European journal of obstetrics, gynecology, and reproductive biology最新文献

{"title":"Efficacy and safety of different doses of mifepristone in the treatment of uterine fibroids: A meta-analysis","authors":"Xiaoxiao Yin,&nbsp;Liuqing He,&nbsp;Haofei Xu,&nbsp;Shunping Lou,&nbsp;Ying Tan,&nbsp;Yunqing Wang,&nbsp;Xinyu Luo,&nbsp;Yefang Huang","doi":"10.1016/j.ejogrb.2024.10.059","DOIUrl":"10.1016/j.ejogrb.2024.10.059","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically assess the safety and effectiveness of mifepristone at doses of 2.5 mg, 5 mg, 10 mg, 25 mg, and 50 mg in the treatment of uterine fibroids.</div></div><div><h3>Methods</h3><div>The protocol is registered with INPLASY (registration number is INPLASY202460075). Computer retrieval PubMed, the Cochrane Library, Embase database related (mifepristone group) compared to placebo and mifepristone or conventional treatment (control group) in the treatment of uterine fibroids randomized controlled trial (RCT), retrieve the time limit for a Library to in October 2023, Refer to the Cochrane faced the quality evaluation of the literature of included in the 6.0 and uses the RevMan 5.4.1 software Meta-analysis and sensitivity analysis.</div></div><div><h3>Results</h3><div>There were 18 studies with a total of 2066 patients as participants. A <em>meta</em>-analysis found that the patients in the mifepristone group had lower uterine volume or uterine fibroid volume than the control group, with a statistically significant difference. Mifepristone treatment for 3 months uterine volume smaller is better than 6 months the difference is statistically significant. Compared with the control group, mifepristone can improve pelvic pain, pelvic pressure, bladder pressure, urinary symptoms, lower back pain, dyspareunia, rectal pain, menorrhagia, hypermenorrhea, and other clinical symptoms. The Mifepristone group had hot flashes, endometrium thickness increases, the incidence of hepatic transaminases associated is significantly higher than the control group, the patients in the 10 mg/d mifepristone group had endometrial thickness that was greater than those in the 5 mg/d mifepristone group.</div></div><div><h3>Conclusions</h3><div>Mifepristone reduces fibroid volume and improves clinical symptoms, and 5 mg/day of mifepristone for three months may be the optimal clinical regimen.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"303 ","pages":"Pages 302-309"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603265","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":"Smoking during pregnancy in an Irish obstetric Population: Prevalence, maternal and ethnic factors","authors":"Julia C. Morrison,&nbsp;Mark A. Dempsey,&nbsp;Clare Greaney,&nbsp;John J. Morrison","doi":"10.1016/j.ejogrb.2024.10.057","DOIUrl":"10.1016/j.ejogrb.2024.10.057","url":null,"abstract":"<div><h3>Objectives</h3><div>Maternal cigarette smoking during pregnancy is associated with adverse health outcomes for the mother and her fetus in utero. A high prevalence of smoking during pregnancy is reported within an Irish obstetric population. However, there are no recent Irish data regarding change in smoking rates over time, or factors associated with declining smoking prevalence. Therefore, the objectives of this study were: 1. To investigate smoking patterns in pregnancy among an Irish obstetric population, 2. To identify trends over time, and 3. To evaluate associated demographic factors.</div></div><div><h3>Study Design</h3><div>The data for this study were obtained from EuroKing, a computerised obstetric database, to which data had been entered prospectively during the 8-year period between January 2015 and December 2022 at Galway University Hospital, Ireland. A total of 22,673 deliveries were recorded during this time period. Complete information regarding the mother’s smoking history was available for 19,247 women at the time of antenatal booking, and again at delivery. Statistical analyses was performed using GraphPad Prism (version 10.1.2). Chi-square test for proportions and trend were used to assess differences between groups.</div></div><div><h3>Results</h3><div>Rates of smoking during pregnancy declined over the duration of the study. The percentage of mothers who smoked during pregnancy declined from 8.3 % in 2015 to 6.0 % in 2022 (P = 0.007). The greatest reduction in smoking was observed among those aged 21 to 30 years, from 15.3 % in 2015 to 10.1 % in 2022 (P &lt; 0.001). There was no significant decline in smoking within the other age groups. There was an overall reduction in the rate of smoking from the time of antenatal booking to delivery of 31.9 %. Increasing maternal age was associated with lower rates of smoking (P &lt; 0.001). Increasing parity was associated with higher rates of smoking (P &lt; 0.001). Smoking rates were highest in the White Irish Traveller ethnic group, at 40.3 % across the 8-year study period. Breastfeeding rates were lower in smokers versus non-smokers (P &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>This study indicates that the rate of maternal smoking during pregnancy in Ireland is approximately 6%, which is less than previously reported. A significant proportion of women who smoked at the time of antenatal booking have ceased smoking by the time of delivery. Overall there was a decline in maternal smoking over the duration of the study. However, high rates of smoking were associated with certain sociodemographic characteristics, including younger maternal age, increasing parity and White Irish Traveller background.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"303 ","pages":"Pages 317-321"},"PeriodicalIF":2.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of low-dose aspirin for the prevention of hypertensive disorders of pregnancy in a sub-Saharan Africa Country: A randomized clinical trial","authors":"P.Z. Mkhize ,&nbsp;V. Dorsamy ,&nbsp;O.P. Khaliq ,&nbsp;C. Bagwandeen ,&nbsp;J. Moodley","doi":"10.1016/j.ejogrb.2024.10.052","DOIUrl":"10.1016/j.ejogrb.2024.10.052","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate whether a daily dose of low-dose aspirin (LDA) can prevent hypertensive disorders of pregnancy (HDP), including preeclampsia, among pregnant women in a South African cohort, and to assess its impact on related maternal and fetal outcomes, such as preterm birth and neonatal complications.</div></div><div><h3>Study design</h3><div>This single-center, open-label, parallel-group randomized controlled trial (RCT) was conducted at a regional hospital in Durban, KwaZulu-Natal, South Africa, from May 2021 to March 2024. A total of 423 pregnant women, aged 18 years or older with singleton pregnancies between 12 and 20 weeks of gestation, were randomized to receive either 162 mg of LDA daily or standard care. The primary outcome was the incidence of HDP, while secondary outcomes included early-onset preeclampsia (EOPE), preterm birth, low birth weight (LBW), and neonatal death. Data analysis used relative risk (RR) and 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Of the 423 women, 209 were in the LDA group and 214 in the control group. The incidence of HDP was significantly lower in the LDA group (6.2 % vs. 25.2 %; RR = 0.25, 95 % CI [0.14–0.44], p &lt; 0.001), corresponding to a 75 % reduction in HDP risk, with an absolute risk reduction (ARR) of 19 % and a number needed to treat (NNT) of 5.3. EOPE was reduced (2.4 % vs. 14.0 %; RR = 0.17, 95 % CI [0.07–0.41], p &lt; 0.001), as was preterm birth (6.7 % vs. 26.2 %; RR = 0.26, 95 % CI [0.15–0.45], p &lt; 0.001). There were no significant differences for LBW or neonatal death. Sensitivity analysis confirmed the importance of initiating LDA before 16 weeks, showing continued reductions in HDP incidence with early initiation.</div></div><div><h3>Conclusion</h3><div>LDA significantly reduces the risk of HDP, EOPE, and preterm birth, particularly when initiated before 16 weeks of gestation. These findings support the use of LDA for preventing hypertensive disorders of pregnancy in low-resource settings and underscore the value of early intervention for improved maternal and fetal outcomes.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"303 ","pages":"Pages 259-265"},"PeriodicalIF":2.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593496","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":"Errors in the use of the FAERS database to assess the safety of Yasmin.","authors":"Mitchell D Creinin, Jonathan Douxfils, Charlotte Beaudart, Jean-Michel Foidart","doi":"10.1016/j.ejogrb.2024.10.053","DOIUrl":"https://doi.org/10.1016/j.ejogrb.2024.10.053","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575367","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":"Easy standardised technique for laparoscopic para-aortic lymph node dissection: Using fascia as a natural retractor.","authors":"Kenro Chikazawa, Shigenori Hayashi, Ken Imai, Natsuki Osawa, Tomoyuki Kuwata, Ryo Konno","doi":"10.1016/j.ejogrb.2024.10.054","DOIUrl":"https://doi.org/10.1016/j.ejogrb.2024.10.054","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617528","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":"Impact of vaginism on mode of delivery and obstetrical outcomes","authors":"Richard Paul-Dehlinger,&nbsp;Konstantinos Chatzistergiou,&nbsp;Jean-Baptiste Chanier,&nbsp;Gregory Bierry,&nbsp;Bruno Renevier,&nbsp;Simon Crequit","doi":"10.1016/j.ejogrb.2024.10.056","DOIUrl":"10.1016/j.ejogrb.2024.10.056","url":null,"abstract":"<div><h3>Introduction</h3><div>According to ICD 10, vaginism is defined as the presence of spasm of the pelvic floor muscles surrounding the vagina, causing occlusion of the vaginal opening. Intromission is impossible or painful. Vaginism, whose prevalence is estimated at 1%, is often diagnosed during pregnancy follow-up, when clinical examination is difficult or impossible. However, few studies report obstetrical complications and pregnancy outcomes associated with this pathology.</div></div><div><h3>Objective</h3><div>Evaluate the impact of vaginism on mode of delivery and obstetrical complications.</div></div><div><h3>Materials and methods</h3><div>Comparative, monocentric, retrospective study at the Montreuil maternity hospital between January 2019 and January 2024 that included all singleton deliveries in cephalic presentation at term. Vaginism was defined as an involuntary contraction of the pelvic muscles that made clinical examination during pregnancy impossible. Mode of delivery (caesarean section during labour, operative delivery, spontaneous vaginal delivery) and obstetric complications (episiotomy, OASIS, complex tear, Postpartum haemorrhage (PPH) due to tear) were compared between patients with vaginism and a control group, in univariate analysis and multivariate logistic regression with adjustment for maternal age, BMI, maternal origin, gestational age, high obstetrical and medical risk level, diabetes with or without insulin use, pregnancy complications, Robson group and birthweight. A propensity score adjustment with matching 1 case to 3 controls was conducted.</div></div><div><h3>Results</h3><div>During the study period, 13,469 patients were included, among which 440 patients had vaginism. In univariate analysis, patients with vaginism had a higher rate of caesarean section (16,8% versus 9,4%, p &lt; 0.001), operative delivery (29,3% versus 13,3%, p &lt; 0.001), episiotomy (12,5% versus 5.3 %, p &lt; 0.001), OASIS (3.4 % versus 1.0 %, p &lt; 0.001), complex tear (17,5% versus 7,7%) and PPH due to tear (2,5% versus 1,1%, p = 0,009).</div><div>After adjustment, vaginism appeared to be an independant risk factor for cesarean section with a psaOR of 1.38 [1.02–1.85], operative delivery psaOR 2.39 [1.83–3,10], OASIS psaOR 2,19 [1.10–4,27], and complex tear psaOR 1,39 [1,02–1,87]</div></div><div><h3>Conclusion</h3><div>Vaginism appears to be an independent risk factor for cesarean section, operative delivery, OASIS, and complex tear. Further studies should evaluate the impact of early and appropriate follow-up during pregnancy on adverse obstetrical outcomes.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"303 ","pages":"Pages 288-293"},"PeriodicalIF":2.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603256","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":"Breaking barriers: Analysing the professional landscape for female gynaecological surgeons in Italy","authors":"Elisabetta Manzoni ,&nbsp;Chiara Dell’Utri ,&nbsp;Daunia Verdi ,&nbsp;Sara Parini ,&nbsp;Daniela Lucidi ,&nbsp;Gaya Spolverato","doi":"10.1016/j.ejogrb.2024.10.039","DOIUrl":"10.1016/j.ejogrb.2024.10.039","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the status of female gynaecological surgeons in Italy in terms of discriminatory practices and the availability of opportunities for improvement within the operating theatre.</div></div><div><h3>Methods</h3><div>This study is a subanalysis of a comprehensive 83-item questionnaire, administered to 3242 female surgeons across various specialties from 1 November to 31 December 2020. This study focuses specifically on 219 female gynaecological surgeons in order to explore their unique experiences and challenges in surgical practice.</div></div><div><h3>Main outcome measures</h3><div>Data concerning subjective satisfaction of respondents were collected. Satisfaction was evaluated using a five-point Likert scale. Data are presented using mean, median or frequency.</div></div><div><h3>Results</h3><div>This subanalysis included 207 respondents. Among the respondents, 47 % reported that they had children, while 31 % had decided not to have children for professional reasons. Nearly half of the respondents (42 %) were trainees. Despite a considerable workload (mean working week of 45 h), 96 % of the respondents reported spending less than half of their working time in the operating theatre. They performed a median of two operations per week, compared with five operations for their male counterparts. Despite challenges, 65 % expressed a commitment to their career path.</div></div><div><h3>Conclusions</h3><div>Efforts to address gender bias, promote work–life balance, and enhance female leadership representation are essential. These findings emphasize the need for systemic changes to create a supportive environment for female gynaecologists. Further research with broader sampling is warranted to fully understand and address these challenges.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"303 ","pages":"Pages 282-287"},"PeriodicalIF":2.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603261","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":"Response to errors in the use of the FAERS database to assess the safety of Yasmin.","authors":"Wenting Xu, Lili Zhu, Jiahui Wang, Lingli Shi, Xiuqin Tang, Qingli Chen, Lihong Wang","doi":"10.1016/j.ejogrb.2024.10.051","DOIUrl":"https://doi.org/10.1016/j.ejogrb.2024.10.051","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617538","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":"Long-term effectiveness of surgical removal of Essure® implants: A retrospective cohort study","authors":"Sébastien Insubri ,&nbsp;Laure Bernard ,&nbsp;Chrystèle Rubod ,&nbsp;Michel Cosson ,&nbsp;Marine Lallemant ,&nbsp;Géraldine Giraudet","doi":"10.1016/j.ejogrb.2024.10.047","DOIUrl":"10.1016/j.ejogrb.2024.10.047","url":null,"abstract":"<div><h3>Study objective</h3><div>To assess symptom resolution and patient satisfaction following surgical explantation of Essure implants in the short and long term.</div></div><div><h3>Design</h3><div>Retrospective monocentric cohort study (Lille Regional University Hospital, France).</div></div><div><h3>Setting</h3><div>Essure is an implantable medical device for definitive sterilisation. Available from 2002, the Essure device has no longer been marketed since 2017. Following numerous reported side effects, the number of requests to withdraw Essure has steadily increased in recent years.</div></div><div><h3>Patients</h3><div>All women who underwent Essure removal between December 2016 and January 2020 to assess the benefits of surgery on these symptoms and patient satisfaction at 6 weeks and 6 months after the procedure.</div></div><div><h3>Interventions</h3><div>Removal of Essure implant with 4 types of surgery.</div></div><div><h3>Measurements</h3><div>The benefits of the surgery were assessed using data from the postoperative consultation 6 to 8 weeks after surgery and then from a telephone call 6 months after surgery.</div></div><div><h3>Main results</h3><div>86 patients were explanted during the study period. Surgery proved beneficial, with a complete reduction in symptoms at 6 months in 74 % of these patients. Many symptoms were relieved by surgery, with complete resolution of symptoms in 62 % of cases for muscle pain, in 69 % of cases for asthenia, in 82 % of cases for abdominal pain and 100 % of cases for menorrhagia. Patient satisfaction was high, with 97.3 % of patients willing to repeat the procedure and 95.95 % recommending it to a friend.</div></div><div><h3>Conclusion</h3><div>Removal of Essure implants in symptomatic patients appears to reduce all symptoms and improve quality of life in short and long term. Nevertheless, there are many symptoms associated with the insertion of Essure implants, and although surgery appears beneficial with good patient compliance, some adverse effects persist. It is therefore important to carry out a pre-operative etiological assessment and provide information on the risk of surgical failure.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"303 ","pages":"Pages 212-217"},"PeriodicalIF":2.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567855","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":"Adherence to recommended prenatal visit schedules and risk for stillbirth, according to probable cause of death","authors":"Tess E.K. Cersonsky ,&nbsp;Nina K. Ayala ,&nbsp;Nailah S. Tucker ,&nbsp;George R. Saade ,&nbsp;Donald J. Dudley ,&nbsp;Halit Pinar ,&nbsp;Robert M. Silver ,&nbsp;Uma M. Reddy ,&nbsp;Adam K. Lewkowitz","doi":"10.1016/j.ejogrb.2024.10.037","DOIUrl":"10.1016/j.ejogrb.2024.10.037","url":null,"abstract":"<div><h3>Objective</h3><div>Suboptimal prenatal care is linked to increased risk of stillbirth, but this association is not well-understood. The study objective was to evaluate the relationship between prenatal visit adherence and cause of death in stillbirths.</div></div><div><h3>Study Design</h3><div>This is a secondary analysis from the Stillbirth Collaborative Research Network of data with complete cause of death evaluation. Appropriateness of prenatal visit frequency was determined per American College of Obstetricians and Gynecologists/American Academy of Pediatrics (ACOG/AAP) recommendations and the novel Michigan Plan for Appropriately Tailored Healthcare in Pregnancy (MiPATH) guidelines. Multivariate regression controlled for differences between groups.</div></div><div><h3>Results</h3><div>Among 451 stillbirths included, 63.6% and 55.9% were non-adherent to ACOG/AAP and MiPATH recommendations, respectively. Non-adherent parturients according to the Michigan plan were more likely to have a stillbirth due to hypertensive disorders of pregnancy.</div></div><div><h3>Conclusion</h3><div>Non-adherence to prenatal visit guidelines is associated with higher risk of stillbirth due to hypertensive disorders of pregnancy.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"303 ","pages":"Pages 159-164"},"PeriodicalIF":2.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564139","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}