Anaesthesia最新文献

{"title":"Excluding oesophageal intubation: time to adopt ‘sustained exhaled carbon dioxide’ and retire ‘no trace = wrong place’","authors":"Tim M. Cook, Sandeep Sudan","doi":"10.1111/anae.70098","DOIUrl":"10.1111/anae.70098","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"81 5","pages":"607-611"},"PeriodicalIF":6.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145658213","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":"Keeping our nerve: what large datasets can (and might) reveal about peri-operative nerve injury","authors":"Yin Y. Lim, Edward R. Mariano, Kelly E. Foster, Alan J. R. Macfarlane","doi":"10.1111/anae.70159","DOIUrl":"10.1111/anae.70159","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"81 5","pages":"622-626"},"PeriodicalIF":6.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146153624","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":"Pre-oxygenation in patients living with obesity","authors":"Etienne Couture,&nbsp;Jean Bussières","doi":"10.1111/anae.70043","DOIUrl":"10.1111/anae.70043","url":null,"abstract":"<p>We read with interest the recent best practice recommendations on airway management in patients living with obesity [<span>1</span>]. We are concerned about the recommendation that patients should be pre-oxygenated in a ramped, head-up position with a high inspiratory fraction of oxygen. There was no mention of the use of spontaneous facemask positive pressure ventilation during the pre-oxygenation period. There was also no mention of the reverse Trendelenburg position as an alternative to the 30° head-up ramped position during pre-oxygenation. In our recent randomised controlled trial [<span>2</span>], we compared the effect of two techniques on the duration of the safe apnoea period after pre-oxygenation in patients living with obesity. The comparison was made between a ramped position combined with spontaneous facemask breathing without positive pressure, and pre-oxygenation in a reverse Trendelenburg position with inspiratory pressure support of 8 cmH₂O and a peak end-expiratory pressure of 10 cmH₂O. We found a longer safe apnoea period in the reverse Trendelenburg group (258 (55.1) vs. 217 (42.3) s; p = 0.005). Other benefits associated with this technique were also reported [<span>2</span>].</p><p>We based our reverse Trendelenburg positive pressure technique on a physiological assessment of the functional residual capacity using different combinations of body position and ventilation strategies in awake patients before bariatric surgery [<span>3</span>]. An increase in functional residual capacity was observed when spontaneous ventilation without positive pressure was converted to positive pressure ventilation. Moreover, compared with supine positioning, the ramped position had no measurable impact on the functional residual capacity. The reverse Trendelenburg position was the only position that resulted in an improved functional residual capacity regardless of the ventilation strategy used [<span>3</span>]. We believe that reverse Trendelenburg positioning with the use of positive pressure ventilation in spontaneously breathing patients living with obesity should be recommended for safer pre-oxygenation in this highly vulnerable population.</p>","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"81 5","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145295449","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":"Acute kidney injury after propofol or sevoflurane anaesthesia for colorectal cancer surgery: a secondary analysis","authors":"Micael Taavo,&nbsp;Robert Frithiof,&nbsp;Mats Enlund,&nbsp;Stephanie Franzén","doi":"10.1111/anae.70198","DOIUrl":"10.1111/anae.70198","url":null,"abstract":"&lt;p&gt;Acute kidney injury is a frequent postoperative complication associated with substantial morbidity and mortality [&lt;span&gt;1&lt;/span&gt;]. Although haemodynamic instability and surgical complexity are well-established risk factors, the influence of anaesthetic maintenance technique on acute kidney injury incidence and severity remains poorly understood [&lt;span&gt;1-3&lt;/span&gt;]. Experimental and clinical data suggest a plausible biological rationale for differential renal effects between drugs, including altered renal perfusion and sympathetic activation associated with volatile inhalational anaesthesia [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;To evaluate whether the choice of anaesthetic drug influences postoperative acute kidney injury, we performed a secondary analysis of a multicentre randomised controlled trial [&lt;span&gt;5&lt;/span&gt;]. Patients undergoing colorectal cancer surgery with available peri-operative creatinine measurements were included. The primary outcome was postoperative acute kidney injury within 7 days, as defined by KDIGO creatinine criteria [&lt;span&gt;6&lt;/span&gt;]. Logistic regression was used to assess the association between anaesthetic technique and acute kidney injury, adjusting for predefined intra-operative variables reflecting haemodynamic and procedural stress (hypotension, blood loss, fluid balance and duration of anaesthesia). Sensitivity analyses using penalised regression models (ridge, lasso and elastic net) yielded consistent results.&lt;/p&gt;&lt;p&gt;Of 3256 patients assessed in the parent trial, 3229 had available peri-operative creatinine measurements and were included in the acute kidney injury incidence analysis. There were then 3213 patients with complete data for all prespecified covariates included in the adjusted analyses (Table 1). There were 2769 (86%) patients classified as ASA physical status 1–2 and 249 (8%) of the overall cohort developed postoperative acute kidney injury. There was no significant difference in acute kidney injury incidence between patients receiving propofol- and sevoflurane-based anaesthesia (121, 8% vs. 128, 8%, p = 0.700). The timing of acute kidney injury diagnosis within 7 postoperative days as assessed using Kaplan–Meier methods did not differ between groups.&lt;/p&gt;&lt;p&gt;Adjusted analyses showed no association between anaesthetic drug and acute kidney injury for any KDIGO stage (Fig. 1). For acute kidney injury stages 2 and 3, event numbers were low, resulting in wide confidence intervals compatible with both increased and decreased risk. In this cohort, the precision of the estimates allows exclusion of absolute between-group differences in postoperative acute kidney injury of ≥ 2.8 percentage points in absolute risk, although smaller differences cannot be ruled out.&lt;/p&gt;&lt;p&gt;This secondary analysis of a large, international randomised trial of anaesthetic drugs found no evidence of a clinically meaningful difference in postoperative acute kidney injury between propofol- and sevoflurane-based anaesthesia in patients undergoing lapa","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"81 5","pages":"741-743"},"PeriodicalIF":6.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.70198","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147381311","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":"Validation and diagnostic performance of the novel B-APNEIC score for predicting severe obstructive sleep apnoea: a cross-sectional study in an Australian population","authors":"Venkatesan Thiruvenkatarajan,&nbsp;Benjamin Teng Jen Khoo,&nbsp;Anil Roy,&nbsp;Wai-Man Liu,&nbsp;Tharun Kathiravan,&nbsp;Roelof Van Wijk","doi":"10.1111/anae.70102","DOIUrl":"10.1111/anae.70102","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The STOP-BANG questionnaire assesses the peri-operative risk of obstructive sleep apnoea and relies on subjective components, which limit its reliability. The B-APNEIC score was proposed as a more objective alternative, incorporating just four STOP-BANG variables: BMI &gt; 35 kg.m^-2; arterial blood pressure; neck circumference &gt; 40 cm; and witnessed breathing interruptions. This study aimed to evaluate the predictive performance of the B-APNEIC score in an Australian sleep clinic population. These findings would have important implications for use in the pre-operative screening of obstructive sleep apnoea.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled participants referred for overnight diagnostic polysomnography. The STOP-BANG questionnaire was administered and the B-APNEIC score was extracted. The primary outcome was the predictive ability of a B-APNEIC score ≥ 3 to detect severe obstructive sleep apnoea. Performance metrics were compared with a STOP-BANG score ≥ 5.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 274 patients, the B-APNEIC score showed a sensitivity of 84% (95%CI 75–90%), specificity of 60% (95%CI 52–67%), positive predictive value of 56% (95%CI 48–64%) and negative predictive value of 86% (95%CI 78–91%) for predicting severe obstructive sleep apnoea. Compared with the STOP-BANG score, the B-APNEIC score showed superior sensitivity (84% vs. 73%); positive predictive value (56% vs. 52%); negative predictive value (86% vs. 78%); Youden Index (0.43 vs. 0.32); and area under the receiver operating characteristic curve (0.72 (95%CI 0.66–0.77) vs. 0.66 (95%CI 0.60–0.72); p = 0.02). Both scores had similar specificity (59%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The B-APNEIC score showed strong predictive accuracy for severe obstructive sleep apnoea and could serve as a simple, objective alternative to STOP-BANG. While further validation in surgical populations is warranted, these findings support its use in pre-operative screening for obstructive sleep apnoea.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"81 5","pages":"655-663"},"PeriodicalIF":6.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145731075","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":"Strategies to advance gender equity in anaesthesia leadership: a state-of-the-art review*","authors":"Kara J. Allen,&nbsp;Anjalee Brahmbhatt,&nbsp;Kathryn Rough,&nbsp;Juliana Caicedo Salazar,&nbsp;Phyllis Phukubye-Johnson,&nbsp;Fiona Desmond","doi":"10.1111/anae.70120","DOIUrl":"10.1111/anae.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Gender equity for anaesthetists remains elusive, despite patient and clinician benefits. Many strategies have been proposed to promote gender equity, yet women remain under-represented in anaesthesia leadership compared with men. This review identifies contemporary implemented strategies to improve gender equity in anaesthesia leadership.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched databases for studies published from January 2019 to March 2024, including reports of implementation. We employed state-of-the-art review methodology to provide a current understanding of this complex sociocultural problem, using Cook's and Stufflebeam frameworks for categorisation and deductive data extraction and analysis based on context, inputs, processes and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We screened 257 abstracts and identified 18 studies for analysis; 14 were conducted in the USA. The most prominent individual interventions were mentorship and sponsorship. These were supported by organisational interventions including professional development curricula; policies; and leadership roles supporting diversity. Two studies reported how programmes were iteratively developed. Reported success metrics included quantitative (increased diversity in leadership, achieving promotion) and qualitative outcomes (networks and wellbeing).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Evidence for best practices to address gender equity in anaesthesia leadership is emerging. Prospective determination of key outcomes enables monitoring of success, including representation and wellbeing. Organisational support, in the form of policies and leadership roles linked to diversity outcomes, amplifies the benefits of mentorship and sponsorship. Future interventions should report the context in which the interventions were mobilised, associated costs and details of the iterative programme delivery and development process.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"81 5","pages":"713-725"},"PeriodicalIF":6.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877361","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":"Peri-operative pain management in major lower extremity amputation in vascular Surgery: a UK anaesthetic and vascular surgery Delphi consensus study*","authors":"Thanapon Ekkunagul,&nbsp;Caitlin Sara MacLeod,&nbsp;Anna Celnik,&nbsp;John Chalmers,&nbsp;Ross Thomson,&nbsp;Alan J. R. Macfarlane,&nbsp;David Bosanquet,&nbsp;John Nagy,&nbsp;Patrice Forget,&nbsp;the Delphi expert panel","doi":"10.1111/anae.70107","DOIUrl":"10.1111/anae.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Major lower extremity amputations occurring secondary to vascular disease remain prevalent worldwide. Pain surrounding these procedures is complex, multifactorial and associated with poor functional and psychosocial outcomes. The evidence base informing pain management approaches in major lower extremity amputations remain largely heterogeneous and limited. This study aimed to establish procedure-specific, multispeciality consensus on the ideal principles and practices required to optimise pain management for vascular surgical patients undergoing major lower extremity amputations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A three-round online modified Delphi consensus process was undertaken, with consultant anaesthetists and consultant vascular surgeons across the UK forming the expert panel. Structured statements were assessed on a 5-point Likert scale against a strong consensus threshold of ≥ 75% ratings in agreement or disagreement, and a rating stability criterion of &lt; 10% change between rounds. Free-text responses were thematically analysed at each round to iteratively modify or generate new statements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-two panellists participated in the study. Of the 44 consensus statements assessed, 32 reached strong consensus agreement. These included: shared cross-speciality responsibility for pain management; the mainstay role of locoregional analgesia; use of perineural catheters; opioid-sparing approaches; and protocolised decision aids with individualisation of analgesia. Barriers to practices identified included resource constraints and the paucity of direct evidence. There was non-consensus in 12 statements, notably on pre-amputation initiation of locoregional analgesia; ultrasound-guided nerve catheter placement; and surgeon-delivered regional analgesia. No statement reached strong consensus disagreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study provides the first procedure-specific consensus, delineating agreed principles and preferred pharmacological and locoregional analgesic approaches to peri-operative pain management in patients undergoing major lower extremity amputations. The areas of non-consensus expose key uncertainties that may inform future research, service organisation and guideline development agendas.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"81 5","pages":"664-674"},"PeriodicalIF":6.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.70107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145771562","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":"Opioid-free vs. opioid-inclusive anaesthesia with or without regional anaesthesia for postoperative pain: a systematic review with network meta-analysis of randomised controlled trials","authors":"Clístenes C. de Carvalho,&nbsp;Kariem El-Boghdadly,&nbsp;Idrys H. L. Guedes,&nbsp;Maria Vitória M. Dantas,&nbsp;Danusa P. B. Tomé,&nbsp;Isabella B. Ramos,&nbsp;Clarissa S. H. Gomes,&nbsp;Guilherme K. P. A. Alves,&nbsp;Arthur P. Bezerra,&nbsp;Jayme M. Santos Neto,&nbsp;Jaideep J. Pandit,&nbsp;Leandro G. Braz","doi":"10.1111/anae.70121","DOIUrl":"10.1111/anae.70121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Concerns about opioid-related adverse effects have increased interest in opioid-free anaesthesia, but the benefits compared with opioid-inclusive techniques, especially in the presence of regional anaesthesia, remain uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We undertook a systematic review with a network meta-analysis of randomised controlled trials comparing six strategies in adults: opioid-free anaesthesia and opioid-inclusive anaesthesia using remifentanil alone or other opioids, each with or without regional anaesthesia. Primary outcome was postoperative pain. Secondary outcomes were: postoperative opioid use; post-anaesthesia care unit discharge time; hospital duration of stay; and incidence of complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 885 trials from 59 countries. Techniques incorporating regional anaesthesia consistently ranked highest for postoperative pain. Regional anaesthesia combined with an opioid-free intra-operative strategy achieved some of the highest surface under the cumulative ranking curve values for pain at 2 h, 12 h and 48 h (93%, 85% and 75%, all low certainty). When regional anaesthesia was used, differences between opioid-free and opioid-inclusive techniques were minimal (moderate certainty). For opioid consumption, regional anaesthesia with an opioid-free strategy ranked best at 2 h (moderate certainty), 12 h (low certainty) and 48 h (low certainty), with surface under the cumulative ranking curve values &gt; 98%. Techniques without regional anaesthesia were associated with higher pain scores and greater opioid requirements. Opioid-free approaches, especially when combined with regional techniques, were associated with lower rates of postoperative nausea and vomiting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Regional anaesthesia was the key determinant of improved postoperative pain control, and intra-operative opioids added little additional benefit when regional techniques provided adequate coverage. Without regional anaesthesia, neither opioid-free nor opioid-inclusive strategies showed consistent analgesic superiority. However, opioid-free techniques reduced postoperative nausea and vomiting. These findings support preferential use of regional anaesthesia where feasible and suggest that avoiding intra-operative opioids may facilitate recovery, particularly when regional techniques are employed effectively.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"81 5","pages":"702-712"},"PeriodicalIF":6.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.70121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897417","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":"Issue Information – Editorial Board","authors":"","doi":"10.1111/anae.70134","DOIUrl":"10.1111/anae.70134","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"81 5","pages":"605-606"},"PeriodicalIF":6.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.70134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641913","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":"Confirming tracheal intubation: does a two-point check miss the point?","authors":"Craig Lyons","doi":"10.1111/anae.70189","DOIUrl":"https://doi.org/10.1111/anae.70189","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"304 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147630257","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}