{"title":"Diagnostic value comparison of the combination of prostate-specific membrane antigen-body PET/MR and the prostate health index with each alone in early diagnosis of prostate cancer","authors":"","doi":"10.1016/j.ajur.2023.10.003","DOIUrl":"10.1016/j.ajur.2023.10.003","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to figure out whether the combination of the prostate health index (PHI) and prostate-specific membrane antigen (PSMA)-PET/MR could improve the diagnostic accuracy for prostate cancer (PCa) than that of each individual method used alone.</div></div><div><h3>Methods</h3><div>In this prospective, observational study, 41 patients who underwent the systematic prostate biopsy between June 2019 and September 2022 were enrolled. Both the PHI test and <sup>18</sup>F-PSMA-1007-PET/MR were performed prior to biopsies. The diagnostic accuracy of different models was compared by logistic regression, areas under the curve (AUCs) of the receiver operating characteristic, and net reclassification index (NRI).</div></div><div><h3>Results</h3><div>Among the 41 patients, 14 (34.1%) were pathologically diagnosed with PCa. The PHI in the PCa group was significantly higher than that in the benign group (44.4 <em>vs.</em> 35.0, <em>p</em>=0.048). Similarly, all the patients in the PCa group received positive results of <sup>18</sup>F-PSMA-1007-PET/MR, of which the positive rate was significantly higher than that in benign group (100% <em>vs.</em> 62.96%, <em>p</em>=0.025). The <sup>18</sup>F-PSMA-1007-PET/MR provided additional diagnostic values to the PHI (AUC: 0.802 <em>vs.</em> 0.692, <em>p</em>=0.025). However, there was no significant difference between the combination model and the <sup>18</sup>F-PSMA-1007-PET/MR alone (AUC 0.802 <em>vs.</em> 0.685, <em>p</em>=0.071). The optimal PHI cutoff of the combination model is 32, with which the model could significantly reduce unnecessary biopsies (NRI: 22.22%, 95% confidence interval: 6.54%–37.90%, <em>p</em>=0.005). However, among patients with the PHI of ≥43.5, there was no significant difference between the combination model and the PHI alone (NRI: 11.11%, 95% confidence interval: −0.74%–22.97%, <em>p</em>=0.066).</div></div><div><h3>Conclusion</h3><div>The combination of the PHI and <sup>18</sup>F-PSMA-1007-PET/MR outperforms the PHI alone for predicting PCa, especially in avoiding unnecessary biopsies. However, for patients with the PHI of ≥43.5, the addition of <sup>18</sup>F-PSMA-1007-PET/MR to the PHI does not yield additional benefits.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 555-562"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140463481","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":"Effectiveness and economic outcomes in patients undergoing laparoscopic radical prostatectomy with a new surgical shear with an integrated energy system: A retrospective study based on a tertiary hospital database in China","authors":"","doi":"10.1016/j.ajur.2023.08.010","DOIUrl":"10.1016/j.ajur.2023.08.010","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to demonstrate a new surgical shear with an integrated energy system (Harmonic ACE®+7) value by determining its effectiveness and economic outcomes compared with conventional ultrasonic shears (CUSs) in a real-world setting.</div></div><div><h3>Methods</h3><div>This was a retrospective study of adults with prostate cancer undergoing laparoscopic radical prostatectomy with the ACE®+7 shear or CUSs between August 2019 and April 2021 at Shanghai Ruijin Hospital (the headquarters and Luwan Center in China). Demographic and diagnosis information, intraoperative and postoperative clinical outcomes, and total and categorical costs were collected. Propensity score matching was performed to form the study population for each clinical group. Data were compared between the two groups using <em>t</em>-test and Chi-squared test.</div></div><div><h3>Results</h3><div>The ACE®+7 was associated with a lower mean number of hemostatic clips used per surgery compared with CUSs (12.8 <em>vs.</em> 19.8, <em>p</em><0.001), a moderate but not significant difference in mean postoperative drainage duration (6.6 [standard deviation, SD 2.2] days <em>vs.</em> 7.9 [SD 4.1] days, <em>p</em>=0.082), a reduction on mean total drainage volume (275.5 [SD 374.3 mL <em>vs.</em> 492.9 [SD 1495.0] mL, <em>p</em>=0.321), and a lower mean rate of postoperative hemostatic drug usage (16.0% <em>vs.</em> 52.0%, <em>p</em><0.001). There was no significant difference in total costs between the ACE®+7 and CUS groups.</div></div><div><h3>Conclusion</h3><div>This study provides real-world data demonstrating that the ACE®+7 shear with an integrated energy system improves clinical outcomes compared with CUSs and can offer cost savings for hospitals and health systems. Using the ACE®+7 during laparoscopic radical prostatectomy allows physicians to help their patients achieve better outcomes and not spend additional money.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 563-568"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141037185","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":"Genitourinary toxicity after pelvic radiation: Prospective review of complex urological presentations","authors":"","doi":"10.1016/j.ajur.2023.01.006","DOIUrl":"10.1016/j.ajur.2023.01.006","url":null,"abstract":"<div><h3>Objective</h3><div>Recent randomised controlled trials underestimated the incidence of genitourinary (GU) complications occurring more than 5 years following pelvic radiotherapy. This study aimed to determine the burden of treatment at a single institution from late GU complications after pelvic radiotherapy.</div></div><div><h3>Methods</h3><div>A prospective study of all presentations for GU complications following pelvic radiotherapy at a tertiary urology department between November 2018 and November 2019 was performed. Subgroup analyses was performed on patients with prostate cancer (PCa) with late toxicity to compare patient demographics, radiotherapy, complications, and management factors.</div></div><div><h3>Results</h3><div>There were 117 hospital encounters involving 46 patients with a 56.4% repeat encounter rate<strong>.</strong> Patients with PCa were the predominant group (<em>n</em>=39, 84.8%). External beam radiotherapy was the most common treatment modality (<em>n</em>=41, 89.1%). The median time from radiotherapy to encounter was 8 (range 0–23) years. Radiation-induced haemorrhagic cystitis was the most common presentation (<em>n</em>=70, 59.8%). Forty-four (42.7%) encounters for GU toxicity were managed operatively and 33 (32.0%) involved a non-operative procedure. Nine patients required packed red cell transfusion, with a total of 154 units transfused<strong>.</strong> Patients with PCa who presented with late GU toxicity had higher median Radiotherapy Oncology Group grades (<em>p</em>=0.020), proportion of emergency admissions (<em>p</em>=0.047), and frequency of clot urinary retention (<em>p</em><0.001).</div></div><div><h3>Conclusion</h3><div>There is a high burden of elective and emergency urology workload attributed to late pelvic radiation toxicity. Late GU toxicity occurring ≥5 years after radiotherapy is common and often more severe.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 633-641"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48553924","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":"An update on the use of stem cell therapy for erectile dysfunction","authors":"","doi":"10.1016/j.ajur.2023.07.005","DOIUrl":"10.1016/j.ajur.2023.07.005","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review aimed to analyze animal and human trial data to better understand the efficacy of stem cell therapy (SCT) for erectile dysfunction (ED) and the obstacles that may hinder its application in this field.</div></div><div><h3>Methods</h3><div>We searched electronic databases, including PubMed and Scopus, for published studies with the Medical Subject Heading terms of “erectile dysfunction” (AND) “stem cell therapy” (OR) “erectile dysfunction” (AND) “clinical trial of stem cell therapy” (OR) “stem cell therapy” (AND) “sexual dysfunction”. The search was limited to English-language journals and full papers only. The initial search resulted in 450 articles, of which 90 relevant to our aims were included in the analysis.</div></div><div><h3>Results</h3><div>ED is a multifactorial disease. Current treatment options rely on pharmacotherapy as well as surgical options. Patients may have side effects or unsatisfactory results following the use of these treatment options. SCT may restore pathophysiological changes leading to ED rather than treating the symptoms. It has been evaluated in animal models and shown promising results in humans. Results confirm that SCT does improve erectile function in animals with different types of SC use. In humans, evidence showed promising results, but the trials were heterogeneous and limited mainly by a lack of randomization and the small sample size. Many challenges could limit future research in this field, including ethical dilemmas, regulation, patient recruitment, the cost of therapy, and the lack of a standardized SCT regimen. Repairing and possibly replacing diseased cells, tissue, or organs and eventually retrieving normal function should always be the goals of any therapy, and this can only be guaranteed by SCT.</div></div><div><h3>Conclusion</h3><div>SCT is a potential and successful treatment for ED, particularly in patients who are resistant to the classic therapy. SCT may promote nerve regeneration and vascular cell regeneration, not only symptomatic treatment.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 530-544"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140277035","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":"Prediction of recurrence risk in patients with non-muscle-invasive bladder cancer","authors":"","doi":"10.1016/j.ajur.2023.04.007","DOIUrl":"10.1016/j.ajur.2023.04.007","url":null,"abstract":"<div><h3>Objective</h3><div>Non-muscle-invasive bladder cancer (NMIBC) remains a common challenge in uro-oncology with conflicting reports on recurrence risk. This study aimed to elucidate the recurrence rate of NMIBC in the Cancer Clinic of Shahid Beheshti Hospital in Iran and to investigate related parameters affecting recurrence risk.</div></div><div><h3>Methods</h3><div>The data of 143 patients with NMIBC, who underwent treatment between January 2017 and January 2020 and were followed up from the initial transurethral resection of bladder tumor until November 30, 2020 in our institution, were retrospectively assessed. The Cox regression analysis and Kaplan–Meier plot of recurrence-free survival were used to determine independent contributing factors for tumor recurrence.</div></div><div><h3>Results</h3><div>Among patients with NMIBC, 83.9% were male, and 16.1% were female, with a mean age of 64.4 (standard deviation [SD] 12.9) years. During the follow-up, 71 (49.7%) patients showed tumor recurrence, with a mean recurrence time of 11.5 (SD 6.9) months. In the Chi-square test or Fisher's exact test, the age (≥65 years) (<em>p</em>=0.037), obesity (body mass index ≥30 kg/m<sup>2</sup>) (<em>p</em>=0.004), no diabetes mellitus (<em>p</em>=0.005), smoking (current or former smoker) (<em>p</em>=0.001), immediate perfusion therapy (<em>p</em>=0.035), number of tumors (>3) (<em>p</em><0.001), and tumor stage (Ta, T1, and Tis) (<em>p</em>=0.001) had independent significant effects on the recurrence of NMIBC. The multivariate Cox regression analysis indicated that preoperative obesity (hazards ratio [HR] 7.90; 95% confidential interval [CI] 4.01–15.55; <em>p</em><0.001), current or former smoking (HR 1.85; 95% CI 1.07–3.20; <em>p</em>=0.027), and a high-grade tumor (HR 4.03; 95% CI 1.59–10.25; <em>p</em>=0.003) were significant predictors of tumor recurrence. The Kaplan–Meier plot of recurrence-free survival showed that obesity (log-rank <em>p</em><0.001), current or former smoking (log-rank <em>p</em>=0.001), and a high-grade tumor (log-rank <em>p</em>=0.006) were associated with a shorter time interval until the first tumor recurrence.</div></div><div><h3>Conclusion</h3><div>The study found a high recurrence rate of NMIBC in Iran from January 2017 to January 2020, with the obesity, smoking history, and the high-grade tumor as contributing factors.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 625-632"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140468533","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":"Correlation analysis between urinary crystals and upper urinary calculi","authors":"","doi":"10.1016/j.ajur.2024.04.003","DOIUrl":"10.1016/j.ajur.2024.04.003","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to analyze the correlation between urinary crystals and urinary calculi.</div></div><div><h3>Methods</h3><div>Clinical data, including urinary crystal types, were collected from 237 patients with urinary calculi. The detection rate of urine crystals and their correlation with stone composition were analyzed. The receiver operating characteristic curve analysis was used to determine the best cut-off value for predicting stone formation risk based on calcium oxalate crystals in urine.</div></div><div><h3>Results</h3><div>Calcium oxalate was the most common component in 237 patients. Among them, 201 (84.81%) patients had stones containing calcium oxalate. In these patients, calcium oxalate crystals were detected in 45.77% (92/201) of cases. In different groups of calcium oxalate stones, calcium oxalate crystals accounted for more than 90% of the total number of crystals detected in each group. The detection rate of calcium oxalate crystals was higher in first-time stone formers than in recurrent patients. The receiver operating characteristic curve analysis suggested a cut-off value of 110 crystals/μL for predicting stone formation, validated with 65 patients and 100 normal people.</div></div><div><h3>Conclusion</h3><div>Calcium oxalate crystals in urine can predict the composition of calcium oxalate stones and indicate a higher risk of stone formation when the number exceeds 110 crystals/μL. This non-invasive method may guide clinical treatment and prevention strategies.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 596-603"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141027734","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":"Efficacy and safety of platelet-rich plasma intracavernous injection for patients with erectile dysfunction: A systematic review, meta-analysis, and meta-regression","authors":"","doi":"10.1016/j.ajur.2024.01.001","DOIUrl":"10.1016/j.ajur.2024.01.001","url":null,"abstract":"<div><h3>Objective</h3><div>Intracavernous injection might be offered to patients with erectile dysfunction (ED) who did not respond to the first-line oral treatment. Platelet-rich plasma (PRP) might offer improvement in erectile function since it contains numerous growth factors. This study aimed to evaluate the efficacy and safety of PRP intracavernous injection for patients with ED.</div></div><div><h3>Methods</h3><div>We conducted relevant literature searches on Cochrane Library, Medline, Scopus, and <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> databases using specific keywords. The results of continuous variables were pooled into the mean difference (MD) and dichotomous variables into the odds ratio along with 95% confidence interval (95% CI).</div></div><div><h3>Results</h3><div>A total of six studies were included. Our pooled analysis revealed that PRP intracavernous injection was associated with a significant increase in the erectile function domain of the International Index of Erectile Function at 1 month (MD 3.47 [95% CI 2.62–4.32], <em>p</em><0.00001, <em>I</em><sup>2</sup>=7%), 3 months (MD 3.19 [95% CI 2.25–4.12], <em>p</em><0.00001, <em>I</em><sup>2</sup>=0%), and 6 months (MD 3.21 [95% CI 2.30–4.13], <em>p</em><0.00001, <em>I</em><sup>2</sup>=0%) after the intervention when compared with baseline values. PRP was also superior to a placebo in terms of improvement in erectile function domain of the International Index of Erectile Function score at 1 month (MD 2.83, <em>p</em><0.00001), 3 months (MD 2.87, <em>p</em><0.00001), and 6 months (MD 3.20, <em>p</em><0.00001) post-intervention. The adverse events from PRP injection were only mild without any serious adverse events.</div></div><div><h3>Conclusion</h3><div>PRP intracavernous injection may offer benefits in improving erectile function in patients with ED with a relatively good safety profile.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 545-554"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139538825","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":"LncRNA HCG18 promotes prostate cancer progression by regulating the miR-512-3p/HK-2 axis","authors":"","doi":"10.1016/j.ajur.2024.01.007","DOIUrl":"10.1016/j.ajur.2024.01.007","url":null,"abstract":"<div><h3>Objective</h3><div>Long non-coding RNAs (lncRNAs) play an important role in tumor progression. Numerous studies show that lncRNAs are strongly associated with prostate cancer (PCa) progression. The aim of this study was to investigate the pathway through which lncRNA <em>HCG18</em> regulates PCa progression by bioinformatics analysis and experiments.</div></div><div><h3>Methods</h3><div>We compared <em>HCG18</em> expression in PCa versus normal tissue and cells by data and cell lines, followed by comparing the changes in tumor cell proliferation, migration, and invasive ability after knockdown of <em>HCG18</em>. Then we searched for its downstream pathway by database and validated the pathway <em>in vivo</em> and <em>in vitro</em>.</div></div><div><h3>Results</h3><div><em>HCG18</em> was highly expressed in PCa and has the ability to promote tumor proliferation, migration, and invasion; knockdown of <em>HCG18</em> led to a decrease in the ability of cells to do so, which can be reversed by knockdown of miR-512-3p or overexpression of hexokinase 2.</div></div><div><h3>Conclusion</h3><div>Our <em>in vivo</em> and <em>in vitro</em> experiments suggest that <em>HCG18</em> can play a role in promoting PCa progression by blocking the inhibition of hexokinase 2 by miR-512-3p via sponge adsorption.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 575-585"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139818662","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":"Robot-assisted radical cystectomy with neobladder diversion in females: Safety profile and functional outcomes","authors":"","doi":"10.1016/j.ajur.2024.02.008","DOIUrl":"10.1016/j.ajur.2024.02.008","url":null,"abstract":"<div><h3>Objective</h3><div>Radical cystectomy (RC) is a standard treatment for localized muscle invasive bladder cancer and high-risk or very high-risk non-muscle invasive bladder cancer not responding to adequate endovesical therapy. In women, traditionally RC is performed with hystero-adnexectomy and resection of the anterior vaginal wall, often resulting in sexual disorders. Vaginal-sparing techniques have been developed to improve functional outcomes. The present study explores the safety and the functional outcome of vaginal-sparing techniques.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed all consecutive female patients undergoing robot-assisted RC (RARC) with neobladder diversion between October 2017 and February 2022. The indications for vaginal-sparing RC were absence of tumor on bladder neck or urethra and no sign of infiltration of posterior bladder wall at the preoperative MRI. Functional results were evaluated with the aid of five questions out of the Bladder Cancer Index questionnaire. Complications were reported according to the Clavien–Dindo classification and cancer control was evaluated by recurrence-free and cancer-specific survival.</div></div><div><h3>Results</h3><div>A total of 22 female patients underwent RARC with neobladder diversion. Neoadjuvant chemotherapy was given in 17 (77%) cases. Clavien–Dindo grades III–IV complications occurred in four (18%) cases. After a mean follow-up of 29 (interquartile range 16–44) months, six (27.3%) patients developed distant metastases, and one (4.5%) woman loco-regional relapse. Sexual-sparing surgery was performed in 19 (86%) patients, and in the others the anterior vaginal wall was resected, but neobladder was still performed. During daytime, no patients reported total incontinence and 73% (11/15) reported total continence or only occasional leaks. Sexual results showed that seven of 15 (47%) women regained sexual activity after surgery, with a quality reported as “good” or “very good” in 40% of all 19 cases.</div></div><div><h3>Conclusion</h3><div>RARC in female with anterior vaginal wall preservation is feasible. The approach showed a good safety profile, with satisfying results on continence and sexual activity. Sexual-sparing approaches should be carried out after correct patient selection.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 618-624"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140464632","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}