodes (25.1%), scalp (19.2%), and liver (14.2%). On average, metastases were diagnosed 12.1 months after the most recent resection, and the mean survival from discovery was 5.7 months. In our patients, primary GBM lesions showed mutations in NF1, TERT, TP53, CDK4, and RB1/PTEN genes. Unique to the metastatic lesions were amplifications in genes such as p53 and PDGFRA/KIT, as well as increased vimentin and Ki-67 expression.</p><p><strong>Conclusions: </strong>There is strong evidence that GBMs acquire novel mutations to survive outside the CNS. In some cases, tumor cells likely mutate after seeding scalp tissue during surgery, and in others, they mutate and spread without surgery. Future studies and genetic profiling of primary and metastatic lesions may help uncover the mechanisms of spread.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476191","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":"Nonopacification of Frontal and Parietal Branches After Middle Meningeal Artery Embolization: A Radiographic Benchmark.","authors":"Li Ma, Samer S Hoz, Mohamed F Doheim, Ali Fadhill, Abdullah Sultany, Alhamza R Al-Bayati, Raul G Nogueira, Michael J Lang, Bradley A Gross","doi":"10.1016/j.wneu.2024.10.013","DOIUrl":"10.1016/j.wneu.2024.10.013","url":null,"abstract":"<p><strong>Background: </strong>Middle meningeal artery embolization (MMAE) has revolutionized the armamentarium for chronic subdural hematoma (CSDH) treatment. Technical and angiographic benchmarks to guide procedural and clinical success are less well established.</p><p><strong>Methods: </strong>A single-center database was reviewed to compare outcomes after standalone MMAE with and without resultant residual angiographic opacification of frontal and parietal (F/P) branches. Primary outcome was surgical rescue for CSDH progression. Secondary outcomes included the efficiency and accumulated efficacy of hematoma resolution. Effect sizes were adjusted via multivariable regression.</p><p><strong>Results: </strong>Of 147 standalone MMAE for CSDH, the overall rate of surgical rescue was 6.8%. Nonopacification of F/P branches via proximal middle meningeal artery or meningo-ophthalmic anastomosis was achieved after 83% of procedures and was associated with a 7-fold decreased rate of surgical rescue (3.3% vs. 24%, P = 0.001). At 90-day follow-up, a higher rate of hematoma resolution ≥50% was achieved if no residual opacification was identified (82% vs. 56%, P = 0.03). The median time to 50% hematoma resolution was 44 days for the no-residual group versus 71 days for the residual group (P < 0.001). The unfavorable effects of residual opacification of F/P branches were verified in a multivariate analysis: a higher risk of surgical rescue (adjusted odds ratio 24.6; P = 0.001) and poor hematoma resolution were both confirmed (adjusted hazard ratio 0.3; P = 0.001).</p><p><strong>Conclusions: </strong>MMAE with nonopacification of F/P branches was associated with augmented efficacy. Nuanced MMAE adequately tackling culprit dural feeders should be considered for more effective procedures.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476194","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":"Incidence of Congenital Posterior Arch Defects of the Atlas in Chinese Population.","authors":"Yuan-Yuan Xie, Xi-Hong Xing, Lsaac Kumi Adu, Hua Zou","doi":"10.1016/j.wneu.2024.10.026","DOIUrl":"10.1016/j.wneu.2024.10.026","url":null,"abstract":"<p><strong>Objective: </strong>To study the incidence of congenital posterior arch defects of the atlas and in combination with other congenital variations in the Chinese population.</p><p><strong>Methods: </strong>We retrospectively reviewed 1405 images of cervical 3-dimensional computed tomography (3D CT) and 1284 images of head and cervical 3-dimensional computed tomography angiography (3D CTA), including images of 1539 male and 1150 female individuals. These images of cervical 3D CT and head and cervical 3D CTA were obtained in the Department of Radiology of 2 hospitals, Second and Third People's Hospital of Jingzhou, China, from January 2020 to October 2023. Congenital posterior arch defects of the atlas were classified according to the criteria of Currarino and colleagues. Congenital posterior arch defects of the atlas combined with other congenital variations including occipitalization of the atlas, the ponticulus posticus variation of the vertebral artery groove of the atlas, cervical fusion, and the transversal foramen of the atlas variant were also observed.</p><p><strong>Results: </strong>A total of 2689 patients were included in this study. The overall prevalence of congenital posterior arch defects of the atlas was 0.74% (20 of 2689). There was no statistically significant difference in incidence between male (0.78%, 12 of 1539) and female patients (0.70%, 8 of 1150) (P > 0.05). Among all posterior defects, type A and B defects were found in 0.6% (16 of 2689) and 0.15% (4 of 2689) cases, respectively. There were no type C, D, and E defects and no anterior arch defects. However, in 20 cases of congenital posterior arch defects of atlas, 40% (8 of 20) combined with other congenital variations including occipitalization of atlas in 4 type A cases, bilateral complete ponticulus posticus variation of atlas vertebral groove in 1 type A case, C2-C3 fusion in 1 type A case, coexistence of unilateral complete ponticulus posticus variation of the vertebral artery groove of the atlas and unilateral unclosed transverse foramen in 1 type B case, and coexistence of unilateral unclosed transverse foramen in 1 type A case.</p><p><strong>Conclusions: </strong>The incidence of congenital posterior arch defects of the atlas was low in a Chinese population. There was no difference between male and female individuals. Types A and B were the 2 major defects in this Chinese population, and the prevalence of type A and B combined with other congenital cervical variations were higher than those of types C, D, and E.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476190","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":"History of Cervical Spine Localization: Surface Landmarks.","authors":"Mark D Johnson, William Schwieterman, Matthew Bugada, Rebecca M Garner, John Na, Charles J Prestigiacomo","doi":"10.1016/j.wneu.2024.10.119","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.119","url":null,"abstract":"<p><p>Interest in the relational anatomy of the anterior neck among spine surgeons grew following the popularization of the anterior cervical discectomy and fusion (ACDF) in the 1950's. Five surface landmarks and their relationship to specific spinal levels have been routinely described including; the angle of the mandible for the C2-C3 interspace, the hyoid bone for the C3 body, the thyroid cartilage for the C4-C5 disc, and the cricoid cartilage and carotid tubercle for the C6 body. We aimed to investigate the origins of these anatomic relationships and their application in modern practice.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569724","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":"Clinical Implications of Surgical Resection without Spinal Fixation in Lumbar Dumbbell Tumors: Evaluating Postoperative Lumbar Alignment and Patient Outcomes.","authors":"Toshiki Okubo, Narihito Nagoshi, Takahito Iga, Kazuki Takeda, Masahiro Ozaki, Satoshi Suzuki, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.1016/j.wneu.2024.10.018","DOIUrl":"10.1016/j.wneu.2024.10.018","url":null,"abstract":"<p><strong>Objective: </strong>This study examined radiographic changes in local and global spinal alignments and clinical outcomes following tumor resection without spinal fixation in patients with lumbar dumbbell tumors (LDTs).</p><p><strong>Methods: </strong>We included 28 patients with LDTs who were followed for at least 2 years after surgery. We analyzed variations in the outcome variables by measuring individual coronal and sagittal parameters from radiographs. Clinical outcomes were assessed using the modified McCormick scale, the Japanese Orthopedic Association score, and the visual analog scale. To evaluate the impact of tumor location on these outcomes, we categorized the patients into 3 groups based on tumor location: upper (T12-L1), middle (L2-3), or lower (L4-S1) group.</p><p><strong>Results: </strong>The local and global spinal parameters (including Cobb angle, cervical lordosis, T1 slope, thoracic kyphosis, thoracolumbar kyphosis, lumbar lordosis [global, upper, middle, lower], sacral slope, pelvic incidence, and pelvic tilt) did not show significant changes after surgery. Preoperatively, all patients experienced gait disturbances, but at the final follow-up, nearly all of them (27 cases, 96.4%) could walk without support. The Japanese Orthopedic Association score and visual analog scale demonstrated significant postoperative improvements. There were no statistically significant group differences in postoperative coronal and sagittal profiles or clinical outcomes among the upper, middle, and lower groups.</p><p><strong>Conclusions: </strong>Tumor resection without spinal fixation had no substantial impact on local and global spinal alignments and led to satisfactory clinical outcomes, suggesting that spinal fixation may not always be necessary when resecting LDTs.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476178","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}