Pub Date : 2023-01-01DOI: 10.32604/chd.2023.026262
Henry P Foote, Huali Wu, Stephen J Balevic, Elizabeth J Thompson, Kevin D Hill, Eric M Graham, Christoph P Hornik, Karan R Kumar
Background: Infants undergoing cardiac surgery with cardiopulmonary bypass (CPB) frequently receive intraoperative methylprednisolone (MP) to suppress CPB-related inflammation; however, the optimal dosing strategy and efficacy of MP remain unclear.
Methods: We retrospectively analyzed all infants under 90 days-old who received intra-operative MP for cardiac surgery with CPB from 2014-2017 at our institution. We combined real-world dosing data from the electronic health record (EHR) and two previously developed population pharmacokinetic/pharmacodynamic models to simulate peak concentration (Cmax) and area under the concentration-time curve for 24 h (AUC24) for MP and the inflammatory cytokines interleukin-6 (IL-6) and interleukin-10 (IL-10). We evaluated the relationships between post-operative, safety, and other clinical outcomes obtained from the EHR with each predicted exposure using non-parametric tests.
Results: A total of 142 infants with median post-natal age 8 (interquartile range [IQR]: 5, 37) days received a total dose of 30 (19, 49) mg/kg of MP. Twelve (8%) died, 37 (26%) met the composite post-operative outcome, 114 (80%) met the composite safety outcome, and 23 (16%) had a major complication. Predicted median Cmax and AUC24 IL-6 exposure was significantly higher for infants meeting the composite post-operative outcome and those with major complications. Predicted median Cmax and AUC24 MP exposure was significantly higher for infants requiring insulin. No exposure was associated with death or other safety outcomes.
Conclusions: Pro-inflammatory IL-6, but not MP exposure, was associated with post-operative organ dysfunction, suggesting current MP dosing may not adequately suppress IL-6 or increase IL-10 to impact clinical outcomes. Prospective study will be required to define the optimal exposure-efficacy and exposure-safety profiles in these infants.
{"title":"Using Pharmacokinetic Modeling and Electronic Health Record Data to Predict Clinical and Safety Outcomes after Methylprednisolone Exposure during Cardiopulmonary Bypass in Neonates.","authors":"Henry P Foote, Huali Wu, Stephen J Balevic, Elizabeth J Thompson, Kevin D Hill, Eric M Graham, Christoph P Hornik, Karan R Kumar","doi":"10.32604/chd.2023.026262","DOIUrl":"https://doi.org/10.32604/chd.2023.026262","url":null,"abstract":"<p><strong>Background: </strong>Infants undergoing cardiac surgery with cardiopulmonary bypass (CPB) frequently receive intraoperative methylprednisolone (MP) to suppress CPB-related inflammation; however, the optimal dosing strategy and efficacy of MP remain unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed all infants under 90 days-old who received intra-operative MP for cardiac surgery with CPB from 2014-2017 at our institution. We combined real-world dosing data from the electronic health record (EHR) and two previously developed population pharmacokinetic/pharmacodynamic models to simulate peak concentration (Cmax) and area under the concentration-time curve for 24 h (AUC24) for MP and the inflammatory cytokines interleukin-6 (IL-6) and interleukin-10 (IL-10). We evaluated the relationships between post-operative, safety, and other clinical outcomes obtained from the EHR with each predicted exposure using non-parametric tests.</p><p><strong>Results: </strong>A total of 142 infants with median post-natal age 8 (interquartile range [IQR]: 5, 37) days received a total dose of 30 (19, 49) mg/kg of MP. Twelve (8%) died, 37 (26%) met the composite post-operative outcome, 114 (80%) met the composite safety outcome, and 23 (16%) had a major complication. Predicted median Cmax and AUC24 IL-6 exposure was significantly higher for infants meeting the composite post-operative outcome and those with major complications. Predicted median Cmax and AUC24 MP exposure was significantly higher for infants requiring insulin. No exposure was associated with death or other safety outcomes.</p><p><strong>Conclusions: </strong>Pro-inflammatory IL-6, but not MP exposure, was associated with post-operative organ dysfunction, suggesting current MP dosing may not adequately suppress IL-6 or increase IL-10 to impact clinical outcomes. Prospective study will be required to define the optimal exposure-efficacy and exposure-safety profiles in these infants.</p>","PeriodicalId":10666,"journal":{"name":"Congenital Heart Disease","volume":"18 3","pages":"295-313"},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10361697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10239293","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}
Pub Date : 2023-01-01DOI: 10.32604/chd.2023.027758
Jae Gun Kwak, Eung Re Kim, Tae-Ke Yun, Sungkyu Cho, Chang-Ha Lee, W. Kim
Objectives: To access the effectiveness of our modi fi ed right-ventricular overhauling procedure on tricuspid valve (TV) growth in patients with pulmonary atresia with intact ventricular septum (PAIVS). Methods: We retrospectively reviewed 21 patients with PAIVS who underwent modi fi ed right ventricular overhauling (mRVoh) between 2008 and 2019 at two institutions. Our mRVoh consisted of wide resection of hypertrophied infundibular and trabecular muscle, peeling off fi brotic endocardial tissue in the right ventricle (RV) cavity, surgical pulmonary valvotomy, and Blalock-Taussig shunt or banding of ductus arteriosus under cardiopulmonary bypass. The TV annulus sizes were measured and analyzed using echocardiography before and after mRVoh. Results: No mortalities were observed during a median follow-up of 3 years (interquartile range: 1.3 – 4.7 years) of follow-up were noted. mRVoh was performed at a median age of 163.5 days (range: 21 – 560 days), including seven neonates and two infants (<60 days). During follow-up, the median TV annular z-score increased signi fi cantly from − 2.24 to − 1.15 before and after mRVoh ( p = 0.004). In ten patients with a prior history of percutaneous interventions for RV out fl ow tract (RVOT) widening at least 6 months before mRVoh, the TV annular z-score signi fi cantly changed during the period after mRVoh ( − 2.03 to − 1.61, p = 0.028) compared with the period before mRVoh ( − 2.51 → – 2.03, p = 0.575) after percutaneous intervention only. Conclusions: mRVoh in PAIVS patients was positively associated with TV annular growth, and it was more effective than percutaneous RVOT widening interventions without mRVoh.
{"title":"Role of Surgery on Growth of Tricuspid Valve in Pulmonary Atresia with Intact Ventricular Septum: Mid-Term Results of Modified Right-Ventricular Overhauling Procedure","authors":"Jae Gun Kwak, Eung Re Kim, Tae-Ke Yun, Sungkyu Cho, Chang-Ha Lee, W. Kim","doi":"10.32604/chd.2023.027758","DOIUrl":"https://doi.org/10.32604/chd.2023.027758","url":null,"abstract":"Objectives: To access the effectiveness of our modi fi ed right-ventricular overhauling procedure on tricuspid valve (TV) growth in patients with pulmonary atresia with intact ventricular septum (PAIVS). Methods: We retrospectively reviewed 21 patients with PAIVS who underwent modi fi ed right ventricular overhauling (mRVoh) between 2008 and 2019 at two institutions. Our mRVoh consisted of wide resection of hypertrophied infundibular and trabecular muscle, peeling off fi brotic endocardial tissue in the right ventricle (RV) cavity, surgical pulmonary valvotomy, and Blalock-Taussig shunt or banding of ductus arteriosus under cardiopulmonary bypass. The TV annulus sizes were measured and analyzed using echocardiography before and after mRVoh. Results: No mortalities were observed during a median follow-up of 3 years (interquartile range: 1.3 – 4.7 years) of follow-up were noted. mRVoh was performed at a median age of 163.5 days (range: 21 – 560 days), including seven neonates and two infants (<60 days). During follow-up, the median TV annular z-score increased signi fi cantly from − 2.24 to − 1.15 before and after mRVoh ( p = 0.004). In ten patients with a prior history of percutaneous interventions for RV out fl ow tract (RVOT) widening at least 6 months before mRVoh, the TV annular z-score signi fi cantly changed during the period after mRVoh ( − 2.03 to − 1.61, p = 0.028) compared with the period before mRVoh ( − 2.51 → – 2.03, p = 0.575) after percutaneous intervention only. Conclusions: mRVoh in PAIVS patients was positively associated with TV annular growth, and it was more effective than percutaneous RVOT widening interventions without mRVoh.","PeriodicalId":10666,"journal":{"name":"Congenital Heart Disease","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69720285","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}
Pub Date : 2023-01-01DOI: 10.32604/chd.2023.029634
I. Paetsch, R. Gebauer, C. Paech, F. Riede, S. Oebel, A. Bollmann, C. Stehning, J. Smink, I. Daehnert, C. Jahnke
{"title":"Optimized Three-Dimensional Cardiovascular Magnetic Resonance Whole Heart Imaging Utilizing Non-Selective Excitation and Compressed Sensing in Children and Adults with Congenital Heart Disease","authors":"I. Paetsch, R. Gebauer, C. Paech, F. Riede, S. Oebel, A. Bollmann, C. Stehning, J. Smink, I. Daehnert, C. Jahnke","doi":"10.32604/chd.2023.029634","DOIUrl":"https://doi.org/10.32604/chd.2023.029634","url":null,"abstract":"","PeriodicalId":10666,"journal":{"name":"Congenital Heart Disease","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69720631","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}
Pub Date : 2023-01-01DOI: 10.32604/chd.2022.021855
Jian-ming Wang, Qi-guang Wang, X. Sheng, J. Geng, J. Xiao, Xianyang Zhu
{"title":"Effectiveness and Safety of Transcatheter Closure of Various Ventricular Septal Defects Using Second-Generation Amplatzer Duct Occluders","authors":"Jian-ming Wang, Qi-guang Wang, X. Sheng, J. Geng, J. Xiao, Xianyang Zhu","doi":"10.32604/chd.2022.021855","DOIUrl":"https://doi.org/10.32604/chd.2022.021855","url":null,"abstract":"","PeriodicalId":10666,"journal":{"name":"Congenital Heart Disease","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69719718","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}
Pub Date : 2023-01-01DOI: 10.32604/chd.2023.026026
Laortip Rattanapittayaporn, M. Oofuvong, J. Tanasansuttiporn, T. Chanchayanon
{"title":"Preoperative Fasting of More Than 14 Hours Increases the Risk of Time-to-Death after Cardiothoracic Surgery in Children: A Retrospective Cohort Study","authors":"Laortip Rattanapittayaporn, M. Oofuvong, J. Tanasansuttiporn, T. Chanchayanon","doi":"10.32604/chd.2023.026026","DOIUrl":"https://doi.org/10.32604/chd.2023.026026","url":null,"abstract":"","PeriodicalId":10666,"journal":{"name":"Congenital Heart Disease","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69719917","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}
Pub Date : 2023-01-01DOI: 10.32604/chd.2023.023042
C. Somerville, Kelsey Kalbfleisch, R. Manshaei, Qiliang Ding, John B.A. Okello, R. Silver, D. Chitayat, V. Thakur, O. Villemain, R. Jobling
{"title":"Compound Heterozygous PLD1 Variants in Right-Sided Heart Malformations","authors":"C. Somerville, Kelsey Kalbfleisch, R. Manshaei, Qiliang Ding, John B.A. Okello, R. Silver, D. Chitayat, V. Thakur, O. Villemain, R. Jobling","doi":"10.32604/chd.2023.023042","DOIUrl":"https://doi.org/10.32604/chd.2023.023042","url":null,"abstract":"","PeriodicalId":10666,"journal":{"name":"Congenital Heart Disease","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69719946","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}
Background: Atrioventricular septal defects (AVSDs) are screened and diagnosed usually rely on the imaging characteristics of fetal echocardiography (FE). However, diagnosis on images is heavily depended on sonographers’ experience and the quantitative data are rarely studied. Objective: This study aimed to realize the prenatal diagnosis of AVSDs by analyzing the quantitative data on FE. Methods: One hundred and thirteen cardiac quantitative data was analyzed in 370 normal and 49 AVSDs fetuses retrospectively. The top six with the highest diagnostic accuracy rate were acquired according to the area under the curve (AUC), and the diagnostic value of six variables was analyzed. Results: Six parameters obtained on the four-chamber view (4CHV), including the atrial to ventricular length ratio in end-diastole (AVLR-ED), AVLR-ED combined with the atrial to ventricular length ratio in end-systole (AVLR-ES), quantile score (Q score) of AVLR-ED, Q score of AVLR-ES, Q score of ventricle length in end-diastole (VL-ED), and AVLR-ES, were the top six with the highest diagnostic value, and the AUC was 0.99 (95%CI 0.99–1.00), 0.99 (95%CI 0.99–1.00), 0.99 (95%CI 0.98–1.00), 0.95 (95%CI 0.91–0.99), 0.93 (95%CI 0.87–0.99), and 0.91 (95%CI 0.83–1.00), respectively. And within the 20% false positive rate, the diagnostic sensitivity was greater than 100%, 100%, 100%, 90%, 90%, and 88%, respectively. Conclusions: Six variables could be used for prenatal diagnosis of AVSDs. Among them, AVLR-ED and Q score of AVLR-ED, obtained on the 4CHV, were more convenient to acquire and had higher diagnostic accuracy.
{"title":"Quantitative Parameters Analysis for Prenatally Echocardiographic Diagnosis of Atrioventricular Septal Defects","authors":"Xiaoxue Zhou, Tingyang Yang, Yehui Zhang, Y. Ruan, Jiancheng Han, Xiaowei Liu, Ying Zhao, X. Gu, Tingting Liu, Hairui Wang, Yihua He","doi":"10.32604/chd.2023.029060","DOIUrl":"https://doi.org/10.32604/chd.2023.029060","url":null,"abstract":"Background: Atrioventricular septal defects (AVSDs) are screened and diagnosed usually rely on the imaging characteristics of fetal echocardiography (FE). However, diagnosis on images is heavily depended on sonographers’ experience and the quantitative data are rarely studied. Objective: This study aimed to realize the prenatal diagnosis of AVSDs by analyzing the quantitative data on FE. Methods: One hundred and thirteen cardiac quantitative data was analyzed in 370 normal and 49 AVSDs fetuses retrospectively. The top six with the highest diagnostic accuracy rate were acquired according to the area under the curve (AUC), and the diagnostic value of six variables was analyzed. Results: Six parameters obtained on the four-chamber view (4CHV), including the atrial to ventricular length ratio in end-diastole (AVLR-ED), AVLR-ED combined with the atrial to ventricular length ratio in end-systole (AVLR-ES), quantile score (Q score) of AVLR-ED, Q score of AVLR-ES, Q score of ventricle length in end-diastole (VL-ED), and AVLR-ES, were the top six with the highest diagnostic value, and the AUC was 0.99 (95%CI 0.99–1.00), 0.99 (95%CI 0.99–1.00), 0.99 (95%CI 0.98–1.00), 0.95 (95%CI 0.91–0.99), 0.93 (95%CI 0.87–0.99), and 0.91 (95%CI 0.83–1.00), respectively. And within the 20% false positive rate, the diagnostic sensitivity was greater than 100%, 100%, 100%, 90%, 90%, and 88%, respectively. Conclusions: Six variables could be used for prenatal diagnosis of AVSDs. Among them, AVLR-ED and Q score of AVLR-ED, obtained on the 4CHV, were more convenient to acquire and had higher diagnostic accuracy.","PeriodicalId":10666,"journal":{"name":"Congenital Heart Disease","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69720573","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}
Pub Date : 2023-01-01DOI: 10.32604/chd.2023.028827
S. Geyer, C. Dellas, Thomas Paul, Matthias M黮ler, K. Norozi
Objectives: To examine whether patients with congenital heart disease (CHD) are less likely to have a partner or children than individuals from the general population. Methods: Longitudinal study with two assessments of the same patients (n = 244) from a hospital population and controls (n = 238) from the German Socio-Economic Panel (GSOEP) using parental education, patients age, and sex as matching criteria. The fi rst patient study was conducted between 5/2003 and 6/2004, the second one between 5/2017 and 4/2019. Controls were drawn from GSOEP-surveys 2004 and 2018. CHD-severity was classi fi ed according to type of surgery: curative, reparative, or palliative. Living single was used as outcome measure, for offspring the outcome was having children or not. Results: Among women with CHD the rate of those living single was higher than among controls with the differences depending on disease complexity (curative: OR = 5.5; reparative: OR = 1.9; palliative: OR = 2.7). No statistically signi fi cant differences between patients and controls emerged in the male study population. With respect to children a marked difference emerged between women with CHD and controls. Among patients the odds of having children were lower than among controls (curative: OR = 0.3; reparative: OR = 0.3; palliative: OR = 0.2). The rate of patients with children with CHD (women: 5.6%; men: 4.9%) was higher than expected (1%) if compared with the general population. Conclusions: Using partnership and children as outcome criteria, patients with CHD are disadvantaged if compared to subjects from the general population. In female patients the social consequences of the disease turned out as more pervasive than in women.
{"title":"Having a Partner and Having Children: Comparisons of Adults with Congenital Heart Disease and the General Population: A 15-Year Case-Control Study","authors":"S. Geyer, C. Dellas, Thomas Paul, Matthias M黮ler, K. Norozi","doi":"10.32604/chd.2023.028827","DOIUrl":"https://doi.org/10.32604/chd.2023.028827","url":null,"abstract":"Objectives: To examine whether patients with congenital heart disease (CHD) are less likely to have a partner or children than individuals from the general population. Methods: Longitudinal study with two assessments of the same patients (n = 244) from a hospital population and controls (n = 238) from the German Socio-Economic Panel (GSOEP) using parental education, patients age, and sex as matching criteria. The fi rst patient study was conducted between 5/2003 and 6/2004, the second one between 5/2017 and 4/2019. Controls were drawn from GSOEP-surveys 2004 and 2018. CHD-severity was classi fi ed according to type of surgery: curative, reparative, or palliative. Living single was used as outcome measure, for offspring the outcome was having children or not. Results: Among women with CHD the rate of those living single was higher than among controls with the differences depending on disease complexity (curative: OR = 5.5; reparative: OR = 1.9; palliative: OR = 2.7). No statistically signi fi cant differences between patients and controls emerged in the male study population. With respect to children a marked difference emerged between women with CHD and controls. Among patients the odds of having children were lower than among controls (curative: OR = 0.3; reparative: OR = 0.3; palliative: OR = 0.2). The rate of patients with children with CHD (women: 5.6%; men: 4.9%) was higher than expected (1%) if compared with the general population. Conclusions: Using partnership and children as outcome criteria, patients with CHD are disadvantaged if compared to subjects from the general population. In female patients the social consequences of the disease turned out as more pervasive than in women.","PeriodicalId":10666,"journal":{"name":"Congenital Heart Disease","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69720324","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}
Pub Date : 2023-01-01DOI: 10.32604/chd.2023.026533
Ivana B. Cerović, Vladislav A. Vukomanović, Jovan Lj. Košutić, Mila S. Stajević, Sanja S. Ninić, Saša S. Popović, Ivan D. Dizdarević, Staša D. Krasić, Sergej M. Prijić
{"title":"Transcatheter Ventricular Septal Defect Closure with Nit-Occlud Lê VSD Device—Five Years’ Experience and Literature Review","authors":"Ivana B. Cerović, Vladislav A. Vukomanović, Jovan Lj. Košutić, Mila S. Stajević, Sanja S. Ninić, Saša S. Popović, Ivan D. Dizdarević, Staša D. Krasić, Sergej M. Prijić","doi":"10.32604/chd.2023.026533","DOIUrl":"https://doi.org/10.32604/chd.2023.026533","url":null,"abstract":"","PeriodicalId":10666,"journal":{"name":"Congenital Heart Disease","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69720117","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}
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