Basic and Clinical Andrology最新文献

{"title":"Stem cell therapy in diabetic men with erectile dysfunction: a 24-month follow-up of safety and efficacy of two intracavernous autologous bone marrow derived mesenchymal stem cells injections, an open label phase 2 clinical trial.","authors":"Saddam Al Demour, Sofia Adwan, Hanan Jafar, Hussam Alhawari, Abdalla Awidi","doi":"10.1186/s12610-024-00229-y","DOIUrl":"10.1186/s12610-024-00229-y","url":null,"abstract":"<p><strong>Background: </strong>Recently we reported results of phase 1 pilot clinical trial of 2 consecutive intracavernous (IC) injection of autologous bone marrow-derived mesenchymal stem cells (BM-MSCs) for the first time in the treatment of diabetic patients with erectile dysfunction (DM-ED). In phase 2 of this study our aim is to evaluate long term safety and efficacy of IC injections of BM-MSC on additional eight patients with DM-ED.</p><p><strong>Results: </strong>Each patient received 2 consecutive IC injections of BM-MSC and evaluated at 1, 3, 6, 12, and 24-month time points. Primary outcome was the tolerability and safety of stem cells therapy (SCT), while the secondary outcome was improvement of erectile function (EF) as assessed using the International Index of Erectile Function-5 (IIEF-5), Erection Hardness Score (EHS) questionnaires, and Color Duplex Doppler Ultrasound (CDDU). IC injections of BM-MSCs was safe and well-tolerated. Minor local and short-term adverse events related to the bone marrow aspiration and IC injections were observed and treated conservatively. There were significant improvement in mean IIEF-5, EHS, all over the follow-up time points in comparison to the baseline. At 24-month follow up there were significant decline in the mean IIEF-5, and EHS compared to the baseline. The mean basal and 20-min peak systolic velocity was significantly higher at 3-month after the IC injections compared to baseline.</p><p><strong>Conclusions: </strong>This phase 2 clinical trial confirmed that IC injections of BM-MSC are safe and improve EF. The decline in EF over time suggests a need for assessing repeated injections.</p><p><strong>Clinical trial registration: </strong>NCT02945462.</p>","PeriodicalId":8730,"journal":{"name":"Basic and Clinical Andrology","volume":"34 1","pages":"13"},"PeriodicalIF":2.4,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stigma and its associations with self-confidence and sexual relations in 4 types of premature ejaculation.","authors":"Jishuang Liu, Tong Bao, Qunfeng Wang, Hui Jiang, Xiansheng Zhang","doi":"10.1186/s12610-024-00226-1","DOIUrl":"10.1186/s12610-024-00226-1","url":null,"abstract":"<p><strong>Background: </strong>Although men with premature ejaculation (PE) always show more negative emotions, including embarrassment, guilt and worry, this may be related to the stigma of PE. To investigated stigma and its associations with self-confidence and sexual relations in 4 PE syndromes, a survey was conducted in our hospital from December 2018 to December 2019 among 350 men with self-reported PE and 252 men without self-reported PE. The stigma, self-confidence and sexual relations were assessed by the Social Impact Scale (SIS) and Self-Esteem and Relationship questionnaire (SEAR), respectively. Ejaculation control, sexual life satisfaction and distress caused by PE were evaluated by the Index of PE.</p><p><strong>Results: </strong>Men with self-reported PE had higher internalized shame and social isolation scores and lower SEAR scores than control subjects. The highest score of internalized shame and social isolation and the lowest score of SEAR appeared in men with lifelong PE (LPE). After age adjustment, the positive relationships were stronger between distress about PE and internalized shame. Whereas, the stronger negative associations were found between social isolation and sexual satisfaction. The strongest association was observed between social isolation and sexual relationship. Therefore, the stigma associated with PE adversely affects the self-confidence, self-esteem, and sexual relationships of men with PE.</p><p><strong>Conclusion: </strong>Men with PE, especially LPE, have a high level of stigma and disharmonious sexual relations, and often lack self-confidence and self-esteem, which have a certain negative impact on their physical and mental health and life. These will be the key issues to be considered when we formulate a personalized treatment plan for PE.</p>","PeriodicalId":8730,"journal":{"name":"Basic and Clinical Andrology","volume":"34 1","pages":"11"},"PeriodicalIF":2.4,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11218248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141475804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term results of three-part penile prosthesis implantation with Ectopic reservoir placement in the treatment of erectile dysfunction: is supramuscular tubulation a reliable method?","authors":"Yunus Erol Bozkurt, Caner Buğra Akdeniz, Bilali Habeş Gümüş","doi":"10.1186/s12610-024-00225-2","DOIUrl":"10.1186/s12610-024-00225-2","url":null,"abstract":"<p><strong>Background: </strong>Penile prosthesis implantation is the last resort for refractory erectile dysfunction. Reservoir placement is one of the biggest challenges in inflatable penile prosthesis implant surgery in several cases, especially in patients with abnormal pelvic anatomy. Ectopic reservoir placement with supramuscular approach has many advantages in these cases.</p><p><strong>Results: </strong>No complications were encountered except wound site infection in 2 patients which could be controlled with antibiotic treatment. EDITS scores were not statistically different between patients divided into 2-year groups according to follow-up time. Median values of EDITS scores were high in all groups, suggesting that couples had high sexual satisfaction both in the long term and in the short term.</p><p><strong>Conclusions: </strong>We recommend placement of the supramuscular tube and reservoir through the incision described, especially in patients whose pelvic anatomy has been modified by lower abdominal surgery.</p>","PeriodicalId":8730,"journal":{"name":"Basic and Clinical Andrology","volume":"34 1","pages":"8"},"PeriodicalIF":2.4,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migrating foreign bodies of penis: a case report and literature review.","authors":"Bo Yang, Ying Ke, Aixin Qiu, Lijie Wen, Xiaolong Xv, Xiaoyun Liu, Yue Zhang","doi":"10.1186/s12610-024-00224-3","DOIUrl":"10.1186/s12610-024-00224-3","url":null,"abstract":"<p><strong>Background: </strong>Only a few cases have been reported about active foreign body implantation in the cavernous body of the penis.</p><p><strong>Case presentation: </strong>A 47-year-old man inserted two needles from the glans penis into the bilateral penile sponge body. Subsequently, two needles migrated through the penile cavernous body into the pelvic cavity. Attempts to remove the needles through the penis were unsuccessful. Eventually, after a duration exceeding one month, the displaced needles were removed in stages from the buttocks.</p><p><strong>Conclusion: </strong>A few cases of intracavernosal-injection-therapy-associated needle breakage and retention have been reported globally. And this is the first case in China documenting the migration of foreign bodies within the penile region. In this condition, it is of utmost importance to engage the expertise of experienced andrologists to minimize the risk of excessive manipulation, thereby ensuring that inadvertent deep penetration of the needle into the penile tissue is prevented. In case the foreign body has migrated deeper into the tissues and the patient does not exhibit any specific symptoms or risks of macrovascular injury-related bleeding, close surveillance of its movement can be implemented. Surgical intervention can be initiated once the foreign body has reached a suitable position. Moreover, a psychiatric evaluation should be recommended for patient to discover any underlying mental health disorders.</p>","PeriodicalId":8730,"journal":{"name":"Basic and Clinical Andrology","volume":"34 1","pages":"9"},"PeriodicalIF":2.4,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination of pregabalin and Amitriptyline in management of chronic idiopathic pain following penile prosthesis implantation: a pilot study","authors":"Hassan Shaker, Nouran Omar El Said, Karim Omar ElSaeed","doi":"10.1186/s12610-024-00223-4","DOIUrl":"https://doi.org/10.1186/s12610-024-00223-4","url":null,"abstract":"Chronic post-penile prosthesis pain is de novo pain persisting > 2 months post-operatively. This pain is inadequately reported, poorly understood and undermanaged. The purpose of this current pilot study was to improvise a medical approach to alleviate the condition and assess the combination of Pregabalin and Amitriptyline in its management. The study enrolled 9 patients complaining of idiopathic penile, pelvic, or scrotal pain persisting > 2 months after penile prosthesis implantation. Patients were prescribed pregabalin 75mg/12h (escalated after 1 week to 150mg/12h upon demand) and Amitriptyline 25mg once daily for 3 months. The pain was reassessed after 10, 30 and 100 days. The dose of pregabalin required and the side effects of the medication were noted. Findings revealed a significant decrease in pain duration (p = 0.007), frequency (p < 0.001), and intensity (p < 0.001); in glanular (p = 0.008), shaft pain (p = 0.046) but not scrotal (p = 0.112). Moreover, a significant decrease was found in sharp pain (p = 0.003) and pain aggravated by touch (p = 0.008) but not aching pain (p = 0.277). Additionally, significant improvement was reported in QoL (p < 0.001) and dose escalation of pregabalin to 150mg/12h was required in only 1 case (11%). The combination of pregabalin and amitriptyline is very effective in the management of chronic idiopathic pain following penile prosthesis implantation. However, due to the ambiguity and lack of reporting of the condition, we recommend a multicentric contribution to acknowledge the condition, and weigh its prevalence accurately, whilst evaluating the efficacy of our approach. This study received ethical approval from Ain Shams University Research Ethics Committee (REC) FWA 000017585, on 04/13/2023 (REC-FMASU@med.asu.edu.eg). no FMASU R98/2023.","PeriodicalId":8730,"journal":{"name":"Basic and Clinical Andrology","volume":"63 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588429","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":"Update on known and emergent viruses affecting human male genital tract and fertility","authors":"Sara Dabizzi, Mario Maggi, Maria Gabriella Torcia","doi":"10.1186/s12610-024-00222-5","DOIUrl":"https://doi.org/10.1186/s12610-024-00222-5","url":null,"abstract":"Many viruses infect the male genital tract with harmful consequences at individual and population levels. In fact, viral infections may induce damage to different organs of the male genital tract (MGT), therefore compromising male fertility. The oxidative stress, induced during viral-mediated local and systemic inflammation, is responsible for testicular damage, compromising germinal and endocrine cell functions. A reduction in sperm count, motility, number of normal sperm and an increase in DNA fragmentation are all common findings in the course of viral infections that, however, generally regress after infection clearance. In some cases, however, viral shedding persists for a long time leading to unexpected sexual transmission, even after the disappearance of the viral load from the blood. The recent outbreak of Zika and Ebola Virus evidenced how the MGT could represent a reservoir of dangerous emergent viruses and how new modalities of surveillance of survivors are strongly needed to limit viral transmission among the general population. Here we reviewed the evidence concerning the presence of relevant viruses, including emergent and re-emergent, on the male genital tract, their route of entry, their adverse effects on male fertility and the pattern of viral shedding in the semen. We also described laboratory strategies to reduce the risk of horizontal or vertical cross-infection in serodiscordant couples undergoing assisted reproductive technologies.","PeriodicalId":8730,"journal":{"name":"Basic and Clinical Andrology","volume":"45 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140129238","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":"Correction: Efficient pathway for men fertility preservation in testicular cancer or lymphoma: a cross-sectional study of national 2018 data.","authors":"Ségolène Prades, Sarah-Lyne Jos, Jacqueline Saïas-Magnan, Louis Bujan, Florence Eustache, Oxana Blagosklonov, Eric Lechevallier, Florence Brugnon, Vanessa Loup-Cabaniols, Dorian Bosquet, Marie Prades, Bérengère Ducrocq, Céline Chalas, Sandrine Giscard-d'Estaing, Anne Mayeur, Isabelle Koscinsky, Françoise Schmitt, Aline Papaxanthos-Roche, Marius Teletin, Emmanuelle Thibault, Damien Beauvillard, Sophie Mirallie, Béatrice Delepine, Annie Benhaim, Pascale May-Panloup, Ségolène Veau, Cynthia Frapsauce, Patricia Fauque, Régis Costello, Nathalie Rives, Catherine Metzler-Guillemain, Jeanne Perrin","doi":"10.1186/s12610-024-00221-6","DOIUrl":"10.1186/s12610-024-00221-6","url":null,"abstract":"","PeriodicalId":8730,"journal":{"name":"Basic and Clinical Andrology","volume":"34 1","pages":"5"},"PeriodicalIF":2.4,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10845733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel homozygous TSGA10 missense variant causes acephalic spermatozoa syndrome in a Pakistani family.","authors":"Khalid Khan, Xiangjun Zhang, Sobia Dil, Ihsan Khan, Ahsanullah Unar, Jingwei Ye, Aurang Zeb, Muhammad Zubair, Wasim Shah, Huan Zhang, Muzammil Ahmad Khan, Limin Wu, Bo Xu, Hui Ma, Zina Wen, Qinghua Shi","doi":"10.1186/s12610-024-00220-7","DOIUrl":"10.1186/s12610-024-00220-7","url":null,"abstract":"<p><strong>Background: </strong>Acephalic spermatozoa syndrome is a rare type of teratozoospermia causing male infertility due to detachment of the sperm head and flagellum, which precludes fertilization potential. Although loss-of-function variations in several genes, including TSGA10, have been associated with acephalic spermatozoa syndrome, the genetic cause of many cases remains unclear.</p><p><strong>Results: </strong>We recruited a Pakistani family with two infertile brothers who suffered from acephalic spermatozoa syndrome. Through whole-exome sequencing (WES) followed by Sanger sequencing, we identified a novel missense variant in TSGA10 (c.1112T > C, p. Leu371Pro), which recessively co-segregated with the acephalic spermatozoa syndrome within this family. Ultrastructural analyses of spermatozoa from the patient revealed that 98% of flagellar cross-sections displayed abnormal axonemal ultrastructure, in addition to the head-flagellum detachment. Real-time quantitative PCR analysis revealed almost no detectable TSAG10 mRNA and western blot analysis also failed to detect TSAG10 protein in patient's sperm samples while TSGA10 expression was clearly detected in control samples. Consistently, immunofluorescence analysis demonstrated the presence of TSGA10 signal in the midpiece of sperm from the control but a complete absence of TSGA10 signal in sperm from the patient.</p><p><strong>Conclusion: </strong>Altogether, our study identifies a novel TSGA10 pathogenic variant as a cause of acephalic spermatozoa syndrome in this family and provides information regarding the clinical manifestations associated with TSGA10 variants in human.</p>","PeriodicalId":8730,"journal":{"name":"Basic and Clinical Andrology","volume":"34 1","pages":"4"},"PeriodicalIF":2.4,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10840149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiology, clinical manifestations, and management methods of cryptitis beside the preputial frenulum in men","authors":"Wenge Fan, Qingsong Zhang, Zhijiang Fan, Mei Wei, Yuan Zhu","doi":"10.1186/s12610-024-00219-0","DOIUrl":"https://doi.org/10.1186/s12610-024-00219-0","url":null,"abstract":"Inflammatory diseases may occur within the crypt beside the preputial frenulum in men. This study was performed to gain an understanding of the etiology, clinical manifestations, and management methods of cryptitis beside the preputial frenulum in men. Thirteen patients treated for cryptitis beside the preputial frenulum served as the observation group, and 40 healthy individuals served as the control group. The patients’ clinical manifestation was the presence of a yellowish oily substance embedded in the crypt. Wiping off the substance revealed a conical blind cavity-like structure with an opening diameter of 1 to 5 mm (2.8 ± 1.3 mm) and depth of 1 to 4 mm (2.5 ± 1.1 mm). No blind cavity-like structures in the crypt were found in the control group. The shortest distance between the opening edges of the bilateral crypts in the observation and control groups was 6 to 14 mm (10.3 ± 2.4 mm) and 2 to 10 mm (3.9 ± 1.9 mm), respectively, with a statistically significant difference. Examination for pathogens in the secretions from skin lesions showed that the three most common pathogens were Candida albicans, Staphylococcus aureus, and Escherichia coli. All patients recovered after antibiotic treatment. A blind cavity-like structure in the crypt may be related to excessive width of the preputial frenulum. Cryptitis may be a secondary infection caused by smegma trapped in the blind cavity-like structure. Maintaining cleanliness in the frenulum area may help to prevent the occurrence of cryptitis. Antibiotic treatment is effective.","PeriodicalId":8730,"journal":{"name":"Basic and Clinical Andrology","volume":"106 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139475972","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":"Management of men with AZFc deletions","authors":"Peter N Schlegel","doi":"10.1186/s12610-023-00217-8","DOIUrl":"https://doi.org/10.1186/s12610-023-00217-8","url":null,"abstract":"<p><b>To the Editor:</b></p><p>The published article by Deng et al. [1] confirms a number of concepts that have been previously published regarding management of men with non-obstructive azoospermia (NOA) associated with AZFc deletions. A critical point of their manuscript is the demonstration of the poor predictive value of fine needle aspiration (FNA) mapping for detection of sperm within the testes of men with NOA. For men with negative FNA maps (no sperm seen), sperm were able to be found and used for assisted reproductive using the more effective microTESE (testicular sperm extraction) approach for sperm retrieval in 65% of men. This raises the question of the clinical utility of FNA mapping in management of men with NOA. In essence, why would you ever use FNA mapping for the management of non-obstructive azoospermia?</p><p>Prior meta-analyses of comparative trials have demonstrated that FNA is twofold less likely to find sperm in NOA than standard multi-biopsy approaches, and microTESE is 1.5-fold more effective at finding sperm than the multi-biopsy approach [2]. Given the high effectiveness of microTESE, there appears to be no situation when you would consider the FNA map – as its results would lead to microTESE, whether the map showed sperm or not. As noted in ASRM/AUA guidelines [3], microTESE remains the gold standard – the most effective and arguably safest approach for sperm retrieval – in NOA.</p><p>Several other facets of the management of men with AZFc deletions are important to highlight. Overall, the ability to get sperm from these men is quite high, relative to other etiologies of (or even idiopathic) NOA. This manuscript only focused on men with azoospermia. But, of particular importance to consider is the relative frequency of cryptozoospermia in men with AZFc deletions. We have observed that nearly 70% of men with AZFc deletions will have rare sperm in the ejaculate. This has led us to perform a careful semen analysis, including the potential evaluation of several aliquots of the centrifuged semen specimen on the day of planned sperm retrieval to avoid unnecessary surgery for these men who can be effectively treated with ejaculated sperm. We have even found and successfully used sperm from the ejaculate in men with AZFc deletions and prior failed biopsy retrieval of sperm.</p><p>In this article, Deng et al. have reported on those men with AZFc deletions and azoospermia, but it is important to consider the possibility of having rare sperm identified in the ejaculate for AZFc-deleted patients. In a recent report [4], we have found that for unselected men with NOA, 9% or more of men with prior documented azoospermia can be found to have rare sperm in the ejaculate – obviating the need for planned surgery – if semen analysis is repeated on the day of sperm retrieval.</p><p>Deng et al. are to be congratulated for bringing together data on management of men with AZFc deletions and NOA. These observations are a valuable contributio","PeriodicalId":8730,"journal":{"name":"Basic and Clinical Andrology","volume":"4 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139421208","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}