Hepatobiliary & Pancreatic Diseases International最新文献

{"title":"A new surgical approach for pseudocyst of dorsal pancreas","authors":"Cheng-Ji Tang , Guo-Guang Li , Chen-Lin Jiang , Sha-Yong Peng , Su-Lai Liu","doi":"10.1016/j.hbpd.2024.09.001","DOIUrl":"10.1016/j.hbpd.2024.09.001","url":null,"abstract":"","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"23 6","pages":"Pages 644-647"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265849","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":"Bleeding after endoscopic papillectomy and its risk factors: A single center experience of 196 cases","authors":"Jin Ho Choi,&nbsp;Won Chul Kim,&nbsp;Joo Kyung Park,&nbsp;Jong Kyun Lee,&nbsp;Kyu Taek Lee,&nbsp;Kwang Hyuck Lee","doi":"10.1016/j.hbpd.2024.02.001","DOIUrl":"10.1016/j.hbpd.2024.02.001","url":null,"abstract":"<div><h3>Background</h3><div><span><span>Endoscopic papillectomy (EP) is an effective method to remove an </span>ampulla of Vater<span> (AoV) adenoma with minimal invasiveness. We reviewed the clinical outcomes and prognosis of patients undergoing EP, including </span></span>tumor recurrence and adverse events.</div></div><div><h3>Methods</h3><div>A total of 196 patients who underwent EP from January 2004 to December 2017 were included. Clinical information was collected through electronic medical records<span>, and risk factors to predict post-procedural bleeding were analyzed using a multivariate logistic regression model.</span></div></div><div><h3>Results</h3><div><span><span>A total of 93.9% patients (184/196) underwent complete resection. During the follow-up period, 14.7% patients (27/184) experienced tumor recurrence, and two of seven surgically resected tumors were malignant. A total of 45.4% patients (89/196) experienced adverse events related to EP. Delayed bleeding occurred in 16.3% of the patients (32/196), and they were all successfully treated with endoscopic hemostasis and conservative management. The most frequent site of delayed bleeding was the distal end of the papillary orifice, and 56.3% (18/32) patients of delayed bleeding were classified as having mild severity, the others had moderate severity. </span>Familial adenomatous polyposis (FAP) [odds ratio (OR) = 3.80, 95% confidence interval (CI): 1.01-14.29; </span><em>P</em> &lt; 0.05] and male sex (OR = 2.82, 95% CI: 1.04-7.63; <em>P</em> = 0.04) showed statistical significance in predicting delayed post-EP bleeding.</div></div><div><h3>Conclusions</h3><div>EP for AoV adenoma was a highly effective and safe procedure. The risk of post-EP delayed bleeding was increased in patients with FAP syndrome and male patients, and post-EP bleeding occurred most commonly in the distal part of the AoV.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"23 6","pages":"Pages 613-619"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139921159","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":"Impact of metabolic disorders on gallstone disease and perioperative recovery after laparoscopic cholecystectomy","authors":"Jun Chen ,&nbsp;Zheng-Tao Liu ,&nbsp;Jing-Ting Lyu ,&nbsp;Guo-Ping Jiang","doi":"10.1016/j.hbpd.2024.08.001","DOIUrl":"10.1016/j.hbpd.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Gallstone disease (GSD), nonalcoholic fatty liver disease (NAFLD), metabolic dysfunction-associated fatty liver disease (MAFLD), and metabolic syndrome (MetS) are common medical disorders worldwide. This study aimed to ascertain how NAFLD, MAFLD, MetS, and other factors affect the development of GSD, and how the GSD-associated factors influence patient recovery after laparoscopic cholecystectomy (LC).</div></div><div><h3>Methods</h3><div>We included 200 patients who were diagnosed with GSD and underwent LC between January 2017 and February 2022. A total of 200 subjects without GSD and “non-calculous causes” during the same period were also included as controls. We compared the metabolic disorder differences between GSD patients and controls. Furthermore, we sub-grouped patients based on the comorbidities of preoperative NAFLD, MAFLD, and MetS, and compared the impacts of these comorbidities on short-term post-LC functional recovery of the patients.</div></div><div><h3>Results</h3><div>The prevalence of NAFLD and MetS were higher in GSD patients (<em>P</em> &lt; 0.05). Based on multivariate logistic regression analysis, hyperglycemia [odds ratio (OR) = 2.2, 95% confidence interval (CI): 1.4–3.4, <em>P</em> = 0.001] and low high-density lipoprotein cholesterol (HDL-C) level (OR = 1.8, 95% CI: 1.1–3.1, <em>P</em> = 0.048) were linked to GSD. NAFLD and MetS linked to liver enzymes after LC (<em>P</em> &lt; 0.05). MetS also linked to the levels of inflammatory indicators after LC (<em>P</em> &lt; 0.05). The obesity, hyperlipidemia, low HDL-C level, and hyperglycemia linked to liver enzymes after LC (<em>P</em> &lt; 0.05). Hyperlipidemia, low HDL-C level, and hypertension linked to inflammation after LC (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>The prevalence of GSD may be linked to NAFLD and MetS. Hyperglycemia and low HDL-C level were independent risk factors of GSD.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"23 6","pages":"Pages 604-612"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918162","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":"Are outcomes for emergency index-admission laparoscopic cholecystectomy performed by hepatopancreatobiliary surgeons better compared to non-hepatopancreatobiliary surgeons? A 10-year audit using 1:1 propensity score matching","authors":"Kai Siang Chan ,&nbsp;Samantha Baey ,&nbsp;Vishal G Shelat ,&nbsp;Sameer P Junnarkar","doi":"10.1016/j.hbpd.2023.08.002","DOIUrl":"10.1016/j.hbpd.2023.08.002","url":null,"abstract":"<div><h3>Background</h3><div>Emergency index-admission cholecystectomy<span> (EIC) is recommended for acute cholecystitis in most cases. General surgeons have less exposure in managing “difficult” cholecystectomies. This study aimed to compare the outcomes of EIC between hepatopancreatobiliary (HPB) versus non-HPB surgeons.</span></div></div><div><h3>Methods</h3><div><span><span>This is a 10-year retrospective audit on patients who underwent EIC from December 2011 to March 2022. Patients who underwent open cholecystectomy, had previous cholecystitis, previous </span>endoscopic retrograde cholangiopancreatography<span> or cholecystostomy were excluded. A 1:1 </span></span>propensity score matching<span> (PSM) was performed to adjust for confounding variables (e.g. age ≥ 75 years, history of abdominal surgery, presence of dense adhesions).</span></div></div><div><h3>Results</h3><div><span>There were 1409 patients (684 HPB cases, 725 non-HPB cases) in the unmatched cohort. Majority (52.3%) of them were males with a mean age of 59.2 ± 14.9 years. Among 472 (33.5%) patients with EIC performed ≥ 72 hours after presentation, 40.1% had dense adhesion. The incidence of any morbidity, open conversion, subtotal cholecystectomy and bile duct injury were 12.4%, 5.0%, 14.6% and 0.1%, respectively. There was one mortality within 30 days from EIC. PSM resulted in 1166 patients (583 per group). Operative time was shorter when EIC was performed by HPB surgeons (115.5 vs. 133.4 min, </span><em>P</em> &lt; 0.001). The mean length of hospital stay was comparable. EIC performed by HPB surgeons was independently associated with lower open conversion [odds ratio (OR) = 0.24, 95% confidence interval (CI): 0.12–0.49, <em>P</em> &lt; 0.001], lower fundus-first cholecystectomy (OR = 0.58, 95% CI: 0.35–0.95, <em>P</em> = 0.032), but higher subtotal cholecystectomy (OR = 4.19, 95% CI: 2.24–7.84, <em>P</em><span> &lt; 0.001). Any morbidity, bile duct injury and mortality were comparable between the two groups.</span></div></div><div><h3>Conclusions</h3><div>EIC performed by HPB surgeons were associated with shorter operative time and reduced risk of open conversion. However, the incidence of subtotal cholecystectomy was higher.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"23 6","pages":"Pages 586-594"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10004988","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":"Split liver transplantation with complicated portal vein variations in graft","authors":"Zhao-Xin Shang ,&nbsp;Qi-Jian Yu ,&nbsp;Fang-Zhou Luo ,&nbsp;Li Zhuang ,&nbsp;Shu-Sen Zheng ,&nbsp;Zhe Yang","doi":"10.1016/j.hbpd.2023.08.001","DOIUrl":"10.1016/j.hbpd.2023.08.001","url":null,"abstract":"","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"23 6","pages":"Pages 658-660"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10406309","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":"Integrated chromosomal instability and tumor microbiome redefined prognosis-related subtypes of pancreatic cancer","authors":"Rui-Han Chen ,&nbsp;Jia-Ying Cao ,&nbsp;Shi Feng ,&nbsp;Hai-Tao Huang ,&nbsp;Yi-Mou Lin ,&nbsp;Jing-Yu Jiang ,&nbsp;Xue-Wen Yi ,&nbsp;Qi Ling","doi":"10.1016/j.hbpd.2024.03.002","DOIUrl":"10.1016/j.hbpd.2024.03.002","url":null,"abstract":"<div><h3>Background</h3><div><span><span>Pancreatic cancer<span> is a common malignancy with poor prognosis and limited treatment. Here we aimed to investigate the role of host </span></span>chromosomal instability (CIN) and tumor </span>microbiome in the prognosis of pancreatic cancer patients.</div></div><div><h3>Methods</h3><div>One hundred formalin-fixed paraffin-embedded (FFPE) pancreatic cancer samples were collected. DNA extracted from FFPE samples were analyzed by low-coverage whole-genome sequencing (WGS) via a customized bioinformatics workflow named ultrasensitive chromosomal aneuploidy detector.</div></div><div><h3>Results</h3><div><span><span><span>Samples were tested according to the procedure of ultrasensitive chromosomal aneuploidy detector (UCAD). We excluded 2 samples with failed quality control, 1 patient lost to follow-up and 6 dead in the </span>perioperative period. The final 91 patients were admitted for the following analyses. Thirteen (14.3%) patients with higher CIN score had worse </span>overall survival (OS) than those with lower CIN score. The top 20 microbes in pancreatic cancer samples included 15 species of bacteria and 5 species of viruses. Patients with high human herpesvirus (HHV)-7 and HHV-5 DNA reads exhibited worse OS. Furthermore, we classified 91 patients into 3 subtypes. Patients with higher CIN score (</span><em>n</em> =13) had the worst prognosis (median OS 6.9 mon); patients with lower CIN score but with HHV-7/5 DNA load (<em>n</em> = 24) had worse prognosis (median OS 10.6 mon); while patients with lower CIN score and HHV-7/5 DNA negative (<em>n</em> = 54) had the best prognosis (median OS 21.1 mon).</div></div><div><h3>Conclusions</h3><div>High CIN and HHV-7/5 DNA load were associated with worse survival of pancreatic cancer. The novel molecular subtypes of pancreatic cancer based on CIN and microbiome had prognostic value.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"23 6","pages":"Pages 620-627"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140167467","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":"Raman spectroscopy in the diagnosis of malignant biliary stricture: A feasibility study.","authors":"Peter Slodička, Přemysl Falt, Václav Ranc, Vincent Dansou Zoundjiekpon, Ondřej Urban","doi":"10.1016/j.hbpd.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.hbpd.2024.11.003","url":null,"abstract":"","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741498","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":"Systemic chemotherapy improves outcome of hepatocellular carcinoma patients treated with transarterial chemoembolization.","authors":"Wei-Chen Zhang, Ke-Yi Du, Song-Feng Yu, Xue-E Guo, Han-Xi Yu, Dong-Yan Wu, Cheng Pan, Cheng Zhang, Jian Wu, Li-Fang Bian, Lin-Ping Cao, Jun Yu","doi":"10.1016/j.hbpd.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.hbpd.2024.11.004","url":null,"abstract":"<p><strong>Background: </strong>Transarterial chemoembolization (TACE) based neoadjuvant therapy was proven effective in hepatocellular carcinoma (HCC). Recently, tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) also showed promise in HCC treatment. However, the prognostic benefits associated with these treatments remain uncertain. This study aimed to explore the relationship between pathologic response and prognostic features in HCC patients who received neoadjuvant therapy.</p><p><strong>Methods: </strong>HCC patients who received TACE either with or without TKIs/ICIs as neoadjuvant therapy before liver resection were retrospectively collected from the First Affiliated Hospital, Zhejiang University School of Medicine in China. Pathologic response was determined by calculating the proportion of non-viable area within the tumor. Major pathologic response (MPR) was defined as the presence of non-viable tumor cells reaching a minimum of 90 %. Complete pathologic response (CPR) was characterized by the absence of viable cells observed in the tumor.</p><p><strong>Results: </strong>A total of 481 patients meeting the inclusion criteria were enrolled, with 76 patients (15.8 %) achieving CPR and 179 (37.2 %) reaching MPR. The median recurrence-free survival (mRFS) in the CPR + MPR group was significantly higher than the non-MPR group (31.3 vs. 25.1 months). The difference in 3-year overall survival (OS) rate was not significant (90.2 % vs. 87.6 %). Multivariate Cox regression analysis identified failure to achieve MPR (hazard ratio = 1.548, 95 % confidence interval: 1.122-2.134; P = 0.008), HBsAg positivity (HR = 1.818, 95 % CI: 1.062-3.115, P = 0.030), multiple lesions (HR = 2.278, 95 % CI: 1.621-3.195, P < 0.001), and baseline tumor size > 5 cm (HR = 1.712, 95 % CI: 1.031-2.849, P = 0.038) were independent risk factors for RFS. Subgroup analysis showed that 67 of 93 (72.0 %) patients who received the combination of TACE, TKIs, and ICIs achieved MPR + CPR.</p><p><strong>Conclusions: </strong>In individuals who received TACE-based neoadjuvant therapy for HCC, failure to achieve MPR emerges as an independent risk factor for RFS. Notably, the combination of TACE, TKIs, and ICIs demonstrated the highest rate of MPR.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781884","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":"Comparison of the efficacy and safety of basket catheters and balloon catheters for endoscopic pancreatic duct stone clearance.","authors":"Si-Huai Xiong, Yuan-Chen Wang, Ji-Yao Guo, Lei Wang, Tian-Yu Shi, Liang-Hao Hu, Zhuan Liao, Wen-Bin Zou","doi":"10.1016/j.hbpd.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.hbpd.2024.11.002","url":null,"abstract":"<p><strong>Background: </strong>The choice of a basket or a balloon catheter during endoscopic retrograde cholangiopancreatography (ERCP) for the clearance of pancreatic duct stones in patients with chronic pancreatitis (CP) remains controversial. This study compared the efficacy and safety of these two devices for pancreatic duct stone extractions.</p><p><strong>Methods: </strong>We compared the efficacy and safety of basket and balloon catheters for pancreatic stone extractions. We enrolled CP patients who underwent ERCP for the first time at Changhai Hospital, Naval Medical University between February 2012 and December 2021. After propensity score matching (1:1), 101 patients were included in each group. The primary outcome was the rate of pancreatic stone clearance. Secondary outcomes included the rate of adverse events during hospitalization, long-term pain relief, and quality of life after one year follow-up period.</p><p><strong>Results: </strong>The rate of complete clearance was comparable between the two groups (86.1 % vs. 84.2 %, P = 0.692). In patients with stones ≥ 2 cm before extracorporeal shock wave lithotripsy (ESWL), the rate of complete clearance was significantly higher in the balloon catheter group when compared to the basket catheter group [100 % (19/19) vs. 70.0 % (14/20), P = 0.031]. In the multivariate analysis, ESWL prior to stone extraction was the only independent predictor of complete clearance [with ESWL 58.4 % (264/452) vs. without ESWL 41.6 % (188/452), odds ratio = 2.3, 95 % confidence interval: 1.2-4.3; P = 0.013]. No significant differences between groups were found regarding the rates of adverse events during hospitalization, quality of life, and pain relief after one year of follow-up.</p><p><strong>Conclusions: </strong>Basket and balloon catheters showed similar efficacy and safety for pancreatic stone extractions. However, the balloon catheter was superior to the basket catheter if the pancreatic stone size was ≥ 2 cm before ESWL.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696054","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":"Central pancreatectomy: An uncommon but potentially optimal choice of pancreatic resection.","authors":"Dimitrios Oikonomou, Ricky H Bhogal, Vasileios K Mavroeidis","doi":"10.1016/j.hbpd.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.hbpd.2024.11.001","url":null,"abstract":"<p><p>Benign, premalignant or low-grade malignant pancreatic tumors are increasingly diagnosed owing to the widespread uptake of cross-sectional imaging. Surgical excision is a potential treatment option for these tumors. Pancreatoduodenectomy and distal pancreatectomy are the standard resections for tumors located in the pancreatic head-neck or body-tail, respectively, and not uncommonly sacrifice a significant amount of healthy pancreatic parenchyma. Central pancreatectomy (CP) is a parenchyma-sparing procedure, initially performed by Dagradi and Serio in 1982, in a patient with pancreatic neck insulinoma. Since then, an increasing number of cases are being performed worldwide, either via open or minimally invasive surgical access. Additionally, pancreatic enucleation is reserved for tumors < 3 cm, without involvement of the main pancreatic duct. CP remains an alternative approach in selected cases, albeit in the presence of some controversies, such as its use in early pancreatic ductal adenocarcinoma or metastatic deposits to the central aspect of the pancreas from other malignancies. In recent years, clarity is lacking as regards indications for CP, and despite accumulating evidence in favor of limited resections for suitable pancreatic tumors, no evidence-based consensus guidelines are yet available. Nevertheless, it appears that appropriate patient selection is of paramount importance to maximize the advantages of preservation of endocrine and exocrine pancreatic functions as well as to mitigate the risks of higher complication rates. In this comprehensive review, we explore the role of CP in the treatment of lesions located in the neck and proximal body of the pancreas.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693828","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}