World Journal of Surgery最新文献

{"title":"Prevalence and Impact of Postoperative Sexual Dysfunction After Major Emergency Abdominal Surgery: A Prospective Cohort Study.","authors":"Astrid Warmbier Jensen, Julie Blockmann, Jakob Burcharth, Dunja Kokotovic","doi":"10.1002/wjs.12555","DOIUrl":"https://doi.org/10.1002/wjs.12555","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual dysfunction is commonly reported after cancer surgery or pelvic surgery; however, the incidence following major emergency abdominal surgery remains unknown. This study aimed to investigate the incidence and sex differences in sexual dysfunction up to 90 days postoperatively after major emergency abdominal surgery.</p><p><strong>Methods: </strong>This single-center prospective cohort study included all consecutive patients undergoing major emergency abdominal surgery at Copenhagen University Hospital Herlev from March 2023 to March 2024. Follow-up was conducted at 30 and 90 days postoperatively. Sexual function was assessed using the Brief Sexual Symptom Checklist (BSSC), and patients were asked to report whether they were sexually active before and after surgery.</p><p><strong>Results: </strong>Of the 180 patients who responded at postoperative day (POD) 30, 69 patients (38.3%) reported being sexually active before surgery but only 31 patients (17.2%) remained active after surgery. At POD 90, 71 (48.3%) of 147 patients reported being sexually active before surgery, whereas 48 patients (32.7%) remained active postoperatively. A significant decrease in sexual activity was observed in both men (63.2% at POD 30 and 45.5% at POD 90) and women (45.2% at POD 30 and 21.1% at POD 90) (p < 0.001 for both time points). Out of the patients who completed the BSSC questionnaire, 32 patients (32.6%) reported dissatisfaction with their sexual function at POD 30, which slightly decreased to 22 patients (26.8%) at POD 90. No significant difference in dissatisfaction rates between men and women was found at either time point.</p><p><strong>Conclusion: </strong>Sexual dysfunction was common after major emergency abdominal surgery in both men and women, with no significant sex differences observed. These findings highlight the need for proactive discussions, information, and management of sexual health in the perioperative period to improve patient outcomes and quality of life.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639846","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":"Patients With Severe Obesity Are Made Eligible for Complex Abdominal Wall Repair After Preoptimization With GLP-1 Agonists: Results of a Bicentric Pilot Study.","authors":"Benoit Romain, Vincent Pfirsch, Simone Manfredelli, Thomas Leroi, Fadi Salman, Ouidad Sami, Diane Westerfeld-Ruillier, Séverine Ledoux, David Moszkowicz","doi":"10.1002/wjs.12547","DOIUrl":"https://doi.org/10.1002/wjs.12547","url":null,"abstract":"<p><strong>Background: </strong>Incisional hernia repairs (IHRs) are not recommended in patients with severe obesity (BMI ≥ 35 kg/m²). Weight loss is challenging, but new medications, such as glucagon-like peptide-1 receptor agonists (GLP-1 agonists), have recently attracted increased attention for their potential weight loss advantages. The aim was to analyze the preliminary results about the safety and weight loss efficiency of the use of GLP-1 agonists in the context of prehabilitation prior to complex IHR.</p><p><strong>Methods: </strong>All patients planned for IHR with a BMI ≥ 35 kg/m² and treated with preoperative GLP-1 agonists were included in the experimental group and compared with a comparable historical surgical cohort treated with a conventional tailored nutritional preoperative management. Weight loss in the experimental group and perioperative and postoperative outcomes were compared between the two groups. The success rate of GLP1 agonists was defined as a weight loss that enables the patient to fall within the recommended limits of a BMI ≤ 35 kg/m² before an IHR.</p><p><strong>Results: </strong>Fifty-two patients in the control group were compared to 24 with GLP-1 agonists. The distribution of GLP-1 agonists was as follows: semaglutide (n = 12; 50%), dulaglutide (n = 7; 29.2%), and liraglutide (n = 5; 20.8%). The mean initial BMI was 40.1 ± 3.6 kg/m² kg/m². The average percentage of weight loss was 11.3 ± 7.4% with GLP-1 agonists (maximum weight loss was observed with semaglutide 2.4 mg/wk). The success rate of GLP1 agonists (defined as BMI ≤ 35 kg/m² before IHR) was reached for 15/24 patients (62.5%). Postoperative total complication rate was lower in the group with GLP-1 agonists (59.6% in the control group vs. 45.8% in GLP-1 and p = 0.2).</p><p><strong>Conclusion: </strong>This study demonstrated the efficacy of GLP-1 agonists in the optimization of patients with obesity, allowing two thirds of the patients to benefit from IHR, with a tendency for lower morbidity.</p><p><strong>Trial registration: </strong>CPP Mediterranee, n° 21.00430.000004.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634792","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":"Intraoperative Blood Loss Predicts Local Recurrence After Curative Resection for Stage I-III Colorectal Cancer.","authors":"Kouki Imaoka, Manabu Shimomura, Hiroshi Okuda, Takuya Yano, Wataru Shimizu, Masanori Yoshimitsu, Satoshi Ikeda, Masahiro Nakahara, Mohei Kohyama, Hironori Kobayashi, Yosuke Shimizu, Masatoshi Kochi, Shintaro Akabane, Daisuke Sumitani, Shoichiro Mukai, Yuji Takakura, Yasuyo Ishizaki, Shinya Kodama, Masahiko Fujimori, Sho Ishikawa, Tomohiro Adachi, Minoru Hattori, Hideki Ohdan","doi":"10.1002/wjs.12533","DOIUrl":"https://doi.org/10.1002/wjs.12533","url":null,"abstract":"<p><strong>Background: </strong>To identify the predictors of local recurrence and distant metastasis after radical surgery for stage I-III colorectal cancer.</p><p><strong>Materials and methods: </strong>Patient and tumor characteristics, clinicopathological stages, perioperative factors, and postoperative outcomes, including local and distant recurrence, of patients who underwent primary colorectal resection were evaluated in this multicenter retrospective analysis. Univariate and multivariate regression analyses were performed to identify the risk factors for local and distant recurrences, with a focus on the intraoperative blood loss (IBL) ratio [IBL (mL)/total blood volume (mL)] and postoperative complications.</p><p><strong>Results: </strong>The risk factors for local and distant recurrence pattern differed. The predictors for local recurrence included perioperative factors, such as the IBL ratio and anastomotic leakage, as well as tumor factors, including pT4, rectal cancer, and poorly differentiated histology, in the multivariate analysis. On the other hand, the predictors for distant recurrence included perioperative factors, such as Clavien-Dindo score ≥ 3, and absence of adjuvant chemotherapy as well as tumor factors including pT stage, pN stage, and rectal cancer. The area under the receiver operating characteristic curve (AUC) for local recurrence in the IBL ratio was 0.745, which was higher than the AUCs for other recurrence patterns in the IBL ratio. Patients with a higher IBL ratio had a higher rate of early local recurrence within 2 years postoperatively (Wilcoxon test and p = 0.028).</p><p><strong>Conclusion: </strong>Reducing IBL and formulating perioperative strategies to prevent anastomotic leakage may help decrease the local recurrence rate and improve prognosis.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634768","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":"Does Completion Thyroid Surgery Pose a Higher Risk of Complications?","authors":"Alaa Sada, Kimberly M Ramonell, Kelly L McCoy, Elizabeth B Habermann, Sally E Carty, Linwah Yip","doi":"10.1002/wjs.12546","DOIUrl":"https://doi.org/10.1002/wjs.12546","url":null,"abstract":"<p><strong>Introduction: </strong>The outcomes of completion thyroidectomy are not well-documented. The study aim is to compare the risks of total thyroidectomy (TT), thyroid lobectomy (TL), and completion thyroidectomy (CT) using a large multi-institutional database.</p><p><strong>Methods: </strong>All cases of thyroidectomy without lymphadenectomy were identified using the CESQIP national database (2013-2023). Completion thyroidectomy was defined as contralateral lobectomy following previous lobectomy. Outcomes were examined including hematoma requiring evacuation, vocal cord dysfunction on post-op laryngoscopy, and clinical concern for hypoparathyroidism.</p><p><strong>Results: </strong>Among 33,154 cases, TT, TL, and CT were performed in 19,057 (57%), 13,135 (40%) and 962 (3%), respectively. 30-day hematoma rates were overall low: 135 (0.8%) in TT, 57 (0.5%) in TL, and < 10 (0.7%) in CT (p < 0.01). 30-day vocal cord dysfunction was documented in 233 (1.4%), 159 (1.3%), and < 10 (1.0%) for TT, TL, and CT, respectively (p = 0.65). Temporary hypoparathyroidism was more common after TT than CT (989 (6%) versus 20 (2%), p < 0.01). Among 16,311 (49%) patients with reported long-term outcomes, there were no differences in the rates of vocal cord dysfunction by type of operation (p = 0.34). However, long-term hypoparathyroidism was more likely after TT than CT (237 (2.5%) versus < 10 (0.7%), p < 0.01).</p><p><strong>Conclusion: </strong>In this multi-institutional endocrine surgery database, the reported long-term complication rates after completion thyroidectomy were the same as for first-time thyroid lobectomy. However, clinical hypoparathyroidism was 2.5-fold more likely for total thyroidectomy than for completion thyroidectomy at 30-days and remained 3.7-fold higher in the long term suggesting that completion thyroidectomy does not pose a higher risk of complications.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626280","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 Comparative Analysis of Scoring Systems and MRI for Diagnosing Acute Appendicitis in Pregnant Patients.","authors":"Eliahu Y Bekhor, Olga Esepkina, Tal Livne, Ubaida Hawashna, Hila Shmilovich, Noam Peleg, Adva Abergel, Shlomit Tamir, Ory Wiesel","doi":"10.1002/wjs.12556","DOIUrl":"https://doi.org/10.1002/wjs.12556","url":null,"abstract":"<p><strong>Introduction: </strong>Acute appendicitis (AA) represents the most prevalent indication for general surgical intervention during pregnancy. Despite the development of scoring systems for AA diagnosis, their validation in pregnant patient remains incomplete. Given the growing utilization of magnetic resonance imaging (MRI), evaluating the accuracy of both scoring systems and MRI in diagnosing AA during pregnancy becomes essential.</p><p><strong>Methods: </strong>We identified pregnant patients who underwent MRI for suspected AA between 2013 and 2023. Patients were categorized into AA and control groups based on established other diagnoses or spontaneous resolution of their symptoms. A national database was used to ensure patients who did not seek further medical attention. The Alvarado, Tzanakis, RIPASA, AIR scoring systems, and MRI findings were compared between the two groups.</p><p><strong>Results: </strong>180 pregnant patients underwent MRI for suspected AA and 28 were diagnosed with AA upon pathology examination. Most patients in the AA group exhibited negative clinical scores (Alvarado 82%, Tzanakis 84%, RIPASA 68%, and AIR 43%). MRI was positive in 79%. Demographic characteristics and clinical presentations were similar between the AA and control groups. The positive predictive values (PPVs) of clinical scores were modest (Alvarado-38%, Tzanakis-57%, RIPASA-22%, and AIR-12%), whereas the negative predictive values (NPVs) were high (80%-86%) across all scoring systems. MRI demonstrated a PPV of 62% and an NPV of 96%.</p><p><strong>Conclusion: </strong>Despite significant clinical and radiological advancements, diagnosing AA in pregnant patient remains challenging. The discrepancy between clinical scores and MRI finding underscores the complexity of AA diagnosis during pregnancy.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617355","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":"Surgical Management of Postcholecystectomy Strasberg Type E4 Bile Duct Injuries.","authors":"Deeksha Kapoor, Azhar Perwaiz, Amanjeet Singh, Amitabh Yadav, Adarsh Chaudhary","doi":"10.1002/wjs.12532","DOIUrl":"https://doi.org/10.1002/wjs.12532","url":null,"abstract":"<p><strong>Introduction: </strong>High-biliary injuries are associated with worse outcomes. Most series do not mention failure rates specific to the injury grade. In our experience, Strasberg E4 injuries are associated with a higher failure rate. This study shares our experience with the surgical management of postcholecystectomy Strasberg E4 injuries.</p><p><strong>Patients and methods: </strong>Patient demographics, radiological findings, operative details, and postoperative complications were collected for patients with Strasberg E4 injury from October 2003 to December 2020. Between 2003 and 2010, the preferred operation was Roux-en-Y hepaticojejunostomy (HJ). In cases of right lobe atrophy or an isolated right hepatic duct injury, a primary hepatic resection was considered. From 2010 onward, Strasberg E4 injuries were considered for a right hepatectomy with the left duct HJ. Patients were followed up at six monthly intervals with liver function tests and abdominal ultrasound.</p><p><strong>Results: </strong>Sixteen patients had Strasberg E4 injuries, thirteen presented with an external biliary fistula and three presented with obstructive jaundice. Nine of the ten patients who underwent HJ before 2010 developed cholangitis at a median follow-up of 14 months (2-28 months). Five of these subsequently underwent a hepatectomy, one underwent a liver transplant, and the other three underwent radiological dilatation of their anastomoses. From 2010 onward, six patients underwent an upfront right hepatectomy with left duct anastomosis. At a median follow-up of 40 months (10-74 months), 3 patients had minor derangement of liver enzymes, and none required an endoscopic or radiological intervention.</p><p><strong>Conclusion: </strong>HJ in E4 injuries often produces poor long-term results. An upfront right hepatectomy with left duct anastomosis might be considered.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617357","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":"Reduced-Ports Robotic Pylorus-Preserving Gastrectomy for Gastric Cancer.","authors":"So Hyun Kang, Nehal Jambi, Eunju Lee, Young Suk Park, Sang-Hoon Ahn, Yun-Suhk Suh, Hyung-Ho Kim","doi":"10.1002/wjs.12543","DOIUrl":"https://doi.org/10.1002/wjs.12543","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic gastrectomy has proven to be safe and effective as a first-line treatment for early gastric cancer in terms of oncologic results. The da Vinci robotic system offers stable 3D vision, near-infrared fluorescence imaging, and articulating wrist movements, making it suitable for performing reduced-ports robotic pylorus-preserving gastrectomy (RP-RPPG). This study examines the feasibility and safety of RP-RPPG for gastric cancer.</p><p><strong>Methods: </strong>Patients who underwent RP-RPPG at a single institution from March 2019 to October 2023 were enrolled. Electronic medical records were retrospectively reviewed for operative time, estimated blood loss (EBL), retrieved number of lymph nodes, postoperative hospital course, and early complications. Learning curve using operation time was analyzed through cumulative sum (CUSUM) and segmental analysis methods.</p><p><strong>Results: </strong>Among the 79 patients included, the median operation time was 175.0 (66.0) minutes, and estimated blood loss was 10.0 (25.0) mL. Early complications occurred in 6 patients (7.6%), but all were managed conservatively without needing invasive intervention. Among them, delayed gastric emptying was observed in 3 patients (3.8%). The learning curve analysis indicated a proficiency threshold after the 38th procedure, aligning with a subsequent decrease in operative times as the surgeon's experience progressed.</p><p><strong>Conclusion: </strong>RP-RPPG is feasible and can be performed safely by an experienced surgeon without increasing early postoperative morbidity.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605985","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":"An Implementation Gap of 120 Years: Complex Problems, Such as Family Planning, Pregnancy, and Parenthood in Surgical Training Require Suitable Research Paradigms and Innovative Change.","authors":"Rhea Liang","doi":"10.1002/wjs.12553","DOIUrl":"https://doi.org/10.1002/wjs.12553","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605750","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":"Correction to: Strengths and Opportunities for Improvement in Surgical Education in Ukraine: A Qualitative Study. Ali Dzhemiliev, Marta Antoniv, Inesa Huivaniuk, et al. World J Surg. 2024; https://doi.org/10.1002/wjs.12262.","authors":"","doi":"10.1002/wjs.12550","DOIUrl":"https://doi.org/10.1002/wjs.12550","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605896","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":"The Influence of the Clinical, Therapeutic and Socio-Personal Profile on the Quality of Life of Patients With Multiple Endocrine Neoplasia Type 1.","authors":"Beatriz Febrero, Esmeralda Teruel, Inmaculada Ros-Madrid, Pedro Segura, José M Rodríguez","doi":"10.1002/wjs.12522","DOIUrl":"https://doi.org/10.1002/wjs.12522","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple endocrine neoplasia type 1 (MEN1) syndrome is characterized by presenting different pathologies with different degrees of tumor aggressiveness, which can greatly affect the quality of life of affected patients.</p><p><strong>Objectives: </strong>To determine the quality of life of MEN1 patients and to analyze the influence of socio-personal, clinical, and therapeutic variables.</p><p><strong>Methods: </strong>A study was conducted on MEN1 patients in a tertiary hospital [2018-2020]. The 36-Item Short Form Health Survey (SF-36) scores were compared with those of a control group (CG) of a healthy population.</p><p><strong>Statistical analysis: </strong>Student's t-test/ANOVA test or the Mann-Whitney U test/Kruskal-Wallis H test. A multivariate analysis was applied to assess the SP, clinical, and therapeutic variables affecting the quality of life.</p><p><strong>Results: </strong>The quality of life scores of 101 MEN 1 patients, who presented lower levels of quality of life in various dimensions compared to the control group, (p < 0.05) were analyzed. Patients with pancreatic pathology showed a worsening in most dimensions of the SF-36 questionnaire (p < 0.05). In addition, pancreatic surgery influenced 3/9 dimensions and the mental component score (MCS) (p < 0.05). In the multivariate analysis, occupational status and pancreatic surgery were the variables most related to the quality of life of patients with MEN1 (p < 0.05) in addition to the existence of a carcinoid tumor, which influenced the physical component score (PCS) (p < 0.05).</p><p><strong>Conclusion: </strong>MEN1 patients have a worse quality of life than the general population. Of the socio-personal variables analyzed, the best predictor is being unemployed. Pancreatic and carcinoid pathology affected quality of life. Pancreatic surgery fundamentally influences the mental component score, whereas total pancreatectomy influences the physical component score.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597954","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}