World Journal of Surgery最新文献

{"title":"Letter to the Editor: LigaSure Versus Conventional Milligan MORGAN Hemorrhoidectomy in Nigerian Patients With Symptomatic Hemorrhoids.","authors":"Shahzeb Ali, Magdalena O'Connor Manson, Giordano Perin","doi":"10.1002/wjs.12572","DOIUrl":"https://doi.org/10.1002/wjs.12572","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812527","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":"Hand Grip Strength and Body Composition According to the Sarcopenic Obesity Guidelines: Impact on Postoperative Complications in Patients With Gastric Cancer.","authors":"Yoko Saino, Ryota Matsui, Koshi Kumagai, Satoshi Ida, Hiromi Matsuo, Aya Fujihara, Misuzu Ishii, Naoki Moriya, Kazuhiro Nomura, Rie Tsutsumi, Hiroshi Sakaue, Souya Nunobe","doi":"10.1002/wjs.12581","DOIUrl":"https://doi.org/10.1002/wjs.12581","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis of sarcopenic obesity (SO) in patients with gastric cancer has been inconsistent among studies examining postoperative complications because diagnostic methods have not been standardized. This study aimed to clarify the differences in the prevalence of obesity with and without low hand grip strength (HGS) according to the diagnostic criteria proposed using the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) and identify the optimal model for predicting postoperative complications.</p><p><strong>Methods: </strong>Patients who underwent radical gastrectomy for gastric cancer between April 2015 and March 2023 were included. According to the ESPEN/EASO diagnostic criteria, patients with a body mass index ≥ 25 kg/m² who met the screening criteria were assessed for percent body fat (PBF) and skeletal muscle mass (SMM) adjusted by weight (SMM/W) and HGS. Depending on the respective cutoff values, six models of low SMM-obesity without HGS and six models of low HGS-obesity with HGS were set. The incidence of postoperative complication with the Clavien-Dindo classification grade 2 or higher was compared across models. Multivariate logistic regression analysis was performed to determine the risk model for postoperative complications, with significance set at p < 0.05.</p><p><strong>Results: </strong>The analysis included 1762 patients with a median age of 67.0 years; 1123 were men (63.7%). The prevalence of low SMM-obesity was significantly higher (5.4%-17.3%) than that of low HGS-obesity (1.2%-2.3%). Among those with low SMM-obesity, PBF > 20.2% for men and > 31.7% for women as well as SMM/W ≤ 42.9% for men and ≤ 35.6% for women had the highest postoperative complication incidence number of cases. This model was an independent risk factor for postoperative complications in the multivariate analysis (odds ratio: 1.671, 95% confidence interval: 1.204-2.299, and p = 0.002).</p><p><strong>Conclusions: </strong>In obese patients with gastric cancer, the preoperative prevalence of low HGS-obesity or low SMM-obesity differed significantly. One of the low SMM-obesity model was associated with postoperative complication after gastrectomy.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804326","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":"Multimodal Prehabilitation for Colorectal Cancer Patients: Study Protocol of a Nationwide Multicentre Study With Uniform Prehabilitation Protocols.","authors":"C R Sabajo, J P Dieleman, J W T Dekker, B van den Heuvel, J M Klaase, G D Slooter","doi":"10.1002/wjs.12565","DOIUrl":"https://doi.org/10.1002/wjs.12565","url":null,"abstract":"<p><strong>Background: </strong>The aim of prehabilitation is to optimize patient specific modifiable risk factors before major surgery, in order to enhance the individual resilience. Due to the lack of universal guidelines, prehabilitation has been conducted in various ways, making it difficult to estimate its effect. In the Netherlands, proposed uniform prehabilitation protocols were developed. The aim of this study is to analyse clinical outcomes of prehabilitation when implemented as standard of care according to the proposed uniform protocols.</p><p><strong>Methods: </strong>Uniform prehabilitation protocols were created based on the multimodal program of the PREHAB randomized controlled trial. All hospitals in the Netherlands that implemented prehabilitation according to the proposed protocols, for patients undergoing elective colorectal surgery, will be asked to participate. This study will recruit 535 patients who underwent prehabilitation and 535 one-to-one nearest neighbour propensity score matched patients who did not undergo prehabilitation (historical cohort). Clinical outcomes will be compared between the prehabilitation group and the historical cohort group using regression analyses. The primary outcome of interest is 90-day presence of postoperative complications. In addition, length of hospital stay and readmissions will be analysed.</p><p><strong>Discussion: </strong>Prehabilitation has been proven to reduce the risk of complications and hospital length of stay. Prehabilitation has however been defined in various ways, since there is no standardized program. This multicentre cohort study will estimate the clinical effect of prehabilitation implemented as standard of care according to proposed uniform protocols. Furthermore, the presented protocols can be used by other hospitals to set up a prehabilitation program.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773697","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":"On the Shoulders of Giants: The Specialist Surgeon Workforce in East, Central and Southern Africa.","authors":"Dominique Vervoort","doi":"10.1002/wjs.12544","DOIUrl":"10.1002/wjs.12544","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"955-956"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574015","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":"Barriers and Motivators for Women in Surgical Training: A Qualitative Study From Malaysia.","authors":"April Camilla Roslani, Anthonia Ginika Uzoigwe, Retnagowri Rajandram, Wah Yun Low","doi":"10.1002/wjs.12516","DOIUrl":"10.1002/wjs.12516","url":null,"abstract":"<p><strong>Background: </strong>Women are significantly underrepresented in surgical specialties, particularly in Southeast Asia. The factors influencing this gender disparity remain poorly understood. This study aims to explore the motivations, challenges, and barriers faced by female medical doctors in pursuing surgical careers in Malaysia.</p><p><strong>Methods: </strong>An exploratory qualitative study was conducted between May 2016 and November 2017, using semi-structured in-depth interviews (IDIs) and focus group discussions (FGDs) with male and female senior surgeons, medical officers, and surgical trainees. A coding tree was constructed and refined after initial rounds of data analysis. Thematic content analysis was performed using the NVivo 11 Pro (Windows) qualitative data analysis software.</p><p><strong>Results: </strong>Ten IDIs and five FGDs (N = 34 participants) revealed three key themes: (A) influences on trainees' career choices, (B) challenges encountered during surgical training, and (C) trainee empowerment. Participants highlighted the demanding nature of surgical training, the lack of flexibility in work schedules, and the male-dominated work environment as significant barriers for women. Despite these challenges, supportive family structures and strong mentorship were found to be critical for the retention of women in surgery.</p><p><strong>Conclusion: </strong>Institutional support, mentorship opportunities, and culture change are essential for improving the representation and retention of female surgeons in Malaysia. Tailored policies that acknowledge the unique challenges faced by women in surgery could foster a more inclusive and supportive environment.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"940-945"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504641","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 Matched Comparison of Patient Outcomes in Emergency General Surgery Conditions: Understanding Variability in Operative and Nonoperative Cases.","authors":"Komal Abdul Rahim, Saad Bin Zafar Mahmood, Kinzah Razzak Ghazi, Aiman Arif, Kantesh Kumar, Saqib Kamran Bakhshi, Mushayda Ali, Zainab Samad, Adil Haider","doi":"10.1002/wjs.12539","DOIUrl":"10.1002/wjs.12539","url":null,"abstract":"<p><strong>Background: </strong>Emergency general surgery (EGS) is a subset of acute care surgery that can be managed surgically and conservatively. Various factors influence decisions regarding operative or nonoperative management. Our study aimed to identify EGS patients who underwent surgical intervention and compare their outcomes to those who underwent nonoperative management.</p><p><strong>Methods: </strong>Data from patients aged ≥ 18 years with primary index admission and EGS conditions defined by the American Association for the Surgery of Trauma from Pakistan's first Joint Commission International Accredited Center were analyzed from 2010 to 2019. The primary exposure was surgical intervention. Differences in inpatient mortality, complications, and length of stay (LOS) were compared using logistic and generalized-linear models after coarsened exact matching.</p><p><strong>Results: </strong>Records from 32,280 primary index admissions showed a higher number of younger patients (mean 47.83 vs. 52.40 years) and no preexisting conditions (60.22% vs. 42.30%) in the operated group compared to the nonoperated group. There were relatively higher uninsured individuals in the nonoperated group compared to the operated group (84.36% vs. 74.22%), respectively. Risk-adjusted differences in outcomes showed higher odds of complication (AOR 1.34 and 95% CI 1.20 and 1.48) and prolonged LOS (β 0.78 and 95% CI 0.65 and 0.91) in operated patients. The risk-adjusted observed/expected rates showed lower inpatient mortality rates in operated patients across all EGS diagnoses.</p><p><strong>Conclusion: </strong>The results showed that patients who underwent surgery had lower risk-adjusted mortality even though they had more complications across all EGS diagnoses, which highlights the urgent need to improve surgical access in developing countries due to higher uninsured individuals in the nonoperated group. Also, the findings stress the need for risk stratification and further studies to mitigate risks and optimize patient recovery based on patient-level factors.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"889-897"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582370","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 Novel 4-Tier Classification for Tumor Budding and the Importance of Tumor Invasive Patterns in the Prognosis of Colorectal Cancer.","authors":"Tejus V NagiReddy, Samir Gupta, Rupali Bavikar, Mangesh Londhe, Prasant Chandra, Advait A Vaidya","doi":"10.1002/wjs.12534","DOIUrl":"10.1002/wjs.12534","url":null,"abstract":"<p><strong>Background: </strong>Colorectal carcinoma (CRC) is a major global health issue, with significant morbidity and mortality. Although the TNM staging system remains the standard for prognosticating CRC, it fails to capture the full complexity of tumor behavior. Tumor budding (TB) and tumor invasive patterns (TIPs) are emerging as promising histopathological markers that may provide additional prognostic insights, particularly in predicting the nodal metastasis (N), lymphovascular invasion (LVI), and perineural invasion (PNI). This study aims to assess the correlation between TB, TIP, and CRC prognosis.</p><p><strong>Materials and methods: </strong>This ambidirectional observational study, conducted at our tertiary care center, included 60 biopsy-proven CRC patients, the majority of whom were at stages 2 and 3. Histopathological evaluation of TB and TIP were performed on Hematoxylin and Eosin (H&E) stained slides. TB and TIP categories are then compared against various histopathological parameters. Statistical analysis was performed.</p><p><strong>Results: </strong>In the 60 CRC cases studied, low TB was observed in 60% of cases, whereas high TB was seen in 5%. TIP analysis showed that 57% of cases had expansile patterns and 35% of cases had infiltrative patterns. A significant association was found between TB and N (p - 0.018) as well as TIP and PNI (p - 0.016). Multivariate analysis revealed that TB remained a strong predictor for N (OR (odds ratio) = 12.8 and p < 0.001). Although not statistically significant, distinct trends were observed between low and zero TB. Our study's findings on TB and TIP align with several historical studies, reinforcing their prognostic significance in CRC. Despite being a small cohort, our study aligns with these findings, emphasizing TB and TIP as critical prognostic markers in CRC.</p><p><strong>Conclusion: </strong>TB and TIP are valuable prognostic tools in CRC, offering insights into tumor behavior and metastasis potential. Their incorporation into routine histopathological evaluation could enhance prognostic accuracy.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"830-839"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582371","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":"Partial adrenalectomy by the posterior retroperitoneoscopic approach: A single institution series of 766 consecutive procedures.","authors":"Polina Knyazeva, Dmitrii Buzanakov, Pier Francesco Alesina, Martin K Walz","doi":"10.1002/wjs.12390","DOIUrl":"10.1002/wjs.12390","url":null,"abstract":"<p><strong>Background: </strong>Partial adrenalectomy (PA), as an alternative to total adrenalectomy in selected cases, allows for the preservation of adrenocortical function, especially in hereditary and/or bilateral diseases. In this study, we analyze our experience in posterior retroperitoneoscopic PA (PRPA) and its impact on adrenocortical function.</p><p><strong>Patients and methods: </strong>From January 2010 to December 2023, 709 PRPAs were performed on 766 adrenal glands in a total of 697 patients (421F; 276M; and mean age 49.3 ± 15.3). Patients suffered from all types of adrenal tumors (239 pheochromocytoma, 225 Conn's syndrome, 102 Cushing's syndrome (CS), 66 nonfunctioning adenomas, 38 adrenal metastases, and 27 others). Mean tumor size was 2.7 ± 1.5 cm. Bilateral disease occurred in 135 patients (60 pheochromocytoma, 19 Conn's syndrome, 32 CS, 2 nonfunctioning adenomas, 17 adrenal metastases, and 5 combined diseases).</p><p><strong>Results: </strong>Mean operating time for unilateral operation was 39.2 ± 17.2 min. Minor postoperative complications were observed in 1.5% and major complications in 0.1%. The median hospital stay was 2 days. In bilateral cases, 18 of 33 (54%) Cushing patients and nine of 102 (9%) non-Cushing patients received corticosteroid replacement therapy (CRT) early postoperatively. Long-term follow-up data were collected for 242 patients (35%). After unilateral surgery, only patients with CS required CRT (8/24). Eleven (24.4%) out of 45 patients with bilateral non-Cushing disease needed CRT. Eight patients (3%) developed ipsilateral recurrent disease.</p><p><strong>Conclusion: </strong>PRPA is a safe procedure with a low complication and recurrence rate. This makes it the preferred operation in cases of bilateral disease and for selected patients with benign pathologies.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"973-981"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629199","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":"Modified APPEND Score for the Diagnosis of Acute Appendicitis in a New Zealand Pasifika Population.","authors":"Renato Pitesa, Andrew G Hill, Andrew D MacCormick","doi":"10.1002/wjs.12510","DOIUrl":"10.1002/wjs.12510","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing acute appendicitis often requires biochemical and imaging support which may not be feasible in low- and middle-income countries (LMICs). The APPEND score, developed in New Zealand, includes C-reactive protein (CRP) which in resource-limited settings, may be hindered by slow processing times. This study aims to evaluate a modified APPEND score (mAPPEND), excluding CRP for diagnosing appendicitis in a New Zealand Pasifika cohort.</p><p><strong>Methods: </strong>This secondary analysis utilized data from two cohorts (2011 and 2017) from Middlemore Hospital, Auckland. Patients aged ≥ 15 years with right iliac fossa pain for < 7 days were included, excluding those with prior appendicectomy or generalized peritonitis. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated, and diagnostic performance was assessed using receiver operating characteristic curve analysis, comparing the area under the curve (AUC) for both scores.</p><p><strong>Results: </strong>Among 143 Pasifika patients, the AUC for the APPEND and mAPPEND scores were comparable (0.84 vs. 0.85 respectively, p = 0.41). The mAPPEND score demonstrated high diagnostic accuracy with scores between 1 and 2 showing high sensitivity (100% and 97%) and NPV (90% and 92%), scores 4-5 showing high specificity (94% and 100%, respectively) and PPV (90% and 100%, respectively), and a score of 3 being the most efficient with a sensitivity of 82% and specificity of 71%.</p><p><strong>Conclusion: </strong>The mAPPEND score maintains high diagnostic accuracy for appendicitis in a New Zealand Pasifika population. This modified score is a simple and viable tool in settings where CRP testing is unfeasible, supporting its use in Pacific Island countries.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"868-872"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450233","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":"Shouldice Versus TAPP for Inguinal Hernia Repair: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Lucas Monteiro Delgado, Bernardo Fontel Pompeu, Caio Mendonça Magalhães, Eric Pasqualotto, William Silva Barbosa, Sergio Mazzola Poli de Figueiredo","doi":"10.1002/wjs.12514","DOIUrl":"10.1002/wjs.12514","url":null,"abstract":"<p><strong>Introduction: </strong>Inguinal hernia (IH) repair is one of the most common surgical procedures worldwide. Among the various techniques available, the Shouldice (SHD) technique is mainly used for nonmesh open repair whereas, the transabdominal preperitoneal (TAPP) approach is a commonly performed minimally invasive method. Despite its widespread use, a direct comparison between the two techniques is lacking. Therefore, this study aims to evaluate the short and long-term outcomes of SHD and TAPP for elective IH repair.</p><p><strong>Methods: </strong>We searched the PubMed, Embase, and Cochrane Library on April 16. Mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals (CIs) were pooled for continuous and binary endpoints, respectively. Heterogeneity was assessed with I² statistics.</p><p><strong>Results: </strong>Thirteen RCTs comprising 2214 patients were included. Of these, 1089 patients (49%) underwent SHD repair and 1125 (51%) patients underwent TAPP repair. The mean BMI was reported in four studies ranging from 23 to 25.7 kg/m². Data regarding hernia sizes were not available. Compared with TAPP, SHD significantly reduced seroma (RR 0.20; 95% CI 0.04-0.90; p = 0.04; and I² = 0%) and increased chronic pain (RR 2.13; 95% CI 1.31-3.46; p < 0.01; and I² = 0%) and 1-day postoperative pain (MD 2.01; 95% CI 0.72-3.29; p < 0.01; and I² = 97%). However, there were no significant differences between the groups in recurrence (RR 0.94; 95% CI 0.66-1.35; p = 0.75; and I² = 12%), hematoma (RR 1.08; 95% CI 0.80-1.46; p = 0.63; and I² = 0%), urinary retention (RR 0.82; 95% CI 0.49-1.36; p = 0.43; and I² = 0%), and testicular atrophy (RR 3.28; 95% CI 0.79-13.54; p = 0.10; and I² = 0%).</p><p><strong>Conclusion: </strong>SHD repair demonstrated a lower occurrence of seromas; however, it was associated with a higher occurrence of both acute and chronic postoperative pain compared to TAPP in patients with a normal BMI. No significant differences were observed between the two techniques in terms of hernia recurrence, hematoma formation, urinary retention, or testicular atrophy rates.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"859-867"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450237","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}