Chronic Respiratory Disease最新文献

{"title":"Impact of switching between different spirometric reference equations on the assessment of asthma severity and control among jordanian adults.","authors":"Walid Al-Qerem, Anan Jarab, Khaled Al-Oweidat, Anas Atef Alrawashdeh, Abbas Iter, Walaa Ashran, Dina K Al-Hashaki, Amir R Aljayeh, Anas Mohammed, Lama Sawaftah, Yousef Mimi, Maher Khdour","doi":"10.1177/14799731261469859","DOIUrl":"10.1177/14799731261469859","url":null,"abstract":"<p><p>BackgroundAccurate assessment of asthma symptom control is central to effective management. Spirometry is the gold standard for evaluating lung function and monitoring physiological impairment, and the Global Lung Function Initiative (GLI) has developed widely used spirometric reference equations applicable across populations. However, population-specific equations may better reflect regional characteristics. This study examined the impact of using different spirometric reference equations on asthma assessment.MethodsIn this cross-sectional study, pre-bronchodilator forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), and FEV₁/FVC were assessed in 384 adults with asthma, and symptom control status was assessed using the Asthma Control Test (ACT). Reference values, z-scores, and lower limits of normal (LLN) were derived using the GLI Global (GLI-2022 race-neutral) equation (GLIgl), GLI-2012 Caucasian equation (GLI2012_cauc), GLI-2012 Other/mixed equation (GLI2012_other), and Al-Qerem local equation (LOCAL). Agreement between equations was evaluated using Cohen's kappa, and their sensitivity and specificity for identifying ACT-defined uncontrolled symptoms were assessed.ResultsSpirometric values differed significantly across equations. Associations between spirometric impairment and ACT-defined uncontrolled symptoms were modest, with low-to-moderate discrimination. Higher FEV₁ and FVC z-scores were consistently associated with higher ACT scores across all equations, although explained variance was limited and model-fit differences were minimal. Pairwise agreement between equation sets was substantial to near-perfect for FEV1 < LLN (kappa = 0.692-0.907) and FEV1/FVC < LLN (kappa = 0.757-0.945), while LLN-defined impairment rates differed across equations.ConclusionsThe choice of spirometric reference equation substantially influences impairment classification and its concordance with ACT-defined symptom control, but overall predictive performance remains modest. Spirometry should be interpreted as a complementary, rather than standalone, tool in asthma assessment, with careful consideration of population-appropriate reference standards.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261469859"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction of a patient health management patient journey map based on health action process approach theory for patients with chronic obstructive pulmonary disease.","authors":"Shengxi Chen, Yinlong Li, Yan Zhang, Xinxin Chen, Panpan Zhang, Yuqin Cheng","doi":"10.1177/14799731261469848","DOIUrl":"10.1177/14799731261469848","url":null,"abstract":"<p><p>BackgroundSelf-management ability for patients with chronic obstructive pulmonary disease (COPD) in China urgently needs to be strengthened. The Health Action Process Approach (HAPA) promotes health-oriented behaviour change by tailoring interventions to each stage of the individual's disease. This approach has been applied across a wide range of fields. However, its application among patients with COPD remains relatively limited.ObjectiveTo construct a patient health management journey map based on the HAPA theory.MethodsUsing the HAPA theory as a framework, a patient health management patient journey map was developed through literature review, reference to standardised guidelines, phenomenological research and expert consultation.ResultsFrom the literature review, 12 relevant articles were included to form the preliminary framework. Semi-structured interviews with 5 respiratory medical staff identified the core stages of the patient journey. In a separate subsequent process, the 8 experts selected for consultation had an average work experience of 19.13 ± 3.27 years. Education levels included 2 with a bachelor's degree and 6 with a master's degree or above; professional titles included 3 associate senior doctors, 3 senior doctors and 2 intermediate doctors; and research specialties included 5 in respiratory medicine and 3 in internal medicine nursing. As for the consultation involvement, 3 experts participated once and 5 experts participated twice or more. The familiarity coefficient with consultation content was 0.851, the judgment basis coefficient was 0.916 and the authority coefficient of the experts was 0.889. The coordination of expert opinions was measured by Kendall's W and was 0.429 (<i>χ</i>^<i>2</i> = 42.452, P < 0.001). Finally, a proof-of-concept test with 5 patients refined the patient journey map's usability by simplifying terminology and adjusting adherence strategies.DiscussionThe patient health management journey map constructed in this study, based on the HAPA theory, is scientific, comprehensive and usable, covering key stages such as disease diagnosis, acute exacerbation management, stable period maintenance and rehabilitation support. It provides patients with comprehensive scientific guidance and promotes the establishment of healthy behaviours.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261469848"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to \"Methodological considerations regarding the interpretation of feasibility outcomes in remote breathing interventions for dysregulated breathing following COVID-19\".","authors":"Sophie Middleton, Theresa C Harvey-Dunstan, Charlotte E Bolton","doi":"10.1177/14799731261483653","DOIUrl":"10.1177/14799731261483653","url":null,"abstract":"","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261483653"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of social isolation and loneliness with the risk of adult-onset asthma: A prospective cohort and mendelian randomization study.","authors":"Juanjuan Zhang, Yuqian Li, Xiangdong Sun, Ruiqi An, Hongjie Zhang, Jianping Gong, Yuanda Zhang, Yijue Li, Yanfeng Gu, Yang Xia","doi":"10.1177/14799731261422727","DOIUrl":"10.1177/14799731261422727","url":null,"abstract":"<p><p>BackgroundDespite proposed aetiological mechanisms involving stress-induced inflammation and behaviour, population-level evidence linking social isolation and loneliness to asthma is lacking. Therefore, we aimed to examine the associations of social isolation, loneliness, and genetic predisposition with asthma risk in middle-aged and older adults, and to quantify the contribution of various risk factors.MethodsA total of 400,184 asthma-free participants were enrolled from the UK Biobank. Loneliness was evaluated using the short form of the Revised UCLA Loneliness Scale, and social isolation was assessed through a composite score based on key social network components. Asthma was evaluated using hospital inpatient records in UK Biobank. Genetic predisposition for asthma was characterized using weighted polygenic risk score (PRS). Cox proportional hazard models were utilized to assess the associations of social isolation and loneliness with the risk of asthma. The one-sample Mendelian randomization (MR) analysis was based on genome-wide association studies of UKB.ResultsOver an 11.6-years median follow-up, a total of 9453 new asthma cases were recorded. In the fully adjusted model, individuals with feelings of loneliness had a 1.27-fold higher risk of asthma (95% CI: 1.15-1.39) than those without. However, social isolation showed no significant association with asthma risk after several factor adjustments. No significant interactions of loneliness and asthma-PRS were detected. In the one-sample MR analyses, we observed suggestive genetic evidence supporting associations of feeling lonely, fewer leisure social activities, being willing to confide in others, and participating in more other group activities with asthma.ConclusionsOur findings suggest that loneliness, but not social isolation is a risk factor for asthma that is independent of various factors and genetic predisposition. Mendelian randomization provides suggestive evidence that loneliness and reduced social activity may be causal risk factors for asthma.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261422727"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explainable machine learning model for predicting acute exacerbations of COPD combining sarcopenia index and traditional risk factors: A retrospective single-center exploratory study.","authors":"Ai-Bin Zhang, Li-Wen Zhou, Yu-Fen An, Qing-Qing Qin, Jian-Tong Wei, Hao Chen","doi":"10.1177/14799731261454690","DOIUrl":"10.1177/14799731261454690","url":null,"abstract":"<p><p>ObjectivesChronic obstructive pulmonary disease (COPD) is a common respiratory disorder. Acute exacerbation of COPD (AECOPD) severely affects patients' quality of life and prognosis. This study aimed to identify novel risk factors and develop an effective predictive model for AECOPD using machine learning (ML) models.MethodsIn this retrospective single-center study, clinical data and biomarkers from 565 participants were analyzed using ML algorithms. Feature selection employed least absolute shrinkage and selection operator regression. Eight ML models were trained and evaluated using receiver operating characteristic (ROC) and clinical decision curve analysis. The Shapley Additive explanations (SHAP) framework assessed feature contributions. An online personalized risk calculator was developed based on the optimal model and individual SHAP values.ResultsThe XGBoost model demonstrated excellent discriminative performance, with areas under the ROC curve of 0.818 and 0.838 for the training and test sets, respectively. Key predictors identified by SHAP analysis included age, current smoking status, frequency of exacerbations in the previous year, albumin levels, sarcopenia index, and COPD Assessment Test score. These variables were integrated into an online calculator for research to illustrate individualized AECOPD risk estimation. However, external validation is still required before its clinical application.ConclusionsWe developed a preliminary ML model for predicting AECOPD, which provides a valuable tool for clinical risk assessment. The results also highlighted the correlation between sarcopenia and AECOPD risk.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261454690"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological considerations regarding the relative roles of wood-smoke exposure and hypoxemia in cognitive impairment among patients with COPD.","authors":"Palakdeep Kaur, Raju Kumar, Jatin Sangwan, Urvashi Chauhan","doi":"10.1177/14799731261469842","DOIUrl":"10.1177/14799731261469842","url":null,"abstract":"","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261469842"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective study to understand the journey and health status of patients with unexplained or refractory chronic cough in the Netherlands.","authors":"Jan Willem Karel van den Berg, Mireille Edens, Anoe Radha Oedit Doebé, Hester van der Velden, Maxime Roosje Heezen","doi":"10.1177/14799731261446951","DOIUrl":"10.1177/14799731261446951","url":null,"abstract":"<p><p>IntroductionThis study aims to characterize the patient journey for refractory chronic cough (RCC) or unexplained chronic cough (UCC) before visiting the Isala Chronic Cough Clinic (ICCC) in the Netherlands.MethodData from 152 patients with RCC or UCC was collected between January 2017 and September 2021from General Practitioner (GP) and hospital charts, the EQ-5D-5L questionnaire, and a patient survey about the care pathway and cough impact on everyday life, based on a single-centre, observational, retrospective study design.ResultsMean age at first ICCC visit was 60.3 ± 11.6 years; 66.4% of patients was female. More patients had RCC (80.9%) than UCC (19.1%). Mean cough duration before ICCC visit was 8.5 ± 6.5 years. 41.4% of patients reported cough >10 years. Common patient-reported problems were social embarrassment (58.0%), exhaustion (54.2%), and sleep disturbance (45.0%). Urinary incontinence was prevalent among women (48.9%). Prior to ICCC, 59.2% had consulted 2-4 specialists for their cough and 16.2% had seen more than 4.ConclusionThis study highlights the long time to diagnosis of RCC or UCC, and the negative effect on patients' physical and psychological health, and everyday activities. Increased awareness may shorten time for diagnosis, and novel therapies may help reduce this disease burden.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261446951"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration of health inequalities in patients treated with home non-invasive ventilation - Associations with respiratory healthcare burden.","authors":"Wiktoria N Milczanowska, Achaya Rajkumar, Nicholas J Williamson, Oluwadamilare Falade, Laura Elliott, Amit S Patel, Kai K Lee","doi":"10.1177/14799731261425236","DOIUrl":"10.1177/14799731261425236","url":null,"abstract":"<p><p>BackgroundHealth inequalities affect many respiratory diseases. However, little is known about the extent or impact amongst patients treated with home non-invasive ventilation (NIV). This study explored health inequalities faced by these patients and associations with respiratory healthcare burden.MethodsA retrospective cohort study was conducted on patients actively receiving home-NIV treatment. Data on patient demographics, hospital healthcare burden and NIV adherence was collected between 4 October 2021 to 4 October 2023, and their relationships were evaluated.Results187 patients met the inclusion criteria. Total hospital bed days was higher in females than in males, (11.7 ± 27.0 days vs 5.2 ± 12.5 days, <i>p</i> = 0.039), and increasing age was positively associated with higher number of respiratory-related hospital admissions (r = 0.146, <i>p</i> = 0.048). There was a weak correlation between deprivation rank and number of NIV care appointments missed (r = -0.163, <i>p</i> = 0.031). A higher BMI (>40 kg/m²) was associated with lower daily home-NIV use (68.7% ± 4.9% vs 83.0% ± 3.1% nights NIV used, <i>p</i> = 0.012).ConclusionPatients with higher BMI had lower NIV adherence, females required more hospital bed days, older patients had more hospital admissions, and more deprived patients missed more hospital appointments.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261425236"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12954001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147316174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diurnal and seasonal variation in six-minute walk distance in pulmonary hypertension: Implications for clinical monitoring.","authors":"Lucy Robertson, Katherine Bunclark, Mark Toshner, Joanna Pepke-Zaba, Karen Sheares, John Cannon, Dolores Taboada Buasso, Karl P Sylvester, Joseph Newman, Benjamin Knox-Brown","doi":"10.1177/14799731261460039","DOIUrl":"10.1177/14799731261460039","url":null,"abstract":"<p><p>IntroductionThe American Thoracic Society (ATS) six-minute walk test (6MWT) guidelines recommend repeat testing at the same time of day to minimise intraday variability. Whether diurnal or seasonal factors affect the 6MWT in pulmonary hypertension (PH) is unclear. We investigated associations between six-minute walk distance (6MWD) and secondary 6MWT parameters with time of day and season using cross sectional and longitudinal analyses.MethodsThis single-centre retrospective study (2019-2025) included PH patients undergoing 6MWT as per ATS guidelines. Cross-sectional analyses compared morning (AM, 07:00-12:00) vs afternoon (PM, 12:01-18:00) and seasonal effects on 6MWD using adjusted linear models. Longitudinal effects were examined with adjusted linear mixed effects models.ResultsThe cross-sectional cohort included 1,665 patients (AM n=734, PM n=931). Estimated marginal mean (EMM) 6MWD was higher in the morning than afternoon (354m vs 339m; p=0.005), with no seasonal variation (Winter 338m, Spring 354m, Summer 345m, Autumn 343m; p=0.20). The longitudinal cohort included 554 patients. EMM 6MWD was similar between AM and PM (396m vs 400m; p=0.16) and across seasons (Winter 395m, Spring 395m, Summer 399m, Autumn 398m; p=0.43). Maximal heart rate (MHR) was higher in the afternoon (115 vs 113 bpm; p=0.002) and lower in Summer/Autumn (113 bpm) vs Winter (116 bpm) and Spring (115 bpm; p=0.017).Conclusion6MWD was stable across time of day and season, supporting greater flexibility in scheduling 6MWTs than suggested by guidelines. Small variations in MHR were associated with circadian and seasonal influences but did not affect 6MWD. Prospective studies are needed to confirm these findings.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261460039"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in all-cause mortality by sex in obstructive and restrictive lung diseases.","authors":"Carli J Lehr, Jacob Mitchell, Elizabeth N Dewey, David A Zidar, Vickram Tejwani, Maeve G MacMurdo, Maryam Valapour, Lyla Mourany, Jarrod E Dalton","doi":"10.1177/14799731261480688","DOIUrl":"10.1177/14799731261480688","url":null,"abstract":"<p><p>Chronic pulmonary diseases are major contributors to death for males and females, yet the extent to which mortality risk within individual pulmonary diseases differs between the sexes remains understudied. We hypothesized that mortality risk differs between males and females with obstructive and restrictive lung diseases after accounting for demographic factors, comorbidities, smoking history, disease severity, and neighborhood-level resource availability. We conducted a retrospective cohort study of adults aged 18-95 years (median age 67 years) with obstructive lung disease (OLD) or restrictive lung disease (RLD) who had their first pulmonary medicine visit at the Cleveland Clinic Health System between 2013 and 2025. Patients were included if they had ≥2 encounters with an OLD or RLD diagnosis and ≥1 pulmonary function test. Multivariable Cox proportional hazards models were used to estimate sex-specific risk of all-cause mortality and by disease subtype after adjusting for demographic characteristics and other clinical risk factors as covariates. The cohort included 70,218 patients (OLD n=49,254, RLD n=20,964) with a median duration of follow-up of 2.6 years. In OLD, males had a 37% higher unadjusted risk of death (hazard ratio [HR] 1.37, 95% CI 1.32-1.43), which remained elevated after adjustment (HR 1.16, 95% CI 1.11-1.20). In RLD, males had a 69% higher unadjusted mortality risk (HR 1.69, 95% CI 1.59-1.80) with persistent excess risk after adjustment (HR 1.49, 95% CI 1.36-1.63). Survival differences persisted after accounting for comorbidities, Area Deprivation Index, smoking history, or differences in pulmonary function.Males with obstructive and restrictive lung disease experienced consistently higher all-cause mortality compared to females in this cohort. These findings highlight sex-associated differences in survival across subtypes of obstructive and restrictive lung disease and underscore the need for future work to clarify underlying mechanisms and further refine prognostic risk stratification across a wide spectrum of chronic pulmonary diseases.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"23 ","pages":"14799731261480688"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}