Pub Date : 2025-11-01DOI: 10.1053/S1055-8586(25)00104-0
{"title":"fm i -- Contents","authors":"","doi":"10.1053/S1055-8586(25)00104-0","DOIUrl":"10.1053/S1055-8586(25)00104-0","url":null,"abstract":"","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"38 ","pages":"Article 151572"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475548","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}
Pub Date : 2025-10-01DOI: 10.1016/j.sempedsurg.2025.151543
Eugenie Lehembre-Shiah , Carolyn D Brookhart , Briony K Varda , Christina Ho , Andrea Badillo , Marc A Levitt , Allison C Mayhew
{"title":"Vaginal considerations in anorectal malformations: Current opinions","authors":"Eugenie Lehembre-Shiah , Carolyn D Brookhart , Briony K Varda , Christina Ho , Andrea Badillo , Marc A Levitt , Allison C Mayhew","doi":"10.1016/j.sempedsurg.2025.151543","DOIUrl":"10.1016/j.sempedsurg.2025.151543","url":null,"abstract":"","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"37 ","pages":"Article 151543"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151719","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}
Pub Date : 2025-10-01DOI: 10.1016/j.sempedsurg.2025.151546
Nili Amir, Kate McCracken
Ovarian torsion in the pediatric population is rare, however, delays in diagnosis and treatment can result in long term consequences including ischemia and necrosis of the affected ovary and/or fallopian tube. Clinical presentation is often vague and can be variable, thus a high index of suspicion is required for diagnosis. Pelvic ultrasound with color doppler can aid in diagnosis, however, a normal result does not exclude torsion and thus diagnosis is suspected based on patient history and clinical symptoms. Detorsion with ovarian conservation is the gold standard for both definitive diagnosis and treatment, even when the ovary appears necrotic. Following detorsion, long-term follow up demonstrates high rate of ovarian recovery and function highlighting the importance of ovarian preservation. Early recognition and prompt intervention are essential to optimize outcomes and preserve fertility in pediatric patients with ovarian torsion.
{"title":"Pediatric ovarian torsion","authors":"Nili Amir, Kate McCracken","doi":"10.1016/j.sempedsurg.2025.151546","DOIUrl":"10.1016/j.sempedsurg.2025.151546","url":null,"abstract":"<div><div>Ovarian torsion in the pediatric population is rare, however, delays in diagnosis and treatment can result in long term consequences including ischemia and necrosis of the affected ovary and/or fallopian tube. Clinical presentation is often vague and can be variable, thus a high index of suspicion is required for diagnosis. Pelvic ultrasound with color doppler can aid in diagnosis, however, a normal result does not exclude torsion and thus diagnosis is suspected based on patient history and clinical symptoms. Detorsion with ovarian conservation is the gold standard for both definitive diagnosis and treatment, even when the ovary appears necrotic. Following detorsion, long-term follow up demonstrates high rate of ovarian recovery and function highlighting the importance of ovarian preservation. Early recognition and prompt intervention are essential to optimize outcomes and preserve fertility in pediatric patients with ovarian torsion.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"37 ","pages":"Article 151546"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186475","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}
Pub Date : 2025-10-01DOI: 10.1016/j.sempedsurg.2025.151545
Courtney J. Harris , Erin E. Rowell , Kristine S. Corkum
With the decreasing mortality of pediatric cancer, issues of survivorship should be addressed at the beginning of therapy. It is known that some treatment protocols cause loss of fertility and hormone production and thus counseling should occur before treatment begins. Currently this is a top unmet need despite its recommendation from several pediatric oncologic and reproductive societies. All patients should be counseled on their risk of infertility related to gonadotoxic therapy and understand whether they are a candidate for a fertility preservation procedure. Both prepubertal and postpubertal girls can undergo ovarian tissue cryopreservation via unilateral oophorectomy, however only postpubertal patients can have ovarian hormone stimulation with egg retrieval. Autotransplantation of cryopreserved ovarian tissue is utilized when fertility or hormone function needs to be restored, while eggs can be thawed for future in-vitro fertilization. This review focuses on female fertility and hormone preservation counseling, options and surgical pearls, current state of research and fertility preservation outcomes, through a case-based format.
{"title":"Special considerations in pediatric female fertility preservation","authors":"Courtney J. Harris , Erin E. Rowell , Kristine S. Corkum","doi":"10.1016/j.sempedsurg.2025.151545","DOIUrl":"10.1016/j.sempedsurg.2025.151545","url":null,"abstract":"<div><div>With the decreasing mortality of pediatric cancer, issues of survivorship should be addressed at the beginning of therapy. It is known that some treatment protocols cause loss of fertility and hormone production and thus counseling should occur before treatment begins. Currently this is a top unmet need despite its recommendation from several pediatric oncologic and reproductive societies. All patients should be counseled on their risk of infertility related to gonadotoxic therapy and understand whether they are a candidate for a fertility preservation procedure. Both prepubertal and postpubertal girls can undergo ovarian tissue cryopreservation via unilateral oophorectomy, however only postpubertal patients can have ovarian hormone stimulation with egg retrieval. Autotransplantation of cryopreserved ovarian tissue is utilized when fertility or hormone function needs to be restored, while eggs can be thawed for future in-vitro fertilization. This review focuses on female fertility and hormone preservation counseling, options and surgical pearls, current state of research and fertility preservation outcomes, through a case-based format.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"37 ","pages":"Article 151545"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186808","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}
Pub Date : 2025-10-01DOI: 10.1016/j.sempedsurg.2025.151538
Jourdin Batchelor , Jessica Y. Shim
Pelvic pain is a common concern among adolescent females, with gynecologic etiologies ranging from dysmenorrhea, most often due to endometriosis, to obstructive anomalies and adnexal masses. Evaluation requires a detailed history, including menstrual and pain characteristics, functional impact, and relevant family history, as well as a focused physical exam tailored to the adolescent’s developmental stage and comfort. Pelvic ultrasonography is often the initial imaging modality, with additional imaging and laboratory testing as adjuncts. Endometriosis, the leading cause of secondary dysmenorrhea, frequently presents with debilitating pain and may require diagnostic laparoscopy if pain persists despite medical therapy. Given the variation in practice patterns and the involvement of multiple specialties, coordinated, evidence-based care is essential. This review outlines the evaluation and surgical management of gynecologic pelvic pain in the pediatric and adolescent population, with a focus on endometriosis.
{"title":"Evaluation and surgical approaches to gynecologic pelvic pain in pediatric patients","authors":"Jourdin Batchelor , Jessica Y. Shim","doi":"10.1016/j.sempedsurg.2025.151538","DOIUrl":"10.1016/j.sempedsurg.2025.151538","url":null,"abstract":"<div><div>Pelvic pain is a common concern among adolescent females, with gynecologic etiologies ranging from dysmenorrhea, most often due to endometriosis, to obstructive anomalies and adnexal masses. Evaluation requires a detailed history, including menstrual and pain characteristics, functional impact, and relevant family history, as well as a focused physical exam tailored to the adolescent’s developmental stage and comfort. Pelvic ultrasonography is often the initial imaging modality, with additional imaging and laboratory testing as adjuncts. Endometriosis, the leading cause of secondary dysmenorrhea, frequently presents with debilitating pain and may require diagnostic laparoscopy if pain persists despite medical therapy. Given the variation in practice patterns and the involvement of multiple specialties, coordinated, evidence-based care is essential. This review outlines the evaluation and surgical management of gynecologic pelvic pain in the pediatric and adolescent population, with a focus on endometriosis.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"37 ","pages":"Article 151538"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076413","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}
Pub Date : 2025-10-01DOI: 10.1016/j.sempedsurg.2025.151542
Kathryn Moton-Ospino , Seema Menon
Abnormal uterine bleeding is common during adolescence and can have significant impact on health and development. The causes are wide leading to diagnostic complexity. This review starts with definitions to help identify abnormal uterine bleeding patterns. A well-established classification system is presented that can be used to organize the evaluation. Underlying causes are discussed with a focus on specific bleeding patterns and appropriate treatment options.
{"title":"Abnormal uterine bleeding during adolescence","authors":"Kathryn Moton-Ospino , Seema Menon","doi":"10.1016/j.sempedsurg.2025.151542","DOIUrl":"10.1016/j.sempedsurg.2025.151542","url":null,"abstract":"<div><div>Abnormal uterine bleeding is common during adolescence and can have significant impact on health and development. The causes are wide leading to diagnostic complexity. This review starts with definitions to help identify abnormal uterine bleeding patterns. A well-established classification system is presented that can be used to organize the evaluation. Underlying causes are discussed with a focus on specific bleeding patterns and appropriate treatment options.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"37 ","pages":"Article 151542"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151713","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}
Pub Date : 2025-10-01DOI: 10.1016/j.sempedsurg.2025.151562
Alexa G. Turpin, Peter C. Minneci, Charles N. Paidas
Malignant ovarian tumors are exceedingly rare in children. The overwhelming majority of ovarian masses in the pediatric population are benign. Distinguishing benign from malignant ovarian pathology can be challenging. Avoidance of oophorectomy for benign ovarian disease and potential fertility sparing surgery for ovarian malignancy are crucial preoperative risk stratification steps for the healthcare team. The presentation of malignant ovarian tumors in girls is often non-specific, and may include abdominal pain and distention, palpable abdominal or pelvic mass, hirsutism or virilization. When evaluating young girls presenting with ovarian masses, it is important to consider their clinical characteristics, as ovarian masses in young, pre-pubescent girls are more likely to be malignant. Imaging should include abdominal-pelvic US, and axial imaging (CT or MRI). Serum tumor markers are essential elements of the work up includingCA-125, β-hCG, AFP, estradiol, testosterone, inhibin, LDH, and FSH. Germline mutations and cancer predisposition syndromes are associated with malignant ovarian tumors. Malignant ovarian masses are categorized into epithelial and non-epithelial subtypes. Epithelial tumors are the most common type of ovarian tumor in adult women. Non-epithelial tumors are most frequent in children. Non-epithelial tumors include the germ cell tumors (most frequent malignant tumor in children), and sex-cord stromal cord tumors. The Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) staging classification is used for staging epithelial tumors and sex-cord stromal tumors and the Children’s Oncology Group (COG) staging is used for staging of germ cell tumors. The goal of treatment for all malignant ovarian tumors is complete resection and adjuvant platinum-based chemotherapy may be necessary for advanced stages. In the pediatric population, fertility sparing surgery should always be included in preoperative decision-making and family counseling.
{"title":"An overview of malignant ovarian tumors in children","authors":"Alexa G. Turpin, Peter C. Minneci, Charles N. Paidas","doi":"10.1016/j.sempedsurg.2025.151562","DOIUrl":"10.1016/j.sempedsurg.2025.151562","url":null,"abstract":"<div><div>Malignant ovarian tumors are exceedingly rare in children. The overwhelming majority of ovarian masses in the pediatric population are benign. Distinguishing benign from malignant ovarian pathology can be challenging. Avoidance of oophorectomy for benign ovarian disease and potential fertility sparing surgery for ovarian malignancy are crucial preoperative risk stratification steps for the healthcare team. The presentation of malignant ovarian tumors in girls is often non-specific, and may include abdominal pain and distention, palpable abdominal or pelvic mass, hirsutism or virilization. When evaluating young girls presenting with ovarian masses, it is important to consider their clinical characteristics, as ovarian masses in young, pre-pubescent girls are more likely to be malignant. Imaging should include abdominal-pelvic US, and axial imaging (CT or MRI). Serum tumor markers are essential elements of the work up includingCA-125, <em>β</em>-hCG, AFP, estradiol, testosterone, inhibin, LDH, and FSH. Germline mutations and cancer predisposition syndromes are associated with malignant ovarian tumors. Malignant ovarian masses are categorized into epithelial and non-epithelial subtypes. Epithelial tumors are the most common type of ovarian tumor in adult women. Non-epithelial tumors are most frequent in children. Non-epithelial tumors include the germ cell tumors (most frequent malignant tumor in children), and sex-cord stromal cord tumors. The Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) staging classification is used for staging epithelial tumors and sex-cord stromal tumors and the Children’s Oncology Group (COG) staging is used for staging of germ cell tumors. The goal of treatment for all malignant ovarian tumors is complete resection and adjuvant platinum-based chemotherapy may be necessary for advanced stages. In the pediatric population, fertility sparing surgery should always be included in preoperative decision-making and family counseling.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"37 ","pages":"Article 151562"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309824","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}
Pub Date : 2025-10-01DOI: 10.1016/j.sempedsurg.2025.151544
Kristin Hare, Krista J Childress
Purpose of review
To provide a comprehensive resource for diagnosis and management of non-obstructive and obstructive Müllerian anomalies for pediatricians, pediatric surgeons, and gynecologists.
Findings
This summary provides a concise comprehensive overview of new nomenclature for identification of obstructive Müllerian anomalies, recommendations on how to differentiate utero-vaginal anomalies in physical examination and imaging, and key considerations for surgical reconstruction timing and surgical technique.
Summary
Detailed review of the clinical presentation, imaging, diagnosis and treatment of obstructive Müllerian anomalies and a brief review of non-obstructive Müllerian anomalies.
{"title":"Obstructive and non-obstructive müllerian anomalies","authors":"Kristin Hare, Krista J Childress","doi":"10.1016/j.sempedsurg.2025.151544","DOIUrl":"10.1016/j.sempedsurg.2025.151544","url":null,"abstract":"<div><h3>Purpose of review</h3><div>To provide a comprehensive resource for diagnosis and management of non-obstructive and obstructive Müllerian anomalies for pediatricians, pediatric surgeons, and gynecologists.</div></div><div><h3>Findings</h3><div>This summary provides a concise comprehensive overview of new nomenclature for identification of obstructive Müllerian anomalies, recommendations on how to differentiate utero-vaginal anomalies in physical examination and imaging, and key considerations for surgical reconstruction timing and surgical technique.</div></div><div><h3>Summary</h3><div>Detailed review of the clinical presentation, imaging, diagnosis and treatment of obstructive Müllerian anomalies and a brief review of non-obstructive Müllerian anomalies.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"37 ","pages":"Article 151544"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187388","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}
Pub Date : 2025-10-01DOI: 10.1016/j.sempedsurg.2025.151540
Aliyah Hauser , Isabelle Levin , Beth I. Schwartz
The fallopian tube develops from the paramesonephric (Mullerian duct) and connects the uterus to the ovary. There are many mild tubal anomalies. While many tubal pathologies are benign and asymptomatic, some may have significant clinical implications if left unidentified or inadequately treated. Clinicians should maintain a broad differential diagnosis when evaluating pediatric and adolescent patients with vague abdominopelvic symptoms. A thorough history and abdominal examination should be performed and may help delineate adnexal etiologies of pain or discomfort. In sexually active adolescents, testing for common sexually transmitted infections such as C. trachomatis and N. gonorrhoeae is recommended, though clinicians should be mindful that a negative infectious workup does not exclude the possibility of an inflammatory fallopian tube pathology. Imaging modalities, such as transabdominal ultrasound and MRI, can be valuable for assessing tubal abnormalities and guiding surgical planning, particularly in premenarchal or never sexually active patients for whom transvaginal ultrasound may be inappropriate. When surgical intervention is indicated, laparoscopy can often provide a safe and effective means of definitive diagnosis and treatment.
{"title":"The fallopian tube and its pathology: Paratubal cysts, tubal torsion, and pelvic inflammatory disease","authors":"Aliyah Hauser , Isabelle Levin , Beth I. Schwartz","doi":"10.1016/j.sempedsurg.2025.151540","DOIUrl":"10.1016/j.sempedsurg.2025.151540","url":null,"abstract":"<div><div>The fallopian tube develops from the paramesonephric (Mullerian duct) and connects the uterus to the ovary. There are many mild tubal anomalies. While many tubal pathologies are benign and asymptomatic, some may have significant clinical implications if left unidentified or inadequately treated. Clinicians should maintain a broad differential diagnosis when evaluating pediatric and adolescent patients with vague abdominopelvic symptoms. A thorough history and abdominal examination should be performed and may help delineate adnexal etiologies of pain or discomfort. In sexually active adolescents, testing for common sexually transmitted infections such as <em>C. trachomatis and N. gonorrhoeae</em> is recommended, though clinicians should be mindful that a negative infectious workup does not exclude the possibility of an inflammatory fallopian tube pathology. Imaging modalities, such as transabdominal ultrasound and MRI, can be valuable for assessing tubal abnormalities and guiding surgical planning, particularly in premenarchal or never sexually active patients for whom transvaginal ultrasound may be inappropriate. When surgical intervention is indicated, laparoscopy can often provide a safe and effective means of definitive diagnosis and treatment.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"37 ","pages":"Article 151540"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092818","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}
Pub Date : 2025-10-01DOI: 10.1016/j.sempedsurg.2025.151541
Melissa A. Parks
Adnexal lesions including ovarian, paraovarian, paratubal, and benign or malignant tumors are the most common reason for gynecologic surgery during childhood. Adnexal lesions can occur at any age and may be secondary to hormonal influences. Presentation of a benign or malignant adnexal lesion is non-specific but is usually asymptomatic and progression slow making early diagnosis challenging. Developing a comprehensive differential diagnosis involves obtaining a thorough history and physical exam and often requires the use of imaging and consideration of a panel of tumor markers. In most cases, management includes observation or ovarian sparing surgery optimizing pubertal development and future fertility. Oophorectomy for benign adnexal lesions is rarely indicated.
{"title":"Adnexal cysts and benign masses in the pediatric and adolescent population: A review","authors":"Melissa A. Parks","doi":"10.1016/j.sempedsurg.2025.151541","DOIUrl":"10.1016/j.sempedsurg.2025.151541","url":null,"abstract":"<div><div>Adnexal lesions including ovarian, paraovarian, paratubal, and benign or malignant tumors are the most common reason for gynecologic surgery during childhood. Adnexal lesions can occur at any age and may be secondary to hormonal influences. Presentation of a benign or malignant adnexal lesion is non-specific but is usually asymptomatic and progression slow making early diagnosis challenging. Developing a comprehensive differential diagnosis involves obtaining a thorough history and physical exam and often requires the use of imaging and consideration of a panel of tumor markers. In most cases, management includes observation or ovarian sparing surgery optimizing pubertal development and future fertility. Oophorectomy for benign adnexal lesions is rarely indicated.</div></div>","PeriodicalId":49543,"journal":{"name":"Seminars in Pediatric Surgery","volume":"37 ","pages":"Article 151541"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103109","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}
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