World Journal of Surgery最新文献

{"title":"Impact of Preoperative Glucagon-Like Peptide-1 Receptor Agonist on Outcomes Following Major Surgery.","authors":"Zayed Rashid, Selamawit Woldesenbet, Mujtaba Khalil, Abdullah Altaf, Jun Kawashima, Khalid Mumtaz, Timothy M Pawlik","doi":"10.1002/wjs.12484","DOIUrl":"10.1002/wjs.12484","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1RA) are increasingly being used for the management of diabetes mellitus and obesity. We sought to define the impact of preoperative GLP-1RA use on outcomes following major surgical procedures.</p><p><strong>Methods: </strong>Patients who underwent a major surgical procedure between 2013 and 2021 were identified using the IBM MarketScan database. Patients who took GLP-1RA within a year before surgery were categorized as \"exposed.\" After propensity score matching (PSM), multivariable regression analysis was used to define the association of GLP-1RA exposure with postoperative complications.</p><p><strong>Results: </strong>Among 138,980 patients (coronary artery bypass graft: n = 39,516, 28.4%; pneumonectomy: n = 4,881, 3.5%; abdominal aortic aneurysm repair: 4,459, 3.3%; pancreatectomy: n = 15,873, 11.4%; and colectomy: n = 74,251, 53.4%), most individuals were male (n = 80,871, 58.2%) with a median age of 58 (IQR 53-61) years. 2944 (2.2%) individuals had GLP-1RA exposure before surgery. Overall incidence of complications was 36.5% (n = 50,724); complications included sepsis (n = 6,385, 4.6%), surgical site infections (n = 7,431, 5.3%), thromboembolism (n = 3,609, 2.6%), pneumonia (n = 4,783, 3.4%), renal (n = 9,017, 6.5%), or cardiopulmonary failure (n = 26,661, 19.2%). On unmatched analysis, patients on GLP-1RA had a higher risk of complications (no GLP-1RA: 36.3% vs. GLP-1RA: 44.5% p < 0.001); however, after PSM to account for measured confounders, GLP-1RA exposure was not associated with the odds of surgical complications (OR 0.99 95% CI 0.91-1.08; p > 0.05). Among patients using GLP-1RA during the 2 weeks before surgery (n = 522, 17.7%), there was no association of GLP-1RA with risk of complications (nonrecent GLP-1RA: 44.7% vs. recent GLP-1RA: 44.1%; p = 0.992).</p><p><strong>Conclusions: </strong>GLP-1RA use was not associated with an increased risk of complications following major surgical procedures.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"698-707"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955978","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":"Intersectoral Collaboration Between Traditional Bonesetters and Formal Healthcare: A Systematic Review on Past Initiatives and Stakeholder Perspectives.","authors":"Joost J Binnerts, Thom C C Hendriks, Samia Hussein, Nefti Bempong-Ahun, Geoffrey C Ibbotson, William J Harrison, Claude Martin, Kavitha Ranganathan, Anam N Ehsan, Bwire M Chirangi, Michael J R Edwards, Erik Hermans","doi":"10.1002/wjs.12503","DOIUrl":"10.1002/wjs.12503","url":null,"abstract":"<p><strong>Background: </strong>Bone fractures in low- and middle-income countries are commonly managed by traditional bonesetters (TBSs). Past studies emphasize the potential for improved fracture care through intersectoral cooperation. This review gauged support among stakeholders for intersectoral collaboration and the results of previous initiatives.</p><p><strong>Methods: </strong>Five medical databases were reviewed. Studies focusing on stakeholder perspectives and articles detailing collaborative initiatives were included. Data extraction and synthesis were carried out using the Cochrane Consumers and Communication Review Group's template. Additionally, all studies underwent quality assessment.</p><p><strong>Results: </strong>Of the 3821 identified articles, 16 were included after full-text screening. Twelve articles presented stakeholder perspectives, whereas four discussed collaborative initiatives. The overall article quality was low: articles on stakeholder perspectives scored on average 1.42 out of 4 points, whereas articles on collaborative initiatives scored a mean 1.25 points. In total, 62% of stakeholders (75% of TBSs, 92% of hospital staff, and 52% of patients) expressed support for intersectoral collaboration. The ratio between stakeholders expressing support versus those opposing was 4.4:1. No articles presented data on governmental perspectives. The most mentioned collaborative forms were TBS training (24% of stakeholders) and an integrative model (16% of stakeholders). Interventional studies all consisted of TBS training, reporting improved clinical outcomes and increased practice integration.</p><p><strong>Conclusion: </strong>Despite the limited and low-quality evidence on collaboration initiatives and perspectives, most stakeholders seem supportive of intersectoral collaboration, with training and integration being commonly suggested. Future research efforts exploring the feasibility of embedding TBSs into current primary care systems should ensure the involvement of local and national government.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"652-663"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365835","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":"Comparison of Hernia Sac Transection and Full Sac Reduction for the Treatment of Inguinal Hernias: A Systematic Review and Meta-Analysis of Clinical Trials.","authors":"Roberto Cirocchi, Georgi I Popivanov, Maria Chiara Cianci, Antonino Morabito, Matteo Matteucci, Sara Lauricella, Diletta Cassini, Carlo Boselli, Ivan Szergyuk, Giovanni Domenico Tebala, Antonia Rizzuto, Paolo Bruzzone","doi":"10.1002/wjs.12474","DOIUrl":"10.1002/wjs.12474","url":null,"abstract":"<p><strong>Background: </strong>The history of inguinal hernia repair has been marked by the description of several therapies over ages, each with its own approach to managing the hernial sac. An analysis of hernia sac transection (with or without high ligation) versus reduction (invagination) in adults who underwent Lichtenstein open tension-free inguinal hernia repair and in adult and pediatric patients who underwent suture repair has been the primary aim of this systematic review and meta-analysis.</p><p><strong>Methods: </strong>The authors conducted a comprehensive review and meta-analysis. A comprehensive literature search yielded 15 publications, consisting of 12 randomized controlled trials (RCTs) including 1598 patients and 3 controlled clinical trials (CCTs) including 243 patients. In total, the included patients amounted to 1.841.</p><p><strong>Results: </strong>Analysis of the data revealed a lower rate of recurrence in patients who had sac reduction (0.35% in randomized controlled trials and 0 in clinical trials) compared to patients who had sac excision and ligation (0.86% in randomized controlled trials and 0.93% in clinical trials). However, this difference was not statistically significant (RCTs: relative risk 2.94 [0.30, 29.24]-CCTs: relative risk 4.46 [0.18, 111.36]).</p><p><strong>Conclusion: </strong>The reduction of sacs does not result in a statistically significant decrease in recurrence compared to patients who underwent sac excision and subsequent ligation. This study has demonstrated that the various courses of treatment for the inguinal hernia sac have similar primary and secondary outcomes in both adult and pediatric patients.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"590-604"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042469","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":"Evaluation of Outcomes for Karydakis Operation for Pilonidal Sinus Disease-Comparison of Original Reports With Later Results.","authors":"Dietrich Doll, Theo Hackmann, Susanne Haas, Søren Laurberg","doi":"10.1002/wjs.12492","DOIUrl":"10.1002/wjs.12492","url":null,"abstract":"<p><strong>Background: </strong>Karydakis published his advancement flap technique to treat pilonidal sinus disease (PSD) in 1973 (GEK73) and reported a very low recurrence rate in 1992 (GEK92) in a large series of cases. Since then, the procedure has been widely adapted without replicating his results.</p><p><strong>Aim: </strong>To compare the outcomes of the Karydakis 1992 report to the global literature and evaluate reasons for the major discrepancy in recurrence rates.</p><p><strong>Methods: </strong>From an international database including all PSD studies, we identified 113 other studies encompassing 9878 patients undergoing the Karydakis advancement flap surgery. Recurrence rates at 5- and 10-year follow-ups were compared to the data presented in the Karydakis 1992 paper.</p><p><strong>Results: </strong>The Karydakis 1992 study reports a recurrence rate < 1% with a follow-up ranging between 2 and 20 years. In the global literature, the 10-year recurrence rate is 8.8% in RCTs and 14.6% in nonRCTs which is 11.6- and 19.2-fold higher.</p><p><strong>Conclusion: </strong>The standard for recurrence rates after the Karydakis advancement flap set by Karydakis has not since been replicated in the global literature. For surgeons and patients alike it is important to have realistic expectations of short- and long-term outcomes.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"584-589"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123773","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: Enhancing Trauma Care Through Innovative Trauma and Disaster Team Response Training: A Blended Learning Approach in Tanzania. Osebo C, Razek T, Deckelbaum D, et al. World J Surg. 2024;7:1616-1625.","authors":"","doi":"10.1002/wjs.12498","DOIUrl":"10.1002/wjs.12498","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"759"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190621","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":"Risk of venous thromboembolic complications in pregnant trauma patients: A matched cohort study.","authors":"Wei Huang, Edward Cho, Meghan Lewis, Anaar Siletz, Feifei Jin, Demetrios Demetriades","doi":"10.1002/wjs.12466","DOIUrl":"10.1002/wjs.12466","url":null,"abstract":"<p><strong>Background: </strong>Trauma and pregnancy are both risk factors for venous thromboembolism (VTE). We hypothesized that pregnant blunt trauma patients would have a higher incidence of VTE complications compared with matched nonpregnant females.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using National Trauma Data Bank data from 2017 to 2022. Female patients with blunt mechanism, age between 15 and 50 years old, were eligible for inclusion. Patients who presented as transfers, hospitalized for less than 72 h, discharged against medical advice, injury severity score <9, or abbreviated injury scale = 6 of any region were excluded. Pregnant patients were matched 1:2 with nonpregnant female patients by age, injury characteristics, comorbidities, and type and timing of chemical VTE prophylaxis. The primary outcomes were the incidences of VTE, deep vein thrombosis (DVT), and pulmonary embolism (PE). Secondary outcomes included other complications and length of stay.</p><p><strong>Results: </strong>We included 735 pregnant and 1470 matched nonpregnant controls. The median time to initiate chemical VTE prophylaxis was 33 h in pregnant and 34 h in nonpregnant patients (p = 0.42). The incidence of VTE in pregnant blunt trauma patients was 27 (3.7%) versus 45 (3.1%) in matched controls (p = 0.446). There were no significant differences in DVT, PE, or any other complication or mortality or in ICU or hospital length of stay. Unplanned admissions to the ICU were significantly more frequent in pregnant patients (3.8% vs. 2.2% and p = 0.026).</p><p><strong>Conclusion: </strong>The incidence of VTE complications was similar in pregnant and matched nonpregnant female blunt trauma patients in this retrospective cohort study, supporting the safety of current VTE prophylaxis practices in pregnant patients.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"743-751"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899005","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":"Adding Semi Elemental Enteral Nutrition Formula Improves Tolerance Without Compromising Bowel Preparation Quality for Colonoscopy: A Non-Inferiority Randomized Controlled Trial.","authors":"Nabil Mohammad Azmi, Anith Nadzira, Nur Afdzillah Abdul Rahman, Zairul Azwan Mohd Azman, Soma Balaganapati Chandrakanthan, Diana Melissa Dualim, Ismail Sagap","doi":"10.1002/wjs.12490","DOIUrl":"10.1002/wjs.12490","url":null,"abstract":"<p><strong>Background: </strong>Aims conventional bowel preparation restricts dietary intake up to 72 h prior to colonoscopy. Bowel preparation process is often perceived as unpleasant leading to poor compliance and subsequent poor bowel preparation. The aim of this trial is to compare the efficacy of low-residue semi-elemental enteral formula (LREF) incorporated diet versus the standard diet in polyethylene glycol (PEG)-based bowel preparation in the aim of creating a more tolerable bowel preparation regimen without compromising bowel cleanliness.</p><p><strong>Methods: </strong>This was a multicenter, prospective, single-blinded, randomized controlled noninferiority trial. The noninferiority margin was set at 15%. One hundred sixty-seven patients were recruited and randomized to either the LREF group or the standard diet (SD) group using a 3L PEG preparation regimen.</p><p><strong>Results: </strong>The LREF group results in comparable satisfactory preparation rating to the standard diet group with a mean BPPS score of 6.87 (SD 1.59) versus 7.14 (SD 1.54) (95% CI[-0.86; 0.32] and p = 0.367). The mean difference (MD) of the BBPS total score between the two groups was -0.27 (95% CI [-0.764 and 0.224]). Equivalence were demonstrated using the two one-sided test (alpha = 5%) with the lower t-value of 2.682 (p = 0.0042) and the upper t-value of -4.493 (p < 0.01). There was also no significant difference in PEG compliance, willingness to repeat the procedure and tolerance to the bowel preparation between the two groups.</p><p><strong>Conclusion: </strong>The LREF incorporated diet is equivalent to regimen in achieving satisfactory bowel cleanliness in patients undergoing PEG-based bowel preparation. We suggest that a LREF incorporated regimen for bowel preparation can be considered in patients who are unable to sustain prolonged fasting to improve the procedural experience.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"576-583"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024965","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 outcomes of parathyroidectomy for pre-kidney transplantation versus post-kidney transplantation patients.","authors":"Darci C Foote, Xue Zhao, Bin You, Joy Z Done, Jennine Weller, Rachel Stemme, Natalie Moreno, Lilah F Morris-Wiseman, Aarti Mathur","doi":"10.1002/wjs.12468","DOIUrl":"10.1002/wjs.12468","url":null,"abstract":"<p><strong>Background: </strong>Hyperparathyroidism (HPT) is common in end-stage kidney disease and resolves in less than half of kidney transplant (KT) recipients. The ideal timing of parathyroidectomy (PTX), before or after KT, remains unclear. We sought to understand differences in morbidity and mortality after PTX pre-KT and post-KT.</p><p><strong>Methods: </strong>We identified adult patients who underwent PTX pre-KT or post-KT between 2012 and 2021 utilizing the National Surgical Quality Improvement Program database. Demographics, clinical characteristics, morbidity, and mortality were compared. Adjusted logistic regression with propensity score weighting assessed odds of 30-day composite morbidity, major adverse cardiovascular events (MACE), readmission, and mortality.</p><p><strong>Results: </strong>We identified 1972 patients who underwent PTX pre-KT and 541 patients who underwent PTX post-KT. Post-KT HPT patients were older (mean age 53.9 v 48.2 and p < 0.01) and more commonly White (45.3% v 32.3% and p < 0.01) and diabetic (30.0% v 18.5% and p < 0.01). In comparison, pre-KT HPT patients were more commonly Black (53.2% v 30.1%), had American Society of Anesthesiologists (ASA) class 3-4 (98.0% v 89.6% and p < 0.01), chronic obstructive pulmonary disease (4.2% v 1.5% and p < 0.01), and congestive heart failure (4.4% v 1.1% and p < 0.01). After adjusting for confounders, patients pre-KT had 1.72-fold increased odds of morbidity (95% confidence interval [CI]: 1.13-2.61), 8.39-fold increased odds of MACE (95% CI: 1.13-62.18), and 2.07-fold increased odds of readmission (95% CI: 1.38-3.10). There was no difference in mortality or risk of infections.</p><p><strong>Conclusions: </strong>Patients who underwent PTX prior to KT were at significantly increased risk for 30-day morbidity and MACE, but no different odds of mortality compared to PTX after KT. This can help inform decision-making regarding timing of PTX in patients with HPT.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"643-651"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024971","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":"Addressing the Dynamics of Research and Publishing in Low- and Middle-Income Countries: A Call to Equitable Collaboration.","authors":"Emmanuel A Ameh, Chisom R Udeigwe-Okeke, Kathryn M Chu","doi":"10.1002/wjs.12511","DOIUrl":"10.1002/wjs.12511","url":null,"abstract":"","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"556-558"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450229","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 Clinical Impact of the Introduction of a Robot-Assisted Program in a Specialized Hernia Center: A Propensity Score Matched Cohort Study on Short-Term Outcomes.","authors":"Mads Marckmann, Mette Willaume Christoffersen, Nadia A Henriksen, Kristian S Kiim","doi":"10.1002/wjs.12477","DOIUrl":"10.1002/wjs.12477","url":null,"abstract":"<p><strong>Background: </strong>The role of robot-assisted approach in hernia surgery remains controversial due to high procedural costs and the proposed equal outcomes compared with open surgery. In this study, we report the 30-day results of the introduction of robot-assisted approach in a specialized regional ventral hernia repair center.</p><p><strong>Methods: </strong>This was a retrospective single-center cohort study including patients undergoing either robot-assisted or open ventral hernia repair from 2017 to 2022. Patients undergoing either approach were matched by propensity scores in a 1:2 ratio on the variables age, type of hernia (primary/incisional), and horizontal fascial defect size to reduce bias risk. Multivariable logistic regression on outcomes length of stay, reoperation, and readmission was performed.</p><p><strong>Results: </strong>A total of 109 patients undergoing robot-assisted repair were compared to 229 undergoing open repair. Overall, 61.2% were patients had incisional hernia. Mean hernia defect size was 4.9 × 6.5 cm (horizontal × vertical). The mean length of stay was shorter after robot-assisted repair (0.1 vs. 1.9 days, p < 0.001) as was the incidence of readmission (3.7% vs. 17.0%, p < 0.001). The incidence of reoperation was tangentially significantly lower after robot-assisted repair (0.9% vs. 6.6%, p = 0.045); however, the estimate was significant after adjusting for confounders (OR 0.11, CI 0.01-0.89, p = 0.038).</p><p><strong>Conclusions: </strong>Length of stay and readmission rates were significantly decreased after the introduction of a robot-assisted approach for ventral hernia repair.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"617-625"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012925","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}