Burns最新文献

{"title":"Epidemiology and care of burns in rural Rwanda: A prospective cohort study","authors":"Rachel Nzungize ,&nbsp;Cameron Gibson ,&nbsp;Eléazar Ndabarora ,&nbsp;Bernard Umutoniwase ,&nbsp;Ronald Tubasiime","doi":"10.1016/j.burns.2025.107815","DOIUrl":"10.1016/j.burns.2025.107815","url":null,"abstract":"<div><h3>Introduction</h3><div>Burns are the fourth most common type of injury presenting to emergency departments in Rwanda; however, research related to the epidemiology of burn injuries is limited. The objectives of this study were to investigate the epidemiology and treatment of burns in a rural region of Rwanda to better inform local public health initiatives.</div></div><div><h3>Methods</h3><div>Data collection took place at Kibogora Level Two Teaching Hospital in the Western Province of Rwanda from July 2023 to November 2024. Patients enrolled in the study included all burn patients who presented to the hospital during the study period. Data were collected through patient interviews and electronic medical records using a standardized form.</div></div><div><h3>Results</h3><div>Eighty burn patients presented to the hospital during the study period. Children most often presented with burn injuries, with 70 % (n = 56) of the study population being 0–15 years old. Scald was the most common type of burn (n = 60, 75 %). Burns were mostly related to cooking activities (n = 60, 75 %). Traditional medicine was used as first aid in 57.5 % (n = 46) of the cases. Time from injury to treatment was &gt; 24 h in 32.5 % (n = 26) of the patients. Complications were common at 43.8 % (n = 35), with the most frequent type being burn wound infection (n = 30, 37.5 %). All patients survived their burn injuries.</div></div><div><h3>Conclusion</h3><div>Prevention efforts should prioritize reaching children and their caregivers while highlighting kitchen safety and the dangers of hot liquids that can cause scald burn injuries. Burn wound infection prevention is also a priority for education.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107815"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736160","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":"Rehabilitation requirement after burns: An observational study of 436 pediatric patients in Chile","authors":"María Rojas-Goldsack ,&nbsp;Rolando Saavedra ,&nbsp;Karina Zalavari ,&nbsp;Johanna Díaz ,&nbsp;Francisca Besio ,&nbsp;Rodrigo Fuentes ,&nbsp;Orlando Flores","doi":"10.1016/j.burns.2025.107816","DOIUrl":"10.1016/j.burns.2025.107816","url":null,"abstract":"<div><h3>Background</h3><div>Burns are injuries that lead to sequelae requiring long-term treatment and rehabilitation. Despite their significance, there is limited research specifically addressing the need for rehabilitation in pediatric burn patients and the duration of such treatment.</div></div><div><h3>Objective</h3><div>To describe the demographic and clinical factors associated with rehabilitation needs in pediatric burn patients, and to report the duration of rehabilitation among those who required and received it.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted including all pediatric patients from a Chilean district who were admitted to a specialized outpatient burn center during 2011. The treatment received by these patients until December 31, 2024, was reviewed. Data were extracted from clinical records. We analyzed demographic, epidemiological, and clinical variables. To evaluate the risk of requiring rehabilitation, we calculated adjusted relative risks with 95 % confidence intervals.</div></div><div><h3>Results</h3><div>From 436 patients (median age at injury: 3.0 (IQR:6.0–1.0) years) admitted in 2011 from burn injuries, 20.9 % required rehabilitation, and 30.8 % of them received rehabilitation treatment for more than a year. Intermediate (RR 10.13; 95 % CI: 3.51–29.26) and deep burns (RR 23.03 95 % CI 6.95–76.29), as well as re-epithelialization time exceeding 15 days (RR 1.03 95 % CI 1.00–1.05), were significantly associated with rehabilitation need. The median rehabilitation duration was 0.18 years (95 % CI: 0.04–0.29).</div></div><div><h3>Conclusions</h3><div>A significant proportion of pediatric burn patients require rehabilitation, often lasting more than one year. Deep burn depth is the strongest predictor of the need for rehabilitation. Rehabilitation duration may vary from a few days to several years. Further research is warranted to elucidate the variables affecting rehabilitation duration.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107816"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736251","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":"Comments on: \"Establishing new education standards in burns – A scoping review\"","authors":"M. Vijayasimha ,&nbsp;Rajesh Prasad Jayaswal","doi":"10.1016/j.burns.2025.107810","DOIUrl":"10.1016/j.burns.2025.107810","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107810"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736245","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":"BACH1 is stabilized by vitamin E and attenuates the formation of hypertrophic scar through the Wnt/β-catenin pathway","authors":"Wenkang Luan ,&nbsp;Shujun Fan ,&nbsp;Hanyi Jiang ,&nbsp;Dongwen Jiang ,&nbsp;Jinxiu Yang ,&nbsp;Leren He","doi":"10.1016/j.burns.2025.107807","DOIUrl":"10.1016/j.burns.2025.107807","url":null,"abstract":"<div><div>The molecular drivers behind the pathogenesis of hypertrophic scar (HS) formation have not been determined in a comprehensive manner. Aside from that, no consensus has been reached on the role of vitamin E in HS. For this reason, we have probed the causal effect of 2940 plasma proteins and 187 diets on HS through Mendelian randomization (MR). Colocalization analysis, summary-data-based MR (SMR), heterogeneity in dependent instruments (HEIDI), and MR phenome-wide association study (MR-PheWAS) were employed to identify the potential drug targets of HS. Human Protein Atlas, differential expression analysis, weighted co-expression network analysis (WGCNA) and single-cell analysis were utilized to confirm the key biomolecules in HS. To investigate the roles of critical molecules, we harvested primary fibroblasts and conducted validations using both in vitro and in vivo animal models. We put forth a viewpoint that the transcription factor BACH1 is causally related to the onset of HS, is a protective factor for HS, and may serve as its therapeutic target. We further determined that BACH1 reveals substantial expression in human skin tissue. BACH1 is under-expressed in HS tissues and fibroblasts. We confirmed that BACH1 and vitamin E act in an anti-scar role in primary fibroblasts and animal models through the Wnt/β-catenin pathway. Overall, our results demonstrate that BACH1 has an inhibitory effect on HS, and vitamin E attenuates the formation of HS by stabilizing BACH1.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107807"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736243","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":"Characteristics and significance of blister fluid cell-free mitochondrial DNA in pediatric small area intermediate-depth burn wounds","authors":"Hailiang Liu ,&nbsp;Shujun Wang ,&nbsp;Dongjie Li ,&nbsp;Dawei Li,&nbsp;Yijie Zhang,&nbsp;Xin Li,&nbsp;Chuan’an Shen","doi":"10.1016/j.burns.2025.107780","DOIUrl":"10.1016/j.burns.2025.107780","url":null,"abstract":"<div><h3>Background</h3><div>Mitochondrial DNA (mtDNA) plays a crucial role in inflammation regulation and can be passively or accidentally released in setting of cellular stress or traumatic injury. In this study, we try to evaluate the distribution and significance of mtDNA in blister fluid of paediatric small area intermediate depth burn wounds.</div></div><div><h3>Methods</h3><div>This trial was conducted as a follow-up analysis of a single-centre, prospective observational study that enrolled 62 children with small area partial-thickness thermal burns. The mtDNA in blister fluid was measured with a PCR-based assay. The levels of cytokines including interleukin-6 (IL-6), interleukin-8 (IL-8) and transforming growth factor β1 (TGF-β1) were evaluated by using ELISA. Association of mtDNA with inflammatory markers and wound healing outcome was analysed.</div></div><div><h3>Results</h3><div>The mtDNA copy number (mtDNA-CN) was determined as median (min, max) value of 76.30 (16.5, 219.1). Spearman rank correlation coefficient analysis showed that the levels of IL-6, IL-8, and TGF-β1 all exhibited significant correlations with mtDNA-CN in burn blister fluid samples (all P &lt; 0.05). Moreover, a significant association between wound healing time and mtDNA-CN in blister fluid was observed (P &lt; 0.05); Kaplan-Meier curves by log-rank test demonstrated that mtDNA-CN in blister fluid was significantly associated with for time to re-epithelialization (P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Blister fluid mtDNA may serve to evaluate burn wound severity in children with small area intermediate-depth burns.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107780"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617815","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":"Comments on: \"Admission lymphopenia predicts risk of pneumonia and AKI in hospitalized burn injuries\"","authors":"Min Zhang ,&nbsp;Xingyi Yang","doi":"10.1016/j.burns.2025.107806","DOIUrl":"10.1016/j.burns.2025.107806","url":null,"abstract":"","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107806"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614204","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":"Use of selective decontamination of the digestive tract in burn patients: A European survey","authors":"Emma Atsuko Tsuchiya ,&nbsp;Mette Krag ,&nbsp;Morten Hylander Møller ,&nbsp;Martin Risom Vestergaard ,&nbsp;Nicolai Haase ,&nbsp;Marie Helleberg ,&nbsp;Rikke Holmgaard ,&nbsp;Johan Heiberg","doi":"10.1016/j.burns.2025.107774","DOIUrl":"10.1016/j.burns.2025.107774","url":null,"abstract":"<div><h3>Background</h3><div>Infectious complications are a major cause of morbidity and mortality in burn patients. Selective decontamination of the digestive tract (SDD) is a prophylactic antimicrobial strategy aimed at suppressing potential pathogenic microorganisms in the gut microbiome. This study aimed to assess the values and preferences for the use of SDD in burn centres across Europe and to evaluate clinicians’ interest in further research on its efficacy.</div></div><div><h3>Methods</h3><div>We circulated a survey on the values and preferences for the use of SDD between March and October 2024, targeting surgeons, anaesthesiologists, and intensivists at European burn centres. The survey comprised 13 questions focusing on SDD usage criteria, regimens, and willingness to participate in a multicentre randomised clinical trial. Data were analysed and presented descriptively.</div></div><div><h3>Results</h3><div>We invited 45 burn centres to participate; 22 responded (49 % response rate). Among these, 27 % (6/22) reported routine use of SDD, primarily for patients with extensive burns or those requiring intensive care. Most centres using SDD (5/6) administered a combination of enteral and intravenous antibiotics and/or antifungals, while one centre (1/6) relied on enteral antimicrobials alone. The most common regimen included intravenous cefotaxime combined with enteral polymyxin E, tobramycin, and amphotericin B or nystatin. Notably, 82 % (18/22) of respondents expressed interest in participating in a multicentre randomised clinical trial on SDD in burn patients.</div></div><div><h3>Conclusion</h3><div>A minority of European burn centres routinely used SDD, while the majority did not. Among those that used SDD, treatment regimens were largely aligned with practices commonly used in ICU patients. Notably, there was significant interest among European burn centres in participating in future clinical trials comparing SDD versus no SDD in burn patients.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107774"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507939","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":"Reconstruction of the axilla after burn injury – A decade of experiences and lessons learned","authors":"Jennifer Ashley Watson,&nbsp;Samuel Knoedler,&nbsp;Luzie Hofmann,&nbsp;Mauro Vasella,&nbsp;Bong-Sung Kim","doi":"10.1016/j.burns.2025.107777","DOIUrl":"10.1016/j.burns.2025.107777","url":null,"abstract":"<div><h3>Background</h3><div>Acute burns and their sequelae in the axilla are debilitating injuries. Reconstruction in this anatomically complex region is challenging due to limited tissue availability and the need to balance functional and aesthetic outcomes.</div></div><div><h3>Methods</h3><div>A retrospective review of patients undergoing axillary reconstruction at the University Hospital Zurich, Zurich, Switzerland, from 2014 to 2024 was conducted. Patients who received pedicled locoregional or free flap reconstructions for acute axillary burns or established contractures were included, while z-plasties and other local random pattern flaps were excluded.</div></div><div><h3>Results</h3><div>Twelve patients (8 males, 4 females; mean age: 44.1 years, mean BMI: 24.6 kg/m², mean TBSA: 36 %) underwent axillary reconstruction using 13 flaps: 10 free flaps (anterolateral thigh [n = 6], transverse myocutaneous gracilis [n = 1], profunda artery perforator [n = 2], superficial circumflex iliac perforator [n = 1]) and three locoregional flaps (parascapular [n = 2], split-latissimus dorsi [n = 1]). Acute reconstructions for third-degree axillary burns were performed in three patients (median time from injury: 12 days), and delayed reconstructions for axillary contractures were performed in 10 cases (median time from injury: 336 days). While no total flap loss occurred, five (38 %) cases experienced complications including delayed wound healing, seroma, or hematoma. Innovative strategies, such as fascial slings for flap suspension, two-stage scar release, and robotic-assisted microvascular anastomoses, enhanced surgical precision and outcomes.</div></div><div><h3>Conclusion</h3><div>For acute burns and post-burn axillary contractures, free or locoregional flaps offer effective reconstruction, ensuring early functional recovery when compared to dermal substitutes. A multidisciplinary, individualized approach remains essential for optimizing care in burn survivors with axillary injuries and contractures.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107777"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617794","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":"Spanish translation, cultural, and content validation of the Mouth Impairment and Disability Assessment in a prospective, longitudinal evaluation of pediatric patients with facial burn injuries","authors":"Bernadette Nedelec ,&nbsp;Ingrid Parry ,&nbsp;Clarissa Ochoa ,&nbsp;David G. Greenhalgh ,&nbsp;Zoë Edger-Lacoursière ,&nbsp;Jakub Sawicki","doi":"10.1016/j.burns.2025.107775","DOIUrl":"10.1016/j.burns.2025.107775","url":null,"abstract":"<div><div>The Mouth Impairment and Disability Assessment (MIDA) was developed to provide clinicians with an outcome measure that thoroughly and objectively evaluates the impairment and disabilities associated with burn injuries of the face involving the mouth. However, thus far, it is only available in English and French-Canadian and has not been used with pediatric burn survivors. Additionally, there is limited longitudinal outcome data describing the recovery trajectory associated with burn injuries of the mouth. Thus, the purpose of this study was to translate the MIDA into Spanish, validate the content with the pediatric burn survivor population who have sustained a burn injury involving their mouth, and prospectively collect data to document the recovery profile and examine the psychometric properties.</div></div><div><h3>Methods</h3><div>This was a prospective, observational case series of pediatric burn survivors. Prior to commencing patient recruitment, a forward-backward translation and cultural adaptation process was undertaken to create a Spanish version of the MIDA. English- and Spanish-speaking pediatric burn survivors who met the inclusion criteria and had signed the informed consent were evaluated using the MIDA at approximately one month, three months, six months, and 12 months post-burn. Individual and subscale summary data from the MIDA are reported. Construct validity was assessed by examining the correlations between MIDA subscale scores at baseline and measures of vertical and horizontal mouth opening.</div></div><div><h3>Results</h3><div>Sixteen predominantly Hispanic (75 %) pediatric burn survivors were evaluated approximately one-month post-burn, eleven were evaluated at three and six months, and nine at twelve months. The majority were male (62.5 %) with a mean age of 10.4 years old and mean total body surface area burn of 33.3 %. The median number of surgeries was two, with a median of one involving the face, mouth, or neck. Content validity was confirmed through cognitive debriefing and self-reported difficulties with all items within the measure at various points across time. The recovery profile varied across time, with many reporting a reduction in function between one and three months, most reporting an improvement by six or twelve months, but some continuing to experience extreme difficulty or dissatisfaction at twelve months.</div></div><div><h3>Discussion</h3><div>The Spanish version of the MIDA can now be used with the burn survivor population to evaluate the outcome of face and neck burns that may result in mouth impairment and disability. In addition, it proved to be a valid measure for quantifying the challenges that arise for pediatric burn survivors. There is a need for future research to investigate which treatment interventions optimize long-term outcomes.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107775"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617730","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":"Discriminative power of organ-specific SOFA assessment in burn sepsis: A temporal biomarker analysis","authors":"Hang Su ,&nbsp;Bo Yuan ,&nbsp;Yan Liu ,&nbsp;Wenjing Xi ,&nbsp;Liang Qiao","doi":"10.1016/j.burns.2025.107771","DOIUrl":"10.1016/j.burns.2025.107771","url":null,"abstract":"<div><h3>Background</h3><div>Severe burn patients face diagnostic challenges in distinguishing sepsis from systemic inflammation using Sepsis-3 criteria. Current Sequential Organ Failure Assessment (SOFA) validation studies focus on composite scores, neglecting subsystem-level analysis in burn-specific pathophysiology.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed 55 severe burn patients (TBSA&gt;30 %) from a Chinese burn center (2021–2022), comparing 19 sepsis cases with 36 controls. We analyzed SOFA subsystems and biomarkers (creatinine, platelet count, NT-proBNP, and PCT) during both the early phase (days 1 and 3 post-burn) and the late phase (after day 3 post-burn), performed TBSA-adjusted logistic regression, and constructed a nomogram.</div></div><div><h3>Results</h3><div>Cardiovascular (84.2 % vs 2.8 %, p &lt; 0.001), renal (31.6 % vs 0 %, p &lt; 0.001), and coagulation (42.1 % vs 5.6 %, p &lt; 0.001) subsystems showed superior diagnostic specificity. Platelet trajectories revealed critical divergence at day 3 (septic: 66 vs control: 120 ×10⁹/L, p &lt; 0.001), while creatinine elevation persisted across phases (day 1: 100 vs 62 μmol/L, p &lt; 0.001, day 3: 84 vs 65 μmol/L, and late phase: 118 vs 58μmol/L, p &lt; 0.001). PCT demonstrated isolated diagnostic utility confined to the late phase (6.12 vs 0.55 μg/L, p &lt; 0.001). Day 3 platelet count, late-phase creatinine, and PCT were incorporated into the nomogram, which achieved an AUC of 0.930 in ROC analysis.</div></div><div><h3>Conclusion</h3><div>Subsystem-specific SOFA analysis identifies creatinine elevation and thrombocytopenia as key sepsis indicators in burns. Serial platelet and creatinine monitoring from day 3 post-injury enhances early detection, while PCT demonstrates diagnostic utility only in the late phase. A clinically applicable nomogram was developed to predict sepsis risk. These findings suggest that these specific organ systems are the principal contributors to the SOFA score in burn-related sepsis.</div></div>","PeriodicalId":50717,"journal":{"name":"Burns","volume":"52 1","pages":"Article 107771"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617717","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}