Clinical Anatomy最新文献

{"title":"Microstructure of the radial head: Insights into anatomical variations and implications for advanced interventions.","authors":"Scott Cole, Randall R Rainwater, Erin Mannen, Mark A Tait, John W Bracey","doi":"10.1002/ca.24191","DOIUrl":"https://doi.org/10.1002/ca.24191","url":null,"abstract":"<p><p>Appropriate management of radial head fractures is integral to prevent long-term consequences like chronic pain and loss of motion. Advanced imaging systems, like micro-computed tomography (μCT), are valuable for understanding radial head fracture patterns as they utilize micrometer scale resolution to define important parameters of bone health like cortical density and trabecular thickness. The purpose of this study was to identify and describe the structural morphology of the radial head utilizing μCT. Nine fresh-frozen cadaveric human radii were divided into four equal quadrants, based, and labeled as posteromedial, posterolateral, anteromedial, and anterolateral. Quadrants were scanned with a SCANCO MicroCT40 with both cortical and cancellous bone density measurements at a resolution of 36.0 μm. Bone density, direct trabecular number, and trabecular thickness were recorded as milligrams of hydroxyapatite/cm<sup>3</sup>. A one-way repeated measures ANOVA was performed to compare the bone densities, trabecular number, and trabecular thickness of each of the four quadrants (p < 0.05). The posteromedial quadrant contained substantially more bone than other quadrants. Significantly greater bone densities were found in the posteromedial quadrant (148.1 mg of HA/cm<sup>3</sup>) compared to the anteromedial quadrant (54.6 mg of HA/cm<sup>3</sup>), posterolateral quadrant (137.5 mg of HA/cm<sup>3</sup>) compared to the anteromedial quadrant (54.6 mg of HA/cm<sup>3</sup>), and posterolateral quadrant (137.5 mg of HA/cm<sup>3</sup>) compared to the anterolateral quadrant (58.1 mg of HA/cm<sup>3</sup>). The trabecular number was not significantly different between quadrants. Trabecular thickness was significantly lower in the anterolateral (0.1417 mg of HA/cm<sup>3</sup>) and anteromedial (0.1416 mg of HA/cm<sup>3</sup>) quadrants compared to the posteromedial (0.1809 mg of HA/cm<sup>3</sup>) quadrant. The posterior half of the radial head was found to have a higher density of columns and arches compared to the anterior half. The microstructure of trabecular bone in the distal radius forms columns, struts, and arches, which allow for efficient transmission of stress through the bone. The microstructure of the radial head has similar microarchitecture to the distal radius with the present study identifying the presence of columns and arches in the radial head. These structures, along with trabecular density, in the posterior radial head may explain the lower incidence of fractures involving the posterior half of the radial head. Furthermore, our study supports the idea that the high incidence of fractures involving the anterolateral quadrant is due to microarchitecture characteristics and the relative lack of supportive structures compared to other areas. The novel insight gained from this study will aid in the development of advanced interventions for preventative measures and better treatment of radial head fractures like more satisfactory purchas","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565051","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":"Correction to “A histological study of the adult ligamentum arteriosum: Novel findings with application to a patent ductus arteriosus”","authors":"","doi":"10.1002/ca.24200","DOIUrl":"10.1002/ca.24200","url":null,"abstract":"<p>Iwanaga, J., Chaudhry, H., Yu, A., Matsuo, K., Kawai, H., Han, A., Tabira, Y., Saga, T., Watanabe, K., Loukas, M., &amp; Tubbs, R. S. (2024). A histological study of the adult ligamentum arteriosum: Novel findings with application to a patent ductus arteriosus. <i>Clinical Anatomy</i>, 37(1), 140–146. https://doi.org/10.1002/ca.24122</p><p>In the originally published article, author Humza Chaudhry's name was misspelled as Humza Choudhury. This has been corrected in the online version of the article.</p><p>We apologize for this error.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 1","pages":"113"},"PeriodicalIF":2.3,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ca.24200","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564967","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":"Main pulmonary artery diameter related to pneumonia severity","authors":"Luis Carlos Lozano-Carrillo,&nbsp;Luis Adrian Alvarez-Lozada,&nbsp;Bernardo Alfonso Fernández-Reyes,&nbsp;Karla V. Rodríguez-Alanís,&nbsp;Alberto Montemayor-Martinez,&nbsp;Oscar de-la-Garza-Castro,&nbsp;Alejandro Quiroga-Garza,&nbsp;Rodrigo Enrique Elizondo-Omaña","doi":"10.1002/ca.24203","DOIUrl":"10.1002/ca.24203","url":null,"abstract":"<p>The diameter (mPAD) of the main pulmonary artery (pulmonary artery trunk) is a crucial indicator for cardiovascular health and prognoses in various conditions. Its enlargement is associated with increased mortality and severity in COVID-19-related pneumonia. However, its relevance to non-COVID pneumonia remains uncertain. The aim of this study was to establish an association between mPAD and the severity of non-COVID pneumonia. Eligible participants with qualified Chest Computed Tomography scans from November 2019 to February 2023 were recruited to a cross-sectional retrospective study. They were stratified into pneumonia and non-pneumonia cohorts. Exclusion criteria included pulmonary hypertension, polytrauma, lung neoplasia, or a history of pulmonary stenosis repair. The mPAD was measured in both groups, and medical records were reviewed to identify comorbidities. Pulmonary CT data were classified by pattern and severity, and the mPAD was measured perpendicularly to the long axis of the artery at the point of bifurcation on an axial slice. Analysis of 380 CT scans (52.6% men, 47.4% women; mean age 52.88 ± 17.58) revealed a significant difference in mPAD between pneumonia and non-pneumonia cases (mean difference: 1.19 mm, 95% CI [0.46, 1.92], <i>p</i> = 0.001). Age correlated positively with mPAD (<i>r</i> = 0.231, 95% CI [0.028, 0.069], <i>p</i> &lt; 0.0001), and this correlation persisted after adjusting for confounders (<i>r</i> = 0.220, 95% CI [0.019, 0.073], <i>p</i> = 0.001). Ordinal logistic regression indicated 1.28 times higher odds of severe pneumonia with a larger diameter. The study highlights associations between mPAD, pneumonia, and severity, suggesting clinical relevance. Furthermore, the mPAD should be carefully considered in defining severity criteria for adverse outcomes in pneumonia patients. Further research is needed to refine clinical criteria on the basis of these findings.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"37 7","pages":"784-790"},"PeriodicalIF":2.3,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564968","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":"Using design thinking to create and implement a 3D digital library of anatomical specimens.","authors":"Morgan Titmus, Beatriz Ir de Oliveira, Paul Ellery, Gary Whittaker, Hannah Radley, Milo Radunski, Leo Ng, Petra Helmholz, Zhonghua Sun","doi":"10.1002/ca.24198","DOIUrl":"https://doi.org/10.1002/ca.24198","url":null,"abstract":"<p><p>Design thinking (DT) is a five-stage process (empathize, define, ideate, prototype, and test) that guides the creation of user-centered solutions to complex problems. DT is in common use outside of science but has rarely been applied to anatomical education. The use of DT in this study identified the need for flexible access to anatomical specimens outside of the anatomy laboratory and guided the creation of a digital library of three-dimensional (3D) anatomical specimens (3D Anatomy Viewer). To test whether the resource was fit for purpose, a mixed-methods student evaluation was undertaken. Student surveys (n = 46) were employed using the system usability scale (SUS) and an unvalidated acceptability questionnaire. These verified that 3D Anatomy Viewer was usable (SUS of 72%) and acceptable (agreement range of 77%-93% on all Likert-type survey statements, Cronbach's alpha = 0.929). Supplementary interviews (n = 5) were analyzed through content analysis and revealed three main themes: (1) a credible online supplementary learning resource; (2) learning anatomy with 3D realism and interactivity; (3) user recommendations for expanding the number of anatomical models, test questions, and gamification elements. These data demonstrate that a DT framework can be successfully applied to anatomical education for creation of a practical learning resource. Anatomy educators should consider employing a DT framework where student-centered solutions to learner needs are required.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472268","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":"Mechanisms of cerebrospinal fluid secretion by the choroid plexus epithelium: Application to various intracranial pathologies","authors":"Laura Øllegaard Johnsen,&nbsp;Kathrine Abildskov Friis,&nbsp;Maria Kirstine Møller-Madsen,&nbsp;Helle Hasager Damkier","doi":"10.1002/ca.24199","DOIUrl":"10.1002/ca.24199","url":null,"abstract":"<p>The choroid plexus (CP) is a small yet highly active epithelial tissue located in the ventricles of the brain. It secretes most of the CSF that envelops the brain and spinal cord. The epithelial cells of the CP have a high fluid secretion rate and differ from many other secretory epithelia in the organization of several key ion transporters. One striking difference is the luminal location of, for example, the vital Na⁺-K⁺-ATPase. In recent years, there has been a renewed focus on the role of ion transporters in CP secretion. Several studies have indicated that increased membrane transport activity is implicated in disorders such as hydrocephalus, idiopathic intracranial hypertension, and posthemorrhagic sequelae. The importance of the CP membrane transporters in regulating the composition of the CSF has also been a focus in research in recent years, particularly as a regulator of breathing and hemodynamic parameters such as blood pressure. This review focuses on the role of the fundamental ion transporters involved in CSF secretion and its ion composition. It gives a brief overview of the established factors and controversies concerning ion transporters, and finally discusses future perspectives related to the role of these transporters in the CP epithelium.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 1","pages":"63-74"},"PeriodicalIF":2.3,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ca.24199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421793","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":"Validity of an ultrasound device to measure bone mineral density","authors":"Jessica L. Puranda,&nbsp;Chris M. Edwards,&nbsp;Vinicius M. R. Weber,&nbsp;Mohamed Aboudlal,&nbsp;Kevin Semeniuk,&nbsp;Kristi B. Adamo","doi":"10.1002/ca.24187","DOIUrl":"10.1002/ca.24187","url":null,"abstract":"<p>This study aims to examine the validity and reliability of the UltraScan650™, a portable ultrasound device, used to measure BMD at the 1/3rd radius position. Fifty-two female first responders and healthcare providers were assessed using DXA (forearm, femur, lumbar, and total body) and the UltraScan650™. Fat and lean mass were also assessed using the DXA. Pearson correlations, Bland–Altman plots, <i>t</i>-tests, and linear regressions were used to assess validity. Intra-class correlation (ICC) coefficients were used to assess reliability. Inter-rater reliability and repeatability were good (ICC = 0.896 [0.818; 0.942], <i>p</i> &lt; 0.001) and excellent (ICC = 0.917 [0.785; 0.989], <i>p</i> &lt; 0.001), respectively. BMD as measured by the UltraScan650™ was weakly correlated to the DXA (<i>r</i> = 0.382 [0.121; 0.593], <i>p</i> = 0.0052). Bland–Altman plots revealed that the UltraScan650™ underestimated BMD (−0.0569 g/cm²), this was confirmed with a significant paired <i>t</i>-test (<i>p</i> &lt; 0.001). A linear regression was performed (0.4744 × UltraScan650™ + 0.4170) to provide more information as to the issue of agreement. Bland–Altman plots revealed a negligible bias, supported by a paired <i>t</i>-test (<i>p</i> = 0.9978). Pearson's correlation revealed a significant relationship (<i>r</i> = −0.771 [−0.862; −0.631], <i>p</i> &lt; 0.0001) between adjusted UltraScan650™—DXA and the average of the two scans (i.e., adjusted UltraScan650™ and DXA), suggesting a proportional constant error and proportional constant variability in measurements of BMD from the UltraScan650™. The UltraScan650™ is not a valid alternative to DXA for diagnostic purposes; however, the UltraScan650™ could be used as a screening tool in the clinical and research setting given the linear transformation is employed.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 1","pages":"54-62"},"PeriodicalIF":2.3,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141321844","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 anatomy of the coronary venous system and relevance to retrograde cardioplegia and cardiac electrophysiological interventions","authors":"Emeka Blessius Kesieme,&nbsp;Keith Gunn Buchan","doi":"10.1002/ca.24195","DOIUrl":"10.1002/ca.24195","url":null,"abstract":"<p>Anomalies of coronary venous system, the valve of the coronary sinus (Thebesian valve) and other cardiac malformations may make interventions through the coronary sinus difficult. These variants may pose a challenge in cannulating the coronary sinus for retrograde cardioplegia and for interventions performed through the coronary sinus by cardiac electrophysiologist/interventional cardiologist. Retrograde cardioplegia is an established method of myocardial protection with advantages, indications, and complications. A good knowledge of the anatomy of the coronary sinus and its variants is important in understanding the difficulties encountered while cannulating the coronary sinus for the delivery of retrograde cardioplegia, cardiac resynchronization therapy, treatment of arrhythmias, and percutaneous mitral valve annuloplasty.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 1","pages":"43-53"},"PeriodicalIF":2.3,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312244","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 conceptus and its parts: ontogenetic recapitulation in early human development","authors":"Brian Freeman","doi":"10.1002/ca.24194","DOIUrl":"10.1002/ca.24194","url":null,"abstract":"<p>Our understanding of the processes of human development that occur during and just after implantation is still incomplete. The anatomical studies by Erich Blechschmidt (1904–1992) at the University of Göttingen demonstrate the uniqueness and beauty of the early stages of individual human development or ontogeny. The interpretations of human embryology by Blechschmidt offer a simple unifying hypothesis: metabolic and biomechanical events are repeated, and this can be described as an ontogenetic recapitulation. This commentary provides a rationale for using some older terms and introducing new ones in the description of early human development. The product of conception is a <i>conceptus</i>; the outer part of the conceptus is the <i>ectoblast</i> and everything inside is the <i>endoblast;</i> the <i>endocyst</i> arises in the endoblast when the future amniotic fluid is forming. The human <i>embryo</i> arises from the innermost part of the endocyst. Terms such as <i>morula</i>, <i>gastrula</i>, and <i>cyema</i>, which are imported from zoology and ignore the role of the zona pellucida and constrained fluid compartments in the conceptus, can be avoided.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"37 7","pages":"778-783"},"PeriodicalIF":2.3,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ca.24194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312155","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":"Upper end of the central canal of the human spinal cord: Quantitative anatomical study and 3D modeling","authors":"Etienne Lefevre,&nbsp;Megane Le Quang,&nbsp;Guillaume Chotard,&nbsp;Steven Knafo,&nbsp;Pierre Mengelle,&nbsp;Yanis Taupin,&nbsp;Dominique Liguoro,&nbsp;Vincent Jecko,&nbsp;Jean-Rodolphe Vignes,&nbsp;Paul Roblot","doi":"10.1002/ca.24196","DOIUrl":"10.1002/ca.24196","url":null,"abstract":"<p>The upper end of the central canal of the human spinal cord has been repeatedly implicated in the pathogenesis of various diseases, yet its precise normal position in the medulla oblongata and upper cervical spinal cord remains unclear. The purpose of this study is to describe the anatomy of the upper end of the central canal with quantitative measurements and a three-dimensional (3D) model. Seven formalin-embalmed human brainstems were included, and the central canal was identified in serial axial histological sections using epithelial membrane antigen antibody staining. Measurements included the distances between the central canal (CC) and the anterior medullary fissure (AMF) and the posterior medullary sulcus (PMS). The surface and perimeter of the CC and the spinal cord were calculated, and its anterior–posterior and maximum lateral lengths were measured for 3D modeling. The upper end of the CC was identified in six specimens, extending from the apertura canalis centralis (ACC) to its final position in the cervical cord. Positioned on the midline, it reaches its final location approximately 15 mm below the obex. No specimen showed canal dilatation, focal stenosis, or evidence of syringomyelia. At 21 mm under the ACC in the cervical cord, the median distance from the CC to the AMF was 3.14 (2.54–3.15) mm and from the CC to the PMS was 5.19 (4.52–5.43) mm, with a progressive shift from the posterior limit to the anterior third of the cervical spinal cord. The median area of the CC was consistently less than 0.1 mm². The upper end of the CC originates at the ACC, in the posterior part of the MO, and reaches its normal position in the anterior third of the cervical spinal cord less than 2 cm below the obex. Establishing the normal position of the upper end of this canal is crucial for understanding its possible involvement in cranio-cervical junction pathologies.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 1","pages":"35-42"},"PeriodicalIF":2.3,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ca.24196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141302071","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":"Superficial retrocalcaneal bursae and nerves: From anatomy to ultrasound-guided procedures","authors":"Vincenzo Ricci,&nbsp;Ke-Vin Chang,&nbsp;Ondřej Naňka,&nbsp;Levent Özçakar","doi":"10.1002/ca.24193","DOIUrl":"10.1002/ca.24193","url":null,"abstract":"<p>The pertinent literature widely describes ultrasound-guided procedures targeting the retrocalcaneal bursa and the tendon tissue to manage insertional Achilles tendinopathy. Synovial bursae and cutaneous nerves of the superficial retrocalcaneal pad are often overlooked pain generators and are poorly considered by clinicians and surgeons. A layer-by-layer dissection of the superficial soft tissues in the retrocalcaneal region of two fresh frozen cadavers was matched with historical anatomical tables of the textbook <i>Traite d'Anatomie Topographique Avec Applications Médico-Chirurgicales</i> (1909 by Testut and Jacob). An accurate and detailed description of the superficial retrocalcaneal pad with its synovial bursae and cutaneous nerves was provided. Cadaveric dissections confirmed the compartmentalized architecture of the superficial retrocalcaneal fat pad and its histological continuum with the superficial lamina of the crural fascia. Superficial synovial tissue islands have been demonstrated on the posterior aspect of the Achilles tendon in one cadaver and on the posterolateral surface of the tendon in the other one. Digitalization of the original anatomical tables of the textbook <i>Traite d'Anatomie Topographique Avec Applications Médico-Chirurgicales</i> (1909 by Testut and Jacob) showed five potential locations of the superficial calcaneal bursa and a superficial retrocalcaneal nerve plexus within the Achilles tendon-fat pad interface. In clinical practice, in addition to the previously described interventions regarding the retrocalcaneal bursa and the tendon tissue, ultrasound-guided procedures targeting the synovial and neural tissues of the superficial retrocalcaneal pad should be considered to optimize the management of insertional Achilles tendinopathy.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":"38 1","pages":"29-34"},"PeriodicalIF":2.3,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ca.24193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141302070","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}