Annales De Chirurgie Plastique Esthetique最新文献

{"title":"Using 320-slice computed tomography to preoperatively investigate the leg perforator arterial system and design a perforator flap for patients with a soft-tissue defect in the leg.","authors":"L Khanh, L V Doan, V H Trung, P A Tuan","doi":"10.1016/j.anplas.2024.09.007","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.09.007","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the leg perforator arterial system, identify the perforator flap's pedicle artery and its projected cutaneous point using a 320-slice computed tomography (CT 320) scanner.</p><p><strong>Methods: </strong>A total of 24 patients with leg soft-tissue defects unilaterally underwent 320-slice CT angiography scanning (CTA 320) with 47 legs. The used method enabled investigation of the perforator arteries originating from the tibial, peroneal arteries, perforator flap's pedicle artery and its projected cutaneous point. These data were used to preoperatively design an improved flap. Then, the CT-confirmed location and length of the flap's pedicle artery were compared with intraoperative findings.</p><p><strong>Results: </strong>Findings of the CTA 320 on 47 legs showed that 217 perforator arteries with diameters of ≥0.5mm were detected; the average number of arteries per leg, their average length and diameter were 4.6±2.1, 30.7±10.4mm and 1.16±0.27mm, respectively. The perforator arteries originating from the anterior tibial artery were mainly distributed in the proximal and middle thirds of the leg. Perforators from the posterior tibial and peroneal arteries were distributed abundantly in the middle and distal thirds of the leg. As identified in the CT, the location and length of the flap's pedicle artery and its projected cutaneous point were consistent with those observed during the surgery.</p><p><strong>Conclusions: </strong>The CTA 320 is a minimally invasive imaging method that provides high-quality images of the leg perforator arterial system and can identify the exact location and projected cutaneous point of the perforator flap's pedicle artery.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592255","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":"LIPOPULP. The impact of fat grafting on pulp sensitivity in fingertip injuries: A retrospective study of seven patients.","authors":"C Macni, M Witters, N Kachouh, A Mayoly, C Jaloux","doi":"10.1016/j.anplas.2024.09.006","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.09.006","url":null,"abstract":"<p><strong>Objective: </strong>This study analyzes the impact of fat grafting on pulp sensitivity disorders in patients who experienced fingertip injuries and developed cold intolerance and hyperesthesia.</p><p><strong>Material/method: </strong>Patients over 10 years old were evaluated using the two-point discriminant score (2PDS), the monofilament test, and the McCabe Cold Sensitivity Severity Scale (CSS) before and after surgery at 3, 6, and 12 months. Other evaluations included the Quick Dash scale (Q-dash), the aesthetics and pain improvement, and patient satisfaction. For children under 10 years old, a parent questionnaire was asked about pain reduction and the ability of parents to trim their children's nails.</p><p><strong>Result: </strong>Seven patients (2<10 years old and 5>10 years old) who all presented sensitivity disorders following a fingertip injury and were operated on for a pulp fat grafting were analyzed. No significant effects were found on the two-point discriminant score (2PDS), the McCabe Cold Sensitivity Severity Scale (CSS scale), the monofilament test, as well as the quality of life. Four patients experienced less pain and aesthetic improvement. No outcome occurred. A small quantity of fat (0.97mL) was injected and patient satisfaction was good at 6.4/10. For the two children, it was easier for parents to cut their children's nails.</p><p><strong>Discussion/conclusion: </strong>While no statistically significant improvement in pulp sensitivity was observed, there were subjective improvements in pain relief and aesthetic outcomes, particularly in children. For children, positive effects were found on pain and the facility for parents to cut their children's nails. More studies are required for children. Pulp fat grafting may be a therapeutic option for patients who suffer from fingertip injury.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592250","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":"[Cutaneous and subcutaneous primary leiomyosarcoma: A retrospective cohort of 26 cases examining clinical data and treatments].","authors":"C Roy, L-R Le Nail, G De Pinieux, R Samargandi","doi":"10.1016/j.anplas.2024.09.001","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.09.001","url":null,"abstract":"<p><strong>Background: </strong>Superficial leiomyosarcoma is a rare malignant soft tissue tumor arising from smooth muscle cells, accounting for 2-3% of superficial sarcomas, with limited literature available on the subject. It is typically observed in patients aged 50-60 years and affects both men and women equally in the subcutaneous subtype, whereas the cutaneous subtype predominantly affects men.</p><p><strong>Objective: </strong>This study aims to examine the clinicopathological features and therapeutic outcomes of patients with leiomyosarcoma.</p><p><strong>Method: </strong>This is a descriptive retrospective study of 26 cases of cutaneous and subcutaneous leiomyosarcomas, with histological confirmation.</p><p><strong>Results: </strong>We identified 10 (38.5%) subcutaneous leiomyosarcomas and 16 (61.5%) cutaneous leiomyosarcomas. The majority of tumors were located in the lower limbs, accounting for 13 (50%) cases. During follow-up, 6 patients experienced recurrence, and 7 developed metastases, including 2 of the 7 patients who had R0 resection margins. Among these, 3 out of the 6 recurrent cases and 3 out of the 7 metastatic cases were subcutaneous leiomyosarcomas. The average time to recurrence was 6.2 years.</p><p><strong>Conclusion: </strong>The observed risk of metastases and recurrences, despite clear surgical margins, in both cutaneous and subcutaneous leiomyosarcomas, along with the delayed onset of these events, justifies prolonged patient follow-up. The lungs, bones and liver have been identified as the most common site of metastasis.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513463","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":"[Impact of the number of pregnancies on the venous outflow of DIEP flap in breast reconstruction: A clinical and CT-scan study].","authors":"I Hadji, G Roccaro, L Ferrero, F Pigneur, B Hersant, J-P Meningaud","doi":"10.1016/j.anplas.2024.10.001","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.10.001","url":null,"abstract":"<p><strong>Introduction: </strong>The DIEP (deep inferior epigastric perforator) flap is the \"gold standard\" for breast reconstruction after cancer, giving better benefits on the quality of life. The most common complication is the venous congestion, because of the dominance of superficial venous outflow while the flap is drained by the deep epigastric vein. Pregnancy, by its physiological and vascular modifications, can reduce the risk of the venous congestion. Few studies explored the impact of pregnancy on the DIEP vascularization.</p><p><strong>Material and methods: </strong>We studied the preoperative CT-scans of 104 patients who benefited reconstruction surgery by DIEP from January 2011 until March 2022. The patients were separated into 5 groups according to number of pregnancies. For each CT-scan, a concomitant vein of deep epigastric artery diameter/SIEV diameter ratio was performed on each side, to assess the relation between pregnancy and the reduction of venous complications.</p><p><strong>Results: </strong>The results showed an increase of this ratio with the number of pregnancies. Patients with no pregnancy (G0) have the highest complication rate, with 41.7% of venous congestion case. On the other hand, in the group of four pregnancies or more (G4), the complication rate was significantly lower, at 10%, and none venous congestion was observed. These results suggest the beneficial effects of pregnancy on vascularization and especially on venous drainage in the DIEP flap.</p><p><strong>Conclusion: </strong>This study highlights the benefit effect of the number of pregnancies on the DIEP vascularization, especially for the reduction of the venous congestion risk. The ratio DIEV/SIEV may be a useful help to predict the risk of venous complications in nullparous patients. These results open to new studies to deepen the understanding of the physiological effects of the pregnancy on the breast reconstruction surgery.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513464","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":"Validating the porcine model for microsurgical perforator training: Can surgeons trained on pig perforator dissection successfully perform human DIEP flap procedures? A pilot study.","authors":"G A G Lombardo, A Stivala, R Cuomo, V Villani, A Nistor, F Rosatti","doi":"10.1016/j.anplas.2024.09.008","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.09.008","url":null,"abstract":"<p><p>Autologous breast reconstruction, especially using the deep inferior epigastric artery perforator (DIEP) flap, is increasingly seen as a reliable, safe, and long-term alternative to implant-based reconstruction. Despite the recognized advantages of the DIEP flap for breast reconstruction, successful realization demands excellent anatomical knowledge, a thorough understanding of autologous breast reconstruction concepts and advanced microsurgical skills. Given that the porcine model is widely employed in microsurgical training, our study aims to assess this model using validated outcomes, with the objective of evaluating the enhancement in a surgeon's learning curve following training with this model. Forty DIEP flaps were harvested on 20 swines by a single surgeon in \"Pius Branzeu Center\" (Timisoara, RO) and \"Drazan Institute\" (University of veterinary of Brno, CZ) laboratories for microsurgical training in 6months (January 2015-June 2015). Then we analyzed data from 40 DIEP flaps harvested by the same surgeon on first 20 consecutive patients undergoing DIEP flap breast reconstruction. Perforator dissection time, surgeon-determined dissection difficulty score (DDS) and venous congestion rate were collected for each flap in porcine model and in patients, then compared and analyzed. The mean of DDS score analysis in first and second swines group dissection resulted as statistically significant (P-value 0.0001), while it was not statistically significant between those analyzed in the second group of swines dissected and patients (P-value 0.8037). Reduction in perforator dissection time between the two swines' groups and in venous congestion rates from the first swines groups to the second to the human group resulted statistically significant too (P-value respectively 0.0001 and 0.0079). The porcine model has been used for a long time together with other animal models for microsurgical training. Our study confirms and objective by validated scores that it is a valid and reliable model, comparable to the human one and which mimics the dissection of human perforating vessels.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513469","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 a smartphone-compatible thermal camera (FLIR One) for preoperative mapping of DIEP perforators].","authors":"J Roukoz, G Bilger, M Chatard, F Hollard-Kissel, M Gédor, M Brix, E Simon","doi":"10.1016/j.anplas.2024.09.002","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.09.002","url":null,"abstract":"<p><strong>Introduction: </strong>The success of surgeries involving free flaps largely depends on accurate preoperative mapping of perforator arteries. Various imaging techniques, such as Doppler ultrasound and CT angiography, are typically used, each having its advantages and disadvantages in terms of cost, accuracy, and patient risk. The main objective of our study is to compare the effectiveness of the FLIR One device for detecting these arteries compared with traditional methods. Thermal imaging appears to be a simpler, less expensive, and less invasive alternative for surgical planning.</p><p><strong>Material and method: </strong>The study, conducted at the Regional Hospital Center of Nancy, included 25 free flaps (DIEP) on an exclusively female cohort of 22 patients, with follow-up from 2022 to 2023. Before the procedure, an abdominal-pelvic CT angiography was performed, followed by additional evaluation with thermal imaging using FLIR One and acoustic Doppler examination on the eve of the operation. This approach aimed to provide precise mapping of vascular perforators for each patient. Three different operators performed these markings, and the results were then compared with intraoperative observations. The imaging protocol also included a Doppler examination to validate the results of the thermal imaging. Statistical analyses with intraclass correlation coefficients (ICC) were performed to evaluate the correlation between different preoperative localization methods of perforating vessels.</p><p><strong>Results: </strong>In 22 patients undergoing 25 DIEP flaps for breast reconstructions, three imaging techniques were used to identify vascular perforators: thermal imaging with FLIR, acoustic Doppler, and CT angiography. FLIR identified the most perforators (n=137), followed by acoustic Doppler (n=128) and CT angiography (n=126). Comparing these with intraoperative results, 66% of perforators identified by FLIR were confirmed, 70% for acoustic Doppler, and 95% for CT angiography. The ICCs shows a significant correlation between these imaging techniques and intraoperative results. FLIR demonstrated a strong correlation with intraoperative observations (ICC of 0.74, P<0.001), followed by a moderate correlation with acoustic Doppler (ICC of 0.56, P<0.03) and CT angiography (ICC of 0.52, P<0.006).</p><p><strong>Conclusion: </strong>The study concludes that thermal imaging with FLIR is a reliable and effective tool for locating vascular perforators. Although the study and FLIR have their own limitations, the tool presents several advantages such as ease of use, speed, and affordability. These characteristics make FLIR particularly attractive as a complement to traditional detection methods, such as acoustic Doppler and CT angiography.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513465","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":"Posterior arm perforator flap for coverage of the scapular area.","authors":"A Majchrzak, G Paleu, B Guena, B Chaput, O Camuzard, E Lupon","doi":"10.1016/j.anplas.2024.09.003","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.09.003","url":null,"abstract":"<p><p>We report on using a pedicled posterior brachial perforator flap to cover a defect of the infraspinous fossa. The first description of the posterior brachial flap came from Masquelet in 1985, and there are very few reports of this flap in the literature, mainly in its pedicled form limited to axillary covers. Scapular soft tissue defect with bone exposure can be covered by several techniques. However, in the event of scapular radiotherapy, some conventional flaps used to cover this type of skin defect may have their pedicle damaged. The posterior arm flap was designed along a line joining the apex of the axillary fossa to the epitrochlea, opposite the medial brachial intermuscular septum. The width of the paddle was defined by a pinch test. The dissection was retrograde, subaponeurotic down to the medial brachial intermuscular septum. To our knowledge, this report is the first to describe the use of this flap to cover the scapular area; the outcome was excellent, with a low donor site morbidity.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513468","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":"Hand and wrist complete degloving: A case report and litterature review.","authors":"L Chouquet, Y Berkane, G Paleu, S Gandolfi, O Camuzard, E Lupon","doi":"10.1016/j.anplas.2024.09.005","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.09.005","url":null,"abstract":"<p><strong>Introduction: </strong>Complete hand degloving injuries are traumatic avulsion injuries causing the skin to pull away from the underlying tissues and are most often caused by industrial machinery. We present the case of a degloving trauma of the whole fingers, hand, and wrist resulting in a \"watch hand\" by analogy with the \"ring finger\" and discuss alternatives and recommendations from the rare cases described of similar traumas.</p><p><strong>Case presentation: </strong>A 33-year-old manual worker, a non-smoker with no significant medical or surgical comorbidities, was admitted for a complete skin avulsion of the left hand and wrist following a work-related accident with a trommel-type industrial roller. Our approach covered the five fingers and the dorsal aspect of the hand and wrist with an artificial dermal matrix, while the palmar side of the hand and wrist was covered with a pedicled groin flap in emergency. At 15months, the patient's sensitivity was classified as S1 on the sensory evaluation scale, joint mobility was less than 30°, and the residual hand retained what we might call \"basic\" functions, i.e., a counterweight when carrying loads and the ability to pick up and hold a light object in the thumb-index grasp.</p><p><strong>Conclusion: </strong>Complete soft tissue hand defects are exceptional and require urgent treatment. If re-implantation is not possible, combining a dermal matrix with a pedicled flap is a simple salvage solution. The risks of vascular, infectious, and stiffening complications in these traumas are high and must be prevented. Patients must be warned of the severity of the trauma, the need for secondary surgeries to restore a policy-digital grip, and the poor functional results expected.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513466","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":"Lip lift with advancement flap as nasal columella reconstruction.","authors":"J Cornacchini, E Lupon, O Camuzard, H Remy","doi":"10.1016/j.anplas.2024.09.004","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.09.004","url":null,"abstract":"<p><p>Basocellular carcinomas are characterized by their non-deep spread neoplastic nature. Although treatment typically proceeds without complication, excision in critical facial regions can lead to aesthetically undesirable defects. Furthermore, elderly patients often express aesthetic concerns, particularly regarding the thinning of the upper lip over time. This article presents the case of a 75-year-old patient with a basocellular carcinoma located on the tip of the nose, amidst a history of multiple neoplastic conditions. To address the defect, an inferiorly-based philtral advancement flap was employed, accompanied by a lip lift procedure, resulting in favorable aesthetic and functional outcomes.</p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513467","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":"[Review of 10 patients with pure perilunate carpal dislocation at a minimum of 18years follow-up].","authors":"M Boukhaled, C Dumontier, L Cathala, A-P Uzel","doi":"10.1016/j.anplas.2024.08.001","DOIUrl":"https://doi.org/10.1016/j.anplas.2024.08.001","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate, in long-term, the functional abilities and the occurrence of osteoarthritis in patients treated for a posterior perilunate carpal dislocation without bone lesion associated.</p><p><strong>Patients and method: </strong>This was a monocentric retrospective observational study on patients operated on at the University Hospital of Guadeloupe for a posterior perilunate dislocation without bone lesion associated with a minimum of 18years of follow-up. Ten patients were included with a mean follow-up of 22.8years. The evaluation criteria were clinical (PRWE, QuickDASH, pain, grip strength, wrist joint mobility, Watson and Reagan tests, Cooney functional score) and radiographic (Gilula curves, carpal height, carpal ulnar translation, scapholunate and radiolunar angles, scapholunate and triquetro-lunar interlines in statics and dynamics, Herzberg's classification of complications).</p><p><strong>Results: </strong>The average Cooney score was 67.5/100. Mean PRWE and QuickDASH scores were 33.9 and 24.8 respectively. The mean flexion-extension arc on the injured side was 71.5° (66.7% compared to the healthy side). Mean grip strength was 27kg (72.8% compared to the healthy side). The prevalence of osteoarthritis was 60%, with three A types, two A1 types, one B type and four B1 types according to Herzberg.</p><p><strong>Conclusion: </strong>The factors influencing the long-term prognosis are the initial displacement of the lunate, the quality of the reduction and the presence of chronic carpal instability, particularly scapholunate. The high prevalence of osteoarthritis in our series (60%) is apparently not correlated with the functional capacities of patients over the long term.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":55512,"journal":{"name":"Annales De Chirurgie Plastique Esthetique","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301754","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}