Journal of Vascular Access最新文献

{"title":"Ultrasound-guided dynamic needle tip positioning versus conventional palpation for improving the success rate of radial artery catheterization: A randomized controlled trial.","authors":"Baoying Feng, Xiayu Zou, Jieqiang Du, Ruiming Luo, Zhixin Wu, Yuyuan You","doi":"10.1177/11297298261444407","DOIUrl":"https://doi.org/10.1177/11297298261444407","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound guidance enhances arterial catheterization by enabling real-time visualization. Various ultrasound-assisted techniques have been described. This study evaluated the clinical utility of ultrasound-guided dynamic needle tip positioning (DNTP) for radial artery catheterization compared with traditional palpation.</p><p><strong>Methods: </strong>Our study included 160 patients scheduled for elective surgery at Foshan Hospital of Traditional Chinese Medicine from February 2024 to March 2025. They were randomly assigned to either the traditional palpation group (<i>n</i> = 80) or the DNTP group (<i>n</i> = 80) via a web-based randomization tool. In accordance with the intention-to-treat (ITT) principle, all 160 randomized patients were included in the primary analysis. Outcomes included first-attempt success, overall success, procedure time, catheter use, and complications. Subgroup analyses were based on arterial depth and cross-sectional area.</p><p><strong>Results: </strong>The DNTP group achieved significantly higher first-attempt and overall success rates than the palpation group (80/80, 100.00% vs 65/80, 81.25% and 80/80, 100.00% vs 66/80, 82.50%; all <i>p</i> < 0.001). Median procedure time was shorter with DNTP (27.5 s (12-98)) compared with palpation (35 s (20-173); <i>p</i> = 0.039). Successful cannulation within 3 min using a single attempt occurred in 100.00% (80/80) of DNTP cases versus 81.25% (65/80) in the palpation group (<i>p</i> < 0.001). Single-catheter use was more frequent in the DNTP group (80/80, 100.00%) than in the palpation group (73/80, 91.25%; <i>p</i> = 0.007). Complication rates were significantly lower with DNTP (13/80, 16.25%) compared with palpation (40/80, 50.00%; <i>p</i> < 0.001). Stratified analyses showed greater benefits of DNTP in patients with deeper arteries (>2 mm) and smaller cross-sectional areas (⩽3 mm²), with significant treatment-subgroup interactions for arterial depth (<i>p</i> = 0.021) and cross-sectional area (<i>p</i> = 0.008).</p><p><strong>Conclusions: </strong>Ultrasound-guided DNTP significantly improves the success rate, efficiency, and safety of radial artery catheterization, particularly in patients with unfavorable arterial anatomy.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298261444407"},"PeriodicalIF":1.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846730","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":"Process evaluation of a pilot study of a self-managed, online cognitive behavioural therapy programme to address needle-related distress in haemodialysis recipients.","authors":"Gorjana Radisic, Richard Le Leu, Kathryn L Collins, Anne L J Burke, Anna Chur-Hansen, Fiona Donnelly, Emily Duncanson, Kathy Hill, Luke Macauley, Stephen McDonald, Shilpanjali Jesudason","doi":"10.1177/11297298261437914","DOIUrl":"https://doi.org/10.1177/11297298261437914","url":null,"abstract":"<p><strong>Background: </strong>Dialysis needle-related distress is prevalent among haemodialysis recipients, with no evidence-based solutions currently available, posing a challenge for both patients and dialysis staff.</p><p><strong>Objective: </strong>To assess the feasibility, acceptability and processes of a novel intervention to manage needle related distress in haemodialysis patients.</p><p><strong>Methods: </strong>The intervention incorporated (1) psychologist evaluation, (2) a self-managed online cognitive behavioural therapy (CBT) programme and (3) a nursing education programme, with pre- and post-intervention evaluations. The intervention was co-designed with patients, psychologists and dialysis nurses and delivered in a tertiary renal unit in South Australia.</p><p><strong>Results: </strong>Of 39 patients referred to the intervention, 18 consented, and only 5 ultimately completed the programme. Barriers to recruitment included the impact of the COVID-19 pandemic, choice of screening tool for needle-fear, discrepancy between self-reported needle-related distress and the distress observed by dialysis nurses. Barriers to intervention delivery included challenges in sustaining patient engagement with the CBT programme due to substantial disease and treatment burden and maintaining nursing staff engagement in high-pressure dialysis environments. Patients who did complete the programme reported it was useful and demonstrated reduction in needle-related distress. The nurse education programme was completed by 133 nurses and was associated with self-reported improvements in knowledge about managing dialysis needle-related distress.</p><p><strong>Conclusion: </strong>A self-managed CBT intervention for needle-related distress was challenging to implement in dialysis recipients and would not be suitable for progression to a full clinical trial.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298261437914"},"PeriodicalIF":1.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846666","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":"A GAVeCeLT-IVAS bundle for Safe Insertion of Long Peripheral Catheters: The SILPeC protocol.","authors":"Davide Giustivi, Giancarlo Scoppettuolo, Vincenzo Faraone, Maria Giuseppina Annetta, Renata Bastos, Fabrizio Brescia, Gloria Ortiz Miluy, Fulvio Pinelli, Antonio Gidaro, Stefano Elli, Adam Fabiani, Timothy R Spencer, Mauro Pittiruti","doi":"10.1177/11297298261444199","DOIUrl":"https://doi.org/10.1177/11297298261444199","url":null,"abstract":"<p><p>In an increasingly complex clinical setting, long peripheral catheters (LPC) are rapidly gaining popularity and represent an effective option for the administration of medications and fluids, especially for patients with difficult venous access. However, inconsistencies in the literature, particularly regarding terminology and insertion techniques, have contributed to significant variability in clinical outcomes. To standardize and promote a safer and more effective insertion of these catheters, the Italian Group of Long-Term Venous Access Devices (GAVeCeLT) and the Italian Vascular Access Society (IVAS) have developed a six-step protocol that provides evidence-based recommendations. This insertion bundle-named SILPeC (Safe Insertion of Long Peripheral Catheters-includes (1) pre-insertion assessment of the vein of the upper limbs, (2) insertion of the optimal site selection, (3) appropriate measures of asepsis, (4) ultrasound-guided puncture, (5) safe connection to infusion lines, and (6) proper device stabilization and appropriate protection of the exit site. Integrating the latest scientific evidence and clinical expertise, the SILPeC bundle provides a standardized and reproducible method for placement and maintenance of LPCs. This project complements the existing GAVeCeLT recommendations for other vascular access devices, contributing to safer and more consistent vascular access practices in both hospital and outpatient settings.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298261444199"},"PeriodicalIF":1.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846746","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":"A meta-analysis of the hemodynamic and echocardiographic changes following arteriovenous fistula ligation in chronic kidney disease patients.","authors":"Mahmoud Einieh, Jose Matias Zaldumbide Diaz, Vitor Rezende, Mohammed Alam, Iuri Ferreira Felix","doi":"10.1177/11297298261441029","DOIUrl":"https://doi.org/10.1177/11297298261441029","url":null,"abstract":"<p><p>Arteriovenous fistulas (AVFs) are the preferred method for establishing long-term vascular access in patients undergoing hemodialysis; however, high-flow AVFs may increase cardiovascular strain after kidney transplantation, often necessitating fistula closure. Currently, no established guideline exists for managing high-flow fistulas in post-transplant patients with stable kidney function, and available studies report heterogeneous results with small sample sizes and different methodologies. We performed a systematic search of PubMed, Cochrane, and Embase up to December 2024 for observational studies and randomized controlled trials comparing AVF ligation versus maintenance in patients with end-stage kidney disease. The meta-analysis was conducted using Cochrane's RevMan software using mean difference (MD) and 95% confidence interval. Twelve studies including 844 patients were analyzed, of whom 409 (48%) underwent AVF ligation, with follow-up ranging from 3 to 62.5 months. AVF ligation was associated with a significant reduction in left ventricular mass index (MD -10.92 g/m²; 95% confidence interval -17.84 to -3.99; <i>p</i> = 0.007) and cardiac index (MD -0.56 L/min/m²; 95% confidence interval -1.05 to -0.07; <i>p</i> = 0.03), indicating attenuation of the hyperdynamic circulatory state related to a persistent AVF. No significant differences were observed in left ventricular ejection fraction or blood pressure parameters. Serum creatinine levels were modestly reduced following AVF ligation (MD -0.12 mg/dL; 95% confidence interval -0.22 to -0.03; <i>p</i> = 0.02), while estimated glomerular filtration rate remained unchanged. Overall, AVF ligation was associated with favorable cardiac remodeling reflected by reductions in left ventricular mass and cardiac output, with supportive changes in secondary echocardiographic parameters and no apparent deterioration in renal function.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298261441029"},"PeriodicalIF":1.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846717","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":"Peripherally inserted central catheter performance in oncology patients: A retrospective analysis in an outpatient setting.","authors":"Letteria Consolo, Francesca Solimeni, Martina Bruno, Ilaria Basile, Carmen Greco, Silvia Pazzaglia","doi":"10.1177/11297298261443384","DOIUrl":"https://doi.org/10.1177/11297298261443384","url":null,"abstract":"<p><strong>Introduction: </strong>Peripherally inserted central catheters (PICCs) are increasingly used in outpatient oncology care, with nurses playing a central role in management. This study aimed to describe PICC use, maintenance, and complication patterns in this setting.</p><p><strong>Methods: </strong>Single-center retrospective study conducted at the Fondazione IRCCS Istituto Nazionale dei Tumori. Adult patients with a PICC and at least one outpatient visit for PICC management between 1 January 2024 and 1 January 2025 were eligible.</p><p><strong>Results: </strong>Two hundred and thirty-one patients were included (mean age 58.5 years, SD ±16.4). Catheter removal was predominantly planned after treatment completion. Unplanned removals were uncommon and mainly related to complications, including suspected infection, occlusion, thrombosis, or accidental dislodgement. The estimated PICC survival probability was 95.1% at 6 months and 89.0% at 12 months.</p><p><strong>Conclusions: </strong>In outpatient oncology patients, PICCs showed sustained functionality, with removal mainly related to treatment completion, supporting continuity-based routine follow-up and tailored surveillance in clinically stable patients.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298261443384"},"PeriodicalIF":1.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of an arteriovenous graft using the transected end of a pre-existing stent graft: A case report.","authors":"Takehisa Nojima, Yasuki Motomiya, Kanako Takai","doi":"10.1177/11297298261441034","DOIUrl":"https://doi.org/10.1177/11297298261441034","url":null,"abstract":"<p><p>Stent grafts have improved secondary patency in arteriovenous grafts (AVGs) by effectively treating venous outflow lesions and have contributed to prolonged secondary patency of AVGs. As AVGs remain functional for longer periods, degeneration of the prosthetic graft itself becomes more frequent, increasing the need for graft-side interventions. During surgical reconstruction of AVGs, surgeons may be required to manage previously implanted stent grafts. We report a case of AVG reconstruction using the transected end of a pre-existing stent graft as the venous anastomosis. A 78-year-old woman undergoing long-term hemodialysis developed graft degeneration with recurrent stenosis despite a functioning stent graft in the venous outflow. Because creation of a new vascular access on the other arm was not feasible, ipsilateral reconstruction was performed. A new prosthetic graft was anastomosed to the radial artery arising from a high bifurcation of the brachial artery at the distal upper arm, near the elbow. On the venous side, the prosthetic graft overlapping the stent graft was completely excised, and the stent graft was transected at a segment not overlapped by the prosthetic graft within the native vein. End-to-end anastomosis was then created between the new prosthetic graft and the transected stent graft. Postoperative angiography confirmed good patency of the anastomosis and venous outflow, and access flow improved significantly. The reconstructed AVG was suitable for cannulation 10 days after surgery. This case suggests that reuse of a transected stent graft during AVG reconstruction may be technically feasible in carefully selected patients.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298261441034"},"PeriodicalIF":1.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823789","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":"PICC migration and perforation of internal jugular vein after neck dissection.","authors":"Federica Dusi, Luca Gazzini, Francesca Zanghi, Astrid Maffei, Giuseppe Nucera, Luca Calabrese, Peter Trebo, Giuseppe Capozzoli","doi":"10.1177/11297298261443389","DOIUrl":"https://doi.org/10.1177/11297298261443389","url":null,"abstract":"<p><p>Peripherally inserted central catheters (PICCs) were introduced as an alternative to centrally inserted central catheters (CICCs) inserted into the jugular vein to provide central venous access. In head and neck reconstructive surgery, PICCs are preferred over CICCs because they do not obstruct surgical access, such as during neck dissection. Additionally, PICCs offer a safer option than peripheral access for the infusion of vesicants, irritants, hyperosmolar solutions, antibiotics, prolonged parenteral nutrition, and chemotherapy agents. We present a case of perforation of the internal jugular vein caused by PICC migration in the early postoperative days following neck dissection and free flap reconstruction. During surgical exploration, a large cervical hematoma was evacuated. Bleeding was traced to multiple lacerations of the internal jugular vein, the largest measuring 15 mm. The venous anastomosis of the radial forearm free flap was intact. The internal jugular vein was temporarily clamped, repaired with sutures, and the PICC was removed intraoperatively. Despite the lacerations being caudal to the anastomosis, the free flap was preserved, and the patient was discharged without further complications. An increase in thoracic pressure, such as that resulting from a forceful cough or vomiting, can lead to the displacement of PICC lines. In patients who have undergone neck dissection, episodes of vomiting or severe coughing should be carefully monitored for the risk of PICC tip migration. This migration could cause simultaneous laceration of the vessel wall, leading to potentially life-threatening hematomas. Monitoring the tip position of PICCs in this type of patient could be performed at the bedside at least weekly during scheduled dressing changes and/or sutureless system changes. In this way, secondary malpositions of the tip could be identified early and potentially life-threatening complications such as those in this report could be avoided.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298261443389"},"PeriodicalIF":1.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823737","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":"A GAVeCeLT-IVAS bundle for safe insertion of short peripheral catheters: The SISPeC protocol.","authors":"Fulvio Pinelli, Renata Bastos, Gloria Ortiz Miluy, Giancarlo Scoppettuolo, Vincenzo Faraone, Maria Giuseppina Annetta, Fabrizio Brescia, Davide Giustivi, Stefano Elli, Antonio Gidaro, Adam Fabiani, Timothy R Spencer, Mauro Pittiruti","doi":"10.1177/11297298261442098","DOIUrl":"https://doi.org/10.1177/11297298261442098","url":null,"abstract":"<p><p>Short peripheral catheters (SPC) are the most widely used peripheral venous access devices in clinical practice. Despite being a relatively simple procedure, their placement is associated with a high rate of complications, including multiple venipunctures, phlebitis, dislodgement, occlusion, and, even if to a lesser extent, local and bloodstream infections. Recent studies suggest several strategies and techniques that, if adopted systematically, may reduce the incidence of both early and late catheter-related complications. This paper describes a structured, sequential insertion bundle - developed by the Italian Group of Long-Term Venous Access Devices (GAVeCeLT) and by the Italian Vascular Access Society (IVAS)-designated SISPeC (Safe Insertion of Short Peripheral Catheters), which consists of six evidence-based steps aiming to minimize complications related to SPC insertion in adults and children: (1) pre-procedural examination of both arms with and without tourniquet; (2) choice of the most appropriate site of venipuncture, preferably avoiding area of flexion (wrist, antecubital fossa) and choosing-when feasible-veins at the forearm or the cephalic vein at the upper arm; (3) appropriate hand hygiene and skin antisepsis; (4) puncture and cannulation of the vein by the cannula-over-needle technique, preferably using a tourniquet; (5) connection to the administration set; (6) appropriate securement of the device and protection of the exit site.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298261442098"},"PeriodicalIF":1.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823779","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":"Two-week postoperative duplex ultrasound as a clinical workflow tool for risk stratification of radiocephalic arteriovenous fistulas.","authors":"Claude Jeffrey Renaud, Allen Yan Lun Liu, Clarice Chua Kah Hwei, Tan Khin Swee Elisabeth, Abdul Haque Bin Abdul Jabbar, Lee Wei Han, Chuo Ren Leong","doi":"10.1177/11297298261443162","DOIUrl":"https://doi.org/10.1177/11297298261443162","url":null,"abstract":"<p><strong>Background: </strong>Radiocephalic arteriovenous fistulas (RCAVFs) are the preferred initial haemodialysis access but are limited by high non-maturation rates, particularly in populations with smaller vessels and high diabetic burden. Preoperative duplex ultrasound (DUS) guides vessel selection but inconsistently predicts postoperative haemodynamic adaptation. We evaluated whether a standardised 2-week postoperative DUS checkpoint could function as a clinical workflow tool for early risk stratification and long-term patency prediction.</p><p><strong>Methods: </strong>In this prospective single-centre study, 57 patients undergoing primary RCAVF creation were followed for up to 10 years. Two-week postoperative DUS assessed vein diameter (VD), brachial artery flow (BAF) and resistive index (RI). Receiver operating characteristic analysis identified thresholds predicting 6-week Kidney-Disease-Outcomes-Quality-Initiative-defined maturation. Kaplan-Meier and Cox regression analyses evaluated long-term primary (PP) and secondary patency (SP).</p><p><strong>Results: </strong>Six-week maturation occurred in 56%, and functional maturation in 61% of patients initiated on dialysis. Two-week VD demonstrated the strongest discrimination for maturation (AUC 0.81, 95% CI 0.50-0.84, <i>p</i> = 0.01), followed by BAF (AUC 0.72, 95% CI 0.65-0.90, <i>p</i> = 0.02). RI showed weaker performance (AUC 0.67, 95% CI 0.50-0.83, <i>p</i> = 0.05). A VD <5 mm independently predicted long-term PP loss up to 10 years (HR 2.43, 95% CI 1.21-4.86, <i>p</i> = 0.01). BAF predicted early maturation but not long-term PP and SP. Early vein and flow expansion kinetics were not independently associated with long-term outcomes.</p><p><strong>Conclusions: </strong>A 2-week postoperative DUS checkpoint provides actionable early structural risk stratification after RCAVF creation. Early structural calibre reflects adaptive remodelling and independently predicts long-term PP, supporting integration of this checkpoint into routine practice.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298261443162"},"PeriodicalIF":1.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments regarding the Japanese \"real world\" study of a covered stent in arteriovenous access.","authors":"Bart Dolmatch, Ziv Haskal","doi":"10.1177/11297298261432157","DOIUrl":"https://doi.org/10.1177/11297298261432157","url":null,"abstract":"","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298261432157"},"PeriodicalIF":1.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823716","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}