Annali italiani di chirurgia最新文献

{"title":"Small Bowel Volvulus Caused by Meckel's Diverticulum.","authors":"Roberto Cammarata, Vincenzo La Vaccara, Silvia Angeletti, Lucrezia Bani, Roberto Coppola, Damiano Caputo","doi":"10.62713/aic.3883","DOIUrl":"10.62713/aic.3883","url":null,"abstract":"<p><p>No abstract present.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 3","pages":"282-285"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639417","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":"Complex Post-Traumatic Reconstruction of the Lower Limb: A Case Report on Managing Soft Tissue Defects and Deltoid Ligament Damage Using an ALT Flap With Fascia Lata Extension and Fascia Lata Graft.","authors":"Federico Ziani, Corrado Rubino, Anna Manconi, Giovanni Arrica, Claudia Trignano, Ilaria Ginatempo, Matilde Tettamanzi, Emilio Trignano","doi":"10.62713/aic.3691","DOIUrl":"https://doi.org/10.62713/aic.3691","url":null,"abstract":"<p><strong>Aim: </strong>High-energy ankle traumas often lead to extensive soft tissue loss and ligament damage, making reconstruction both challenging and crucial for restoring stability and function. This study evaluated the effectiveness of using a free anterolateral thigh (ALT) flap with a fascia lata extension for addressing complex soft tissue defects and repairing the deltoid ligament in complex post-traumatic ankle injuries.</p><p><strong>Case presentation: </strong>A 38-year-old man was examined at the Plastic Surgery Unit three months after a motorcycle crash for reconstruction of a soft tissue defect and deltoid ligament repair. Clinical examination revealed a 3 × 5 cm soft tissue defect with bone exposure and ankle instability. Reconstruction was planned and performed using a free ALT flap with an extension of the fascia lata and a fascia lata graft for deltoid ligament repair. No complications of the flap and no clinical signs of local infection were observed. During the follow-up period of 12 months, the ankle stability and the gait were improved with a reduction in pain.</p><p><strong>Results: </strong>No complications related to the flap or clinical signs of infection were observed postoperatively. During the 12-month follow-up period, the patient exhibited improved ankle stability, reduced pain, and enhanced gait. At the one-year follow-up, the patient achieved a satisfactory functional outcome with an American Orthopedic Foot and Ankle Society (AOFAS) score of 79 points. The reconstructed tissue demonstrated adequate coverage, and the deltoid ligament repair provided joint stability. While flap bulkiness necessitated minor debulking surgery, the aesthetic and functional outcomes were satisfactory, with the patient expressing high satisfaction at 15 months post-surgery.</p><p><strong>Conclusions: </strong>The ALT flap combined with fascia lata graft is a viable option for soft tissue loss and deltoid ligament injury in clinical cases. While the ALT flap offers numerous advantages, including ease of harvest, pedicle length, and versatility, its bulkiness may necessitate revision surgery. However, despite this drawback, the combination of ALT flap and fascia lata demonstrated positive outcomes in our patient, highlighting its effectiveness in providing adequate tissue coverage and repairing the deltoid ligament.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 5","pages":"579-588"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075351","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":"Predictive Value of Bedside Ultrasound Evaluation of Venous Excess Ultrasound Grading System for Acute Kidney Injury in Children Undergoing Cardiac Surgery.","authors":"Weite Cao, Ruqian Wang, Ling Wang, Hong Luo","doi":"10.62713/aic.3966","DOIUrl":"https://doi.org/10.62713/aic.3966","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to investigate the predictive value of bedside ultrasound evaluation of venous excess ultrasound grading system (VExUS) for acute kidney injury (AKI) in children after cardiac surgery.</p><p><strong>Methods: </strong>This retrospective study included 122 pediatric patients who underwent cardiac surgery at the West China Second University Hospital of Sichuan University between January 2024 and November 2024. Based on the occurrence of AKI, patients were divided into the AKI (n = 42) and non-AKI (n = 80) groups. Univariate and binary logistics regression analyses were performed to identify factors influencing AKI. The predictive value of the VExUS grading system for AKI in children after pediatric cardiac surgery was evaluated using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>There were no statistically significant differences (p > 0.05) between the two groups regarding age, gender, Body Mass Index (BMI), length of hospital stay, intraoperative blood loss, postoperative hypotension, 24-hour postoperative urine output, aortic cross-clamp time, preoperative left ventricular ejection fraction, postoperative inadequate circulating blood volume, and preoperative use of positive inotropic drugs, operation time, plasma input, congenital heart disease, radical operation, and emergency surgery. However, statistically significant differences were found in postoperative blood glucose levels, VExUS scores, cardiopulmonary bypass duration, and cyanosis (p < 0.05). Binary logistics regression analysis revealed that blood glucose levels, VExUS, and cyanosis were significant factors influencing AKI after pediatric cardiac surgery (p < 0.05). ROC analysis showed that the area under the curve (AUC) of 0.803 for VExUS, with a standard error of 0.043 (95% confidence interval (CI): 0.719-0.887), a Youden index of 0.48, sensitivity of 76.25%, and specificity of 71.43%.</p><p><strong>Conclusions: </strong>The VExUS grading system demonstrates significant clinical utility in predicting AKI in children undergoing cardiac surgery.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 5","pages":"673-680"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075580","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":"Indwelling Pleural Catheter for Recurrent Pleural Effusion in a Centenarian: A Case Report.","authors":"Paolo Scanagatta, Sara Cagnetti, Eugenio Ravalli, Francesco Inzirillo, Gianluca Ancona, Giuseppe Naldi, Casimiro Eugenio Giorgetta","doi":"10.62713/aic.3866","DOIUrl":"https://doi.org/10.62713/aic.3866","url":null,"abstract":"<p><strong>Aim: </strong>Recurrent pleural effusion represents a clinical challenge, particularly in elderly and frail patients. While talc pleurodesis is traditionally considered the treatment of choice, the use of tunneled indwelling pleural catheters (IPCs) offers a less invasive alternative with fewer associated risks. This case report describes the management of recurrent malignant pleural effusion in a centenarian using a tunneled indwelling catheter.</p><p><strong>Case presentation: </strong>A 100-year-old woman, not eligible for invasive treatments due to her advanced age and frailty, was initially managed with talc pleurodesis using the \"slurry\" technique. The treatment was unsuccessful, with recurrence of the effusion observed after 20 days. The patient was subsequently treated with the placement of a 15F tunneled catheter (UNICO™ In-Vita CH 15, REDAX, Poggio Rusco, Italy) under local anesthesia for long-term effusion control. Caregivers managed the catheter at home, supported by periodic outpatient follow-ups.</p><p><strong>Results: </strong>Despite the advanced age and complexity of the clinical case, the catheter effectively controlled symptoms without complications such as infections or dislocations. The patient reported significant improvement in dyspnea and quality of life, with a favorable course until her death, which occurred 60 days after catheter placement. The mild inflammation induced by the catheter, as reflected by a 15 mg/L increase in C-reactive protein, likely contributed to progressive pleurodesis, gradually reducing pleural fluid production. This case underscores the role of IPCs as a safe and effective option for managing recurrent pleural effusions in elderly patients, providing symptom relief and improved quality of life with minimal complications.</p><p><strong>Conclusions: </strong>Tunneled IPCs represent a valuable therapeutic option for elderly patients who are not candidates for more invasive procedures. Adequate caregiver education and regular follow-up are essential to optimizing outcomes and minimizing complications. Further prospective studies are needed to validate these findings and refine treatment strategies for this vulnerable patient population.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 6","pages":"718-724"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301088","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":"Risk Stratification for Postoperative Infection Following Laparoscopic-to-Open Cholecystectomy Conversion: Construction and Evaluation of a Clinical Prediction Model.","authors":"Jianwei Zhang, Riyuan Zhang, Weiling Chen, Qun Yang, Suhua Zheng, Chong Chen","doi":"10.62713/aic.4073","DOIUrl":"https://doi.org/10.62713/aic.4073","url":null,"abstract":"<p><strong>Aim: </strong>This study focused on identifying independent risk factors for surgical site infection (SSI) following conversion from laparoscopic to open cholecystectomy and on developing a predictive model for preoperative risk stratification.</p><p><strong>Methods: </strong>A total of 214 patients who underwent conversion from laparoscopic cholecystectomy to open cholecystectomy at the People's Hospital of Pingyang between January 2021 and June 2024 were included in this study. The patients were divided into two groups based on the occurrence of SSI within 30 days after surgery: the SSI group and the non-SSI group. Clinical data, including demographic information, laboratory test results, and medical history, were collected for both groups. Patients were randomly assigned to a training set (n = 151) and a validation set (n = 63) in a 7:3 ratio. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for SSI. A nomogram model was constructed based on these variables. Receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used to evaluate the model's performance and predictive value.</p><p><strong>Results: </strong>Multivariate logistic regression analysis identified C-reactive protein (CRP), gallbladder wall thickness, preoperative endoscopic retrograde cholangio-pancreatography (p-ERCP), and preoperative percutaneous transhepatic biliary drainage (p-PTBD) as independent risk factors for SSI, while albumin was identified as an independent protective factor. The nomogram showed satisfactory predictive performance, with an area under the curve (AUC) of 0.78 (95% CI: 0.691-0.869) in the training set and 0.831 (95% CI: 0.702-0.959) in the validation set. Calibration curves demonstrated good agreement between predicted and observed probabilities, with Hosmer-Lemeshow test p-values of 0.693 and 0.585 for the training and validation sets, respectively. DCA revealed a net clinical benefit when the threshold probability was below 80%.</p><p><strong>Conclusions: </strong>This predictive model, incorporating routinely available clinical variables, exhibited robust discrimination and calibration in identifying SSI risk following conversion to open cholecystectomy. External validation and prospective studies are warranted to further assess its clinical applicability and utility in surgical decision-making.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 6","pages":"742-749"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301094","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":"Spontaneous Complete Regression of Breast Cancer: Two Case Report.","authors":"Orhan Yılmaz, Ugur Kesici, Mehmet Guray Duman, Ozgur Yuzer, Asli Erturk, Pinar Ozay Nayir","doi":"10.62713/aic.3461","DOIUrl":"10.62713/aic.3461","url":null,"abstract":"<p><p>Spontaneous regression (SR) is a tumor's partial or complete disappearance without any treatment. In the literature, it has been documented that SR is uncommon in breast cancer (BC) and other types of cancer. Multiple mechanisms are believed to contribute to the development of SR. However, its mechanism still needs to be clearly demonstrated. Although two SR patients were presented in our study, the evidence needed to be more sufficient to determine the mechanism. However, due to Programmed Death-Ligand 1 (PD-L1) negativity in both patients, the hypothesis in the literature that PD-L1 has strong antitumoral activity was not supported. In addition, it was determined that the patient in case 2 was the first Cerb B2 positive case reported in the literature and had the earliest SR period. Due to this, it has been disclosed that the SR mechanism of BC will be concluded within 21 days at the earliest. This situation suggests that breast surgeons, in particular, should conduct a thorough physical examination and, if necessary, re-radiological examination before surgery on patients for whom surgery is decided after diagnosis. Being careful in this regard may increase the number of SR in BC cases and allow molecular investigations on living tissue samples to reveal the underlying mechanism.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 5","pages":"767-771"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520758","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":"Strategies for Perioperative Anticoagulant Reversal in Orthopedic Surgery: A Review.","authors":"Yuanyuan Fang, Min He, Xiaoying Zhang","doi":"10.62713/aic.3625","DOIUrl":"https://doi.org/10.62713/aic.3625","url":null,"abstract":"<p><strong>Aim: </strong>The administration of anticoagulation therapy during major orthopedic surgeries is a clinical challenge due to the risk of thrombotic events and bleeding complications. This review aims to evaluate the current strategies and emerging developments in perioperative anticoagulation reversal.</p><p><strong>Methods: </strong>We conducted a literature review on the management of perioperative anticoagulant therapy, which included the current status of anticoagulant reversal agents, as well as personalized medicine, pharmacogenomics, artificial intelligence (AI), and novel drug delivery systems.</p><p><strong>Results: </strong>The review indicates that reversal agents such as idarucizumab and andexanet alfa are crucial in managing bleeding associated with direct oral anticoagulants (DOACs). Personalized medicine, guided by pharmacogenomics, allows for tailored anticoagulation regimens. AI and machine learning (ML) algorithms can enhance the predictive capabilities for bleeding and thrombotic risks. Additionally, nanotechnology and biomarkers offer innovative approaches to drug delivery and personalized treatment.</p><p><strong>Conclusions: </strong>Integrating evidence-based guidelines with innovative reversal agents, personalized medicine, AI and nanotechnology opens a new era in perioperative anticoagulation management. These advancements can ensure patient safety, minimize bleeding risks, and improve surgical outcomes. Future research should focus on the clinical validation of these strategies to ensure their effectiveness across diverse patient populations.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 5","pages":"788-800"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520759","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":"Application of Cefaclor in Orthodontics through Micro-Implant Anchorage in Patients with Periodontitis.","authors":"Fengxing Xu","doi":"10.62713/aic.3281","DOIUrl":"https://doi.org/10.62713/aic.3281","url":null,"abstract":"<p><strong>Aim: </strong>Chronic periodontitis leads to gingival swelling, hyperplasia, and tooth mobility, which affects orthodontic treatment. The aim of this study was to investigate the application of cefaclor in orthodontics through micro-implant anchorage in patients with periodontitis.</p><p><strong>Methods: </strong>A retrospective study was conducted on patients with periodontitis who received micro-implant anchorage treatment in the department of orthodontics at the First People's Hospital of Yongkang City from July 2019 to January 2022. According to different treatment regimens, these patients were divided into the test group (patients receiving cefaclor and micro-implant anchorage treatment) and the control group (patients receiving micro-implant anchorage treatment only). The plaque index (PLI), gingival index (GI), sulcus bleeding index (SBI), and serum inflammatory factor levels were compared between the two groups after treatment.</p><p><strong>Results: </strong>One hundred and five patients were included in the study, (44 males and 61 females, median age 21 [15-25] years), 51 in the cefaclor group and 54 in the no cefaclor group. After treatment, the PLI, GI, and SBI scores in the two groups were higher than those before treatment, and the levels of serum inflammatory markers significantly increased (p < 0.05). After treatment, the PLI, GI, and SBI scores in the test group were significantly lower than those in the control group (p < 0.001). The levels of serum interleukin-1β, interleukin-6, interleukin-8, and tumor necrosis factor-α were significantly lower in the test group, and the interleukin-2 level was higher in the test group (p < 0.001). There was no significant difference in the incidence of complications between the two groups (p > 0.05).</p><p><strong>Conclusions: </strong>Cefaclor and micro-implant anchorage have a good clinical effect on orthodontics in patients with periodontitis, improving periodontal health and reducing inflammatory response.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 3","pages":"374-381"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141449468","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":"Omental Flap Technique in Pancreaticojejunostomy: Does it Prevent Pancreatic Fistula Development after Pancreaticoduodenectomy?","authors":"Doğan Erdoğan, Mehmet Ali Uzun","doi":"10.62713/aic.3512","DOIUrl":"https://doi.org/10.62713/aic.3512","url":null,"abstract":"<p><strong>Aim: </strong>The aim of our study was to investigate the clinical results of omental flap application during pancreaticojejunostomy (PJ) anastomosis in pancreatoduodenectomy (PD) surgeries.</p><p><strong>Methods: </strong>The data of patients who underwent pancreaticoduodenectomy in our hospital were evaluated retrospectively. The patients were divided into two groups; patients with an omental flap (Group 1) and those without an omental flap (Group 2). The demographic and other characteristics of the groups and the incidence of postoperative pancreatic fistula (POPF) development were compared.</p><p><strong>Results: </strong>One hundred patients were included (39 females, 61 males) Group 1 consisted of 20 patients with omental flaps and Group 2 consisted of 80 patients without omental flaps. While no clinically significant (Grade B and C) leaks were observed in Group 1, both biochemical and clinically significant leak rates were lower in Group 1 compared to 4 patients (5%) in Group 2. There was no statistically significant difference compared with Group 2 (p > 0.05).</p><p><strong>Conclusions: </strong>Although not statistically significant in this study, postoperative complication rates and the incidence of POPF tended to decrease in patients who underwent omental flaps.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 3","pages":"411-415"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141449489","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":"Low Radiation Doses in Oncocytic Lesions of the Parotid Gland: A Double-edged Sword. A Comprehensive Review.","authors":"Antonio Pontoriero, Paola Critelli, Marco Zeppieri, Anna Brogna, Filippo Flavio Angileri, Antonino Bottari, Alberto Stagno, Silvana Parisi, Stefano Pergolizzi","doi":"10.62713/aic.3360","DOIUrl":"10.62713/aic.3360","url":null,"abstract":"<p><p>Oncocytic lesions represent a group of benign and potentially precancerous tumors characterized by the accumulation of oncocytes, which are large, granular, and eosinophilic cells. Diagnosing oncocytic lesions in the parotid gland typically involves a combination of imaging techniques, such as ultrasound, Computed Tomography (CT) scans, and Magnetic Resonance Imaging (MRI). Fine-needle aspiration (FNA) biopsy with histopathological examination remains the primary diagnostic tool for these lesions. Accurate diagnosis is crucial for appropriate management decisions. Treatment options for oncocytic lesions in the parotid gland include surgery, conservative management, and radiation therapy (RT). However, in the head and neck region, radiation doses can be a double-edged sword. While RT is a treatment modality, low radiation doses can promote the development of oncocytic lesions in the parotid gland. The prognosis for patients with oncocytic lesions is generally favorable, especially when the lesions are benign and appropriately managed. Current research focuses on the molecular mechanisms underlying oncocytic lesions in response to low-dose radiation exposure. The development of these lesions following low radiation doses represents a significant clinical concern. This manuscript provides a comprehensive overview of the current knowledge regarding oncocytic lesions in the parotid gland, including risk factors, diagnosis, treatment options, and ongoing research, offering valuable insights for clinicians and researchers.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"95 4","pages":"510-521"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054722","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}