Efort Open Reviews最新文献

{"title":"Surgical management of metastatic lesions in the proximal femur: a systematic review.","authors":"Afrim Iljazi, Mads Sten Andersen, Stig Brorson, Michael Mørk Petersen, Michala Skovlund Sørensen","doi":"10.1530/EOR-24-0138","DOIUrl":"10.1530/EOR-24-0138","url":null,"abstract":"<p><strong>Purpose: </strong>The proximal femur is a frequent site of cancer dissemination in the extremities. Patients treated surgically for skeletal metastases have poorer overall health compared to other orthopedic patients, with only one-third expected to survive two years post-surgery. Choosing a treatment that minimizes revision risk and ensures the implant outlives the patient is therefore crucial. We conducted a systematic review to assess the revision rate following internal fixation (IF) or endoprosthetic reconstruction (EPR) of the proximal femur for metastatic bone disease (MBD).</p><p><strong>Methods: </strong>This study adhered to the PRISMA guidelines. MEDLINE and Embase were searched, identifying 10,299 records. After removing duplicates, 7731 unique records were screened, 334 of which were retrieved for full-text screening. We included 34 studies in the qualitative synthesis. The MINORS instrument was used for quality assessment.</p><p><strong>Results: </strong>The quality of the included studies was low to moderate, with median scores of 6/16 for non-comparative studies and 10/24 for comparative studies. We therefore refrained from a comparative analysis. Revision rates varied between 0 and 12.4% following EPR (25 studies) and between 0 and 26.7% following IF, while implant removal rates ranged between 0 and 8.3% and 0 and 26.7%, respectively.</p><p><strong>Conclusions: </strong>Revision and implant removal rates for various methods of EPR and IF are satisfactory. However, a meta-analysis or comparison between IF and EPR is not feasible due to a lack of prospective studies, randomized trials and high-quality studies.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 2","pages":"104-114"},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus document on the management of wound closure in orthopaedic surgery.","authors":"Pablo Sanz-Ruiz, José Ramón Caeiro-Rey, Juan Carlos Martínez-Pastor, José Luis Martín-Alguacil, Antonio Murcia-Asensio, Jesús Moreta","doi":"10.1530/EOR-24-0002","DOIUrl":"10.1530/EOR-24-0002","url":null,"abstract":"<p><p>Wounds in orthopaedic surgery differ from wounds in other surgical fields in various ways. Tissues that are highly affected due to the trauma itself, the presence of an orthopaedic implant and the performance of prosthetic surgery in patients with many comorbidities make these wounds need special consideration. Complications of the surgical wound in orthopaedic surgery are not unusual, being the main cause of medical care and readmission in the first 90 days. There is no consensus on the best way to perform closure in orthopaedic surgery. The national 'Adequate Wound Management in Orthopaedic Surgery' survey has shown interindividual variability in wound closure and soft tissue management in orthopaedic surgery at the local level. This consensus document, generated by a group of experts in soft tissue management in orthopaedic surgery, proposes recommendations based on evidence (using the GRADE methodology) to promote best practices in this field. This document considers recommendations for surgical wound closure, dressing management and haemostasis. In addition, some of the 32 questions in the national survey, plus others relevant to the subject, were taken as a starting point for developing the contents.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 2","pages":"82-94"},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a role for acromioclavicular (AC) joint capsular repair and reconstruction in high-grade AC separations? A systematic review.","authors":"Al-Achraf Khoriati, Tony Antonios, Zien Alabdin Fozo, Aliya Choudhury, Magnus Arnander, Eyiyemi Pearse, Duncan Tennent","doi":"10.1530/EOR-2023-0121","DOIUrl":"10.1530/EOR-2023-0121","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical and biomechanical evidence for the addition of acromioclavicular (AC) ligament repair and reconstruction in the surgical management of high-grade AC joint (ACJ) dislocation.</p><p><strong>Methods: </strong>This is a systematic review of biomechanical and clinical studies that describe AC reconstructive or reparative techniques. The search ranged from 1946 to 2024 and included OVID, MEDLINE, PubMed, CINAHL, Embase, Google Scholar and the Cochrane Library databases. Clinical and biomechanical outcomes were evaluated.</p><p><strong>Results: </strong>Thirty-two eligible studies were identified. Of these, four biomechanical studies focused on the ACJ exclusively. Twenty-eight other studies (15 clinical and 13 biomechanical) were identified involving reconstruction of the ACJ in addition to the treatment of the coracoclavicular (CC) ligaments. There was clinical evidence of improved outcomes with ACJ repair and reconstruction, although comparison was difficult. In comparative studies, ACJ-specific Taft and acromioclavicular joint instability scores were improved in patients with ACJ reconstruction. Constant score and subjective shoulder value also increased, although this was observed in studies lacking a control group. The biomechanical studies provide evidence of increased translational and rotational stability with ACJ repair and reconstruction, but the optimal technique has not been identified.</p><p><strong>Conclusion: </strong>ACJ repair and reconstruction, in addition to CC repair, results in improved biomechanical and functional outcomes and should be considered when treating high-grade ACJ injuries. There is insufficient evidence in the literature to be able to recommend a specific technique to treat ACJ injuries.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 2","pages":"115-124"},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total knee arthroplasty following previous hardware implantation: do hardware removal strategies influence periprosthetic joint infections? A systematic review and meta-analysis.","authors":"Domenico De Mauro, Chiara Comisi, Enrico Festa, Tiziana Ascione, Massimo Mariconda, Giovanni Balato","doi":"10.1530/EOR-24-0100","DOIUrl":"10.1530/EOR-24-0100","url":null,"abstract":"<p><strong>Purpose: </strong>Total knee arthroplasty (TKA) in patients who underwent previous knee surgeries can be a challenging procedure both technically and for the complication rate. Conversion TKA is affected by a higher risk of infection compared to primary TKA. The aims of this meta-analysis are i) to compare the infectious risk among patients undergoing TKA after a prior hardware implantation, evaluating removal vs maintenance of the hardware, and ii) within the removal group, to compare staged vs concurrent procedure.</p><p><strong>Methods: </strong>In accordance with the PRISMA guidelines, a systematic literature review was conducted up to January 2024. The review was registered in the PROSPERO database: CRD42024510444. The inclusion criteria comprised the following: i) patients aged 18 years or older, ii) individuals who had undergone total knee replacement and iii) those with a history of prior nonabsorbable hardware implantation. The pooled incidence of periprosthetic joint infections (PJI) was reported using odds ratios with corresponding 95% confidence intervals (CIs).</p><p><strong>Results: </strong>The investigation of database and references identified 284 studies. PJI risks differed significantly among groups, with a higher risk in the removal group (z = 3.5630, P = 0.0004). Furthermore, within the removal group, the risk of PJI was lower in cases of staged removal compared to concurrent removal (z = 2.0931, P = 0.0363).</p><p><strong>Conclusions: </strong>TKA following a previous knee hardware implantation indicates a higher PJI risk when the hardware is removed compared to leaving it in place. If hardware removal is necessary, staged removal is recommended. The presence of minor hardware is the only scenario where, if removal is necessary, one-stage approach is preferred.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 2","pages":"95-103"},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DNA methylation and its influence on the pathogenesis of osteoarthritis: a systematic literature review.","authors":"Thomas Nau, Samira Cutts, Nerissa Naidoo","doi":"10.1530/EOR-22-0088","DOIUrl":"10.1530/EOR-22-0088","url":null,"abstract":"<p><strong>Purpose: </strong>Evolving evidence demonstrates the role of epigenetics in the pathogenesis of osteoarthritis (OA), whereas in terms of mechanism, DNA methylation has received the highest attention thus far. This systematic review summarizes the current knowledge of DNA methylation and its influence on the pathogenesis of OA.</p><p><strong>Methods: </strong>A protocol in alignment with the PRISMA guidelines was employed to systematically review eight bibliographic databases between 1 January 2015 and 31 January 2021, to identify associations between DNA methylation and articular chondrocytes in OA.</p><p><strong>Results: </strong>We identified 23 gene-specific studies and 28 genome-wide methylation analyses. Gene-specific studies focused on pro-inflammatory markers in OA, demonstrating that DNA hypomethylation in the promoter region results in overexpression and hypermethylation is linked to gene silencing. Others reported on the association between OA risk genes and DNA methylation. Genome-wide methylation studies reported on differentially methylated regions (DMRs) comparing OA and non-OA chondrocytes. DMRs were seen in hip OA and knee OA chondrocytes.</p><p><strong>Conclusion: </strong>The current body of literature demonstrates the potential and crucial role of DNA methylation in the pathogenesis and progression of OA. This knowledge contributes to the understanding of the pathomechanisms behind OA at gene-specific and genome-wide levels. The observed differences in DNA methylation between healthy and diseased tissues indicate the occurrence of changes in DNA methylation. Based on this, future research in this field that explores the characteristics of potentially reversible changes in DNA methylation may lead to opportunities for causative treatment options for OA.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 2","pages":"66-74"},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The structure, process and outcomes of interprofessional care among knee osteoarthritis patients: a scoping review.","authors":"Jessica Hiu Toon Lee, Mandy Ming Pui Kan, Arkers Kwan Ching Wong","doi":"10.1530/EOR-2023-0209","DOIUrl":"10.1530/EOR-2023-0209","url":null,"abstract":"<p><p>Knee osteoarthritis (OA) is a common chronic condition that leads to joint pain and disability among older adults. An interprofessional collaborative approach has nowadays been widely advocated in knee OA management although little is known about the characteristics of care, roles and responsibilities of healthcare providers and how they collaborate as a team to optimise treatment outcomes. The Donabedian structure-process-outcome framework was used in the review. Six databases were searched from February 2013 to March 2023. A total of 26 articles that met our inclusion criteria were reported. All studies (n = 26) identified the physiotherapist as a critical member of the interprofessional team. Several studies (n = 5) have offered training to healthcare providers in the management of knee OA. The intervention components in most studies included disease-based education (n = 21) and exercise therapy (n = 16). A comprehensive understanding of the existing interprofessional knee OA care in this review could potentially assist the government and healthcare organisations in developing interprofessional practice guidelines and designing intervention programmes that maximise their benefits.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 1","pages":"37-47"},"PeriodicalIF":4.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11728870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications after knee derotational osteotomies in patients with anterior knee pain and/or patellofemoral instability: a systematic review with meta-analysis.","authors":"Inês Figueiredo, Cristina Valente, Ricardo Ribeiro, Bárbara Ferreira, Eluana Gomes, Diego Delgado, Mikel Sánchez, Renato Andrade, João Espregueira-Mendes","doi":"10.1530/EOR-2024-0036","DOIUrl":"10.1530/EOR-2024-0036","url":null,"abstract":"<p><strong>Purpose: </strong>Investigate intra- and post-operative complications and revisions following distal femoral and/or high tibial derotational osteotomies to correct rotational malalignments of the lower limb in patients with anterior knee pain (AKP) and/or patellofemoral instability (PFI).</p><p><strong>Methods: </strong>A literature search was conducted on PubMed, EMBASE and Web of Science (until 30 September 2023), including studies reporting complications, reinterventions and revisions following knee derotational osteotomies. Incidence rates were collected for each level of derotational osteotomy (distal femur, high tibia or double-level). A meta-analysis using the Freeman-Tukey double arcsine transformation was conducted to estimate the pooled proportions with their 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Twenty-one studies involving 564 osteotomies (n = 484) were included, with a mean follow-up of 45.6 ± 15.7 months. The overall complication proportion was 7.5% (95% CI: 3.9-11.8%). Postoperative residual AKP was seen in a pooled proportion of 7.6% (95% CI: 0.7-18.8%), and persistent PFI was not common (0.1%; 95% CI: 0.0-1.7%). Intraoperative complications occurred in a pooled proportion of 3.8% (95% CI: 2.4-6.0%), with peroneal nerve injury being the most common (1.3%) after derotational high tibial osteotomy. Reintervention was needed in a pooled proportion of 13.0% (95% CI: 2.9-27.2%), primarily for hardware removal (n = 158; 28.3%). There was a pooled proportion of knees requiring revision procedures of 12.3% (95% CI: 2.6-26.1%).</p><p><strong>Conclusions: </strong>Distal femur and high tibial derotational osteotomies exhibit a considerable incidence of intra- and post-operative complications. Peroneal nerve injury, although infrequent, is a significant complication, underscoring the importance of implementing intraoperative preventive measures during derotational high tibial osteotomy.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 1","pages":"14-27"},"PeriodicalIF":4.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11728914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges.","authors":"Pierre Hoffmeyer","doi":"10.1530/EOR-2024-0200","DOIUrl":"10.1530/EOR-2024-0200","url":null,"abstract":"","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 1","pages":"1-2"},"PeriodicalIF":4.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11728856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal timing for bilateral total knee arthroplasty: comparing simultaneous and staged procedures at various intervals: a systematic review and network meta-analysis.","authors":"Cheng-Yang Chang, Kun-Han Lee, Jui-Chien Wang, Shang-Wen Tsai, Cheng-Fong Chen, Po-Kuei Wu, Wei-Ming Chen","doi":"10.1530/EOR-2024-0070","DOIUrl":"10.1530/EOR-2024-0070","url":null,"abstract":"<p><strong>Purpose: </strong>A staged bilateral total knee arthroplasty (BTKA) procedure is considered when a patient is not deemed suitable for simultaneous BTKA due to concerns about the risk of mortality and complications. However, no network meta-analysis has been conducted to compare simultaneous vs staged BTKA procedures with different intervals in terms of postoperative mortality and overall complication rates.</p><p><strong>Methods: </strong>Four databases - Medline, Embase, Cochrane Library and Web of Science - were searched from inception to December 19, 2023, for studies comparing patients who underwent staged BTKA with different intervals and simultaneous BTKA. The primary outcome domains were 1-year mortality and 90-day overall complications. Secondary outcomes included neurological, cardiovascular, pulmonary, infectious and venous thromboembolic complications within 90 days.</p><p><strong>Results: </strong>Fifteen observational studies were included. Staged BTKA with intervals between 6 weeks and 3 months (odds ratio (OR): 0.69, 95% CI: 0.53-0.91), between 3 and 6 months (OR: 0.67, 95% CI: 0.53-0.84) and longer than 6 months (OR: 0.67, 95% CI: 0.55-0.83) exhibited a lower mortality risk compared to simultaneous BTKA. Staged BTKA with an interval shorter than 6 weeks and longer than 6 months exhibited a higher risk of pulmonary (OR: 1.24, 95% CI: 1.03-1.49; OR: 1.64, 95% CI: 1.10-2.44) and infectious complications (OR: 1.50, 95% CI: 1.15-1.96; OR: 1.52, 95% CI: 1.14-2.02) compared to simultaneous BTKA. An interval between 3 and 6 months ranked best in outcomes of 1-year mortality (P score = 0.7849) and 90-day complications (P score = 0.7077).</p><p><strong>Conclusions: </strong>Staged BKTA with an interval of more than 6 weeks but less than 6 months is associated with a lower risk of postoperative mortality and complications. However, these results should be interpreted with caution due to potential biases inherent in the inclusion of nonrandomized studies.</p><p><strong>Level of evidence: </strong>II.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 1","pages":"28-36"},"PeriodicalIF":4.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11728876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Network meta-analysis comparing WALANT, locoregional, local and general anesthesia techniques in carpal tunnel release.","authors":"Laurentiu-Cosmin Focsa, Pierre-Alban Bouché, Thomas Apard, Daphné Querel, Marc-Antoine Rousseau, Jules Descamps","doi":"10.1530/EOR-2024-0014","DOIUrl":"10.1530/EOR-2024-0014","url":null,"abstract":"<p><strong>Purpose: </strong>To compare anesthesia techniques (WALANT (wide-awake anesthesia no tourniquet), locoregional anesthesia, local anesthesia with tourniquet or sedation) for carpal tunnel release (CTR).</p><p><strong>Methods: </strong>A comprehensive literature search was conducted on PubMed, MEDLINE, Embase and the Cochrane Library up to May 2023. Two independent reviewers selected the studies and extracted the data. The primary outcomes included the pain experienced at the moment of anesthesia and during the surgery and the mean morphine equivalents (MME) administered following the surgery and overall patient satisfaction. Our secondary outcomes consisted of the mean room occupancy time and the mean duration of the procedure, followed by the complication rate. The review process was conducted according to PRISMA guidelines.</p><p><strong>Results: </strong>A total of 3166 studies were identified, which included 23 studies comparing various anesthesia types and 28,748 CTR surgeries. The WALANT group experienced significantly lower pain levels during anesthesia (-2.67 (95% CIs: 0.12-4.99)) and surgery (-2.04 (95% CIs: 0.08-4.07)) compared to the local anesthesia group. There was no difference in the use of MME for pain relief among different anesthesia techniques. Satisfaction rates were comparable, but WALANT exhibited the highest probability for utmost satisfaction. The mean room occupancy time was lower in patients receiving local anesthesia compared with when sedation was added, with a mean difference of -27.16 (95% CIs: -52.03 to -1.85).</p><p><strong>Conclusions: </strong>The WALANT technique for CTR reported better outcomes for pain (during anesthesia and surgery), higher satisfaction and low probability to expand the operating room occupancy time.</p><p><strong>Level of evidence: </strong>Level II of evidence.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 1","pages":"3-13"},"PeriodicalIF":4.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11728873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}