Perfusion-Uk最新文献

{"title":"The safety of cell saver washing all shed mediastinal blood before re-transfusing it to the patient.","authors":"Sara Scicluna, Magnus Dencker, Henrik Bjursten","doi":"10.1177/02676591241297545","DOIUrl":"10.1177/02676591241297545","url":null,"abstract":"<p><p>IntroductionCardiotomy suction blood is used in cardiopulmonary bypass (CPB) surgery to maintain blood volume in the CPB system, although it is known to contain micro emboli, cytokines and free plasma hemoglobin. Our aim was to investigate whether cell saver washing the cardiotomy suction blood before re-transfusing it is safe.MethodsThis is a retrospective study of 1671 elective coronary artery bypass patients, 209 of whom had their pericardial blood processed in a cell saver (Ce-S group). PS matching was performed with patients who had their pericardial blood returned back to the CPB-system by the cardiotomy suction (Ca-S group). Perioperative transfusion requirements, surgical outcome, postoperative lab data and mortality were then compared.ResultsThere were no differences in baseline characteristics or EuroSCORE between the groups. The number of patients requiring transfusions did not differ, but the patients in the Ca-S group received more platelets (0.34 ± 1.0 vs 0.16 ± 0.7 units, <i>p</i> = .03) than in the Ce-S group. CRP (c-reactive protein) levels at day 2 and 4 were higher in the Ca-S group (174.8 ± 67.2 and 148.9 ± 74.3 mg/L vs 160.1 ± 64.6 and 125.9 ± 67.2 mg/L, <i>p</i> = .03, <i>p</i> = .002) and so were ASAT (aspartate aminotransferase) levels (0.97 ± 0.8 vs 0.81 ± 0.6 μkat/L, <i>p</i> = .03). Mortality, postoperative ventilation time, stroke, mediastinal infections and length of stay in the ICU were the same in both groups.ConclusionsIn this retrospective study of patients undergoing elective CABG surgery, washing the cardiotomy suction blood before re-transfusion was not associated with higher risk of allogenic blood transfusion, postoperative stroke, mediastinal infections, or 30- and 365-days mortality.Clinical registration numberLU EPN 2016/4.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1364-1371"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body adiposity index and other indexes of body composition in predicting cardiovascular disease in the Chinese population: A Cohort study.","authors":"Wen-Shu Luo, Yi Ding, Zhi-Rong Guo","doi":"10.1177/02676591241300973","DOIUrl":"10.1177/02676591241300973","url":null,"abstract":"<p><p>ObjectiveThe purpose of this study was to compare the ability of four obesity indicators, including waist circumference (WC), body mass index (BMI), body adiposity index (BAI), and waist-to-height ratio (WHtR) on prediction for incident cardiovascular disease (CVD) in Chinese Han population.MethodsWe analyzed data from a prospective population cohort of 3598 participants aged 35 to 74 years from Jiangsu China. The logistic regression model was used to analyze the association between four obesity indicators and CVD risk. The ROC curve was used to assess and compare the diagnostic performance of four obesity indicators.ResultsDuring 8 years (median 6.3 years) of follow-up time, 82 CVD endpoints were collected during follow up (36 men and 46 women). After adjustment for age, smoking status, alcohol consumption and family history of CVD, in men, WC, BMI, and BAI were associated with triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and hypertension. In women, WC, BMI and WHtR were associated with TG, HDL-C, hyperglycemia and hypertension, BAI was only associated with HDL-C, hyperglycemia, and hypertension. ROC curve analysis indicated that BAI have the highest area under the curve to identify CVD, and BMI has the lowest area under the curve to identify CVD in Chinese males. WHtR has the highest area under the curve to identify CVD, and BMI has the lowest area under the curve to identify CVD in Chinese females.ConclusionsCVD risk was more consistently correlated with BAI in Chinese men and more consistently correlated with WHtR and WC in Chinese women.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1397-1404"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of percutaneous post-closure technique during the decannulation for veno-arterial extracorporeal membrane oxygenation.","authors":"Junchu Wei, Andong Lu, Chenliang Pan, Liangshan Wang, Juan Ma, Nan Bai, Kang Dong, Jing Zhao, Ming Bai","doi":"10.1177/02676591241300946","DOIUrl":"10.1177/02676591241300946","url":null,"abstract":"<p><p>BackgroundIn recent years, during the decannulation process for veno-arterial extracorporeal membrane oxygenation (VA-ECMO), methods for suturing the femoral artery have included the pre- and post-closure techniques. The safety and efficacy of the pre-closure technique are widely recognised; however, reports on the post-closure technique are scarce. This study aimed to evaluate the safety and efficacy of the post-closure technique using ProGlide (Abbott Healthcare, Green Oaks, IL, USA) device during VA-ECMO decannulation.MethodsWe reviewed 170 patients who underwent VA-ECMO between January 2021 and June 2023. All patients had their femoral artery puncture sites closed using the post-closure technique upon decannulation. The success rate of this technique and incidence of lower limb complications were recorded and analysed.ResultTechnical success was achieved in 157 (92.4%) patients. Sixteen patients (9.4%) experienced lower limb-related complications, including 8 (4.7%) with lower limb arterial thrombosis and 11 (6.5%) with pseudo-aneurysms. Among all lower limb-related complications, four patients (2.4%) required interventional procedures. This study included 170 patients: 80 in the 'S' (15-16 F) group and 90 in the 'M' (17-19 F) group. In the univariate analysis of different arterial cannula sizes for in-hospital lower limb-related complications, the differences were not statistically significant (<i>p</i> > 0.05). The multivariate logistic model indicated that, compared to the S (15-16 F) group, the M (17-19 F) group was not associated with an increased rate of in-hospital lower limb-related complications.ConclusionsThe suture-mediated closure of the femoral artery during VA-ECMO decannulation is a promising therapeutic strategy.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1415-1422"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-analysis of improved mitral regurgitation after aortic valve replacement.","authors":"Noritsugu Naito, Hisato Takagi","doi":"10.1177/02676591241291338","DOIUrl":"10.1177/02676591241291338","url":null,"abstract":"<p><p>BackgroundThis meta-analysis aimed to compare survival outcomes among patients experiencing improvement in untreated significant mitral regurgitation (MR) following surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR) for severe aortic stenosis, in contrast to those without improvement.MethodsWe conducted a comprehensive search through February 2024. Pooled hazard ratios (HR) with 95% confidence intervals (CI) were computed. Kaplan-Meier curves depicting all-cause mortality were reconstructed using individual patient data derived from the included studies.ResultsA systematic review identified twelve non-randomized studies encompassing 4040 patients. The pooled all-cause mortality of the meta-analysis demonstrated a significant reduction in patients whose MR improved compared to those with persistent MR after aortic valve replacement (AVR) (HR [95% CI] = 0.55 [0.47-0.64], <i>p</i> < .01). The hazard ratio, derived from reconstructed time-to-event data, indicated lower all-cause mortality in patients with improved MR after AVR relative to the other cohort (HR [95% CI] = 0.50 [0.40-0.62], <i>p</i> < .01 in all patients, 0.48 [0.34-0.68], <i>p</i> < .01 in patients undergoing SAVR, and 0.58 [0.42-0.80], <i>p</i> < .01 in those receiving TAVR).ConclusionIn conclusion, this meta-analysis revealed that improved MR after AVR, whether surgically or by transcatheter approach, correlates with superior survival. The benefits of simultaneous or staged intervention on the mitral valve in individuals undergoing AVR warrant validation in future investigations.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1325-1337"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective investigation of varied dose of heparin for cardiopulmonary bypass for repair of cardiac myxomas.","authors":"Dengzhi Wei, Xiaoxu Wang, Haiying Tian, Xu Li, Daokang Xiang, Yizhu Shu","doi":"10.1177/02676591241307572","DOIUrl":"10.1177/02676591241307572","url":null,"abstract":"<p><p>IntroductionThere is no consensus on the dose of heparin to be used intraoperatively in cardiac myxomas, so the goal of this study was to look into the differences in the clinical effects on the perioperative period of patients with cardiac myxomas when different doses of heparin were used intraoperatively.Methods and Analysis70 patients who had cardiac myxomas excision via cardiopulmonary bypass between January 2024 and July 2024. The 70 patients were separated into two groups based on the heparin dose administered prior to cardiopulmonary bypass heparinization. 42 patients in group A had a dose of ≤400 U/kg, while 28 patients in group B received a dose of >400 U/kg.ResultPT, INR, and APTT were significantly prolonged in patients with cardiac myxomas in group A in the postoperative period 24 h after surgery, which was statistically significant (<i>P</i> < .05) compared with that in group B. Intraoperative heparin dose appeared to influence changes in coagulation at 24 h postoperatively, but was mainly dominated by APTT. Also, heparinized doses showed a weak positive correlation with 24-h postoperative drainage volume. In addition, the dimension of the cardiac myxomas appeared to have some correlation with the patient's preoperative APTT and age.ConclusionWhen patients with cardiac myxomas were heparinized intraoperatively with varying doses of heparin, the enhancement of coagulation in the 24 h after surgery was more pronounced in the group given higher doses of heparin, and endogenous coagulation pathways were activated much more than exogenous coagulation pathways in the 24 h after surgery.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1487-1494"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemoadsorption during cardiopulmonary bypass to absorb plasma-free hemoglobin in patients with acute type a aortic dissection: A randomized controlled trial.","authors":"Yu Bao, XiaoJun Wang, YunFeng Zi, Xu Qian, YongBo Li, ShuXi Li, Zhao Wang","doi":"10.1177/02676591241305276","DOIUrl":"10.1177/02676591241305276","url":null,"abstract":"<p><p>AimsThis study aimed to investigate the effect of hemoadsorption (HA) on plasma-free hemoglobin (pfHb) levels during cardiopulmonary bypass (CPB) and the clinical outcomes in patients with acute type A aortic dissection (ATAAD).MethodsIn this single-center randomized trial, patients were assigned to either a group using the HA380 device or a control group without it. The primary outcome was changes in pfHb levels during CPB and within the first 48 hours after surgery. The study concentrated on comparing compared the data between the two groups using analysis of variance for repeated measures. Concurrently, both correlation and linear regression analyses were employed to identify the factors influencing pfHb levels.ResultsThe mean pfHb concentration was lower in the HA380 group than in the control group,but there were no significant differences between the two groups (<i>F</i> = 2.883, 95% confidence interval CI: -0.006 to 0.072, <i>p</i> = .093) using a repeated measures analysis of covariance model. Linear regression analysis identified body mass index (BMI) as the primary factor influencing the adsorption effect (<i>B</i> = 0.01, 95% CI: 0.36-1.24, <i>p</i> = .001). Additionally, the major postoperative complications within the first 48 hours did not show significant differences between the groups, including acute kidney injury (AKI) (25% HA380 group vs 36% control group, <i>p</i> = .261) and postoperative liver dysfunction (PLD) (5% HA380 group vs 16% control group, <i>p</i> = .106).ConclusionThe use of the HA380 device in CPB during cardiac operations may contribute to reduced pfHb levels. However, the difference was statistically non-significant because pfHb adsorption was notably influenced by the patient's BMI. Consequently, BMI should be considered when deploying HA380 in prolonged CPB procedures, including ATADD repair. Enhancing either the number of devices or the duration of HA in patients with overweight or obesity may potentially improve postoperative clinical outcomes.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1477-1486"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative bleeding outcome of fresh frozen plasma prime in pediatric cardiac surgery: A systematic review & meta-analysis.","authors":"Dian Kesumarini, Yunita Widyastuti, Cindy Elfira Boom, Andrea Laurentius, Lucia Kris Dinarti","doi":"10.1177/02676591241298822","DOIUrl":"10.1177/02676591241298822","url":null,"abstract":"<p><p>IntroductionBleeding after cardiac surgeries holds risk of mortality and morbidity in pediatrics. This systematic review aimed to evaluate postoperative blood loss and blood transfusion requirements for pediatric patients undergoing cardiac surgery with fresh frozen plasma (FFP) priming.MethodsIn 2024, the search reviewed four databases on randomized trials (RCTs) examining the impact of FFP prime intervention on 24-h postoperative blood loss and transfusion requirements in pediatric cardiac surgeries. The journals were appraised using <i>Grading of Recommendation Assessment, Development, and Evaluation</i> checklists, and random effects models estimated the effect size with a 95% confidence interval. Significance and study heterogeneity were indicated by <i>p</i>-values and I².ResultsOf the screened 2070 articles, one high-quality and four moderate-quality RCTs involving 354 children were identified. No significant reduction in 24-h mean postoperative blood loss was found following FFP priming (mean difference MD: -0.78, 95% CI [-3.3 to 1.75], <i>p</i> = .55) in general pediatric cardiac surgeries. However, subgroup analysis showed significant decrease in blood loss for younger children (<7 months) or those with lower body weight (<6 kg). There was no significant difference between groups in FFP (MD: -0.19, 95% CI [-0.42 to 0.05], <i>p</i> = .13) or red blood cell transfusion (MD: -0.25, 95% CI [-0.51 to 0.02], <i>p</i> = .07).ConclusionAdministering FFP as prime fluid in cardiac surgery did not reduce postoperative bleeding in general pediatric patients, but younger children (<7 months) and those with lower weight (<6 kg) were the subjects who benefited from the FFP priming before surgery.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1305-1316"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The early decline in platelet count is associated with increased adverse outcomes in non heparin-induced thrombocytopenia pediatric patients undergoing VA-ECMO.","authors":"Yu Jin, He Wang, Chun Zhou, Peiyao Zhang, Zhangyu Lin, Wenting Wang, Peng Gao, Jia Liu, Jinping Liu","doi":"10.1177/02676591241301614","DOIUrl":"10.1177/02676591241301614","url":null,"abstract":"<p><p>IntroductionThe impact of non heparin-induced thrombocytopenia on the clinical outcomes for pediatric cardiac surgery patients who required veno-arterial extracorporeal membrane support (VA-ECMO) for failure to wean from cardiopulmonary bypass (CPB) is uncertain. This study aimed to investigate the relationship between thrombocytopenia and prognosis in these patients.MethodsThis retrospective study enrolled 96 pediatric patients (age < 18) who received VA-ECMO directly transitioned from CPB at Fuwai Hospital from January 2010 to June 2020. The association between relative decrease in platelet count (△PLT) post-ECMO 24 h and clinical outcomes was explored.ResultsThere were significant differences in Post-ECMO 24 h platelet counts, platelet count nadir, and duration of platelet decline between the survivors and non-survivors in CPB-ECMO groups. A positive correlation was found between △PLT post-ECMO 24 h and plasma-free hemoglobin (pFHb) (<i>p</i> = .014, r = 0.305), peak serum creatinine (<i>p</i> = .016, r = 0.299), peak AST (<i>p</i> = .014, r = 0.302), duration of platelet transfusion (<i>p</i> = .032, r = 0.270),The △PLT post-ECMO 24 h had predictive value on in-hospital mortality [(<i>p</i> < .001, AUROC = 0.781 (95% CI: 0.670-0.892)], massive bleeding (<i>p</i> = .001, AUROC 95% CI: 0.627-0.870), hemolysis (<i>p</i> = .046, AUROC 95% CI: 0.510-0.780), and nosocomial infection (<i>p</i> = .020, AUROC 95% CI: 0.536-0.801). Multivariate logistic regression showed that △PLT post-ECMO 24 h was associated with in-hospital mortality and hemolysis.ConclusionsThe relative early decrease in platelet count 24 h following transition to ECMO is associated with increased patient mortality, and is positively associated with adverse outcomes in pediatric cardiac surgery patients transferred from CPB to ECMO. Moreover, this decline rate can predict in-hospital survival, major bleeding, hemolysis, and hospital-acquired infections.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1405-1414"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perfusion: The evolution from empirism to a recognized profession.","authors":"Filip De Somer","doi":"10.1177/02676591251369329","DOIUrl":"10.1177/02676591251369329","url":null,"abstract":"","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1303-1304"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unsupervised machine learning to explore inflammation following cardiopulmonary bypass.","authors":"Enrico Squiccimarro, Roberto Lorusso, Paolo Vetuschi, Michela Rauseo, Gianluca Paternoster, Giuseppe Speziale, Richard P Whitlock, Domenico Paparella","doi":"10.1177/02676591251372507","DOIUrl":"https://doi.org/10.1177/02676591251372507","url":null,"abstract":"<p><p>IntroductionCardiac surgery with cardiopulmonary bypass (CPB) often induces systemic inflammatory reaction syndrome (SIRS), affecting postoperative outcome. We aimed to explore adaptive/maladaptive inflammation using unsupervised machine learning.MethodsWe conducted a post hoc analysis of 1908 adult patients who underwent elective cardiac surgery with CPB between June 2016 and June 2020 at a single institution. Patients were assessed for SIRS 12 hours post-surgery and clustered using the partitioning around medoids (PAM) algorithm based on Gower distance. The influence of SIRS on a composite outcome comprising death, stroke/TIA, renal replacement therapy, reoperation for bleeding, mechanical circulatory support, and ICU stay >96 hours was analyzed via multivariable logistic regression.ResultsSIRS occurred in 28.7% of patients (median age 69 years; 68.7% male). Clustering revealed two subgroups: maladaptive SIRS (52.9%) with higher preoperative risk and worse outcomes, and adaptive SIRS (47.1%) with favorable outcomes. Maladaptive SIRS patients had higher 30-day mortality (21.7% vs 1.6%, p < .001). Adaptive SIRS patients had outcomes similar to SIRS-negative controls. In selected clusters, SIRS was independently associated with a lower risk of the composite outcome (OR 0.44; 95% CI 0.26-0.74, p = .002).ConclusionUnsupervised machine learning effectively identifies adaptive and maladaptive SIRS in cardiac surgery patients, providing a basis for personalized postoperative care. Several clinical and procedural factors associated with maladaptive SIRS may be modifiable, supporting future precision strategies to reduce harmful inflammation after cardiac surgery.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591251372507"},"PeriodicalIF":1.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}