American Journal of Sports Medicine最新文献

{"title":"Hip Arthroscopy: How Far We Have Come, and Where We Need to Go.","authors":"Andrea M Spiker","doi":"10.1177/03635465241290992","DOIUrl":"https://doi.org/10.1177/03635465241290992","url":null,"abstract":"","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":"52 13","pages":"3195-3197"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes and Long-term Survivorship After Osteochondral Autologous Transfer Combined With Valgus High Tibial Osteotomy: An Analysis After 19 Years With 56 Patients.","authors":"Yannick J Ehmann, Thekla Esser, Romed P Vieider, Marco-Christopher Rupp, Julian Mehl, Andreas B Imhoff, Sebastian Siebenlist, Philipp Minzlaff","doi":"10.1177/03635465241280231","DOIUrl":"10.1177/03635465241280231","url":null,"abstract":"<p><strong>Background: </strong>Osteochondral defects of the medial femoral condyle combined with varus malalignment in young and active patients are a debilitating condition, which can result in early osteoarthritis. Osteochondral autologous transfer (OAT) combined with valgus high tibial osteotomy (HTO) might therefore be a comprehensive solution to maintain long-term knee function.</p><p><strong>Purpose/hypothesis: </strong>The purpose of this study was to report clinical results and survivorship after combined OAT and valgus HTO for symptomatic osteochondral defects of the medial femoral condyle in the setting of varus malalignment at a long-term follow-up. It was hypothesized that undergoing combined OAT and valgus HTO would produce favorable clinical results along with a low rate of conversion to arthroplasty.</p><p><strong>Study design: </strong>Case series; Level of evidence, 4.</p><p><strong>Methods: </strong>All patients treated between 1998 and 2008 with combined valgus HTO and OAT for deep osteochondral defects of the medial femoral condyle and concomitant varus malalignment >2° without meniscal repair/transplantation, osteoarthritis, or ligamentous instability/reconstruction were included. The survival rates of this combined procedure were evaluated. Failure was defined as conversion to knee joint arthroplasty during the follow-up period. Patient-reported outcomes were collected pre- and postoperatively, including the Lysholm score, visual analog scale score, Knee injury and Osteoarthritis Outcome Score (KOOS), Tegner Activity Scale score, and subjective level of satisfaction (scale 0-10).</p><p><strong>Results: </strong>Of 74 patients who were included for 10-year follow-up, 3 had died. A total of 15 patients were lost to follow-up, so 56 patients could be reevaluated, for a follow-up rate of nearly 80%. The mean age at surgery was 38.8 ± 9.9 years (range, 19.9-62.4 years), and the mean follow-up time was 18.9 ± 3.0 years (median, 18.8 years; range, 14.1-24.8 years). The survival rates were 87% at 10 years, 86% at 15 years, and 77% at 19 years after surgery. At final follow-up, the Lysholm score showed a mean increase of 39 points (95% CI, 25.4-50.0 points; <i>P</i> < .001) from 40 points to 79 points, representing a significant improvement. Overall, 96% of patients surpassed the minimal clinically important difference (MCID) for the Lysholm score. The visual analog scale score decreased by a mean of 4.8 points (range, 5-10 points) from 7.5 points to 2.7 points (<i>P</i> < .001), and 80% of patients surpassed the MCID. The mean Tegner Activity Scale score was 4.5 ± 1.6, and the mean KOOS subscale scores at final follow-up were as follows: Pain: 81 ± 21 (range, 19-100), Symptoms: 80 ± 22 (range, 21-100), Activities of Daily Living: 85 ± 21 (range, 18-100), Sports: 68 ± 32 (range, 0-100), and Quality of Life: 67 ± 28 (range, 0-100). Overall, 78% of the patients were satisfied with the results of the operation.</p><p><strong>Conclusion","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"3004-3012"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Therapeutic Efficacy and Autophagy-Mediated Mechanisms of Action of Urine-Derived and Adipose-Derived Stem Cells in Osteoarthritis.","authors":"Tianhao Xu, Kaibo Zhang, Yunan Hu, Runze Yang, Jiexi Tang, Weili Fu","doi":"10.1177/03635465241277176","DOIUrl":"10.1177/03635465241277176","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis (OA) is a prevalent and disabling disease that affects a significant proportion of the global population. Urine-derived stem cells (USCs) have shown great prospects in the treatment of OA, but there is no study that has compared them with traditional stem cells.</p><p><strong>Purpose: </strong>This study aimed to compare the therapeutic efficacy and mechanisms of USCs and adipose-derived stem cells (ADSCs) for OA treatment.</p><p><strong>Study design: </strong>Controlled laboratory study.</p><p><strong>Methods: </strong>We compared the biological properties of USCs and ADSCs using CCK-8, colony formation, EdU, adhesion, and apoptosis assays. We evaluated the protective effects of USCs and ADSCs on IL-1β-treated OA chondrocytes by chemical staining, immunofluorescence, and Western blotting. We assessed the effects of USCs and ADSCs on chondrocyte autophagy by transmission electron microscopy, immunofluorescence, and Western blotting. We also compared the therapeutic efficacy of intra-articular injections of USCs and ADSCs by gross, histological, micro-computed tomography, and immunohistochemical analyses in an OA rat model induced by anterior cruciate ligament transection.</p><p><strong>Results: </strong>USCs showed higher proliferation, colony formation, DNA synthesis, adhesion, and anti-apoptotic abilities than ADSCs. Both USCs and ADSCs increased the expression of cartilage-specific proteins and decreased the expression of matrix degradation-related proteins and inflammatory factors in OA chondrocytes. USCs had a greater advantage in suppressing MMP-13 and inflammatory factors than ADSCs. Both USCs and ADSCs enhanced autophagy in OA chondrocytes, with USCs being more effective than ADSCs. The autophagy inhibitor 3-MA reduced the enhanced autophagy and protective effects of USCs and ADSCs on OA chondrocytes.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first study to explore the efficacy of USCs in the treatment of knee OA and to compare them with ADSCs. Considering the superior properties of USCs in terms of noninvasive acquisition, a high cost-benefit ratio, and low ethical concerns, our study suggests that they may be a more promising therapeutic option than ADSCs for OA treatment under rigorous regulatory pathways.</p><p><strong>Clinical relevance: </strong>USCs may be a superior cell source for stem cells to treat knee OA, and this study strengthens the evidence for the application of USCs.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"3130-3146"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a Simulated Game and Doubleheader Inning on Peak Kinetics in Softball Pitching Across Pitch Types.","authors":"Anthony W Fava, Jessica L Downs Talmage, Thomas van Hogerwou, Gretchen D Oliver","doi":"10.1177/03635465241278359","DOIUrl":"10.1177/03635465241278359","url":null,"abstract":"<p><strong>Background: </strong>Softball pitchers frequently pitch at high volumes. Previous research has demonstrated changes in mechanics, range of motion, and perceived levels of fatigue and pain at high workloads. To date, little research has assessed changes in kinetics at high workloads across pitch types to understand the injury risk.</p><p><strong>Purpose: </strong>To examine changes in peak kinetics of the shoulder, elbow, and wrist of the pitching arm throughout a simulated game and doubleheader inning.</p><p><strong>Study design: </strong>Descriptive laboratory study.</p><p><strong>Methods: </strong>A total of 19 high school softball pitchers (mean age, 15.1 ± 1.5 years; mean height, 1.6 ± 0.2 m; mean weight, 76.3 ± 16.9 kg) participated. Pitchers threw 4 innings of 25 randomly assigned pitches to mimic a game's high pitch count. Participants then rested for 30 minutes before subsequently proceeding to pitch the first inning of a doubleheader. Each pitcher threw a fastball, drop ball, curveball, and changeup. Peak shoulder, elbow, and wrist kinetics were compared across the first, last, and doubleheader innings and pitch types.</p><p><strong>Results: </strong>Compared with the first inning, significant decreases in kinetics were observed at the shoulder, elbow, and wrist in the last (<i>P</i> < .016) and doubleheader (<i>P</i> < .016) innings, particularly for shoulder and elbow compression force during the drop ball and curveball pitch types and wrist net force for all pitch types but the changeup. Significant decreases in elbow and wrist kinetics were observed during the changeup between the last and doubleheader innings (<i>P</i> < .016). Furthermore, differences in kinetics were observed between pitch types (<i>P</i> < .008); notably, the changeup had reduced kinetics compared with the fastball and breaking ball pitch types (drop ball, curveball) across innings.</p><p><strong>Conclusion: </strong>Across innings, attenuations in select joint kinetics of the pitching arm occurred that were specific to the pitch type. Across pitch types, peak kinetics was often greater during the fastball, while the changeup displayed the lowest peak kinetics.</p><p><strong>Clinical relevance: </strong>The joints examined in this study are common sites of overuse injuries in pitchers. This work adds to previous findings on decrements in neuromuscular function as well as self-reported fatigue and pain with tournament-style pitching that may increase the injury risk. Collectively, these findings support developing a protocol combining functional testing and player-reported outcomes to aid sports specialists' decisions for pitchers to continue to pitch or return to play, which may help prevent musculoskeletal injuries and time loss from sports participation.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"3118-3129"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Clinical Evaluation and Treatment of Arthrogenic Muscle Inhibition: A Need for Validation and Innovation-Letter to the Editor.","authors":"Grant E Norte, David A Sherman, Justin L Rush, Christopher D Ingersoll, Stephan G Bodkin, Lynn Snyder-Mackler, Terry L Grindstaff, Julie P Burland, J Ty Hopkins, Troy Blackburn, Meredith Chaput, Yu Konishi, David A Rice, Joseph M Hart, Matthew S Harkey, Ryan Zarzycki, Riann M Palmieri-Smith, Lindsey K Lepley, Adam S Lepley, Derek N Pamukoff, Jihong Park, Caroline Lisee, Brian Pietrosimone, Abbey C Thomas, John Goetschius, Timothy W Tourville, Dawon J Kidgell, Christopher M Kuenze","doi":"10.1177/03635465241272410","DOIUrl":"https://doi.org/10.1177/03635465241272410","url":null,"abstract":"","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":"52 12","pages":"NP34-NP36"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Knee Pain, Joint Loading, and Structural Abnormalities on MRI in 13-Year-Old Children in a Population-Based Birth Cohort\".","authors":"","doi":"10.1177/03635465241293399","DOIUrl":"10.1177/03635465241293399","url":null,"abstract":"","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":"52 12","pages":"NP40"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subacromial Balloon Placement: Response.","authors":"Alexis B Sandler, John P Scanaliato, Nata Parnes","doi":"10.1177/03635465241277201","DOIUrl":"https://doi.org/10.1177/03635465241277201","url":null,"abstract":"","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":"52 12","pages":"NP32-NP33"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients With Graft Tears Leaving the Tuberosity Covered Have Similar Functional Outcomes to Those With an Intact Graft After Superior Capsular Reconstruction.","authors":"Raffy Mirzayan, Daniel C Acevedo, Janis F Yao, Karimdad A Otarodifard, Michael Hall, Brian D Suh, Anshuman Singh","doi":"10.1177/03635465241278358","DOIUrl":"https://doi.org/10.1177/03635465241278358","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Studies to date of superior capsular reconstruction (SCR) comparing outcomes of healed grafts versus torn grafts do not separate graft tears based on location of the tear, rather they combine and report all tears as a single group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose/hypothesis: &lt;/strong&gt;The purpose of this study was to correlate functional outcome with graft integrity and graft tear location after SCR with a dermal allograft. It was hypothesized that the functional outcomes of patients with an intact graft would be equivalent to those with graft tears leaving the tuberosity covered.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Cohort study; Level of evidence, 3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients who underwent SCR with an acellular dermal allograft at a single institution were included. Pre- and postoperative American Shoulder and Elbow Surgeons (ASES), Oxford Shoulder Score, visual analog scale (VAS) for pain, and postoperative Single Assessment Numeric Evaluation (SANE) scores were recorded. A magnetic resonance imaging scan was performed postoperatively to assess graft integrity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 39 patients met inclusion criteria. Mean age of patients was 60.4 ± 8.7 years; mean follow-up was 53.3 ± 25 months (range, 14-98 months). Magnetic resonance imaging performed at a mean of 17.5 months (range, 6-66 months) demonstrated an intact graft in 14 (36%); tear from the glenoid in 11 (28%), from midsubstance in 4 (10%), and from the tuberosity in 8 (21%); and complete graft absence in 2 (5%). Patients were divided into group 1 (intact graft), group 2 (tuberosity covered: tears from glenoid and midsubstance tears), and group 3 (tuberosity bare: tears from the tuberosity and dissolved or absent grafts). In group 1, there was significant improvement in ASES (37.9 to 88.5; &lt;i&gt;P&lt;/i&gt; &lt; .001), Oxford (25.2 to 46.2; &lt;i&gt;P&lt;/i&gt; &lt; .001), and VAS (6.8 to 0.9; &lt;i&gt;P&lt;/i&gt; &lt; .001). In group 2, there was significant improvement in ASES (32.2 to 86.1; &lt;i&gt;P&lt;/i&gt; &lt; .001), Oxford (23.4 to 44.2; &lt;i&gt;P&lt;/i&gt; &lt; .001), and VAS (7.3 to 1.3; &lt;i&gt;P&lt;/i&gt; &lt; .001). In group 3, there was no significant improvement in ASES (40.3 to 45.8; &lt;i&gt;P&lt;/i&gt; = .50) or Oxford (33.5 to 31.4; &lt;i&gt;P&lt;/i&gt; = .81), but there was a significant reduction in VAS (7.1 to 5.4; &lt;i&gt;P&lt;/i&gt; = .03). There was no significant difference between group 1 and 2 in postoperative ASES (88.5 vs 86.1; &lt;i&gt;P&lt;/i&gt; = .59), Oxford (46.2 vs 44.2; &lt;i&gt;P&lt;/i&gt; = .07), VAS (0.9 vs 1.3, &lt;i&gt;P&lt;/i&gt; = .42) and SANE (85.4 vs 83.2; &lt;i&gt;P&lt;/i&gt; = .92) scores. However, group 3 had significantly lower ASES (45.8; &lt;i&gt;P&lt;/i&gt; &lt; .001), lower Oxford (31.4; &lt;i&gt;P&lt;/i&gt; &lt; .001), lower SANE (45.4; &lt;i&gt;P&lt;/i&gt; &lt; .001), and higher VAS (5.4; &lt;i&gt;P&lt;/i&gt; &lt; .001) scores than groups 1 and 2. There were no differences in outcomes based on sex (&lt;i&gt;P&lt;/i&gt; = .72), previous surgery (&lt;i&gt;P&lt;/i&gt; = .06), preoperative acromiohumeral distance (&lt;i&gt;P&lt;/i&gt; = .57), and preoperative Goutallier stage of the supraspinatus (&lt;i&gt;P&lt;/i&gt; = .16).&lt;/p&gt;&lt;p&gt;&lt;strong","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":"52 12","pages":"3065-3074"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"The Effect of Varying Sizes of Ramp Lesions in the ACL-Deficient and Reconstructed Knee: A Biomechanical Robotic Investigation\".","authors":"","doi":"10.1177/03635465241292634","DOIUrl":"https://doi.org/10.1177/03635465241292634","url":null,"abstract":"","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":"52 12","pages":"NP39"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone Marrow Stimulation for Arthroscopic Rotator Cuff Repair: A Meta-analysis of Randomized Controlled Trials.","authors":"Eoghan T Hurley, Bryan S Crook, Richard M Danilkowicz, Laith M Jazrawi, Raffy Mirzayan, Jonathan F Dickens, Oke Anakwenze, Christopher S Klifto","doi":"10.1177/03635465231213873","DOIUrl":"10.1177/03635465231213873","url":null,"abstract":"<p><strong>Background: </strong>Bone marrow stimulation (BMS) has been proposed to augment healing at the time of arthroscopic rotator cuff repair (ARCR) by creating several bone marrow vents in the footprint of the rotator cuff, allowing mesenchymal stem cells, platelets, and growth factors to cover the area as a \"crimson duvet.\"</p><p><strong>Purpose: </strong>To perform a meta-analysis of randomized controlled trials (RCTs) to compare the outcomes after BMS and a control for those undergoing ARCR.</p><p><strong>Study design: </strong>Meta-analysis; Level of evidence, 1.</p><p><strong>Methods: </strong>A literature search of 3 databases was performed based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RCTs comparing BMS and a control for ARCR were included. Clinical outcomes were compared, and a <i>P</i> value <.05 was considered to be statistically significant.</p><p><strong>Results: </strong>A total of 7 RCTs with 576 patients were included. Overall, 18.8% of patients treated with BMS and 21.0% of patients treated with a control had a retear (<i>I</i>² = 43%; <i>P</i> = .61). With BMS, the mean Constant score was 88.2, and with the control, the mean Constant score was 86.7 (<i>P</i> = .12). Additionally, there was no significant difference in the American Shoulder and Elbow Surgeons score (94.3 vs 93.2, respectively; <i>P</i> = .31) or visual analog scale score (0.9 vs 0.9, respectively; <i>P</i> = .89).</p><p><strong>Conclusion: </strong>The level 1 evidence in the literature did not support BMS as a modality to improve retear rates or clinical outcomes after ARCR.</p>","PeriodicalId":55528,"journal":{"name":"American Journal of Sports Medicine","volume":" ","pages":"3167-3172"},"PeriodicalIF":4.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139704058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}