Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"Indications for and outcomes of muscle flap reconstruction after pediatric posterior spinal fusion: An ACS-NSQIP analysis of 32,466 surgeries","authors":"Dylan K. Kim ,&nbsp;Kathleen Gu ,&nbsp;Anthony J. Tang ,&nbsp;Matthew J. Weintraub ,&nbsp;Omar Taha ,&nbsp;Thomas A. Imahiyerobo ,&nbsp;Benjamin D. Roye ,&nbsp;Michael G. Vitale ,&nbsp;Christine H. Rohde","doi":"10.1016/j.bjps.2025.03.023","DOIUrl":"10.1016/j.bjps.2025.03.023","url":null,"abstract":"<div><h3>Background</h3><div>Muscle flap reconstruction immediately after pediatric spinal fusion surgeries has been associated with favorable post-operative outcomes. This study employed a database with large geographic coverage to further characterize indications for and outcomes of such reconstructions.</div></div><div><h3>Methods</h3><div>Overall, 32,466 posterior spinal fusion cases from 2016 to 2022 were identified within the ACS-NSQIP Pediatric (NSQIP-P) database. Multivariable logistic regression was used to identify variables independently associated with the outcomes of flap reconstruction. Efficacy of muscle flap reconstruction was assessed using a training set, validation set without flap reconstruction, and test set with flap reconstruction, followed by difference-in-differences analysis between the validation and test sets (<em>p</em>&lt;0.05).</div></div><div><h3>Results</h3><div>Muscle flap reconstruction occurred in 3.0% of the cases with the rate increasing from 1.7% in 2016 to 4.4% in 2022. When compared to idiopathic spinal deformity, neuromuscular (OR: 1.56, 95% CI: 1.27–1.91) classification was associated with an increased likelihood of flap reconstruction. Moreover, 13+ instrumented levels (OR: 2.41, 95% CI: 1.84–3.14), prior spine surgery (OR: 2.48, 95% CI: 2.08–2.97), and American Society of Anesthesiologists class &gt;2 (OR: 1.47, 95% CI: 1.24–1.75) also increased the likelihood of flap reconstruction. Flap reconstruction was associated with a lower rate of post-operative complications than the expected rate calculated in a cohort that did not use such reconstruction (<em>p</em>&lt;0.001).</div></div><div><h3>Conclusion</h3><div>Muscle flap reconstruction in pediatric spinal fusion cases has increased more than twofold in prevalence and occurs in cases with higher surgical complexity and risk. Flap reconstruction is independently associated with a lower rate of post-operative complications than expected.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 273-281"},"PeriodicalIF":2.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715089","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":"Umbilical morphometry and centile curves in boys aged 1-14 years: Establishing reference values for umbilical reconstruction","authors":"Prativa Choudhury ,&nbsp;Vikesh Agrawal ,&nbsp;Devasenathipathy Kandasamy ,&nbsp;Vishesh Jain ,&nbsp;Devendra Kumar Yadav ,&nbsp;Anjan Kumar Dhua ,&nbsp;Shivani Phugat ,&nbsp;Naina Mehra ,&nbsp;Vishali Batra ,&nbsp;Prabudh Goel","doi":"10.1016/j.bjps.2025.03.012","DOIUrl":"10.1016/j.bjps.2025.03.012","url":null,"abstract":"<div><div>Umbilicoplasty is essential for the reconstruction of congenital malformations such as bladder-exstrophy-epispadias complex and gastroschisis. Reference values for umbilical morphometry are critical for anatomically acceptable outcomes.</div></div><div><h3>Objective</h3><div>To measure vertical height and width of the umbilicus in male participants aged 1–14 years and generate age-specific centile curves for umbilical reconstruction.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed computed tomography data from 887 male participants aged 1–14 years; those with previous abdominal surgeries or pathologies were excluded. Umbilical dimensions were measured in the coronal and axial planes. Generalized Additive Models for Location, Scale, and Shape modeling generated centile curves (3rd to 97th) for umbilical dimensions.</div></div><div><h3>Results</h3><div>The mean umbilical height and width were 16.67±5.54 mm and 16.5±4.52 mm, respectively, both positively correlating with age. The 50th percentile showed annual growth rates of ∼0.93 mm (height) and ∼0.75 mm (width). In younger children, the umbilicus appeared as an oblate spheroid; width exceeded height. Dimensions equalized around 4 years of age; thereafter, the umbilicus developed vertical ellipticity, with height exceeding width during puberty.</div></div><div><h3>Conclusion</h3><div>These findings provide insights into umbilical morphological development during childhood and adolescence, offering valuable reference data for umbilical reconstruction in case of various malformations and post-transumbilical procedures.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 132-138"},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680681","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":"International observerships in plastic surgery: Key insights and recommendations for success","authors":"Miriam Vicente-Ruiz","doi":"10.1016/j.bjps.2025.03.016","DOIUrl":"10.1016/j.bjps.2025.03.016","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 5-6"},"PeriodicalIF":2.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610485","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":"Do we publish what we present? An updated analysis of abstracts from the 2012-2020 annual meetings of the American Society for Reconstructive Microsurgery","authors":"Rose S. Maisner ,&nbsp;Miranda X. Morris ,&nbsp;Alexandria Ayala ,&nbsp;Binh N. Vo ,&nbsp;J. Alexander Sizemore ,&nbsp;Nicholas C. Oleck ,&nbsp;Katie G. Egan ,&nbsp;Brett T. Phillips ,&nbsp;James A. Butterworth ,&nbsp;Haripriya S. Ayyala","doi":"10.1016/j.bjps.2025.03.015","DOIUrl":"10.1016/j.bjps.2025.03.015","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 1-4"},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601187","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 national survey of the current management of nonmalignant lipomatous tumours and a proposal for unified UK guidelines for practice","authors":"N. Blessley-Redgrave,&nbsp;P. Zigova,&nbsp;R. Weale,&nbsp;T. Bragg","doi":"10.1016/j.bjps.2025.03.011","DOIUrl":"10.1016/j.bjps.2025.03.011","url":null,"abstract":"<div><div>Although there exists clear guidance to determine which lipomatous lesions should be referred to a sarcoma multidisciplinary team (MDT) for discussion, subsequent guidelines for management advice are only focused on malignant lesions. This study aimed to address the management of benign and intermediate lipomatous lesions with reference to the available literature, precedent from 15 of the 17 UK sarcoma MDTs, and local experience.</div><div>Fifteen mock cases were presented to each MDT to determine local management pathways. This revealed significant heterogeneity within the management of these benign and intermediate lipomatous lesions across the UK. After combining this data with the available evidence in the literature, we developed recommendations for management of these lesions with the aim to reduce national variability. We propose the first set of national management guidelines specific to benign lipomatous lesions, which stratifies resources according to lipomatous tumour type.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 313-320"},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725187","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":"The psychosocial outcomes following cosmetic surgery are largely unknown: A systematic review","authors":"Kirsty M. Garbett ,&nbsp;Nicole Paraskeva ,&nbsp;Paul White ,&nbsp;Helena Lewis-Smith ,&nbsp;Harriet Smith ,&nbsp;Jason Anquandah ,&nbsp;Phillippa C. Diedrichs","doi":"10.1016/j.bjps.2025.03.013","DOIUrl":"10.1016/j.bjps.2025.03.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Cosmetic surgery is marketed and widely considered to exert positive psychosocial outcomes, particularly in relation to body image, self-esteem, and mental health. The present systematic review aimed to conduct a timely, up-to-date assessment of the existing academic empirical literature, applying stringent inclusion criteria to summarize only the highest quality of evidence in the field.</div></div><div><h3>Methods</h3><div>The following databases were systematically searched: EBSCO, Cochrane Library, Scopus, and ProQuest. Screening was completed by two independent reviewers. Prospective studies that utilized a control cohort to examine at least one psychosocial outcome using a validated measure after cosmetic surgery were included. Risk was double assessed using the Effective Public Health Practice Project Quality Assessment Tool.</div></div><div><h3>Results</h3><div>Seventeen studies met the inclusion criteria. There was considerable heterogeneity across research designs, control groups, measures, and statistical analyses. Overall, the quality of studies was poor. Results suggest short-term improvements in some psychosocial outcomes after cosmetic surgery (particularly in relation to body-area–specific satisfaction, self-esteem, sexual well-being and physical well-being), with limited and inconclusive evidence for outcomes such as mental health, holistic body image, quality of life and social functioning. Very few studies have explored psychosocial outcomes beyond 6-months after the surgery.</div></div><div><h3>Conclusion</h3><div>Current evidence regarding psychosocial outcomes following cosmetic surgery is weak. There is an urgent need to conduct high-quality research that will require collaboration among surgeons, research psychologists, and methodologists. Recommendations include pre-registration, larger sample sizes, longer follow-up duration, and appropriate control group recruitment. Considering the increasing popularity of cosmetic surgery globally, this field of research should assume priority.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 282-297"},"PeriodicalIF":2.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmented reality for perforator mapping: A systematic review and meta-analysis","authors":"Hester Lacey ,&nbsp;Yi Min Khoong ,&nbsp;Baljit Dheansa","doi":"10.1016/j.bjps.2025.03.006","DOIUrl":"10.1016/j.bjps.2025.03.006","url":null,"abstract":"<div><h3>Background</h3><div>Augmented reality (AR) is increasingly used to aid perioperative navigation of patient anatomy, improve intraoperative accuracy and reduce operating times. This review compares outcomes relating to AR versus conventional imaging for perforator mapping in flap reconstruction.</div></div><div><h3>Methods</h3><div>A systematic search was performed, suitable articles reviewed, and data extracted by 2 independent reviewers, with conflicts resolved by consensus. Meta-analysis was conducted to evaluate AR versus Doppler on outcomes including distance between imaged perforators and intraoperative findings, number of perforators identified, perforator localisation time, total operating time, and postoperative complications.</div></div><div><h3>Results</h3><div>Of 1005 articles retrieved, 14 were eligible for meta-analysis. Intraoperative use of AR was associated with a significantly shorter distance between identified perforators and intraoperative findings (SMD = −1.88; 95% CI −3.69 to −0.08; P = 0.04) and identification of more perforators than conventional Doppler (SMD = 0.12; 95% CI 0.01 to 0.23; P = 0.04). AR decreased time taken for perforator localisation (SMD = −2.53; 95% CI −5.14 to 0.08; P = 0.06) and significantly reduced total operating time (SMD = −16.34; 95% CI −21.72 to −10.95; P&lt; 0.00001). There was no significant difference between the 2 groups in the number of postoperative complications (SMD = 1.12; 95% CI 0.46 to 2.74; P = 0.80).</div></div><div><h3>Conclusions</h3><div>The results suggest that AR technologies offer increased intraoperative accuracy of perforator identification and reduced time to perforator identification and total operating times compared to conventional imaging. Further high-quality studies with larger sample sizes are required to definitively confirm the benefits to support their widespread uptake and use.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 170-180"},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697204","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":"The 5-factor modified frailty index as a predictor of outcomes in abdominal wall reconstruction","authors":"Michael I. Kim ,&nbsp;Eloise W. Stanton ,&nbsp;Carly Askinas ,&nbsp;Joseph N. Carey ,&nbsp;David A. Daar ,&nbsp;Emma C. Koesters","doi":"10.1016/j.bjps.2025.03.014","DOIUrl":"10.1016/j.bjps.2025.03.014","url":null,"abstract":"<div><h3>Background</h3><div>Frailty is a known predictor of adverse postoperative outcomes in certain settings; however, its utility in abdominal wall reconstruction (AWR) is yet to be established. Patients undergoing AWR typically have health complexities and comorbidities. However, few risk stratification tools exist for this patient population. This study evaluated the relevance and predictive value of the 5-factor modified frailty index (mFI-5) for outcomes following AWR.</div></div><div><h3>Methods</h3><div>The American College of Surgeons National Surgical Quality Improvement Program database (2011–2022) was searched to identify adult patients undergoing AWR. Patients were stratified according to the mFI-5 (0, 1, 2, and ≥ 3). The demographic and 30-day complication data, such as reoperation, readmission, and wound complications, were collected. Multivariable logistic regression adjusted for covariates, and marginal effects analysis estimated predicted probabilities for outcomes.</div></div><div><h3>Results</h3><div>In the 26,856 identified patients, mFI-5 ≥ 3 compared with 0 was independently associated with increased odds of all-cause complications (odds ratio [OR] 1.87, 95% confidence interval [CI] 1.54–2.28, p &lt; 0.001), wound complications (OR 1.49, 95% CI 1.17–1.90, p = 0.001), reoperation (OR 1.43, 95% CI 1.03–1.98, p = 0.031), readmission (OR 1.40, 95% CI 1.09–1.80, p = 0.008), and mortality (OR 3.19, 95% CI 1.56–6.52, p = 0.002). Predicted probabilities of complications increased from 15.1% (mFI-5 = 0) to 25.0% (mFI-5 ≥ 3), and almost 50% of the patients in the most-frail cohort were discharged to a non-home setting.</div></div><div><h3>Conclusion</h3><div>The mFI-5 is associated with increased risk of adverse outcomes in AWR, with higher frailty scores linked to elevated rates of significant postoperative complications. Incorporating frailty assessments into preoperative workflows may improve patient counseling and risk stratification.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 298-306"},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725185","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":"The future of wearable ergonomic devices in plastic surgery: A systematic review","authors":"Maissa Trabilsy ,&nbsp;Syed Ali Haider ,&nbsp;Sahar Borna ,&nbsp;Cesar A. Gomez-Cabello ,&nbsp;Ariana Genovese ,&nbsp;Srinivasagam Prabha ,&nbsp;Antonio J. Forte ,&nbsp;Brian D. Rinker ,&nbsp;Adekunle I. Elegbede ,&nbsp;M. Susan Hallbeck ,&nbsp;Olivia A. Ho","doi":"10.1016/j.bjps.2025.03.007","DOIUrl":"10.1016/j.bjps.2025.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Throughout the last decade, surgeons across specialties are increasingly using wearable support devices to minimize occupational discomfort during procedures. However, there is still a paucity of their use in plastic surgery. This review evaluates the types of ergonomic devices used across surgical specialties and their impact on pain reduction.</div></div><div><h3>Methods</h3><div>A systematic search was conducted on October 23, 2024, using Embase, PubMed, Scopus, Web of Science, and Cumulative Index to Nursing and Allied Health Literature. Inclusion criteria required the utilization of a wearable ergonomic device by surgeons in peer-reviewed, original research. Two investigators independently conducted the screening, extraction, and synthesis of results.</div></div><div><h3>Results</h3><div>Of the 954 reports identified, 11 articles were selected for analysis. The average study sample size was 13, with a range from 3 to 25 surgeons. The average time reported was 108 min, with a range from 10 to 383.5 min. The physical supporting devices included 6 upper extremity/body exoskeletons, 2 posture sensing and/or training devices, 1 lower extremity/body exoskeleton, 1 neck exoskeleton, one trunk exoskeleton, 1 exoskeleton-based radiation protection apron, and 1 external surgeon support system. These studies took place mainly in general surgery, with only one study in plastic surgery. All studies reported a positive surgeon experience using their respective device.</div></div><div><h3>Conclusion</h3><div>This review reveals that nearly half of the identified devices were upper body/upper extremity supporting devices, mainly used in general surgery with favorable experiences among the surgeons. This underscores the possibility of expanding the utilization of these devices further into plastic surgery and highlights the need for more research into plastic surgeons’ experiences using these ergonomic tools in the operating room.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 85-101"},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675039","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":"Fat-augmented latissimus dorsi muscle flaps as a reliable technique for breast reconstruction in underweight patients: A bicentric retrospective case-control study","authors":"Koichi Tomita ,&nbsp;Mifue Taminato ,&nbsp;Yoshihito Itani ,&nbsp;Hirohisa Kusuhara ,&nbsp;Hitomi Nakao ,&nbsp;Yu Sueyoshi ,&nbsp;Tateki Kubo","doi":"10.1016/j.bjps.2025.03.005","DOIUrl":"10.1016/j.bjps.2025.03.005","url":null,"abstract":"<div><div>Breast reconstruction in underweight patients (BMI &lt; 18.5 kg/m²) poses unique challenges due to limited subcutaneous fat and higher risks of unnatural contours with implant-based methods. This study evaluated the efficacy of fat-augmented latissimus dorsi (FALD) muscle flaps in addressing these challenges. We retrospectively analyzed outcomes of 12 underweight and 38 normal-weight patients undergoing unilateral breast reconstruction with FALD muscle flaps. Data collection included patient demographics, operative details, fat grafting volumes, complications, and patient-reported outcomes using BREAST-Q. The underweight group required additional fat grafting more frequently (75% vs. 63%, p = 0.003). Despite smaller flap weights (140 g vs. 165 g, p = 0.08) and reduced fat graft volumes (135 ml vs. 186 ml, p = 0.06), both groups achieved comparable aesthetic outcomes. Postoperative complications, including seroma and oil cysts, were similar between groups. While additional fat grafting sessions were more commonly needed in the underweight group, the final aesthetic results, evaluated by surgeon ratings and patient satisfaction, were equivalent to those in the normal-weight group, with high scores observed across all BREAST-Q domains. This study demonstrates that the FALD muscle flap is an effective and adaptable technique for autologous breast reconstruction in underweight patients. By utilizing available fat deposits and adapting to anatomical constraints, this method achieves both functional and aesthetic success. Further research with larger cohorts is needed to confirm these findings and refine this approach for broader application.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 38-47"},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643298","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}