Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery最新文献

{"title":"Granulocytic Sarcoma Mimicking Cholesteatoma: Beware the Temporal Bone in Haematological Patients.","authors":"Karan Mayani-Mayani, Emilio González-Arnay, Luis Acosta-Criado, Nassr-Aldin Abbas-Khoja, M Eugenia Abad-Collazo, Manuel García-Viera, José-Maria Raya Sánchez, José Govantes-Rodríguez","doi":"10.1159/000532080","DOIUrl":"10.1159/000532080","url":null,"abstract":"<p><p>Granulocytic sarcoma is a myeloid neoplasm that can occur in isolation or in association with acute leukaemia. The temporal bone represents a sanctuary site for myeloid progenitors: granulocytic sarcoma may develop in this location before or concomitantly with the onset of acute leukaemia. This atypical presentation with clinical and radiological data that closely mimic those of cholesteatoma often delays an accurate diagnosis. We here describe the clinical case of a 28-year-old male with granulocytic sarcoma of the external auditory canal that preceded the relapse of promyelocytic leukaemia.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"299-304"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10367401","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":"What Is Different in COVID-19-Associated Olfactory Loss from Classical Postinfectious Olfactory Impairment?","authors":"Basile Nicolas Landis, Julien Wen Hsieh, Iordanis Konstantinidis, Eric H Holbrook, Caroline Huart, Eri Mori, Thomas Hummel","doi":"10.1159/000533228","DOIUrl":"10.1159/000533228","url":null,"abstract":"","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"245-247"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10614460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10396140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and Management of Adult Laryngeal Trauma: An Analysis of the National Trauma Data Bank.","authors":"Katherine Xu, Emma De Ravin, Christian Fritz, Harman S Parhar, Alvaro Moreira, Karthik Rajasekaran","doi":"10.1159/000534646","DOIUrl":"10.1159/000534646","url":null,"abstract":"<p><strong>Introduction: </strong>Laryngeal injuries are rare but life-threatening airway emergencies. Increased understanding of the epidemiology of these injuries can inform treatment and improve outcomes. We aimed to characterize the demographics and management of adult laryngeal trauma.</p><p><strong>Methods: </strong>The National Trauma Data Bank (NTDB) was queried from 2007 to 2015 for patients ≥18 years old with laryngeal trauma. Patient demographics, injury characteristics, and treatment course were collected. Outcomes were assessed via multivariate logistic regression.</p><p><strong>Results: </strong>From 7.3 million patients, 6,890 (0.1%) patients with laryngeal trauma were identified. Eighty-five percent of patients were male, and the median age was 40. Of these patients, 343 (5.0%) were dead on arrival and of the remaining patients, 510 (7.8%) of patients were deceased at discharge. Common concomitant injuries included facial fractures (27%), intracranial injuries (21%), and rib and sternum fractures (19%). The most common cause of injury was motor vehicle accident (26%), followed by assault with firearms/explosives (12%) and assault with cutting instruments (8%). Forty-three percent of patients received mechanical ventilation and 15% received surgical repair. After correcting for gender, age, and injury severity, firearm injuries (odds ratio [OR] 3.46, 95% CI: [2.88-4.15]) and cutting/piercing injuries (OR 2.23, 95% CI: [1.89-2.64]) were positively associated with the need for mechanical ventilation. Motor vehicle trauma (OR 0.63, 95% CI: [0.46-0.84]) was negatively associated with surgical repair while striking injuries (OR 1.61, 95% CI: [1.25-2.06]) were positively associated. Lastly, shorter time to tracheostomy was significantly associated with shorter ICU stays (p &lt; 0.0001).</p><p><strong>Conclusion: </strong>This study is the largest epidemiologic study of laryngeal trauma to date and identifies the risk of surgical intervention with firearm and cutting injuries as well as the importance of earlier time to tracheostomy for ICU management.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":"85 6","pages":"340-347"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10652646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134650278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival and Swallowing Function after Primary Radiotherapy versus Transoral Robotic Surgery for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma.","authors":"Ryan T Hughes, Beverly J Levine, Nelson May, Rachel F Shenker, Jae H Yang, Claire M Lanier, Bart A Frizzell, Kathryn M Greven, Joshua D Waltonen","doi":"10.1159/000531995","DOIUrl":"10.1159/000531995","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to investigate the impact of primary transoral robotic surgery (TORS) versus radiotherapy (RT) on progression-free survival (PFS), overall survival (OS), and 1-year swallowing function for patients with early-stage HPV-associated oropharyngeal squamous cell carcinoma (OPSCC).</p><p><strong>Methods: </strong>Patients with stage I-II (AJCC 8th Ed.) HPV-associated OPSCC treated with TORS followed by risk-adapted adjuvant therapy or (chemo)radiotherapy between 2014 and 2019 were identified. PFS, OS, and swallowing outcomes including gastrostomy tube (GT) use/dependence, and Functional Oral Intake Scale (FOIS) change over 1 year were compared.</p><p><strong>Results: </strong>One hundred sixty-seven patients were analyzed: 116 treated with TORS with or without adjuvant RT and 51 treated with RT (50 chemoRT). The RT group had more advanced tumor/nodal stage, higher comorbidity, and higher rates of concurrent chemotherapy. There were no differences in 3-year PFS (88% TORS vs. 75% RT) or OS (90% vs. 81%) between groups, which persisted after adjusting for stage, age, and comorbidity. GT use/dependence rates were higher in the RT group. Mean (SD) FOIS scores in the TORS group were 6.9 (0.4) at baseline and 6.4 (1.0) at 1 year, compared with 6.7 (0.6) and 5.6 (1.7) for the RT group. Only clinical nodal stage was found to be significantly associated with FOIS change from baseline to 1 year.</p><p><strong>Conclusion: </strong>There were no differences in PFS or OS between patients treated with primary TORS or RT for early-stage HPV-associated OPSCC. Clinical N2 status is associated with FOIS change at 1 year and may be the major factor affecting long-term swallowing function, irrespective of primary treatment modality.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"284-293"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10176932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Approaches for Possible Positions of an Olfactory Implant to Stimulate the Olfactory Bulb.","authors":"Susanne Menzel, Iordanis Konstantinidis, Marco Valentini, Paolo Battaglia, Mario Turri-Zanoni, Giorgio Sileo, Giulia Monti, Paolo Giocondo Maria Castelnuovo, Thomas Hummel, Alberto Macchi","doi":"10.1159/000529563","DOIUrl":"10.1159/000529563","url":null,"abstract":"<p><strong>Introduction: </strong>Current scientific developments seem to allow for an \"olfactory implant\" in analogy to cochlear implants. However, the position and surgical approaches for electrical stimulation of the olfactory system are unclear.</p><p><strong>Methods: </strong>In a human anatomic cadaver study, we investigated different endoscopic approaches to electrically stimulate the olfactory bulb (OB) based on the following considerations: (1) the stimulating electrode should be close to the OB. (2) The surgical procedure should be as non-invasive and safe as possible and (3) as easy as possible for an experienced ENT surgeon.</p><p><strong>Results: </strong>In summary, the endoscopic intracranial positioning of the electrode via a widened ostium of the fila olfactoria or a frontal sinus surgery like a Draf IIb procedure is a good option in terms of patients' risk, degree of difficulty for ENT surgeons, and position to the OB. Endoscopic intranasal positioning appeared to be the best option in terms of patient risk and the degree of difficulty for ENT surgeons. Although a bigger approach to the OB using a drill and the combined intranasal endoscopic and external approach enabled a close placement of the electrode to the OB, they do not seem relevant in practice due to their higher invasiveness.</p><p><strong>Conclusion: </strong>The study suggested that an intranasal positioning of a stimulating electrode is possible, with placements beneath the cribriform plate, extra- or intracranially, applying elegant surgical techniques with low or medium risk to the patient and a close placement to OB.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"253-263"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9227426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Audiometric and Self-Reported Outcomes in Patients with Otosclerosis and a Small Air-Bone Gap after Stapes Surgery.","authors":"Henryk Skarzynski,&nbsp;Beata Dziendziel,&nbsp;Elzbieta Gos,&nbsp;Piotr Henryk Skarzynski","doi":"10.1159/000528260","DOIUrl":"https://doi.org/10.1159/000528260","url":null,"abstract":"<p><strong>Introduction: </strong>The main determinant in deciding on stapes surgery in patients with otosclerosis is the degree of hearing loss, specifically the size of the preoperative air-bone gap (ABG). The debate over the minimum ABG centers on the risk-to-benefit ratio of stapes surgery in patients with small ABG (sABG). The aim of this study was to measure the audiological outcomes and self-assessed satisfaction in a group of otosclerosis patients with an sABG who underwent stapedotomy.</p><p><strong>Methods: </strong>There were 83 patients with preoperative sABG ≤25 dB HL (mean of 500, 1,000, 2,000, 4,000 Hz) included in this study. Audiometry was performed before surgery and 6 months and 12-36 months after surgery. Self-reported patient outcomes before and after surgery were collected using questionnaires.</p><p><strong>Results: </strong>At the 6-month follow-up, the ABG was closed within 10 dB in 63 (78.8%) cases. Preoperatively, tinnitus was present in 70% of patients, of which 66% reported that tinnitus was a moderate or severe problem. Postoperatively, 71% of patients experienced a significant reduction in tinnitus severity and 34% of them reported complete disappearance. The self-report outcomes relating to quality of life and hearing reflected a good level of satisfaction in most patients.</p><p><strong>Conclusion: </strong>The possibility of reducing bothersome tinnitus after stapes surgery, and thus improving the patient's quality of life, should be taken into account when making a decision on stapes surgery in these patients.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":"85 2","pages":"88-96"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9645498","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":"Clinical Significance of Serum Iron Metabolism-Related Markers in Patients with Nasopharyngeal Carcinoma.","authors":"Jiaqi Mei, Xue Xiao, Naixu Liang, Liangzhe Dong, Songxiao Wei, Lifeng Mo, Weilin Zhao, Yonglin Cai","doi":"10.1159/000530714","DOIUrl":"10.1159/000530714","url":null,"abstract":"<p><strong>Introduction: </strong>It is known that iron metabolism is dysregulated in nasopharyngeal carcinoma (NPC). However, a meaningful assessment of the iron metabolic status in cancer patient is still under debate. This study aims to evaluate the status of iron metabolism, as well as to explore the correlation between those related serum markers and clinicopathological features of patients with NPC.</p><p><strong>Methods: </strong>Peripheral blood was collected from 191 pretreatment NPC patients and 191 healthy controls. The red blood cell parameters, plasma Epstein-Barr virus (EBV) DNA load, serum iron (SI), total iron-binding capacity (TIBC), transferrin, soluble transferrin receptor (sTFR), ferritin, and hepcidin were quantitatively detected.</p><p><strong>Results: </strong>The mean levels of hemoglobin and red blood cell count in the NPC group were significantly lower than those in the control group, while no statistical differences in mean MCV were found between the two groups. Median levels of SI, TIBC, transferrin, and hepcidin were significantly lower in the NPC group than in the control group. Compared to patients with the T1-T2 classification, patients with the T3-T4 classification exhibited significantly lower expression levels of SI and TIBC. Serum levels of ferritin and sTFR were significantly higher in patients with M1 classification than those with M0 classification. The EBV DNA load was associated with serum levels of sTFR and hepcidin.</p><p><strong>Conclusion: </strong>NPC patients had functional iron deficiency. The degree of iron deficiency was related to the tumor burden and metastasis of NPC. EBV might be involved in the regulation of iron metabolism in the host.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":"85 4","pages":"223-230"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9960071","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":"Construction of Prognostic Nomogram in Patients with N3-Stage Nasopharyngeal Carcinoma.","authors":"Wenmiao Cao, Xiaoxin Li, Jianqi Yang, Enming Xing, Wenjuan Wu, Yizhi Ge, Buhai Wang","doi":"10.1159/000530053","DOIUrl":"10.1159/000530053","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to retrospectively identify the metastatic influence factors and predict the prognosis and develop an individualized prognostic prediction model for patients with N3-stage nasopharyngeal carcinoma (NPC).</p><p><strong>Methods: </strong>The study collected 446 NPC patients with N3 stage from the Surveillance, Epidemiology, and End Results database between 2010 and 2015. The patients were classified into subgroups based on the histological types and metastatic status. Multivariable logistic, Cox regression, and Kaplan-Meier method with the log-rank test were performed. The nomogram model was created using the prognostic factors identified from Cox regression analysis. The predictive accuracy was determined based on the concordance index (c-index) and calibration curves.</p><p><strong>Results: </strong>The 5-year overall survival (OS) of the NPC patients with N3 stage was 43.9%, and the prognosis of patients without any distant metastases was largely longer than that with metastases. No difference was observed between different pathological types in the entire cohort. However, patients with non-keratinized squamous cell carcinoma had a better OS than that of the patients with keratinized squamous cell carcinoma in a nonmetastatic subgroup. Using the Cox regression analysis results, the nomogram successfully classified these patients into low- and high-risk subgroups and presented the survival difference. The c-index of the nomogram for predicting the prognosis was satisfactory.</p><p><strong>Conclusion: </strong>This study identified metastatic risk factors and developed a convenient clinical tool for the prognosis of NPC patients. This tool can be used for individualized risk classification and decision-making regarding treatment of NPC patients with N3 stage.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":"85 4","pages":"195-207"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10313983","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":"Cerebellar Abscess Induced by Cochlear Fistula due to Chronic Suppurative Otitis Media.","authors":"Natsuko Shibamiya, Moriyasu Yamauchi, Yuichiro Kuratomi, Shizuo Komune","doi":"10.1159/000531252","DOIUrl":"10.1159/000531252","url":null,"abstract":"<p><p>Cochlear fistulas with cholesteatoma as the primary disease have been reported frequently in the relevant literature. However, there are no reports of cochlear fistula without cholesteatoma due to chronic suppurative otitis media with intracranial complications. We report a case of cochlear fistula due to chronic otitis media that was diagnosed after the onset of a cerebellar abscess. The patient was a 25-year-old man with severe autism. He was admitted to our hospital with otorrhea from his left ear, emesis, and impaired consciousness. Computed tomography (CT) of the head showed left suppurative otitis media, left cerebellar abscess, and brainstem compression due to hydrocephalus. Right extra-ventricular drainage and brain abscess drainage were urgently performed. The next day, foramen magnum decompression and abscess drainage with partial resection of the swollen cerebellum were performed for decompression purposes. He was subsequently treated with antimicrobial therapy, but magnetic resonance imaging of the head showed an increase in the size of the cerebellar abscess. Re-examination of the temporal bone CT scans revealed a bony defect in the left cochlear promontory angle. We assumed that the cochlear fistula was responsible for the otogenic brain abscess. Thus, the patient underwent surgical closure of the cochlear fistula. After the operation, the cerebellar abscess lesion gradually shrank, and his general condition stabilized. Cochlear fistula should be considered in the management of patients with inflammatory middle ear disease associated with otogenic intracranial complications in the middle ear.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":"85 4","pages":"238-242"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9955276","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":"An Analysis of Postoperative Complications in Medialization Thyroplasty: NSQIP Data.","authors":"Lauren A DiNardo,&nbsp;Mattie Rosi-Schumacher,&nbsp;Cathleen C Kuo,&nbsp;Ryan Nagy,&nbsp;Michele M Carr","doi":"10.1159/000526282","DOIUrl":"https://doi.org/10.1159/000526282","url":null,"abstract":"<p><strong>Introduction: </strong>Medialization thyroplasty is a procedure indicated for treatment of impaired vocal fold movement. The purpose of this study was to identify variables associated with length of hospital stay (LOS), reoperation, and readmission in patients who underwent a medialization thyroplasty procedure for unilateral vocal cord paralysis.</p><p><strong>Methods: </strong>Adults who underwent unilateral medialization thyroplasty were identified using the 2017 to 2019 NSQIP databases via Current Procedural Terminology code 31591. Data collected included patient demographics, comorbidities, preoperative labs, American Society of Anesthesiologists classification, inpatient status, operative length, and complications. Univariate and multivariate logistic regression were used to analyze effects on total LOS, reoperation, and readmission.</p><p><strong>Results: </strong>320 patients were identified, with a mean age of 61 years (95% Cl 59.4-62.7) and a female-to-male ratio of 1.1:1. Forty-two (13.1%) patients reported dyspnea as a preoperative symptom. Seven patients (2.2%) reported postoperative complications, 2 with multiple complications: 2 surgical site infections, 2 pneumonias, 2 unplanned intubations, 2 myocardial infarctions, 1 septic shock, 1 cardiac arrest, 1 ventilator use (>48 h), and 1 acute renal failure. Fifty-one (15.9%) were inpatient procedures, with a mean LOS of 1.43 days (95% CI 0.92-1.94). Preoperative functional status and bilirubin were significantly associated with longer LOS (p < 0.001). There were 6 (1.9%) readmissions and 2 (0.6%) reoperations. In univariate analysis, dyspnea varied with reoperation which is important to note in this patient population with glottic insufficiency.</p><p><strong>Conclusion: </strong>Medialization thyroplasty is a procedure with a low risk of mortality. However, preexisting patient comorbidities are associated with an increased risk of postoperative complications and an increased length of stay.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":"85 1","pages":"20-27"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9211134","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}