Climacteric最新文献

{"title":"Practices and challenges in the management of the menopause in the Asia-Pacific Menopause Federation.","authors":"Seng Bin Ang, Felicia Clara Jun Hui Tan, Stella Rizalina Sasha Sugianto, Sonia Davison, Qi Yu, Masakazu Terauchi, Mee-Ran Kim, Jignesh Shah, S K Zinnat Ara Nasreen, Choon Moy Ho, Enkhee Sodnomdorj, M Fidel Ganis Siregar, Rubina Hussain, Ma Corazon Zaida N Gamilla, Yang Chua, Yung-Chieh Tsai, Unnop Jaisamrarn","doi":"10.1080/13697137.2025.2514030","DOIUrl":"10.1080/13697137.2025.2514030","url":null,"abstract":"<p><strong>Objectives: </strong>The experiences and needs of women undergoing the menopausal transition vary widely amongst countries in the Asia-Pacific. Thus, practices and challenges amongst clinicians treating perimenopausal and menopausal women in the Asia-Pacific also vary. This study aims to characterize the diverse practices and challenges in managing the menopause across the Asia-Pacific.</p><p><strong>Methods: </strong>Clinicians in the member organizations of the Asia-Pacific Menopause Federation were invited to participate in a questionnaire seeking information on their usual practices and the challenges faced in managing the menopause.</p><p><strong>Results: </strong>A total of 39 clinicians from 14 countries in the Asia-Pacific Menopause Federation responded to the questionnaire. While there were similar practices in assessment, clinicians' preferences in prescribing menopausal hormonal therapy varied widely. Challenges they faced included cultural and literacy barriers amongst their patients, a lack of support for menopause care in their healthcare systems and limited availability of novel therapies.</p><p><strong>Conclusion: </strong>Practices in managing the menopause vary across the Asia-Pacific. Further research and governmental support are needed to establish consensus on managing the menopause and supporting midlife women's health issues in the Asia-Pacific.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474110","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":"Adjuvant treatment with tamoxifen for estrogen receptor-positive breast cancer and gynecological risks in premenopausal and perimenopausal women - a systematic review.","authors":"Julie Isabelle Plougmann Gislinge, Kresten Rubeck Petersen, Signe Borgquist, Pernille Ravn","doi":"10.1080/13697137.2025.2509839","DOIUrl":"10.1080/13697137.2025.2509839","url":null,"abstract":"<p><strong>Objective: </strong>Tamoxifen (TMX) is known to increase the risk of endometrial cancer (EC) in postmenopausal women, but data on the effects in premenopausal and perimenopausal women remain inconsistent and not well illuminated. This study aimed to evaluate whether TMX increases the risks of gynecological symptoms and EC in premenopausal and perimenopausal women receiving adjuvant therapy for estrogen receptor-positive breast cancer.</p><p><strong>Methods: </strong>Systematic searches in PubMed, Cochrane and Web Of Science yielded 319 relevant articles, of which 38 were analyzed after excluding duplicates and non-qualifying studies. The Oxford Criteria were used to ensure consistent evaluation before final inclusion. No meta-analysis was conducted due to study heterogeneity.</p><p><strong>Results: </strong>Ten studies (two meta-analyses, one systematic review, four retrospective cohort studies, one retrospective comparative study, one prospective cohort study and one case-control study) were included. TMX was associated with an increased risk of EC in premenopausal and perimenopausal women (mean relative risk 2.25; standard deviation 0.9) compared to no treatment or treatment with raloxifene or aromatase inhibitors. Risk appeared in some studies to increase with treatment duration and persisted for ≥5 years post treatment. TMX also significantly increased the risk of gynecological symptoms, benign and premalignant endometrial pathology, intrauterine procedures and hysterectomy (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>TMX seems to increase EC risk and significantly increase the risk of gynecological symptoms in premenopausal and perimenopausal women, with risk persisting years following treatment cessation. Healthcare professionals should counsel these women on potential risks and emphasize prompt evaluation of gynecological symptoms.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332536","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":"Hormone therapy and insulin resistance in non-diabetic postmenopausal women: a systematic review and meta-analysis.","authors":"Tanya Li, Nathan S Jiang, Julia Kaskey, Peter F Schnatz, Matthew Nudy","doi":"10.1080/13697137.2025.2509844","DOIUrl":"10.1080/13697137.2025.2509844","url":null,"abstract":"<p><strong>Objective: </strong>Menopause increases the risk of insulin resistance and cardiometabolic diseases. This study summarizes the effects of hormone therapy (HT) on insulin resistance in non-diabetic postmenopausal women.</p><p><strong>Method: </strong>The study analyzed randomized controlled trials (1998-2024) that assessed the impact of HT on insulin resistance using homeostasis model assessment of insulin resistance (HOMA-IR) in non-diabetic postmenopausal women. Raw mean differences (RMDs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup analysis compared estrogen alone (E alone) and estrogen plus progestogen (E + P) to placebo.</p><p><strong>Results: </strong>Seventeen randomized controlled trials with 5772 women (3644 on HT: E alone [<i>n</i> = 1259] or E + P [<i>n</i> = 2385]; 2128 on placebo) were included. The weighted mean (standard deviation) age was 56.91 (5.95) years, with treatment lasting 8 weeks to 3 years. HT significantly reduced HOMA-IR (RMD = -0.24 [-0.32 to -0.16], <i>p</i> < 0.001, <i>I</i>² = 60.3%). Subgroup analysis showed reductions in both E alone (RMD = -0.42 [-0.55 to -0.29], <i>p</i> < 0.001, <i>I</i>² = 35%) and E + P (RMD= -0.14 [-0.23 to -0.04], <i>p</i> = 0.005, <i>I</i>² = 13.7%) compared to placebo.</p><p><strong>Conclusion: </strong>HT significantly lowers insulin resistance in healthy, non-diabetic postmenopausal women, with E alone yielding greater reductions than combination therapy.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324608","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":"Enhancing quality of life: addressing vulvovaginal atrophy and urinary tract symptoms.","authors":"Angelica Lindén Hirschberg","doi":"10.1080/13697137.2025.2514029","DOIUrl":"https://doi.org/10.1080/13697137.2025.2514029","url":null,"abstract":"<p><p>About 50% of postmenopausal women experience symptoms of vulvovaginal atrophy (VVA) including vulvovaginal dryness, burning, itching and dyspareunia as a natural physiological consequence of hypoestrogenism. These symptoms can have a major impact on quality of life and sexual function. VVA is a component of genitourinary syndrome of menopause, also associated with urinary tract problems such as frequent urination, urge incontinence and recurrent urinary tract infections. Vaginal low-dose estrogen is an effective treatment for symptoms of VVA, overactive bladder and urge incontinence, and prevents recurrent urinary tract infections. In contrast, systemic menopausal hormone therapy seems to worsen urinary incontinence. Women with breast cancer treated with aromatase inhibitors often have severe symptoms of VVA and urinary tract problems. Non-hormonal lubricants and moisturizers should be the first-line treatment in these patients. However, there is no evidence of increased cancer recurrence by low-dose vaginal estrogen in breast cancer survivors. When non-hormonal products are ineffective, low-dose vaginal estrogen could be considered in collaboration with the woman's oncologist. An individualized approach is required for the management of VVA and urinary tract symptoms. As VVA is a chronic condition, women should not be denied long-term use of vaginal estrogens if the treatment is of benefit to them.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324607","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":"Burden, trends and projections of low bone mineral density in premenopausal/postmenopausal women.","authors":"Jun Liao, Yide Wang, Reyla Turson, Rui Fang","doi":"10.1080/13697137.2025.2514026","DOIUrl":"https://doi.org/10.1080/13697137.2025.2514026","url":null,"abstract":"<p><strong>Objectives: </strong>Low bone mineral density (LBMD) significantly contributes to global morbidity and mortality, especially in postmenopausal women. However, its burden in premenopausal women remains underrecognized. This study evaluated the global burden, temporal trends and future projections of LBMD-related outcomes.</p><p><strong>Methods: </strong>Data were obtained from the Global Burden of Disease 2021 dataset covering 204 countries. Premenopausal and postmenopausal women from 1990 to 2021 were included. Incidence, mortality and disability-adjusted life years (DALYs) were extracted, and age-standardized rates were calculated. The study explored demographic and epidemiologic changes, applied inequality indices and employed a Bayesian Markov chain Monte Carlo model to forecast trends through 2035.</p><p><strong>Results: </strong>Between 1990 and 2021, LBMD-related mortality rose by 27.39% (95% uncertainty interval [UI] 16.83-39.69) among premenopausal women and 138.73% (95% UI 98.45-186.25) among postmenopausal women. In 2021, the postmenopausal age-standardized rate (27.92 per 100,000) was 63.5 times higher than that of premenopausal women (0.44 per 100,000). By 2035, although rates may decline, overall deaths and DALYs will likely increase due to population growth and aging.</p><p><strong>Conclusion: </strong>Despite decreasing standardized rates, the absolute burden of LBMD continues to grow. Early screening and targeted prevention, especially for postmenopausal and underrecognized premenopausal women, is crucial to lessen its global impact.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324606","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":"Effect of hormone therapy on tryptophan metabolism and atherosclerosis among postmenopausal women.","authors":"Intira Sriprasert, James R Hilser, Naoko Kono, Roksana Karim, Frank Z Stanczyk, Donna Shoupe, Howard N Hodis, Wendy J Mack, Hooman Allayee","doi":"10.1080/13697137.2025.2509838","DOIUrl":"10.1080/13697137.2025.2509838","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the effect of hormone therapy (HT) on tryptophan-kynurenine pathway metabolites and associations with atherosclerosis among postmenopausal women.</p><p><strong>Methods: </strong>Eighty early postmenopausal participants from the Early versus Late Intervention Trial with Estradiol (40 each from HT vs. placebo) were selected for analysis. Tryptophan, <i>N</i>-acetyltryptophan, kynurenine, kynurenic acid and <i>N</i>-acetylkynurenine baseline and 36-month levels were measured by mass spectrometry. Mixed models tested HT effects on each metabolite, association of estradiol (E2) level with change in metabolite levels and association between change of metabolite with carotid artery intima-media thickness (CIMT) progression.</p><p><strong>Results: </strong>Compared with placebo, HT significantly reduced kynurenic acid (mean change HT minus placebo -0.27; 95% confidence interval [CI] - 0.42, -0.12; <i>p</i> = 0.0007) and <i>N</i>-acetylkynurenine (-0.38; 95% CI -0.68, -0.08; <i>p</i> = 0.04) levels. Reduction in kynurenic acid was inversely associated with higher E2 levels. Decreased CIMT progression was associated with lower kynurenic acid (0.0131 µm/year per unit; 95% CI 0.0049, 0.0212; <i>p</i> = 0.002) and <i>N</i>-acetylkynurenine (0.0061 µm/year per unit; 95% CI 0.0020, 0.0103; <i>p</i> = 0.004) levels.</p><p><strong>Conclusions: </strong>Plasma tryptophan-kynurenine pathway metabolites were reduced by HT and these reduced metabolite levels were associated with decreased atherosclerosis progression. Reduction of kynurenic acid by HT was supported by its association with E2 levels, which may explain, in part, the reduction in atherosclerosis progression with HT in early postmenopausal women.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282713","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":"Psyche and menopause: embracing the (positive) flip side of the coin.","authors":"Elena Vegni, Lidia Borghi","doi":"10.1080/13697137.2025.2509854","DOIUrl":"https://doi.org/10.1080/13697137.2025.2509854","url":null,"abstract":"<p><p>While the biological processes of menopause are universal, individual experiences vary widely, shaped by psychological, social and cultural factors. Recent perspectives advocate for an empowerment-based model, emphasizing the importance of incorporating both medical and psychological dimensions into menopause management. This contribution builds upon previous models and integrates a psychological framework that considers menopause as not only a time of loss but also a period of growth, self-realization and transformation. From a psychological perspective, menopause invites a redefinition of identity, with key psychological changes structured around two central dimensions: body-space and time perception. The transition away from the cyclical rhythms of fertility to a more stable bodily and temporal experience provides women with a grounding sense of self and fosters a deeper engagement with long-term goals. These changes, although potentially disorienting, represent a developmental opportunity for stabilization and growth. By embracing this broader understanding, clinicians and researchers can support women in thriving during and beyond this stage, moving beyond solely symptoms management and fostering a collaborative relationship with women navigating this transition. Implications for clinical practice of this approach are discussed, offering guidance on how clinicians can integrate psychological well-being into menopause care.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-4"},"PeriodicalIF":2.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265409","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":"Safety of menopause hormone therapy in postmenopausal women at higher risk of venous thromboembolism: a systematic review.","authors":"Amy Hicks, Danielle Robson, Bianca Tellis, Sally Smith, Scott Dunkley, Rodney Baber","doi":"10.1080/13697137.2025.2503874","DOIUrl":"https://doi.org/10.1080/13697137.2025.2503874","url":null,"abstract":"<p><strong>Objective: </strong>Studies have shown that oral estrogen with or without progestogen increases the risk of venous thromboembolism (VTE). Recent data suggest that transdermal estrogen confers little to no increased risk of VTE. There is no systematic review that examines menopause hormone therapy (MHT) use in women with risk factors for VTE. This systematic review therefore aims to summarize the evidence in this population.</p><p><strong>Method: </strong>The OVID Medline, Embase, PubMed and CENTRAL online databases were searched. A total of 762 studies were screened and 10 were included in the study.</p><p><strong>Results: </strong>Six studies were case-control studies, two were randomized controlled trials (RCTs), one was an RCT that contained a nested case-control study and one was a cohort study. Studies were heterogeneous in their definition of menopause, dose, form and route of administration of MHT, and the underlying VTE risk factor being assessed. In women with risk factors for VTE, transdermal estrogen conferred no increased risk of VTE. Oral estrogen alone has the next safest profile, and oral estrogen plus a progestogen conferred the highest increased risk of VTE.</p><p><strong>Conclusion: </strong>Transdermal MHT appears safe in women with risk factors for VTE. Oral MHT, notably oral estrogen plus a synthetic progestogen, does increase relative risk. More contemporary data are required to confirm these findings.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-26"},"PeriodicalIF":2.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246746","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":"Genetic insights into the causal associations between immune cells and ovarian aging in the European population.","authors":"Tongyun Qi, Wei Zhao, Erxidi Chen, Yanqi Zhong, Benben Cao, Yizhou Huang, Lijun Yin, Jianhong Zhou, Jianhua Qian","doi":"10.1080/13697137.2025.2503877","DOIUrl":"https://doi.org/10.1080/13697137.2025.2503877","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the potential causal relationship between 731 immune cell traits and age at natural menopause (ANM), a measurable endpoint for ovarian aging.</p><p><strong>Methods: </strong>Based on variant ANM data from the ReproGen Consortium, two-sample Mendelian randomization (MR) analyses were conducted in a European population to identify significant immune cell traits associated with menopausal timing using inverse variance weighting (IVW) methods as the primary strategy. The study performed additional scrutiny to test the robustness of the significant associations via weighted median and MR-Egger as complementary methods, heterogeneity and pleiotropy analyses, the Steiger test and reverse MR for testing directionality, and leave-one-out analysis for biased and dominant variants. Replication analyses were also carried out using an independent dataset for ANM from UK Biobank.</p><p><strong>Results: </strong>After false discovery rate (FDR) correction, 10 significant immune cell traits were identified, suggesting putative causal associations with menopausal timing. Six immunophenotypes were associated with earlier ANM including CD39⁺ activated regulatory T cell (Treg) %activated Treg, NK% CD3^- lymphocyte and CD27 on four B cell types (IgD^-CD38^dim B cell, memory B cell, unswitched memory B cell, switched memory B cell). Four immunophenotypes were associated with later ANM: CD39⁺ resting Treg absolute count, HLA DR⁺ CD4⁺ %lymphocyte, CD24 on IgD^-CD38^dim memory B cell and HVEM (Herpesvirus Entry Mediator, also named as TNFRSF14) on CD4⁺ T cell. These results were validated in the replication dataset from UK Biobank. No reverse causation was found.</p><p><strong>Conclusion: </strong>This study demonstrates a causal relationship between 10 immune cell traits and menopausal timing, thereby expanding our knowledge about reproductive aging from the perspectives of inflammaging.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-10"},"PeriodicalIF":2.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215107","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":"Prevalence of depressive symptoms during the menopausal transition in Türkiye: impact of symptom severity, aging anxiety and health-related quality of life.","authors":"Banu Aslan, Özgür Önal","doi":"10.1080/13697137.2025.2507909","DOIUrl":"https://doi.org/10.1080/13697137.2025.2507909","url":null,"abstract":"<p><strong>Objective: </strong>This research aimed to determine the prevalence of depressive symptoms during the menopausal transition (MT) among women in Türkiye and to examine the effects of menopausal symptom severity, aging anxiety, health-related quality of life (HRQoL) and sociodemographic factors on these symptoms.</p><p><strong>Methods: </strong>The cross-sectional study included 1146 women aged 45-55 years in the MT phase who voluntarily agreed to participate. The data were collected via a link containing survey questions on Google Forms, including sociodemographic information, health status, gynecological/obstetric history, menopause questions and the following scales: Perimenopausal Depression Scale, Menopause Rating Scale (MRS), Aging Anxiety Scale and Short Form Health Survey.</p><p><strong>Results: </strong>The prevalence of depressive symptoms during the MT (≥20 points) was found to be 27.1% (95% confidence interval: 24.6-29.8), with 3.8% experiencing severe depression, 12.7% moderate depression and 10.6% mild depression. Binary multiple logistic regression analysis identified residence in the Eastern and Southeastern Anatolia regions, alcohol consumption, higher MRS scores and lower mental component levels as significant predictors of depressive symptoms during the MT.</p><p><strong>Conclusions: </strong>This study provides valuable data on the prevalence of depressive symptoms during the MT among perimenopausal women in Türkiye, offering insights for developing targeted strategies for at-risk groups.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215108","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}