Clinical Otolaryngology最新文献

{"title":"The Effect of Using Perioperative Platelet-Rich Plasma on Wound Healing Rate and Prevention of Salivary Fistula Formation in Patients Undergoing Partial Parotidectomy.","authors":"Selim Kul, Sema Zer Toros, Çağrı Becerik, Lütfü Şeneldir, Sebahat Aksaray","doi":"10.1111/coa.14265","DOIUrl":"https://doi.org/10.1111/coa.14265","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to examine the effects of autologous platelet-rich plasma (PRP), which increases new connective tissue synthesis and revascularisation, on healing in parotid surgery wounds, prevention of salivary fistula formation, drain removal time and hospitalisation in the postoperative period.</p><p><strong>Materials and methods: </strong>Fifty-four patients who had an operation on partial parotidectomy were randomised, and then two groups were created. PRP was obtained by centrifuging the blood taken from the patients in the study group at the end of the surgery. This obtained PRP was injected into the surgical site, and then the wound flap was closed by suturing. Patients were evaluated for parameters such as the development of salivary fistula, duration of drain removal, discharge time and all other complications during the postoperative 4 weeks.</p><p><strong>Results: </strong>Drain removal and discharge times of the PRP group cases were statistically shorter than those in the control group. The rate of development of a salivary fistula was remarkably high in the control group, but it was not statistically significant. A statistically significant correlation was found between the location of the compared tumour, the volume of material removed and the incidence of all complications.</p><p><strong>Conclusions: </strong>PRP reduced the duration of drain removal and discharge times for those who had an operation on partial parotidectomy. Thus, the decreased discharge time provides both reduced health costs and reduced risk of developing nosocomial infections. Although it was not statistically significant, a significant difference was observed in the rates of salivary fistula development.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817363","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":"Risk Stratification of Suspected Head and Neck Cancer Referral Letters: A Prospective Cohort Study.","authors":"Annabel Hill, Timothy Davies, Kate Howson, Jeffrey Lancaster, Katharine Davies","doi":"10.1111/coa.14269","DOIUrl":"https://doi.org/10.1111/coa.14269","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812276","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":"'How Long Do I Have?' - Examining survival outcomes in laryngeal cancer patients managed with non-curative intent in Northern UK: Insights from the Northern Head & Neck Cancer Alliance Retrospective Study.","authors":"Amarkumar Rajgor, Rhona Hurley, Catriona M Douglas, Claire Paterson, James Moor, Shane Lester, Sara Sionis, Katharine Davies, James O'Hara, Gareth Inman, Terry Jones, David Winston Hamilton","doi":"10.1111/coa.14260","DOIUrl":"https://doi.org/10.1111/coa.14260","url":null,"abstract":"<p><strong>Introduction: </strong>Historically, 15% of laryngeal cancer patients undergo non-curative management, but pragmatic data on this group are limited. This information is crucial to help patients make informed decisions about their care. Supported by the Northern Head & Neck Alliance, this retrospective study is the first to present survival outcomes for non-curative laryngeal cancer patients in Northern UK.</p><p><strong>Methods: </strong>Retrospective data were compiled for patients with laryngeal squamous cell cancer from five large tertiary head and neck centres in Northern UK (Newcastle, Glasgow, Sheffield, Leeds, and Middlesbrough). The collected data encompassed demographic details, treatment and clinical outcomes.</p><p><strong>Results: </strong>Among 373 patients, the mean age was 72, and 73% were male. The median follow-up was 6 months. 17% had early-stage (T1-2), and 83% had late-stage (T3-4) disease. By data collection, 99% had died. The mean survival time (MST) was 9.1 months. Patients with metastases had an MST of 6.9 months, while those without had 9.4 months. Early-stage patients had an MST of 13.3 months, compared to 8.2 months for advanced disease. By subsite, MSTs were 8.2 months for supraglottic, 12.5 for glottic, 5.5 for subglottic, and 7.9 for transglottic cancers.</p><p><strong>Conclusion: </strong>This study stands as the first to explore survival outcomes in laryngeal cancer patients undergoing non-curative management. The findings can provide valuable insights for informing patients about survival in the absence of radical treatment, facilitating important decision-making conversations.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806334","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 Distribution and Therapeutic Effectiveness of Clinical Unilateral Ménière's Disease Phenotypes.","authors":"Yongjia Chen, Xinzhang Cai, Yulu Zhang, Chufeng He, Xuewen Wu, Lu Jiang, Hongsheng Chen, Jing Liu, Bo Pang, Shuai Zhang, Anhai Chen, Mengzhu Jiang, Huping Huang, Yijiang Bai, Zequn Nie, Lingyun Mei","doi":"10.1111/coa.14264","DOIUrl":"https://doi.org/10.1111/coa.14264","url":null,"abstract":"<p><strong>Objectives: </strong>The first purpose of this study was to ascertain the distribution of unilateral Ménière's disease (MD) clinical subgroups in China and compare with the population reported in Europe and the United States. The second purpose was to investigate the effectiveness in different clinical phenotypes.</p><p><strong>Methods: </strong>Participants were categorised into one of five subtypes using a previously reported classification scheme based on cluster analysis. The distribution and clinical characteristics were analysed and compared with the two cohorts reported in Europe and the United States. Participants were followed up to observe the therapeutic effectiveness over a 2-year period.</p><p><strong>Results: </strong>A total of 245 patients diagnosed with UMD were enrolled in the study, with 84 of these participants providing complete and detailed follow-up data. All of the unilateral MD patients were accurately classified: 58.0% were classic MD, 25.7% were delayed MD, 1.2% was familial MD, 12.7% were sporadic MD with migraine and 2.4% were autoimmune MD. Our findings revealed a significant difference in the distribution between this cohort and the European cohort. Follow-up assessments revealed worse vertigo control rate in the patients with migraine compared to the classical MD (50.0% vs. 82.6%, p = 0.034).</p><p><strong>Conclusion: </strong>The distribution of unilateral MD subtypes in this Chinese population differs from that in the European population, and the therapeutic effectiveness varies across subtypes in this cohort. Our study highlights the importance of the clinical heterogeneity in unilateral MD, and further studies are needed to identify the optimal interventions for specific subgroups.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766926","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":"Epidemiology of Cholesteatoma in the UK Biobank.","authors":"Emma Wilson, Barbara Anne Jennings, Mizanur Khondoker, Carl M Philpott, Peter Prinsley, Daniel S Brewer","doi":"10.1111/coa.14257","DOIUrl":"https://doi.org/10.1111/coa.14257","url":null,"abstract":"<p><strong>Objectives: </strong>To identify factors associated with cholesteatoma in a large UK cohort. Although some risk factors are frequently reported (male sex, history of chronic otitis media), other associations require further evidence (deprivation, smoking).</p><p><strong>Design and setting: </strong>Briefly, 1140 cholesteatoma cases from UK BioBank were compared to 4551 non-cholesteatoma middle ear disease and 493 832 ear disease-free controls. Adjusted odds ratios were calculated for demographic factors including age, sex, ethnicity, deprivation and smoking status with logistic regressions. Odds ratios for overlapping ICD-10 codes are also calculated.</p><p><strong>Results: </strong>Cholesteatoma was significantly associated with sex (Adjusted odds ratio (AOR) for males = 1.33, 95%CI = [1.179-1.491]), age (AOR = 1.02, 95%CI = [1.011-1.026]) and deprivation (AOR = 1.08, 95%CI = [1.059-1.097]) compared to ear disease-free controls (p < 0.001). Age and deprivation distributions for cholesteatoma and non-cholesteatoma ear disease were similar. Although there was no significant association with smoking status, cholesteatoma was significantly associated with the ICD-10 code mental and behavioural disorders due to tobacco use (OR = 2.34, p < 0.001, 95%CI = [1.942, 2.813]). Cholesteatoma was also strongly associated with a wide range of inflammatory middle ear conditions and chronic sinus inflammation, suggesting an increased susceptibility to inflammation of the upper airways.</p><p><strong>Conclusion: </strong>This study shows a large overlap between cholesteatoma and non-cholesteatoma ear disease in terms of numbers and demographics, with sex being a key factor distinguishing between the two, suggesting that there are both common and distinct associated factors.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766923","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":"Quality of Information Provided by Artificial Intelligence Chatbots Surrounding the Reconstructive Surgery for Head and Neck Cancer: A Comparative Analysis Between ChatGPT4 and Claude2.","authors":"Paolo Boscolo-Rizzo, Alberto Vito Marcuzzo, Chiara Lazzarin, Fabiola Giudici, Jerry Polesel, Marco Stellin, Andrea Pettorelli, Giacomo Spinato, Giancarlo Ottaviano, Marco Ferrari, Daniele Borsetto, Simone Zucchini, Franco Trabalzini, Egidio Sia, Nicoletta Gardenal, Roberto Baruca, Alfonso Fortunati, Luigi Angelo Vaira, Giancarlo Tirelli","doi":"10.1111/coa.14261","DOIUrl":"https://doi.org/10.1111/coa.14261","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial Intelligences (AIs) are changing the way information is accessed and consumed globally. This study aims to evaluate the information quality provided by AIs ChatGPT4 and Claude2 concerning reconstructive surgery for head and neck cancer.</p><p><strong>Methods: </strong>Thirty questions on reconstructive surgery for head and neck cancer were directed to both AIs and 16 head and neck surgeons assessed the responses using the QAMAI questionnaire. A 5-point Likert scale was used to assess accuracy, clarity, relevance, completeness, sources, and usefulness. Questions were categorised into those suitable for patients (group 1) and those for surgeons (group 2). AI responses were compared using t-Student and McNemar tests. Surgeon score agreement was measured with intraclass correlation coefficient, and readability was assessed with Flesch-Kincaid Grade Level (FKGL).</p><p><strong>Results: </strong>ChatGPT4 and Claude2 had similar overall mean scores of accuracy, clarity, relevance, completeness and usefulness, while Claude2 outperformed ChatGPT4 in sources (110.0 vs. 92.1, p < 0.001). Considering the group 2, Claude2 showed significantly lower accuracy and completeness scores compared to ChatGPT4 (p = 0.003 and p = 0.002, respectively). Regarding readability, ChatGPT4 presented lower complexity than Claude2 (FKGL mean score 4.57 vs. 6.05, p < 0.001) requiring an easy-fairly easy English in 93% of cases.</p><p><strong>Conclusion: </strong>Our findings indicate that neither chatbot exhibits a decisive superiority in all aspects. Nonetheless, ChatGPT4 demonstrates greater accuracy and comprehensiveness for specific types of questions and the simpler language used may aid patient inquiries. However, many evaluators disagree with chatbot information, highlighting that AI systems cannot serve as a substitute for advice from medical professionals.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766924","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 Use of Fluorescent Markers to Detect and Delineate Head and Neck Cancer: A Scoping Review.","authors":"Akash Srinivasan, Viktorija Kaminskaite, Stuart C Winter","doi":"10.1111/coa.14263","DOIUrl":"https://doi.org/10.1111/coa.14263","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of surgery for head and neck squamous cell carcinoma (HNSCC) is to achieve clear resection margins, whilst preserving function and cosmesis. Fluorescent markers have demonstrated potential in the intraoperative visualisation and delineation of tumours, such as glioma, with consequent improvements in resection. The purpose of this scoping review was to identify and compare the fluorescent markers that have been used to detect and delineate HNSCC to date.</p><p><strong>Methods: </strong>A literature search was performed using the Ovid MEDLINE, Ovid Embase, Cochrane CENTRAL, ClinicalTrials.gov and ICTRP databases. Primary human studies published through September 2023 demonstrating the use of fluorescent markers to visualise HNSCC were selected and reviewed independently by two authors.</p><p><strong>Results: </strong>The search strategy identified 5776 records. Two hundred and forty-four full texts were reviewed, and sixty-five eligible reports were included. The most used fluorescent markers in the included studies were indocyanine green (ICG) (n = 14), toluidine blue (n = 11), antibodies labelled with IRDye800CW (n = 10) and 5-aminolevulinic acid (5-ALA) (n = 8). Toluidine blue and ICG both have limited specificity, although novel targeted options derived from ICG may be more effective. 5-ALA has been demonstrated as a topical marker and, recently, via enteral administration but it is associated with photosensitivity reactions. The fluorescently labelled antibodies cetuximab-IRDye800CW and panitumumab-IRDye800CW are promising options being investigated by ongoing trials.</p><p><strong>Conclusion: </strong>Multiple safe fluorescent markers have emerged which may aid the surgical resection of HNSCC. Further research in larger cohorts is required to identify which marker should be considered gold standard.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766927","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":"Completion Thyroidectomy Trends and Rates: A Systematic Review and Meta-Analysis.","authors":"Daniel Soibelman, Ohad Ronen","doi":"10.1111/coa.14262","DOIUrl":"https://doi.org/10.1111/coa.14262","url":null,"abstract":"<p><strong>Background: </strong>In January 2016, the American Thyroid Association (ATA) published an update to the guidelines concerning the management of adult patients with thyroid nodules and well-differentiated thyroid cancers. One of the revised recommendations states that lobectomy is a reasonable surgical approach for low-risk patients. This systematic review compares the rates of completion thyroidectomy surgeries before and after the publication of the recent ATA guidelines.</p><p><strong>Methods: </strong>A systematic review was conducted according to the PRISMA guidelines of the preferred reporting items for systematic reviews and meta-analyses. PubMed and Embase databases were searched to find articles which demonstrate the rates of completion thyroidectomy surgeries in the last 6 years, before and after the recent ATA guidelines publication. Overall, 8744 titles and abstracts were screened, and 964 articles were fully assessed for eligibility. Eventually, 40 studies were included for data extraction. More than 48 000 patients with thyroid malignancy were included in the review, and were divided into three time periods according to the publication date of 2015 ATA guidelines.</p><p><strong>Results: </strong>We found that the rate of completion thyroidectomy was 51.8% before 2016 and 43.1% after the 2015 ATA guidelines publication. We observed a 17% reduction of early completion thyroidectomy surgeries since the 2015 ATA guidelines publication relative to previous periods, among patients with malignant pathology.</p><p><strong>Conclusions: </strong>Apparently, more centres worldwide implemented the new guidelines and prefer a conservative surgical approach as compared to the pre-ATA 2015 era.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715349","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":"A Retrospective Study on the Gender Differences in Clinical Manifestations of Bell's Palsy.","authors":"Dong Keon Yon, Dokyoung Kim, Myung Chul Yoo, Sung Soo Kim, Hwa Sung Rim, Sang Hoon Kim, Jae Yong Byun, Seung Geun Yeo","doi":"10.1111/coa.14259","DOIUrl":"https://doi.org/10.1111/coa.14259","url":null,"abstract":"<p><strong>Objectives: </strong>Although many studies have assessed the clinical features and the factors affecting treatment outcomes of Bell's palsy, few have analysed differences between men and women. This study therefore evaluated whether the clinical features and treatment results, and the factors affecting them, differ between men and women with Bell's palsy.</p><p><strong>Methods: </strong>This retrospective study included 1708 patients (791 men and 917 women) who presented with facial palsy to the otolaryngology department between January 1986 and December 2022. Clinical features and treatment outcomes were compared in men and women diagnosed with Bell's palsy.</p><p><strong>Results: </strong>Age distribution, side affected by facial palsy, House-Brackmann (HB) Grade, underlying disease such as diabetes and hypertension, electroneuronography (ENoG) results, electromyography (EMG) results, and treatment methods did not differ significantly between men and women with Bell's palsy (p > 0.05 each). Factors significantly associated with better prognosis in men included milder initial facial palsy and better electromyography (EMG) results (p < 0.05). Factors significantly associated with better prognosis in women included younger age, milder initial facial palsy, and better EMG results (p < 0.05). Women had significantly better prognosis than men when treated with steroids within 3 days of the onset of paralysis (p < 0.05).</p><p><strong>Conclusion: </strong>Milder initial facial palsy and better EMG results were associated with better prognosis in both men and women with Bell's palsy. Younger age at onset and early stage treatment with steroids were associated with a higher recovery rate in women, but not in men.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681010","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":"Older Aboriginal and Torres Strait Islander People's Experiences With Hearing Loss and Audiological Services: A Scoping Review.","authors":"Ayesha Chowdhury, Rong Tian, Paul McIlhiney, Dona M P Jayakody","doi":"10.1111/coa.14254","DOIUrl":"10.1111/coa.14254","url":null,"abstract":"<p><strong>Introduction: </strong>In Australia, older Aboriginal and Torres Strait Islander people have the highest prevalence of hearing loss, for which dedicated audiological services are available. However, there is limited research on the experiences older Aboriginal and Torres Strait Islander people have with hearing loss and audiological services. Therefore, this study aimed to consolidate existing literature with a scoping review, specifically on the above to identify gaps and guide future research.</p><p><strong>Method: </strong>Ten databases, including electronic journal databases and government databases, were systematically searched. Additional studies were sought from article reference lists, review articles, conference abstracts and Google Scholar. We identified 540 records and 22 of them met our inclusion criteria. Our inclusion criteria constituted research of any design on the experiences of older Aboriginal and Torres Strait Islander people (aged 45+ years) with hearing loss and audiological services.</p><p><strong>Results: </strong>Seventeen studies reported on experiences with hearing loss, four studies reported on experiences with audiological services and one study reported on both experiences. Prevalence of hearing loss was estimated to be 20%-34% in older Aboriginal and Torres Strait Islander people; a discrepancy between self-reported and objective hearing difficulties was also identified. Audiological services currently available to older Aboriginal and Torres Strait Islander people were also underutilised.</p><p><strong>Conclusions: </strong>Future research on older Aboriginal and Torres Strait Islander people is required to uncover: (1) the reasons for underreported hearing loss; (2) types of hearing loss experienced; (3) barriers to accessing audiological services; and (4) best hearing-loss management and rehabilitation practices.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615830","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}