Anaesthesia Critical Care & Pain Medicine最新文献

{"title":"Scoping Review of Early Mobility in the Intensive Care Unit Following Cardiac Surgery.","authors":"Emily K Phillips, Jacqueline L Hay, Caroline Monnin, April Gregora, Kathy Smith, Carly Shaski, Gavin Bozek, Sarah Gilchrist, Andrew Fagan, Maureen C Ashe, Anna M Chudyk, Annette S H Schultz, Sheila O'Keefe-McCarthy, Rakesh C Arora, Todd A Duhamel","doi":"10.1016/j.accpm.2025.101603","DOIUrl":"https://doi.org/10.1016/j.accpm.2025.101603","url":null,"abstract":"<p><strong>Introduction: </strong>Early mobility in the intensive care unit (ICU) within 24 hours following cardiac surgery (CS) is guideline-recommended, safe, and supports improved patient outcomes. The evolution of early mobility following CS research has not been explored. Prior reviews have not included non-randomized controlled trials nor assessed the quality of intervention reporting using standard guidelines.</p><p><strong>Objective: </strong>This scoping review addresses these gaps and maps CS ICU early mobility literature to understand the extent, range, and nature of the extant literature.</p><p><strong>Design: </strong>The databases Medline, Embase, PsycINFO, Scopus, CINAHL, ClinicalTrials.org, and CS association websites were searched from inception to January 2025. Extracted details included early mobility definitions and modes, outcome measures, alignment of intervention reporting with the Consensus of Exercise Reporting Template (CERT), and the inclusion of sex/gender in results/discussions.</p><p><strong>Results: </strong>A total of 109 studies were included. 43 studies defined early mobility, ranging from the day of surgery to within 2 weeks post-operatively. Many early mobility modes were noted, most commonly ambulation. Primary outcomes varied, with hospital length of stay and pulmonary function the most often studied. There was a consistent lack of reporting of CERT items. Only two studies presented findings disaggregated by sex/gender, and only 13 studies considered sex/gender in the discussion.</p><p><strong>Conclusions: </strong>There is inconsistency in the extant CS ICU early mobility literature, specifically in early mobility definitions and modes, outcome measures, quality of intervention reporting, and consideration of sex/gender. Improvements to research design and reporting should be encouraged to support the advancement of the science.</p>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":" ","pages":"101603"},"PeriodicalIF":4.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208054","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":"Association between serum uric acid level and outcome in intensive care unit, an ancillary analysis of the FROG-ICU cohort (URIC-ICU).","authors":"Antoine Borouchaki, Charles de Roquetaillade, Louis Boutin, Etienne Gayat, Alexandre Mebazaa, Benjamin G Chousterman","doi":"10.1016/j.accpm.2025.101610","DOIUrl":"https://doi.org/10.1016/j.accpm.2025.101610","url":null,"abstract":"<p><strong>Background: </strong>There is increasing evidence that elevated serum uric acid (SUA) levels are associated with increased risk of AKI. However, very little data is available on SUA levels in the ICU setting. We aimed at studying the level of SUA in ICU patients and its association with patient outcomes and incidence of acute kidney injury (AKI).</p><p><strong>Methods: </strong>We conducted an ancillary study using the prospective FROG-ICU cohort. We selected patients with SUA measurement at inclusion. The primary endpoint was 90-day mortality. The secondary endpoints were 1-year mortality, occurrence of AKI, and MAKE at day 30. To better characterize the association between SUA and outcomes, we performed a propensity score matching analysis and a subgroup analysis of patients with unaltered glomerular filtration rate (GFR) at admission.</p><p><strong>Results: </strong>A total of 1741 patients were included with a median SOFA score of 7 [5-10] and a median SUA value of 175 µmol/L [113-273]. Higher SUA at admission (>175 µmol/L) was significantly associated with 90-day mortality after adjustment, OR: 1.43 CI_95% [1.11-1.82], and with every secondary endpoint. This association remained significant after propensity score matching. The association between SUA and AKI and mortality was also significant in the subgroup of patients with unaltered GFR at admission.</p><p><strong>Conclusions: </strong>Patients admitted to the ICU displayed a low level of SUA compared to the general population. Higher SUA level was associated with increased 90-day mortality, increased incidence of AKI, even among patients without altered GFR on admission, suggesting a possible role of uric acid in the worsening of renal function.</p><p><strong>Study registration: </strong>ClinicalTrials.gov under number NCT01367093 (https://clinicaltrials.gov/study/NCT01367093?term = NCT01367093&rank = 1).</p>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":" ","pages":"101610"},"PeriodicalIF":4.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208090","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":"Organization of French level 1 adult trauma centers: a national survey.","authors":"Guillaume Bouhours, Lucas Dabouineau, Paer-Selim Abback, Eric Cesareo, Jonathan Charbit, Jean-Stéphane David, Pauline Devauchelle, Delphine Garrigue, Pauline Glasman, Sophie Hamada, Antoine Lamblin, Sébastien Mirek, Jean-Denis Moyer, Hervé Quintard, Pierre Pasquier, Julien Pottecher, Véronique Ramonda, Nathalie Zappella, Thomas Clavier","doi":"10.1016/j.accpm.2025.101624","DOIUrl":"https://doi.org/10.1016/j.accpm.2025.101624","url":null,"abstract":"<p><strong>Introduction: </strong>The specialized care of acute trauma patients is increasingly organized within networks, with the most critical patients referred to level 1 trauma centers (TC1). This French national survey aimed to evaluate the organizational and structural characteristics of these centers.</p><p><strong>Material and methods: </strong>A 195-item survey was conducted across 40 centers classified as TC1 according to consensual criteria. It included a general analysis of the hospital, followed by an internal analysis of each department, specifically admitting severe acute trauma patients. The survey collected data on the architectural, human, and functional organization, activity, and general satisfaction regarding each department.</p><p><strong>Results: </strong>All surveyed centers responded, 65% (26/40) of them were integrated into a trauma network. These TC1 admitted 409 (±332) severe trauma patients/year, including 90 (±75) grade A/very severe and 138 (±120) grade B/severe. Across the 40 TC1, a total of 46 reception areas were identified with a mean of 2.9 (±1.7) beds/area, and a surface of 20.4 (±8.9) m²/area. Their distances from the CT-scanner and operating room were 81 (±90) and 82 (±76) m, respectively. For grade A (unstable despite prehospital medical care) and B (stabilized after prehospital medical care and/or specific anatomic lesion) patients, the trauma team leader was an anesthesiologist-intensivist in 97.5% and 90.5% of admissions, respectively. Eleven (23.9%) reception areas reported multiple medical specialties involved in the admission of severe trauma patients, and 19 (41.3%) reported having dedicated nurses.</p><p><strong>Conclusion: </strong>This survey highlights the variability of the functional, architectural, and human resource organization of French TC1.</p>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":" ","pages":"101624"},"PeriodicalIF":4.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208094","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":"Intravenous magnesium administration errors, attributing factors and associated respiratory or cardiopulmonary arrest in obstetric and non-obstetric patients - A systematic review.","authors":"Santosh Patel","doi":"10.1016/j.accpm.2025.101621","DOIUrl":"https://doi.org/10.1016/j.accpm.2025.101621","url":null,"abstract":"<p><strong>Background: </strong>The primary objective of this systematic review was to investigate intravenous (IV) magnesium administration errors and associated adverse outcomes in hospital settings. The secondary objective was to identify contributory factors using the human factors and analysis classification system (HFACS) framework.</p><p><strong>Methods: </strong>PubMed, Scopus and Google Scholar were searched using the systematic search protocol for the past five decades. Magnesium administration errors were included, provided the route of administration was IV, and the clinical outcomes were described. Reports of errors via other routes were excluded.</p><p><strong>Results: </strong>The search identified 32 reports (31 obstetric and 15 non-obstetric patients). Errors occurred in wide-ranging locations. Most errors (36 of 46) occurred during maintenance dose infusion. For obstetric patients, errors occurred in patients with preeclampsia (n = 24) or preterm labour (n = 7) during varying periods of pregnancy. In four women, perimortem (2 patients) or within a few hours of cardiopulmonary resuscitation, lower segment caesarean sections were performed. Nearly two-thirds (63%) of patients developed either respiratory arrest only (9 obstetrics and four non-obstetric) or cardiopulmonary arrest (10 obstetrics and six non-obstetric). The permanent harm occurred in six patients (death -3 and vegetative state -3). Most contributory factors were skill-based errors, adverse mental state, communication and coordination of care, and deficiencies in magnesium-related processes.</p><p><strong>Conclusions: </strong>The findings highlight the need for improved IV magnesium administration practices across wards and acute care settings. Standardisation of magnesium products, their labelling, preparation, as well as reliable monitoring processes during the therapeutic use of magnesium, are essential to prevent magnesium infusion errors.</p>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":" ","pages":"101621"},"PeriodicalIF":4.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208047","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":"Nucleated red blood cells as a prognostic marker for mortality in septic critically ill patients: an observational study.","authors":"Felix Niebhagen, Anna Kirsch, Richard Schau, Sandra Waske, Lars Heubner, Martin Mirus, Axel Rand, Andreas Güldner, Hanns-Christoph Held, Ralph Schneider, Ulf Bodechtel, Jan Mehrholz, Thea Koch, Peter Spieth, Mario Menk","doi":"10.1016/j.accpm.2025.101605","DOIUrl":"https://doi.org/10.1016/j.accpm.2025.101605","url":null,"abstract":"<p><strong>Background: </strong>Nucleated red blood cells (NRBCs) in the blood of critically ill patients are associated with increased mortality. The predictive value of NRBCs among septic critically ill patients remains indistinct. The aim of the present analysis was to evaluate the predictive validity of NRBCs in septic critically ill patients.</p><p><strong>Methods: </strong>Data from septic critically ill patients were collected between 2020 and 2023. Daily NRBC values were recorded, and their predictive validity for mortality was statistically analysed. A cut-off level based on the maximum NRBC value during the patients' intensive care unit (ICU) stay was determined using ROC analysis and Youden's method. Survival was depicted using Kaplan-Meier curves.</p><p><strong>Results: </strong>465 septic critically ill patients were analysed. Patients who died had significantly higher maximum NRBC values during their ICU stay compared to survivors (290/µL [60/2010] vs. 30/µL [10/170]; p <  0.001). A cut-off of maximum NRBCs of ≥100/µL effectively divided the study population into two groups with the most significant difference in ICU mortality (AUC 0.745; 95% CI 0.693-0.797; p <  0.001). Increased maximum NRBC values of ≥100/µL were associated with fivefold higher odds of death (odds ratio [OR] 5.03; 95% CI 3.19-7.90; p <  0.001). Higher mortality rates were confirmed using a Cox proportional-hazards model (hazard ratio [HR] 1.84; 95% CI 1.16-2.98; p =  0.012).</p><p><strong>Conclusions: </strong>Measuring NRBCs can help predict mortality in septic critically ill patients with high prognostic accuracy. A cut-off of ≥100/µL for NRBCs appears to effectively stratify the study population regarding mortality.</p>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":" ","pages":"101605"},"PeriodicalIF":4.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208115","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 Guide to CIED Magnet Responses: Critical Information for Anaesthetists.","authors":"Olivier Montandrau, Olivier Untereiner, Mikael Perin, Pierre Jorrot, Pierre-François Winum, Charlotte Martin, Fabien Espitalier, Marc Beaussier","doi":"10.1016/j.accpm.2025.101606","DOIUrl":"https://doi.org/10.1016/j.accpm.2025.101606","url":null,"abstract":"<p><p>The perioperative management of patients with cardiac implantable electronic devices (CIEDs) has significantly improved in recent years. However, the use of magnets remains insufficiently defined in guidelines, despite ongoing variability in magnet responses across different manufacturers and the increasing implantation of leadless devices, whose response to magnet remains unknown. Anaesthetists must be familiar with device-specific magnet responses to ensure optimal perioperative management of CIEDs. Magnets activate a sensor that triggers asynchronous pacing in pacemakers and disables tachyarrhythmia detection in implantable cardioverter-defibrillators. Although magnets often help mitigate the risk of electromagnetic interference, particularly when the surgical site is close to the CIED, their application is not always feasible. In high-risk interference scenarios, especially for supra-umbilical procedures in pacemaker-dependent patients, preoperative electrophysiology consultation is essential for device reprogramming. In emergency situations, a pre-incision magnet test can help identify the specific type of CIED and guide management.</p>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":" ","pages":"101606"},"PeriodicalIF":4.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193515","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":"Comments on virtual reality for reduction of intraprocedural pharmacological sedation and analgesia in adult patients.","authors":"Sebastian M Wilkinson, Shubhashish Banerjee","doi":"10.1016/j.accpm.2025.101630","DOIUrl":"https://doi.org/10.1016/j.accpm.2025.101630","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":" ","pages":"101630"},"PeriodicalIF":4.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193483","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":"Perioperative antimicrobial prophylaxis and surgical site infection prevention, what clinicians and researchers must know.","authors":"Marc Garnier, Quentin Saint-Genis, Claire Roger, Romain Guilhaumou, Marc Leone, Matthieu Boisson","doi":"10.1016/j.accpm.2025.101600","DOIUrl":"https://doi.org/10.1016/j.accpm.2025.101600","url":null,"abstract":"<p><p>Surgical site infections (SSIs) are among the most common healthcare-associated infections, leading to increased morbidity, prolonged hospital stays, and significant healthcare costs. Surgical antimicrobial prophylaxis (SAP) is a critical strategy for SSI prevention, yet its effectiveness is threatened by antimicrobial resistance and variability in clinical practice. This narrative review provides an evidence-based update on the pathophysiology of SSIs, highlighting the interplay between endogenous microbiota, surgical stress, and perioperative factors such as hypoxia, immune modulation, and microbiome disruption. The current state-of-the-art in SAP is reviewed, including antibiotic selection, timing, dosing, intraoperative redosing, and the avoidance of unnecessary postoperative administration. Key intra- and postoperative measures to reduce the risk of SSI are covered, including glycaemic control, body temperature management, goal-directed fluid therapy, and skin antisepsis. A critical appraisal of the supporting evidence is included, with emphasis on areas of ongoing debate. The final section outlines future research priorities: optimizing dosing in obese patients, evaluating continuous infusion, tailoring prophylaxis to surgical site and microbiome, and addressing the management of patients colonized with multidrug-resistant organisms. Non-antibiotic strategies and rapid diagnostic tests are also discussed as promising avenues to enhance precision in infection prevention. By integrating current knowledge with emerging perspectives, this review aims to support the refinement of SSI prevention strategies and contribute to antimicrobial stewardship in modern surgical practice.</p>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":" ","pages":"101600"},"PeriodicalIF":4.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193592","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":"Post-Intensive Care Syndrome. What clinicians and researchers must know.","authors":"Fanny Vardon, Carolin Fleichsmann-Struzek, Nicola Latronico, Raphaël Cinotti","doi":"10.1016/j.accpm.2025.101620","DOIUrl":"https://doi.org/10.1016/j.accpm.2025.101620","url":null,"abstract":"<p><p>The COVID-19 pandemic has highlighted intensive care as a cornerstone of modern medicine. In spite of global aging and the increase of comorbidities in the general population, a large proportion of patients survive their hospitalization in the Intensive Care Unit (ICU). Nevertheless, these positive results are challenged by the higher mortality rates than other non-critically ill populations after discharge. Moreover, there is growing evidence that ICU survivors display a high rate of mental health disorders (anxiety and depression symptoms, post-traumatic stress disorders), somatic impairment (muscle atrophy, neuropathy, and myopathy with persistent muscle weakness, chronic kidney disease, chronic respiratory failure), or cognitive impairment. Patient's relatives also suffer from mental health disorders (anxiety and depression symptoms, complicated bereavement). All these chronic health issues significantly impair the quality of life and increase healthcare costs. Post-Intensive Care Syndrome (PICS) is a term that encompasses all these complications. The COVID-19 pandemic has highlighted PICS as a public health concern. This review summarizes the most recent findings on PICS. It addresses epidemiological data about the frequency of somatic disorders, cognitive impairment, and mental health problems in both patients and their relatives and describes the pathophysiology mechanisms underlying PICS. The review also provides insights into management experimentations and treatment interventions that have been tested so far to improve the outcome of critically ill survivors. Finally, the review proposes measures to implement PICS management in follow-up centers and a research agenda to pave the future research on this topic.</p>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":" ","pages":"101620"},"PeriodicalIF":4.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193617","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":"Effect of LMA®Gastro^TM airway for Intraoperative Transesophageal Echocardiography.","authors":"Zijin Shen, Zhiyuan Wang, Haibin Wang, Jia Cao, Jianhua Qiu, Rong Dong","doi":"10.1016/j.accpm.2025.101626","DOIUrl":"https://doi.org/10.1016/j.accpm.2025.101626","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore the effect of the LMA®Gastro^TM airway (Teleflex Medical, Athlone, Ireland) for intraoperative TEE.</p><p><strong>Methods: </strong>This randomized controlled trial enrolled patients undergoing transurethral prostatectomy between April 2023 and May 2024 at the authors' Hospital. The participants were randomly assigned to the endotracheal tube intubation (ETT) or LMA®Gastro^TM groups. The primary outcome was the time taken for TEE probe insertion. The secondary outcomes included the initial success rate of TEE probe insertion, the number of TEE probe insertion attempts, the number of patients with blood on the airway equipment, postoperative symptoms, and symptoms at discharge.</p><p><strong>Results: </strong>A total of 97 patients were enrolled, with 49 (mean age 68.3 ± 6.0 years) receiving laryngeal mask airway placement and 48 (mean age 67.5 ± 6.8 years) receiving endotracheal intubation. The time for TEE probe insertion was shorter in the LMA®Gastro^TM group than in the ETT group (24.4 ± 6.8 vs. 34.3 ± 8.5 seconds, P = 0.001; 95% confidence interval of the difference: -13.0 to -6.8 seconds). The initial success rate of TEE probe insertion in the LMA®Gastro^TM group was higher than in the ETT group. There were similar rates of blood on the airway device upon removal between the two groups.</p><p><strong>Conclusion: </strong>In patients undergoing transurethral prostatectomy, the LMA®Gastro™ Airway resulted in shorter TEE probe insertion time and a higher initial success rate for TEE probe placement compared with ETT. It also reduced the incidence of postoperative throat pain in patients. The finding indicated promising application of LMA®Gastro™ Airway in operations requiring TEE.</p>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":" ","pages":"101626"},"PeriodicalIF":4.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193508","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}