Pub Date : 2024-10-01DOI: 10.1016/j.hansur.2024.101772
Vincent Martinel , Benjamin Ferembach , Karim Anani , Floris Van Rooij , Bethany Grew , Thomas Apard
A 48-year-old right-handed male surgeon complained of finger numbness, pain, cramps and weakness of 2 years’ progression, without improvement after 2 carpal tunnel corticosteroid injections and splinting. The patient was diagnosed with lacertus syndrome with Hagert’s triad. Sensory collapse test was positive, but the sensations during the test were not consistent with the literature. Therefore, a sensory collapse test was performed in combination with electromyography; immediately following cutaneous stimulation, partial transient collapse in muscle tone was observed, without complete interruption. Following surgical release of the ipsilateral median nerve at the lacertus fibrosus, the symptoms were resolved, and combined sensory collapse test and electromyography revealed minimal to no collapse in muscle tone following cutaneous stimulation.
{"title":"Muscle activity analysis using electromyography during sensory collapse test: An experimental case report","authors":"Vincent Martinel , Benjamin Ferembach , Karim Anani , Floris Van Rooij , Bethany Grew , Thomas Apard","doi":"10.1016/j.hansur.2024.101772","DOIUrl":"10.1016/j.hansur.2024.101772","url":null,"abstract":"<div><div>A 48-year-old right-handed male surgeon complained of finger numbness, pain, cramps and weakness of 2 years’ progression, without improvement after 2 carpal tunnel corticosteroid injections and splinting. The patient was diagnosed with lacertus syndrome with Hagert’s triad. Sensory collapse test was positive, but the sensations during the test were not consistent with the literature. Therefore, a sensory collapse test was performed in combination with electromyography; immediately following cutaneous stimulation, partial transient collapse in muscle tone was observed, without complete interruption. Following surgical release of the ipsilateral median nerve at the lacertus fibrosus, the symptoms were resolved, and combined sensory collapse test and electromyography revealed minimal to no collapse in muscle tone following cutaneous stimulation.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 5","pages":"Article 101772"},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304686","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 : 2024-10-01DOI: 10.1016/j.hansur.2024.101774
Lucas Audiffret, Marie Witters, Alice Mayoly, Najib Kachouh, Sébastien Viaud-Ambrosino, Emilie Bougie, Régis Legré, Charlotte Jaloux
Objectives
Several prospective blinded studies have found poorer sensitivity for the sensory collapse test than reported by Susan E Mackinnon’s team. However, the blinded examiner had no knowledge of the patient's clinical presentation, or even of the purpose of the test. In these conditions, it seems difficult to perform the sensory collapse test correctly. The aim of the present study was to evaluate the efficacy of the sensory collapse test in the diagnosis of nerve compression in the upper extremity, using a trained, “partially” blinded examiner, with a minimum of clinical information in order to avoid bias due to poor execution of the test, while still unable to influence the test result.
Methods
Seventy-two patients with diagnosis of nerve entrapment in the upper extremity were included prospectively. The sensory collapse test was performed by two examiners, one of whom was blinded to laterality and to the site of nerve compression, aware only of the affected nerve. Using electrodiagnosis study as reference, the sensitivity and specificity of the sensory collapse test were calculated for each examiner.
Results
The unblinded examiner showed 72% sensitivity and 57% specificity, and the blinded 68% sensitivity and 57% specificity.
Conclusions
The sensory collapse test is useful for diagnosis of nerve entrapment in the upper limb, even with a blinded examiner.
{"title":"Sensitivity and specificity of the sensory collapse test for nerve entrapment syndrome in the upper extremity","authors":"Lucas Audiffret, Marie Witters, Alice Mayoly, Najib Kachouh, Sébastien Viaud-Ambrosino, Emilie Bougie, Régis Legré, Charlotte Jaloux","doi":"10.1016/j.hansur.2024.101774","DOIUrl":"10.1016/j.hansur.2024.101774","url":null,"abstract":"<div><h3>Objectives</h3><div>Several prospective blinded studies have found poorer sensitivity for the sensory collapse test than reported by Susan E Mackinnon’s team. However, the blinded examiner had no knowledge of the patient's clinical presentation, or even of the purpose of the test. In these conditions, it seems difficult to perform the sensory collapse test correctly. The aim of the present study was to evaluate the efficacy of the sensory collapse test in the diagnosis of nerve compression in the upper extremity, using a trained, “partially” blinded examiner, with a minimum of clinical information in order to avoid bias due to poor execution of the test, while still unable to influence the test result.</div></div><div><h3>Methods</h3><div>Seventy-two patients with diagnosis of nerve entrapment in the upper extremity were included prospectively. The sensory collapse test was performed by two examiners, one of whom was blinded to laterality and to the site of nerve compression, aware only of the affected nerve. Using electrodiagnosis study as reference, the sensitivity and specificity of the sensory collapse test were calculated for each examiner.</div></div><div><h3>Results</h3><div>The unblinded examiner showed 72% sensitivity and 57% specificity, and the blinded 68% sensitivity and 57% specificity.</div></div><div><h3>Conclusions</h3><div>The sensory collapse test is useful for diagnosis of nerve entrapment in the upper limb, even with a blinded examiner.</div></div><div><h3>Level of evidence</h3><div>3.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 5","pages":"Article 101774"},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304689","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 : 2024-10-01DOI: 10.1016/j.hansur.2024.101778
Hugo Zimmermann , Cyril Quemeneur , Thibaut Goetsch , Frédéric Le Saché , Sébastien Bloc
WALANT (Wide Awake Local Anesthesia No Tourniquet) has been widely implemented in hand surgery. We conducted a systematic review from 1979 to 2022, led by a team of anesthesiologist. Only randomized studies comparing WALANT to other types of regional anesthesia were included. The outcomes studied were pain, duration of the procedure, intraoperative bleeding, complications, and patient satisfaction. Twelve articles were included in the analysis. We found a reduction of 2.77 on the VAS (95% CI −3.79; −1.75, I² 93%) for intraoperative pain in the WALANT group. There was no significant difference (MD 0.79, 95% CI 95% −0.11; 1.69, I² 73%) for duration of surgery. Patient satisfaction was consistently high in the WALANT group. Intraoperative bleeding was minimal and not clinically relevant. Compared to other types of regional anesthesia in hand surgery, the WALANT technique decreases pain for the patients without increasing the length of surgery.
WALANT（宽醒局部麻醉无止血带）已在手外科手术中广泛实施。我们在麻醉师团队的领导下，对 1979 年至 2022 年期间的研究进行了系统性回顾。只纳入了将 WALANT 与其他类型区域麻醉进行比较的随机研究。研究结果包括疼痛、手术持续时间、术中出血、并发症和患者满意度。分析共纳入了 12 篇文章。我们发现 WALANT 组术中疼痛的 VAS 值降低了 2.77（95% CI -3.79；-1.75，I² 93%）。手术持续时间无明显差异（MD 0.79，95% CI 95% -0.11；1.69，I² 73%）。WALANT 组患者的满意度一直很高。术中出血量极少，与临床无关。与其他类型的手部手术区域麻醉相比，WALANT技术在不增加手术时间的情况下减轻了患者的疼痛。
{"title":"Wide-Awake Local Anesthesia No Tourniquet in hand surgery: A systematic review and meta-analysis","authors":"Hugo Zimmermann , Cyril Quemeneur , Thibaut Goetsch , Frédéric Le Saché , Sébastien Bloc","doi":"10.1016/j.hansur.2024.101778","DOIUrl":"10.1016/j.hansur.2024.101778","url":null,"abstract":"<div><div>WALANT (Wide Awake Local Anesthesia No Tourniquet) has been widely implemented in hand surgery. We conducted a systematic review from 1979 to 2022, led by a team of anesthesiologist. Only randomized studies comparing WALANT to other types of regional anesthesia were included. The outcomes studied were pain, duration of the procedure, intraoperative bleeding, complications, and patient satisfaction. Twelve articles were included in the analysis. We found a reduction of 2.77 on the VAS (95% CI −3.79; −1.75, I² 93%) for intraoperative pain in the WALANT group. There was no significant difference (MD 0.79, 95% CI 95% −0.11; 1.69, I² 73%) for duration of surgery. Patient satisfaction was consistently high in the WALANT group. Intraoperative bleeding was minimal and not clinically relevant. Compared to other types of regional anesthesia in hand surgery, the WALANT technique decreases pain for the patients without increasing the length of surgery.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 5","pages":"Article 101778"},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335119","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 : 2024-10-01DOI: 10.1016/j.hansur.2024.101771
Pauline Gonzalez-Espino , Gero Meyer zu Reckendorf
{"title":"An unusual case of trigger finger","authors":"Pauline Gonzalez-Espino , Gero Meyer zu Reckendorf","doi":"10.1016/j.hansur.2024.101771","DOIUrl":"10.1016/j.hansur.2024.101771","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 5","pages":"Article 101771"},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304685","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 : 2024-10-01DOI: 10.1016/j.hansur.2024.101784
Giovanni Fabrizzio Pedrotti, Alfonso Soria Galvarro Vargas, Jefferson Braga Silva
With an aging population and the increasing prevalence of arthritic pathologies of the hand and wrist, denervation is one therapeutic option for hand surgeons. In case of pain but preserved motion, denervation is a treatment of choice. We conducted a systematic review of the literature, searching the MEDLINE, LILACS, SciELO and PubMed databases for cohorts reported in the last 20 years on denervation of the wrist and trapeziometacarpal, metacarpophalangeal and interphalangeal joints with a focus on postoperative outcomes, selecting 25 articles. The 1187 patients were divided into 3 groups: wrist denervation (999 patients), trapeziometacarpal denervation (124 patients), and metacarpophalangeal and interphalangeal denervation (64 patients). Improvements were found for pain (55.73%, 86%, 85%, respectively), range of motion (11.8%, 4°, 17°) and satisfaction (80.67%, 87.5%, 81.8%). Grip strength increased in wrist and trapeziometacarpal denervation (31.04% and 23%). The results suggest that denervation can be an alternative to arthroplasty or arthrodesis for painful wrist and hand joints, without precluding subsequent procedures if necessary.
{"title":"Denervation of the hand and wrist: A systematic review","authors":"Giovanni Fabrizzio Pedrotti, Alfonso Soria Galvarro Vargas, Jefferson Braga Silva","doi":"10.1016/j.hansur.2024.101784","DOIUrl":"10.1016/j.hansur.2024.101784","url":null,"abstract":"<div><div>With an aging population and the increasing prevalence of arthritic pathologies of the hand and wrist, denervation is one therapeutic option for hand surgeons. In case of pain but preserved motion, denervation is a treatment of choice. We conducted a systematic review of the literature, searching the MEDLINE, LILACS, SciELO and PubMed databases for cohorts reported in the last 20 years on denervation of the wrist and trapeziometacarpal, metacarpophalangeal and interphalangeal joints with a focus on postoperative outcomes, selecting 25 articles. The 1187 patients were divided into 3 groups: wrist denervation (999 patients), trapeziometacarpal denervation (124 patients), and metacarpophalangeal and interphalangeal denervation (64 patients). Improvements were found for pain (55.73%, 86%, 85%, respectively), range of motion (11.8%, 4°, 17°) and satisfaction (80.67%, 87.5%, 81.8%). Grip strength increased in wrist and trapeziometacarpal denervation (31.04% and 23%). The results suggest that denervation can be an alternative to arthroplasty or arthrodesis for painful wrist and hand joints, without precluding subsequent procedures if necessary.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 5","pages":"Article 101784"},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142368023","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 : 2024-10-01DOI: 10.1016/j.hansur.2024.101764
Jean Paul Brutus , Bianieff Tchiloemba , Anna Galstyan , Tom Lattré , Aviva Wolff , Alison Taylor
This paper explores transformative strategies in hand therapy aimed at improving the patient experience - a critical factor linked to improved clinical outcomes and increased satisfaction for patients and therapists. The focus is on three key areas: personalized interactions, empathic communication, and sensory engagement. Personalized interactions ensure therapy is uniquely tailored to each patient’ needs, fostering a sense of individual attention and care. Empathic communication involves understanding and responding effectively to patients’ verbal and nonverbal cues, creating a supportive environment where patients feel genuinely heard. Sensory engagement utilizes the therapeutic environment’s visual, olfactory, and auditory elements to create a calming, welcoming space conducive to healing and relaxation. Integrating these strategies aims to increase treatment effectiveness and improve therapist well-being by promoting a fulfilling and less stressful work environment. Through a comprehensive review of existing evidence, current practices and innovative approaches, this paper advocates for a holistic, patient-centered model of hand therapy that significantly improves treatment outcomes and enhances the overall therapeutic experience, ensuring it is both practical and compassionate.
{"title":"Elevating patient experience: Transformative strategies in hand therapy","authors":"Jean Paul Brutus , Bianieff Tchiloemba , Anna Galstyan , Tom Lattré , Aviva Wolff , Alison Taylor","doi":"10.1016/j.hansur.2024.101764","DOIUrl":"10.1016/j.hansur.2024.101764","url":null,"abstract":"<div><div>This paper explores transformative strategies in hand therapy aimed at improving the patient experience - a critical factor linked to improved clinical outcomes and increased satisfaction for patients and therapists. The focus is on three key areas: personalized interactions, empathic communication, and sensory engagement. Personalized interactions ensure therapy is uniquely tailored to each patient’ needs, fostering a sense of individual attention and care. Empathic communication involves understanding and responding effectively to patients’ verbal and nonverbal cues, creating a supportive environment where patients feel genuinely heard. Sensory engagement utilizes the therapeutic environment’s visual, olfactory, and auditory elements to create a calming, welcoming space conducive to healing and relaxation. Integrating these strategies aims to increase treatment effectiveness and improve therapist well-being by promoting a fulfilling and less stressful work environment. Through a comprehensive review of existing evidence, current practices and innovative approaches, this paper advocates for a holistic, patient-centered model of hand therapy that significantly improves treatment outcomes and enhances the overall therapeutic experience, ensuring it is both practical and compassionate.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 5","pages":"Article 101764"},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147185","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 : 2024-10-01DOI: 10.1016/j.hansur.2024.101756
Nora Huber, Tobias Götschi, Andreas Schweizer, Lisa Reissner
Scapholunate ligament lesion is the most common ligament lesion in the wrist. We assessed the reliability of sonography in detecting it during Watson test. Twenty patients with scapholunate ligament lesion confirmed on MRI and intraoperatively were assessed preoperatively between July 2020 and April 2023. Sonography was performed on the scaphoid dorsal subluxation in wrist neutral and during Watson test and compared with the healthy contralateral side. Dorsal subluxation was measured by two independent investigators and intra- and inter-observer reliability were assessed. We found a significant difference between dorsal subluxation of the scaphoid in the healthy (0.89 mm, SD 0.67 mm) compared to the pathological side (1.67 mm, SD 0.95 mm). Reliability was very good and the standard error of measurement was less than 0.4 mm for all measurements. Sonography during Watson test demonstrated high reliability in diagnosing scapholunate lesions.
{"title":"Catch the shift: Ultrasound diagnosis of scapholunate lesion during Watson test","authors":"Nora Huber, Tobias Götschi, Andreas Schweizer, Lisa Reissner","doi":"10.1016/j.hansur.2024.101756","DOIUrl":"10.1016/j.hansur.2024.101756","url":null,"abstract":"<div><div>Scapholunate ligament lesion is the most common ligament lesion in the wrist. We assessed the reliability of sonography in detecting it during Watson test. Twenty patients with scapholunate ligament lesion confirmed on MRI and intraoperatively were assessed preoperatively between July 2020 and April 2023. Sonography was performed on the scaphoid dorsal subluxation in wrist neutral and during Watson test and compared with the healthy contralateral side. Dorsal subluxation was measured by two independent investigators and intra- and inter-observer reliability were assessed. We found a significant difference between dorsal subluxation of the scaphoid in the healthy (0.89 mm, SD 0.67 mm) compared to the pathological side (1.67 mm, SD 0.95 mm). Reliability was very good and the standard error of measurement was less than 0.4 mm for all measurements. Sonography during Watson test demonstrated high reliability in diagnosing scapholunate lesions.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 5","pages":"Article 101756"},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891367","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 : 2024-10-01DOI: 10.1016/j.hansur.2024.101752
Hanna Jazottes , Michel Chammas , Cyril Lazerges , Bertrand Coulet , Jonathan Charbit , Pierre-Emmanuel Chammas
Introduction
The widespread pre-hospital use of tourniquets, particularly in the upper limb, raises questions about associated morbidity, which has been little studied and may have serious consequences for functional prognosis.
Methods
A review of 9 patients was carried out, analyzing pre-hospital tourniquet use in terms of complications affecting recovery.
Results
There were serious complications: musculocutaneous nerve palsy in 1 patient, and compartment syndrome, rhabdomyolysis and ischemia-reperfusion syndrome in another. A role of prolonged pre-hospital tourniquet application in postoperative infection was also suspected in 2 patients.
Discussion
The risk-benefit ratio and indications for using a tourniquet on the upper limb in the pre-hospital setting need to be reconsidered.
{"title":"Morbidity associated with pre-hospital upper-limb tourniquet in civilian trauma: a case series","authors":"Hanna Jazottes , Michel Chammas , Cyril Lazerges , Bertrand Coulet , Jonathan Charbit , Pierre-Emmanuel Chammas","doi":"10.1016/j.hansur.2024.101752","DOIUrl":"10.1016/j.hansur.2024.101752","url":null,"abstract":"<div><h3>Introduction</h3><div>The widespread pre-hospital use of tourniquets, particularly in the upper limb, raises questions about associated morbidity, which has been little studied and may have serious consequences for functional prognosis.</div></div><div><h3>Methods</h3><div>A review of 9 patients was carried out, analyzing pre-hospital tourniquet use in terms of complications affecting recovery.</div></div><div><h3>Results</h3><div>There were serious complications: musculocutaneous nerve palsy in 1 patient, and compartment syndrome, rhabdomyolysis and ischemia-reperfusion syndrome in another. A role of prolonged pre-hospital tourniquet application in postoperative infection was also suspected in 2 patients.</div></div><div><h3>Discussion</h3><div>The risk-benefit ratio and indications for using a tourniquet on the upper limb in the pre-hospital setting need to be reconsidered.</div></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 5","pages":"Article 101752"},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141636244","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 : 2024-10-01DOI: 10.1016/j.hansur.2024.101781
A. Patrignani , A. Pagnotta , C. Amendola , E. Bruno , F. Lo Torto , D. Ribuffo
{"title":"Hand reconstruction in Huriez syndrome: The “therapeutic” role of distant flaps","authors":"A. Patrignani , A. Pagnotta , C. Amendola , E. Bruno , F. Lo Torto , D. Ribuffo","doi":"10.1016/j.hansur.2024.101781","DOIUrl":"10.1016/j.hansur.2024.101781","url":null,"abstract":"","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 5","pages":"Article 101781"},"PeriodicalIF":0.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335115","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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