{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:25:30Z","timestamp":1793319930297,"version":"4.5.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T00:00:00Z","timestamp":1620172800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T00:00:00Z","timestamp":1620172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Capital\u2019s Funds for Health Improvement and Research","award":["2020-2-4085"],"award-info":[{"award-number":["2020-2-4085"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Surg Onc"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Treatments for metastatic fracture of the humeral shaft continue to evolve as advances are made in both oncological and operative management. The purposes of this study were to critically evaluate the effectiveness of intercalary endoprostheses in treating metastatic humeral shaft fractures and to clarify the surgical indications for this technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixty-three patients treated surgically for 66 metastatic fractures of the humerus shaft were retrospectively reviewed. Intramedullary nailing (IMN)\u00a0was performed in 16 lesions, plate fixation (PF)\u00a0in 33 lesions, and prosthetic replacement\u00a0in 17 lesions. The operative time, intraoperative blood loss, and postoperative complications were noted. The function of the upper extremities was assessed by the Musculoskeletal Tumor Society (MSTS) score and American Shoulder and Elbow Surgeons (ASES) score. All included patients were followed until reconstructive failure or death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The operative time was relatively shorter in the prosthesis group than in either the IMN group (<jats:italic>p<\/jats:italic>= 0.169) or PF group (<jats:italic>p<\/jats:italic>= 0.002). Notably, intraoperative blood loss was significantly less in the prosthesis group than in either the IMN group (<jats:italic>p<\/jats:italic>= 0.03) or PF group (<jats:italic>p<\/jats:italic>= 0.012). The average follow-up time was 20.3 (range, 3\u201375) months, and the overall survival rate was 59.7% at 12 months and 46.7% at 24 months. One rotator cuff injury, 3 cases of iatrogenic radial nerve palsy, 5 cases of local tumor progression, and 1 mechanical failure occurred in the osteosynthesis group, whereas one case of aseptic loosening of the distal stem and one case of local relapse were observed in the prosthesis group. There were no significant differences in functional scores among the three groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intercalary prosthetic replacement of the humeral shaft may be a reliable solution for pathologic fractures patients; it is indicated for lesions with substantial bone loss, or accompanied soft tissue mass, or for those patients with better prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12957-021-02250-1","type":"journal-article","created":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T14:03:30Z","timestamp":1620223410000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Intercalary prosthetic replacement is a reliable solution for metastatic humeral shaft fractures: retrospective, observational study of a single center series"],"prefix":"10.1186","volume":"19","author":[{"given":"Zhiqing","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhipeng","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3982-1052","authenticated-orcid":false,"given":"Taiqiang","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodong","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongli","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,5]]},"reference":[{"key":"2250_CR1","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1097\/01.blo.0000093052.96273.a7","volume":"415","author":"FJ Frassica","year":"2003","unstructured":"Frassica FJ, Frassica DA. Evaluation and treatment of metastases to the humerus. Clin Orthopaedics Related Res. 2003;415:212\u20138.","journal-title":"Clin Orthopaedics Related Res"},{"key":"2250_CR2","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1097\/00003086-199901000-00016","volume":"358","author":"R Wedin","year":"1999","unstructured":"Wedin R, Bauer H. P: Failures after operation for skeletal metastatic lesions of long bones. Clin Orthopaedics Related Res. 1999;358:128\u201339.","journal-title":"Clin Orthopaedics Related Res"},{"issue":"3","key":"2250_CR3","first-page":"469","volume":"20","author":"ET Habermann","year":"1989","unstructured":"Habermann ET, Lopez RA. Metastatic disease of bone and treatment of pathological fractures. Orthop Clin North Am. 1989;20(3):469\u201386.","journal-title":"Orthop Clin North Am"},{"key":"2250_CR4","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1097\/00003086-198309000-00041","volume":"178","author":"BJ Gainor","year":"1983","unstructured":"Gainor BJ, Buchert P. Fracture healing in metastatic bone disease. Clin Orthop Relat Res. 1983;178:297\u2013302.","journal-title":"Clin Orthop Relat Res"},{"issue":"3","key":"2250_CR5","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1002\/1097-0142(197203)29:3<684::AID-CNCR2820290322>3.0.CO;2-K","volume":"29","author":"CA Perez","year":"1972","unstructured":"Perez CA, Bradfield JS, Morgan HC. Management of pathologic fractures. Cancer. 1972;29(3):684\u201393. https:\/\/doi.org\/10.1002\/1097-0142(197203)29:3<684::AID-CNCR2820290322>3.0.CO;2-K.","journal-title":"Cancer"},{"issue":"8","key":"2250_CR6","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.2106\/00004623-197658080-00001","volume":"58","author":"KD Harrington","year":"1976","unstructured":"Harrington KD, Sim FH, Enis JE, Johnston JO, Diok HM, Gristina AG. Methylmethacrylate as an adjunct in internal fixation of pathological fractures. Experience with three hundred and seventy-five cases. J Bone Joint Surg Am. 1976;58(8):1047\u201355. https:\/\/doi.org\/10.2106\/00004623-197658080-00001.","journal-title":"J Bone Joint Surg Am"},{"issue":"5","key":"2250_CR7","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1302\/0301-620X.98B5.35312","volume":"98-B","author":"YI Kim","year":"2016","unstructured":"Kim YI, Kang HG, Kim JH, Kim SK, Lin PP, Kim HS. Closed intramedullary nailing with percutaneous cement augmentation for long bone metastases. Bone Joint J. 2016;98-B(5):703\u20139. https:\/\/doi.org\/10.1302\/0301-620X.98B5.35312.","journal-title":"Bone Joint J"},{"issue":"2","key":"2250_CR8","first-page":"171","volume":"77","author":"A McGrath","year":"2011","unstructured":"McGrath A, Sewell MD, Hanna SA, Pollock RC, Skinner JA, Cannon SR, et al. Custom endoprosthetic reconstruction for malignant bone disease in the humeral diaphysis. Acta Orthop Belg. 2011;77(2):171\u20139.","journal-title":"Acta Orthop Belg"},{"issue":"3","key":"2250_CR9","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1007\/s00264-008-0540-0","volume":"33","author":"O Ofluoglu","year":"2009","unstructured":"Ofluoglu O, Erol B, Ozgen Z, Yildiz M. Minimally invasive treatment of pathological fractures of the humeral shaft. Int Orthop. 2009;33(3):707\u201312. https:\/\/doi.org\/10.1007\/s00264-008-0540-0.","journal-title":"Int Orthop"},{"issue":"6","key":"2250_CR10","doi-asserted-by":"crossref","first-page":"365","DOI":"10.55095\/achot2014\/050","volume":"81","author":"P Schwabe","year":"2014","unstructured":"Schwabe P, ., Ruppert M, ., Tsitsilonis S, ., Melcher I, K-D Schaser, S M\u00e4rdian. Surgical management and outcome of skeletal metastatic disease of the humerus. Acta Chir Orthop Traumatol Cech 2014, 81:365-370, 6.","journal-title":"Acta Chir Orthop Traumatol Cech"},{"key":"2250_CR11","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1302\/0301-620X.78B4.0780652","volume":"78","author":"A Abudu","year":"1996","unstructured":"Abudu A, Carter SR, Grimer RJ. The outcome and functional results of diaphyseal endoprostheses after tumour excision. J Bone Joint Surg Br. 1996;78:652\u20137.","journal-title":"J Bone Joint Surg Br"},{"key":"2250_CR12","doi-asserted-by":"publisher","first-page":"S9","DOI":"10.1016\/j.injury.2013.10.044","volume":"45","author":"A Baltov","year":"2014","unstructured":"Baltov A, Mihail R, Dian E. Complications after interlocking intramedullary nailing of humeral shaft fractures. Injury-Int J Care Injured. 2014;45:S9\u2013S15. https:\/\/doi.org\/10.1016\/j.injury.2013.10.044.","journal-title":"Injury-Int J Care Injured"},{"key":"2250_CR13","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1007\/s11999-015-4588-z","volume":"474","author":"J Benevenia","year":"2016","unstructured":"Benevenia J, Kirchner R, Patterson F, Beebe K, Wirtz DC, Rivero S, et al. Outcomes of a modular intercalary endoprosthesis as treatment for segmental defects of the femur, tibia, and humerus. Clin Orthopaedics Related Res. 2016;474:539\u201348.","journal-title":"Clin Orthopaedics Related Res"},{"issue":"4","key":"2250_CR14","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1016\/j.otsr.2018.03.009","volume":"104","author":"R Casadei","year":"2018","unstructured":"Casadei R, Drago G, Di Pressa F, Donati D. Humeral metastasis of renal cancer: Surgical options and review of literature. Orthop Traumatol Surg Res. 2018;104(4):533\u20138. https:\/\/doi.org\/10.1016\/j.otsr.2018.03.009.","journal-title":"Orthop Traumatol Surg Res"},{"issue":"6","key":"2250_CR15","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1016\/S0748-7983(96)92450-6","volume":"22","author":"S Dijkstra","year":"1996","unstructured":"Dijkstra S, Stapert J, Boxma H, Wiggers T. Treatment of pathological fractures of the humeral shaft due to bone metastases: a comparison of intramedullary locking nail and plate osteosynthesis with adjunctive bone cement. Eur J Surg Oncol. 1996;22(6):621\u20136. https:\/\/doi.org\/10.1016\/S0748-7983(96)92450-6.","journal-title":"Eur J Surg Oncol"},{"issue":"7","key":"2250_CR16","doi-asserted-by":"publisher","first-page":"423","DOI":"10.5435\/JAAOS-20-07-423","volume":"20","author":"EA Carroll","year":"2012","unstructured":"Carroll EA, Schweppe M, Langfitt M, Miller AN, Halvorson JJ. Management of humeral shaft fractures. J Am Acad Orthop Surg. 2012;20(7):423\u201333. https:\/\/doi.org\/10.5435\/JAAOS-20-07-423.","journal-title":"J Am Acad Orthop Surg"},{"issue":"12","key":"2250_CR17","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1016\/j.ejso.2007.11.010","volume":"34","author":"B Fuchs","year":"2008","unstructured":"Fuchs B, Ossendorf C, Leerapun T, Sim FH. Intercalary segmental reconstruction after bone tumor resection. Eur J Surg Oncol. 2008;34(12):1271\u20136. https:\/\/doi.org\/10.1016\/j.ejso.2007.11.010.","journal-title":"Eur J Surg Oncol"},{"issue":"6","key":"2250_CR18","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1007\/s00590-017-1985-x","volume":"27","author":"GN Panagopoulos","year":"2017","unstructured":"Panagopoulos GN, Mavrogenis AF, Mauffrey C, Lesensk\u00fd J, Angelini A, Megaloikonomos PD, et al. Intercalary reconstructions after bone tumor resections: a review of treatments. Eur J Orthop Surg Traumatol. 2017;27(6):737\u201346. https:\/\/doi.org\/10.1007\/s00590-017-1985-x.","journal-title":"Eur J Orthop Surg Traumatol"},{"issue":"11","key":"2250_CR19","doi-asserted-by":"publisher","first-page":"2013","DOI":"10.1016\/j.jse.2018.03.027","volume":"27","author":"J Zhao","year":"2018","unstructured":"Zhao J, Yu XC, Xu M, Zheng K, Hu YC, Wang F, et al. Intercalary prosthetic reconstruction for pathologic diaphyseal humeral fractures due to metastatic tumors: outcomes and improvements. J Shoulder Elbow Surg. 2018;27(11):2013\u201320. https:\/\/doi.org\/10.1016\/j.jse.2018.03.027.","journal-title":"J Shoulder Elbow Surg"},{"issue":"1","key":"2250_CR20","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1186\/s12885-019-5865-0","volume":"19","author":"K Zheng","year":"2019","unstructured":"Zheng K, Yu XC, Hu YC, Shao ZW, Xu M, Wang BC, et al. Outcome of segmental prosthesis reconstruction for diaphyseal bone tumors: a multi-center retrospective study. BMC Cancer. 2019;19(1):638. https:\/\/doi.org\/10.1186\/s12885-019-5865-0.","journal-title":"BMC Cancer"},{"key":"2250_CR21","first-page":"231","volume":"248","author":"HC Chin","year":"1989","unstructured":"Chin HC, Frassica FJ, Hein TJ, Shives TC, Pritchard DJ, Sim FH, et al. Metastatic diaphyseal fractures of the shaft of the humerus. The structural strength evaluation of a new method of treatment with a segmental defect prosthesis. Clin Orthop Relat Res. 1989;248:231\u20139.","journal-title":"Clin Orthop Relat Res"},{"key":"2250_CR22","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1097\/00003086-200203000-00034","volume":"396","author":"JC Henry","year":"2002","unstructured":"Henry JC, Damron TA, Weiner MM, Higgins ME, Werner FW, Sim FH. Biomechanical analysis of humeral diaphyseal segmental defect fixation. Clin OrthopRelat Res. 2002;396:231\u20139. https:\/\/doi.org\/10.1097\/00003086-200203000-00034.","journal-title":"Clin OrthopRelat Res"},{"issue":"6","key":"2250_CR23","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/S1058-2746(09)80019-0","volume":"3","author":"RR Richards","year":"1994","unstructured":"Richards RR, An KN, Bigliani LU, Friedman RJ, Gartsman GM, Gristina AG, et al. A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg. 1994;3(6):347\u201352. https:\/\/doi.org\/10.1016\/S1058-2746(09)80019-0.","journal-title":"J Shoulder Elbow Surg"},{"key":"2250_CR24","first-page":"241","volume":"286","author":"CH Gerrand","year":"1993","unstructured":"Gerrand CH, Rankin K. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res. 1993;286:241\u20136.","journal-title":"Clin Orthop Relat Res"},{"issue":"6","key":"2250_CR25","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1007\/s11999-008-0246-z","volume":"466","author":"TA Damron","year":"2008","unstructured":"Damron TA, Leerapun T, Hugate RR, Shives TC, Sim FH. Does the second-generation intercalary humeral spacer improve on the first? Clin Orthop Relat Res. 2008;466(6):1309\u201317. https:\/\/doi.org\/10.1007\/s11999-008-0246-z.","journal-title":"Clin Orthop Relat Res"},{"issue":"2","key":"2250_CR26","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1007\/s00068-007-7035-3","volume":"33","author":"J Blum","year":"2007","unstructured":"Blum J, Engelmann R, K\u00fcchle R, Hansen M, Rommens PM. Intramedullary nailing of humeral head and humeral shaft fractures. Eur J Trauma Emerg Surg. 2007;33(2):149\u201358. https:\/\/doi.org\/10.1007\/s00068-007-7035-3.","journal-title":"Eur J Trauma Emerg Surg"},{"key":"2250_CR27","doi-asserted-by":"crossref","unstructured":"Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res. 1980;153:106\u201320.","DOI":"10.1097\/00003086-198011000-00013"},{"issue":"3","key":"2250_CR28","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1097\/TA.0b013e3181692132","volume":"66","author":"K Sarahrudi","year":"2009","unstructured":"Sarahrudi K, Wolf H, Funovics P, Pajenda G, Hausmann JT, V\u00e9csei V. Surgical treatment of pathological fractures of the shaft of the humerus. J Trauma. 2009;66(3):789\u201394. https:\/\/doi.org\/10.1097\/TA.0b013e3181692132.","journal-title":"J Trauma"},{"issue":"1","key":"2250_CR29","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/1477-7800-3-5","volume":"3","author":"DM Thai","year":"2006","unstructured":"Thai DM, Kitagawa Y, Choong PF. Outcome of surgical management of bony metastases to the humerus and shoulder girdle: a retrospective analysis of 93 patients. Int Semin Surg Oncol. 2006;3(1):5. https:\/\/doi.org\/10.1186\/1477-7800-3-5.","journal-title":"Int Semin Surg Oncol"},{"key":"2250_CR30","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1097\/01.blo.0000165857.12676.00","volume":"437","author":"J Bickels","year":"2005","unstructured":"Bickels J, Kollender Y, Wittig JC, Meller I, Malawer MM. Function after resection of humeral metastases: analysis of 59 consecutive patients. Clin Orthop Relat Res. 2005;437:201\u20138.","journal-title":"Clin Orthop Relat Res"},{"issue":"4","key":"2250_CR31","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1302\/0301-620X.83B4.0830471","volume":"83","author":"R Capanna","year":"2001","unstructured":"Capanna R, Campanacci DA. The treatment of metastases in the appendicular skeleton. J Bone Joint Surg Br. 2001;83(4):471\u201381. https:\/\/doi.org\/10.1302\/0301-620X.83B4.0830471.","journal-title":"J Bone Joint Surg Br"},{"issue":"7","key":"2250_CR32","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1007\/s00402-002-0428-1","volume":"122","author":"WM Franck","year":"2002","unstructured":"Franck WM, Olivieri M, Jannasch O, Hennig FF. An expandable nailing system for the management of pathological humerus fractures. Arch Orthop Trauma Surg. 2002;122(7):400\u20135. https:\/\/doi.org\/10.1007\/s00402-002-0428-1.","journal-title":"Arch Orthop Trauma Surg"},{"key":"2250_CR33","doi-asserted-by":"crossref","unstructured":"Tome J, Carsi B, Garcia-Fernandez C, Marco F, Lopez-Duran Stern L. Treatment of pathologic fractures of the humerus with Seidel nailing. Clin Orthop Relat Res. 1998;350:51\u20135.","DOI":"10.1097\/00003086-199805000-00006"},{"issue":"8","key":"2250_CR34","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1016\/j.jse.2011.06.019","volume":"21","author":"R Wedin","year":"2012","unstructured":"Wedin R, Hansen BH, Laitinen M, Trovik C, Zaikova O, Bergh P, et al. Complications and survival after surgical treatment of 214 metastatic lesions of the humerus. J Shoulder Elbow Surg. 2012;21(8):1049\u201355. https:\/\/doi.org\/10.1016\/j.jse.2011.06.019.","journal-title":"J Shoulder Elbow Surg"},{"issue":"4","key":"2250_CR35","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1007\/s00402-010-1172-6","volume":"131","author":"M Laitinen","year":"2011","unstructured":"Laitinen M, Nieminen J, Pakarinen TK. Treatment of pathological humerus shaft fractures with intramedullary nails with or without cement fixation. Arch Orthop Trauma Surg. 2011;131(4):503\u20138. https:\/\/doi.org\/10.1007\/s00402-010-1172-6.","journal-title":"Arch Orthop Trauma Surg"},{"issue":"1","key":"2250_CR36","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1002\/jso.21893","volume":"104","author":"P Ruggieri","year":"2011","unstructured":"Ruggieri P, Mavrogenis AF, Bianchi G, Sakellariou VI, Mercuri M, Papagelopoulos PJ. Outcome of the intramedullary diaphyseal segmental defect fixation system for bone tumors. J Surg Oncol. 2011;104(1):83\u201390. https:\/\/doi.org\/10.1002\/jso.21893.","journal-title":"J Surg Oncol"}],"container-title":["World Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-021-02250-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12957-021-02250-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-021-02250-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T08:26:33Z","timestamp":1698999993000},"score":1,"resource":{"primary":{"URL":"https:\/\/wjso.biomedcentral.com\/articles\/10.1186\/s12957-021-02250-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,5]]},"references-count":36,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2250"],"URL":"https:\/\/doi.org\/10.1186\/s12957-021-02250-1","relation":{},"ISSN":["1477-7819"],"issn-type":[{"value":"1477-7819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,5]]},"assertion":[{"value":"30 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The implementation of this study was approved by the Ethics Review Committee (ERC) of Peking University People\u2019s Hospital (2020PHB148-01) and informed consents from all subjects were waived.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed written consent was obtained from the volunteer to publish their personal details information.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"140"}}