BMC Urology最新文献

{"title":"Clinical outcomes and prognostic factors in patients undergoing radical nephrectomy with lymphadenectomy for pN1 renal cell carcinoma.","authors":"Xianjun Cao, Jiao Jiao, Yanzhen Hao, Guangbin Li, Feng Han, Yu Su","doi":"10.1186/s12894-025-01905-5","DOIUrl":"https://doi.org/10.1186/s12894-025-01905-5","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the clinical effectiveness of radical nephrectomy combined with regional lymphadenectomy in patients with locally advanced renal cell carcinoma (RCC) at the pathological N1 stage.</p><p><strong>Methods: </strong>We retrospectively analyzed clinical data from a cohort of 112 patients diagnosed with locally advanced RCC at the pathological N1 stage who underwent radical nephrectomy between June 2012 and June 2024. The indications for LND in this study were preoperative imaging suggesting lymph node enlargement (short diameter ≥1 cm) or intraoperative suspicion of metastasis; the scope of dissection followed the anterior template (including lymph nodes from the renal hilum to the level of the inferior mesenteric artery). The analysis included univariate and multivariate Cox proportional hazards regression models, as well as Kaplan-Meier survival curves.</p><p><strong>Results: </strong>The cohort comprised 112 patients with pT1-4N1M0 RCC, with a mean age of 49 years (±14) and consisted of 74 males and 38 females. Among these patients, 32 had stage pT1-2 cancer, while 80 presented with more advanced stages (pT3 and above). The median follow-up time was 51 months (range: 12-110 months), with 101 (90.2%) patients completing follow-up and 11 (9.8%) lost to follow-up by the end of the study. The median number of lymph nodes dissected during surgery was 8.0 (range 4.0-13.0), and the median number of pathological lymph node metastases was 2.0 (range 1.0-6.0). The postoperative complication rate was 5.4% (6/112), with 5 (4.5%) Grade II and 1 (0.9%) Grade III complications according to the Clavien-Dindo classification. Throughout the follow-up period, tumor progression was observed in 58 patients, including 9 cases of local recurrence and 54 cases of distant metastasis. The median relapse-free survival (RFS) was approximately 0.90 years (range 0.35-2.60 years), while the median overall survival (OS) was about 2.25 years (range 1.15-4.10 years). The 1-, 3-, and 5-year RFS rates were 44.6%, 21.5%, and 12.1%, respectively, and the corresponding OS rates were 78.5%, 36.8%, and 17.2%. Multivariate analysis identified sarcomatoid differentiation (P=0.001) and postoperative tumor progression (P=0.001) as independent risk factors for poor overall survival. Preoperative lymph node enlargement was identified as an independent risk factor for distant metastasis (P=0.038), while multigroup regional lymph node metastasis was linked to an increased risk of local recurrence (P=0.031).</p><p><strong>Conclusion: </strong>Patients with lymph node metastatic locally advanced RCC exhibit a high risk of postoperative recurrence and metastasis, leading to a poor prognosis. Consequently, these patients require close monitoring and follow-up. Key adverse factors associated with tumor recurrence or poor survival identified include preoperative regional lymph node enlargement, sarcomatoid differentiation, and postoperative tum","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"248"},"PeriodicalIF":1.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238020","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":"Analysis of risk factors for postoperative bladder cancer in patients with upper tract urothelial carcinoma and construction of nomogram prediction model.","authors":"Xin Li, Jianxi Wang, Kangning Wang, Shuo Tan","doi":"10.1186/s12894-025-01926-0","DOIUrl":"10.1186/s12894-025-01926-0","url":null,"abstract":"<p><strong>Objective: </strong>To explore the risk factors for bladder cancer following upper tract urothelial carcinoma (UTUC) surgery and to construct a nomogram prediction model.</p><p><strong>Methods: </strong>A retrospective cohort of 292 patients with UTUC treated at our hospital from February 2010 to April 2020 was enrolled and divided into a training set (204 cases) and an internal validation set (88 cases). Based on the postoperative occurrence of bladder cancer, the training set was subdivided into a bladder cancer group and a non-bladder cancer group. An additional 268 UTUC patients from other hospitals during the same period were selected as an external validation group. Logistic regression analysis was used to determine the influencing factors. The nomogram risk prediction model for postoperative bladder cancer was developed. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve, calibration curve, Hosmer-Lemeshow (H-L) test, and decision curve analysis (DCA) were used to evaluate the predictive performance of the nomogram model.</p><p><strong>Results: </strong>Tumor stage T3-T4, tumor grade G3, history of bladder cancer, and preoperative ureteroscopy examination were independent risk factors for postoperative bladder cancer in UTUC patients, and preventive bladder perfusion was an independent protective factor (P < 0.05). Internal verification: The AUC values of the ROC curves for the training and validation sets were 0.864 and 0.831, respectively. The calibration curves showed good agreement between the nomogram's predictions and actual observations. The H-L test revealed that χ² = 7.555 and 7.365, P = 0.478 and 0.392, respectively. The clinical practicality of the nomogram in DCA was relatively high. External validation: The AUC was 0.847. The calibration curve showed good agreement, and the H-L test resulted in χ2 = 6.175, P = 0.538. DCA confirmed the model's high clinical utility.</p><p><strong>Conclusion: </strong>The nomogram, which integrates tumor stage, tumor grade, history of bladder cancer, preoperative ureteroscopy, and preventive intravesical instillation, demonstrates a high predictive ability for postoperative bladder cancer.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"247"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225049","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":"Renal cancer survival and use of 5alpha-reductase inhibitors or androgen deprivation therapy.","authors":"Olli Lipponen, Antti Pöyhönen, Andres Kotsar, Thea Veitonmäki, Teuvo Lj Tammela, Kaisa Sunela, Teemu J Murtola","doi":"10.1186/s12894-025-01923-3","DOIUrl":"10.1186/s12894-025-01923-3","url":null,"abstract":"<p><strong>Purpose: </strong>Several etiological factors have been implicated in renal cell carcinoma (RCC), and hormonal receptor activity appears to influence RCC-specific mortality. This study aimed to examine the potential association between the use of 5α-reductase inhibitors and androgen deprivation therapy (ADT) and RCC-specific mortality in a population-based cohort of men.</p><p><strong>Methods: </strong>This study included a cohort of 7,720 Finnish men newly diagnosed with RCC between 1995 and 2012. The median follow-up period was 4.75 years. The risk of RCC-specific mortality associated with the use of 5α-reductase inhibitors and androgen deprivation therapy was analyzed using Cox proportional hazards regression. The influence of tumor histology and primary treatment were also evaluated. Long-term risks were assessed in lag-time analyses. Potential confounding by indication was addressed by repeating the analyses for α-blocker users for comparison.</p><p><strong>Results: </strong>Use of 5α-reductase inhibitors prior to RCC diagnosis was associated with a slight risk increase for RCC-specific mortality compared to non-users (HR 1.18, 95% CI 1.02-1.36), with similar association observed also among α-blocker users. However, post-diagnostic use of 5α-reductase inhibitors was not associated with RCC-specific mortality (HR 0.93, 95% CI 0.81-1.07). The lag time analysis did not demonstrate any long-term risk reduction for either 5α-reductase inhibitors or α-blockers. Additionally, no association was observed between ADT use and RCC-specific mortality.</p><p><strong>Conclusion: </strong>Use of 5α-reductase inhibitors or androgen deprivation therapy does not consistently associate with RCC-survival following diagnosis.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"243"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205700","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":"The diagnostic value of urinary exosomes in prostate cancer: a prospective multicenter study.","authors":"Yun Li, Dongwei Pan, Zuheng Wang, Jin Ji, Xin Jin, Xi Chen, Wenhao Lu, Lei Wang, Fubo Wang","doi":"10.1186/s12894-025-01941-1","DOIUrl":"10.1186/s12894-025-01941-1","url":null,"abstract":"<p><strong>Objective: </strong>The diagnosis of prostate cancer (PCa) relies on prostate-specific antigen (PSA) in blood, but the specificity of PSA remains inadequate. This study aims to develop and validate a highly efficient and accurate diagnostic model based on urinary exosomes combined with machine learning (ML) techniques, to identify PCa patients at an early stage and provide support for clinical decision-making.</p><p><strong>Methods: </strong>This study included 287 patients from Shanghai Changhai Hospital, Shanghai Shibei Hospital, and Taizhou People's Hospital, consisting of 89 PCa patients and 198 benign prostatic hyperplasia (BPH) patients. Urinary exosomes were collected from these patients. LASSO regression was used to screen key variables, and nine ML algorithms (including XGBoost, random forest, and logistic regression) were employed to construct the diagnostic model. Model performance was evaluated using AUC, learning curves, calibration curves, and decision curve analysis (DCA), and the contributions of key predictors were visualized using the SHAP method.</p><p><strong>Results: </strong>Among the 11 clinical features included, 3 key features were selected: u-PSA, u-PSMA, and u-AMACR. Among the nine algorithms, the GBDT model performed best, achieving an AUC of 1.000 in the training cohort and 0.987 in the validation cohort. SHAP analysis showed that u-PSA, u-PSMA, and u-AMACR were the most important predictors for PCa. The learning curves indicated that the model fit well and remained stable, while DCA demonstrated significant clinical net benefit, and the calibration curves indicated good diagnostic performance.</p><p><strong>Conclusion: </strong>The urinary exosome-based PCa diagnostic model demonstrates high diagnostic efficacy and can assist physicians in better identifying PCa, reducing unnecessary biopsies.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"246"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205638","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 potential imaging-based predictor for renal functional outcomes after partial nephrectomy for localized renal masses.","authors":"Seong Min Ahn, Dae Chul Jung, Min Hoan Moon, Jung Wook Lee, Kyunghwa Han, Yonghan Kwon","doi":"10.1186/s12894-025-01907-3","DOIUrl":"10.1186/s12894-025-01907-3","url":null,"abstract":"<p><strong>Background: </strong>To determine whether postoperative renal parenchymal volume from first post-operative computed tomography (CT) is a significant prognostic factor for chronic kidney disease (CKD) on the long-term follow up after partial nephrectomy (PN).</p><p><strong>Methods: </strong>This retrospective study included 319 patients who underwent PN for T1 localized renal cell carcinoma (RCC) between September 2006 and December 2020. Kidney volume data of first postoperative CT and preoperative CT was made with a three-dimensional rendering software. Time-dependent cox proportional-hazards regression analysis was used to find important risk factors that indicate the development of new-onset CKD following PN, adding kidney volume data to various clinical parameters.</p><p><strong>Results: </strong>Of the 319 patients who underwent PN for T1 localized RCC, a total of 13 patients (4.0%) had new-onset CKD at last follow up and developed it at a median follow up of 46 months. Univariate analyses of the Cox proportional hazards model showed that age, hypertension, preoperative/postoperative eGFR, and total kidney volume/kilogram body weight were potential risk factors associated with new-onset CKD development. In multivariable cox proportional models, the likelihood-ratio test confirmed that overall performance of models was improved by including total kidney volume (p = 0.008).</p><p><strong>Conclusions: </strong>Renal parenchymal volume of first postoperative CT was a significant risk factor of CKD development on long-term follow up in patients with T1 RCC after PN. Therefore, first postoperative imaging studies will be able to help predict CKD development, as well as to assess the success of the surgery and to monitor recurrence or complications.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"244"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205641","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":"Andrological profile of infertile men with necrozoospermia (phenotypical features and etiologies): retrospective analysis of a cohort of more than 300 patients.","authors":"Marianne Abboud, Angèle Boursier, Julie Prasivoravong, François Marcelli, Florence Boitrelle, Anne-Laure Barbotin, Geoffroy Robin","doi":"10.1186/s12894-025-01921-5","DOIUrl":"10.1186/s12894-025-01921-5","url":null,"abstract":"<p><strong>Background: </strong>Necrozoospermia is a rare cause of male infertility, with a reported incidence of 0.2 to 0.4% in the literature. There are three types of etiology for necrozoospermia: testicular, post-testicular and mixed causes. The main objective of this study is to identify the risk factors of severe necrozoospermia and establish an andrological profile.</p><p><strong>Methods: </strong>The dataset of patients suffering from necrozoospermia was retrospectively collected in the reproductive biology and andrology departments of the university hospital of Lille between 2003 and 2021. The following data were collected: age, body mass index, profession, drug use, hormone assays, semen analyses, history of genital or male accessory gland infection, pelvic surgery, hyperthyroidism, polycystic kidney disease, varicocele, any seminal tract anomality. Patients were divided into three groups according to the degree of sperm vitality: mild (vitality between 40 and 54%), moderate (20-40%) and severe (< 20%) necrozoospermia. The various causes of necrozoospermia were categorized as follow : testicular, post-testicular, mixed, idiopathic.</p><p><strong>Results: </strong>Semen analysis showed a significant decrease in ejaculate volume in the severe group compared to the moderate (-0.8mL; p = 0.0068) and mild (-1.3mL; p = 0.042) ones, but within WHO reference limits (> 1.4 mL). Comparison of total testicular volumes showed significantly higher values for the severe group compared to the moderate (+ 7.9 mL; p = 0.0005) and mild (+ 6.7mL; p = 0.0032) ones. Patients with seminal tract anomalies had significantly more severe necrozoospermia (-10.78% vitality ; p = 0.0001).</p><p><strong>Conclusion: </strong>Having a post-testicular cause, especially a seminal tract anomality, is a risk factor of severe necrozoospermia. In this case, the andrological profile is normal testicular volume, averaging 16mL, a decrease in ejaculated volume meaning there is, no clear impairment of spermatogenesis.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"242"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205673","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":"Ureterorenoscopy performed by residents under expert supervision: a training approach ensuring patient safety and effectiveness.","authors":"Emanuele Serafin, Andrea Franceschini, Francesco Ditonno, Endri Toska, Alberto Baielli, Antonio Raiti, Damiano D'Aietti, Francesca Montanaro, Luca Rahmati, Mattia Ronca, Peres Fokana Pongmoni, Sonia Costantino, Vincenzo Vetro, Alessandro Veccia, Riccardo Rizzetto, Alberto Bianchi, Alessandra Gozzo, Vincenzo Lacola, Maria Angela Cerruto, Riccardo Bertolo, Alessandro Antonelli","doi":"10.1186/s12894-025-01909-1","DOIUrl":"10.1186/s12894-025-01909-1","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"245"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205627","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":"Fluoroscopy-free Moses technology for treating nephrolithiasis accompanied with infundibular stenosis: a prospective safety and efficacy cohort study.","authors":"Xu Liu, Haitao Liu, Kailong Wang, Junnan Xu, Xin Chen, Hairui Chen, Xu Zhang, Haixing Mai","doi":"10.1186/s12894-025-01918-0","DOIUrl":"10.1186/s12894-025-01918-0","url":null,"abstract":"<p><strong>Background: </strong>Utilization of C-arm and X-ray machines in flexible ureterorenoscopy (f-URS) with Holmium Laser for the treatment of stones exposes both surgeons and patients to potentially harmful radiation. This study investigates the safety and efficacy of our new procedure, X-ray-free retrograde intrarenal surgery (RIRS), for treating nephrolithiasis associated with intrarenal infundibular stenosis.</p><p><strong>Methods: </strong>From Apr 2023 to Mar 2024, a prospective analysis as conducted on the medical records of 25 patients, comprising 7 women (28%) and 18 men (72%). Postoperative follow-up at 3 and 6 months revealed stone-free rates of 76% and 84%, respectively.Univariate logistic regression was applied to further analyze the independent risk factor of the successful rate of stones accompanied with intrarenal stenoses.</p><p><strong>Results: </strong>According to the definition established in this study identifying and incising the narrow calyx neck and removing the stone completely without fluoroscopic guidance, the success rate reached 72.0% (18/25). There was a statistical difference in success rates between the lower calyx calculus treatment group (4) and the upper/middle calyx calculus treatment group (14) (P = 0.004). There was no significant statistical difference in success rates between anterior stenosis with calculus treatment (9) and posterior stenosis with calculus treatment (9) (P = 0.748). The location of calculus have a significant impact on the surgical success rate (P = 0.013).</p><p><strong>Conclusions: </strong>Flexible ureterorenoscopy (f-URS) using calyx neck incision and Moses mode holmium laser lithotripsy appears to be a safe and effective technique. With a success rate comparable to that of the traditional X-ray-guided balloon dilation technique, RIRS is particularly suitable for patients with kidney stones located at the upper and middle poles of the kidney, while it can also be considered for patients with stones in the lower calyx. Application to lower calyx stones should be cautiously considered due to anatomical challenges and relatively lower success rates observed.</p><p><strong>Trial registration: </strong>The trial was registered prior to patient enrollment at the Chinese Clinical Trial Registry (ChiCTR2300070059), date of registration: March 31st, 2023.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"240"},"PeriodicalIF":1.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191143","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":"Penile gangrene induced by colovesical fistula: a case report.","authors":"Dongming Lu, Ye Shuchao, Liao Shangfan, Wu Yongyang, Xie Xueping","doi":"10.1186/s12894-025-01945-x","DOIUrl":"10.1186/s12894-025-01945-x","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"241"},"PeriodicalIF":1.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191129","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":"Renoprotective effects of compound 21 and empagliflozin in L-Name-induced hypertensive rats.","authors":"Onural Ozhan, Mehmet Colak, Elif Karaca, Feyzi Dogru, Zeynep Kucukakcali, Ahmet Acet, Hakan Parlakpinar","doi":"10.1186/s12894-025-01938-w","DOIUrl":"10.1186/s12894-025-01938-w","url":null,"abstract":"","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"239"},"PeriodicalIF":1.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191134","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}