Child's Nervous System最新文献

{"title":"Are we all seeing the same thing? Discrepancies between parent-reported and physician-reported positional plagiocephaly severity scores.","authors":"Grace Soojin Ryu, Mary Newland, Andrea Hiller, Elias Rizk, Thomas Samson","doi":"10.1007/s00381-025-06833-1","DOIUrl":"https://doi.org/10.1007/s00381-025-06833-1","url":null,"abstract":"<p><strong>Purpose: </strong>Positional plagiocephaly (PP) and brachycephaly are conditions characterized by head flattening. There has been a sharp rise in the number of patients diagnosed since the American Academy of Pediatrics initiated the \"Back to Sleep\" policy to combat sudden infant death syndrome. This study compares providers' and guardians' perceived head shape differences, highlighting how these scores can alleviate parental anxiety.</p><p><strong>Methods: </strong>A retrospective chart review was performed for all pediatric patients seen for a PP consult from January 2018 to November 2023. Fifty-nine patients (43 with plagiocephaly and 16 with brachycephaly) met the inclusion criteria, in which documentation recorded two severity scores, one rating each by the provider and parental guardian. Patient demographics, severity scores, and comorbidities were recorded. The institution utilized validated, qualitative assessment forms that evaluated plagiocephaly on a 15-point scale and brachycephaly on a 9-point scale.</p><p><strong>Results: </strong>For plagiocephaly, the providers and guardians rated severity with a median of 4 (IQR 3-4.5) and 4 (IQR 3-7), respectively (Wilcoxon signed rank test, p-value < 0.05). For brachycephaly, the providers and guardians rated severity with a mean of 3.59 (SD 1.28) and 4.69 (SD 1.66), respectively (paired T-test, p-value < 0.005).</p><p><strong>Conclusions: </strong>Our study highlights the similarities in scores assessing clinical severity between providers and parents evaluated in a standardized, qualitative assessment for PP. On average, plagiocephaly reflected a \"mild\" severity, while brachycephaly reflected a \"mild\" to \"moderate\" severity on a graded scale. Future studies are needed to determine how patient-provider interactions may influence parents' scores through shared decision-making.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"176"},"PeriodicalIF":1.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Craniovertebral lipoma associated with hydrocephalus: report of two cases.","authors":"Kirill Sysoev, Arina Kulaeva, Dimitrios Tsiptsios, Alexander Kim","doi":"10.1007/s00381-025-06806-4","DOIUrl":"https://doi.org/10.1007/s00381-025-06806-4","url":null,"abstract":"<p><p>Craniovertebral lipomas in children are rare, especially in association with hydrocephalus. We present two cases of craniovertebral lipomas, accompanied by hydrocephalus. Despite eliminating cerebrospinal fluid pathway occlusion as a result of lipoma resection, both patients were complicated by exaggerated ventriculomegaly requiring ventriculoperitoneal shunt placement. Eventually, both children were discharged home after regression of symptoms of increased intracranial pressure and remained stable during long-term follow-up. However, the pathogenesis of expanding hydrocephalus in such cases is yet unclear.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"173"},"PeriodicalIF":1.3,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963635","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":"Retro-odontoid mass resolution analysis and timing following posterior cervical spinal fixation: 16-year paediatric neurosurgery experience in a single UK institute.","authors":"Mostafa Elmaghraby, Fardad T Afshari, Ruben Miranda Cardoso, Azam Ali Baig, Hadleigh J Cuthbert, Gopiga Thanabalasundaram, Adrian Gardner, Guirish A Solanki","doi":"10.1007/s00381-025-06804-6","DOIUrl":"https://doi.org/10.1007/s00381-025-06804-6","url":null,"abstract":"<p><p>A retro-odontoid mass (R-OM) is a soft tissue mass that develops posterior to the odontoid process of the C2 vertebra. The instability leads to non-physiologic motion producing an inflammatory process with fibro cartilaginous mass that lead to spinal cord compression. Cervical fusion has been previously shown to reduce it in rheumatoid pannus.</p><p><strong>Aims: </strong>(1) Investigate impact of cervical fixation on R-OM in a paediatrics, (2) assess which group have the greatest reduction, and (3) assess the timing of reduction.</p><p><strong>Methods: </strong>Between 2005 and 2021, 52 children underwent craniocervical junction (CCJ) fixation. Of these, 35 (67%) children had measurable R-OM at the time of presentation. These children underwent either occipito-cervical or atlanto-axial fixation for atlantoaxial instability. All cases were treated in a single tertiary paediatric neurosurgical centre by a multidisciplinary team. All procedures were performed by the same neurosurgical team. Demographic data, including age, gender, diagnosis, type of surgery, and measurements of pre- and post-operative R-OM were recorded. Serial post-operative scans provided evidence of regression of R-OM. R-OM measurements were performed using T2 W mid-sagittal and axial views of MRI to calculate anterio-posterior (AP), craniocaudal (CC), and mediolateral/width (LL) dimensions.</p><p><strong>Results: </strong>Twenty-four children underwent atlantoaxial (69%), and 11 children had occipito-cervical fixation (31%). The mean age was 8.9 years (range 2-18) with M:F ratio of 1:1.3. Metabolic causes were the most common group undergoing surgery, with MPS IV being the most prevalent subgroup. Pooled evaluation of all cases revealed significant reduction in R-OM following fixation in all measured dimensions. Subgroup analysis of underlying pathology revealed that the metabolic group showed the most significant reduction. Analysis of timing of regression of the R-OM revealed that the maximal reduction occurred at the mean of 3 years (35.54 months) following fixation with the range of 2 weeks to 10 years (0.13 to 120.77 months).</p><p><strong>Conclusion: </strong>In our experience, R-OM is a common feature in atlantoaxial instability in the paediatric population. Cervical fixation leads to regression in R-OM, supporting instability as the driving force for formation of R-OM. Hence, resection of R-OM directly is not recommended and could expose the child to unnecessary risk.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"171"},"PeriodicalIF":1.3,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974705","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":"Comparative analysis of bipedicled fasciocutaneous flaps in meningomyelocele repair: influence of perforator preservation on postoperative outcomes and hospitalization duration.","authors":"Munur Selcuk Kendir, Mehmet Dadaci, Mehmet Fatih Erdi, Ilker Uyar, Zikrullah Baycar, Bilsev Ince","doi":"10.1007/s00381-025-06829-x","DOIUrl":"https://doi.org/10.1007/s00381-025-06829-x","url":null,"abstract":"<p><strong>Purpose: </strong>Meningomyelocele (MMC), a severe congenital defect of the central nervous system, is commonly associated with high morbidity and mortality. Surgical closure of MMC is essential to prevent infection, cerebrospinal fluid leakage, and nerve damage. In cases with large defects, flap surgery is required. This study examines whether preserving musculocutaneous perforators which enters to the flap itself during the repair with bipedicle fasciocutaneous flaps improves outcomes compared to flaps without perforator preservation.</p><p><strong>Methods: </strong>We retrospectively analyzed 79 MMC patients who underwent repair with bipedicle fasciocutaneous flaps from January 2013 to December 2022. Patients were divided into two groups: Group 1 (perforators not preserved) and Group 2 (perforators preserved). We evaluated flap perfusion, complications, operation time, hospital stay, and discharge readiness.</p><p><strong>Results: </strong>Results showed that Group 2 had a lower incidence of early postoperative venous insufficiency (15.2% vs. 34.29%, p < 0.05), partial flap necrosis (4.55% vs. 11.43%, p < 0.05), wound dehiscence (6.82% vs. 22.86%, p < 0.05), and secondary surgeries (13.64% vs. 25.71%, p < 0.05). Group 2 patients were ready for discharge significantly sooner (6.93 days vs. 9.26 days, p < 0.05). No significant differences were observed in operation time or blood loss between the groups.</p><p><strong>Conclusion: </strong>Preserving perforators in bipedicle fasciocutaneous flaps enhances flap viability, reduces complication rates, and shortens hospital stays. This technique should be adopted for MMC repairs to improve clinical outcomes.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"170"},"PeriodicalIF":1.3,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062555","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":"Craniopharyngiomas in children: the pendulum moves again for an aggressive surgery-late complications and considerations with a recent series of 26 patients treated in Lyon.","authors":"Pierre-Aurélien Beuriat, Alexandru Szathmari, Federico Di Rocco, Carine Villanueva, Lucie Bazus, Sara Cabet, Marina Veyrie, Carmine Mottolese","doi":"10.1007/s00381-025-06815-3","DOIUrl":"https://doi.org/10.1007/s00381-025-06815-3","url":null,"abstract":"<p><strong>Background: </strong>Craniopharyngioma (CP) surgery in children leads to high rate of recurrence, and morbid complications. Transcranial approach is the most frequently proposed surgical technique, but transsphenoidal endoscopic approach is also used. Pre- and post-operative complications of the tumor are well known, but early multidisciplinary management could improve the long-term outcome of these patients. The aim of this study was to analyse the risk factors for pre-and post-operative long-term complications in a series of patients operated with an aggressive removal for CP.</p><p><strong>Methods: </strong>A retrospective study of 26 children diagnosed with CP was carried out. The surgical total removal was possible in 88% of cases after the revision of the post-operative MRI realized in the first 48 h.</p><p><strong>Results: </strong>Children with hypothalamic involvement were more likely to have endocrine deficits and to be overweight or obese pre-operatively. They also had a higher risk of early post-operative complications, and late morbidities.</p><p><strong>Conclusion: </strong>Children with CP and strong hypothalamic involvement, have a higher risk of pre- and post-operative complications but complete removal is associated with a high rate of cure with global good neuropsychological results. Early multidisciplinary post-operative management should be reinforced to improve the long-term outcome but surgery with total removal can insure definitive acceptable clinical results.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"169"},"PeriodicalIF":1.3,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-year outcomes following modified transsylvian peri-insular hemispherotomy.","authors":"Samuel B Tomlinson, Kathleen Galligan, Sudha K Kessler, Benjamin C Kennedy","doi":"10.1007/s00381-025-06825-1","DOIUrl":"https://doi.org/10.1007/s00381-025-06825-1","url":null,"abstract":"<p><strong>Purpose: </strong>Hemispherotomy is an effective treatment for well-selected patients with drug-resistant hemispheric epilepsy. Successful hemispherotomy leading to seizure cessation has been associated with improved neurodevelopmental outcomes and reduced healthcare utilization. This study reports seizure outcomes and complications in a large, consecutive, single-surgeon series of pediatric hemispherotomy cases using a surgical approach with modifications to previously-reported techniques.</p><p><strong>Methods: </strong>All patients undergoing transsylvian peri-insular hemispherotomy for drug-resistant hemispheric epilepsy between May 2017 and April 2021 by a single surgeon were prospectively enrolled in an epilepsy surgery registry. With retrospective review of medical records, data were collected on baseline characteristics (demographics, epilepsy history, anti-seizure medications, neurodevelopmental status, EEG features, and imaging characteristics), operative complications, hospital course, and seizure outcomes (Engel scale at 12- and 24-month follow-up).</p><p><strong>Results: </strong>All 32 consecutive patients (aged 15 months-19 years) were seizure-free (Engel Class 1) 12 and 24 months after hemispherotomy. At 12 months, 31 patients (97%) had Engel Class 1A outcomes, and 1 patient (3%) had an Engel Class 1D outcome. These results were maintained through 24-month follow-up. Among 31 patients taking anti-seizure medications before surgery, 22 (71%) were weaned off all agents by 24 months. One patient (3%) developed post-operative hydrocephalus requiring ventriculoperitoneal shunt placement.</p><p><strong>Conclusion: </strong>In an etiologically heterogeneous cohort of patients undergoing hemispherotomy for drug-resistant epilepsy, a modified transsylvian peri-insular technique led to high rates of sustained seizure freedom with minimal complications.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"168"},"PeriodicalIF":1.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative fever following hemispherotomy managed with baclofen: unnoticed treatment.","authors":"Mohammad Elbaroody, Hossam Eldin Mostafa, Salsabil Abo Al-Azayem, Amani Nawito, Nirmeen A Kishk, Basim Ayoub","doi":"10.1007/s00381-025-06813-5","DOIUrl":"https://doi.org/10.1007/s00381-025-06813-5","url":null,"abstract":"<p><strong>Background: </strong>There are different types of fever after hemispherotomy; to our knowledge, this is the first time in literature in which baclofen was used to control central fever following hemispherotomy.</p><p><strong>Case presentation: </strong>A 12-year-old female patient who has a history of neonatal hemorrhagic stroke presented with uncontrolled seizures despite receiving three antiepileptic drugs. MRI brain showed marked volume reduction in the left cerebral hemisphere. She underwent a left modified hemispherotomy. Two weeks after surgery, she developed a fever with evidence of infection for which she underwent surgical debridement, the fever subsided gradually and she was discharged after 2 weeks. Then 1 week later, she presented again with a fever and the T-max was 39 °C. After the exclusion of infection and aseptic meningitis, there was a possibility of central fever for which we started baclofen at 5 mg once per day and gradually increased the dose till she reached 20 mg per day at which the fever vanished. The patient remained seizure-free and afebrile for 10 months after surgery.</p><p><strong>Conclusions: </strong>Postoperative fever is very common after hemispherectomy or functional hemispherotomy, and the non-infectious etiology is the most encountered. Central fever is a diagnosis of exclusion and its diagnosis leads to avoiding the misuse of antibiotics. We found baclofen safely and successively controlled central fever after hemispherotomy.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"167"},"PeriodicalIF":1.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978535","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 pediatric case of upward migration of distal shunt catheter followed by outward migration of ventricular catheter.","authors":"Keisuke Murofushi, Satoshi Tsutsumi, Natsuki Sugiyama, Hideaki Ueno, Hidehiro Okura, Hisato Ishii","doi":"10.1007/s00381-025-06794-5","DOIUrl":"https://doi.org/10.1007/s00381-025-06794-5","url":null,"abstract":"<p><strong>Introduction: </strong>Catheter migration and coiling are rare complications of ventriculoperitoneal shunt (VPS).</p><p><strong>Case report: </strong>A 4-month-old girl presented with poor feeding and vomiting. At presentation, the patient showed sunset phenomenon and tense fontanelles. Magnetic resonance imaging revealed tetraventricular dilation.</p><p><strong>Results: </strong>The patient underwent right VPS and was discharged on postoperative day (POD) 8. She visited hospital 33 days later, with considerable swelling in the right frontoparietal region. Radiography revealed upward VPS catheter migration and coiling. The patient underwent shunt revision and was discharged on POD 8. However, 12 days later, she returned to hospital with frequent vomiting. Neuroimaging revealed an outward migration of the ventricular catheter. The patient underwent shunt revision again, which was complicated by meningitis. After resolution of it, a left VPS was installed.</p><p><strong>Conclusions: </strong>VPS catheters installed in loose pediatric connective tissues are influenced by many factors that may cause an unexpected catheter migration.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"165"},"PeriodicalIF":1.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977107","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":"Use of orthotic helmets in children with positional plagiocephaly and brachycephaly: a systematic review.","authors":"Amauri Dalla Corte, Marcelo Anchieta Rohde","doi":"10.1007/s00381-025-06826-0","DOIUrl":"10.1007/s00381-025-06826-0","url":null,"abstract":"<p><strong>Purpose: </strong>This review aims to evaluate the scientific evidence on the efficacy and safety of cranial orthotic therapy (helmet therapy) in children under 12 months with moderate to severe posicional plagiocephaly and brachycephaly.</p><p><strong>Methods: </strong>A systematic review was performed in PubMed, EMBASE, and Cochrane databases. Additional searches were conducted in regulatory agency repositories for relevant notifications.</p><p><strong>Results: </strong>A total of 19 studies were included in the review, assessing various treatment modalities for PP. Repositioning therapy demonstrated effectiveness in reducing cranial asymmetry for mild to moderate cases, but several studies (class I and II evidence) indicated that it was less effective than both physical therapy and helmet use. Physical therapy, particularly manual therapy combined with caregiver counseling, showed superior outcomes for non-synostotic cranial asymmetry. Helmet therapy was consistently recommended for infants with moderate to severe deformities, with better outcomes when initiated during early infancy.</p><p><strong>Conclusion: </strong>Helmet therapy is safe and effective for specific cases, especially moderate to severe PP or brachycephaly, with improved results when started early. However, available studies have methodological limitations, and the decision to use helmet therapy should be individualized, considering the severity of the deformity, patient age, and response to other treatments.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"163"},"PeriodicalIF":1.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986525","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":"Prospective review of 30-day morbidity and mortality following surgery for brain tumours in children.","authors":"E Campbell, L Todd, A Amato-Watkins, R O'Kane, M Sangra, M Canty","doi":"10.1007/s00381-025-06817-1","DOIUrl":"https://doi.org/10.1007/s00381-025-06817-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to record the 30-day and inpatient morbidity and mortality in paediatric patients undergoing neurosurgery for brain tumours in a tertiary neurosciences centre over a 10-year period. The intention was to establish the frequency of significant adverse events and review the current published rates of morbidity in this patient group.</p><p><strong>Methods: </strong>All deaths and adverse events occurring within our department are prospectively recorded. Each adverse event was categorised, allocated a clinical impact severity score, and linked to a neurosurgical procedure wherever possible. Where a patient suffered several adverse events in the same admission, each event was recorded separately. If a patient had been discharged home, an adverse event was recorded if it occurred within 30 days of admission.</p><p><strong>Results: </strong>A total of 285 procedures were performed in 209 patients (aged < 16 years). Eighty-five significant adverse events were identified. Four clinical indicators are the following: Significant adverse event rate: 78 (27.4%) operations were linked to at least one significant adverse event. Unscheduled return to theatre rate: 33 (11.6%) operations were associated with an adverse event that resulted in an unscheduled return to theatre. Surgical site infection rate: Eight (2.8%) operations were associated with an infection. Post-procedure hydrocephalus treatment rate: 37 (13.0%) operations were followed by a further surgical procedure to treat hydrocephalus.</p><p><strong>Conclusion: </strong>Complications and adverse events occur frequently following neurosurgery for intracranial tumours in children. Prospective, continuous surveillance will promote improvement in the neurosurgical care delivered to this patient group.</p>","PeriodicalId":9970,"journal":{"name":"Child's Nervous System","volume":"41 1","pages":"162"},"PeriodicalIF":1.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986517","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}