Pediatrics and Neonatology最新文献

{"title":"High cumulative antibiotic exposure in extremely low birth weight infants during the first month of life: Risk factors and clinical outcomes.","authors":"Yu-Hsuan Wu, Han-Yang Chiang, Ming-Chou Chiang, Yi-Jung Chang, Cheng-Hsun Chiu, Chien-Chung Lee","doi":"10.1016/j.pedneo.2024.06.011","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.06.011","url":null,"abstract":"<p><strong>Background: </strong>Extremely low birthweight (ELBW) infants invariably receive multiple antibiotic therapies during hospitalization. However, the causes of high cumulative antibiotic exposure, as well as the impact of such exposure on the outcomes of preterm infants, particularly long-term neurodevelopmental outcomes, remain to be elucidated. Furthermore, the cumulative effects of simultaneous use of multiple antibiotics are often overlooked.</p><p><strong>Methods: </strong>We included ELBW infants born between January 1, 2016, and December 31, 2020. The duration of antibiotic therapy was calculated as Days of Therapy (DOT), with each antibiotic administered during the first month of life added cumulatively. The infants were divided into two groups: the low cumulative antibiotic exposure group and the high cumulative antibiotic exposure group.</p><p><strong>Results: </strong>Of 453 eligible ELBW infants, 358 met the inclusion criteria. Multivariable logistic regression indicated a low birthweight [adjusted odds ratio (aOR) 0.996, 95% confidence interval (CI) 0.994, 0.998], chorioamnionitis (aOR 2.195, 95% CI 1.145, 4.210), sepsis (aOR 2.538, 95% CI 1.417, 4.544), and necrotizing enterocolitis (aOR 11.798, 95% CI 2.637, 52.784) as independent factors associated with high cumulative antibiotic exposure. These infants were associated with poor short-term outcomes, including mortality (aOR 9.031, 95% CI 2.433, 33.448), moderate to severe bronchopulmonary dysplasia (aOR 2.895, 95% CI 1.471, 5.699), and retinopathy of prematurity necessitating therapy (aOR 2.503, 95% CI 1.363, 4.597). Although infants in the low cumulative antibiotic exposure group had higher neurodevelopmental scores across all three BSID-III domains at each corrected age compared to those in the high cumulative antibiotic exposure group, the cumulative antibiotic exposure did not significantly influence the score changes in the linear mixed-effects models.</p><p><strong>Conclusions: </strong>High cumulative antibiotic exposure in early life is associated with adverse short-term outcomes in ELBW infants. The impacts on long-term neurodevelopmental require further investigation. When prescribing antibiotics to infants, caution should be exercised to avoid unnecessary exposure.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741548","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":"Hepatopulmonary syndrome in biliary atresia children increased postoperative complications after liver transplantation.","authors":"Ju-Yin Chen, Mei-Hwei Chang, Ming-Chih Ho, Shinn-Forng Peng, Wen-Ming Hsu, Wen-Hsi Lin, Jia-Feng Wu","doi":"10.1016/j.pedneo.2024.06.012","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.06.012","url":null,"abstract":"<p><strong>Background: </strong>Hepatopulmonary syndrome (HPS) is a complication in biliary atresia (BA) children following hepatoportoenterostomy. Liver transplantation (LT) was the definitive treatment of HPS. However, little was known about the risk factors between HPS and mortalities. We aimed to evaluate the role of HPS and the predictors of complications after LT in BA children.</p><p><strong>Methods: </strong>One hundred and twenty (54 males and 66 females) children with BA receiving LT were retrospectively enrolled. The primary outcome was postoperative biliary/vascular complication rates and the secondary outcome was post-LT mortality rates.</p><p><strong>Results: </strong>Among 120 BA children receiving LT, six (5%) children were diagnosed with HPS before LT. The overall survival rate of LT in BA children was 80% and the overall survival rate of LT in BA children with and without HPS was 17% and 83%, respectively. Vascular complications and HPS were predictors for poor overall survival rates both in univariate logistic regression analyses (hazard ratio [HR], 11.63 and 5.96; P < 0.0001 and P = 0.001, respectively) and multivariate logistic regression analyses (HR, 10.02 and 4.16; P < 0.0001 and P = 0.007, respectively). Kaplan-Meier analysis indicated the predictive role of HPS on poor overall survival rates (P < 0.0001), higher risks of biliary complications (P < 0.0001), and higher risks of jaundice (P < 0.01) post-LT.</p><p><strong>Conclusion: </strong>The present study comprising children over long-term follow-up revealed that the development of pre-LT HPS had a poor impact on overall survival rates and higher risks of biliary complications in BA children receiving LT.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696249","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":"Association of toll-like receptors with the airway-intestinal microbiota and pneumonia development in preterm infants - A case control study.","authors":"Lei Zhang, Hong Liu, Wei Tang, Ling Zhou, Yuedong Huang","doi":"10.1016/j.pedneo.2024.10.008","DOIUrl":"https://doi.org/10.1016/j.pedneo.2024.10.008","url":null,"abstract":"<p><strong>Background: </strong>The prevention and treatment of pneumonia and lung injury in preterm infants are major challenges for pediatricians worldwide. Few studies have analyzed the composition of bacterial colonies in the airway and intestine and their relationship with toll-like receptors (TLRs) as it relates to pneumonia in preterm infants.</p><p><strong>Methods: </strong>This study included 70 infants born at 32-35 weeks gestation. Oral-tracheal aspirates at the time of birth, first-pass meconium, and serum specimens were collected. Bacterial deoxyribonucleic acid (DNA) was extracted from the Oral-tracheal aspirates and meconium, and 16S ribosomal ribonucleic acid (rRNA) genes were amplified and sequenced. The levels of TLR2 and TLR4 were analyzed using an enzyme-linked immunosorbent assay. Preterm infants were classified into non-pneumonia (A) and pneumonia (B) groups according to their clinical manifestations.</p><p><strong>Results: </strong>Significant differences in the alpha and beta diversities were observed between the two groups. Infants with pneumonia had less bacterial diversity in the airways and intestinal flora at birth than those without pneumonia. The three most predominant phyla in the airways at birth were Proteobacteria, Firmicutes, and Actinobacteria. The levels of TLR2 and TLR4 in oral-tracheal aspirates were higher in infants with pneumonia than in those without pneumonia, although serum TLR2 and TLR4 levels did not differ between the groups. Streptococcus in the oral tracheal aspirate was negatively correlated with TLR2 and TLR4 levels, and Ureaplasma in the oral-tracheal aspirate was negatively correlated with TLR4 levels in the airway.</p><p><strong>Conclusion: </strong>Reduced perinatal microbiota diversity is associated with the levels of TLR2 and TLR4, and may also have a significant impact on the development of pneumonia.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711961","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":"Genetic burden in neonatal and pediatric-onset pulmonary hypertension: A single-center retrospective study using exome sequencing in a Chinese population.","authors":"Chen Chen, Hang Zhou, Fang Fu, Ruibin Huang, You Wang, Fei Guo, Chunlin Ma, Fucheng Li, Dan Wang, Qiuxia Yu, Yan Lu, Guilan Chen, Tingying Lei, Ru Li","doi":"10.1016/j.pedneo.2024.06.010","DOIUrl":"10.1016/j.pedneo.2024.06.010","url":null,"abstract":"<p><strong>Objective: </strong>This single-center retrospective study aimed to investigate the genetic factors contributing to neonatal and pediatric pulmonary hypertension in a Chinese population using trio whole-exome sequencing (trio-WES).</p><p><strong>Method: </strong>This retrospective analysis reviewed the clinical and genetic profiles of children under 18 years of age diagnosed with pulmonary hypertension between March 2017 and March 2022. The diagnosis of pediatric pulmonary hypertension was confirmed through echocardiography and catheterization. Trio-WES was performed on the patients and their parents after obtaining informed consent.</p><p><strong>Results: </strong>A total of 51 children with neonatal and pediatric pulmonary hypertension were included, comprising 20 with pediatric pulmonary arterial hypertension and 31 with persistent pulmonary hypertension of the newborn. Trio-WES detected 16 pathogenic or likely pathogenic variants in 14 patients across ten genes, including: BMPR2 (n = 2), CHD7 (n = 2), FOXF1 (n = 2), MED13L (n = 1), TNNI3 (n = 2), ALMS1 (n = 1), KMT2D (n = 2), NKX2-1 (n = 1), NONO (n = 1), and CACNA1E (n = 1). In addition, two patients exhibited de novo pathogenic copy number variations.</p><p><strong>Conclusion: </strong>Our findings demonstrate the significant diagnostic value of trio-WES in pediatric pulmonary hypertension, supporting its recommendation for these patients.</p>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and prognosis of SARS-CoV-2 infection in children with hematological malignancies: A multicenter, retrospective study in China","authors":"Weilin Wang ,&nbsp;Xueju Xu ,&nbsp;Songting Bai ,&nbsp;Lu Wang ,&nbsp;Jixia Luo ,&nbsp;Daiyan Zhao ,&nbsp;Ping Li ,&nbsp;Qiuxia Fan ,&nbsp;Chunmei Wang ,&nbsp;Qianghua Yao ,&nbsp;Bai Li ,&nbsp;Dao Wang","doi":"10.1016/j.pedneo.2023.12.006","DOIUrl":"10.1016/j.pedneo.2023.12.006","url":null,"abstract":"<div><h3>Background</h3><div>Data on SARSCoV-2 infection in children with hematological malignancies (HM) are limited. Here, we describe the clinical features of children with HM after SARS-CoV-2 infection and investigate the potential risk factors for disease severity.</div></div><div><h3>Methods</h3><div>Children with HM and SARS-CoV-2 infection from five hospitals in five cities in Henan, China from October 2022 to January 2023 were retrospectively included. Clinical information and Coronavirus disease 2019 (COVID-19) vaccination status were collected for further analyses.</div></div><div><h3>Results</h3><div>A total of 285 children with HM and SARS-CoV-2 infections were included. COVID-19 was asymptomatic in 3.2% of the patients (n = 9), mild in 89.1% (n = 254), moderate in 5.3% (n = 15), severe in 1.8% (n = 5), and critical in 0.7% (n = 2). Fever (92.4%) and cough (56.9%) were the most common symptoms. Most (249, 88.3%) children were managed at home during their COVID-19 illness. Of the 36 children admitted to the hospital, two required intensive care unit care, 11 required supplementary oxygen, and two non-invasive ventilation. A total of 283 (99.3%) children fully recovered and two (0.7%) died due to COVID-19. Significant risk factors for increased severity of infection in multivariable analyses were the presence of comorbidity (OR, 10.4; 95%CI, 2.8–38.7; p &lt; 0.0001), neutropenia (OR, 10.4; 95%CI, 2.6–41.8; p = 0.001), and lymphopenia (OR, 4.2; 95%CI, 1.2–15.4; p = 0.029). A total of 30.9% (88/285) of the children received at least one dose of the inactivated COVID-19 vaccine at COVID-19 diagnosis. Compared with children who received at least one dose of the COVID-19 vaccine, fever was significantly more common in unvaccinated children (79.3% vs. 93.8%, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Children with HM are not at an increased risk of severe COVID-19 compared to the general pediatric population. However, comorbidities such as lymphopenia and neutropenia may increase the risk of developing moderate or severe/critical disease. Our data may help in management decisions for this vulnerable population.</div></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"65 6","pages":"Pages 553-559"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140327472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"X-linked myotubular myopathy in a family of two infant siblings: A case report and review","authors":"Amelia Suan-Lin Koe,&nbsp;Yee Yin Tan,&nbsp;Shrenik Vora","doi":"10.1016/j.pedneo.2024.02.009","DOIUrl":"10.1016/j.pedneo.2024.02.009","url":null,"abstract":"<div><div>X-linked myotubular myopathy (XLMTM) is a severe type of congenital skeletal muscle disorder usually presenting at birth requiring extensive resuscitation. While having phenotypic variability, its diagnosis carries a poor prognosis due to high rates of hospitalization and mortality by early infancy. Management of patients with XLMTM should therefore be guided by shared decision-making with parents, considering the severity and progression of the disease, quality of life, and demands on caregivers. We describe a family unit of two half-siblings presenting with the severe neonatal form of XLMTM, with varying prognosis and outcomes. Furthermore, a novel maternally-derived c.343-1G &gt; A variant in intron-5 of the <em>MTM1</em> gene was identified in this family. Hereby, we propose an algorithm for the management of XLMTM, outlining important considerations during the antenatal and postnatal follow-up period.</div></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"65 6","pages":"Pages 527-531"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Music and movement therapy improves quality of life and attention and associated electroencephalogram changes in patients with attention-deficit/hyperactivity disorder","authors":"Mei-Wen Lee ,&nbsp;Ni-Jung Yang ,&nbsp;Hin-Kiu Mok ,&nbsp;Rei-Cheng Yang ,&nbsp;Yi-Hung Chiu ,&nbsp;Lung-Chang Lin","doi":"10.1016/j.pedneo.2023.11.007","DOIUrl":"10.1016/j.pedneo.2023.11.007","url":null,"abstract":"<div><h3>Background</h3><div>Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder. Treatments for ADHD include pharmacological and nonpharmacological therapy. However, pharmacological treatments have side effects such as poor appetite, sleep disturbance, and headache. Moreover, nonpharmacological treatments are not effective in ameliorating core symptoms and are time-consuming. Hence, developing an alternative and effective treatment without (or with fewer) side effects is crucial. Music therapy has long been used to treat numerous neurological diseases. Although listening to music is beneficial for mood and cognitive functions in patients with ADHD, research on the effects of music and movement therapy in children with ADHD is lacking.</div></div><div><h3>Methods</h3><div>The present study investigated the effects of an 8-week music and movement intervention in 13 children with ADHD. The Pediatric Quality of Life Inventory (PedsQL) was used to evaluate changes in participants' quality of life. Conners’ Kiddie Continuous Performance Test (K-CPT 2) and the Swanson, Nolan, and Pelham rating scale (SNAP-IV) were used to assess core symptoms. Electroencephalogram (EEG) recordings were analyzed to determine neurophysiological changes.</div></div><div><h3>Results</h3><div>The results revealed that the participants' quality of life increased significantly after the 8-week intervention. Furthermore, the participants' hit reaction times in the block 1 and block 2 tests of K-CPT 2 decreased significantly after the intervention. EEG analysis demonstrated an increase in alpha power and Higuchi's fractal dimension and a decrease in delta power in certain EEG channels.</div></div><div><h3>Conclusion</h3><div>Our music and movement intervention is a potential alternative and effective tool for ADHD treatment and it can significantly improve patients’ quality of life and attention.</div></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"65 6","pages":"Pages 581-587"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140761923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of familial symptomatic spontaneous idiopathic pneumoperitoneum","authors":"Christelle Destinval,&nbsp;Jean-Louis Lemelle","doi":"10.1016/j.pedneo.2024.07.003","DOIUrl":"10.1016/j.pedneo.2024.07.003","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"65 6","pages":"Pages 605-606"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung ultrasound in the evaluation of pulmonary edema in newborns with critical congenital heart disease","authors":"Basak Kaya ,&nbsp;Dilek Dilli ,&nbsp;Yasin Sarikaya ,&nbsp;Hasan Akduman ,&nbsp;Rumeysa Citli ,&nbsp;Utku A. Orun ,&nbsp;Mehmet Tasar ,&nbsp;Aysegul Zenciroglu","doi":"10.1016/j.pedneo.2024.02.006","DOIUrl":"10.1016/j.pedneo.2024.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Newborns with critical congenital heart disease (CCHD) with increased pulmonary blood flow (PBF) are at high risk for congestive heart failure. In this study, we aimed to evaluate the presence and degree of pulmonary edema in newborns with CCHD using lung ultrasound (LUS) during the perioperative period.</div></div><div><h3>Methods</h3><div>Prospective clinical trial, 44 newborn patients with CCHD were evaluated in this prospective clinical trial. LUS was repeatedly performed to determine the course of pulmonary edema during the perioperative period. LUS was performed simultaneously with chest radiography (CXR), which was the main part of patient management. The primary outcome of this study was to identify whether a correlation existed between LUS and CXR findings. The secondary outcomes were to determine the relationship between LUS and the need for respiratory support, diuretic use, vasoactive inotropic score (VIS), and pro-B-type natriuretic peptide (pro-BNP) levels durin<u>g</u> the perioperative period.</div></div><div><h3>Results</h3><div>The mean gestational age of the patients was 38.3 ± 1.7 weeks, with a mean birth weight of 3026 ± 432 g. In the preoperative period, both LUS and CXR images were consistent with clinical signs of pulmonary edema. On the first postoperative day, pulmonary edema increased compared to the preoperative period but gradually decreased by the 6th day of surgery (p &lt; 0.05). Positive correlations were observed between the LUS and CXR findings at all study points (p &lt; 0.05). The LUS findings exhibited trends parallel to those of VIS, serum pro-BNP levels, need for respiratory support, and diuretic requirements. As expected, these trends were more pronounced in CCHDs where PBF increased.</div></div><div><h3>Conclusion</h3><div>In CCHD, serial lung ultrasound (LUS) assessments, particularly in cases with increased PBF, can provide valuable guidance for managing patients during the perioperative period.</div></div>","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"65 6","pages":"Pages 532-538"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esophageal inlet patch in a 7-year-old girl with subacute dysphagia","authors":"Ana Fernández-García ,&nbsp;Samuel Sáez Álvarez ,&nbsp;Carmen González-Lamuño Sanchis ,&nbsp;Cristina Iglesias Blázquez ,&nbsp;María Rodríguez Ruiz ,&nbsp;Javier Arredondo Montero","doi":"10.1016/j.pedneo.2024.07.004","DOIUrl":"10.1016/j.pedneo.2024.07.004","url":null,"abstract":"","PeriodicalId":56095,"journal":{"name":"Pediatrics and Neonatology","volume":"65 6","pages":"Pages 603-604"},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}