Journal of Spinal Cord Medicine最新文献

{"title":"Neuropathic pain development and maintenance and its association with motor recovery after cervical spinal cord injury.","authors":"Kosuke Saita, Masahiko Sumitani, Yurie Koyama, Shurei Sugita, Yoshitaka Matsubayashi, Toru Ogata, Hiroshi Ohtsu, Hirotaka Chikuda","doi":"10.1080/10790268.2024.2309421","DOIUrl":"10.1080/10790268.2024.2309421","url":null,"abstract":"<p><strong>Background: </strong>In our published randomized controlled trial, we revealed that patients with acute ASIA Grade C incomplete cervical spinal cord injury (SCI) who underwent early surgery (within 24 h post-injury) had accelerated motor recovery at six months than those with delayed surgery (>2 weeks post-injury); however, neuropathic pain (NeP) worsened regardless of surgery timing. Here, we conducted <i>post-hoc</i> analyses to intensively assess NeP development and maintenance.</p><p><strong>Methods: </strong>Of 44 patients (median 64.5 years; three female; early intervention, <i>n</i> = 26), NeP was categorized into at-level and below-level pain and evaluated at  two weeks and one year after injury using the Neuropathic Pain Symptom Inventory (NPSI). We compared the two groups based on background characteristics. A mixed-design analysis of variance with sex as a covariate was conducted to analyze motor recovery and Health-related quality of life (HRQOL) in groups with severe (NPSI ≥ 10) or mild (NPSI < 10) pain.</p><p><strong>Results: </strong>Upper and lower limb motor impairments were comparable between both groups regardless of pain severity. Severe at-level pain remained stable and worsened at one year than mild at-level pain; however, the upper- and lower-limb motor scores and HRQOL had comparable recovery. Background characteristics did not affect severity or time course of NeP. Patients with severe below-level pain demonstrated slower lower-limb motor recovery than those with mild below-level pain, whereas HRQOL improved regardless of pain severity.</p><p><strong>Conclusions: </strong>Both at-level and below-level NeP developed and persisted relatively early in the course of traumatic SCI with incomplete motor paralysis; their severities worsened over time or remained severe since onset.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"585-592"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933864","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":"Statement of Retraction.","authors":"","doi":"10.1080/10790268.2025.2506313","DOIUrl":"10.1080/10790268.2025.2506313","url":null,"abstract":"","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"743"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095242","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":"Evaluation of domain-specific vs general purpose GPT models for SCI-related gastrointestinal, cardiovascular and pulmonary complications.","authors":"Alejandro García-Rudolph, David Sanchez-Pinsach, Eloy Opisso","doi":"10.1080/10790268.2024.2420433","DOIUrl":"10.1080/10790268.2024.2420433","url":null,"abstract":"","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"718-719"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677514","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":"Transcutaneous neuromodulation versus oxybutynin for neurogenic detrusor overactivity in persons with spinal cord injury: A randomized, investigator blinded, parallel group, non-inferiority controlled trial.","authors":"Samantak Sahu, Srikumar Venkataraman, Asem Rangita Chanu, U Singh","doi":"10.1080/10790268.2024.2370099","DOIUrl":"10.1080/10790268.2024.2370099","url":null,"abstract":"<p><strong>Study design: </strong>This study is a randomized, investigator-blinded, controlled trial with a non-inferiority design.</p><p><strong>Objective: </strong>To investigate the effectiveness of neuromodulation by transcutaneous electrical stimulation of the somatic afferent nerves of the foot in neurogenic detrusor overactivity (NDO) in persons with spinal cord injury (SCI) and compare its effectiveness with oral oxybutynin.</p><p><strong>Setting: </strong>The study was conducted in a rehabilitation in-patient ward of a tertiary care hospital.</p><p><strong>Methods: </strong>Twenty-nine persons with SCI with NDO, either sex, aged 18 years and above were randomized into two groups, one group receiving oral oxybutynin (5 mg thrice a day for two weeks) and the other transcutaneous electrical stimulation (5 Hz, 200 µs pulse, biphasic, amplitude up to 60 mA, 30 min/day for two weeks). Bladder capacity was evaluated by clinical bladder evaluation (i.e. bladder capacity measured by adding leak volume, voiding volume if any, and post-void residue using a catheter) and cystometric bladder capacity by one-channel cystometry. Maximum cystometric pressure was evaluated by one-channel water cystometry. Data were analyzed with Fisher's Exact, t-test, and Wilcoxon rank sum tests.</p><p><strong>Results: </strong>Bladder capacity improved significantly in the oxybutynin and neuromodulation groups as measured by one-channel water cystometry (136 ml vs. 120.57 ml) and clinical evaluation (138.93 ml vs. 112 ml). The increase in the neuromodulation group achieved the pre-decided non-inferiority margin of 30 ml over the oxybutynin group when measured by one-channel water cystometry but not by clinical evaluation. Maximum cystometric pressure did not significantly improve in either group when compared with the baseline.</p><p><strong>Conclusion: </strong>Transcutaneous neuromodulation and oxybutynin effectively increased bladder capacity in persons with SCI with NDO. Neuromodulation by once-a-day transcutaneous electrical stimulation was non-inferior to thrice-a-day oxybutynin when evaluated by one-channel water cystometry.<b>Trial registration:</b> Clinical Trials Registry India identifier: CTRI/2018/05/013735.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"621-628"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494084","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":"Predicting inpatient rehabilitation length of stay for adults with traumatic spinal cord injury.","authors":"Tara A Whitten, Adalberto Loyola Sanchez, Bina Gyawali, Elisavet D E Papathanassoglou, Jeffrey A Bakal, Jacqueline A Krysa","doi":"10.1080/10790268.2024.2325165","DOIUrl":"10.1080/10790268.2024.2325165","url":null,"abstract":"<p><strong>Introduction: </strong>Most post-injury traumatic spinal cord injury (TSCI) care occurs in the inpatient rehabilitation setting. The inpatient rehabilitation length of stay (R-LOS) has been shown to be a significant predictor of motor function restoration in persons with TSCI. Due to the complexity, and heterogeneity of individuals with TSCI, the R-LOS is challenging to predict at admission.</p><p><strong>Purpose: </strong>To identify the main predictors of R-LOS and derive an equation to estimate R-LOS in persons with TSCI.</p><p><strong>Methods: </strong>This is a retrospective analysis of data from adults with TSCI from The Rick Hansen Spinal Cord Injury Registry in Alberta, Canada, who received rehabilitation care between May 10, 2005, and January 28, 2020. Multiple linear regression analysis was used to determine significant relationships between R-LOS and measures of participant demographics, length of stay, impairment and injury classification, and comorbidities.</p><p><strong>Results: </strong>The analysis included 736 adults with TSCI from an eligible cohort of 1365. The median R-LOS was 65 days (IQR 39-99 days), ranging from 1 to 469 days. Multivariate linear regression analysis identified two significant predictors of R-LOS, total FIM score and the injury classification. This model was used to derive a R-LOS prediction equation, which explained 34% of the variance in R-LOS.</p><p><strong>Conclusion: </strong>We developed a simple equation to predict R-LOS based on the level of impairment and total FIM scores in persons with TSCI. These data have implications for health system planning, improvement, and innovation, and provide insights to support further research into the predictors of R-LOS, identification of higher-risk individuals.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"593-603"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140102718","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":"On the Move pad - a portable multipurpose pad: User feedback.","authors":"Chang Dae Lee, Rosemarie Cooper, Rory A Cooper","doi":"10.1080/10790268.2024.2364381","DOIUrl":"10.1080/10790268.2024.2364381","url":null,"abstract":"<p><strong>Context/objective: </strong>Hard-shell toilet seats may compromise safety and hinder the participation of individuals at risk for pressure injuries (PIs) when using these facilities away from home in public, hotel, or family/friend restrooms. Moreover, people often add \"wash-cloths\" for additional padding for comfort, and to reduce the risk of PIs due to pressure or shearing on their wheelchairs surfaces. This study investigated the utilization of portable pads, initially designed for toilet use but adaptable to various places and contexts, while examining pad usability.</p><p><strong>Design: </strong>A cross-sectional descriptive survey design.</p><p><strong>Setting: </strong>Inpatient care, outpatient care, and community setting.</p><p><strong>Participants: </strong>45 individuals at risk of PIs.</p><p><strong>Results: </strong>Participants extended the use of these pads beyond toilets, employing them as wheelchair armrest and leg rest pads in other settings. Feedback from a customized questionnaire indicated high levels of usefulness (8.5/10) and ease of use (9.1/10) attributed to the pads. Among the features, the top three favored were ease of use, comfort/cushioning, and function. Participants expressed a desire for a variety of sizes and colors to enable versatile usage and suggested incorporating a pocket for storing small items.</p><p><strong>Conclusions and relevance: </strong>Individuals at risk of PIs require cushioning not only on hard-shell toilet seats, but also for additional padding, protection and enhancing the use of wheelchairs. Rehabilitation professionals can play a crucial role in educating and training both clients and caregivers to understand PI prevention, enabling them to effectively leverage the pads in appropriate situations, thereby enhancing their comfort in their wheelchairs during social engagement.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"710-717"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318807","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":"Perspectives of veterans with spinal cord injuries and disorders and their providers on impacted healthcare during the COVID-19 pandemic.","authors":"Lance Washington, Marinella Galea, Steven Knezevic, B Jenny Kiratli, Ona Bloom, Jennifer Sippel, Ann M Spungen, Doug Ota, Andrea K Finlay","doi":"10.1080/10790268.2025.2517934","DOIUrl":"https://doi.org/10.1080/10790268.2025.2517934","url":null,"abstract":"<p><strong>Objective: </strong>Veterans with spinal cord injuries and disorders (SCI/D) reported experiencing challenges from disrupted and deferred health services during the COVID-19 pandemic, including disrupted care coordination, supply chain, and essential services, such as wheelchair repair. This study used qualitative methods to examine the perspectives of Veterans with SCI/D (VSCI/D) and SCI/D healthcare providers on how the COVID-19 pandemic impacted health services.</p><p><strong>Design/setting/participants: </strong>Virtual focus groups were conducted with both VSCI/D who received care at the Veterans Health Administration (VHA) and VHA SCI/D providers who provided services for VSCI/D between March 2020 and March 2022.</p><p><strong>Outcome measures: </strong>Topics assessed COVID-19 pandemic experiences including healthcare access and needs, Veteran and provider perspectives of Veterans' experiences during the pandemic, Veterans' coping strategies, and future emergency preparedness strategies.</p><p><strong>Results: </strong>There were 11 Veterans and 11 providers who participated in focus groups. Five themes were identified: (1) challenges with healthcare, care coordination, and homecare; (2) supply chain issues; (3) adapting to virtual platforms for support and therapy; (4) communication and reliable information about COVID-19; and (5) challenges with isolation and limited independence.</p><p><strong>Conclusion: </strong>This study highlights challenges VSCI/D faced during the COVID-19 pandemic. Recommendations to enhance VHA support for VSCI/D during future emergencies include strengthening home care support, system level changes to supply management to be more flexible, and interdisciplinary town halls to transparently share comprehensive information. Virtual peer support groups may address challenges with isolation and limited independence.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530770","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":"United States Veteran Perceptions of the Veterans Health Administration Spinal Cord Injuries and Disorders Annual Evaluation.","authors":"Jennifer L Sippel, Kevin T Stroupe, Gabriel Escudero, Zhiping Huo, Ibuola O Kale, Bella Etingen, Charlesnika T Evans, I Manosha Wickremasinghe, Bridget Bennett, Bridget M Smith","doi":"10.1080/10790268.2025.2517928","DOIUrl":"https://doi.org/10.1080/10790268.2025.2517928","url":null,"abstract":"<p><strong>Context: </strong>Veterans Health Administration (VHA) offers Annual Evaluations (AEs) to Veterans with spinal cord injuries and disorders (SCI/D) for preventive services, managing common complications, psychosocial services, and addressing equipment needs.</p><p><strong>Objective: </strong>Obtain Veteran perceptions of AE services and examine their association with Veteran characteristics and receipt of AEs.</p><p><strong>Methods: </strong>Surveys were sent to <i>n</i> = 8,421 Veterans in the VHA SCI/D Registry electronically (<i>n</i> = 8,121) or through US mail (<i>n</i> = 300), with a 23.64% response rate. After excluding participants with missing data, <i>n</i> = 1,687 Veterans were included in descriptive and logistic regression analyses.</p><p><strong>Results: </strong>Respondents were aged 60.7 years (SD=11.60) on average; most were male (91.2%), white (75.9%), and non-Hispanic (90.5%). 72.4% indicated receiving their most recent SCI/D AE about one year ago, 24.8% more than one year ago, and 3.4% had never had an AE. The most frequently reported reasons for not receiving an AE were COVID-19 related concerns (46.1%), and that AE was not offered (23.4%). Most (73.7%) indicated the AE was \"Very Important\" for their health and well-being. Veterans living more than 120  min from their VA had lower odds (0.51, 95% CI 0.32-0.80) of reporting recent AEs compared to Veterans who lived within 30  min.</p><p><strong>Conclusions: </strong>Veterans expressed high levels of satisfaction with the AE and found many aspects to be valuable. Additional strategies are needed to address travel barriers and COVID-19 related access challenges to bolster AE receipt. Future research and efforts to leverage technology for reminders may improve AE uptake.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-13"},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530772","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":"Spinal epidural electrical stimulation for the recovery of motor function in lower limbs after spinal cord injury: A pilot study.","authors":"H S Chhabra, K K V Kalidindi, N Garg, A Sharma, B Chhibber, H Kumar, G Vishwakarma, M Gupta, M R Bhat","doi":"10.1080/10790268.2025.2517935","DOIUrl":"https://doi.org/10.1080/10790268.2025.2517935","url":null,"abstract":"<p><strong>Study design: </strong>Single-arm prospective pilot study.</p><p><strong>Purpose: </strong>To assess the safety and efficacy of sEES in the recovery of motor function after severe SCI in the Indian population and to evaluate the feasibility of a larger study.</p><p><strong>Overview of literature: </strong>Standing and walking are highly desirable goals for persons with spinal cord injury (SCI). Activity-based locomotor training is the only available practice to enhance recovery at present. However, it does not yield significant outcomes in individuals with severe spinal cord injury. In recent years, Spinal epidural electrical stimulation (sEES) has been reported to produce rhythmic motor activity in limbs in a few case reports and also in clinical trials in animals and more recently, in a few human case reports.</p><p><strong>Methods: </strong>We conducted a single-arm prospective pilot study at a tertiary care spine surgery center in five subjects with chronic spinal cord injury with an absence of useful power in lower limbs and satisfying the eligibility criteria. The Institute Ethics Committee and the Research Review Committee approved the study and it was registered with the Clinical Trials Registry of India.</p><p><strong>Results: </strong>No intraoperative or early postoperative complications were noted in any of the subjects. Two subjects had wound complications at 1 and 3 months, respectively and were managed successfully. All of these participants were unable to stand, step, or walk without assistance before the recruitment. With epidural stimulation, four subjects gained better control of standing full weight bearing (without assistance). Four (<u>80%</u>) subjects were able to coordinate stepping on a treadmill and three (60%) were able to walk without knee braces with epidural stimulation. Objective functional outcome measures such as the Walking Index of spinal cord injury and Spinal Cord Independence Measure showed significant improvement (P = 0.004 and 0.002, respectively) with sEES. The trial could be implemented successfully, <i>i.e.</i> the desired recruitment could be achieved within a defined period, with procedural adherence and participant compliance.</p><p><strong>Conclusions: </strong>sEES is a safe intervention. Locomotor training with sEES improves the motor abilities and functional recovery of persons with chronic SCI. A larger prospective study with more subjects needs to be done to draw a definite conclusion and seems to be feasible using the protocol, outcome measures, and recruitment strategy of the pilot study.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530771","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":"Cortical intermittent theta burst stimulation and neurogenic bladder management after traumatic incomplete spinal cord injury: A case report.","authors":"Rohit Banerjee, Deeksha Patel, Kamran Farooque, Siddharth Jain, Amlesh Seth, Suman Das, Kanwal Preet Kocchar, Nand Kumar, Suman Jain","doi":"10.1080/10790268.2025.2514320","DOIUrl":"https://doi.org/10.1080/10790268.2025.2514320","url":null,"abstract":"<p><strong>Context: </strong>Neurogenic bladder is one of the major complications of spinal cord injury (SCI). Due to inadequate, ill-timed intervention, it can be lethal and lead to chronic case of renal calculus, renal failure or recurrent urinary tract infections. Intermittent theta burst stimulation (iTBS) is a patterned, non-invasive transcranial magnetic stimulation procedure that can improve the functional status of patients with SCI by manipulating cortico-spinal plasticity. Trans spinal magnetic stimulation has shown transient improvement in establishing voluntary urination and specific bladder parameters in patients with incomplete SCI (iSCI). The present case report evaluates the effect of motor cortical iTBS combined with a customized exercise regime on neurogenic lower urinary tract symptoms in a patient with incomplete dorsal spinal cord injury.</p><p><strong>Findings: </strong>This is a case of a patient with iSCI who sustaining a stabbing injury. Initial neurological assessment indicated a D5/6 hemi transection. Surgical intervention was followed by cortical iTBS administration for 2 weeks, adjunct to comprehensive rehabilitation for 6 weeks. Urodynamics studies were evaluated for bladder function and neurogenic bladder symptom score (NBSS). We found an improvement in bladder parameters (capacity, compliance, postvoid residual volume, detrusor pressure and bladder indices) linear to the NBSS score, indicating a reduction in neurogenic symptoms.</p><p><strong>Conclusion/clinical relevance: </strong>iTBS combined with bladder rehabilitation, can be a promising, effective treatment strategy in improving bladder dyssynergia and lower urinary tract dysfunction in patients with incomplete SCI.Trial registration: Clinical Trials Registry India identifier: CTRI/2023/08/056.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-4"},"PeriodicalIF":1.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327546","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}