Annali italiani di chirurgia最新文献

{"title":"18 Years Experience of an Italian Breast Unit Among Male Breast Cancer: A Retrospective Observational Study.","authors":"Federico Taraschi, Alessandra Cossa, Stefano Maggi, Augusto Lombardi, Ezio Maria Nicodemi","doi":"10.62713/aic.3888","DOIUrl":"10.62713/aic.3888","url":null,"abstract":"<p><strong>Aim: </strong>Male breast cancer has increased by approximately 26% over the past 25 years, there is a need to research specific treatment options. Currently, there is no established standard treatment which is therefore based on female disease. The purpose of this study is to analyze the clinical characteristics, survival outcomes, and the need for tailored treatment strategies in male breast cancer patients.</p><p><strong>Methods: </strong>This is an observational, retrospective, single-center clinical study. The research involved 21 male patients who underwent surgery for breast cancer from 2003 to 2020 in our hospital. In order to strengthen the statistical value of the results obtained, the survival curves of three selected studies in the literature were compared with that obtained in the present study.</p><p><strong>Results: </strong>All our patients underwent total mastectomy and axillary lymph node dissection. Twenty patients were diagnosed with invasive ductal carcinoma, while only one patient with invasive lobular carcinoma. The 5-year survival was 71.4% with a median survival for metastatic patients of 5.7 years. A statistically significant difference was found when comparing 5-year survival with one of the other three studies (<i>p</i> = 0.048).</p><p><strong>Conclusions: </strong>Our findings highlight the delayed clinical presentation of male breast cancer and a 5-year overall survival of 71.4%, underscoring the need for targeted screening strategies to improve early diagnosis and outcomes.The lack of knowledge of this disease at sociocultural and health level is the main reason for delay in diagnosis, a factor that strongly affects the prognosis.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 7","pages":"950-955"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641606","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":"Radiotherapy as an Adjunct to Surgery in the Management of Adult Soft Tissue Sarcomas of the Hand: The First Case Report Using Stereotactic Technology and a Brief Review of Radiation Effects.","authors":"Valentina Zagardo, Gianluca Scalia, Corrado Fichera, Davide Matera, Giuseppe Emmanuele Umana, Gianluca Ferini","doi":"10.62713/aic.3970","DOIUrl":"10.62713/aic.3970","url":null,"abstract":"<p><p>Adult soft tissue sarcomas of the hand are rare, representing approximately 2% of upper extremity tumors. Their indolent growth often leads to misdiagnosis and treatment delays. While amputation has traditionally been the standard approach, advances in limb-sparing techniques, supplemented by radiotherapy, have improved local control and functional preservation. However, radiotherapy in hand sarcomas carries significant risks, including impaired wound healing, fibrosis, stiffness, edema, fractures, and, in rare cases, necrosis and radiation-induced sarcomas. This case-based narrative review is built around an institutional case: an 81-year-old woman with recurrent leiomyosarcoma of the left hand who developed graft necrosis following radiotherapy after R2 resection. Despite initially favorable outcomes, the patient experienced severe skin graft complications, leading to functional impairment and the need for additional wound management. A comprehensive narrative literature review of hand sarcomas treated with radiotherapy highlights the challenge of balancing effective tumor control with minimizing adverse effects. While radiotherapy provides high local control rates, particularly in cases with residual disease, complications such as graft necrosis, as reported here, can significantly affect functional outcomes. The review emphasizes the importance of achieving clear surgical margins, as even modern radiotherapy techniques like volumetric modulated arc therapy (VMAT) guided by stereotactic equipment may fail to prevent complications. Long-term follow-up remains essential to detect and manage late sequelae, with the aim of restoring any compromised function. This case underscores the need for careful patient management and the difficult benefit/risk trade-off associated with radiotherapy when surgery alone is insufficient.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 7","pages":"894-904"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641568","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":"Effect of Stepped Rehabilitation Training on Hip Joint Function and Bone Metabolism Markers in Patients Undergoing Hip Arthroplasty.","authors":"Ting Zhang, Xianping Lin, Yang Zhou, Liang Lu, Chengyu Hu, Li Ji","doi":"10.62713/aic.4037","DOIUrl":"https://doi.org/10.62713/aic.4037","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study investigates the effects of stepped rehabilitation training on hip joint function and bone metabolism markers in patients undergoing hip arthroplasty (HA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective analysis included 97 patients who underwent HA in our hospital between December 2021 and December 2023. The patients were divided into a control group (52 cases) and an observation group (45 cases) based on different rehabilitation training approaches. The control group received routine nursing and rehabilitation exercises, while the observation group underwent stepped rehabilitation training in addition to the standard care. The surgery-related indicators, hip joint function, bone metabolism-related markers, and quality of life at 1, 2, and 4 weeks of training were compared between the two groups. Repeated-measures analysis of variance (ANOVA) was applied to explore the changes in hip function indexes and bone metabolism-related markers at different time points, and their interactions with the groups were examined. The association between changes in bone metabolism-related markers from baseline to week 4 and corresponding changes in Harris hip scores over the same period was assessed using locally weighted regression scatterplot smoothing (LOWESS) method.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The hip joint range of motion, hip abduction strength arm, Harris hip score, levels of serum bone alkaline phosphatase (BALP), type I collagen amino-terminal lengthening peptide (PINP) and osteocalcin, Barthel index score, and 36-Item Short Form Health Survey (SF-36) scores sequentially increased in both groups at weeks 1, 2, and 4 of the training, with the observation group exhibiting higher values than the control group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Levels of type I collagen carboxy-terminal peptide (CTX), intact parathyroid hormone (iPTH), and tartrate-resistant acid phosphatase 5b (TRACP-5b) decreased sequentially in both groups at weeks 1, 2, and 4 of the training, with the observation group demonstrating lower levels than the control group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Furthermore, significant differences were observed in the time, inter-group, and interaction effects of hip joint function and bone metabolization-related markers between the two groups during the training period (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Moreover, a nonlinear association was found between the changes in bone metabolism-related markers from baseline to week 4 and the corresponding changes in Harris hip scores over the same time points. Additionally, there was no statistically significant difference in the total postoperative complication rate between the observation group (6.67%) and the control group (15.38%) (&lt;i&gt;p&lt;/i&gt; = 0.177).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Stepped rehabilitation training can promote hip joint function recovery in patients undergoing hip arthroplasty, improve bone metabolic balance through upregulating osteogenic markers and suppressing osteoclastic activity","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 7","pages":"982-993"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641565","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":"Late Conversion of a Distally Migrated Abdominal Aortic Endograft in a Symptomatic Patient.","authors":"Raffaella Berchiolli, Vittorio Malquori, Valerio Artini, Giulia Bertagna, Daniele Adami, Nicola Troisi","doi":"10.62713/aic.3976","DOIUrl":"https://doi.org/10.62713/aic.3976","url":null,"abstract":"<p><p>Graft migration is still an issue during the follow-up of patients undergoing Endo Vascular Aneurysm Repair (EVAR) for Abdominal Aortic Aneurysm (AAA). Open surgical conversion still represents the treatment of choice in patients fit for open surgery. We herein describe the case of a 73-year-old man with abdominal pain, pararenal AAA, and complete migration of an Anaconda stent-graft previously implanted 10 years earlier. The patient was urgently treated with open surgical conversion. Postoperative course was uneventful.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 7","pages":"859-862"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641566","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":"Role of Early Enteral Nutrition on Postoperative Recovery of Older Patients Undergoing Intestinal Obstruction Surgery.","authors":"Juanjuan Ni, Juan Liu, Chao Chen","doi":"10.62713/aic.4038","DOIUrl":"https://doi.org/10.62713/aic.4038","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to explore the effect of early enteral nutrition on the postoperative recovery of elderly patients undergoing surgery for intestinal obstruction.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on medical records of elderly patients (n = 100) who underwent surgery for intestinal obstruction between January 2021 and January 2024. Based on the nutritional support, patients were categorized into the enteral nutrition group (n = 43) and the control group (n = 57). The two groups were compared in terms of baseline characteristics, pain scores, nutritional status, recovery parameters, and postoperative complications.</p><p><strong>Results: </strong>Visual analogue score (VAS) pain scores were significantly lower at all postoperative time points in the enteral nutrition group compared to the control group (<i>p</i> < 0.01). By postoperative day 8, levels of total protein, albumin, prealbumin, and transferrin had remarkably increased in both groups (<i>p</i> < 0.001), with more pronounced improvements observed in the enteral nutrition group (<i>p</i> < 0.001). The time to first flatus, time of first defecation, time of gastrointestinal function recovery and length of hospital stay were all significantly shorter in the enteral nutrition group (<i>p</i> < 0.001). No significant differences were observed in the overall incidence of postoperative complications between the two groups (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>Early enteral nutrition support is associated with enhanced postoperative nutritional status, reduced pain, and accelerated recovery in elderly patients following surgery for intestinal obstruction without increasing the risk of complications.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 7","pages":"916-923"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641611","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":"Comparison of Short-Term Radiographic Outcomes Between Femoral Varus Osteotomy and Salter Osteotomy in the Management of Legg-Calvé-Perthes Disease.","authors":"Han Yang, You Zhou, Xinhao Chen, Zidan Tang, Na Ma, Rui Xie, Yong Hang, Ran Zhang, Xiaopeng Kang","doi":"10.62713/aic.4028","DOIUrl":"https://doi.org/10.62713/aic.4028","url":null,"abstract":"<p><strong>Aim: </strong>To compare short-term radiographic outcomes of femoral varus osteotomy (FVO) and Salter innominate osteotomy (SIO) in treating Legg-Calvé-Perthes disease (LCPD) and to identify prognostic factors through multivariate analysis.</p><p><strong>Methods: </strong>This retrospective study included 33 pediatric LCPD patients (mean age: 6.80 ± 1.82 years) treated between January 2016 and January 2021, with a mean follow-up of 21.09 ± 10.63 months. Patients were categorized into FVO (n = 20) and SIO (n = 13) groups. Radiographic parameters, including center-edge angle, acetabular index (AI), acetabular head index (AHI), and Sharp angle, were evaluated preoperatively and postoperatively. Hip morphology was assessed using the modified Stulberg classification. Multivariate ordered logistic regression was used to identify predictors of radiographic outcome.</p><p><strong>Results: </strong>Postoperative AI and AHI differed significantly between the two groups (<i>p</i> < 0.001). Stulberg classification outcomes showed a higher proportion of excellent results in the SIO group (53.84%) compared to the FVO group (40.00%), although the difference was not statistically significant (<i>p</i> = 0.091). Multivariate analysis identified older age and advanced Catterall stage as independent predictors of poorer outcomes (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Both surgical approaches demonstrate clinical efficacy in the management of LCPD. However, SIO offers enhanced acetabular remodeling potential. Key prognostic factors include skeletal maturity and the degree of epiphyseal involvement (Catterall stage III/IV), suggesting that early surgical intervention may yield improved outcomes.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 7","pages":"941-949"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641564","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":"The Impact of Minimally Invasive Video-Assisted Thyroidectomy in Thyroid Cancer Patients: Retrospective Analysis of Safety Profile and Postoperative Pain.","authors":"Jun Zhao, Xinzhe Zhai, Jian Wang, Jianli Han","doi":"10.62713/aic.4074","DOIUrl":"https://doi.org/10.62713/aic.4074","url":null,"abstract":"<p><strong>Aim: </strong>This study investigates the safety profile and postoperative pain in thyroid cancer (TC) patients who underwent conventional open thyroidectomy (COT) and minimally invasive video-assisted thyroidectomy (MIVAT).</p><p><strong>Methods: </strong>This retrospective analysis included 119 TC patients treated in our hospital between December 2018 and January 2022. Of these patients, 59 cases received COT (control group) and 60 underwent MIVAT (research group). Various surgical indices (e.g., incision length, intraoperative blood loss, stitch removal time, and hospitalization time), postoperative adverse events (hypocalcemia, secondary bleeding, incision infection, and transient postoperative swallowing discomfort based on subjective complaints), postoperative pain relief time, and degree of surgical trauma were comparatively analyzed. Furthermore, preoperative mortality and morbidity risk assessment were performed using a modified Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM), while postoperative pain severity was determined using the Visual Analogue Scale (VAS).</p><p><strong>Results: </strong>The research group demonstrated significantly smaller incision length (<i>p</i> < 0.001), reduced intraoperative bleeding (<i>p</i> < 0.001), shorter stitch removal time (<i>p</i> < 0.001), shorter hospitalization time (<i>p</i> < 0.001), minimal postoperative adverse event rate (<i>p</i> < 0.05), and lower modified POSSUM scores (all <i>p</i> < 0.001). However, the Glasgow Coma Scale (GCS) score showed no significant difference between the groups. Additionally, the research group exhibited lower postoperative VAS scores (<i>p</i> < 0.001) and shorter pain relief time (<i>p</i> < 0.001) than the control group.</p><p><strong>Conclusions: </strong>Using MIVAT in TC patients contributes to favorable surgical outcomes and safety, with minimal surgical trauma and adequate postoperative pain relief, highlighting its potential for broader clinical implementation.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 7","pages":"933-940"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641612","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":"An Extremely Rare Case of Pneumatosis Intestinalis Likely Induced by Afatinib Treatment for EGFR-mutated Stage IV Non-small Cell Lung Cancer.","authors":"Lavinia Amato, Roberto Cirocchi, Serena Ungania, Luca Ballelli, Valentina Stamponi, Giacomo Sacchetti, Angelo Pio Damiani, Saverio Valiani, Daniele Brunelli, Alessandro Contine","doi":"10.62713/aic.3879","DOIUrl":"10.62713/aic.3879","url":null,"abstract":"<p><p>Pneumatosis intestinalis (PI) is a rare radiological finding given by the presence of gas within the bowel wall, mainly caused by endoscopic procedures, infections and other gastrointestinal diseases. To date, cytotoxic chemotherapeutic agents, immunotherapy drugs and monoclonal antibodies used for molecular targeted therapy in oncological patients have been reported as a possible cause of PI, but their role remains unclear. We hereby report the case of a 61-year-old patient with stage IV lung adenocarcinoma in treatment with afatinib-a tyrosine kinase inhibitor (TKI), since the diagnosis, who presented to the emergency department with abdominal pain secondary to left-colonic PI. A conservative treatment with drug suspension was successfully attempted. To the best of our knowledge, even though many monoclonal antibodies are associated with this condition, this is the first case report of PI likely induced by afatinib. Although PI is extremely rare, clinicians should be aware of the risk of PI in patients undergoing afatinb therapy and the present case represents a significant warning to differentiate the associated conditions of PI and evaluate whether or not emergency surgery is actually necessary. Therefore, abdominal symptoms in patients receiving oncological treatments should not be overlooked, and clinicians should not hesitate to request targeted radiological investigations to facilitate early diagnosis and management of PI. Timely event detection is imperative to optimal management and to prevent further deterioration, recurrent PI, or even perforation, especially in oncological patients.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 7","pages":"869-877"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641608","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":"A Simple Approach for Guiding the Direction of Bone Drill During Intramedullary Reaming in Indirect Fibular Groove Deepening: A Technical Tip.","authors":"Bin Wang, Bin Zhang","doi":"10.62713/aic.4079","DOIUrl":"https://doi.org/10.62713/aic.4079","url":null,"abstract":"<p><p>Various techniques have been developed to treat peroneal tendon subluxation or dislocation, including superior peroneal retinaculum (SPR) reinforcement and repair, tendon rerouting, tissue transfer, bone blocking, groove deepening, and indirect groove deepening. Indirect fibular groove deepening is typically performed by accessing the intramedullary cavity through the distal fibula. Precise control of drilling direction and depth during intramedullary reaming is critical. In this paper, we introduce a novel technique to guide the direction of the bone drill during indirect fibular groove deepening. This method improves upon the existing indirect fibular groove deepening technique, offering an economical, simple, and equipment-independent solution.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 7","pages":"863-868"},"PeriodicalIF":0.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641607","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":"A Novel Ensemble Approach for Rib Fracture Detection and Visualization using CNNs and Grad-CAM.","authors":"Ling Wu, Hongyu Chen, Puxu Li, Kai Yang","doi":"10.62713/aic.3666","DOIUrl":"10.62713/aic.3666","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to develop a reliable and efficient system for predicting and locating rib fractures in medical images using an ensemble of convolutional neural networks (CNNs).</p><p><strong>Methods: </strong>We employed five CNN architectures-Visual Geometry Group Network 16 (VGG16), Densely Connected Convolutional Network 169 (DenseNet169), Inception Version 4 (Inception V4), Efficient Network B7 (EfficientNet-B7), and Residual Network Next 50 layers (ResNeXt-50)-trained on a dataset of 840 grayscale computed tomography (CT) scan images in .jpg format collected from 42 patients at a local hospital. The images were categorized into two groups representing healed and fresh fractures. The ensemble model was designed to improve predictive accuracy and robustness, utilizing techniques like gradient-weighted class activation mapping (Grad-CAM) for visualization of fracture locations.</p><p><strong>Results: </strong>The ensemble model achieved an accuracy of 0.96, area under the curve (AUC) of 0.97, recall of 0.97, and F1 score of 0.96. Grad-CAM visualizations could effectively locate rib fractures, providing crucial assistance in diagnostics.</p><p><strong>Conclusions: </strong>The ensemble model demonstrates high accuracy and robustness in fracture detection, underscoring its potential for enhancing diagnostic processes in clinical settings. Despite limitations such as the small dataset size and lack of diverse demographic representation, the results are promising for future clinical application.</p>","PeriodicalId":8210,"journal":{"name":"Annali italiani di chirurgia","volume":"96 1","pages":"86-97"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999011","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}