Climacteric最新文献

{"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":3.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354080/pdf/","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":"OA","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}

{"title":"Genitourinary syndrome of menopause among Chinese women during the menopausal transition and postmenopause: findings from a longitudinal cohort study.","authors":"Yubo Fan, Jingbo Huang, Feiling Huang, Ruiyi Tang, Penghui Feng, Xuanjin Yang, Zhuolin Xie, Lingjin Yang, Xiaonan Ma, Keyang Yang, Rong Chen","doi":"10.1080/13697137.2025.2497427","DOIUrl":"10.1080/13697137.2025.2497427","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the prevalence and related factors of genitourinary syndrome of menopause (GSM) in a Chinese longitudinal cohort.</p><p><strong>Method: </strong>A total of 616 women in the menopausal transition or postmenopausal stage from an urban Chinese community were included in this study. The study assessed the prevalence, degree and factors associated with different types of GSM.</p><p><strong>Results: </strong>The prevalence of moderate/severe GSM rose from 23.9% in the early menopausal transition to 36.8% in the late menopausal transition, to 56.1% in postmenopause stage +1 and 71.4% in postmenopause stage +2. More than half of the postmenopausal women reported loss of libido (68.7%), vaginal dryness (60.2%), stress urinary incontinence (59.8%) and low sexual pleasure (58.8%). Multivariable analysis revealed that Stages of Reproductive Aging Workshop +10 (STRAW +10) stages (<i>p</i> = 0.009), marital status (<i>p</i> < 0.001) and anxiety (<i>p</i> = 0.005) were independently associated with GSM.</p><p><strong>Conclusion: </strong>This study shows that as women progress through the menopausal transition, GSM symptoms become increasingly common and severe. In particular, postmenopausal women experience a higher burden of these symptoms. Additionally, menopausal stage, marital status and anxiety were identified as independent factors associated with GSM. These findings provide a comprehensive insight of GSM among middle-aged Chinese women, underlining the importance of diagnosis and treatment for GSM.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"319-328"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075914","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":"Genitourinary syndrome of menopause: a multicenter study from the Indian Midlife Registry.","authors":"Asna Beg Ashraf, Meeta Meeta, A B Chitra, Sangeeta Pahwa, Jyoti Shah, Manjit Mohi, Geeta Reddy, Kiran Aggarwal, Amrita Sarkari, Sudha Sharma, Jyoti Jaiswal, Jignesh Shah, Bipasa Sen, Jyothi Unni, Sheela Mane, Jyothika Desai","doi":"10.1080/13697137.2025.2496681","DOIUrl":"10.1080/13697137.2025.2496681","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the prevalence and characteristics of genitourinary syndrome of menopause (GSM) in midlife women.</p><p><strong>Methods: </strong>The cross-sectional study from the Indian Midlife Registry included women aged >40 years attending outpatient clinics at multiple centers across India. Real-world data were collected on an Electronic Health Record platform. GSM was diagnosed in the presence of either two genitourinary or sexual symptoms or one symptom and a Vaginal Health Index (VHI) score of ≤15.</p><p><strong>Results: </strong>A total of 1781 women, 826 perimenopausal and 955 postmenopausal, were included. The prevalence of GSM was 48.5%, and the most prevalent symptoms were lower urinary tract symptoms (LUTS) (38.2%) and vaginal dryness (26.4%). The VHI score was ≤15 in 42.1% of women. Based on logistic regression analysis, age ≥70 years, late postmenopause, low education, insomnia and other sleep problems were associated with higher odds of GSM.</p><p><strong>Conclusion: </strong>GSM is highly prevalent in Indian women. GSM remains under-recognized and undertreated. Sleep problems, advanced age, late postmenopause and low education significantly increase the odds. This study underscores the importance of routine screening for GSM, especially in those with sleep disturbances or LUTS in order to improve quality of life (QoL).</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"329-336"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of HIV on body composition and its relationship with physical function in mid-life women: a cross-sectional study from Zimbabwe.","authors":"Mícheál Ó Breasail, Jakub Mesinovic, Tafadzwa Madanhire, Cynthia Kahari, Peter R Ebeling, Victoria Simms, Rashida A Ferrand, Kate A Ward, Celia L Gregson","doi":"10.1080/13697137.2025.2496685","DOIUrl":"10.1080/13697137.2025.2496685","url":null,"abstract":"<p><strong>Objective: </strong>Menopause-related changes in body composition and physical function are unclear in Southern Africa, particularly in the context of a generalized HIV epidemic with high antiretroviral therapy (ART) coverage.</p><p><strong>Method: </strong>A total of 263 Zimbabwean women (53% women living with HIV [WLH]) aged 40-60 years provided data on menopause, ART use, anthropometry, body composition (appendicular lean mass [ALM], muscle area, fat mass), handgrip strength (HGS) and gait speed. Linear regression determined relationships between body composition and physical function, unadjusted and age-menopause-adjusted, stratified by HIV status. Univariate logistic regression investigated associations between body composition and self-reported falls.</p><p><strong>Results: </strong>WLH (96% ART established) were a median (interquartile range) 10.4 (6.4-14.5) years since diagnosis, with lower weight, body mass index, ALM, fat mass and HGS than women living without HIV (WLWOH). With menopause transition, WLH lost weight, ALM, gynoid mass and muscle area (all <i>p</i>-trend <0.05); however, WLWOH did not. Both WLH and WLWOH lost HGS (<i>p</i>-trend <0.05). ALM was positively associated with HGS in all women. In WLH, greater percentage body fat, particularly gynoid fat, was associated with increased odds of falls (1.69 [1.00-2.89], <i>p</i> = 0.049 and 1.72 [1.08-2.75], <i>p</i> = 0.023, respectively).</p><p><strong>Conclusion: </strong>Women living with HIV were more likely to experience adverse changes in body composition through menopause; fat mass gains were associated with risk of falls.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"351-359"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076343","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":"Awareness of menopause and menopause hormone therapy in India: perspectives of healthcare providers and consumers.","authors":"Meeta Meeta, Sujatha Guduru, Tanvir Tanvir, Akanshi Madan","doi":"10.1080/13697137.2025.2503876","DOIUrl":"10.1080/13697137.2025.2503876","url":null,"abstract":"<p><strong>Objective: </strong>This study was a dual-module approach that aimed to evaluate knowledge and concerns of healthcare providers (HCPs) about menopause hormone therapy (MHT) in under-resourced communities, and to understand the awareness and sources of information on menopause and MHT in these communities.</p><p><strong>Methods: </strong>The cross-sectional survey study consisted of two modules: the population module was administered offline and followed the computer-aided personal interview methodology; and the HCP module was an online, self-administered survey.</p><p><strong>Results: </strong>Out of 32,518 women surveyed from underprivileged communities, 50% were unaware of the effects of menopause, and 62% were unaware of the available treatment; if offered by the HCP, 48% were willing to take treatment. Responses from 1261 HCPs showed that systemic MHT was prescribed by 62.4% of HCPs and vaginal estrogen therapy by 86.0%. Although 95% of HCPs were aware of the indications, risks and benefits of MHT, 57% used alternative therapies as first-line therapy and 71% used them as an adjunct to MHT.</p><p><strong>Conclusions: </strong>There is a lack of awareness regarding the impact of menopause on health and on the use of MHT, and educational programs may encourage women to seek help. While HCPs are knowledgeable, hesitancy in the use of systemic MHT indicates the need for professional training programs to increase confidence in prescription writing.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"286-295"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198382","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}